Design of Innovative Clothing for Pressure Injury Prevention: End-User Evaluation in a Mixed-Methods Study.

The global relevance of pressure injury (PI) prevention technologies arise from their impact on the quality of life of people with limited mobility and the costs associated with treating these preventable injuries. The purpose of this mixed methods study is to evaluate the design of a prototype integrating Smart Health Textiles for PI prevention based on feedback from specialist nurses who care for individuals who are prone to or have PIs. This is a mixed methods study. A structured questionnaire was conducted as part of an evaluation of a prototype garment for the prevention of PIs. This questionnaire was applied during the evaluation of the prototype and afterwards focus group discussions were held with experts. Descriptive statistics techniques were used to analyze the data and thematic and integrated content analysis was conducted through concomitant triangulation. Nineteen nurses took part, aged 30 to 39 years (52.6%) and with 12.31 ± 8.96 years of experience. Participants showed that the prototype required more manipulation and physical effort, which interfered its usefulness, in addition to presenting difficulties with the openings and the material of the closure system, which interfered with the ease of use and learning. Overall satisfaction with the product was moderate, with some areas for improvement found, such as satisfaction, recommendations to colleagues, and pleasantness of use. It is concluded that areas for improvement have been found in all dimensions, including in the design of openings and the choice of materials. These findings supply significant insights for improving clothing to meet the needs of healthcare professionals and patients.

Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol.

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.

End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups' show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

Intimate Relationships as Perceived by Adolescents: Concepts and Meanings.

Adolescence is a period of great changes and the assumption of risk behaviours at the level of sexuality may have implications for health and well-being. Nowadays, adolescents live free from constraints and prioritise freedom, using their own terminology to label their relationships, it becoming in turn important to conceptualise intimacy relationships from their perspective. Therefore, a qualitative, descriptive, and exploratory study was performed. Participants included 109 adolescents aged 14 and 18 years old from public schools in central Portugal. Data were collected using 12 focus groups and a content analysis was undertaken. These terms attributed to intimate relationships by adolescents are, for the most part, mutual for both genders: crush, friendzone, friends with benefits, making out, dating, and similar in terms of meaning. In an intimate relationship, adolescents give priority to factors such as respect, trust, and love. The fear of loneliness, obsession, and low self-esteem are reasons pointed out by adolescents for maintaining an unhealthy intimate relationship. Adolescents' knowledge of language about their intimate relationships is essential to establish effective communication and to build intervention programs in the healthy intimacy relationships field.

Detailed analysis of expression and promoter methylation status of apoptosis-related genes in prostate cancer.

Apoptosis is known to be involved in tumorigenesis and a defective ratio between cell proliferation and apoptosis may contribute to the emergence of a malignant phenotype. Transcriptional silencing of apoptosis-related genes associated with aberrant promoter methylation may impair the apoptotic machinery, ultimately leading to cancer development. Aberrant promoter methylation of numerous genes involved in many different pathways is frequent in prostate cancer. Our aim was to quantitatively assess the methylation status of several apoptosis-related genes in prostate adenocarcinoma (PCa) and its precursor lesion, high-grade prostatic intraepithelial neoplasia (HGPIN). First, 120 PCa and 39 HGPIN were screened for altered expression of BCL2, CASP8, CASP3, DAPK DR3, DR4, DR6, FAS, TMS1, TNFR2, using 28 benign prostate hyperplasias and 10 normal prostates as controls. Underexpressed genes were then assessed by quantitative methylation-specific PCR to determine the promoter methylation status. Finally, quantitative mRNA expression of aberrantly methylated genes was performed and methylation data was correlated with standard clinicopathologic parameters. DAPK, DR4 and TNFR2 were significantly overexpressed in HGPIN and PCa, whereas BCL2, TMS1, and FAS were downregulated. Although methylation levels were significantly higher for TMS1 and BCL2 (correlating with advanced stage), an inverse correlation with mRNA expression was found only for BCL2. We concluded that the apoptotic pathways are largely preserved in prostate carcinogenesis, in particular the extrinsic pathway, with the exception of FAS and TMS1, which are epigenetically downregulated. In addition, BCL2 was also found to be frequently silenced in PCa due to aberrant promoter methylation, thus supporting a future role for apoptosis-targeted therapy in prostate cancer.

Quantitative hypermethylation of a small panel of genes augments the diagnostic accuracy in fine-needle aspirate washings of breast lesions.

PURPOSE: We hypothesized that comprehensive breast cancer methylation profiling might provide biomarkers for diagnostic assessment of suspicious breast lesions using fine needle aspiration biopsy (FNA). EXPERIMENTAL DESIGN: Twenty-three gene promoters were surveyed by quantitative methylation-specific PCR in bisulfite-modified DNA from 66 breast carcinomas (BCa), 31 fibroadenomas (FB) and 12 normal breast (NT) samples to define a set of genes differentially methylated in malignant and non-malignant tissues. This set was tested in 78 FNA washings obtained pre-operatively (66 malignant, 12 benign), with histopathological diagnosis. Receiver operator characteristic (ROC) curve analysis identified a gene panel which might distinguish cancer from non-cancerous lesions. Finally, this panel was validated in an independent series of FNA washings (45 cases) in which cytomorphology did not reach definitive diagnosis. RESULTS: In tissue samples, 14-3-3-sigma, DAPK, CCND2, RASSF1A, CALCA, APC, HIN1, RARbeta2, TIG1, and GSTP1 methylation levels differed significantly among BCa, FB, and NT. ROC curve analysis identified a panel of four gene loci (CCND2, RASSF1A, APC, and HIN1) that discriminated BCa from benign lesions in a set of 78 FNA washings from histologically characterized breast lesions. When this panel was tested in the validation dataset of 45 FNA washings, breast cancer was identified with perfect specificity (100%) when 3 of 4 gene loci tested positive, providing estimated added information of 91% over cytomorphologic evaluation alone. CONCLUSIONS: Our data provide evidence that multigene methylation analysis augments diagnostic accuracy of cytological assessment of suspicious breast lesions, and might be a valuable ancillary tool for breast cancer diagnosis.

Flow cytometry evaluation of lead and cadmium effects on mouse spermatogenesis.

Flow cytometry (FCM) is a powerful tool to evaluate cell DNA content and ploidy levels. We have assessed the accuracy of two protocols of nuclei isolation from paraffinized samples (P1 and P2) by comparing FCM results with those obtained using fresh material (F1-F3). After isolation, nuclei were stained with propidium iodide and quantitatively analysed by FCM for changes in germ cell ratios. Results obtained with Protocol P2 were similar to those obtained using the protocol that gave best results for fresh tissues (F2). Protocol P2 was then applied to paraffin embedded testicular samples from ICR-CD1 mice exposed to 1, 2 and 3 mg CdCl(2)/kg bw by single subcutaneous injection, and to 74 and 100 mg PbCl(2)/kg bw administered in four repeated doses. The highest doses of CdCl(2) decreased the number of haploid (1C) cells and increased the number of diploid (2C), S phase and tetraploid (4C) cells. Treatment with PbCl(2) did not induce significant changes in testicular cells subpopulations. These results support the usefulness of FCM in evaluating the effect of toxic substances on mouse spermatogenesis, using both fresh and paraffinized material.