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The experiment was conducted in an Open Top Chamber facility located in the Mediterranean basin to investigate how nitrogen (N) fertilization affects the response of wheat to ozone (O3) exposure. The study considered the response of Artur Nick, a modern wheat cultivar commonly used in the area, to three O3 exposure levels (ambient and elevated ambient, +20 and +40 nL L-1 O3), and two N fertilization doses (100 and 200 kg ha-1). Measurements included leaf gas exchange, leaf chlorophyll content, leaf and grain N content, plant growth and yield parameters. Ozone × N interactive effects were studied and quantified based on accumulated O3 concentrations above a 40 nL L-1 threshold (AOT40) and phytotoxic O3 dose (POD) indices, which are used in O3-risk assessments, from which critical levels (CL) for a 5 % effect were derived. Results revealed that O3 impacts on growth and yield parameters were stronger under the highest N fertilization dose. In consequence, O3 Critical Levels (CL) were as much as 3-4 times lower for grain yield in the high-N compared to the low-N treatment. Interestingly, O3 limited the fertilizer stimulus, strongly reducing the N use efficiency for grain yield and the agronomic efficiency of N for protein yield. Another important aspect was that 71 % of the POD was accumulated before anthesis, stressing the potential importance of O3 exposure during the vegetative phase of wheat under Mediterranean conditions, which is usually considered less important than post-anthesis exposure. In conclusion, this study suggests the need to consider crop N management in the derivation of O3 CLs, due to its effect on dose-response relationships used for CL derivation, including the potential O3 effects in N use efficiency. Therefore, N modulation could be considered in the O3-risk assessment methodology to be applied in risk exercises when negotiating air pollution abatement policies.
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Contaminantes Atmosféricos , Fertilizantes , Nitrógeno , Ozono , Triticum , Triticum/crecimiento & desarrollo , Contaminantes Atmosféricos/análisis , Medición de RiesgoRESUMEN
The article "Study of liver toxicity and DNA damage due to exposure to the pesticide Mancozeb in an experimental animal model - A pilot model", by N.D. Suarez Uribe, M.F. Pezzini, J. Dall'Agnol, N. Marroni, S. Benitez, D. Benedetti, J. Da Silva, C.T. Cerski, E. Dallegrave, S. Macedo, S.C.W.S.E.F. de Oliveira, D. Joveleviths, published in Eur Rev Med Pharmacol Sci 2023; 27 (13): 6374-6383-DOI: 10.26355/eurrev_202307_32997-PMID: 37458654 has been retracted by the Editor in Chief for the following reasons: After publication, concerns were raised by an unidentified reader who underlined some similarities between this publication and a previous publication published in the Journal of Clinical and Experimental Gastroenterology. After being informed, the authors claimed the previous journal published the article without consent, and, therefore, the authors promptly withdrew the previous publication. The retraction published by the other journal does not contain any information regarding the reason for withdrawal. As a matter of fact, the journal does not have any evidence about the authors' claim and still considers this research a duplicate publication. For the above-mentioned reasons, the Editor in Chief decided to withdraw the manuscript. This manuscript has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/32997.
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OBJECTIVE: Mancozeb is one of the most widely used Ethylenebisdithiocarbamates fungicides in Brazil. A pilot experimental model was created to evaluate its potential hepatotoxic effect. MATERIALS AND METHODS: An experimental study was performed with 27 male Wistar rats (3 groups). The Control Group received a saline solution, while Intervention Groups I and II received 250 mg/kg and 500 mg/kg of Mancozeb respectively, once a week, for 12 weeks. Anthropometric measurements were carried out, and the marker of biological exposure in urine was dosed. Biochemical tests, evaluation micronucleus count, comet and oxidative stress markers assay, and histological assessment of the liver were also performed. RESULTS: The hepatotoxic effect of Mancozeb was confirmed by anthropometric measurements, genotoxicity, and oxidative stress. Statistically significant results were found when the exposed groups were compared to the control group. CONCLUSIONS: These results were supported by inflammatory infiltration and balloonization in the treated groups. The experimental model effectively demonstrated the deleterious effect of Mancozeb on the liver.
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Plaguicidas , Ratas , Animales , Masculino , Plaguicidas/toxicidad , Ratas Wistar , Daño del ADN , Hígado , Modelos AnimalesRESUMEN
Increasing surface ozone is a main concern for crop production in the Global Change framework, especially in the Mediterranean basin where climate conditions favor its photochemical formation. Meanwhile, increasing common crop diseases, such as yellow rust, one of the most important pathogens affecting global wheat production has been detected in the area in recent decades. However, the impact of O3 on the occurrence and impact of fungal diseases is scarcely understood. A close-to-field-conditions assay (Open Top Chamber facility) situated in a Mediterranean cereal rainfed farming area was carried out to study the impact of increasing O3 levels and N-fertilization on spontaneous fungal outbreaks in wheat. Four O3-fumigation levels reproducing pre-industrial to future pollutant atmospheres with additional 20 and 40 nL L-1 over the ambient levels were considered (7 h-mean ranging from 28 to 86 nL L-1). Two top N-fertilization supplementations (100 and 200 kg ha-1) were nested within the O3 treatments; foliar damage, pigment content and gas exchange parameters were measured. Pre-industrial natural background O3 levels strongly favored the yellow rust infection, where the O3-polluted levels currently observed at the farm highly benefited the crop, mitigating the presence of rust by 22 %. However, future expected high O3-levels neutralized the beneficial infection-controlling effect by inducing early wheat senescence, decreasing the chlorophyll index of the older leaves by up to 43 % under the higher O3 exposure. Nitrogen promoted the rust infection by up to 49.5 % without interacting with the O3-factor. Achieving future air quality standards might require considering new varietal improvement programs, to be able to adapt crops to an increased pathogen tolerance without requiring the assistance provided by O3-pollution.
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Contaminantes Atmosféricos , Contaminación del Aire , Basidiomycota , Ozono , Ozono/análisis , Triticum , Procesos Fotoquímicos , Hojas de la Planta/química , Contaminantes Atmosféricos/análisisRESUMEN
A theoretical analysis of binary collisions of quantum droplets under feasible experimental conditions is reported. Droplets formed from degenerate dilute Bose gases made up from binary mixtures of ultracold atoms are considered. Reliable expressions for the surface tension of the droplets are introduced based on a study of low energy excitations of their ground state within the random phase approximation. Their relevance is evaluated considering an estimation of the expected excitation energy having in mind the Thouless variational theorem. The surface tension expressions allow calculating the Weber number of the droplets involved in the collisions. Several regimes on the outcomes of the binary frontal collisions that range from the coalescence of the quantum droplets to their disintegration into smaller droplets are identified. Atoms losses of the droplets derived from self-evaporation and three-body scattering are quantified for both homo- and hetero-nuclear mixtures. Their control is mandatory for the observation of some interesting effects arising from droplets collisions.
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We present an ab initio numerical investigation of the internal conical refraction of structured light beams in a biaxial crystal. Starting from the solutions of the Fresnel equation, a theoretical analysis is developed without assuming any analytical approximation, thus obtaining a set of exact equations that can be solved by standard methods of integration for any impinging light beam. As examples of applications, we consider the particular cases of linearly and circularly polarized Gaussian and Bessel beams inside a KTP crystal. Numerical calculations follow the evolution of the refracted beam inside the crystal. It is seen that for realistic boundary conditions, a refraction cone appears in a certain range of distances within the crystal, and its shape is rather sensitive to the initial conditions.
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A cancer research training program explored different approaches for staffing their in-person and virtual programs for high school students. The inclusion of undergraduate near-peer mentors had a universal benefit when implemented across in-person and virtual training programs of one- and ten-week durations. Benefits are described for four stakeholder groups: the high school trainees, program staff, scientist partners, and peer mentors themselves. Peer mentors described that their involvement enhanced their own professional development and, for some, drove a new interest in cancer research. Scientist partners described that peer mentors helped translate their work in the virtual environment for high school students. High school trainees reported their sessions with peer mentors to be one of their favorite parts of the program. Interprofessional peer mentors were highly relatable to students and modeled communication and paths in biomedical research. Staff reported that peer mentors supported student engagement during community shadowing sessions, allowing staff to focus on developing the shadowing experiences with partners. The benefit of including peer mentors was substantial from all viewpoints explored. Their intensive inclusion in cancer research training programs supports sustainability and capacity building in biomedical workforce development.
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Mortality due to cardiovascular disease in pregnancy is a growing problem in developed countries, being nowadays the leading cause of maternal death. Within this group, the most common cause of death are congenital or acquired heart diseases, representing a challenge in the management of these patients, since the pregnancy-related physiological alterations can impair their basal condition and treatment. We present the case of a 34-year-old patient, without any relevant pathological antecedents, who developed a second-degree atrioventricular block, Mobitz type I, following the administration of methylergometrine during cesarean section due to failure to progress in labour. We emphasize the importance of considering the side effects of commonly used drugs in pregnant patients, despite rare possibility of some adverse reactions.
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Bloqueo Atrioventricular , Metilergonovina , Inercia Uterina , Adulto , Bloqueo Atrioventricular/inducido químicamente , Cesárea , Femenino , Humanos , Mortalidad Materna , Metilergonovina/efectos adversos , EmbarazoRESUMEN
OBJECTIVES: To compare the prevalence of carotid atherosclerosis in virologically suppressed HIV patients with that of a community sample, and to evaluate the capacity of various cardiovascular risk (CVR) equations for predicting carotid atherosclerosis. METHODS: This was a cross-sectional study with two randomly selected groups: HIV patients from an HIV unit and a control group drawn from the community. Participants were matched by age (30-80 years) and sex without history of cardiovascular disease. Carotid plaque, common carotid intima-media thickness (cc-IMT) and subclinical atherosclerosis (carotid plaque and/or cc-IMT > 75th percentile) were assessed by carotid ultrasound. The Systematic Coronary Risk Evaluation (SCORE), Framingham, REGICOR, reduced Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D), and COMVIH equations were applied, and their abilities to predict carotid plaque were compared using the area under the curve (AUC). RESULTS: Each group included 379 subjects (77.8% men, age 49.7 years). Duration of antiretroviral therapy was 15.5 years. There were no differences between the groups for carotid plaque (HIV, 33.2%; control, 31.3%), mean cc-IMT (HIV, 0.63 mm; control, 0.61 mm) or subclinical atherosclerosis (HIV, 42.9%; control, 47.9%). Thymidine analogues were independently associated with subclinical atherosclerosis in HIV-infected patients. CVR equations revealed AUCs between 0.715 and 0.807 for prediction of carotid plaque; prediction was better in the control group and did not improve when HIV-adapted scales were used. CONCLUSIONS: The features of carotid atherosclerosis did not differ between the HIV-infected and the control group, although CVR equations were more predictive for carotid plaque in controls than in HIV-infected patients. HIV-specific equations did not improve prediction.
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Enfermedades Cardiovasculares , Enfermedades de las Arterias Carótidas , Infecciones por VIH , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
AIMS: To evaluate the mycoremediation of polychlorinated biphenyls (PCBs) by either single cultures or binary consortia of Pleurotus pulmonarius LBM 105 and Trametes sanguinea LBM 023. METHODS AND RESULTS: PCBs tolerance, removal capacity, toxicity reduction and ligninolytic enzyme expression were assessed when growing single culture and binary consortium of fungus in 217 mg l-1 of a technical mixture of Aroclor 1242, 1254 and 1260 in transformer oil. A decrease in tolerance and variation in ligninolytic enzyme secretion were observed in PCB-amended solid media. Pleurotus pulmonarius LBM 105 mono-culture was able to remove up to 95·4% of PCBs, whereas binary consortium and T. sanguinea LBM 023 could biodegrade about 55% after 24 days. Significant detoxification levels were detected in all treatments by biosorption mechanism. CONCLUSIONS: Pleurotus pulmonarius LBM 105 in single culture had the best performance regarding PCBs biodegradation and toxicity reduction. Ligninolytic enzyme secretion changed in co-culture. SIGNIFICANCE AND IMPACT OF THE STUDY: The evaluation of PCBs bioremediation effectiveness of basidiomycetes consortium in terms of PCB removal, toxicity and ligninolytic enzyme production to unravel the differences between using individual cultures or consortium has not been reported. The results from this study enable the selection of P. pulmonarius LBM 105 mono-culture to bioremediate PCBs as it showed higher efficiency compared to binary consortium with T. sanguinea LBM 023 for potential decontamination of PCB-contaminated transformer oil.
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Bifenilos Policlorados , Biodegradación Ambiental , Pleurotus , Bifenilos Policlorados/análisis , Polyporaceae , TrametesRESUMEN
Resumen Objetivo: Identificar los factores determinantes de la mejoría de la calidad de vida en pacientes sometidos a cirugía de contorno corporal. Materiales y Método: Se estudió una cohorte prospectiva de 113 pacientes sometidos a cirugía de contorno corporal. Se estudiaron características sociodemográficas, mediciones antropométricas, variables relativas a la cirugía y se aplicó el instrumento Body-Qol®. Para el análisis estadístico se utilizó estadística descriptiva, modelos de ecuaciones de estimación generalizada y modelos de regresión lineal y logística. Resultados: Se encontró mejoría en la calidad de vida de forma global (p < 0,0001) y por dominios. Los pacientes con pérdida masiva de peso tuvieron peores puntajes pre y postoperatorio, sin embargo, un delta de mejoría comparable con los pacientes estéticos. Dentro de los factores determinantes, existió una relación positiva entre la edad y la mejoría en la calidad de vida de forma global. El índice de masa corporal (IMC) se encontró asociado negativamente con la mejoría del puntaje global. Dentro de los factores de la cirugía, los pacientes sometidos a lipoabdominoplastía tuvieron una mayor mejoría con respecto a otras técnicas. Además, el patrón de resección ampliado y en flor de Lis se asoció a menor mejoría en el puntaje global. Conclusión: La cirugía de contorno corporal mejora la calidad de vida de forma significativa. Los principales factores determinantes de esta mejoría fueron la edad, el IMC, el antecedente de pérdida masiva de peso y el patrón de resección.
Aim: To identify the factors that have an impact on the quality of life of patients with body contouring surgery. Materials and Method: A prospective cohort of 113 patients was studied. Sociodemographic characteristics, antropometric measures and variables related to the surgery were analized. The Body-Qol® instrument was aplied. Descriptive statistic, generalized estimated equation models and lineal and logistic regresions were used for the statistical analysis. Results: Improvement in the quality of life was found globally (p < 0,0001) and in every domain of the scale. The patients with massive weight loss had worse scores pre- and post-operatively than the esthetic patients. A positive association between age and improvement on quality of life was found. Body mass index (BMI) was negatively associated with improvement of the score. The patients that had a lipoabdominoplasty had a major improvement in comparison with other techniques. Also, the extended resection pattern and Fleur de Lis pattern were associated with lesser improvement in the global score. Conclusion: Body contouring surgery improves quality of life significantly. The principal factors that have an impact on quality of life were age, BMI, massive weight loss and resection pattern.
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Humanos , Masculino , Femenino , Calidad de Vida , Procedimientos de Cirugía Plástica , Contorneado Corporal , Pérdida de Peso , Índice de Masa Corporal , Epidemiología Descriptiva , Estudios ProspectivosRESUMEN
OBJECTIVE: To determine the level of agreement within and between observers in the categorization of breast density on mammograms in a group of professionals using the fifth edition of the American College of Radiology's BI-RADS® Atlas and to analyze the concordance between experts' categorization and automatic categorization by commercial software on digital mammograms. METHODS: Six radiologists categorized breast density on 451 mammograms on two occasions one month apart. We calculated the linear weighted kappa coefficients for inter- and intra-observer agreement for the group of radiologists and between the commercial software and the majority report. We analyzed the results for the four categories of breast density and for dichotomous classification as dense versus not dense. RESULTS: The interobserver agreement among radiologists and the majority report was between moderate and nearly perfect for the analysis by category (κ=0.64 to 0.84) and for the dichotomous classification (κ=0.63 to 0.84). The intraobserver agreement was between substantial and nearly perfect (κ=0.68 to 0.85 for 4 categories and k=0.70 to 0.87 for the dichotomous classification). The agreement between the majority report and the commercial software was moderate both for the four categories (κ=0.43) and for the dichotomous classification (κ=0.51). CONCLUSION: Agreement on breast density within and between radiologists using the criteria established in the fifth edition of the BI-RADS® Atlas was between moderate and nearly perfect. The level of agreement between the specialists and the commercial software was moderate.
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Densidad de la Mama , Neoplasias de la Mama , Mamografía , Neoplasias de la Mama/diagnóstico por imagen , Humanos , Mamografía/métodos , Variaciones Dependientes del Observador , Radiólogos , Programas InformáticosRESUMEN
We show that applying feedback and weak measurements to a quantum system induces phase transitions beyond the dissipative ones. Feedback enables controlling essentially quantum properties of the transition, i.e., its critical exponent, as it is driven by the fundamental quantum fluctuations due to measurement. Feedback provides the non-Markovianity and nonlinearity to the hybrid quantum-classical system, and enables simulating effects similar to spin-bath problems and Floquet time crystals with tunable long-range (long-memory) interactions.
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Takotsubo cardiomyopathy is part of the group of diseases called stress-induced cardiomyopathies. Its usual clinical presentation is indistinguishable from an acute coronary syndrome. However, early diagnosis is important, as it may debut as a cardiogenic shock in approximately 8% of cases, with morbidity and mortality rates comparable to those of acute coronary syndrome. For this reason, although it is a relatively infrequent condition, the perioperative period is a stress factor that can act as a trigger of this pathology. A case is presented of the onset of Takotsubo cardiomyopathy as a cardiogenic shock during admission in a Postoperative Recovery Unit.
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Adrenalectomía , Complicaciones Posoperatorias/etiología , Choque Cardiogénico/etiología , Cardiomiopatía de Takotsubo/complicaciones , Anciano , Femenino , Humanos , Factores de TiempoRESUMEN
Introducción: El instrumento Breast-Q® se ha ocupado para medir la calidad de vida de las pacientes sometidas a cirugía de aumento mamario. Se desconocen los factores que determinan la mejoría en la calidad de vida de estas pacientes. El objetivo de este trabajo es identificar los factores determinantes de la mejoría de la calidad de vida en pacientes sometidas a aumento mamario. Materiales y métodos: Se estudió una cohorte prospectiva de 52 pacientes sometidas a aumento mamario. Se estudiaron características sociodemográficas, mediciones antropométricas, variables relativas a la cirugía y se aplicó el instrumento Breast-Q®. Para el análisis estadístico se utilizó estadística descriptiva, el test de Wilcoxon para muestras pareadas y modelos de regresión lineal y logística. Resultados: Se encontró mejoría en la calidad de vida de forma global (p < 0,00001) y en todos los dominios salvo en el de «síntomas físicos¼. Dentro de los factores determinantes, existió una relación positiva entre el volumen de la prótesis y la mejoría en la calidad de vida de forma global (p = 0,032) y en los dominios «autoimagen y autoestima¼ (p = 0,01) y «vida sexual¼ (p = 0,001). Conclusión: La cirugía de aumento mamario incrementa significativamente la calidad de vida medido mediante el instrumento Breast-Q®. Los determinantes de la mejoría en la calidad de vida estarían directamente relacionados con el volumen de la prótesis.
Introduction: Breast-Q® instrument has been used for measuring the quality of life of patients undergoing breast augmentation surgery. The factors that determine the improvement in the quality of life of these patients are unknown. The aim of this work is to identify the determinant factors of improvement in the quality of life in patients undergoing breast augmentation. Materials and methods: A prospective cohort of 52 patients undergoing breast augmentation was studied. Sociodemographic features, anthropometric measurements, variables related to surgery were studied and the Breast-Q® instrument was applied. For statistical analysis it was used descriptive statistics and linear and logistic regression models. Results: We found improvement in the quality of life, globally (P < .00001) and in all domains except "physical symptoms’ domain. Among the determining factors, there was a positive correlation between the prosthesis volume and improvement in quality of life globally (P = .032) and in the domains "self-image and self-esteem" (P = .01) and "sexual life" (P = .001). Conclusion: Breast augmentation surgery significantly increases the quality of life measured by the Breast-Q® instrument. The determinant factors of improvement in quality of life, would be directly related to the implants volume.
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Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Mama/cirugía , Mamoplastia/métodos , Mamoplastia/psicología , Calidad de Vida , Índice de Masa Corporal , Estudios de Cohortes , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
Tide pools habitats are naturally exposed to a high degree of environmental variability. The consequences of living in these extreme habitats are not well established. In particular, little it is known about of the effects of hypercanic seawater (i.e. high pCO2 levels) on marine vertebrates such as intertidal pool fish. The aim of this study was to evaluate the effects of increased pCO2 on the physiology and behavior in juveniles of the intertidal pool fish Girella laevifrons. Two nominal pCO2 concentrations (400 and 1600µatm) were used. We found that exposure to hypercapnic conditions did not affect oxygen consumption and absorption efficiency. However, the lateralization and boldness behavior was significantly disrupted in high pCO2 conditions. In general, a predator-risk cost of boldness is assumed, thus the increased occurrence of shy personality in juvenile fishes may result in a change in the balance of this biological interaction, with significant ecological consequences.
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Conducta Animal , Dióxido de Carbono/química , Ecosistema , Perciformes/fisiología , Agua de Mar/química , Animales , HomeostasisRESUMEN
Introducción: El instrumento Breast-Q® se ha ocupado de medir la calidad de vida de las pacientes sometidas a cirugía de reducción mamaria o mastopexia. Se desconocen los factores que determinan la mejoría en la calidad de vida de estas pacientes. El objetivo de este trabajo es identificar los factores determinantes de la mejoría de la calidad de vida en pacientes sometidas a reducción mamaria. Materiales y métodos: Se estudió una cohorte prospectiva de 41 pacientes sometidas a reducción mamaria o mastopexia sin implantes. Se estudiaron características sociodemográficas, mediciones antropométricas, variables relativas a la cirugía y se aplicó el instrumento Breast-Q®. Para el análisis estadístico se utilizó estadística descriptiva, modelos de ecuaciones de estimación generalizada y modelos de regresión lineal y logística. Resultados: Se encontró mejoría en la calidad de vida de forma global (p < 0,0001) y por dominios. Dentro de los factores determinantes, existió una relación positiva entre la magnitud de la resección y la mejoría en la calidad de vida de forma global (p = 0,032) y en el dominio de síntomas físicos (p = 0,012). Destaca además una mejoría del 50% con resecciones de tejido mamario sobre los 300 g. Conclusión: La cirugía de reducción mamaría y mastopexia incrementan significativamente la calidad de vida medida mediante el instrumento Breast-Q® en pacientes con hipertrofia o ptosis mamaria. Los determinantes de esta mejora estarían directamente relacionados con la cantidad de tejido resecado, con una mejoría del 50% con resecciones sobre los 300 g.
Introduction: Breast-Q® instrument has been used for measuring the quality of life of patients undergoing breast reduction or breast lift surgery. The factors that determine the improvement in the quality of life of these patients are unknown. The aim of this work is to identify the determinant factors of improvement in the quality of life in patients undergoing breast reduction. Materials and methods: A prospective cohort of 41 patients undergoing breast reduction or breast lift without implants was studied. Sociodemographic features, anthropometric measurements, variables related to surgery were studied and the Breast-Q® instrument was applied. For statistical analysis it was used descriptive statistics, generalized estimating equations models and linear and logistic regression models. Results: We found improvement in the quality of life, globally (P < .0001) and per domains. Among the determining factors, there was a positive correlation between the extent of resection and improved quality of life globally (P = .032) and in the domain of physical symptoms (P = .012). Also highlights an improvement of 50% with resection of breast tissue above 300 g. Conclusion: Breast reduction and breast lift surgery significantly increases the quality of life measured by the Breast-Q® instrument in patients with breast hypertrophy or ptosis. The determinant factors of this improvement would be directly related to the amount of tissue resected, with a 50% improvement with resections above 300 g.
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Humanos , Femenino , Adulto , Mamoplastia/métodos , Mamoplastia/psicología , Calidad de Vida , Encuestas y Cuestionarios , Mama/cirugía , Satisfacción del Paciente , Estudios ProspectivosRESUMEN
A major hurdle in eHealth implementation is that it is difficult to put into practice. In this study, the primary aim was to identify the main barrier associated with implementing eHealth. This study surveyed IMIA members from May to November 2015. From the results, it is clear that medical professionals were recording most of their data by hand. This paper culture is a paradigm that is difficult to break. Cultural factors are the primary barrier in eHealth implementation.