Calculation of an Enhanced A_{1g} Symmetry Mode Induced by Higgs Oscillations in the Raman Spectrum of High-Temperature Cuprate Superconductors.

In superconductors the Anderson-Higgs mechanism allows for the existence of a collective amplitude (Higgs) mode which can couple to eV light mainly in a nonlinear Raman-like process. The experimental nonequilibrium results on isotropic superconductors have been explained going beyond the BCS theory including the Higgs mode. Furthermore, in anisotropic d-wave superconductors strong interaction effects with other modes are expected. Here we calculate the Raman contribution of the Higgs mode from a new perspective, including many-body Higgs oscillations effects and their consequences in conventional, spontaneous Raman spectroscopy. Our results suggest a significant contribution to the intensity of the A_{1g} symmetry Raman spectrum in d-wave superconductors. In order to test our theory, we predict the presence of measurable characteristic oscillations in THz quench-optical probe time-dependent reflectivity experiments.

Raman Study of Cooper Pairing Instabilities in (Li_{1-x}Fe_{x})OHFeSe.

We studied the electronic Raman spectra of (Li_{1-x}Fe_{x})OHFeSe as a function of light polarization and temperature. In the B_{1g} spectra alone we observe the redistribution of spectral weight expected for a superconductor and two well-resolved peaks below T_{c}. The nearly resolution-limited peak at 110 cm^{-1} (13.6 meV) is identified as a collective mode. The peak at 190 cm^{-1} (23.6 meV) is presumably another collective mode since the line is symmetric and its energy is significantly below the gap energy observed by single-particle spectroscopies. Given the experimental band structure of (Li_{1-x}Fe_{x})OHFeSe, the most plausible explanations include conventional spin-fluctuation pairing between the electron bands and the incipient hole band and pairing between the hybridized electron bands. The absence of gap features in A_{1g} and B_{2g} symmetry favors the second case. Thus, in spite of various differences between the pnictides and chalcogenides, this Letter demonstrates the proximity of pairing states and the importance of band structure effects in the Fe-based compounds.

Design, Implementation and Adoption of an Electronic Dental Record Within an Electronic Health Record in the Public Healthcare System of Buenos Aires City.

This paper describes the development and implementation of a Dental Record within an Electronic Health Record in the public Primary Health Care network of Buenos Aires City. In the five months of implementation, the adoption was progressively increasing but with a great deal of variability among the health facilities. Pediatric population was the most common assisted and the most frequent oral health problem was caries.

Change Management in Healthcare Organizations: Soft Skills Training Strategies Through Blended Learning Environments.

Teaching soft skills for change management in healthcare organizations is becoming increasingly necessary, even more, when implementing health information systems (HIS). There is little evidence that these skills can be learned through online teaching environments. This paper describes the experience of having taught soft skills to health informatics master's degree students, through blended learning environments.

Adoption Factors Related to Electronic Vaccine Record in the Public Primary Care Network of Buenos Aires City.

The Electronic Health Record used in the public primary care network of Buenos Aires City has a specific module for the vaccines registration. The present study explores the factors of EHR adoption by nurses. We found 5 barriers and one facilitator for adoption. Barriers are related with organize the flow of patients especially during vaccine campaigns, adapt the work stations and integrate the records with the vaccine central program.

Developing an Electronic Record Tool Representative of Primary Health Care in the Public Health Care System of Buenos Aires City.

The Primary Health Care strategy is based on organization of interdisciplinary teams and comprehensive approach to health, disease and health care processes. To strengthen information systems so that they represent primary health care complexities, participatory meetings were held with primary care practitioners from the public health care system of Buenos Aires City. Terms for the record tool and its components were chosen using consensus methodologies. This process involved 300 practitioners from 49 centers, and submission of 21 proposals. It was decided to change the term "Electronic Medical Record" with "Comprehensive Health Record." It was also agreed that, apart from "Reason for Consultation," the field "Problem Situation" would be added, that "Care Service" would be replaced with "Care Act," and that a new module "Health Team Management and Education Activities" would be included to document practitioners team activities.

Exportation of dissolved (inorganic and organic) and particulate carbon from mangroves and its implication to the carbon budget in the Indian Sundarbans.

Mangroves are known for exchanging organic and inorganic carbon with estuaries and oceans but studies that have estimated their contribution to the global budget are limited to a few mangrove ecosystems which exclude world's largest the Sundarbans. Here, we worked in the Indian Sundarbans and in the Hooghly river/estuary in May (pre-monsoon) and December (post-monsoon), 2014. Aims were, i) to quantify the riverine export of particulate organic carbon (POC) and dissolved organic and inorganic carbon (DOC, DIC)) of the Hooghly into the Bay of Bengal (BoB), ii) to estimate the C export (DOC, DIC, POC) from the Sundarbans into the BoB by using a simple mixing model, as well as iii) to revise the existing C budget constructed for the mangroves. The riverine exports of POC, DOC and DIC account for 0.07TgCyr-1, 0.34TgCyr-1 and 4.14TgCyr-1, respectively, and were largest during the monsoon period. Results revealed that mangrove plant derived organic matter and its subsequent degradation is the primary source of DIC and DOC in the Hooghly estuary whereas POC is linked to soil erosion. Mangroves are identified as a major source of carbon (POC, DOC, DIC) transported from the Sundarbans into the BoB, with export rates of 0.58 TgCyr-1, 3.03TgCyr-1, and 3.69TgCyr-1 respectively, altogether amounting to 7.3TgCyr-1. This C export from the Indian Sundarbans exceeds the 'missing C' of the previous budget, thus necessitating further research to finally resolve the mangrove C budget. However, these first baseline data on C exports from the world's largest deltaic mangrove improves limited global data inventory and signifies the need of acquiring more data from different mangrove settings to reduce uncertainties.

What Are the Advantages of 3D Cameras in Gynaecological Laparoscopy?

Introduction Minimally invasive operative techniques are being used increasingly in gynaecological surgery. The expansion of the laparoscopic operation spectrum is in part the result of improved imaging. This study investigates the practical advantages of using 3D cameras in routine surgical practice. Materials and Methods Two different 3-dimensional camera systems were compared with a 2-dimensional HD system; the operating surgeon's experiences were documented immediately postoperatively using a questionnaire. Results Significant advantages were reported for suturing and cutting of anatomical structures when using the 3D compared to 2D camera systems. There was only a slight advantage for coagulating. The use of 3D cameras significantly improved the general operative visibility and in particular the representation of spacial depth compared to 2-dimensional images. There was not a significant advantage for image width. Depiction of adhesions and retroperitoneal neural structures was significantly improved by the stereoscopic cameras, though this did not apply to blood vessels, ureter, uterus or ovaries. Conclusion 3-dimensional cameras were particularly advantageous for the depiction of fine anatomical structures due to improved spacial depth representation compared to 2D systems. 3D cameras provide the operating surgeon with a monitor image that more closely resembles actual anatomy, thus simplifying laparoscopic procedures.

Managing User Needs During the EHR Implementation in Buenos Aires City: The HelpDesk Role.

Enablement, guidance, and proactive preparation for a new IT system implementation has proven to be a smart way to prepare people to embrace change. These activities are closely related to change management approaches which seek to help people understand and adopt specific behaviors. That being said, investing in such activities becomes the cornerstone of the success of the project. Leading IT companies around the world include in their strategy for new services and offering deployments, a proactive HelpDesk service. This not only helps build long lasting/trusted relationships between end users and IT sectors but also helps reduce cost and maximizes the Return of Investment. A streamlined process and easy to use/fluent communication channel between parties are powerful risk management/Quality Assurance and Continuous Improvement tools. In this paper, we address the example of a HelpDesk support team implementation of a city-scaled Electronic Health Records implementation.

Cultural Problems Associated with the Implementation of eHealth.

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.

Rapid quantification of casein in skim milk using Fourier transform infrared spectroscopy, enzymatic perturbation, and multiway partial least squares regression: Monitoring chymosin at work.

In this study, we introduce enzymatic perturbation combined with Fourier transform infrared (FTIR) spectroscopy as a concept for quantifying casein in subcritical heated skim milk using chemometric multiway analysis. Chymosin is a protease that cleaves specifically caseins. As a result of hydrolysis, all casein proteins clot to form a creamy precipitate, and whey proteins remain in the supernatant. We monitored the cheese-clotting reaction in real time using FTIR and analyzed the resulting evolution profiles to establish calibration models using parallel factor analysis and multiway partial least squares regression. Because we observed casein-specific kinetic changes, the retrieved models were independent of the chemical background matrix and were therefore robust against possible covariance effects. We tested the robustness of the models by spiking the milk solutions with whey, calcium, and cream. This method can be used at different stages in the dairy production chain to ensure the quality of the delivered milk. In particular, the cheese-making industry can benefit from such methods to optimize production control.

Elaboración e implementación de una agenda digital en atención primaria en la Ciudad Autónoma de Buenos Aires / Implementing an electronic health record in primary care of Ciudad Autónoma de Buenos Aires

INTRODUCCIÓN: un sistema de salud debe garantizar el derecho a la salud de las personas. El sistema de salud Argentino es fragmentado, inequitativo e ineficiente en la utilización de recursos. La Ciudad Autónoma de Buenos Aires implementa, desde Diciembre 2015, una Agenda Digital en Salud que colabora en revertir estas características, a la vezque hace foco en fortalecer la Red de Atención Primaria de la Salud. MÉTODOS: Este trabajo describe los primeros 6 meses de implementación de un Sistema de Información en Salud. RESULTADOS: la implementación piloto comprende 14 Centrosde Atención Primaria y Salud Comunitaria (CeSAC) y al mes de Junio están en funcionamiento 4 de ellos con el nuevosistema. CONCLUSIÓN: un sistema de salud en red garantiza la continuidad del cuidado, mejora los indicadores en salud y la satisfacción ciudadana, así como la eficiencia en el uso de los recursos

INTRODUCTION: It is well known that a health care system must guarantee people the right to health. Fragmentation, inequity and inefficient management of resources are characteristics of the argentinian health caresystem. Since December 2015 Buenos Aires city is implementing a Digital Agenda which helps reverse this situation andaccompanies the plan of strengthening primary health care network. METHODS: This paper describes the first 6 months ofa Health Care Information System implementation in Primary Care. RESULTS: 4 Primary Health Care Centers were fullimplemented in June 2016 and we hope the pilot is finished in December 2016. CONCLUSION: an integrated Health Care System ensures continuity of care, improves citizen satisfaction and the efficient resources utilization.

Deciding Factors for the Referral of a Female Patient to a Specific Hospital from the Viewpoint of Practice-Based Specialists.

Background: One of the key points of patient care is the cooperation between practice-based specialists and clinical facilities. The present study was undertaken in order to illustrate the deciding factors, from the viewpoint of practice-based specialists, for the referral of a female patient to a specific hospital. Methods: Altogether a total of 322 practice-based specialists from various disciplines were contacted in writing and sent a questionnaire. In this survey the recipients were questioned about the criteria, in order of importance, applied for the referral of a (female) patient to a specific clinical facility. Results: In the foreground for the referral of a patient to a specific hospital are the aspects of medical quality and competence. On a closer look we find the surgical spectrum, especially the availability of endoscopic and special operations as a main factor. Further factors are a low rate of complications and the availability of modern diagnostic methods. Also evaluated as an important aspect was the easy reachability of a competent consultant. Factors of lower relevance for referral behaviour were personal familiarity with the colleagues employed in the hospital, specific further training events and the course of previous cooperation. Conclusions: A modern diagnostic and therapeutic spectrum coupled with an easy reachability of competent contact partners are the main factors for cooperation from the viewpoint of the practice-based specialist. Of lowest relevance, among others, was the aspect of previous cooperation. Thus, it can be seen that by means of changes in cooperation an improvement in patient care can be achieved at any time.

Prognostic significance and relationship of worst lead residual ST segment elevation with myocardial damage assessed by cardiovascular MRI in myocardial infarction.

OBJECTIVE: To investigate the relation of residual worst lead ST segment elevation (WL-STE) after ST segment myocardial infarction (STEMI) with infarct size and microvascular injury assessed by cardiovascular magnetic resonance (CMR) imaging. BACKGROUND: WL-STE in patients with acute reperfused STEMI has been shown to identify high risk patients for major adverse cardiovascular events (MACE). However, the relation of WL-STE with myocardial damage is unknown. METHODS: In this multicentre study we analysed ECG data 90 min after primary percutaneous coronary intervention (PCI) in 763 STEMI patients. WL-STE was defined as the absolute magnitude of STE in the most affected lead on the post-PCI ECG. Patients were categorised into three groups (<1 mm, 1-2 mm, and ≥2 mm). CMR was performed within 1 week after infarction for comprehensive assessment of myocardial damage using a standardised protocol. The primary clinical endpoint was MACE defined as death, reinfarction, and new congestive heart failure within 12 months after infarction. RESULTS: WL-STE <1 mm, 1-2 mm, and ≥2 mm was present in 155 (20%), 328 (43%), and 280 (37%) patients, respectively. Myocardial damage determined by CMR demonstrated a graded relationship of infarct size (median (IQR) 13.3 (6.2-20.3)%LV vs 13.7 (7.6-21.3)%LV vs 22.5 (15.6-31.2)%LV, p<0.001), the myocardial salvage index (60.8 (37.0-84.5) vs 55.0 (36.6-73.9) vs 42.7 (26.2-58.2), p<0.001), and microvascular obstruction (0.0 (0.0-0.9)%LV vs 0.0 (0-1.0)%LV vs 1.2 (0.0-3.6)%LV, p<0.001) across the three groups. WL-STE ≥2 mm was strongly associated with MACE 12 month after infarction (HR 1.93, 95% CI 1.11 to 3.37; p=0.02). CONCLUSIONS: This largest CMR study to date correlating post-PCI WL-STE with markers of myocardial damage demonstrates that WL-STE is significantly associated with infarct size, myocardial salvage, microvascular obstruction, and MACE in a high risk STEMI population. TRIAL REGISTRATION NUMBER: NCT00712101.

[The Rostock Headache Questionnaire ("Rokoko")--validation of a tool to screen and to qualify primary headaches]. / Der Rostocker Kopfschmerzfragen-Komplex ("Rokoko")--Validierung einer schnellen diagnostischen Hilfe bei der Einordnung primärer Kopfschmerzen.

Primary headache disorders should be diagnosed based on the detailed history of the patient. However, only few questions are necessary to allocate the symptoms to migraine, tension-type headache or other primary headaches in most cases. The "Rostock Headache Questionnaire" (Rokoko) is suitable for being completed by the investigator or the patient him/herself within a few minutes. Validation parameters of a sample of n = 87 patients (median: 44 years), diagnosed by headache experts in a personal interview ("gold standard"), are presented. Sensitivity and specificity for migraine without aura (0.87/0.51), migraine with aura (0.71/0.95), tension-type headache (0.57/0.93), or a combination of both (0.22/0.93) are based on the parameters pain frequency (recurrent vs. permanent), and the presence or absence of aura symptoms. To differentiate tension-type headache into episodic or chronic forms, the questionnaire can be analysed individually based on the frequency of headache days. The questionnaire enables the fast acquisition of relevant data in headache diagnosis and headache research with sufficient sensitivity and specificity. In addition, further information about triggering and symptoms of headaches can be assessed. The questionnaire can be used both by neurologists or psychiatrists and by general practitioners. The questionnaire does not replace the physical examination.

Raman-scattering detection of nearly degenerate s-wave and d-wave pairing channels in iron-based Ba0.6K0.4Fe2As2 and Rb0.8Fe1.6Se2 superconductors.

We show that electronic Raman scattering affords a window into the essential properties of the pairing potential V(k,k') of iron-based superconductors. In Ba0.6K0.4Fe2As2 we observe band dependent energy gaps along with excitonic Bardasis-Schrieffer modes characterizing, respectively, the dominant and subdominant pairing channel. The d(x(2)-y(2)) symmetry of all excitons allows us to identify the subdominant channel to originate from the interaction between the electron bands. Consequently, the dominant channel driving superconductivity results from the interaction between the electron and hole bands and has the full lattice symmetry. The results in Rb(0.8)Fe(1.6)Se(2) along with earlier ones in Ba(Fe(0.939)Co(0.061))(2)As(2) highlight the influence of the Fermi surface topology on the pairing interactions.

Spreading knowledge in medical informatics: the contribution of the hospital Italiano de Buenos Aires.

UNLABELLED: Medical Informatics (MI) is an emerging discipline with a high need of trained and skillful professionals. OBJECTIVE: To describe the educational experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires. METHODS: A descriptive study of the development of the Medical Informatics Residency Program (MIRP) and the e-learning courses related to medical informatics. RESULTS: A four-year MIRP with 15 rotations was started in 2000, and was awarded national educational accreditation. Eight residents have been fully trained and their main academic contributions are shown in this study. The e-learning courses related to medical informatics (Healthcare Management, Epidemiology & Biostatistics, Information Retrieval, Computer Literacy started, 10x10 Spanish version and HL7 introductory course) started in 2006 and were followed by more than 2266 students from all over the world, with an increase trend in foreign students. CONCLUSIONS: These educational activities have produced skilled human resources for the development and maintenance of the health informatics projects at our Hospital. In parallel, the number of students trained by e-learning continues to increase, demonstrating the worldwide need of knowledge in this field.

BIBW2992, an irreversible EGFR/HER2 inhibitor highly effective in preclinical lung cancer models.

Genetic alterations in the kinase domain of the epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) patients are associated with sensitivity to treatment with small molecule tyrosine kinase inhibitors. Although first-generation reversible, ATP-competitive inhibitors showed encouraging clinical responses in lung adenocarcinoma tumors harboring such EGFR mutations, almost all patients developed resistance to these inhibitors over time. Such resistance to first-generation EGFR inhibitors was frequently linked to an acquired T790M point mutation in the kinase domain of EGFR, or upregulation of signaling pathways downstream of HER3. Overcoming these mechanisms of resistance, as well as primary resistance to reversible EGFR inhibitors driven by a subset of EGFR mutations, will be necessary for development of an effective targeted therapy regimen. Here, we show that BIBW2992, an anilino-quinazoline designed to irreversibly bind EGFR and HER2, potently suppresses the kinase activity of wild-type and activated EGFR and HER2 mutants, including erlotinib-resistant isoforms. Consistent with this activity, BIBW2992 suppresses transformation in isogenic cell-based assays, inhibits survival of cancer cell lines and induces tumor regression in xenograft and transgenic lung cancer models, with superior activity over erlotinib. These findings encourage further testing of BIBW2992 in lung cancer patients harboring EGFR or HER2 oncogenes.