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1.
Children (Basel) ; 11(6)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38929208

RESUMO

OBJECTIVE: To understand the prevalence of home-related anxiety among adolescent athletes during the novel coronavirus pandemic and to ascertain the factors influencing this anxiety. METHODS: We employed cluster sampling to select 1150 adolescent athletes (aged 8-18 years) from six sports training schools in Yantai City, Shandong Province. Mental health status was assessed and recorded. Chi-square tests and multivariable logistic regression were used to analyze the factors contributing to athletes' anxiety. RESULTS: The survey revealed a COVID-19 infection rate of 38.23% (437 individuals) with an anxiety score of 40.98 ± 8.20 and an anxiety detection rate of 11.29% (129 individuals) during the COVID-19 epidemic. Female athletes exhibited a higher anxiety rate of 14.40% compared to 8.40% in male athletes. Multivariate analysis identified female gender as a risk factor for anxiety (OR = 1.64), while participation in aquatics emerged as a protective factor (OR = 0.24, 95% CI: 1.08-2.48). Professional training duration exceeding three years increased anxiety risk (OR = 3.05, 95% CI: 1.67-5.58), as did not seeking help during difficulties (OR = 2.59, 95% CI: 1.33-5.01). Interestingly, parental care was linked to increased anxiety risk (OR = 2.44, 95% CI 1.34-4.44), while care from friends was protective (OR = 0.60, 95% CI: 0.36-1.01), which was possibly due to the pressure associated with parental expectations. CONCLUSIONS: Adolescent athletes, particularly females and those with extended training durations, exhibit a heightened susceptibility to anxiety. This study also highlights that athletes who proactively seek assistance during challenging situations tend to experience lower anxiety levels. Additionally, a lack of COVID-19 infection and the involvement of concerned parents contribute to reduced anxiety among these young athletes.

2.
Am J Surg ; 226(2): 291-293, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36935284

RESUMO

In conclusion, billing trends reflect declining reimbursement and utilization of hernia repair, and increasing markup ratios may create a financial barrier to accessing hernia for uninsured and underinsured patients. As a new set of hernia repair CPT codes are used in practice, close attention should be paid to the downstream effects of billing practices in hernia repair on physician and patient alike.


Assuntos
Herniorrafia , Cirurgiões , Idoso , Humanos , Estados Unidos , Medicare
3.
J Environ Manage ; 332: 117354, 2023 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-36724597

RESUMO

As electric vehicles (EVs) are developing at a rapid pace, the foreseeable "scrap tide" of EV batteries poses a severe challenge to ecological protection. This article investigates a dual-recycle channel closed-loop supply chain and provides regulatory solutions to retired EV batteries' recycling. Specifically, we construct four supervision scenarios: S1 no policy intervention, S2 reward-penalty scheme, S3 deposit-refund scheme, and S4 dual scheme combining S2 and S3. Based on the Stackelberg game and empirical data, all scenarios' recycling performance is evaluated and compared with a view to "society, economy, and environment". The results revealed: (1) Compared with S1, the recycling rate and carbon reduction rate in S2∼S4 increase by 2.6049%/0.0092%, 4.0379%/0.0285%, and 6.6660%/0.0379%, respectively; (2) The difference between S2 and S3 in recycling performance depends on regulatory intensities, yet the latter places greater burdens on consumers and firms. The S4 presents optimal environmental performance but at the expense of socioeconomic development; (3) As regulatory intensity increases, social welfare rises driven by environmental benefits, then falls due to overburdened supply chain profits, consumer surplus, and policy expenditures; (4) Carbon trading prices and EVs' potential market sizes affect regulatory schemes' operations. Our results contribute to policy-making and managerial practices for EV battery recycling.


Assuntos
Formulação de Políticas , Reciclagem , Reciclagem/métodos , Fontes de Energia Elétrica , Eletricidade , Carbono
4.
JMIR Serious Games ; 10(3): e38465, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35834303

RESUMO

BACKGROUND: In aging societies, dementia risk increases with advancing age, increasing the incidence of dementia-related degenerative diseases and other complications, especially fall risk. Dementia also escalates the care burden, impacting patients, their families, social welfare institutions, and the social structure and medical system. OBJECTIVE: In elderly dementia, traditional card recognition rehabilitation (TCRR) does not effectively increase one's autonomy. Therefore, from the usability perspective, we used the Tetris game as a reference to develop an interactive somatosensory game rehabilitation (ISGR) with nostalgic style for elders with mild cognitive impairment (MCI). Through intuitive gesture-controlled interactive games, we evaluated subjective feelings concerning somatosensory game integration into rehabilitation to explore whether the ISGR could improve the willingness to use and motivation for rehabilitation among elders with MCI. METHODS: A total of 15 elders with MCI (7 males and 8 females with an average age of 78.4 years) underwent 2 experiments for 15 minutes. During experiment 1, TCRR was performed, followed by completing the questionnaire of the System Usability Scale (SUS). After 3-5 minutes, the second experiment (the ISGR) was conducted, followed by completing another SUS. We used SUS to explore differences in impacts of TCRR and ISGR on willingness to use among elders with MCI. In addition, we further investigated whether the factor of gender or prior rehabilitation experience would affect the rehabilitation willingness or not. RESULTS: The novel ISGR made the elderly feel interested and improved their willingness for continuous rehabilitation. According to the overall SUS score, the ISGR had better overall usability performance (73.7) than the TCRR (58.0) (t28=-4.62, P<.001). Furthermore, the ISGR individual item scores of "Willingness to Use" (t28=-8.27, P<.001), "Easy to Use" (t28=-3.17, P<.001), "System Integration" (t28=-5.07, P<.001), and "Easy to Learn" (t28=-2.81, P<.001) were better than TCRR. The somatosensory game was easier to learn and master for females than for males (t13=2.71, P=.02). Besides, the ISGR was easier to use (t12=-2.50, P=.02) and learn (t14=-3.33, P<.001) for those without prior rehabilitation experience. The result indicates that for elders with no rehabilitation experience ISGR was easier to use and simpler to learn than TCRR. CONCLUSIONS: Regardless of prior rehabilitation experience, the ISGR developed in this study was easy to learn and effective in continuously improving willingness to use. Furthermore, the adoption of a nostalgic game design style served the function of cognitive training and escalated interest in rehabilitation. The ISGR also improved user stickiness by introducing different game scenarios and difficulties, increasing long-term interest and motivation for rehabilitation. For future research on the adoption of interactive somatosensory games in rehabilitation, additional rehabilitation movements can be developed to benefit the elderly with MCI.

5.
Lab Chip ; 22(12): 2376-2391, 2022 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-35635092

RESUMO

Flexible and wearable electronic sensors hold great promise for improving the quality of life, especially in the field of healthcare monitoring, owing to their low cost, flexibility, high electromechanical coupling performance, high sensitivity, and biocompatibility. To achieve high piezoelectric performance similar to that of rigid materials while satisfying the flexible requirements for wearable sensors, we propose novel hybrid films based on lead zirconate titanate powder and microfibrillated cellulose (PZT/MFC) for plantar pressure measurements. The flexible films made using the polarization process are tested. It was found that the maximum piezoelectric coefficient was 31 pC N-1 and the maximum tensile force of the flexible films was 26 N. A wide range of bending angles between 15° and 180° proves the flexibility capability of the films. In addition, the charge density shows a proportional relation with the applied mechanical force, and it could sense stress of 1 kPa. Finally, plantar pressure sensors are arranged and packaged with a film array followed by connection with the detection module. Then, the pressure curves of each point on the plantar are obtained. Through analysis of the curve, several parameters of human body motions that are important in the rehabilitation of diabetic patients and the detection of sports injury can be performed, including stride frequency, length and speed. Overall, the proposed PZT/MFC wearable plantar pressure sensor has broad application prospects in the field of sports injury detection and medical rehabilitation training.


Assuntos
Traumatismos em Atletas , Dispositivos Eletrônicos Vestíveis , Celulose , Corpo Humano , Humanos , Chumbo , Pressão , Qualidade de Vida , Titânio , Zircônio
6.
Micromachines (Basel) ; 13(4)2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35457804

RESUMO

Plastic pollution has emerged as a growing concern worldwide. In particular, the most abundant plastic debris, microplastics, has necessitated the development of rapid and effective identification methods to track down the stages and evidence of the pollution. In this paper, we combine low-cost plastic staining technologies using Nile Red with the continuous feature offered by microfluidics to propose a low-cost 3D printed device for the identification of microplastics. It is observed that the microfluidic devices indicate comparable staining and identification performance compared to conventional Nile Red staining processes while offering the advantages of continuous recognition for long-term environmental monitoring. The results also show that concentration, temperature, and residency time possess strong effects on the identification performance. Finally, various microplastics have been applied to further demonstrate the effectiveness of the proposed devices. It is found that, among different types of microplastics, non-spherical microplastics show the maximal fluorescence level. Meanwhile, natural fibers indicate better staining quality when compared to synthetic ones.

7.
Artigo em Inglês | MEDLINE | ID: mdl-37015711

RESUMO

The design goals of recently developed serious games are to improve attention, affective recognition, and social interactions among individuals with autism. However, most previous studies on serious games used behavioral questionnaires to evaluate their effectiveness. The cognitive assessment of individuals with autism after behavioral intervention or drug treatment has become important because it provides promising biomarkers to assess improvement after cognitive intervention. In this study, we developed a game-based social interaction platform incorporating an eye-tracking system for children and preadolescents with autism. Three modules (focusing on gaze following, facial emotion recognition, and social interaction skills) are included in the platform; participants with autism learn these according to their cognitive abilities. The eye-tracking results showed decreased fixation durations when autistic children looked at positive emotional expressions and focused on multiple targets. Prolonged saccade durations and shorter fixation times for social-related facial emotion expressions were also found in preadolescents and teenagers with autism. Our findings suggest that these atypical gaze patterns are reliable biomarkers for evaluating the social and cognitive functions of autistic individuals while playing serious games. The proposed platform's game-based modules and the findings regarding aberrant gaze patterns in autistic individuals demonstrate the possibility of evaluating cognitive functions and intervention effectiveness by using eye-tracking signals in a serious game or real-life environment.

8.
J Xray Sci Technol ; 30(1): 111-122, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34719473

RESUMO

OBJECTIVE: To investigate feasibility of the quantitative parameters of dual-energy computed tomography (DECT) to assess therapy response in advanced non-small cell lung cancer (NSCLC) compared with the traditional enhanced CT parameters based on the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. METHODS: Forty-five patients with unresectable locally advanced NSCLC who underwent DECT before and after chemotherapy or concurrent chemoradiotherapy (cCRT) were prospectively enrolled. By comparing baseline studies with follow-up, patients were divided into two groups according to RECIST guidelines as follows: disease control (DC, including partial response and stable disease) and progressive disease (PD). The diameter (D), attenuation, iodine concentration and normalized iodine concentration of arterial and venous phases (ICA, ICv, NICA, NICv) and the percentage of these changes pre- and post-therapy were measured and calculated. The Pearson correlation was used to analyze correlation between various quantitative parameters. The receiver operating characteristic (ROC) curves were used to evaluate accuracy of therapy response prediction. RESULTS: The change percentages of Attenuation (Δ-Attenuation-A and Δ-Attenuation-V), IC (ΔICA and ΔICV) and NIC (ΔNICA and ΔNICV) pre- and post-therapy correlate with the change percentage of D (ΔD). Among these, ΔICA strongly correlates with ΔD (r = 0.793, P < 0.001). The areas under ROC curves generated using Δ-Attenuation-A, ΔICA, and ΔNICA are 0.796, 0.900, and 0.880 with the corresponding cutoff value of 9.096, -15.692, and -4.7569, respectively, which are significantly different (P < 0.001). CONCLUSIONS: The quantitative parameters of DECT iodine map, especially iodine concentration, in arterial phase provides a new quantitative image marker to predict therapy response of patients diagnosed with advanced NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Iodo , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/terapia , Quimiorradioterapia , Meios de Contraste , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Tomografia Computadorizada por Raios X/métodos
9.
Environ Sci Pollut Res Int ; 29(3): 3394-3405, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34389947

RESUMO

The construction industry has been greatly developed in the past few decades, especially in the extensive use of underground space. The increasing amount of waste (e.g., soil, sludge, and rock) generated in the underground construction constitutes an important part of construction and demolition waste (CDW), but the related problems are rarely addressed in an independent quantitative study. In order to facilitate recycling of underground construction waste (UCW), quantitative methods for predicting UCW are proposed based on mass conservation in this study. Through on-site investigation and literature review, the source characteristics of UCW and corresponding recycling potential are firstly analyzed. Secondly, the corresponding quantitative method is proposed for predicting each type of UCW according to the principle of mass conservation. Finally, the proposed quantitative methods are applied in two real underground infrastructure projects to verify the accuracy. The results show that the accuracy of quantitative methods for predicting shield sludge and engineering soil is 82.03-95.79% and 94.49% respectively. The quantitative methods for predicting the amount of UCW proposed in this study is effective. In both cases, underground construction produced a large amount of construction waste with great recycling potential. UCW can theoretically reach 100% recycling, and full reuse and recycling of UCW will bring huge benefits and be conducive to the sustainable development of the construction industry.


Assuntos
Indústria da Construção , Gerenciamento de Resíduos , Materiais de Construção , Resíduos Industriais/análise , Reciclagem , Desenvolvimento Sustentável
10.
Sensors (Basel) ; 20(11)2020 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-32512897

RESUMO

A novel probabilistic approach for model updating based on approximate Bayesian computation with subset simulation (ABC-SubSim) is proposed for damage assessment of structures using modal data. The ABC-SubSim is a likelihood-free Bayesian approach in which the explicit expression of likelihood function is avoided and the posterior samples of model parameters are obtained using the technique of subset simulation. The novel contributions of this paper are on three fronts: one is the introduction of some new stopping criteria to find an appropriate tolerance level for the metric used in the ABC-SubSim; the second one is the employment of a hybrid optimization scheme to find finer optimal values for the model parameters; and the last one is the adoption of an iterative approach to determine the optimal weighting factors related to the residuals of modal frequency and mode shape in the metric. The effectiveness of this approach is demonstrated using three illustrative examples.

11.
PLoS One ; 15(3): e0230445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32176732

RESUMO

Single-nucleotide polymorphisms (SNPs) is associated with efficacy of specific drugs. Although there are several methods for SNP genotyping in clinical settings, alternative methods with lower cost, higher throughout and less complexity are still needed. In this study, we modified Kompetitive Allele Specific PCR to enable multiplex SNP genotyping by introducing additional fluorescent cassettes that specifically help to differentiate more amplification signals in a single reaction. This new format of assay achieved a limit of detection down to 310 copies/ reactions for simultaneous detection of 2 SNPs with only standard end-point PCR workflow for synthetic controls, and genotyped 117 clinical samples with results that were in 100% agreement with hospital reports. This study presented a simplified, cost-effective high-throughput SNP genotyping alternative for pharmacogenetic variants, and enabled easier access to pharmaceutical guidance when needed.


Assuntos
Técnicas de Genotipagem/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Farmacogenética/métodos , Polimorfismo de Nucleotídeo Único/genética , Alelos , Genótipo , Humanos
12.
Health Care Manag Sci ; 23(2): 249-263, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30919231

RESUMO

In this research, we studied operating room scheduling problem of assigning a set of surgeries to several multifunctional operating rooms. The objectives are to maximize the utilization of the operating rooms, to minimize the overtime-operating cost, and to minimize the wasting cost for the unused time. To begin with, a revised mathematical model is constructed to assign surgeries to operating rooms within one week. Then, we proposed four easy-to-implement heuristics that can guarantee to find feasible solutions for the studied problem efficiently. Furthermore, we presented four local search procedures that can improve a given solution significantly. Finally, a hybrid genetic algorithm (HGA) that incorporated with initial solutions, local search procedures and elite search procedure is applied to the studied problem. Computational results show that for small problem instances, the HGA can find near optimal solutions efficiently while for large problem instances, the HGA performs significantly better than the four proposed heuristics. We concluded that surgery schedules obtained by using HGA has less wasting cost for the unused time, much higher utilization of operating rooms, and produce less overtime-operating cost.


Assuntos
Algoritmos , Agendamento de Consultas , Salas Cirúrgicas/organização & administração , Eficiência Organizacional , Humanos , Modelos Teóricos , Salas Cirúrgicas/economia
13.
Medicine (Baltimore) ; 98(38): e16655, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567931

RESUMO

In this study, we first reported of a modified hybrid fixation method in expansive open-door laminoplasty (EOLP) in order to reduce medical costs. The purpose of the present study is to compare the surgical outcomes and cost-effectiveness of the modified fixation with all levels miniplate fixation in EOLP for multilevel cervical spondylotic myelopathy.Data of 67 patients who underwent EOLP from July 2015 to June 2016 were retrospectively analyzed, with 33 in the modified group and 34 in the all miniplate group based on their surgical approaches. Laminae were kept open with alternate levels miniplate and anchor fixation in the modified group, while with all levels miniplate fixation in the all miniplate group. Medical costs and clinical results including Japanese Orthopedic Association (JOA) scores, Visual Analogue Scale (VAS) scores and occurrences of complications were investigated and compared between the 2 groups. After evaluation on X-ray, CT, and MRI, radiographic data reflecting cervical alignments, spinal canal enlargement and spinal cord decompression were collected and compared within each group and between the 2 groups.After a follow-up period of about 18 months, no significant differences in operation time, intraoperative blood loss, complication rates, VAS scores, neurological recovery rates and postoperative hospital stays were observed between the 2 groups. However, EOLP with the modified fixation costed less. When comparing the 2 groups, cervical curvature index (CCIs) which reflected cervical alignments and anteroposterior diameters (APDs) reflecting spinal canal enlargement at all the follow-ups had no significant differences. Postoperative open angles which reflected spinal cord decompression of C4 and C6 were significantly smaller in the modified group. However, that difference was no longer detected at the final follow-up. Within each group, APDs increased significantly after surgery. However, no significant differences in CCIs and open angles at different follow-ups were observed in each group.Compared with all miniplate fixation, the modified hybrid fixation in EOLP showed almost the same clinical and radiographic results. However, the modified hybrid fixation method could reduce costs.


Assuntos
Placas Ósseas , Vértebras Cervicais/cirurgia , Laminoplastia/métodos , Espondilose/cirurgia , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Laminoplastia/economia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espondilose/diagnóstico por imagem , Resultado do Tratamento , Escala Visual Analógica
14.
BMC Neurol ; 18(1): 12, 2018 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-29370778

RESUMO

BACKGROUND: Data on the association between socioeconomic status and post-stroke functional outcome in developing countries is lacking. We aimed to evaluate the association in stroke survivors in deprived rural Southern China. METHODS: We conducted door-to-door interviews and collected data using a structured questionnaire in stroke survivors from five fourth-class rural areas of Guangdong Province through a non-government initiated registry from August 2014 to March 2015. Descriptive statistics were used to provide information on the demographic, socioeconomic and clinical characteristics of the selected population. Univariate and multivariate logistic regression were used to examine the relationship of socioeconomic status indexed by self-reported average family income and functional impairment defined as a modified Rankin Scale of 3 to 5. RESULTS: Among the 425 stroke survivors, 52.7% lived below the poverty line set by the local government. About 50% of patients suffered from functional impairment and required assistance in their daily life. Compared with their wealthier counterpart, stroke survivors with lower income were more likely to have functional impairment (OR 2.85, 95% CI 1.93-4.23). The effect size increased and remained significant after adjusting for possible confounding factors (OR 3.17, 95% CI 2.04-4.91). CONCLUSIONS: Poorer patients tend to have poorer post-stroke functional outcome. Primary and secondary strategies targeting underprivileged populations in less-developed areas are thus urgently needed in China.


Assuntos
População Rural , Classe Social , Acidente Vascular Cerebral/epidemiologia , Sobreviventes , China/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pobreza , Sistema de Registros , Inquéritos e Questionários
15.
Int J Ophthalmol ; 9(5): 750-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27275435

RESUMO

AIM: To draw a Meta-analysis over the comparison of the intraocular pressure (IOP)-lowering efficacy and safety between the commonly used fixed-combinations of prostaglandin analogs and 0.5% timolol with prostaglandin analogs (PGAs) monotherapy. METHODS: After searching the published reports from MEDLINE, EMBASE, the Cochrane Library, all randomized controlled clinical trials (RCTs) comparing the fixed combination of PGAs/timolol therapy (FCs) and PGAs monotherapy with treatment duration at least 6mo were included. The efficacy outcomes were mean diurnal IOP, percentage of participants whose IOP were lower than 18 mm Hg, incidence of visual field change, while the safety outcomes included corneal side effects, hyperemia and eye irritation. The analysis was carried out in RevMan version 5.3 software. RESULTS: After six-month medical intervention, the mean diurnal IOP of FCs was lower than PGAs (MD -1.14, 95% CI -1.82 to -0.46, P=0.001); the percentage of target IOP achieving between FCs and PGAs showed no significant difference (RR 1.18, 95% CI 0.97 to 1.43, P=0.10). No statistically significant differences of the incidence of hyperemia (RR 0.67, 95% CI 0.45 to 1.01, P=0.06) and eye irritation (RR 1.20, 95% CI 0.95 to 1.51, P=0.12) between the FCs and PGAs monotherapy were detected. Only one research involved in corneal events, result of this trial revealed no difference between two intervention groups regarding corneal effects (central endothelial cell density, MD -0.20, 95% CI -0.72 to 0.32, P=0.45; central corneal thickness, MD -0.01, 95% CI -0.02 to 0.00, P=0.23). The evaluation of visual field change was not performed due to the limited duration of the trials included in this Meta-analysis. CONCLUSION: The long-term efficacy of the FCs overweighed the PGAs monotherapy in lowering IOP, but in the incidence of hyperemia and eye irritation syndromes, the differences are not statically significant. More RCTs with detailed and authentic data over the assessments of visual functions and morphology of optic nerve heads are hoped to be conducted.

16.
J Formos Med Assoc ; 115(10): 867-875, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26506918

RESUMO

BACKGROUND/PURPOSE: The Taiwan National Health Insurance program has allocated a specific fund for dental services to patients with specific disabilities (PSDs); however, the trends and the quality are unknown. In this study, we conducted quantity analyses and quality assessments of dental service use among PSDs using a nationwide population-based database. METHODS: PSDs were identified according to the codes of diagnosis fee. Quantity analyses included the number of patients receiving dental services, the number of visits, and the percentages of categories of dental service use. Quality assessments included refilling rates for operative dental treatments and unfinished rates for endodontic therapies. RESULTS: For quantity analyses, dental services were accessible to 3-4% of patients with disabilities and were mostly provided to younger PSDs. The general population received more operative and endodontic therapies, and PSDs received more periodontal therapies. For quality assessments, the teeth of PSDs had a 9.74-15.07% refilling rate, which was higher than that of the general population (1.39-6.37%). Furthermore, the teeth of PSDs had a 32.03% unfinished endodontic rate, which was higher than that of the general population (21.42%). CONCLUSION: During 2010-2012, only 3-4% of patients with disabilities had access to dental services, mostly provided to younger PSDs. Teeth of PSDs had higher refilling rates and unfinished endodontic sessions than the general population. We suggest that a more comprehensive dental care system is necessary to improve the quantity and quality of dental services, especially in middle-aged and older PSDs.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Reembolso de Seguro de Saúde , Programas Nacionais de Saúde , Bases de Dados Factuais , Humanos , Taiwan
17.
Clin Ther ; 36(2): 255-63, 2014 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-24480637

RESUMO

BACKGROUND: Pilsicainide hydrochloride is a class IC antiarrhythmic agent used for the treatment of supraventricular and ventricular arrhythmias and atrial fibrillation. OBJECTIVE: The objective of the present study was to determine the pharmacokinetics (PK) of a pilsicainide hydrochloride injection in healthy Chinese adults. The study was conducted to meet China State Food and Drug Administration requirements for the marketing of the new generic formulation of pilsicainide hydrochloride. METHODS: This Phase I, randomized, parallel-group, open-label, single-dose PK study was conducted in healthy Chinese volunteers. Subjects were randomized to receive a single dose of 0.25-, 0.50-, and 0.75-mg/kg pilsicainide hydrochloride with a 10-minute intravenous infusion. Serial blood and urine samples were collected up to 24 hours after dosing; drug concentrations in plasma and urine were then determined by using LC-MS/MS. The PK parameters of pilsicainide were calculated from the plasma concentration-time data according to noncompartmental methods. Safety profile was evaluated by monitoring adverse events, clinical laboratory parameters, and the results of 12-lead ECGs. RESULTS: Thirty healthy volunteers (mean [SD] age, 28.0 [4.95] years; weight, 59.3 [6.51] kg; height, 165.0 [7.25] cm; body mass index, 21.7 [1.94] kg/m(2)) were randomly divided into 3 groups, each consisting of 5 men and 5 women. After single-dose intravenous administration of 0.25, 0.50, and 0.75 mg/kg of pilsicainide hydrochloride, mean Cmax was 0.34 (0.11), 0.54 (0.15), and 1.05 (0.19) µg/mL, respectively; AUC0-24 was 0.76 (0.12), 1.61 (0.37), and 2.61 (0.46) h · µg/mL; and AUC0-∞ was 0.79 (0.13), 1.71 (0.46), and 2.72 (0.50) h · µg/mL. The ranges for t½z, CL, and Vz were 5.19 to 5.98 hours, 4.73 to 5.44 mL/min/kg, and 2.23 to 0.58 L/kg, respectively. The mean urinary recovery rate within 24 hours was 75.0% (12.0%), 65.0% (19.2%), and 66.4% (14.1%). Men and women had significantly different AUC0-24 values in the 0.50-mg/kg dose group (P = 0.044), and Vz showed significant differences between men and women in all 3 dose groups (P = 0.001). According to ECG parameters, PR intervals were significantly prolonged after administration at all 3 doses (P = 0.034, P < 0.001, and P = 0.034); no significant changes were seen in QRS width, QTc interval, or other parameters. CONCLUSIONS: Pilsicainide hydrochloride demonstrated linear PK, and the increase in the exposure of pilsicainide (AUC0-24 and AUC0-∞) was dose proportional after single doses of 0.25, 0.50, and 0.75 mg/kg. All 3 pilsicainide hydrochloride doses were well tolerated in these Chinese volunteers. ChiCTR-ONC-13003546.


Assuntos
Antiarrítmicos/efeitos adversos , Antiarrítmicos/farmacocinética , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/farmacocinética , Lidocaína/análogos & derivados , Administração Intravenosa/efeitos adversos , Adulto , Antiarrítmicos/administração & dosagem , Química Farmacêutica , China , Relação Dose-Resposta a Droga , Feminino , Humanos , Lidocaína/administração & dosagem , Lidocaína/efeitos adversos , Lidocaína/farmacocinética , Masculino
18.
BMC Oral Health ; 13: 8, 2013 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-23331491

RESUMO

BACKGROUND: The need to obtain information on the dental prosthetic treatment needs (DPTNs) of inpatients with schizophrenia is unrecognized. This study aims to assess the DPTNs of this population and investigate the association between these needs and related factors. METHODS: The results of an oral health survey involving 1,103 schizophrenic adult inpatients in a long-term care institution in Taiwan were used. Chi-square tests and multiple logistic analyses were used to measure the independent effects of the characteristics of each subject on their DPTNs. RESULTS: Of the subjects, 805 (73.0%) were men and 298 (27.0%) were women. The mean age was 50.8 years. A total of 414 (37.5%) required fixed prosthesis, whereas 700 (63.5%) needed removable prosthesis. Multivariate analyses show that fixed prosthesis is associated with age only after adjusting for other potential independent variables. Older subjects who had a lower educational attainment or a longer length of stay required removable prosthesis. CONCLUSIONS: The findings of this study show that the DPTNs of schizophrenic inpatients are not being met. Therefore, a special approach to the dental prosthetic treatment of these patients should be developed.


Assuntos
Assistência Odontológica para Doentes Crônicos , Prótese Dentária/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pacientes Internados , Esquizofrenia , Adulto , Idoso , Análise de Variância , Distribuição de Qui-Quadrado , Intervalos de Confiança , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Modelos Logísticos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Taiwan , Adulto Jovem
19.
J Community Health Nurs ; 27(2): 84-95, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20437289

RESUMO

This study aimed to investigate the relationship among falls, fear of falling (FOF), and health-related quality of life (HRQOL) in elderly people living in the community. The study was a community-based surveillance with residents aged 65 or over in Taipei, Taiwan. Data were collected in face-to-face interviews. Of the 4,056 participants, the prevalence of falls was 13.8% and the prevalence of FOF among women (62.6%) was significantly higher than that among men (46.2%). Adjusted by covariate factors, fear of falling was identified as a major factor related to HRQOL in the elderly and should be emphasized to assist the improvement of HRQOL in geriatrics.


Assuntos
Acidentes por Quedas , Idoso/psicologia , Atitude Frente a Saúde/etnologia , Medo/psicologia , Qualidade de Vida/psicologia , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso/estatística & dados numéricos , Idoso de 80 Anos ou mais , Análise de Variância , Distribuição de Qui-Quadrado , Efeitos Psicossociais da Doença , Feminino , Humanos , Modelos Lineares , Masculino , Pesquisa Metodológica em Enfermagem , Prevalência , Inquéritos e Questionários , Taiwan/epidemiologia , Saúde da População Urbana/estatística & dados numéricos
20.
Med Hypotheses ; 72(6): 729-31, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19231092

RESUMO

Pulse pressure (PP) is emerging as a major pressure predictor of cardiac disease. However, there are two major limitations for PP as an evaluation index. First, PP has alterability in the same individual. Second, PP is "floating", it has no relation to an absolute BP level. In order to overcome the defects of PP, we propose a novel parameter, "pulse pressure/systolic pressure" called "pulse pressure index (PPI)" for assessment of cardiovascular outcomes. On the basis of elastic chamber theory, the following equation can be derived: PPI=pulse pressure/systolic pressure=(Cs-Cd)/(Cs-C(0)), (Cs, Cd and C(0), arterial compliance at systolic pressure, diastolic pressure and zero-pressure, respectively). PPI can overcome the defects of PP and become a useful index in clinical evaluation for assessment of cardiovascular outcomes.


Assuntos
Determinação da Pressão Arterial/métodos , Pressão Sanguínea , Cardiopatias/diagnóstico , Cardiopatias/fisiopatologia , Modelos Cardiovasculares , Simulação por Computador , Diagnóstico por Computador , Humanos
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