Mapping Physicians' Experiences with Medicinal Products from Whole Medical Systems: A Descriptive Analysis of the Vademecum of Anthroposophic Medicines.

BACKGROUND: Therapy in whole medical systems involves a large number of medicinal products. One source of knowledge of clinical properties of such products is the experience of therapy providers. A systematic approach to documentation, assessment, and aggregation of physicians' experiences with anthroposophic medicinal products (AMPs) has been developed: the Vademecum of Anthroposophic Medicines. MATERIAL AND METHODS: The Vademecum contains structured information on AMPs, including therapeutic rationale, indications, and therapy recommendations. The information is based on a 17-item questionnaire of physicians' therapy experiences, which is peer-reviewed by an interdisciplinary editorial board. We conducted a descriptive analysis of the Vademecum, 4th edition. RESULTS: The Vademecum comprised 799 different AMPs, used for 1,773 indications, based on 2,543 questionnaires submitted by 274 physicians from 19 countries. The 799 AMPs comprised 52.6% of all AMPs marketed in Germany in 2015-2016. The 1,773 indications corresponded to 544 different ICD-10 three-digit codes, amounting to 29.3% (n = 544/1,854) of all three-digit codes. A total of 30.6% (n = 542/1,773) of indications were supported by ≥2 questionnaires. CONCLUSIONS: The current Vade-mecum covers more than half of all AMPs, used for more than one fourth of all ICD-10 three-digit codes. The Vademecum approach may be relevant for medicinal products from other whole medical systems.

Nikolaeva et al.'s reference book on seed dormancy and germination.

Despite the recent advances in seed science research, information on seed dormancy and germination traits is still missing for many lineages of the seed plants. We translated and digitized a huge data set on seed dormancy and germination from the Reference Book On Dormant Seed Germination by M. Nikolaeva, M. Razumova, and V. Gladkova published in Russian in 1985 and previously not readily accessible to the great majority of people in the international scientific community interested in seeds. The data set contains information on the seed dormancy classification (sensu Nikolaeva et al., 1985; Baskin and Baskin, 2004), dormancy-breaking conditions/germination, and for some of the included species storage behaviour, of seeds of nearly 3000 gymnosperm and angiosperm species from 843 genera and 164 families occurring worldwide. Additionally, the data set contains about 550 references, many of them unknown to seed scientists, to seed ecology research conducted between 1926 and 1985. The data set should be of value to applied, basic, and theoretical plant biologists, ecologists, and evolutionary biologists interested in the various aspects of regeneration of plants from seeds. There are no copyright or proprietary restrictions for research or teaching purposes. The originator of the data would appreciate notification when and how the data are used. When used in published analyses, this paper should be referred to as the data source.

Análisis bibliométrico de la retinopatía diabética en revistas médicas cubanas: un producto de información con valor agregado / Bibliometric analysis of diabetic retinopathy in Cuban medical journals: an information product with added value

Los estudios métricos sobre la producción científica constituyen productos de información útiles a las comunidades académicas; sin embargo, no existen abundantes indagaciones que cuantifiquen y evalúen las fuentes que publican trabajos sobre retinopatía diabética. Este trabajo se propuso determinar la producción científica sobre retinopatía diabética publicada en revistas médicas cubanas entre los años 1970 y 2017. Se realizó una revisión bibliográfica a partir de la identificación en los registros de los términos [adultos - retinopatía diabética]. Se utilizó el gestor de referencias bibliográficas Zotero, para recuperar y analizar los metadatos de cada artículo seleccionado; Microsoft Excel para la tabulación de los resultados y Mindjet mindManager (2010), para la elaboración del mapa conceptual. Se seleccionaron 56 artículos relacionados con la temática después de aplicados los criterios de inclusión y exclusión. La producción científica de la retinopatía diabética publicada en revistas médicas cubanas se concentra en los últimos 10 años. El peso de la distribución de los artículos recae en revistas que pertenencen a Institutos Nacionales. Asimismo, la tendencia de los tipos de trabajos se concentra en investigaciones originales de carácter descriptivo, estudios de caso y artículos de revisión; y en menor cuantía los estudios de cohortes, analíticos y experimentales(AU)

Metric studies about scientific production are information products useful to academic communities. However, not many inquiries are available which quantify and evaluate the sources publishing papers about diabetic retinopathy. The present study was aimed to determine the scientific production about diabetic retinopathy published in Cuban medical journals in the period 1970-2017. A bibliographic review was conducted based on identification of records of the terms [adults - diabetic retinopathy]. Retrieval and analysis of the metadata for each paper selected was performed with the bibliographic reference manager Zotero, while Microsoft Excel was used for tabulation of results and Mindjet MindManager (2010) to develop the conceptual map. A total 56 papers about the study topic were selected upon application of inclusion and exclusion criteria. Scientific production about diabetic retinopathy published in Cuban medical journals is concentrated in the last ten years. Most of the papers were found to have been published by journals sponsored by national institutes. Regarding paper types, most were original studies of a descriptive nature, case studies and review papers, and to a lesser degree cohort, analytic and experimental studies(AU)

Assessment of Blood Lead, Zinc, and Mercury Concentrations and Cholinesterase Activity in Captive-reared Alligator Snapping Turtles ( Macrochelys temminckii) in Louisiana, USA.

The alligator snapping turtle ( Macrochelys temminckii) is a freshwater apex predator that has experienced severe population declines throughout its range due to historical overharvesting and habitat degradation. Because of its long lifespan, high trophic level, and limited home range, it is a suitable sentinel species for monitoring environmental contaminants. In Louisiana, US a pilot program aims to augment free-ranging populations by releasing captive-reared individuals. Baseline values of potential environmental contaminants were determined as part of an overall health assessment to evaluate captive-reared alligator snapping turtles for release. Blood samples from 3-yr-old ( n=23) and 4-yr-old ( n=11) captive-reared alligator snapping turtles were tested for lead (Pb), mercury (Hg), and zinc (Zn) levels by atomic absorption spectrophotometry and cholinesterase (ChE) activity (as a biomarker for organophosphate and carbamate exposure) by the modified Ellman method. Reference intervals were determined for Zn (34 to 295 µg/dL), Hg (0 to 4.8 µg/dL), and ChE (0.17 to 1.65 µmole acetylthiocholine/mL per minute). Elevations of Pb, Zn, or Hg, or decreases in ChE activity levels of this cohort during recapture sampling may indicate point-source intoxications or bioaccumulation, both ultimately attributable to environmental contamination. The released animals may serve as sentinels for biomonitoring of their new habitat for the evaluated toxicants.

Tele-Ophthalmology for Age-Related Macular Degeneration and Diabetic Retinopathy Screening: A Systematic Review and Meta-Analysis.

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.

Naked in the Old and the New World: Differences and Analogies in Descriptions of European and American herbae nudae in the Sixteenth Century.

The sixteenth century could be understand as a period of renaissance of interest in nature and as a period of development of natural history as a discipline. The spreading of the printing press was connected to the preparation of new editions of Classical texts and to the act of correcting and commenting on these texts. This forced scholars to confront texts with living nature and to subject it to more careful investigation. The discovery of America uncovered new horizons and brought new natural products, which were exotic and unknown to Classical tradition. The aim of this study is to compare strategies and categories, which were used in describing plants of the Old and the New World. Attention will be paid to the first reactions to the new flora, to the methods of naming and describing plants, to the ways of gaining knowledge about plants from local sources or by means of one's own observation. The confrontation with novelty puts naturalists in the Old World and in the New World in a similar situation. It reveals the limits of traditional knowledge based on Classical authorities. A closer investigation, however, brings to light not only the sometimes unexpected similarities, but also the differences which were due to the radical otherness of American plants.

Validación de un manual sobre buenas prácticas de enfermería en cuidados intensivos / Validação d'um manual de boas práticas de enfermagem nos cuidados intensivos / Validation of a manual on good nursing practices in intensive care

Introducción: los profesionales de enfermería deben poseer una formación que garantice asumir con calidad los retos que imponen la complejidad del paciente crítico. Objetivo: validar un libro de buenas prácticas de enfermería en cuidados intensivos para la seguridad del paciente. Método: triangulación metodológica mediante criterio de 20 expertos por el método Delphi y pre-experimento con prueba de entrada y salida en la Unidad de Cuidados Intensivos del Hospital General Docente Octavio de la Concepción y de la Pedraja de Baracoa, Guantánamo, desde 2016- 2017. Resultados: el consenso general de los expertos fue de "muy de acuerdo" para los fundamentos que sustentan la seguridad del paciente en las buenas prácticas de enfermería en las UCI y la calidad del libro propuesto. Las calificaciones de los procederes de enfermería de la prueba de salida, correspondiente al pre-experimento, fueron significativamente superiores a las de entrada. Conclusiones: se acepta como válido y factible el libro de buenas prácticas de enfermería en la UCI para la seguridad del paciente(AU)

Introduction: Nursing professionals must have a training that guarantees quality assurance of the challenges imposed by the complexity of the critical patient. Objective: to validate a book of good nursing practices in intensive care for patient safety. Method: methodological triangulation by criteria of 20 experts by the Delphi method and pre-experiment with entrance and exit test in the Intensive Care Unit of the General Teaching Hospital Octavio de la Concepcion y de la Pedraja of Baracoa, Guantanamo, since 2016 to 2017. Results: the general consensus of the experts was "very much in agreement" for the foundations that support patient safety in good nursing practices in the ICU and the quality of the proposed book. The qualifications of the nursing procedures of the exit test, corresponding to the pre-experiment, were significantly higher than the entrance tests. Conclusions: the book of good nursing practices in the ICU for patient safety is accepted as valid and feasible(AU)

Introdução: os profissionais de enfermagem devem ter um treinamento que garanta com qualidade os desafios impostos pela complexidade do paciente crítico. Objetivo: validar um livro de boas práticas de enfermagem em terapia intensiva para a segurança do paciente. Método: triangulação metodológica usando critérios 20 especialistas por método Delphi e pré-experimento com entrada de teste e saída na Unidade de Terapia Intensiva do Hospital Geral de Ensino "Octavio de la Concepcion e Pedraja" Baracoa Guantánamo a partir de 2016 - 2017. Resultados: o consenso geral dos especialistas foi "concordo totalmente" para os fundamentos que suportam a segurança do paciente na melhor prática de enfermagem em UTI e qualidade do livro proposto. As qualificações dos procedimentos de enfermagem do teste de saída, correspondentes ao pré-experimento, foram significativamente superiores aos testes de entrada. Conclusões: o livro de boas práticas de enfermagem na UTI para segurança do paciente é aceito como válido e factível(AU)

Validación de un manual sobre buenas prácticas de enfermería en cuidados intensivos / Validation of a manual on good nursing practices in intensive care

Introducción: los profesionales de enfermería deben poseer una formación que garantice asumir con calidad los retos que imponen la complejidad del paciente crítico. Objetivo: validar un libro de buenas prácticas de enfermería en cuidados intensivos para la seguridad del paciente. Método: triangulación metodológica mediante criterio de 20 expertos por el método Delphi y pre-experimento con prueba de entrada y salida en la Unidad de Cuidados Intensivos del Hospital General Docente Octavio de la Concepción y de la Pedraja de Baracoa, Guantánamo, desde 2016- 2017. Resultados: el consenso general de los expertos fue de muy de acuerdo para los fundamentos que sustentan la seguridad del paciente en las buenas prácticas de enfermería en las UCI y la calidad del libro propuesto. Las calificaciones de los procederes de enfermería de la prueba de salida, correspondiente al pre-experimento, fueron significativamente superiores a las de entrada. Conclusiones: se acepta como válido y factible el libro de buenas prácticas de enfermería en la UCI para la seguridad del paciente(AU)

Introduction: Nursing professionals must have a training that guarantees quality assurance of the challenges imposed by the complexity of the critical patient. Objective: to validate a book of good nursing practices in intensive care for patient safety. Method: methodological triangulation by criteria of 20 experts by the Delphi method and pre-experiment with entrance and exit test in the Intensive Care Unit of the General Teaching Hospital "Octavio de la Concepcion y de la Pedraja" of Baracoa, Guantanamo, since 2016 to 2017. Results: the general consensus of the experts was "very much in agreement" for the foundations that support patient safety in good nursing practices in the ICU and the quality of the proposed book. The qualifications of the nursing procedures of the exit test, corresponding to the pre-experiment, were significantly higher than the entrance tests. Conclusions: the book of good nursing practices in the ICU for patient safety is accepted as valid and feasible(AU)

Introdução: os profissionais de enfermagem devem ter um treinamento que garanta com qualidade os desafios impostos pela complexidade do paciente crítico. Objetivo: validar um livro de boas práticas de enfermagem em terapia intensiva para a segurança do paciente. Método: triangulação metodológica usando critérios 20 especialistas por método Delphi e pré-experimento com entrada de teste e saída na Unidade de Terapia Intensiva do Hospital Geral de Ensino "Octavio de la Concepcion e Pedraja" Baracoa Guantánamo a partir de 2016 - 2017. Resultados: o consenso geral dos especialistas foi concordo totalmente para os fundamentos que suportam a segurança do paciente na melhor prática de enfermagem em UTI e qualidade do livro proposto. As qualificações dos procedimentos de enfermagem do teste de saída, correspondentes ao pré-experimento, foram significativamente superiores aos testes de entrada. Conclusões: o livro de boas práticas de enfermagem na UTI para segurança do paciente é aceito como válido e factível(AU)

Huellas del francés en el lenguaje cardiológico ( I ) / No disponible

No disponible

Normal hematology and serum chemistry of northern fur seals (Callorhinus ursinus) in captivity.

Northern fur seals (Callorhinus ursinus) are endemic to the North Pacific Ocean. They were hunted for their fur and became endangered in the late 1800s, but their populations recovered following the introduction of protection laws. Recently, populations have been decreasing again, although the reasons are unclear. For individuals that are bred and reared in captivity as part of ex situ conservation projects, details of blood characteristics are essential to ensure good health. However, the normal ranges of hematology and serum chemistry of captive northern fur seals have not been defined. This study determined the normal ranges of hematology and serum chemistry of captive fur seals. Blood samples were collected every month for 2 years from four captive northern fur seals in Japan (three born in an aquarium and one kept in the same aquarium following rescue). Fifteen blood characteristics and 29 serum chemistry properties were compared with those previously reported for wild northern fur seals in the USA. Several parameters were not within the normal ranges reported previously in wild northern fur seals. In particular, levels of alkaline phosphatase was outside of the normal ranges previously reported. The hematological and serum chemistry ranges in this study can help provide a guideline for understanding the health of northern fur seals in captivity.

Evaluation of resources for analyzing drug interactions.

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<0.05 for each comparison). Overall completeness scores were higher for Micromedex Drug Interactions (median 5, interquartile range [IQR] 4 to 5) compared to all other resources (p<0.01 for each comparison) and were higher for Lexicomp Interactions (median 4, IQR 4 to 5), Facts & Comparisons eAnswers (median 4, IQR 4 to 5), and Drug Interaction Facts (4, IQR 4 to 5) compared to all other resources, except Micromedex (p<0.05 for each comparison). Ease of use, in terms of time to locate information and time to gather information, was similar among resources. Consistency score was higher for Micromedex (69.9%) compared to all other resources (p<0.05 for each comparison). CONCLUSIONS: Clinical Pharmacology Drug Interaction Report, Lexicomp Interactions, and Micromedex Drug Interactions scored highest in scope. Micromedex Drug Interactions and Lexicomp Interactions scored highest in completeness. Consistency scores were overall low, but Micromedex Drug Interactions was the highest.

Santiago Ramón y Cajal en la literatura, el cine y la televisión / Santiago Ramón y Cajal in literature, cinema and television

Introducción. La vida y obra de Santiago Ramón y Cajal ha sido recogida en artículos científicos, obras biográficas y autobiográficas, cómics, películas, series televisivas o documentales que han intentado reflexionar sobre su vida o sus aportaciones a la ciencia y acercarlo a la población general. Objetivo. Analizar cómo ha sido representada la figura de Santiago Ramón y Cajal en la literatura, el cine y la televisión, y conocer al científico a través de su obra de ficción. Desarrollo. Son múltiples las obras biográficas escritas sobre Santiago Ramón y Cajal, artículos científicos, cómics, libros para niños y jóvenes, sin olvidar las obras autobiográficas, ensayos, e incluso literatura de ciencia ficción, que permiten una buena aproximación a la vida del científico y a su obra. Su figura ha sido también llevada al cine (Salto a la gloria) o a la televisión (Ramón y Cajal, historia de una voluntad; Las mariposas del alma), que han acercado a Cajal, con mayor o menor acierto y exactitud, a la población general. Conclusiones. A través de los numerosos escritos biográficos, apuntes históricos, artículos, la propia obra científica, de ensayo y de ficción de Cajal, así como de las representaciones que el cine y la televisión han hecho del Nobel español, podemos realizar una interesante aproximación al científico, al profesor, al divulgador, al médico humanista y, en suma, al hombre que realizó tan importantes aportaciones a la neurociencia (AU)

Introduction. The life and work of Santiago Ramón y Cajal has been portrayed in scientific papers, biographical and autobiographical works, comics, films, television series or documentaries that have attempted to reflect upon his life or his contributions to science and to bring him closer to the general public. Aims. To analyse the different ways Santiago Ramón y Cajal has been represented in literature, cinema and television, and to become more closely acquainted with this scientist through his fictional writings. Development. A number of biographical works have been written about Santiago Ramón y Cajal, including scientific papers, comics, books for children and youngsters, as well as the autobiographical writings, essays and even science fiction stories, which provide a good introduction to the life of the scientist and his work. His life has also been adapted to film (Leap to fame) or television (Ramón y Cajal, historia de una voluntad; The butterflies of the soul), which have, with varying degrees of success and accuracy, made him better known to the general population. Conclusions. The numerous biographical writings, historical notes, articles, the scientific work itself, the essays and fictional works by Cajal, as well as the portrayals of the Spanish Nobel Prize winner produced for films and television, can be used to obtain some interesting insights into the scientist, teacher, science populariser, humanist physician and, in short, the man who made such important contributions to neuroscience (AU)

[Explanation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma].

The development and compilation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma are introduced from three aspects, named the guideline methodology, the guideline structure and the guideline content. Based on the acupuncture-moxibustion practice and clinical research, the evidence-based medicine method is adopted. During the development and compilation of the guideline, the characteristics and advantages of acupuncture and moxibustion are specially considered in the treatment of this disease; the latest optimum evidences at home and abroad, experts' experience and patients' value are closely integrated with each other. Additionally, the worldwide accepted assessments of evidence quality and the recommendation (GRADE system) are combined with the clinical evidences of the ancient and modern famous acupuncture-moxibustion experts, and the clinical research evidences are with the experts' consensus to the large extent. The purpose of the guideline is to provide the maximal guidance to the clinical physicians.

COMPARISON OF PRE- AND POSTQUARANTINE BLOOD CHEMISTRY AND HEMATOLOGY VALUES FROM WILD-CAUGHT COWNOSE RAYS (RHINOPTERA BONASUS).

Though one of the most widely kept elasmobranchs in human care, the cownose ray (CNR; Rhinoptera bonasus ), remains a species with minimal published information on hematologic reference intervals. As part of a larger study investigating the health and nutrition of the CNR, this study established a preliminary data set of plasma chemistry and hematology values specific to animals recently caught from the wild and compared this data set (intake sample) to values obtained following a period of quarantine (27-40 days) in an aquarium (exit sample). Blood samples were collected from 47 wild female (n = 46) and male (n = 1) CNR caught in pound nets off the coast of North Carolina and South Carolina. Differences between intake and exit values were analyzed. Due to the preponderance of female animals, data were not analyzed for sex differences. Plasma biochemical profiles were performed and analyzed. A select number of complete blood cell counts were performed (n = 24 from 12 animals). Statistically significant differences (P < 0.05) specific to time of sampling were determined for packed cell volume, total solids, blood urea nitrogen, sodium, chloride, potassium, phosphorus, cholesterol, glucose, and aspartate aminotransferase. Values reported are a significant expansion on the existing limited data for CNRs and will serve as a reference for health assessment of individuals both in the wild and in exhibit populations.

Postmortem Body and Organ Measurements in Neonates and Infants: A Review of Reference Resources Used by Ontario Pathologists (Part 1).

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.