Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/22
Julio Ramirez
Improvement cycles are regularly used by performance improvement teams to optimize patients’ outcomes by improving the quality of care. One of the best-known cycles for performance improvement in healthcare is the Plan-Do-Study-Act (PDSA) cycle (Figure 1a).[1] During the first phase, Plan, we identify barriers to optimal care, develop a plan to implement new interventions, and identify the outcomes that will be monitored; during the second phase, Do, the new interventions are implemented; during the third phase, Study, we measure the outcomes defined in the planning phase to assess improvement; and during the fourth phase, Act, we make changes to our practice before beginning the next iteration of the cycle to improve implementation.
{"title":"Improvement Cycles in Medical Education: From Quality Improvement to Patient Care and Clinical Research","authors":"Julio Ramirez","doi":"10.18297/jri/vol5/iss1/22","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/22","url":null,"abstract":"Improvement cycles are regularly used by performance improvement teams to optimize patients’ outcomes by improving the quality of care. One of the best-known cycles for performance improvement in healthcare is the Plan-Do-Study-Act (PDSA) cycle (Figure 1a).[1] During the first phase, Plan, we identify barriers to optimal care, develop a plan to implement new interventions, and identify the outcomes that will be monitored; during the second phase, Do, the new interventions are implemented; during the third phase, Study, we measure the outcomes defined in the planning phase to assess improvement; and during the fourth phase, Act, we make changes to our practice before beginning the next iteration of the cycle to improve implementation.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75143266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/6
Julio A. Ramirez
{"title":"International Respiratory Infections Society COVID Research Conversations: Podcast 2 with Dr. Michael S. Niderman and Dr. Edward J. Schenck","authors":"Julio A. Ramirez","doi":"10.18297/jri/vol5/iss1/6","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/6","url":null,"abstract":"","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88344410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/17
Alejandra González, Mariano Fielli, Cytia Guzmán, G. Yusti, Pablo Idoyaga, A. Fernández
Streptococcus pneumoniae is the main causative agent of pneumonia, with a 10 to 25 percent rate of isolation in blood cultures. Controversies exist regarding the prognostic impact of a history of human immunodeficiency virus (HIV) infection on community-acquired pneumonia. The aim of our work was to analyze and compare the clinical presentation, radiological findings and progression of pneumococcal pneumonia in patients infected with and not infected with HIV. We retrospectively analyzed adult patients with positive blood cultures for Streptococcus pneumoniae and clinical and radiological findings compatible with pneumonia in the period between January 2012 and May 2017. Age, sex, comorbidities, clinical and laboratory variables, radiological severity, progression and mortality were analyzed. Comparative analysis between HIV-positive and -negative patients was carried out. Receiver operating curves (ROC) for CURB65 were performed to predict mortality in both groups. We included 107 patients (21 HIV-positive and 86 HIV-negative). HIV patients were on average younger (38 vs 58 years) with lower hematocrits (31.7 vs 36.5%) and fewer comorbidities (47 vs 72%). Overall mortality was 36 percent, and the area under the curve (AUC) of the CURB-65 ROC was 0.69 (95% confidence interval: 0.58–0.79) for all patients without differences between the two groups. Patients with a history of HIV infection had the same progression and mortality as the group of patients without that background.
{"title":"Characteristics and outcomes of bacteremic pneumococcal pneumonia of patients with and without HIV infection in Argentina","authors":"Alejandra González, Mariano Fielli, Cytia Guzmán, G. Yusti, Pablo Idoyaga, A. Fernández","doi":"10.18297/jri/vol5/iss1/17","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/17","url":null,"abstract":"Streptococcus pneumoniae is the main causative agent of pneumonia, with a 10 to 25 percent rate of isolation in blood cultures. Controversies exist regarding the prognostic impact of a history of human immunodeficiency virus (HIV) infection on community-acquired pneumonia. The aim of our work was to analyze and compare the clinical presentation, radiological findings and progression of pneumococcal pneumonia in patients infected with and not infected with HIV. We retrospectively analyzed adult patients with positive blood cultures for Streptococcus pneumoniae and clinical and radiological findings compatible with pneumonia in the period between January 2012 and May 2017. Age, sex, comorbidities, clinical and laboratory variables, radiological severity, progression and mortality were analyzed. Comparative analysis between HIV-positive and -negative patients was carried out. Receiver operating curves (ROC) for CURB65 were performed to predict mortality in both groups. We included 107 patients (21 HIV-positive and 86 HIV-negative). HIV patients were on average younger (38 vs 58 years) with lower hematocrits (31.7 vs 36.5%) and fewer comorbidities (47 vs 72%). Overall mortality was 36 percent, and the area under the curve (AUC) of the CURB-65 ROC was 0.69 (95% confidence interval: 0.58–0.79) for all patients without differences between the two groups. Patients with a history of HIV infection had the same progression and mortality as the group of patients without that background.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76576122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/29
Jeffrey F. Spindel
Introduction: Human prion diseases are a group of rare en- cephalopathies resulting in rapidly progressive dementia and ultimately death. While there are no effective treatments for any form of prion disease, prompt and efficient diagnosis is essential to prevent the spread of the self-propagating pro- tein, which may occur through aerosols, and avoid unnecessary or invasive testing. Diagnosis relies largely on physical examination, with many nonspecific findings, and laboratory testing, which has wide ranges of reported accuracy and high false positive rates with diseases such as Alzheimer’s dementia. Methods: Patients who underwent testing for prion dis- ease were retrospectively identified from the electronic health records at a single-center university hospital. Presenting symptoms, as well as laboratory, radiographic, and electroencephalogram findings, were recorded and analyzed by group of final diagnosis, including prion disease, not prion disease, and undiagnosed. Results: There were 27 patients identified, two who had a final diagnosis of prion disease, 20 who had a formal diagnosis other than prion disease, and five who remained undiagnosed until death. There was a high degree of overlap in present- ing symptoms. A high rate of false positive laboratory values, higher than previously reported, occurred for both the protein 14-3-3
{"title":"Prion Disease: A Challenging Diagnosis","authors":"Jeffrey F. Spindel","doi":"10.18297/jri/vol5/iss1/29","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/29","url":null,"abstract":"Introduction: Human prion diseases are a group of rare en- cephalopathies resulting in rapidly progressive dementia and ultimately death. While there are no effective treatments for any form of prion disease, prompt and efficient diagnosis is essential to prevent the spread of the self-propagating pro- tein, which may occur through aerosols, and avoid unnecessary or invasive testing. Diagnosis relies largely on physical examination, with many nonspecific findings, and laboratory testing, which has wide ranges of reported accuracy and high false positive rates with diseases such as Alzheimer’s dementia. Methods: Patients who underwent testing for prion dis- ease were retrospectively identified from the electronic health records at a single-center university hospital. Presenting symptoms, as well as laboratory, radiographic, and electroencephalogram findings, were recorded and analyzed by group of final diagnosis, including prion disease, not prion disease, and undiagnosed. Results: There were 27 patients identified, two who had a final diagnosis of prion disease, 20 who had a formal diagnosis other than prion disease, and five who remained undiagnosed until death. There was a high degree of overlap in present- ing symptoms. A high rate of false positive laboratory values, higher than previously reported, occurred for both the protein 14-3-3","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83573178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this study we revisit the identification of COVID-19 from chest x-ray images using Deep Learning. We collect a relatively large COVID-19 dataset comparing with previous studies that contains 309 real COVID-19 chest x-ray images. We prepare also 2000 chest x-ray images of pneumonia cases and 1000 images of healthy chest cases. Deep Transfer Learning is used to detect abnormalities in our images dataset. We fine-tune three pre-trained deep convolutional neural networks (CNNs) models on a training dataset; DenseNet 121, NASNetLarge and NASNetMobile. The evaluation of our models on a test dataset shows that these models achieve a sensitivity rate of around 99.45 % on average, and a specificity rate of around 99.5 % on average. These results could be helpful for an automatic diagnosis of COVID-19 infections, but the clinical diagnosis stills always necessary.
{"title":"COVID-19 Detection from Chest X-ray Images using CNNs Models: Further Evidence from Deep Transfer Learning","authors":"Mohamed Samir Boudrioua","doi":"10.2139/ssrn.3630150","DOIUrl":"https://doi.org/10.2139/ssrn.3630150","url":null,"abstract":"In this study we revisit the identification of COVID-19 from chest x-ray images using Deep Learning. We collect a relatively large COVID-19 dataset comparing with previous studies that contains 309 real COVID-19 chest x-ray images. We prepare also 2000 chest x-ray images of pneumonia cases and 1000 images of healthy chest cases. Deep Transfer Learning is used to detect abnormalities in our images dataset. We fine-tune three pre-trained deep convolutional neural networks (CNNs) models on a training dataset; DenseNet 121, NASNetLarge and NASNetMobile. The evaluation of our models on a test dataset shows that these models achieve a sensitivity rate of around 99.45 % on average, and a specificity rate of around 99.5 % on average. These results could be helpful for an automatic diagnosis of COVID-19 infections, but the clinical diagnosis stills always necessary.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84611408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.18297/JRI/VOL4/ISS1/5
F. Arnold, K. Mahmood, Angeline Prabhu, Darmaan Aden, Anupama Raghuram, Mark V. Burns, Leslie A Beavin, D. Chung, K. Palmer, J. Ramirez
{"title":"COPD exacerbation caused by SARS-CoV-2: A Case Report from the Louisville COVID-19 Surveillance Program","authors":"F. Arnold, K. Mahmood, Angeline Prabhu, Darmaan Aden, Anupama Raghuram, Mark V. Burns, Leslie A Beavin, D. Chung, K. Palmer, J. Ramirez","doi":"10.18297/JRI/VOL4/ISS1/5","DOIUrl":"https://doi.org/10.18297/JRI/VOL4/ISS1/5","url":null,"abstract":"","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44807112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/72
J. Ramirez
Background: Patients infected with the novel coronavirus SARS-CoV-2 are frequently hospitalized with community-acquired pneumonia (CAP). The objective of this study was to define the clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 CAP in the city of Louisville, KY. Methods: This was a retrospective observational study of 700 patients with SARS-CoV-2 infection hospitalized to eight of the adult hospitals in the city of Louisville. Patients with 1) a positive RT-PCR for SARS-CoV-2, 2) fever, cough, or shortness of breath, and 3) an infiltrate at chest imaging were defined as having SARS-CoV-2 CAP. Demographic characteristics of the study population were compared with census data from the city of Louisville. For each patient more than 500 variables were abstracted from electronic medical records and recorded using Research Electronic Data Capture software. Data was analyzed by descriptive and inferential statistics using R version 3.4.0. Results: SARS-CoV-2 CAP was identified in 632 (90%) patients hospitalized with COVID-19. The median age of the patients was 63 years, 53% were females, 31% were black and 12% Hispanic. The most frequent comorbidities were hypertension (56%), obesity (50%), and diabetes (33%). Mortality was 17% for the total population and 34% for the 249 patients admitted to ICU. For each category of race, ethnicity and comorbidities, the proportion of hospitalized patients with SARS-CoV-2 CAP was significantly different when compared to the Louisville population (p < 0.001). Conclusion: Patients of black race, Hispanic ethnicity, and patients with history of hypertension, obesity or diabetes are overrepresented among hospitalized patients with SARS-CoV-2 CAP when compared to the Louisville population. Hospitalized patients with SARS-CoV-2 CAP are likely to require ICU care, with death occurring in approximately one of six hospitalizations.
{"title":"Characteristics and Outcomes of Adults Hospitalized with SARS-CoV-2 Community-Acquired Pneumonia in Louisville, Kentucky","authors":"J. Ramirez","doi":"10.18297/jri/vol4/iss1/72","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/72","url":null,"abstract":"Background: Patients infected with the novel coronavirus SARS-CoV-2 are frequently hospitalized with community-acquired pneumonia (CAP). The objective of this study was to define the clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 CAP in the city of Louisville, KY. Methods: This was a retrospective observational study of 700 patients with SARS-CoV-2 infection hospitalized to eight of the adult hospitals in the city of Louisville. Patients with 1) a positive RT-PCR for SARS-CoV-2, 2) fever, cough, or shortness of breath, and 3) an infiltrate at chest imaging were defined as having SARS-CoV-2 CAP. Demographic characteristics of the study population were compared with census data from the city of Louisville. For each patient more than 500 variables were abstracted from electronic medical records and recorded using Research Electronic Data Capture software. Data was analyzed by descriptive and inferential statistics using R version 3.4.0. Results: SARS-CoV-2 CAP was identified in 632 (90%) patients hospitalized with COVID-19. The median age of the patients was 63 years, 53% were females, 31% were black and 12% Hispanic. The most frequent comorbidities were hypertension (56%), obesity (50%), and diabetes (33%). Mortality was 17% for the total population and 34% for the 249 patients admitted to ICU. For each category of race, ethnicity and comorbidities, the proportion of hospitalized patients with SARS-CoV-2 CAP was significantly different when compared to the Louisville population (p < 0.001). Conclusion: Patients of black race, Hispanic ethnicity, and patients with history of hypertension, obesity or diabetes are overrepresented among hospitalized patients with SARS-CoV-2 CAP when compared to the Louisville population. Hospitalized patients with SARS-CoV-2 CAP are likely to require ICU care, with death occurring in approximately one of six hospitalizations.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85708316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/12
Julio A. Ramirez
{"title":"Life in the Time of COVID","authors":"Julio A. Ramirez","doi":"10.18297/jri/vol4/iss1/12","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/12","url":null,"abstract":"","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73217099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/RGH/VOL4/ISS1/2
J. Ramirez, R. Carrico, R. Cavallazzi, Leslie A Beavin, Anupama Raghuram, Mark V. Burns, K. Mahmood, Darmaan Aden, Angeline Prabhu, Dawn Balcom, S. Furmanek, L. Wolf, K. Palmer, M. Tella, Connor Glick, F. Arnold
ULJRI | https://doi.org/10.18297/jri/vol4/iss1/2 1 Abstract The human coronaviruses (HCoVs) are an important etiology of community-acquired respiratory tract infections. Community-acquired pneumonia (CAP) may be caused by serotypes of endemic HCoVs or highly pathogenic HCoVs. In this review we compared the clinical characteristic, management, outcomes, and infection control practices for patients with CAP due to endemic HCoVs versus patients with CAP due to 2019 novel coronavirus (SARS-CoV-2).
{"title":"Community-Acquired Pneumonia due to Endemic Human Coronaviruses compared to 2019 Novel Coronavirus: A Review","authors":"J. Ramirez, R. Carrico, R. Cavallazzi, Leslie A Beavin, Anupama Raghuram, Mark V. Burns, K. Mahmood, Darmaan Aden, Angeline Prabhu, Dawn Balcom, S. Furmanek, L. Wolf, K. Palmer, M. Tella, Connor Glick, F. Arnold","doi":"10.18297/RGH/VOL4/ISS1/2","DOIUrl":"https://doi.org/10.18297/RGH/VOL4/ISS1/2","url":null,"abstract":"ULJRI | https://doi.org/10.18297/jri/vol4/iss1/2 1 Abstract The human coronaviruses (HCoVs) are an important etiology of community-acquired respiratory tract infections. Community-acquired pneumonia (CAP) may be caused by serotypes of endemic HCoVs or highly pathogenic HCoVs. In this review we compared the clinical characteristic, management, outcomes, and infection control practices for patients with CAP due to endemic HCoVs versus patients with CAP due to 2019 novel coronavirus (SARS-CoV-2).","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81987350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/JRI/VOL4/ISS1/7
Kamepalli, Fidsa, Cwsp, R. K
It is time we realize that food is a form of healthcare and promote a proper human dietary lifestyle. What is normal for one person may be poison for another. Being and getting healthy should not be predicated by any disease or infection that is out there. We human beings, who have been living with microbes in and on us, should not be afraid of the bug of the day. Whatever we do to survive as a human, depends on complex interactions of each one’s immune system with their own environment and how their unique genetic system interacts with epigenetic mechanisms with food, being the biggest influence. The interaction between multiple factors (environment, lifestyle, genetic/epigenetics, microbiome, lipidology, and immunology) predispose or protect one from acute or chronic disease processes and nutrition is the most important stimulation human genes get influenced by (Figure 1). The current mass medicine mindset helps with population-based theory generation, but the real solutions must be based on the N=1 personalized approach—if we have to fight the bug of the day. The dietary lifestyle one follows has a lot to do with the outcome of a disease process.
{"title":"How Immune T-Cell Augmentation Can Help Prevent COVID-19: A Possible Nutritional Solution Using Ketogenic Lifestyle","authors":"Kamepalli, Fidsa, Cwsp, R. K","doi":"10.18297/JRI/VOL4/ISS1/7","DOIUrl":"https://doi.org/10.18297/JRI/VOL4/ISS1/7","url":null,"abstract":"It is time we realize that food is a form of healthcare and promote a proper human dietary lifestyle. What is normal for one person may be poison for another. Being and getting healthy should not be predicated by any disease or infection that is out there. We human beings, who have been living with microbes in and on us, should not be afraid of the bug of the day. Whatever we do to survive as a human, depends on complex interactions of each one’s immune system with their own environment and how their unique genetic system interacts with epigenetic mechanisms with food, being the biggest influence. The interaction between multiple factors (environment, lifestyle, genetic/epigenetics, microbiome, lipidology, and immunology) predispose or protect one from acute or chronic disease processes and nutrition is the most important stimulation human genes get influenced by (Figure 1). The current mass medicine mindset helps with population-based theory generation, but the real solutions must be based on the N=1 personalized approach—if we have to fight the bug of the day. The dietary lifestyle one follows has a lot to do with the outcome of a disease process.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88565611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：