4,867 research outputs found
HYDRODYNAMIC MODEL STUDY OF A SHALLOW, STRATIFIED LAKE (L. PUSIANO, ITALY) FOR WATER QUALITY IMPROVEMENT PLANNING
No full textsj-docx-1-cjk-10.1177_20543581231192746 – Supplemental material for Development and Implementation of an Acute Kidney Injury Remote Patient Monitoring Program: Research Letter
No full textSupplemental material, sj-docx-1-cjk-10.1177_20543581231192746 for Development and Implementation of an Acute Kidney Injury Remote Patient Monitoring Program: Research Letter by Mariam Charkviani, Erin F. Barreto, Kristina K. Pearson, Brigid M. Amberg, Rachel H. Amundson, Sarah J. Bell, Eric J. Cleveland, Craig E. Daniels, Christopher M. Kohler, Angela M. Leuenberger, Lindsey M. Philpot, David A. Ramirez, Karen J. Reinschmidt, Ziad Zoghby and Andrea G. Kattah in Canadian Journal of Kidney Health and Disease</p
Data (i.e., evidence) about evidence based medicine
No full textUpdate — December 7, 2014. –
Evidence-based medicine (EBM) is not working for many reasons, for example:
1. Incorrect in their foundations (paradox): hierarchical levels of evidence are supported by opinions (i.e., lowest strength of evidence according to EBM) instead of real data collected from different types of study designs (i.e., evidence).
http://dx.doi.org/10.6084/m9.figshare.1122534
2. The effect of criminal practices by pharmaceutical companies is only possible because of the complicity of others: healthcare systems, professional associations, governmental and academic institutions. Pharmaceutical companies also corrupt at the personal level, politicians and political parties are on their payroll, medical professionals seduced by different types of gifts in exchange of prescriptions (i.e., bribery) which very likely results in patients not receiving the proper treatment for their disease, many times there is no such thing: healthy persons not needing pharmacological treatments of any kind are constantly misdiagnosed and treated with unnecessary drugs. Some medical professionals are converted in K.O.L. which is only a puppet appearing on stage to spread lies to their peers, a person supposedly trained to improve the well-being of others, now deceits on behalf of pharmaceutical companies. Probably the saddest thing is that many honest doctors are being misled by these lies created by the rules of pharmaceutical marketing instead of scientific, medical, and ethical principles. Interpretation of EBM in this context was not anticipated by their creators.
“The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs.” ―Peter C. Gøtzsche
“doctors and their organisations should recognise that it is unethical to receive money that has been earned in part through crimes that have harmed those people whose interests doctors are expected to take care of. Many crimes would be impossible to carry out if doctors weren’t willing to participate in them.” —Peter C Gøtzsche, The BMJ, 2012, Big pharma often commits corporate crime, and this must be stopped.
Pending (Colombia): Health Promoter Entities (In Spanish: EPS ―Empresas Promotoras de Salud).
3. Misinterpretations
New technologies or concepts are difficult to understand in the beginning, it doesn’t matter their simplicity, we need to get used to new tools aimed to improve our professional practice. Probably the best explanation is here in these videos (credits to Antonio Villafaina for sharing these videos with me).
English https://www.youtube.com/watch?v=pQHX-SjgQvQ&w=420&h=315
Spanish https://www.youtube.com/watch?v=DApozQBrlhU&w=420&h=315
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Hypothesis: hierarchical levels of evidence based medicine are wrong
Dear Editor,
I have data to support the hypothesis described in the title of this letter.
Before rejecting the null hypothesis I would like to ask the following open question:Could you support with data that hierarchical levels of evidence based medicine are correct? (1,2)
Additional explanation to this question:
– Only respond to this question attaching publicly available raw data.– Be aware that more than a question this is a challenge: I have data (i.e., evidence) which is contrary to classic (i.e., McMaster) or current (i.e., Oxford) hierarchical levels of evidence based medicine. An important part of this data (but not all) is publicly available.
References
1. Ramirez, Jorge H (2014): The EBM challenge. figshare. http://dx.doi.org/10.6084/m9.figshare.1135873
2. The EBM Challenge Day 1: No Answers.
Competing interests: I endorse the principles of open data in human biomedical research
Read this letter on The BMJ – August 13, 2014.http://www.bmj.com/content/348/bmj.g3725/rr/762595Re: Greenhalgh T, et al. Evidence based medicine: a movement in crisis? BMJ 2014; 348: g3725.
____________________________________
Fileset contents
Raw data:
Excel archive: Raw data, interactive figures, and PubMed search terms. Google Spreadsheet is also available (URL below the article description).
Figure 1.
Unadjusted (Fig 1A) and adjusted (Fig 1B) PubMed publication trends (01/01/1992 to 30/06/2014).
Figure 2.
Adjusted PubMed publication trends (07/01/2008 to 29/06/2014)
Figure 3.
Google search trends: Jan 2004 to Jun 2014 / 1-week periods.
Figure 4.
PubMed publication trends (1962-2013) systematic reviews and meta-analysis, clinical trials, and observational studies.
Figure 5.
Ramirez, Jorge H (2014): Infographics: Unpublished US phase 3 clinical trials (2002-2014) completed before Jan 2011 = 50.8%. figshare.http://dx.doi.org/10.6084/m9.figshare.1121675
Raw data: "13377 studies found for: Completed | Interventional Studies | Phase 3 | received from 01/01/2002 to 01/01/2014 | Worldwide".
This database complies with the terms and conditions of ClinicalTrials.gov:
http://clinicaltrials.gov/ct2/about-site/terms-conditions
Supplementary Figures (S1-S6). PubMed publication delay in the indexation processes does not explain the descending trends in the scientific output of evidence-based medicine.
Acknowledgments
I would like to acknowledge the following persons for providing valuable concepts in data visualization and infographics:
- Maria Fernanda Ramírez. Professor of graphic design. Universidad del Valle. Cali, Colombia.
- Lorena Franco. Graphic design student. Universidad del Valle. Cali, Colombia.
Related articles by this author (Jorge H. Ramírez)
1. Ramirez JH. Lack of transparency in clinical trials: a call for action. Colomb Med (Cali) 2013;44(4):243-6. URL: http://www.ncbi.nlm.nih.gov/pubmed/24892242
2. Ramirez JH. Re: Evidence based medicine is broken (17 June 2014). http://www.bmj.com/node/759181
3. Ramirez JH. Re: Global rules for global health: why we need an independent, impartial WHO (19 June 2014). http://www.bmj.com/node/759151
4. Ramirez JH. PubMed publication trends (1992 to 2014): evidence based medicine and clinical practice guidelines (04 July 2014). http://www.bmj.com/content/348/bmj.g3725/rr/759895
Recommended articles
1. Greenhalgh Trisha, Howick Jeremy,Maskrey Neal. Evidence based medicine: a movement in crisis? BMJ 2014;348:g3725
2. Spence Des. Evidence based medicine is broken BMJ 2014; 348:g22
3. Schünemann Holger J, Oxman Andrew D,Brozek Jan, Glasziou Paul, JaeschkeRoman, Vist Gunn E et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies BMJ 2008; 336:1106
4. Lau Joseph, Ioannidis John P A, TerrinNorma, Schmid Christopher H, OlkinIngram. The case of the misleading funnel plot BMJ 2006; 333:597
5. Moynihan R, Henry D, Moons KGM (2014) Using Evidence to Combat Overdiagnosis and Overtreatment: Evaluating Treatments, Tests, and Disease Definitions in the Time of Too Much. PLoS Med 11(7): e1001655. doi:10.1371/journal.pmed.1001655
6. Katz D. A-holistic view of evidence based medicinehttp://thehealthcareblog.com/blog/2014/05/02/a-holistic-view-of-evidence-based-medicine/
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The energy transition in the Dutch chemical industry – Worth its salt?: An analysis of decarbonization pathways in the salt and chlor-alkali industries in the Netherlands
No full textMIDDENEngineering and Policy Analysi
Recuperación de suelos degradados en zona de ladera del departamento del Cauca :
No full textIP 6295-13-200-99Incluye anexos.v.1. Informe final / Jose Manuel Restrepo -- v.2. Evaluacion dela adaptabilidad de dos especies de micorrizas Restrepo -- v.2. Evaluacion de la adaptabilidaddedos especiesde micorrizas / Viviana Andrea Ramirez, Yuri Viviana Luna Gomez, Doris Valencia Ramirez -'- v.3.Adaptabilidad de algunas leguminosas de cobertura para la recuperacion de suelos / Claudia MaritzaCastaño Ramirez... [et al.] --v.4. Inventario floristico de la zona erosionada de la subcuenca del rio aguacate (Municipio de Restrepo, departamento del Valle) / Andres F. Giraldo, Jose Manuel Restrepo M., Daniel Villada Z. --v.5. Instrumentos metodologicos y recursos utilizados para la recuperacion de suelos erosionadosen laderas/ Daniel Villada, Jose Manuel Restrepo M. -- v.6. Aplicacion del modelo hidrologico SWAT(Soiland WaterAssessment Tool), para la evaluacion del efecto de la cobertura del suelo sobre el comportamiento dela produccion de caudales solidos y liquidos en la subcuenca de la quebrada aguamona, cuenca alta del rio Dagua Valle del Cauca Colombia / Jhon Fernando Millan Castillo, Julian Yesid Isaza Rengifo.LIBRO(S): Inventario floristico de la zona erosionada de la subcuenca delrio aguacate / Andres F. Giraldo,;Jose Manuel Retrepo M., Daniel Villada Z.. Cali : FIDAR, 2001.-- 32 h. ;28 cm. -- Instrumentos metodologicos;y recursos utilizados para la recuperacion de suelos erosionadosen laderas / Daniel Villada, Jose Manuel;Restrepo M. Cali : FIDAR, 2001. -- 44 p. ; 28 cm
Recuperación de suelos degradados en zona de ladera del departamento del Cauca :
No full textIP 6295-13-200-99Incluye anexos.v.1. Informe final / Jose Manuel Restrepo -- v.2. Evaluacion dela adaptabilidad de dos especies de micorrizas Restrepo -- v.2. Evaluacion de la adaptabilidaddedos especiesde micorrizas / Viviana Andrea Ramirez, Yuri Viviana Luna Gomez, Doris Valencia Ramirez -'- v.3.Adaptabilidad de algunas leguminosas de cobertura para la recuperacion de suelos / Claudia MaritzaCastaño Ramirez... [et al.] --v.4. Inventario floristico de la zona erosionada de la subcuenca del rio aguacate (Municipio de Restrepo, departamento del Valle) / Andres F. Giraldo, Jose Manuel Restrepo M., Daniel Villada Z. --v.5. Instrumentos metodologicos y recursos utilizados para la recuperacion de suelos erosionadosen laderas/ Daniel Villada, Jose Manuel Restrepo M. -- v.6. Aplicacion del modelo hidrologico SWAT(Soiland WaterAssessment Tool), para la evaluacion del efecto de la cobertura del suelo sobre el comportamiento dela produccion de caudales solidos y liquidos en la subcuenca de la quebrada aguamona, cuenca alta del rio Dagua Valle del Cauca Colombia / Jhon Fernando Millan Castillo, Julian Yesid Isaza Rengifo.LIBRO(S): Inventario floristico de la zona erosionada de la subcuenca delrio aguacate / Andres F. Giraldo,;Jose Manuel Retrepo M., Daniel Villada Z.. Cali : FIDAR, 2001.-- 32 h. ;28 cm. -- Instrumentos metodologicos;y recursos utilizados para la recuperacion de suelos erosionadosen laderas / Daniel Villada, Jose Manuel;Restrepo M. Cali : FIDAR, 2001. -- 44 p. ; 28 cm
The role of magnesium in the electrochemical behaviour of 5XXX aluminium-magnesium alloys
No full textAn investigation concerning the effects of magnesium on the intergranular corrosion susceptibility of AA5XXX aluminium alloys was carried out. In the present work, magnesium is found to be highly mobile in the bulk metal as well as in the aluminium oxide. This mobility is also found to be dependent on the temperature and bulk magnesium concentration. Interestingly, the corrosion susceptibility of the AA5XXX series appears to be directly related to the magnesium mobility as well. It was found that magnesium is the most favoured alloying element in the aluminium metal that actively contributes to the formation and composition of the oxide layer. Nevertheless, the extent of this contribution strongly depends on the magnesium content of the alloy and the applied temperature. Auger composition-depth profiles performed on alloys with different Mg contents indicate that when the bulk magnesium concentration is high, the Mg enrichment on the oxide layer becomes stronger. This situation brings as a consequence the formation of thicker oxide layers. At grain boundaries, magnesium enrichment was measured and quantify. A mechanism for intergranular corrosion is proposed. This mechanism is based on the combination of three main factors: magnesium-rich precipitates at grain boundaries, magnesium enrichments at grain boundaries as free-atoms, and hydrogen diffusion into the grain boundaries.Mechanical Maritime and Materials Engineerin
Causas de muerte y factores de riesgo en la población infantil del municipio de Chinchiná- Caldas a finales del siglo xx
No full textText, mapas, imagenes y fotografíasspa:La mortalidad infantil además de ser un indicador demográfico, da cuenta de la calidad de vida y de atención que recibe este sector de la población. La cantidad de muertes y las causas de estas, evidencian transformaciones en las condiciones de salud de la población, al mostrar diversos comportamientos según sexo, edad y área de desarrollo (Cristancho Fajardo, 2017). En la presente investigación se buscó relacionar los principales factores de riesgo con la causa de muerte de los individuos entre 1 mes y 6 años de edad durante los años de 1970 a 1996 en el municipio de Chinchiná-Caldas. Para ello, se revisó las actas de defunción localizadas en la Basílica Menor Nuestra Señora de las mercedes, las cuales tienen datos de los individuos fallecidos entre los que se incluyen las enfermedades que ocasionaron la muerte. La enfermedad causa de muerte fueron clasificadas en cuatro grandes grupos, las enfermedades infecciosas y parasitarias, enfermedades respiratorias, las enfermedades nutricionales y metabólicas y las enfermedades inespecíficas. Los resultados indican que, la mortalidad infantil en Chinchiná durante los años 1970 a 1996 es más frecuente en las edades entre 1 y 3 años. Asimismo, las enfermedades más recurrentes fueron las infecciosas y parasitarias, además de las respiratorias, lo cual puede obedecer al impacto tanto de factores sociales y culturales como bilógicos presentes en la época estudiada.eng:Infant mortality, in addition to being a demographic indicator, accounts for the quality of life and care that this sector of the population receives. The number of deaths and their causes show transformations in the health conditions of the population, showing different behaviors according to sex, age and area of development (Cristancho Fajardo, 2017). In the present investigation, we sought to relate the main risk factors with the cause of death of individuals between 1 month and 6 years of age during the years 1970 to 1996 in the municipality of Chinchiná-Caldas. For this, the death certificates located in the Basilica Menor Nuestra Señora de las Mercedes were reviewed, which have data on the deceased individuals, including the diseases that caused death. The disease cause of death was classified into four large groups: infectious and parasitic diseases, respiratory diseases, nutritional and metabolic diseases, and nonspecific diseases. The results indicate that infant mortality in Chinchiná during the years 1970 to 1996 is more frequent in ages between 1 and 3 years. Likewise, the most recurrent diseases were infectious and parasitic, in addition to respiratory, which may be due to the impact of both social and cultural factors as well as biological ones present at the time studied.Lista de Imágenes 8/gráficas 9/Lista de Tablas 9/ RESUMEN 10/ CÁPITULO I 14/
Formulación del problema y Justificación 14/Objetivos 17/ CAPITULO II 18/
Antecedentes de la investigación18/Antecedentes de la muestra 21/CAPITULO III 28/Un acercamiento a la dinámica poblacional en términos epidemiológicos a través de los archivos históricos 28/Factor de riesgo 29/Causa de muerte 30/Actas de defunción
CAPITULO IV 32/histórico de la Basílica Menor Nuestra Señora de las Mercedes (BMNSM) 32/ histórico del Municipio de Chinchiná 35/Entrevistas 36/Análisis de datos 39/CAPITULO V 40/Resultados 40/Actas de defunción 40/Mortalidad infantil por grupos de enfermedades 50/Mortalidad infantil por rangos de edad 53/Periódicos 58/Entrevistas 61/CAPITULO VI 70/La mortalidad infantil en Chinchiná, Caldas entre los años de 1970-1996 70/ CONCLUSIONES 70/BIBLIOGRÁFIA 80/ANEXO 1 84/ANEXO 2 86/ANEXO 3 89.UniversitarioAntropólogo(a
An assembly model for the autophagy initiation complex
No full textThis electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Thesis: S.M., Massachusetts Institute of Technology, Department of Biology, 2019Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (pages 59-64).Autophagy is a highly conserved eukaryotic homeostasis process that facilitates degradation of intracellular components. During times of starvation, autophagy is vital in replenishing pools of biosynthetic precursors through degradation of these cytosolic components, and it also plays key roles in responding to cytotoxic stress as it acts to specifically degrade damaged organelles, aggregated proteins, and pathogens. This is achieved by the formation of an autophagosome, a double membrane organelle that engulfs cytoplasmic components and then fuses with the vacuole or the lysosome leading to degradation of the engulfed components. Of note, defects in autophagy have been genetically linked with cancer, neurodegeneration, inflammation and aging, highlighting the importance of deeply understanding this process. Although several genetic screens have enumerated the proteins required for autophagy, our mechanistic understanding of how these proteins interact and function in autophagy is very limited. In this work, I focus on the most upstream autophagy protein complex, called the Atg1 complex or autophagy initiation complex (AIC), which binds high curvature lipid vesicles and is thought to catalyze their fusion to initiate autophagosome biogenesis. In chapters 1-4 of this work, I review what is currently known about different steps of the mechanism of AIC formation, its interactions with lipid vesicles and its putative functional role in initiating autophagosome formation, highlighting outstanding questions throughout. Finally, in Chapter 5, I describe my efforts to develop a new single-molecule approach to study the mechanism of AIC assembly, and discuss the important unanswered questions that this new approach may allow us to address.by Daniel Fernando Ramirez Montero.S.M.S.M. Massachusetts Institute of Technology, Department of Biolog
Dynamic analysis of resistance in Colombian elite Hevea brasiliensis genotypes as a breeding strategy for enhancing South American leaf blight management under disease non-escape conditions in the Amazon region
No full textSouth American Leaf Blight (SALB) is the primary limitation to the establishment of new rubber (Hevea brasiliensis) crops in Latin America. This study aimed to assess the temporal dynamics of resistance to SALB in 99 elite Colombian genotypes and the IAN 873 cultivar (control) of H. brasiliensis in small-scale clone trials conducted under conditions with a high disease prevalence in the northwestern Colombian Amazon. Resistance monitoring was carried out on a monthly basis and analyzed over five climatic periods. Three variables were recorded: attack severity (AT, ranging from 0 to 4), reaction type (TR, ranging from 1 to 6) and stromal density (ST, ranging from 0 to 4). The maximum scores for TR and ST were used to classify the level of resistance of the genotypes. Highly significant differences in the mean values of AT, TR and ST among the genotypes, across the periods, and in the interaction between genotype and period were found. Over time, an increase in symptoms (AT) and signs (TR and ST) of SALB was observed. During the rainy periods, SALB intensity was highest, resulting in a leaf area affected ranging from 16 to 30%. Eight genotypes showed partial resistance (PR) (TR 5 or ST > 2). The temporal analysis identified 23 Colombian superior genotypes with varying degrees of SALB resistance, which can be a valuable breeding resource for improving SALB management in the Colombian Amazon region.Fil: Galindo Rodríguez, Lyda Constanza. Universidad de la Amzonia; ColombiaFil: Sterling, Armando. Universidad de la Amzonia; ColombiaFil: Muñoz Ramirez, Herminton. Universidad de la Amzonia; ColombiaFil: Martinez Moyano, Edgar. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Fonseca Restrepo, Jesica Andrea. Universidad de la Amzonia; ColombiaFil: Loaiza Molina, Luis Carlos. Universidad de la Amzonia; Colombi
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