ABSTRACT
Objective: To investigate the frequencies and bacterial load of three species of periodontal bacteria in samples from oropharyngeal cancer patients versus healthy individuals. Study design: This is a case-control study based on biopsies collected from tumor tissues obtained from patients with oropharyngeal squamous cell carcinoma between 2016 and 2017 and shed oral mucosal epithelial cells that were collected from controls using the Cepimax® brush, carrying out several brushings towards the posterior third edge of the tongue and the cheek. Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia detection and absolute quantification was determined through q-PCR. Statistical analysis included a U- test, X 2 , Fisher's exact test, odds ratio (OR) and Conditional logistic regression analysis and unconditional regression analysis (p < 0.05). Results: A total of 48 donors older than 55 years old participated in this study. The population was distributed into 24 patients (cases) and 24 controls. A robust association was established in cases and controls with significance regarding Prevotella intermedia (OR: 15.00) and Porphyromonas gingivalis (OR:11.00). In the comparison between the amount of each bacteria in the groups, P. intermedia showed a higher bacterial load in oropharyngeal cancer patients (p = 0.04). However, multivariate analysis adjusted to the presence of different bacteria and the diverse confounding variables did not reveal significant differences for oropharyngeal cancer association. Conclusion: P. gingivalis and P. intermedia were detected more frequently in the group of patients with cancer. The bivariate analysis of the bacterial load evidenced significant differences for Prevotella intermedia, suggesting that it could be associated with oropharyngeal cancer.
ABSTRACT
The monitoring of patients with dementia who receive comprehensive care in day centers allows formal caregivers to make better decisions and provide better care to patients. For instance, cognitive and physical therapies can be tailored based on the current stage of disease progression. In the context of day centers of the Mexican Federation of Alzheimer, this work aims to design and evaluate Alzaid, a technological platform for assisting formal caregivers in monitoring patients with dementia. Alzaid was devised using a participatory design methodology that consisted in eliciting and validating requirements from 22 and 9 participants, respectively, which were unified to guide the construction of a high-fidelity prototype evaluated by 14 participants. The participants were formal caregivers, medical staff, and management. This work contributes a high-fidelity prototype of a technological platform for assisting formal caregivers in monitoring patients with dementia considering restrictions and requirements of four Mexican day centers. In general, the participants perceived the prototype as quite likely to be useful, usable, and relevant in the job of monitoring patients with dementia (p-value < 0.05). By evaluating and designing Alzaid that unifies requirements for monitoring patients of four day centers, this work is the first effort towards a standard monitoring process of patients with dementia in the context of the Mexican Federation of Alzheimer.
Subject(s)
Alzheimer Disease , Dementia , Humans , Caregivers/psychology , Monitoring, PhysiologicABSTRACT
Introducción: en la actualidad, se reconocen cuadros vestibulares periféricos y centrales que pueden ser diagnosticados mediante la videonistagmografía (VNG). Los avances en la tecnología han provocado en los profesionales una constante actualización en el uso e interpretación de las distintas pruebas que conlleven, en su lectura cruzada, un diagnóstico acertado y a tratamientos de rehabilitación exitosos. El objetivo fue describir las interpretaciones de los resultados de las pruebas oculomotoras, posicionales y calóricas de la VNG para lograr un diagnóstico detallado de las disfunciones vestibulares. Materiales y métodos: revisión documental obtenida de 40 fuentes reportadas en la literatura científica entre 2010 a 2020 tomadas de bases de datos, tesis de grado y libros. Discusión: dentro de la revisión se encontraron tres categorías (pruebas oculomotoras, posicionales y calóricas) y siete subcategorías (nistagmo espontáneo, nistagmo evocado por la mirada, rastreo, sacadas, optocinético, Dix-Hallpike y roll test). Conclusión: los diversos elementos encontrados en la presente revisión son relevantes ya que precisan no solo el tipo de vértigo, sino también su localización topográfica, lo que favorece el proceso de evaluacióndiagnóstico en la población en general.
Introduction: At present, peripheral and central vestibular frames are recognized that can be diagnosed by videonystagmography (VNG). Advances in technology have caused professionals to constantly update the use and interpretation of the different tests that lead, in their cross-reading, to an accurate diagnosis and successful rehabilitation treatments. The objective was to describe the interpretations of the results of the oculomotor, positional and caloric tests of the VNG, for a detailed diagnosis of the vestibular dysfunctions. Materials and method: Documentary review obtained from 40 sources reported in the scientific literature between 2010 and 2020, taken from databases, thesis and books. Discussion: Within the review, three categories were found (oculomotor, positional and caloric tests) and seven subcategories (spontaneous nystagmus, gaze-evoked nystagmus, tracking, saccades, optokinetic, Dix-Hallpike and roll test). Conclusion: The various elements found in this review are relevant in that they specify not only the type of vertigo but also its topographic location, favoring the evaluation-diagnosis process in the general population.
Subject(s)
Humans , Nystagmus, Pathologic , Caloric Tests , Electronystagmography , Eye MovementsABSTRACT
BACKGROUND AND OBJECTIVE: In day centers, people with dementia are assigned to specific groups to receive care according to the progression of the disease. This article presents the design and evaluation of a dashboard aimed at facilitating the comprehension of the progression of people with dementia to support decision-making of healthcare professionals (HCPs) when determining patient-group assignment. MATERIALS AND METHOD: A participatory design methodology was followed to build the dashboard. The grounded theory methodology was utilized to identify requirements. A total of 8 HCPs participated in the design and evaluation of a low-fidelity prototype. The perceived usefulness and perceived ease of use of the high-fidelity prototype was evaluated by 15 HCPs (from several day centers) and 38 psychology students utilizing a questionnaire based on the technology acceptance model. RESULTS: HCPs perceived the dashboard as extremely likely to be useful (Mdn=6.5 out of 7) and quite likely to be usable (Mdn=6 out of 7). Psychology students perceived the dashboard as quite likely to be useful and usable (both with Mdn=6). CONCLUSIONS: Making use of a participatory design helped foster in HCPs a sense of ownership of the dashboard, thus facilitating its acceptance. The creation of low-fidelity and high-fidelity prototypes led to identifying valuable, timely, and specific feedback at different stages of the development process as well as to establishing a set of lessons learned for the development of dashboards in the healthcare domain.
Subject(s)
Decision Support Systems, Clinical , Dementia , Disease Progression , Adult Day Care Centers , Comprehension , Dementia/diagnosis , Health Personnel , Humans , Research Design , Surveys and QuestionnairesABSTRACT
BACKGROUND AND OBJECTIVE: The workings of medical educational tools are implemented using a myriad of approaches ranging from presenting static content to immersing students in gamified virtual-reality environments. The objective of this paper is to explore whether and how different approaches for designing medical educational tools affect students' learning performance. MATERIALS AND METHODS: Four versions of an educational tool for the study of clinical cases were implemented: a 2D version, a gamified 2D version, a gamified 3D version, and a gamified immersive-virtual-reality version. All complying with the same functional requirements. Each version was used and evaluated by an independent group of students. The participants (nâ¯=â¯78) evaluated the applications regarding usefulness, usability, and gamification. Afterward, the students took an exam to assess the retention of information on the clinical cases presented. RESULTS: One-sample Wilcoxon signed-rank tests confirmed that the participants perceived that it was at least quite likely that gamification helped improved their learning. In addition, based on the participants' perception, the gamification of the immersive-virtual-reality version helped the most to improve their learning performance in comparison with the gamified 2D and 3D versions. CONCLUSIONS: Regardless of whether different versions of a medical educational tool (complying with the same functional requirements) are perceived as equally useful and usable, the design approach (either 2D, 3D, or immersive-virtual-reality with or without gamification) affects students' retention of information on clinical cases.
Subject(s)
Education, Medical , Virtual Reality , Delivery of Health Care , Humans , LearningABSTRACT
One of the objectives in the field of artificial intelligence for some decades has been the development of artificial agents capable of coexisting in harmony with people and other systems. The computing research community has made efforts to design artificial agents capable of doing tasks the way people do, tasks requiring cognitive mechanisms such as planning, decision-making, and learning. The application domains of such software agents are evident nowadays. Humans are experiencing the inclusion of artificial agents in their environment as unmanned vehicles, intelligent houses, and humanoid robots capable of caring for people. In this context, research in the field of machine ethics has become more than a hot topic. Machine ethics focuses on developing ethical mechanisms for artificial agents to be capable of engaging in moral behavior. However, there are still crucial challenges in the development of truly Artificial Moral Agents. This paper aims to show the current status of Artificial Moral Agents by analyzing models proposed over the past two decades. As a result of this review, a taxonomy to classify Artificial Moral Agents according to the strategies and criteria used to deal with ethical problems is proposed. The presented review aims to illustrate (1) the complexity of designing and developing ethical mechanisms for this type of agent, and (2) that there is a long way to go (from a technological perspective) before this type of artificial agent can replace human judgment in difficult, surprising or ambiguous moral situations.
Subject(s)
Artificial Intelligence , Morals , Humans , Judgment , Software , Surveys and QuestionnairesABSTRACT
BACKGROUND AND OBJECTIVE: This paper presents Alzheed, a mobile application for monitoring patients with Alzheimer's disease at day centers as well as a set of design recommendations for the development of healthcare mobile applications. The Alzheed project was conducted at Day Center "Dorita de Ojeda" that is focused on the care of patients with Alzheimer's disease. MATERIALS AND METHODS: A software design methodology based on participatory design was employed for the design of Alzheed. This methodology is both iterative and incremental and consists of two main iterative stages: evaluation of low-fidelity prototypes and evaluation of high-fidelity prototypes. Low-fidelity prototypes were evaluated by 11 day center's healthcare professionals (involved in the design of Alzheed), whereas high-fidelity prototypes were evaluated using a questionnaire based on the technology acceptance model (TAM) by the same healthcare professionals plus 30 senior psychology undergraduate students uninvolved in the design of Alzheed. RESULTS: Healthcare professional participants perceived Alzheed as extremely likely to be useful and extremely likely to be usable, whereas senior psychology undergraduate students perceived Alzheed as quite likely to be useful and quite likely to be usable. Particularly, the median and mode of the TAM questionnaire were 7 (extremely likely) for healthcare professionals and 6 (quite likely) for psychology students (for both constructs: perceived usefulness and perceived ease of use). One-sample Wilcoxon signed-rank tests were performed to confirm the significance of the median for each construct. CONCLUSIONS: From the experience of designing Alzheed, it can be concluded that co-designing with healthcare professionals leads to (i) fostering group endorsement, which prevents resistance to change and (ii) helps to meet the needs of both healthcare professionals and patients, guaranteeing the usefulness of the application. In addition, evaluation of mobile healthcare applications by users involved and uninvolved in the application's design process helps to improve the ease of use of the application.
Subject(s)
Alzheimer Disease/diagnosis , Delivery of Health Care/standards , Mobile Applications/statistics & numerical data , Mobile Applications/standards , Monitoring, Physiologic/methods , Research Design , Software , Female , Health Personnel , Humans , Students , Surveys and QuestionnairesABSTRACT
Se elaboró un método de marcaje de microesferas (mic A) con 113mIn y 99mTc. Se determinó el PH óptimo de marcaje, la influencia de la cantidad de Tween 80 y de cloruro estannoso (SnCl2, H2O), y el tiempo óptimo y mínimo de calentamiento y agitación. Los radiofármacos 99mTc-Sn-micA y 113m In-Sn-micA preparados por el método elaborado tienen pureza radioquímica mayor del 95. La introducción de este método dará la posibilidad de preparar los radiofármacos mencionados sin necesidad de importarlos
Subject(s)
Isotope Labeling/methods , Technetium Tc 99m Aggregated Albumin , IndiumABSTRACT
Se elaboró un método de marcaje de microesferas (mic A) con 113mIn y 99mTc. Se determinó el PH óptimo de marcaje, la influencia de la cantidad de Tween 80 y de cloruro estannoso (SnCl2, H2O), y el tiempo óptimo y mínimo de calentamiento y agitación. Los radiofármacos 99mTc-Sn-micA y 113m In-Sn-micA preparados por el método elaborado tienen pureza radioquímica mayor del 95. La introducción de este método dará la posibilidad de preparar los radiofármacos mencionados sin necesidad de importarlos
Subject(s)
Indium , Isotope Labeling/methods , Technetium Tc 99m Aggregated AlbuminABSTRACT
Se describen los métodos de radioiodación empleados en la preparación de albúmina sérica humana y estrógenos. Se plantea que los rendimientos del marcaje con el radioioduro varían del 75-96 , lo cual está en función del método empleado y del propio compuesto en sí. Se informa que la pureza radioquímica encontrada fue más elevada para la albúmina y el estradiol, en relación con los restantes compuestos. Se señala que en los estudios de biodistribución de los estrógenos radioiodados en ratas, el dietil-etil-bestrol fue el de mayor deposición en la próstata y las suprarenales
Subject(s)
Rats , Animals , Serum Albumin, Radio-Iodinated , Estrogens , Radionuclide Imaging , Isotope LabelingABSTRACT
Se describen los métodos de radioiodación empleados en la preparación de albúmina sérica humana y estrógenos. Se plantea que los rendimientos del marcaje con el radioioduro varían del 75-96 , lo cual está en función del método empleado y del propio compuesto en sí. Se informa que la pureza radioquímica encontrada fue más elevada para la albúmina y el estradiol, en relación con los restantes compuestos. Se señala que en los estudios de biodistribución de los estrógenos radioiodados en ratas, el dietil-etil-bestrol fue el de mayor deposición en la próstata y las suprarenales
