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1.
Artigo em Inglês | MEDLINE | ID: mdl-39216510

RESUMO

Foreign language syndrome (FLS) is a rare phenomenon described as transient fixation on a second language following anesthesia administration. There have only been 12 previously reported cases of FLS and none involving female patients or oral and maxillofacial surgery (OMS). While volatile anesthetics were administered during at least 2 cases, at minimum 5 cases occurred without volatile anesthetics - instead manifesting with IV sedation medications commonly used with OMS outpatient procedures (ie, midazolam, fentanyl, and propofol). In our case, a healthy 21-year-old female underwent extraction of wisdom teeth under general anesthesia and developed FLS. Our purpose is not to elucidate the poorly understood pathophysiology of FLS but raise awareness of its potential following OMS procedures. FLS may be difficult to diagnose but appears to be self-limiting and typically resolves within approximately 24 hours. No stroke workup is warranted, and discharge home is likely appropriate with phone follow-up the following day.

2.
J Med Internet Res ; 26: e55757, 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39037772

RESUMO

BACKGROUND: The proliferation of digital technology has the potential to transform diabetes management. One of the critical aspects of modern diabetes management remains the achievement of glycemic targets to avoid acute and long-term complications. OBJECTIVE: This study aims to describe the landscape of evidence pertaining to the relative effectiveness or efficacy and safety of various digital interventions for the self-management of type 2 diabetes mellitus (T2DM), with a primary focus on reducing glycated hemoglobin A1c (HbA1c) levels. METHODS: A systematic literature review (SLR) was conducted by searching Embase, MEDLINE, and CENTRAL on April 5, 2022. Study selection, data extraction, and quality assessment were performed by 2 independent reviewers. Eligibility criteria for the SLR included randomized controlled trials (RCTs) and comparative observational studies evaluating interventions containing both human (eg, coaching) and digital components (eg, glucose meter) in adult patients with T2DM. The primary meta-analysis was restricted to studies that reported laboratory-measured HbA1c. In secondary analyses, meta-regression was performed with the intensity of coaching in the digital intervention as a categorical covariate. RESULTS: In total, 28 studies were included in this analysis. Most studies (23/28, 82%) used the reduction of HbA1c levels as the primary end point, either directly or as a part of a multicomponent outcome. In total, 21 studies reported statistically significant results with this primary end point. When stratified into 3 intervention categories by the intensity of the intervention supporting the digital health technology (analyzing all 28 studies), the success rate appeared to be proportional to the coaching intensity (ie, higher-intensity studies reported higher success rates). When the analysis was restricted to RCTs using the comparative improvement of HbA1c levels, the effectiveness of the interventions was less clear. Only half (12/23, 52%) of the included RCTs reported statistically significant results. The meta-analyses were broadly aligned with the results of the SLR. The primary analysis estimated a greater reduction in HbA1c associated with digital interventions compared with usual care (-0.31%, 95% CI -0.45% to -0.16%; P<.001). Meta-regression estimated reductions of -0.45% (95% CI -0.81% to -0.09%; P=.02), -0.29% (95% CI -0.48% to -0.11%; P=.003), and -0.28% (95% CI -0.65% to 0.09%; P=.20) associated with high-, medium-, and low-intensity interventions, respectively. CONCLUSIONS: These findings suggest that reducing HbA1c levels in individuals with T2DM with the help of digital interventions is feasible, effective, and acceptable. One common feature of effective digital health interventions was the availability of timely and responsive personalized coaching by a dedicated health care professional.


Assuntos
Diabetes Mellitus Tipo 2 , Hemoglobinas Glicadas , Autogestão , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangue , Humanos , Autogestão/métodos , Hemoglobinas Glicadas/análise , Ensaios Clínicos Controlados Aleatórios como Assunto , Automonitorização da Glicemia/métodos
3.
Endocr Pract ; 29(10): 830-847, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37460058

RESUMO

Increasingly, people with diabetes (PWD) are using wearable and other devices to support self-management. During air travel, there are 4 stakeholders involved in maximizing the safety of wireless devices for diabetes care used in flight: (1) manufacturers of the devices, (2) airlines, (3) the Transportation Security Administration, and (4) the U.S. Food and Drug Administration. These stakeholders have all developed technologies and policies that assist PWD who prepare for and take appropriate actions during long-haul flights. This article discusses the performance and use of 6 classes of specific wireless diabetes devices during an airplane flight, including the following: (1) blood glucose monitors, (2) continuous glucose monitors, (3) insulin pumps, (4) smart pens for dosing insulin injections, (5) advanced hybrid closed-loop systems, and (6) spinal cord stimulators for painful diabetic neuropathy. Through the policies and safeguards of the 4 stakeholders and the proper self-care measures that insulin-using PWD can take, it is possible to maintain safe glycemic levels on flights across multiple time zones.

4.
Small ; 16(44): e2002837, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33030299

RESUMO

Despite their potential as a next-generation alternative to current state-of-the-art lithium (Li)-ion batteries, rechargeable aqueous zinc (Zn)-ion batteries still lag in practical use due to their low energy density, sluggish redox kinetics, and limited cyclability. In sharp contrast to previous studies that have mostly focused on materials development, herein, a new electrode architecture strategy based on a 3D bicontinuous heterofibrous network scaffold (HNS) is presented. The HNS is an intermingled nanofibrous mixture composed of single-walled carbon nanotubes (SWCNTs, for electron-conduction channels) and hydrophilic cellulose nanofibers (CNFs, for electrolyte accessibility). As proof-of-concept for the HNS electrode, manganese dioxide (MnO2 ) particles, one of the representative Zn-ion cathode active materials, are chosen. The HNS allows uniform dispersion of MnO2 particles and constructs bicontinuous electron/ion conduction pathways over the entire HNS electrode (containing no metallic foil current collectors), thereby facilitating the redox kinetics (in particular, the intercalation/deintercalation of Zn2+ ions) of MnO2 particles. Driven by these advantageous effects, the HNS electrode enables substantial improvements in the rate capability, cyclability (without structural disruption and aggregation of MnO2 ), and electrode sheet-based energy (91 Wh kgelectrode -1 )/power (1848 W kgelectrode -1 ) densities, which lie far beyond those achievable with conventional Zn-ion battery technologies.

5.
J Oral Maxillofac Surg ; 78(8): 1343-1348, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32360235

RESUMO

Angiofibromas located in the maxillofacial region are rare and almost exclusively occur in adolescent males. These benign tumors are highly vascular, locally invasive, and commonly found in the nasopharyngeal space. In the present report, we describe a very rare case of an intraosseous mandibular angiofibroma in a 23-year-old male patient with histomorphologic and molecular confirmation. This type of tumor occurring in the mandible has been reported previously only once, to the best of our knowledge.


Assuntos
Angiofibroma/diagnóstico por imagem , Angiofibroma/diagnóstico , Angiofibroma/cirurgia , Neoplasias de Cabeça e Pescoço , Neoplasias Nasofaríngeas , Adolescente , Adulto , Humanos , Masculino , Mandíbula , Nasofaringe , Adulto Jovem
6.
J Oral Maxillofac Surg ; 78(8): 1297-1303, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32360574

RESUMO

PURPOSE: The purpose of the present study was to correlate specific arthroscopic findings in temporomandibular joint (TMJ) arthroscopy and histologic results from arthroscopic-guided synovial biopsy. PATIENTS AND METHODS: A retrospective cohort study was completed of patients who had undergone arthroscopy and arthroscopic synovial biopsy from January 1, 2011 to March 31, 2016 at the senior author's practice in Miami, Florida. The demographic, arthroscopic, histologic, serologic, and historical variables were recorded by electronic medical record review. Two-tailed Fisher's exact tests were used to test the correlation of the arthroscopic and histologic variables. RESULTS: A total of 210 patients were included in the present study. The mean age was 43.1 ± 18.8 years, and the study population included 91.7% women. The following histologic findings had significant associations: lymphoplasmacytic infiltrate with petechiae synovitis (P = .0018), chronic inflammation with joint stenosis (P = .019), and crystal deposition with visualization of crystals (P = .0472). Hyperplastic synovium found on histologic examination was associated with both petechiae synovitis and adhesions. Histologic vascular proliferation was associated with synovial plica and joint stenosis. CONCLUSIONS: The findings from the present study indicated an association between specific findings during arthroscopy and histologic findings. A prospective study is required to validate the findings to evaluate their utility in patient care.


Assuntos
Sinovite , Transtornos da Articulação Temporomandibular , Adulto , Artroscopia , Feminino , Florida , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Membrana Sinovial , Articulação Temporomandibular , Adulto Jovem
7.
Diabetes Spectr ; 32(3): 231-236, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31462879

RESUMO

IN BRIEF Diabetes applications for electronic devices (apps) leverage the computing power and wireless connectivity of smartphones to offer unique advantages over more traditional tools such as paper logbooks and glucose meters. As these apps and the devices they connect with continue to evolve, health care providers play an important role in guiding patients by recommending specific apps, demonstrating best practices on their usage, and cautioning against their limitations.

8.
Ann Behav Med ; 51(2): 159-169, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27680568

RESUMO

BACKGROUND: Studies identifying correlates of physical activity (PA) at all levels of the ecological model can provide an empirical basis for designing interventions to increase older adults' PA. PURPOSE: Applying ecological model principles, this study concurrently examined individual, psychosocial, and environmental correlates of older adults' PA to determine whether built environment factors contribute to PA over and above individual/demographic and psychosocial variables. METHODS: Using a cross-sectional observational design, 726 adults, aged ≥66 years, were recruited from two US regions. Explanatory variables included demographics, self-efficacy, social support, barriers, and environmental variables measured by using geographic information systems (GIS) and self-report. Outcomes included reported walking for errands and leisure/exercise and accelerometer-measured daily moderate to vigorous PA (MVPA). Analyses employed mixed-model regressions with backward elimination. RESULTS: For daily MVPA, the only significant environmental variable was GIS-based proximity to a park (p < 0.001) after controlling for individual/demographic and psychosocial factors. Walking for errands was positively related to four environmental variables: reported walking/cycling facilities (p < 0.05), GIS-based intersection density (p < 0.01), mixed land use (p < 0.01), and private recreation facilities (p < 0.01). Walking for leisure/exercise was negatively related to GIS-based mixed land use (p < 0.05). Non-Hispanic white race/ethnicity, self-efficacy, and social support positively related to all three PA outcomes (p < 0.05). CONCLUSIONS: Correlates of older adults' PA were found at all ecological levels, supporting multiple levels of influence and need for multilevel interventions. Environmental correlates varied by PA outcome. Walking for errands exhibited the most environmental associations.


Assuntos
Planejamento Ambiental , Exercício Físico/psicologia , Atividades de Lazer , Recreação , Caminhada/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Modelos Teóricos , Autoeficácia
9.
Prev Med ; 96: 87-93, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28039068

RESUMO

While neighborhood design can potentially influence routine outdoor physical activities (PA), little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g., walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (2003-07; ages 70-89years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). Analyses were conducted on the 400 LIFE-Pilot participants randomized to a one-year endurance-plus-strengthening PA intervention or health education control that completed one-year PA assessment (CHAMPS questionnaire). Outcomes of interest were exercise and leisure walking, walking for errands, and moderate-intensity gardening. Neighborhood compactness was assessed objectively using geographic information systems via a subsequent grant (2008-12). PA increased weekly exercise and leisure walking relative to control, irrespective of neighborhood compactness. However, walking for errands decreased significantly more in PA relative to control (net mean [SD] difference=16.2min/week [7.7], p=0.037), particularly among those living in less compact neighborhoods (net mean [SD] difference=29.8 [10.8] minutes/week, p=0.006). PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls (net mean [SD] difference=29.3 [10.8] minutes/week, p=0.007). The results indicate that formal targeting of active transport as an adjunct to structured PA programs may be important to diminish potential compensatory responses in functionally impaired older adults. Structured endurance-plus-strengthening PA may help older adults maintain or increase such routine activities over time. TRIAL REGISTRATION: clinicaltrials.gov Identifier=NCT01072500.


Assuntos
Envelhecimento , Planejamento Ambiental/estatística & dados numéricos , Exercício Físico/fisiologia , Características de Residência/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Atividades de Lazer , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Caminhada
10.
Cephalalgia ; 36(2): 185-93, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25944818

RESUMO

BACKGROUND: Migraine headache is a neurological disorder affecting millions worldwide. However, little is known about the mechanisms contributing to migraine. Recent genome-wide association studies have found single nucleotide polymorphisms in the gene encoding transient receptor potential channel M8. Transient receptor potential channel M8 is generally known as a cold receptor but it has been implicated in pain signaling and may play a role in migraine pain. METHODS: In order to investigate whether transient receptor potential channel M8 may contribute to the pain of migraine, the transient receptor potential channel M8 activator icilin was applied to the dura mater using a rat behavioral model of headache. Cutaneous allodynia was measured for 5 hours using Von Frey filaments. RESULTS: Dural application of icilin produced cutaneous facial and hind paw allodynia that was attenuated by systemic pretreatment with the transient receptor potential channel M8-selective antagonist AMG1161 (10 mg/kg p.o.). Further, the anti-migraine agent sumatriptan (0.6 mg/kg s.c.) or the non-selective NOS inhibitor L-NAME (20 mg/kg i.p.) also attenuated allodynia when given as a pretreatment. CONCLUSIONS: These data indicate that transient receptor potential channel M8 activation in the meninges produces behaviors in rats that are consistent with migraine and that are sensitive to pharmacological mechanisms known to have efficacy for migraine in humans. The findings suggest that activation of meningeal transient receptor potential channel M8 may contribute to the pain of migraine.


Assuntos
Hiperalgesia/fisiopatologia , Transtornos de Enxaqueca/fisiopatologia , Canais de Cátion TRPM/metabolismo , Animais , Modelos Animais de Doenças , Hiperalgesia/metabolismo , Masculino , Transtornos de Enxaqueca/metabolismo , Pirimidinonas/farmacologia , Ratos , Ratos Sprague-Dawley
11.
Int J Behav Nutr Phys Act ; 12: 157, 2015 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-26684894

RESUMO

BACKGROUND: Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitations associated with subsequent disability. METHODS: The Lifestyle Interventions and Independence for Elders (LIFE) trial dataset (n = 1600) was used to explore the associations between perceived built environment variables and baseline obesity levels. Age-stratified recursive partitioning methods were applied to identify distinct subgroups with varying obesity prevalence. RESULTS: Among participants aged 70-78 years, four distinct subgroups, defined by combinations of perceived environment and race-ethnicity variables, were identified. The subgroups with the lowest obesity prevalence (45.5-59.4%) consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4%) consisted of non-African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. Overall support for the partitioned subgroupings was obtained using mixed model regression analysis. CONCLUSIONS: The results suggest that, in combination with race/ethnicity, features of the perceived neighborhood built and social environments differentiated distinct groups of vulnerable older adults from different age strata that differed in obesity prevalence. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation. TRIAL REGISTRATION: Clinicaltrials.gov Identifier = NCT01072500.


Assuntos
Pessoas com Deficiência , Meio Ambiente , Limitação da Mobilidade , Obesidade/epidemiologia , Características de Residência , Meio Social , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Planejamento Ambiental , Etnicidade , Feminino , Humanos , Estilo de Vida , Masculino , Percepção , Densidade Demográfica , Prevalência , Grupos Raciais , Risco
12.
J Sci Educ Technol ; 23(1): 138-144, 2014 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-24563603

RESUMO

Given limited funding for school-based science education, non-school-based programs have been developed at colleges and universities to increase the number of students entering science- and health-related careers and address critical workforce needs. However, few evaluations of such programs have been conducted. We report the design and methods of a controlled trial to evaluate the Stanford Medical Youth Science Program's Summer Residential Program (SRP), a 25-year-old university-based biomedical pipeline program. This 5-year matched cohort study uses an annual survey to assess educational and career outcomes among four cohorts of students who participate in the SRP and a matched comparison group of applicants who were not chosen to participate in the SRP. Matching on sociodemographic and academic background allows control for potential confounding. This design enables the testing of whether the SRP has an independent effect on educational- and career-related outcomes above and beyond the effects of other factors such as gender, ethnicity, socioeconomic background, and pre-intervention academic preparation. The results will help determine which curriculum components contribute most to successful outcomes and which students benefit most. After 4 years of follow-up, the results demonstrate high response rates from SRP participants and the comparison group with completion rates near 90%, similar response rates by gender and ethnicity, and little attrition with each additional year of follow-up. This design and methods can potentially be replicated to evaluate and improve other biomedical pipeline programs, which are increasingly important for equipping more students for science- and health-related careers.

13.
Cureus ; 16(8): e66414, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39119213

RESUMO

Pituitary macroadenomas, especially those complicated by internal hemorrhage (pituitary apoplexy), can lead to severe endocrine dysfunction and visual disturbances. This is particularly challenging to diagnose in the postpartum period due to physiological changes associated with childbirth and breastfeeding. This case report aims to highlight the diagnostic and therapeutic complexities of managing severe hyponatremia and visual changes in a woman with a pituitary macroadenoma in the postpartum period.A 34-year-old female, five months postpartum, presented with a one-month history of intermittent nausea, headaches, and blurry vision, which worsened over the past week. Initial laboratory results revealed severe hyponatremia with a sodium level of 112 mEq/L. Imaging studies, including MRI, confirmed a 1.9 x 1.8 x 1.7 cm pituitary macroadenoma with internal hemorrhage exerting mass effect on the optic chiasm. The patient was managed with hypertonic saline for hyponatremia and empiric glucocorticoid supplementation for suspected adrenal insufficiency. A multidisciplinary approach involving endocrinology, neurosurgery, and ophthalmology was employed to address her complex medical needs. This case underscores the importance of considering pituitary pathology in women presenting with severe hyponatremia and visual changes postpartum. A multidisciplinary approach is essential for optimal management and prevention of long-term complications. Early recognition and appropriate intervention are crucial in ensuring a favorable outcome.

14.
J Orthop Res ; 42(8): 1852-1860, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38433389

RESUMO

"Top 20" status on Doximity, an online networking service for medical professionals, is an indicator of the reputation of a residency program. The study assesses how training at a Top 20 (T20) orthopaedic residency program impacts career productivity and funding. Fellowship and Residency Electronic Interactive Database was used in 2022 to identify active orthopaedic residency programs. Demographic and training data was collected for each orthopaedic surgeon using institutional websites and Doximity. The Residency Navigator feature on Doximity was used to rank residency programs by "reputation." Programs were categorized as either T20 or non-T20. The relative citation ratio (RCR) was calculated using the NIH iCite tool and Hirsch index (h-index) was calculated using Scopus. Industry funding was collected from the Centers for Medicare & Medicaid Services Open Payments Program (CMS) for all available years (2014-2020). A total of 2812 academic orthopaedic surgeons were included in the study. Among academic orthopaedic surgeons in the United States, T20 trained orthopedists had more publications and citations (p < 0.001), along with higher h-indices (p < 0.001), RCR (p < 0.001), and industry funding (p = 0.043). Additionally, T20 trained orthopedists were 1.375 times more likely to obtain professor status (95% confidence interval: 1.150-1.645, p < 0.001). Even after propensity-matched analysis, T20 trained orthopedists maintained these differences. Training at a T20 residency program is associated with promotion, productivity, and funding. These findings are especially of concern to medical students who must consider the importance of a residency program's reputation when deciding where to apply for residency.


Assuntos
Internato e Residência , Internato e Residência/economia , Humanos , Cirurgiões Ortopédicos/educação , Cirurgiões Ortopédicos/economia , Estados Unidos , Eficiência , Ortopedia/educação , Ortopedia/economia , Feminino , Masculino
15.
Artigo em Inglês | MEDLINE | ID: mdl-38529210

RESUMO

Background: Academic medical centers greatly benefit from retaining their physicians; that ensures continuity in patient care, enhances resident education, and maintains a pool of experienced clinicians and researchers. Despite its importance, little research has been published on the retainment of academic faculty in orthopaedics. To address this gap, this study investigates the demographic trends of academic orthopaedic surgeons from 2016 to 2022. By analyzing data pertaining to gender distribution, years of practice, research productivity, and institutional rankings, we aimed to gain insights into the factors influencing faculty retainment, institution changes, and new entrants into academic orthopaedics. Methods: A retrospective cross-sectional analysis of U.S. academic orthopaedic surgeons affiliated with programs under the Accreditation Council for Graduate Medical Education (ACGME) in 2016 and 2022 was performed. Faculty present in both the 2016 and the 2022 data were classified as being "retained" in academia; those present only in 2016, as having "left" academia; and those present only in 2022, as being "new" to academia. The retained group was then divided into movers (those who moved to other institutions) and non-movers. Results: Retained orthopaedists had fewer years of practice, a higher h-index (Hirsch index), and more publications. Non-fellowship-trained orthopaedists had less retainment in academia, and orthopaedists with fellowships in oncology had more retainment in academia. Additionally, movers also had fewer years in practice but an equal level of scholarly productivity when compared with non-movers. Lastly, higher-ranked academic programs retained a greater proportion of orthopaedic surgeons. Conclusions: Over the study period, a majority of orthopaedists (56.99%) chose to remain in academia. Those retained tended to be in the earlier stages of their careers, yet demonstrated higher research output. Notably, the representation of female orthopaedists in academic orthopaedics is on the rise. Conversely, lower-ranked programs faced higher turnover rates, highlighting the challenges that they encounter in retaining faculty members. Clinical Relevance: Academic medical centers benefit from retaining orthopaedic surgeons by maintaining patient relationships, having consistency in resident education, and building on clinical and research expertise. Likewise, orthopaedists benefit from understanding the trends in current academic employment, in order to optimize career planning decisions.

16.
Sci Adv ; 10(14): eadn3784, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38569040

RESUMO

Conventional power-integrated wireless neural recording devices suffer from bulky, rigid batteries in head-mounted configurations, hindering the precise interpretation of the subject's natural behaviors. These power sources also pose risks of material leakage and overheating. We present the direct printing of a power-integrated wireless neural recording system that seamlessly conforms to the cranium. A quasi-solid-state Zn-ion microbattery was 3D-printed as a built-in power source geometrically synchronized to the shape of a mouse skull. Soft deep-brain neural probes, interconnections, and auxiliary electronics were also printed using liquid metals on the cranium with high resolutions. In vivo studies using mice demonstrated the reliability and biocompatibility of this wireless neural recording system, enabling the monitoring of neural activities across extensive brain regions without notable heat generation. This all-printed neural interface system revolutionizes brain research, providing bio-conformable, customizable configurations for improved data quality and naturalistic experimentation.


Assuntos
Encéfalo , Cabeça , Animais , Camundongos , Reprodutibilidade dos Testes , Crânio , Eletrônica , Tecnologia sem Fio
17.
J Diabetes Sci Technol ; : 19322968241275701, 2024 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-39369312

RESUMO

INTRODUCTION: An error grid compares measured versus reference glucose concentrations to assign clinical risk values to observed errors. Widely used error grids for blood glucose monitors (BGMs) have limited value because they do not also reflect clinical accuracy of continuous glucose monitors (CGMs). METHODS: Diabetes Technology Society (DTS) convened 89 international experts in glucose monitoring to (1) smooth the borders of the Surveillance Error Grid (SEG) zones and create a user-friendly tool-the DTS Error Grid; (2) define five risk zones of clinical point accuracy (A-E) to be identical for BGMs and CGMs; (3) determine a relationship between DTS Error Grid percent in Zone A and mean absolute relative difference (MARD) from analyzing 22 BGM and nine CGM accuracy studies; and (4) create trend risk categories (1-5) for CGM trend accuracy. RESULTS: The DTS Error Grid for point accuracy contains five risk zones (A-E) with straight-line borders that can be applied to both BGM and CGM accuracy data. In a data set combining point accuracy data from 18 BGMs, 2.6% of total data pairs equally moved from Zones A to B and vice versa (SEG compared with DTS Error Grid). For every 1% increase in percent data in Zone A, the MARD decreased by approximately 0.33%. We also created a DTS Trend Accuracy Matrix with five trend risk categories (1-5) for CGM-reported trend indicators compared with reference trends calculated from reference glucose. CONCLUSION: The DTS Error Grid combines contemporary clinician input regarding clinical point accuracy for BGMs and CGMs. The DTS Trend Accuracy Matrix assesses accuracy of CGM trend indicators.

18.
Ann Behav Med ; 46(2): 157-68, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23609341

RESUMO

BACKGROUND: Few studies have evaluated how to combine dietary and physical activity (PA) interventions to enhance adherence. PURPOSE: We tested how sequential versus simultaneous diet plus PA interventions affected behavior changes. METHODS: Two hundred participants over age 44 years not meeting national PA and dietary recommendations (daily fruit and vegetable servings and percent of calories from saturated fat) were randomized to one of four 12-month telephone interventions: sequential (exercise first or diet first), simultaneous, or attention control. At 4 months, the other health behavior was added in the sequential arms. RESULTS: Ninety-three percent of participants were retained through 12 months. At 4 months, only exercise first improved PA, and only the simultaneous and diet-first interventions improved dietary variables. At 12 months, mean levels of all behaviors in the simultaneous arm met recommendations, though not in the exercise- and diet-first arms. CONCLUSIONS: We observed a possible behavioral suppression effect of early dietary intervention on PA that merits investigation.


Assuntos
Dieta , Exercício Físico , Promoção da Saúde/métodos , Atividade Motora , Cooperação do Paciente/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais
19.
Artigo em Inglês | MEDLINE | ID: mdl-37406178

RESUMO

INTRODUCTION: Quantification of a researcher's productivity relies on objective bibliometric measurements, such as the Hirsch index (h-index). However, h-index is not field and time-normalized and possesses bias against newer researchers. Our study is the first to compare the relative citation ratio (RCR), a new article-level metric developed by the National Institutes of Health, with h-index in academic orthopaedics. METHODS: Academic orthopaedic programs in the United States were identified using the 2022 Fellowship and Residency Electronic Interactive Database. Available demographic and training data for surgeons were collected. RCR was calculated using the National Institutes of Health iCite tool, and h-index was calculated using Scopus. RESULTS: Two thousand eight hundred twelve academic orthopaedic surgeons were identified from 131 residency programs. H-index, weighted RCR (w-RCR), and mean RCR (m-RCR) all significantly differed by faculty rank and career duration. However, while h-index and w-RCR varied between sexes (P < 0.001), m-RCR did not (P = 0.066), despite men having a longer career duration (P < 0.001). DISCUSSION: We propose that m-RCR be used in conjunction with w-RCR or h-index to promote a fairer, comprehensive depiction of an orthopaedic surgeon's academic effect and productivity. Use of m-RCR may reduce the historic bias against women and younger surgeons in orthopaedics, which has implications in employment, promotion, and tenure.


Assuntos
Cirurgiões Ortopédicos , Ortopedia , Masculino , Humanos , Feminino , Estados Unidos , Eficiência , Docentes , Bibliometria
20.
J Orthop Res ; 41(7): 1494-1504, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36515300

RESUMO

The effects of locally applied zinc chloride (ZnCl2 ) on early and late-stage parameters of fracture healing were evaluated in a diabetic rat model. Type 1 Diabetes has been shown to negatively impact mechanical parameters of bone as well as biologic markers associated with bone healing. Zinc treatments have been shown to reverse those outcomes in tests of nondiabetic and diabetic animals. This study is the first to assess the efficacy of a noncarrier mediated ZnCl2 on bony healing in diabetic animals. This is a promising basic science approach which may lead to benefits for diabetic patients in the future. Treatment and healing were assessed through quantification of callus zinc, radiographic scoring, microcomputed tomography (µCT), histomorphometry, and mechanical testing. Local ZnCl2 treatment increased callus zinc levels at 1 and 3 days after fracture (p ≤ 0.025). Femur fractures treated with ZnCl2 showed increased mechanical properties after 4 and 6 weeks of healing. Histomorphometry of the ZnCl2 -treated fractures found increased callus cartilage area at Day 7 (p = 0.033) and increased callus bone area at Day 10 (p = 0.038). In contrast, callus cartilage area was decreased (p < 0.01) after 14 days in the ZnCl2 -treated rats. µCT analysis showed increased bone volume in the fracture callus of ZnCl2 -treated rats at 6 weeks (p = 0.0012) with an associated increase in the proportion of µCT voxel axial projections (Z-rays) spanning the fracture site. The results suggest that local ZnCl2 administration improves callus chondrogenesis leading to greater callus bone formation and improved fracture healing in diabetic rats.


Assuntos
Diabetes Mellitus Experimental , Fraturas do Fêmur , Ratos , Animais , Zinco/farmacologia , Diabetes Mellitus Experimental/complicações , Microtomografia por Raio-X , Calo Ósseo , Consolidação da Fratura , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/tratamento farmacológico , Fraturas do Fêmur/complicações
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