Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 739
Filtrar
Más filtros

Intervalo de año de publicación
1.
Prev Med ; 180: 107881, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38286273

RESUMEN

Visual assessment is currently used for primary screening or triage of screen-positive individuals in cervical cancer screening programs. Most guidelines recommend screening and triage up to at least age 65 years old. We examined cervical images from participants in three National Cancer Institute funded cervical cancer screening studies: ALTS (2864 participants recruited between 1996 to 1998) in the United States (US), NHS (7548 in 1993) in Costa Rica, and the Biopsy study (684 between 2009 to 2012) in the US. Specifically, we assessed the visibility of the squamocolumnar junction (SCJ), which is the susceptible zone for precancer/cancer by age, as reported by colposcopist reviewers either at examination or review of cervical images. The visibility of the SCJ declined substantially with age: by the late 40s the majority of people screened had at most partially visible SCJ. On longitudinal analysis, the change in SCJ visibility from visible to not visible was largest for participants from ages 40-44 in ALTS and 50-54 in NHS. Of note, in the Biopsy study, the live colposcopic exam resulted in significantly higher SCJ visibility as compared to review of static images (Weighted kappa 0.27 (95% Confidence Interval: 0.21, 0.33), Asymmetry chi-square P-value<0.001). Lack of SCJ visibility leads to increased difficulty in diagnosis and management of cervical precancers. Therefore, cervical cancer screening programs reliant on visual assessment might consider lowering the upper age limit for screening if there are not adequately trained personnel and equipment to evaluate and manage participants with inadequately visible SCJ.


Asunto(s)
Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Femenino , Humanos , Anciano , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/patología , Detección Precoz del Cáncer/métodos , Displasia del Cuello del Útero/patología , Biopsia
2.
Health Care Manag Sci ; 27(2): 188-207, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38689176

RESUMEN

A patient fall is one of the adverse events in an inpatient unit of a hospital that can lead to disability and/or mortality. The medical literature suggests that increased visibility of patients by unit nurses is essential to improve patient monitoring and, in turn, reduce falls. However, such research has been descriptive in nature and does not provide an understanding of the characteristics of an optimal inpatient unit layout from a visibility-standpoint. To fill this gap, we adopt an interdisciplinary approach that combines the human field of view with facility layout design approaches. Specifically, we propose a bi-objective optimization model that jointly determines the optimal (i) location of a nurse in a nursing station and (ii) orientation of a patient's bed in a room for a given layout. The two objectives are maximizing the total visibility of all patients across patient rooms and minimizing inequity in visibility among those patients. We consider three different layout types, L-shaped, I-shaped, and Radial; these shapes exhibit the section of an inpatient unit that a nurse oversees. To estimate visibility, we employ the ray casting algorithm to quantify the visible target in a room when viewed by the nurse from the nursing station. The algorithm considers nurses' horizontal visual field and their depth of vision. Owing to the difficulty in solving the bi-objective model, we also propose a Multi-Objective Particle Swarm Optimization (MOPSO) heuristic to find (near) optimal solutions. Our findings suggest that the Radial layout appears to outperform the other two layouts in terms of the visibility-based objectives. We found that with a Radial layout, there can be an improvement of up to 50% in equity measure compared to an I-shaped layout. Similar improvements were observed when compared to the L-shaped layout as well. Further, the position of the patient's bed plays a role in maximizing the visibility of the patient's room. Insights from our work will enable understanding and quantifying the relationship between a physical layout and the corresponding provider-to-patient visibility to reduce adverse events.


Asunto(s)
Accidentes por Caídas , Algoritmos , Arquitectura y Construcción de Hospitales , Unidades Hospitalarias , Habitaciones de Pacientes , Humanos , Arquitectura y Construcción de Hospitales/métodos , Unidades Hospitalarias/organización & administración , Accidentes por Caídas/prevención & control , Habitaciones de Pacientes/organización & administración , Seguridad del Paciente , Personal de Enfermería en Hospital/organización & administración , Estaciones de Enfermería
3.
BMC Anesthesiol ; 24(1): 28, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38233786

RESUMEN

BACKGROUND: During arthroscopic rotator cuff repair (ARCR), clear surgical field visibility (SFV) is the basis of successful surgery, but the choice of anesthesia maintenance drugs may have different effects on SFV. In this study, we aimed to compare the effects of propofol- and sevoflurane-based general anesthesia on SFV in patients undergoing ARCR. METHODS: Patients (n = 130) undergoing elective ARCR in the lateral decubitus position were randomized into either the propofol group or sevoflurane group (65 per group). The duration of surgery and increased pressure irrigation (IPI), Boezaart score, rocuronium consumption and usage of remifentanil were recorded. The time of both spontaneous respiration recovery and extubation and the incidences of postoperative nausea and vomiting and agitation were also recorded. RESULTS: The Boezaart score, duration of IPI and ratio of the duration of IPI to the duration of surgery (IPI/S ratio) were similar between the groups (P > 0.05). Rocuronium consumption, number of patients requiring remifentanil infusion and total remifentanil consumption were significantly lower in the sevoflurane group (P < 0.05). The spontaneous respiration recovery time was significantly longer in the propofol group (P < 0.05), but there were no differences in the extubation time between the groups(P > 0.05). CONCLUSIONS: Compared with propofol, sevoflurane provides equally clear SFV while improving the convenience of anesthesia maintenance in ARCR patients with interscalene plexus (ISB) combined with general anesthesia. TRIAL REGISTRATION: This single-center, prospective, RCT was retrospective registered at Chinese Clinical Trial Registry with the registration number ChiCTR2300072110 (02/06/2023).


Asunto(s)
Anestésicos por Inhalación , Éteres Metílicos , Propofol , Humanos , Propofol/farmacología , Sevoflurano , Remifentanilo , Rocuronio , Estudios Prospectivos , Manguito de los Rotadores/cirugía , Estudios Retrospectivos , Éteres Metílicos/farmacología , Piperidinas/farmacología , Anestesia General , Anestésicos Intravenosos/farmacología , Anestésicos por Inhalación/farmacología
4.
BMC Pediatr ; 24(1): 248, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600453

RESUMEN

AIM: Age estimation plays a critical role in personal identification, especially when determining compliance with the age of consent for adolescents. The age of consent refers to the minimum age at which an individual is legally considered capable of providing informed consent for sexual activities. The purpose of this study is to determine whether adolescents meet the age of 14 or 18 by using dental development combined with machine learning. METHODS: This study combines dental assessment and machine learning techniques to predict whether adolescents have reached the consent age of 14 or 18. Factors such as the staging of the third molar, the third molar index, and the visibility of the periodontal ligament of the second molar are evaluated. RESULTS: Differences in performance metrics indicate that the posterior probabilities achieved by machine learning exceed 93% for the age of 14 and slightly lower for the age of 18. CONCLUSION: This study provides valuable insights for forensic identification for adolescents in personal identification, emphasizing the potential to improve the accuracy of age determination within this population by combining traditional methods with machine learning. It underscores the importance of protecting and respecting the dignity of all individuals involved.


Asunto(s)
Determinación de la Edad por los Dientes , Humanos , Adolescente , Determinación de la Edad por los Dientes/métodos , Radiografía Panorámica , Tercer Molar , Ligamento Periodontal , Aprendizaje Automático
5.
Childs Nerv Syst ; 40(9): 2825-2828, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39044040

RESUMEN

PURPOSE: This study aims to evaluate the effectiveness of the Piezosurgery® device in endoscopic-assisted correction of trigonocephaly. Trigonocephaly is a type of craniosynostosis characterized by a triangular-shaped forehead due to the premature fusion of the metopic suture. Traditional open cranial vault reconstruction, although common, is invasive and poses risks. The study explores a less invasive alternative using ultrasonic microvibrations for bone cutting, potentially reducing soft tissue damage and improving surgical outcomes. METHODS: The Piezosurgery® device was employed in endoscopic trigonocephaly correction surgeries performed on patients under 4 months old at the French Referral Center for Craniosynostosis in Lyon. The technique involves making a small skin incision and performing osteotomies from the anterior fontanel to the glabella. A rigid 0° endoscope provides visibility, and the Piezosurgery® device enables precise bone cutting while preserving the dura mater. Post-surgery, patients were discharged within 3 days and required to wear a remodeling helmet for 6-8 months. RESULTS: The use of Piezosurgery® device allowed precise osteotomies with minimal soft tissue damage. No dura mater injuries occurred in the patient series. The procedure was efficient, with an average duration of 80 min, and blood loss was minimal, reducing the need for blood transfusions. The endoscopic approach facilitated shorter surgical times and reduced postoperative infection risks. Enhanced visibility during surgery, due to cavitation effects, improved the accuracy of bone cuts. The technique demonstrated promising safety and esthetic outcomes, although it incurred higher costs compared to traditional methods. CONCLUSION: Piezosurgery® device provides a safe and effective method for minimally invasive endoscopic correction of trigonocephaly. The device's ability to selectively cut bone while preserving soft tissues offers significant advantages, despite longer surgical times and higher costs. This technique represents a viable alternative to traditional open surgery, promoting better clinical outcomes and reduced recovery times.


Asunto(s)
Craneosinostosis , Piezocirugía , Humanos , Craneosinostosis/cirugía , Lactante , Piezocirugía/métodos , Piezocirugía/instrumentación , Masculino , Femenino , Neuroendoscopía/métodos , Neuroendoscopía/instrumentación , Resultado del Tratamiento , Endoscopía/métodos
6.
Sensors (Basel) ; 24(11)2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38894097

RESUMEN

Road safety is a serious concern worldwide, and traffic signs play a critical role in confirming road safety, particularly in the context of AVs. Therefore, there is a need for ongoing advancements in traffic sign evaluation methodologies. This paper comprehensively analyzes the relationship between traffic sign retroreflectivity and LiDAR intensity to enhance visibility and communication on road networks. Using Python 3.10 programming and statistical techniques, we thoroughly analyzed handheld retroreflectivity coefficients alongside LiDAR intensity data from two LiDAR configurations: 2LRLiDAR and 1CLiDAR systems. The study focused specifically on RA1 and RA2 traffic sign classes, exploring correlations between retroreflectivity and intensity and identifying factors that may impact their performance. Our findings reveal variations in retroreflectivity compliance rates among different sign categories and color compositions, emphasizing the necessity for targeted interventions in sign design and production processes. Additionally, we observed distinct patterns in LiDAR intensity distributions, indicating the potential of LiDAR technology for assessing sign visibility. However, the limited correlations between retroreflectivity and LiDAR intensity underscore the need for further investigation and standardization efforts. This study provides valuable insights into optimizing traffic sign effectiveness, ultimately contributing to improved road safety conditions.

7.
J Environ Manage ; 352: 120070, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38266524

RESUMEN

Wind power is one of the fastest growing renewable energy sectors and plays a focal role in the transition to a fossil fuel free society in Europe. Technological developments have enabled the construction of turbines within forested areas, which has raised concerns regarding the audio-visual impact on these landscapes. However, there is a paucity of research with regard to the role that forests may play in mitigating the negative impacts of wind farms. In this study, we created a simplified model for noise attenuation based on the ISO 9613-2 and Nord2000 noise models and a visibility model which both relates the audio-visual effect to forest stand structure and applied them in the GIS environment. Our findings suggest that forests can act as effective noise barriers, with the sound attenuation level dependent on the distance that sound travels through the forest, as well as the size and density of the trees. However, in the case of a high elevation sound source (such as wind turbines), the forest begins to act as a noise shield from a distance of between 500 and 1500 m, depending on the height of the forest and the land topography. While current noise models do not consider the impact of tree species, our visibility model accounts for tree size, density and species, as well as understorey and thinning. Our results indicate that spruce trees provide a better visual constraint whereas visibility distances within mature Calluna-type pine forests tend to be more extensive. Both models include variables that can be adjusted by forest management, thereby allowing integration with forest planning software. Overall, this study presents indicative methods for the evaluation of potential forest landscape shields, a concept that could have broad applications, including Landscape Value Trading.


Asunto(s)
Fuentes Generadoras de Energía , Viento , Bosques , Árboles , Ruido
8.
Public Health Nurs ; 41(2): 193-197, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37994294

RESUMEN

Farm work is one of the nation's most hazardous occupations, and migrant and seasonal farmworkers face significant health inequities. Awareness and understanding of the needs of this population are crucial in assuring they receive appropriate support. Documentary programs can raise awareness of community member views to better inform services and advocacy efforts. Visions for the future of farm work were collected from farmworkers and persons supporting them through a community-based, participatory documentary project led by Student Action with Farmworkers (SAF) from 2021 to 2022. Seventy-nine submissions from participants in North and South Carolina, including text responses and file uploads, were collected and thematically analyzed. Five themes were identified: (1) employment benefits and conditions, (2) living conditions, (3) health access and quality, (4) dignity and visibility of farm work, and (5) policy change for a better future. The visions for the future of farm work expressed by these agricultural workers, advocates, and students raise important implications for agricultural communities, public health practitioners, researchers, funders, and policymakers. Application of these findings in the development and delivery of public health services for farmworkers has the potential to positively impact the morbidity and mortality rates of this at-risk population.


Asunto(s)
Agricultores , Migrantes , Humanos , Granjas , Factores de Riesgo , Estudiantes , Agricultura
9.
Entropy (Basel) ; 26(4)2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38667895

RESUMEN

We investigate whether it is possible to distinguish chaotic time series from random time series using network theory. In this perspective, we selected four methods to generate graphs from time series: the natural, the horizontal, the limited penetrable horizontal visibility graph, and the phase space reconstruction method. These methods claim that the distinction of chaos from randomness is possible by studying the degree distribution of the generated graphs. We evaluated these methods by computing the results for chaotic time series from the 2D Torus Automorphisms, the chaotic Lorenz system, and a random sequence derived from the normal distribution. Although the results confirm previous studies, we found that the distinction of chaos from randomness is not generally possible in the context of the above methodologies.

10.
Forensic Sci Med Pathol ; 20(1): 8-13, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36853501

RESUMEN

The purpose of this study is to estimate chronological age and determine whether individuals were aged under or over 18 years using root pulp visibility (RPV) in cone-beam computed tomography (CBCT) images. The study included CBCT images of 699 individuals aged between 15 and 75 years. One thousand twenty-three mandibular second molar (2M) teeth were evaluated using Olze's RPV method in four stages. Descriptive statistics of the stages and the relationship between the stages and the chronological age were assessed. The distribution of the stages was analyzed according to the 18-year age threshold. There was a positive correlation between RPV stages and chronological ages in both sexes. For females and males, the mean ages of stage 0, stage 1, and stage 2, for females and males, were found as 27.21, 28.93, and 33.68 years, and 37.69, 40.9, and 44.88 years, respectively. Stage 0 and stage 1 were found both in individuals aged under and over 18 years, and stage 2 and stage 3 were not observed in individuals aged under 18 years. The presence of stage 2 and stage 3 may be an indication that an individual is aged over 18 years according to Olze's RPV age estimation method. For more reliable results, 2M teeth should be examined bilaterally in forensic science.


Asunto(s)
Mandíbula , Diente Molar , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , Anciano , Mandíbula/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Pulpa Dental/diagnóstico por imagen
11.
Rev Infirm ; 73(297): 39-40, 2024 Jan.
Artículo en Francés | MEDLINE | ID: mdl-38242622

RESUMEN

Rigorous monitoring of vital functions in intensive care requires optimal visibility of patients and their environment. Conversely, respect for privacy is an ethical imperative to respect. Liquid crystal electrical film is a device that can be applied to windows and can take opaque or transparent form on demand. Its use could satisfy the visibility of patients and respect for their privacy.


Asunto(s)
Unidades de Cuidados Intensivos , Privacidad , Humanos , Cuidados Críticos , Pacientes
12.
J Neurosci ; 42(12): 2562-2569, 2022 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-35121637

RESUMEN

A key goal of consciousness science is identifying neural signatures of being aware versus unaware of simple stimuli. This is often investigated in the context of near-threshold detection, with reports of stimulus awareness being linked to heightened activation in a frontoparietal network. However, because of reports of stimulus presence typically being associated with higher confidence than reports of stimulus absence, these results could be explained by frontoparietal regions encoding stimulus visibility, decision confidence, or both. In an exploratory analysis, we leverage fMRI data from 35 human participants (20 females) to disentangle these possibilities. We first show that, whereas stimulus identity was best decoded from the visual cortex, stimulus visibility (presence vs absence) was best decoded from prefrontal regions. To control for effects of confidence, we then selectively sampled trials before decoding to equalize confidence distributions between absence and presence responses. This analysis revealed striking differences in the neural correlates of subjective visibility in PFC ROIs, depending on whether or not differences in confidence were controlled for. We interpret our findings as highlighting the importance of controlling for metacognitive aspects of the decision process in the search for neural correlates of visual awareness.SIGNIFICANCE STATEMENT While much has been learned over the past two decades about the neural basis of visual awareness, the role of the PFC remains a topic of debate. By applying decoding analyses to functional brain imaging data, we show that prefrontal representations of subjective visibility are contaminated by neural correlates of decision confidence. We propose a new analysis method to control for these metacognitive aspects of awareness reports, and use it to reveal confidence-independent correlates of perceptual judgments in a subset of prefrontal areas.


Asunto(s)
Corteza Visual , Estado de Conciencia/fisiología , Femenino , Humanos , Juicio , Imagen por Resonancia Magnética , Masculino , Estimulación Luminosa/métodos , Corteza Visual/fisiología , Percepción Visual/fisiología
13.
J Synchrotron Radiat ; 30(Pt 5): 910-916, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37610345

RESUMEN

Vertical beam size measurements were carried out at Beijing Electron-Positron Collider II (BEPCII) using a phase grating and an absorption grating based on the Talbot effect. The transverse coherence of synchrotron radiation is closely related to beam size. Due to the partial coherence of the synchrotron radiation source, the coherence length can be calculated by measuring the visibility decay of interferograms recorded at different distances behind the gratings. A vertical beam size of 68.19 ± 2 µm was obtained based on the relationship between the coherence length and beam size at the 3W1 beamline of BEPCII. A comparison of the vertical emittance derived from the grating Talbot method and the synchrotron radiation visible light interferometer method was presented. The vertical emittances from the two methods are 1.41 nm rad and 1.40 nm rad, respectively. The 0.1% difference indicates that the grating Talbot method for beam size measurement is reliable. This technique has great potential for small beam size measurement of fourth-generation synchrotron radiation light sources, considering its small diffraction limitation and simple experimental setups.

14.
J Exp Biol ; 226(12)2023 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-37203595

RESUMEN

Turbidity challenges the visual performance of aquatic animals. Here, we use the natural diversity of ephemeral rearing sites occupied by tadpoles of two poison frog species to explore the relationship between environments with limited visibility and individual response to perceived risk. To compare how species with diverse natural histories respond to risk after developing in a range of photic environments, we sampled wild tadpoles of (1) Dendrobates tinctorius, a rearing-site generalist with facultatively cannibalistic tadpoles and (2) Oophaga pumilio, a small-pool specialist dependent on maternal food-provisioning. Using experimental arenas, we measured tadpole activity and space use first on a black and white background, and then on either black or white backgrounds where tadpoles were exposed to potentially predatory visual stimuli. The effects of rearing environment on D. tinctorius tadpoles were clear: tadpoles from darker pools were less active than tadpoles from brighter pools and did not respond to the visual stimuli, whereas tadpoles from brighter pools swam more when paired with conspecifics versus predatory insect larvae, suggesting that tadpoles can visually discriminate between predators. For O. pumilio, tadpoles were more active on experimental backgrounds that more closely matched the luminosity of their rearing sites, but their responses to the two visual stimuli did not differ. Larval specialisation associated with species-specific microhabitats may underlie the observed responses to visual stimuli. Our findings demonstrate that light availability in wild larval rearing conditions influences risk perception in novel contexts, and provides insight into how visually guided animals may respond to sudden environmental disturbances.


Asunto(s)
Anuros , Natación , Animales , Larva/fisiología , Anuros/fisiología , Especificidad de la Especie , Conducta Predatoria/fisiología
15.
J Anim Ecol ; 92(7): 1306-1319, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36413028

RESUMEN

Visibility (viewshed) plays a significant and diverse role in animals' behaviour and fitness. Understanding how visibility influences animal behaviour requires the measurement of habitat visibility at spatial scales commensurate to individual animal choices. However, measuring habitat visibility at a fine spatial scale over a landscape is a challenge, particularly in highly heterogeneous landscapes (e.g. forests). As a result, our ability to model the influence of fine-scale visibility on animal behaviour has been impeded or limited. In this study, we demonstrate the application of the concept of three-dimensional (3D) cumulative viewshed in the study of animal spatial behaviour at a landscape level. Specifically, we employed a newly described approach that combines terrestrial and airborne light detection and ranging (LiDAR) to measure fine-scale habitat visibility (3D cumulative viewshed) on a continuous scale in forested landscapes. We applied the LiDAR-derived visibility to investigate how visibility in forests affects the summer habitat selection and the movement of 20 GPS-collared female red deer Cervus elaphus in a temperate forest in Germany. We used integrated step selection analysis to determine whether red deer show any preference for fine-scale habitat visibility and whether visibility is related to the rate of movement of red deer. We found that red deer selected intermediate habitat visibility. Their preferred level of visibility during the day was substantially lower than that of night and twilight, whereas the preference was not significantly different between night and twilight. In addition, red deer moved faster in high-visibility areas, possibly mainly to avoid predation and anthropogenic risk. Furthermore, red deer moved most rapidly between locations in the twilight. For the first time, the preference for intermediate habitat visibility and the adaption of movement rate to fine-scale visibility by a forest-dwelling ungulate species at a landscape scale was revealed. The LiDAR technique used in this study offers fine-scale habitat visibility at the landscape level in forest ecosystems, which would be of broader interest in the fields of animal ecology and behaviour.


Asunto(s)
Ciervos , Ecosistema , Animales , Femenino , Bosques , Conducta Animal , Movimiento
16.
Prev Med ; 174: 107596, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37451555

RESUMEN

Cervical cancer screening and treatment of screen positives is an important and effective strategy to reduce cervical cancer morbidity and mortality. In order to have an accurate cervical cancer screening and evaluation of positives, the entire Squamocolumnar Junction (SCJ) must be visible. Throughout the life course, the position of the SCJ changes and affects its visibility. SCJ visibility was analyzed among participants screened at the League Against Cancer Clinic in Lima, Peru. Of the 4247 participants screened, the SCJ was fully visible in 49.7% of participants, partially visible in 23.1%, and not visible in 27.2%. Visibility decreased with age, and by age 45 years old, the SCJ was not fully visible in over 50% of participants. Our results show that a high percentage of participants at ages still recommended for screening do not have totally visible SCJ, and we may need to reconsider the upper age limit for screening and find new strategies for evaluation of those with a positive screening test and non-visible SCJ.


Asunto(s)
Neoplasias del Cuello Uterino , Femenino , Humanos , Persona de Mediana Edad , Neoplasias del Cuello Uterino/diagnóstico , Detección Precoz del Cáncer , Perú , Tamizaje Masivo
17.
BMC Public Health ; 23(1): 1817, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37726734

RESUMEN

BACKGROUND: 'Treat All' policies recommending immediate antiretroviral therapy (ART) soon after HIV diagnosis for all people living with HIV (PLHIV) are now ubiquitous in sub-Saharan Africa. While early ART initiation and retention is effective at curtailing disease progression and transmission, evidence suggests that stigma may act as a barrier to engagement in care. This study sought to understand the relationships between HIV stigma and engagement in care for PLHIV in Rwanda in the context of Treat All. METHODS: Between September 2018 and March 2019, we conducted semi-structured, qualitative interviews with adult PLHIV receiving care at two health centers in Kigali, Rwanda. We used a grounded theory approach to data analysis to develop conceptual framework describing how stigma influences HIV care engagement in the context of early Treat All policy implementation in Rwanda. RESULTS: Among 37 participants, 27 (73%) were women and the median age was 31 years. Participants described how care engagement under Treat All, including taking medications and attending appointments, increased their visibility as PLHIV. This served to normalize HIV and use of ART but also led to high levels of anticipated stigma in the health center and community at early stages of treatment. Enacted stigma from family and community members and resultant internalized stigma acted as additional barriers to care engagement. Nonetheless, participants described how psychosocial support from care providers and family members helped them cope with stigma and promoted continued engagement in care. CONCLUSIONS: Treat All policy in Rwanda has heightened the visibility of HIV at the individual and social levels, which has influenced HIV stigma, normalization, psychosocial support and care engagement in complex ways. Leveraging the individual and community support described by PLHIV to deliver evidence-based, peer or provider-delivered stigma reduction interventions may aid in attaining Treat All goals.


Asunto(s)
Cognición , Apoyo Comunitario , Adulto , Humanos , Femenino , Masculino , Rwanda , Investigación Cualitativa , Análisis de Datos
18.
BMC Anesthesiol ; 23(1): 369, 2023 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-37950214

RESUMEN

BACKGROUND: Needle visualization is essential to avoid vascular puncture and nerve injury in ultrasound-guided regional anesthesia. Several factors that statistically influence needle visibility have been described but the dimensions of their individual impact remain unclear. This study aimed to quantify the impact of various independent factors on ultrasound needle visibility. METHODS: A total of 1500 ultrasound videos of in-plane needle insertions were obtained in embalmed cadavers with ten different commercially available echogenic and non-echogenic needles at different insertion angles and bevel orientations in a full factorial study design. The visibility of needle tip and shaft were rated as "good" or "poor" visibility. Nominal logistic regression analyses were calculated for the visibility of the needle tip and shaft. RESULTS: SonoPlex Stim Sprotte, SonoTAP Facet (needle tip and shaft) and Spinostar PencilPoint (needle tip)), insertion angle and bevel orientation were associated with good ultrasound visibility, reaching statistical significance (p < 0.05). The range of the effect on the log-odds scale for needle tip visibility was largest for the insertion angle with 6.33, followed by the tissue condition (3.76), bevel orientation (1.45) and the needle types (1.25). Regarding the needle shaft visibility, the largest effect range was observed with the insertion angle (7.36), followed by the tissue conditions with 3.96, needle type (1.86) and bevel orientation (0.95). CONCLUSION: In-plane needle visibility in ultrasound images depends mainly on the insertion angle, as expected. This is closely followed by the tissue condition, which is a factor related to the patient, thus cannot be altered to improve needle visibility. In the dimensions of the log-odds scale, the choice of a specific needle is far less important towards achieving a good visualization, whereas optimizing the bevel orientation can have a larger impact than the needle choice. Concluding from the relative dimensions of factors that determine needle visibility in this model, the importance of needles with echogenic features may be overrated.


Asunto(s)
Anestesia de Conducción , Ultrasonografía Intervencional , Humanos , Ultrasonografía Intervencional/métodos , Modelos Logísticos , Ultrasonografía/métodos , Anestesia de Conducción/métodos , Agujas , Cadáver
19.
J Assist Reprod Genet ; 40(11): 2619-2626, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37715874

RESUMEN

PURPOSE: This study assessed the visibility of embryologists on fertility clinic websites among Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member clinics. METHODS: During a 1-month interval (March 2022), all Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member fertility clinic websites were evaluated. The professional representation of the primary care team was examined including specialties, the presence of headshots, and biographies. RESULTS: A total of 446 fertility clinic websites were scanned in the search. The embryology team has the least common professional identification by their names (53.58%) compared to gynecology clinicians (96.21%, p < 0.001) and nurses (55.58%, p < 0.001). This trend also applies to other types of professional identifiers, such as headshots and biographies. Professional headshots of embryologists (50.34%) were less prominent than those of gynecology clinicians (93.51%, p < 0.001). A similar trend was observed in the biographies of the embryology team (47.20%) compared to gynecology clinicians (95.08%, p < 0.001). CONCLUSION: The present study revealed that embryologists have low professional visibility on fertility clinic websites. Fertility clinics may prioritize enhancing the online visibility of their embryology laboratory team. This approach could potentially enhance the recognition of their team, foster transparency, and provide accessible information about the skills and expertise of healthcare professionals involved in the treatment process.


Asunto(s)
Clínicas de Fertilidad , Ginecología , Humanos , Estudios Transversales , Técnicas Reproductivas Asistidas , Internet
20.
Sensors (Basel) ; 23(24)2023 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-38139585

RESUMEN

Poor visibility has a significant impact on road safety and can even lead to traffic accidents. The traditional means of visibility monitoring no longer meet the current needs in terms of temporal and spatial accuracy. In this work, we propose a novel deep network architecture for estimating the visibility directly from highway surveillance images. Specifically, we employ several image feature extraction methods to extract detailed structural, spectral, and scene depth features from the images. Next, we design a multi-scale fusion network to adaptively extract and fuse vital features for the purpose of estimating visibility. Furthermore, we create a real-scene dataset for model learning and performance evaluation. Our experiments demonstrate the superiority of our proposed method to the existing methods.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA