The evaluation of a web-based tool for measuring the uncorrected visual acuity and refractive error in keratoconus eyes: A method comparison study.

PURPOSE: To evaluate the outcome of a web-based digital assessment of visual acuity and refractive error, compared to a conventional supervised assessment, in keratoconus patients with complex refractive errors. MATERIAL AND METHODS: Keratoconus patients, aged 18 to 40, with a refractive error between -6 and +4 diopters were considered eligible. An uncorrected visual acuity and an assessment of refractive error was taken web-based (index test) and by manifest refraction (reference test) by an optometrist. Corrected visual acuity was assessed with the prescription derived from both the web-based tool and the manifest refraction. Non-inferiority was defined as the 95% limits-of-agreement (95%LoA) of the differences in spherical equivalent between the index and reference test not exceeding +/- 0.5 diopters. Agreement was assessed by a Bland-Altman analyses. RESULTS: A total of 100 eyes of 50 patients were examined. The overall mean difference of the uncorrected visual acuity measured -0.01 LogMAR (95%LoA:-0.63-0.60). The variability of the differences decreased in the better uncorrected visual acuity subgroup (95%LoA:-0.25-0.55). The overall mean difference in spherical equivalent between the index and reference test exceeded the non-inferiority margin: -0.58D (95%LoA:-4.49-3.33, P = 0.008). The mean differences for myopic and hyperopic subjects were 0.09 diopters (P = 0.675) and -2.06 diopters (P<0.001), respectively. The corrected visual acuities attained with the web-based derived prescription underachieved significantly (0.22±0.32 logMAR vs. -0.01±0.13 LogMAR, P <0.001). CONCLUSIONS: Regarding visual acuity, the web-based tool shows promising results for remotely assessing visual acuity in keratoconus patients, particularly for subjects within a better visual acuity range. This could provide physicians with a quantifiable outcome to enhance teleconsultations, especially relevant when access to health care is limited. Regarding the assessment of the refractive error, the web-based tool was found to be inferior to the manifest refraction in keratoconus patients. This study underlines the importance of validating digital tools and could serve to increase overall safety of the web-based assessments by better identification of outlier cases.

Quality Innovation Networks Share Varied Resources for Nursing Homes on Mostly User-Friendly Websites.

BACKGROUND/OBJECTIVE: Quality innovation networks' (QINs') support of nursing homes (NHs) is a national strategy to systematically improve the quality of care experienced by residents. QINs have been tasked with providing NHs with information, resources, tools, and training to assist in developing best practices and to support quality improvement efforts in infection prevention (including joining the National Healthcare Safety Network [NHSN]), avoid unnecessary hospitalizations, and increase use of hospice and palliative care. Our objective was to examine QIN online resources provided to NHs to support best practices and improvement efforts. DESIGN: An environmental scan was conducted. SETTING/MEASUREMENT: Each QIN website was evaluated on (1) usability, (2) accessibility and prominence, (3) website design, (4) availability of training materials, (5) recency of update, (6) identification of key personnel, and (8) quality focus areas (ie, infection prevention, NHSN, antibiotic stewardship, reducing unnecessary or avoidable hospitalizations, and palliative and hospice care). RESULTS: QIN websites varied dramatically in design and resources offered to NHs as well as in the content and ease of finding information. Antibiotic stewardship and NHSN resources were widely available. Information (ie, fact sheets) on reducing avoidable hospitalizations was commonly available, while resources, such as tool kits, webinars, training, and contact information for personnel on reducing avoidable hospitalizations, were available to 23 states. Infection prevention resources were varied and limited to 34 states. Both palliative care and hospice resources were available through only a few QINs (13 states and 20 states, respectively). CONCLUSIONS: Given that much of the information, tool kits, and resources are standardized and in the public domain, centralized resources with tailored or specialized links to unique local resources, like in-person trainings and state-specific contact information, could be more beneficial for NHs. J Am Geriatr Soc 67:2376-2381, 2019.

Healthy People for the 21st Century: Understanding Use of Healthy People 2020 as a Web-Based Initiative.

OBJECTIVE: This study assesses how the nation's preeminent health promotion and disease prevention initiative, Healthy People, is utilized by key stakeholders. METHODS: A Web-based survey was administered to assess awareness and use of Healthy People among state, local, tribal health organizations and other key stakeholder groups. Follow-up interviews were conducted with a subset of respondents. RESULTS: Awareness and use of Healthy People have remained high among state, local, and tribal stakeholders. Healthy People 2020 is most frequently used as a data source. The Leading Health Indicators (LHIs) are an important element of the initiative, and nearly 90% of organizations that use the LHIs found them valuable. Awareness and use of other tools and resources are more limited. CONCLUSIONS: Healthy People continues to be a valued resource among public health stakeholders; however, continued outreach is needed to promote the use of tools and resources available on healthypeople.gov for this decade and beyond. Healthy People is a national initiative used most frequently as a data source by state and local health departments, tribal organizations, and other public health practitioners.

Evaluation of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Fellowship Program Website Content and Quality.

PURPOSE: The qualities that applicants value in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellowship programs have been studied, but the availability of this information on program websites has not yet been reviewed. The authors evaluated the availability of resident-valued ASOPRS fellowship program information on the Internet. METHODS: The authors performed an Internet search of the 53 ASOPRS fellowship program websites and evaluated websites for 20 characteristics of interest to ASOPRS fellowship applicants such as teaching faculty, program description, rotation schedule, operative cases, and interview information. RESULTS: Of the 53 ASOPRS fellowship programs, 43 (81.1%) had a fellowship program-dedicated website. The fellowship websites contained a mean 7.6 characteristics (38.1%, range 0-15). Faculty listing, program description, and case diversity were the most commonly included data (74.4%, 72.1%, and 69.8%, respectively). Fellow selection process, interview information, and graduate job placement were least commonly included (7.0%, 2.3%, and 0.0%, respectively). There was no significant difference in website inclusiveness based on fellowship region or faculty number. Programs affiliated with an ophthalmology residency were more complete than those that were not (40.3% vs. 20.0%, p = 0.0098). CONCLUSIONS: This review found that most programs had websites and contained a reasonable number of characteristics. However, applicant-valued information regarding surgical volume, procedure variety, application information, and postgraduate employment history were often missing. American Society of Ophthalmic Plastic and Reconstructive Surgery fellowship programs may improve match outcomes by providing and enhancing program websites with details that their applicants seek.

Protein single-model quality assessment by feature-based probability density functions.

Protein quality assessment (QA) has played an important role in protein structure prediction. We developed a novel single-model quality assessment method-Qprob. Qprob calculates the absolute error for each protein feature value against the true quality scores (i.e. GDT-TS scores) of protein structural models, and uses them to estimate its probability density distribution for quality assessment. Qprob has been blindly tested on the 11th Critical Assessment of Techniques for Protein Structure Prediction (CASP11) as MULTICOM-NOVEL server. The official CASP result shows that Qprob ranks as one of the top single-model QA methods. In addition, Qprob makes contributions to our protein tertiary structure predictor MULTICOM, which is officially ranked 3rd out of 143 predictors. The good performance shows that Qprob is good at assessing the quality of models of hard targets. These results demonstrate that this new probability density distribution based method is effective for protein single-model quality assessment and is useful for protein structure prediction. The webserver of Qprob is available at: http://calla.rnet.missouri.edu/qprob/. The software is now freely available in the web server of Qprob.

e-Dermatología: redes sociales y otros recursos web / e-Dermatology: social networks and other web based tools

La utilización de las redes sociales e Internet como herramientas para buscar información médica por parte de los pacientes es ya un fenómeno cotidiano, y si los dermatólogos queremos participar en esa conversación, aportando contenidos de calidad, deberemos adaptarnos a este nuevo escenario e incorporar nuevas maneras de comunicarnos, tanto con pacientes como con otros profesionales. Decenas de dermatólogos españoles han roto ya esa brecha digital y han empezado a aportar contenido relevante en forma de blogs, cuyos contenidos difunden a través de las redes sociales. Pero la utilización de estas nuevas tecnologías no se encuentra exenta de riesgos desde un punto de vista ético y deontológico, además de poner en juego nuestra reputación digital. Internet también conlleva una saturación por exceso de información, y el adecuado uso de ciertas herramientas puede evitar esa infoxicación y mejorar nuestra productividad

The use by patients of social networking sites and the Internet to look for health related information has already become an everyday phenomenon. If, as dermatologists, we want to be part of this new conversation and provide quality content, we will have to adapt to digital media and find new ways of communicating with both our patients and our colleagues. Dozens of Spanish dermatologists have already ventured into the online space and have begun to provide important content through blogs, which they also disseminate via the social media. However, the use of these new technologies can also pose certain risks from the standpoint of ethics and our codes of practice and even place an individual's digital reputation in jeopardy. Another aspect of this new situation is that the Internet produces information saturation, and the appropriate use of certain tools can help to improve our productivity and prevent such information overload or infoxication

Influencia de la website sobre el patrocinio: Segmentación PLS-POS / The influence of websites on soponsorship: PLS-Pos segmentation

El patrocinio es una de las técnicas de marketing no convencionales que más inversión atrae en el área deportiva. Junto con el sitio web, es una de las principales fuentes de ingresos de las entidades y organizaciones deportivas. Este estudio aplica una segmentación no observada orientada a la predicción (PLS-POS) con el objetivo de examinar el efecto del sitio web sobre el proceso de transmisión de imagen según la teoría propuesta por Gwinner (1997). Obtuvimos 225 encuestas insertando un cuestionario creado ad hoc en un banner de un evento internacional de tenis. La variable actitud hacia el deporte es la mejor variable para segmentar la muestra según los resultados del PLS-POS y la técnica de árbol de decisión CHAID. El estudio aporta dos importantes novedades, por un lado examina la influencia del sitio web sobre el efecto del patrocinio, y por otro, aplica una metodología inédita en el estudio del patrocinio

Sponsorship is among the unconventional marketing techniques that attract the most investment in the sports field. Along with webs, sponsorship is one the main sources of income for sports entities and organizations. Following Gwinner’s theory (1997), this study applies a predictionoriented unobserved segmentation (PLS-POS) with the aim of exploring the impact of websites on the image transfer process. We gathered 225 surveys by displaying a banner in a tennis international event. The variable ‘attitude towards sport’ is the best one for segmenting the sample according to the results of the PLS-POS method and the CHAID decision tree technique. The study introduces two significant developments: on one hand, it analyzes the impact of websites on the effect of sponsorship, while on the other hand it applies an unprecedented methodology to the study of sponsorship

Sitio web de inmunología para el sistema Cubano de salud / A website on immunology for the Cuban health system

Introducción: las páginas web, sitios web, blogs u otras formas de publicación digital permiten promover la construcción colectiva del conocimiento, la generación de oportunidades de aprendizaje y la toma de decisiones más acertadas. La actualización en inmunología, su relación con la fisiología humana y las enfermedades que la afectan, son de competencia para todas las especialidades médicas. Objetivo: crear un sitio web para reunir toda la variedad posible de recursos de información en esta disciplina. Métodos: el sitio web de inmunología fue creado con herramientas digitales destinadas por Infomed e Infomed 2.0 para tales fines: WordPress, AdminPor y la plataforma de blogs. Se mantiene actualizado por medio de la búsqueda activa y diseminación de información relevante y pertinente. Como novedad, los términos que describen las enfermedades, genes y cromosomas mencionados en las notas publicadas, son enlazados por medio de hipervínculos a bases de datos internacionales, de referencia para el conocimiento de los términos en cuestión: OMIM, Gene y Ensembl, respectivamente. Resultados: entre los recursos disponibles por medio de enlaces en el sitio están 11 guías de práctica clínica, 53 revistas científicas, 70 libros o capítulos, 20 sociedades científicas y un repositorio de artículos con 405 trabajos de revisión a texto completo. Se aportan elementos de la historia de la especialidad y se presentan instituciones que laboran en ese campo en Cuba. Conclusiones: se proporciona de este modo una amplia colección de recursos para elevar la competencia y el desempeño profesionales en esta especialidad(AU)

Introduction: Webpages, websites, blogs or other variants of digital publication allow to promote the collective construction of knowledge, the generation of new opportunities for learning and more appropriate decision making. Updating on immunology, its relation to human physiology and the diseases affecting human health, are a competence for all medical specialties. Objective: to create a website in order to collect the increasing variety of information resources of such discipline. Methods: The website on Immunology specialty was created with the digital tools available for such purposes from Infomed and Infomed 2.0: WordPress, AdminPor and the blogs platform. It is updated by an active search and dissemination of relevant and pertinent information. As a novelty, terms describing diseases, genes and chromosomes that are mentioned in the published posts, are linked to international databases of reference for the knowledge of the respective expressions: OMIM, Gene and Ensembl. Results: Among the available resources through hypertext in the website are 11 clinical practice guidelines, 53 scientific journals, 70 books or chapters, 20 scientific societies and a repository of articles containing 405 free full text review papers. Elements about the history of the speciality and the institutions working on the field in Cuba are also covered. Conclusions: A wide collection of resources is offered in order to increase the professional abilities and skills in this speciality(AU)

The quality of pediatric orthopaedic information on the internet.

BACKGROUND: Many patients use the Internet for health information. However, there are few guarantees to the reliability and accuracy of this information. This study examined the quality and content of the Internet Web pages for 10 common pediatric orthopaedic diagnoses. METHODS: We identified 10 common diagnoses in pediatric orthopaedics: brachial plexus injury, cerebral palsy, clubfoot, developmental dysplasia of the hip, leg length discrepancy, osteochondroma, polydactyly, scoliosis, spina bifida, and syndactyly. We used 2 of the most popular search engines to identify the top 10 Web sites for each disease. We evaluated the Web sites utilizing both the quality-based Health On the Net (HON) Foundation criteria and our own content-based grading sheets. The custom grading sheets focused on essential information about disease summary, pathogenesis, diagnosis, treatment, and prognosis. RESULTS: Three orthopaedic surgeons graded 98 academic, commercial, nonprofit, and physicians' Web sites for 10 diseases. Academic Web sites scored the highest in content (mean, 60.8% ± 15.5%), whereas commercial Web sites scored the lowest (mean, 46.7% ± 22.2%). Among the diagnoses, osteochondroma Web sites had the highest content scores (mean, 75.8% ± 11.8%), whereas polydactyly Web sites had the lowest content scores (mean, 39.3% ± 15.7%). In contrast, Web sites about developmental dysplasia of the hip had the highest HON scores (65.0 ± 11.1), whereas those about brachial plexus birth palsy scored the lowest (42.6% ± 16.9%). Among the content subgroups, scores were generally higher for disease summary and diagnostics and lower for prognosis. CONCLUSIONS: The Internet Web sites reviewed demonstrated a wide range of content and information. We found that nonprofit and academic Web sites were the most reliable sources, whereas commercial and, surprisingly, physician-run Web sites were the least reliable. We advise physicians to talk to their patients about the information they get on the Internet and how it dictates their expectations. We hope this study, combined with further understanding of how our patients use this information, can help improve the Internet content. CLINICAL RELEVANCE: Physicians should know that their patients may be receiving misleading information from the Internet and be able to discuss this with their patients.

An online tool for improving biospecimen data element reporting.

Detailed documentation of the experimental materials and methods is essential for the validation of scientific papers. Human biospecimens are increasingly utilized as materials in cancer research and information about the biospecimens used is a component of this documentation. We hypothesized that previously reported biospecimen data are inadequate for accurate replication and/or validation of a substantial proportion of studies. To examine this issue, we analyzed biospecimen reporting in a representative cross section of publications over the past 12 years (1998, 2004, 2010) in the journals, Cancer Research (CR, n=46) and Clinical Cancer Research (CCR, n=73). We assessed biospecimen data in relation to the standards outlined as the Tier 1 recommended data elements from the Biospecimen Reporting for Improved Study Quality (BRISQ), in addition to ethics criteria. These data elements encompass features of biospecimens influenced by the patient, medical procedure, and biospecimen acquisition, handling and storage processes. Analysis found that while there was a significant increase in the reporting of ethics board approval status (p<0.008) and name of the ethics board (p<0.0001), there were no significant differences between these journals or over this period in reporting other biospecimen-related data elements. Of the 15 Tier 1 data elements assessed in CR and CCR, the data elements commonly obtained from the "Clinical Chart" (8/15 elements) were significantly better reported than elements that would typically be obtained from the "Biobank" (p<0.0001). Our findings demonstrate that reporting of biospecimen-related data elements has been incomplete. As one part of the solution to this issue, we propose the use of an online data-elements reporting tool (www.biobanking.ca) by biobanks. This BRISQ Report tool aims to help biobanks provide the relevant biospecimen-related data as a structured report, and to promote its inclusion as supplementary material in publications to improve the quality of future research studies.

Web-based course for teaching Human Anatomy. The UPF experience

The extraordinary development of new technologies has led to enormous changes in Undergraduate Education. These changes concern several aspects in teacher/student relationships, and imply new approaches to the teaching of theoretical and practical classes and to the preparation of additional materials. Human Anatomy is an ideal subject with which to use these new teaching tools. The teaching methods for this subject are easily adapted to new technologies, and with the introduction of new imaging and therapeutic techniques the need for knowledge has also changed significantly in recent years. In the last few years many initiatives that link new needs in anatomic knowledge with the new facilities offered by computer technology have been taken and show promising results. The use of multimedia materials makes the subject much more appealing for new generations of students, who are more familiar with computers than teachers and are accustomed to using research materials and information from non-conventional resources. Here we describe our experience over the last four years of introducing multimedia materials via Internet to teach Human Anatomy in the Biology degree at the Universitat Pompeu Fabra in Barcelona (Spain) (AU)

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