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1.
Child Adolesc Psychiatr Clin N Am ; 33(3): 437-445, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38823815

RESUMO

The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with "all of the above" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Equidade em Saúde , Adolescente , Criança , Humanos , Psiquiatria do Adolescente/educação , Psiquiatria Infantil/educação , Diversidade Cultural
2.
Food Technol Biotechnol ; 62(1): 35-45, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38601970

RESUMO

Research background: There is considerable diversity in newly developed pummelo × sweet orange citrus hybrids. Most hybrids showed lower peel thickness and high juice yield but there is a lack of information on fruit quality parameters and molecular characterization. Therefore, the aim of the current study is to determine the content of antioxidants and properties of the fresh juice of 24 new pummelo × sweet orange citrus hybrids (Citrus maxima [Burm. f.] Osbeck × Citrus sinensis [L.] Osbeck) and the parental genotypes along with molecular characteristics determined using acidity specific markers. Experimental approach: The correlation and estimate of inheritance of the fruit juice properties: ascorbic acid, total phenol, total flavonoid, total antioxidant, total soluble solid and sugar contents, pH, titratable acidity, along with sensory evaluation was performed. Molecular characterization of these hybrids was carried out using de novo generated acidity specific simple sequence repeat (SSR) markers. Results and conclusions: The main constituents of the fruit juice of pummelo × sweet orange hybrids were observed in the range of w(ascorbic acid)=40.00-58.13 mg/100 g, total phenols expressed as gallic acid equivalents w(GAE)=40.67-107.33 mg/100 g, total antioxidants expressed as Trolox equivalents b(Trolox)=2.03-5.49 µmol/g, total flavonoids expressed as quercetin equivalents w(QE)=23.67-59.33 mg/100 g, along with other properties: total soluble solids=7.33-11.33 %, w(total sugar)=2.10-5.76 %, w(reducing sugar)=1.69-2.78 %, w(non-reducing sugar)=0.39-3.17 % and titratable acidity 1.00-2.11 %. The above parameters differed significantly in the fruit juice of the evaluated pummelo × sweet orange hybrids. Considering these parameters, the hybrids SCSH 17-9, SCSH 13-13, SCSH 11-15 and SCSH 3-15 had superior antioxidant properties in terms of these parameters. A higher heritability (≥80 %) was also observed for all juice properties. Molecular characterization of pummelo × sweet orange hybrids showed that >50 % of the hybrids were grouped with medium acidity parents. Both molecular and biochemical parameter-based clustering showed that interspecific hybrids exhibit transgressive segregation with increased antioxidants that help alleviate the health problems. Novelty and scientific contribution: These newly developed pummelo × sweet orange citrus hybrids are a valuable source of high-quality antioxidants for a healthy diet. The identification of trait markers that enable selection at the seedling stage is of great benefit to citrus breeders, as the characteristic features of a mature tree are not yet visible at the juvenile stage.

3.
Chemosphere ; 352: 141453, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38364916

RESUMO

Polyethylene Terephthalate (PET) is a polymer which is considered as one of the major contaminants to the environment. The PET waste materials can be recycled to produce value-added products. PET can be converted to nanoparticles, nanofibers, nanocomposites, and nano coatings. To extend the applications of PET nanomaterials, understanding its commercialization potential is important. In addition, knowledge about the factors affecting recycling of PET based nanomaterials is essential. The presented review is focused on understanding the PET commercialization aspects, keeping in mind market analysis, growth drivers, regulatory affairs, safety considerations, issues associated with scale-up, manufacturing challenges, economic viability, and cost-effectiveness. In addition, the paper elaborates the challenges associated with the use of PET based nanomaterials. These challenges include PET contamination to water, soil, sediments, and human exposure to PET nanomaterials. Moreover, the paper discusses in detail about the factors affecting PET recycling, commercialization, and circular economy with specific emphasis on life cycle assessment (LCA) of PET recycled nanomaterials.


Assuntos
Nanocompostos , Nanopartículas , Humanos , Polietilenotereftalatos , Reciclagem , Polímeros
4.
Bioengineered ; 14(1): 2242124, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37548430

RESUMO

Recently, the development of sustainable and environmentally friendly biomaterials has gained the attention of researchers as potential alternatives to petroleum-based materials. Biomaterials are a promising candidate to mitigate sustainability issues due to their renewability, biodegradability, and cost-effectiveness. Thus, the purpose of this study is to explore a cost-effective biomaterial-based delivery system for delivering fertilizers to plants. To achieve this, rice straw (agro-waste) was selected as a raw material for the extraction of cellulose. The cellulose was extracted through alkali treatment (12% NaOH), followed by TEMPO-based oxidation. The cellulose nanofibers were characterized using Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy, and transmission electron microscopy. In scanning electron microscopy, a loosening of the fibrillar structure in cellulose nanofibers (CNFs) was observed with a diameter of 17 ± 4 nm. The CNFs were loaded with nitrogen-based fertilizer (ammonium chloride) in 1:1, 1:2, and 2:1 (w/w) proportions. The loading was estimated through surface charge variation; in the case of the 1:1 sample, maximum reductions in surface charge were seen from -42.0 mV to -12.8 mV due to the binding of positive ammonium ions. In the release kinetics study, a controlled release pattern was observed at 1:1, which showed a 58% cumulative release of ammonium ions within 8 days. Thus, the study paves the way for value-added uses of rice straw as an alternative to the current environmentally harmful practices.


Bio-based cellulose nanofibers (CNFs) from rice straw via circular economy approach.Controlled release fertilizers for sustainable agriculture.Nanotechnology for precision agriculture and decarbonization via agricultural waste management.


Assuntos
Nanofibras , Oryza , Celulose/química , Fertilizantes , Oryza/química , Nanofibras/química , Desenvolvimento Sustentável , Preparações de Ação Retardada , Espectroscopia de Infravermelho com Transformada de Fourier , Materiais Biocompatíveis , Íons
5.
J Pain Symptom Manage ; 66(2): e255-e264, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37100306

RESUMO

BACKGROUND: Few advance care planning (ACP) interventions have been scaled in primary care. PROBLEM: Best practices for delivering ACP at scale in primary care do not exist and prior efforts have excluded older adults with Alzheimer's Disease and Related Dementias (ADRD). INTERVENTION: SHARING Choices (NCT#04819191) is a multicomponent cluster-randomized pragmatic trial conducted at 55 primary care practices from two care delivery systems in the Mid-Atlantic region of the U.S. We describe the process of implementing SHARING Choices within 19 practices randomized to the intervention, summarize fidelity to planned implementation, and discuss lessons learned. OUTCOMES: Embedding SHARING Choices involved engagement with organizational and clinic-level partners. Of 23,220 candidate patients, 17,931 outreach attempts by phone (77.9%) and the patient portal (22.1%) were made by ACP facilitators and 1215 conversations occurred. Most conversations (94.8%) were less than 45 minutes duration. Just 13.1% of ACP conversations included family. Patients with ADRD comprised a small proportion of patients who engaged in ACP. Implementation adaptations included transitioning to remote modalities, aligning ACP outreach with the Medicare Annual Wellness Visit, accommodating primary care practice flexibility. LESSONS LEARNED: Study findings reinforce the value of adaptable study design; co-designing workflow adaptations with practice staff; adapting implementation processes to fit the unique needs of two health systems; and modifying efforts to meet health system goals and priorities.


Assuntos
Planejamento Antecipado de Cuidados , Doença de Alzheimer , Humanos , Idoso , Estados Unidos , Medicare , Comunicação , Projetos de Pesquisa
6.
Chemosphere ; 319: 138005, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36731660

RESUMO

The inevitable need for waste valorisation and management has revolutionized the way in which the waste is visualised as a potential biorefinery for various product development rather than offensive trash. Biowaste has emerged as a potential feedstock to produce several value-added products. Bioenergy generation is one of the potential applications originating from the valorisation of biowaste. Bioenergy production requires analysis and optimization of various parameters such as biowaste composition and conversion potential to develop innovative and sustainable technologies for most effective utilization of biowaste with enhanced bioenergy production. In this context, feedstocks, such as food, agriculture, beverage, and municipal solid waste act as promising resources to produce renewable energy. Similarly, the concept of microbial fuel cells employing biowaste has clearly gained research focus in the past few decades. Despite of these potential benefits, the area of bioenergy generation still is in infancy and requires more interdisciplinary research to be sustainable alternatives. This review is aimed at analysing the bioconversion potential of biowaste to renewable energy. The possibility of valorising underutilized biowaste substrates is elaborately presented. In addition, the application and efficiency of microbial fuel cells in utilizing biowaste are described in detail taking into consideration of its great scope. Furthermore, the review addresses the significance bioreactor development for energy production along with major challenges and future prospects in bioenergy production. Based on this review it can be concluded that bioenergy production utilizing biowaste can clearly open new avenues in the field of waste valorisation and energy research. Systematic and strategic developments considering the techno economic feasibilities of this excellent energy generation process will make them a true sustainable alternative for conventional energy sources.


Assuntos
Resíduos de Alimentos , Resíduos Sólidos , Resíduos Sólidos/análise , Bioengenharia , Fontes Geradoras de Energia , Reatores Biológicos , Biocombustíveis/análise
7.
Sci Total Environ ; 872: 161960, 2023 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-36739026

RESUMO

Nanostructured oxides and oxyhydroxides of iron are imperative constituents of the Earth's geological and biological processes i.e. biogeochemical cycles. So, the characteristic applications of iron oxide nanoparticles (FeONps) are closely linked to their surroundings and biological sinks. This work reports a low-cost green approach to promote 'waste-to-wealth' ideology by the direct and self-catalysis of iron rust into its nanoparticles (N-FeONps). A comparison is drawn based on the properties, morphologies, and applications after synthesizing FeONps by chemical precipitation method (C-FeONps). Spherical nanoparticles with vibrational properties are obtained in the size domain of 32 nm (N-FeONps) and 23 nm (C-FeONps). The application of Uniform deformation model, Uniform stress deformation model, Uniform deformation energy density model, and Size-strain plot models reveal comparatively greater defects in the crystal structures of C-FeONps. The biosafety profiling of natural and chemically designed nano-units performed on the species of bacteria, fungus, algae, and plants have shown enhanced safety terms associated with N-FeONps. The performance of N-FeONps has surpassed its chemical counterpart in medical applications such as antioxidant activity and anti-inflammatory activity with approximate percentages of 26 % and 51 % respectively. The findings of this piece of work favors the naturally obtained FeONps (N-FeONps), as they are economically viable, non-toxic, and have a greater antioxidant and anti-inflammatory arena. Hence, this waste-to-wealth ideology should be promoted for maintaining waste and designing solutions for the medical industries in one go.


Assuntos
Nanopartículas Metálicas , Nanopartículas , Compostos Férricos/química , Monitoramento Biológico , Nanopartículas Metálicas/química , Ferro/química , Antioxidantes , Óxidos , Medição de Risco
8.
Ophthalmic Surg Lasers Imaging Retina ; 53(10): 538-545, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36239672

RESUMO

BACKGROUND AND OBJECTIVE: To characterize rhegmatogenous retinal detachment (RRD) presentation and repair outcomes by race and socioeconomic status. MATERIALS AND METHODS: Retrospective cohort one-center study of adults with a new RRD repair from 2012 to 2020. Logistic and linear regression analyses were conducted. RESULTS: 61.7% were male, 84.5% White and 9.4% Black (total n = 1092). 95.8% White and 94.2% Black patients had retinal reattachment (P = .234). Macula-off status was more likely with Medicare/Medicaid than private insurance (OR 1.63, 95% CI 1.11 to 2.41, P = .014); and less likely with higher income (OR 0.88, CI 0.81 to 0.96, P = .003). Black patients had worse best visual acuity (BVA) at presentation and follow-up (follow-up -6.93 letters, CI -13.19 to -0.64, P = .031), and higher odds of postoperative ocular hypertension (OHTN) (OR 2.41, CI 1.28 to 4.60, P = .007). CONCLUSIONS: Despite equivalent retinal reattachment rates, Black patients have worse BVA, and are more likely to develop OHTN than White patients. Macula-off status is less likely in patients with higher income or private insurance. [Ophthalmic Surg Lasers Imaging Retina 2022;53:538-545.].


Assuntos
Glaucoma , Descolamento Retiniano , Adulto , Idoso , Feminino , Glaucoma/cirurgia , Humanos , Masculino , Medicare , Complicações Pós-Operatórias/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Recurvamento da Esclera/métodos , Classe Social , Resultado do Tratamento , Estados Unidos/epidemiologia , Vitrectomia/métodos
9.
Child Adolesc Psychiatr Clin N Am ; 31(4): 603-614, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36182213

RESUMO

Child and adolescent psychiatrists (CAPs) work at the intersections of families, cultures, and systems, which affect engagement in care, assessment, and treatment planning. There are several practical strategies that CAPs can apply to practice cultural humility, to join with families, to facilitate difficult conversations and to work through misalignment. Culturally inclusive family-based care can promote greater understanding and lead to stronger outcomes with families as well as help mitigate mental health impact of structural racism and social inequities.


Assuntos
Família , Psiquiatria , Adolescente , Criança , Atenção à Saúde , Humanos
10.
Nat Prod Res ; 36(6): 1565-1569, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33567925

RESUMO

The present study investigated antioxidant properties, total phenolic and flavonoid contents in methanol extract of the leaf, stem bark, and fruit of Olea ferruginea Royle, Olea europaea L., and Tilia europaea L. grow naturally in the north-west Indian Himalaya. Phenolics and flavonoids content was found to be maximum in methanol extracts of stem bark and leaf (9.28 mg GAE/g fw and 14.73 mg QE/g fw, respectively) of O. ferruginea plants. Ferric reducing antioxidant power and DPPH radical scavenging activity were found to be maximum in leaf and stem bark (38.88 mM AAE/g fw and 20.31 mM AAE/g fw, respectively) of O. ferrugenia plants, whereas maximum ABTS radical scavenging activity (4.52 mM AAE/g fw) was recorded with stem bark of T. europaea plants. These tree species were found rich in natural compounds and also possess antioxidant activities. Therefore, their pharmaceutical and local uses for the health benefits are suggested.


Assuntos
Antioxidantes , Flavonoides , Antioxidantes/química , Flavonoides/química , Fenóis/análise , Extratos Vegetais/química , Folhas de Planta/química
11.
J Clin Med ; 10(21)2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34768413

RESUMO

This study evaluates the accuracy of drill guides fabricated in medical-grade, biocompatible materials for static, computer-aided implant surgery (sCAIS). The virtually planned drill guides of ten completed patient cases were printed (n = 40) using professional (Material Jetting (MJ)) and consumer-level three-dimensional (3D) printing technologies, namely, Stereolithography (SLA), Fused Filament Fabrication (FFF), and Digital Light Processing (DLP). After printing and post-processing, the drill guides were digitized using an optical scanner. Subsequently, the drill guide's original (reference) data and the surface scans of the digitized 3D-printed drill guide were superimposed to evaluate their incongruencies. The accuracy of the 3D-printed drill guides was calculated by determining the root mean square (RMS) values. Additionally, cast models of the planned cases were used to check that the drill guides fitted manually. The RMS (mean ± SD) values for the accuracy of 3D-printed drill guides were-MJ (0.09 ± 0.01 mm), SLA (0.12 ± 0.02 mm), FFF (0.18 ± 0.04 mm), and DLP (0.25 ± 0.05 mm). Upon a subjective assessment, all drill guides could be mounted on the cast models without hindrance. The results revealed statistically significant differences (p < 0.01) in all except the MJ- and SLA-printed drill guides. Although the measured differences in accuracy were statistically significant, the deviations were negligible from a clinical point of view. Within the limits of this study, we conclude that consumer-level 3D printers can produce surgical guides with a similar accuracy to a high-end, professional 3D printer with reduced costs.

12.
Biosensors (Basel) ; 11(9)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34562885

RESUMO

The development of reliable and robust diagnostic tests is one of the most efficient methods to limit the spread of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, most laboratory diagnostics for COVID-19, such as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase-polymerase chain reaction (RT-PCR), are expensive, time-consuming, and require highly trained professional operators. On the other hand, the lateral flow immunoassay (LFIA) is a simpler, cheaper device that can be operated by unskilled personnel easily. Unfortunately, the current technique has some limitations, mainly inaccuracy in detection. This review article aims to highlight recent advances in novel lateral flow technologies for detecting SARS-CoV-2 as well as innovative approaches to achieve highly sensitive and specific point-of-care testing. Lastly, we discuss future perspectives on how smartphones and Artificial Intelligence (AI) can be integrated to revolutionize disease detection as well as disease control and surveillance.


Assuntos
Teste para COVID-19/instrumentação , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , Inteligência Artificial , COVID-19/imunologia , Teste para COVID-19/economia , Humanos , Imunoensaio , Testes Imediatos , SARS-CoV-2/genética , SARS-CoV-2/imunologia , Sensibilidade e Especificidade , Smartphone
13.
Int J Mol Sci ; 22(16)2021 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-34445228

RESUMO

Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today's craniomaxillofacial surgeons use patient information for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 ± 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.


Assuntos
Benzofenonas , Sistemas Automatizados de Assistência Junto ao Leito , Polímeros , Impressão Tridimensional , Próteses e Implantes , Crânio/lesões , Humanos , Procedimentos de Cirurgia Plástica
14.
J Clin Med ; 10(16)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34441859

RESUMO

Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient's unique anatomy. Material extrusion or Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.

15.
World Neurosurg ; 148: e356-e362, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33418118

RESUMO

BACKGROUND: To develop a novel 3D-printer-assisted method to fabricate patient-specific implants for cranioplasty and to demonstrate its feasibility and its use in 16 consecutive cases. METHODS: We report on 16 consecutive patients who have undergone cranioplasty surgery for an extensive skull defect after decompressive surgery and in which the bone flap was not available. We present the workflow for the implant production using a 3D-printer-assisted molding technique. Preoperative, intraoperative, and postoperative data were analyzed/evaluated. RESULTS: Eleven out of our 16 patients (68.7%) presented with extensive hemispheric bone defects. Indication for initial craniotomy were traumatic brain injury (4; 25%), acute subdural hematoma (4; 25%), ischemic stroke (3; 18.8%), tumor (3; 18.8%), and ruptured aneurysm (2; 12.5%). Median (range) operation time was 121 (89-206) minutes. Median (range) intraoperative blood loss was 300 (100-3300) mL. The mean (range) follow-up period is 6 (0-21) months. Complications occurred in 7 out of our 16 patients (43.8%), in 6 (37.5%) of which a reoperation was required to evacuate an extra-axial hematoma (3; 50%), for shunting of an epidural fluid collection (1; 16.7%), or for skin flap necrosis (1; 16.7%). One patient (16.7%) developed a chronic asymptomatic subdural fluid collection that was stable over the follow-up period. CONCLUSIONS: Our workflow to intraoperatively produce patient-specific implants in a timely manner to cover cranial defects proved to be feasible. The results are cosmetically appealing, and postoperative CT scans show well-fitting implants. As implantable printable substrates are already available, we aim to advance and certify 3D-printed patient-specific implants in the near future.


Assuntos
Craniectomia Descompressiva , Procedimentos de Cirurgia Plástica/métodos , Impressão Tridimensional , Próteses e Implantes , Crânio/cirurgia , Adulto , Idoso , Análise Custo-Benefício , Feminino , Seguimentos , Hematoma/etiologia , Hematoma/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Polimetil Metacrilato , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Impressão Tridimensional/economia , Próteses e Implantes/economia , Desenho de Prótese , Retalhos Cirúrgicos , Tomografia Computadorizada por Raios X , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-32838062

RESUMO

BACKGROUND: Coronavirus disease - 19 (COVID-19) spread throughout the world and become pandemic. To stop and control the rapid infection of COVID-19 lockdown is the best option. Sudden lockdown implies change in entire lifestyle of the population. Social isolation affects individual's lives by greater reduction in their physical activity, which might increase the chance of infection by reducing immunity. To what extent, the physical activity is reduced during this lockdown period among physiotherapy professionals, and students who propagate physical activity is not known. Hence, we aimed to evaluate the impact of the COVID-19 lockdown on physical activity level and energy expenditure among physiotherapy professionals and students. MATERIAL AND METHODS: One hundred and forty three volunteered physiotherapy professionals and students participated in web-based open E-survey. The survey was carried out by sending the Google Forms link for International Physical activity questionnaire-short form (IPAQ-SF) through social networking sites using Google Forms to gather the amount of PA before and during COVID-19 lockdown period and analysed using Wilcoxon signed rank test. RESULTS: Among identified 261 potential survey participants, 143 responded, reaching a response rate of 54.8%. Total physical activity before and during COVID-19 lockdown period were 7809.7 (3849.7-11769.8) MET-min/week and 4135.7 (867.2-7404.1) MET-min/week; p < 0.0001. While energy expenditure before and during COVID-19 lockdown period were 8189.8 (4242.1-12137.6) kcal/wk and 4221.7 (1004.6-7438.8) kcal/wk; p < 0.0001. CONCLUSION: A significant reduction in self-report physical activity and energy expenditure levels were observed among physiotherapy professionals and students during the COVID-19 lockdown period.

17.
Indian J Tuberc ; 67(4): 502-508, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33077051

RESUMO

BACKGROUND: The delay in the diagnosis and treatment initiation of patients with MDR-TB worsens individual prognosis and increases the risk of disease transmission in the community. These delays have been attributed to delay in treatment-seeking by the patient and shifting to multiple healthcare facilities before being tested and diagnosed through India's National Tuberculosis Elimination Program (NTEP). OBJECTIVE: to identify treatment pathways in patients with MDR-TB from the time of onset of symptoms and treatment seeking until diagnosis at a PMDT site and subsequent treatment initiation. We also compared these characteristics with those of patients with DS-TB. METHODS: We recruited a total of 168 patients with MDR-TB and DS-TB each, in Delhi. Data were analyzed using IBM SPSS Version 25. RESULTS: The mean (SD) patient delay for initial treatment-seeking was 20.9 (15.9) days in patients with MDR-TB, and 16.1 (17.1) days in patients with DS-TB (p < 0.001). The median time from visit to the first healthcare facility (HCF) until confirmation of MDR-TB diagnosis was 78.5 days, and until treatment initiation was 102.5 days. Among patients with DS-TB, the time interval from a visit to the first HCF until the initiation of ATT-DOTS was 61.5 days.. Patients diagnosed with DS-TB, whose first source of treatment was a private facility (n = 49), reported a significant delay in the initiation of ATT-DOTS (p < 0.001). CONCLUSIONS: Despite the introduction of universal drug sensitivity testing in individuals having presumptive MDR-TB, a significant delay in the diagnosis and initiation of effective MDR-TB treatment persists as a major public health challenge in India.


Assuntos
Antituberculosos/uso terapêutico , Procedimentos Clínicos , Diagnóstico Tardio , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis , Tempo para o Tratamento , Tuberculose Resistente a Múltiplos Medicamentos , Adulto , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/normas , Diagnóstico Tardio/efeitos adversos , Diagnóstico Tardio/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Índia/epidemiologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/tendências , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Aceitação pelo Paciente de Cuidados de Saúde , Prognóstico , Tempo para o Tratamento/organização & administração , Tempo para o Tratamento/normas , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/terapia , Tuberculose Resistente a Múltiplos Medicamentos/transmissão
18.
J Clin Med ; 9(5)2020 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-32429549

RESUMO

Computer-assisted surgery with three-dimensional (3D) printed surgical guides provides more accurate results than free-hand surgery. Steam sterilization could be one of the factors that affect the dimensions of surgical guide resin materials, leading to inaccuracies during surgeries. The purpose of this study was to evaluate the effects of steam sterilization on the dimensional accuracy of indication-specific hollow cube test bodies, manufactured in-house using Class IIa biocompatible resin materials (proprietary and third-party). To evaluate the pre- and post-sterilization dimensional accuracy, root mean square (RMS) values were calculated. The results indicate that, in all the groups, steam sterilization resulted in an overall linear expansion of the photopolymeric resin material, with an increase in outer dimensions and a decrease in inner dimensions. The effects on the dimensional accuracy of test bodies were not statistically significant in all the groups, except PolyJet Glossy (p > 0.05). The overall pre- and post-sterilization RMS values were below 100 and 200 µm, respectively. The highest accuracies were seen in proprietary resin materials, i.e., PolyJet Glossy and SLA-LT, in pre- and post-sterilization measurements, respectively. The dimensional accuracy of third-party resin materials, i.e., SLA-Luxa and SLA-NextDent, were within a comparable range as proprietary materials and can serve as an economical alternative.

19.
J Clin Med ; 9(3)2020 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-32204321

RESUMO

The use of patient-specific implants (PSIs) in craniofacial surgery is often limited due to a lack of expertise and/or production costs. Therefore, a simple and cost-efficient template-based fabrication workflow has been developed to overcome these disadvantages. The aim of this study is to assess the accuracy of PSIs made from their original templates. For a representative cranial defect (CRD) and a temporo-orbital defect (TOD), ten PSIs were made from polymethylmethacrylate (PMMA) using computer-aided design (CAD) and three-dimensional (3D) printing technology. These customized implants were measured and compared with their original 3D printed templates. The implants for the CRD revealed a root mean square (RMS) value ranging from 1.128 to 0.469 mm with a median RMS (Q1 to Q3) of 0.574 (0.528 to 0.701) mm. Those for the TOD revealed an RMS value ranging from 1.079 to 0.630 mm with a median RMS (Q1 to Q3) of 0.843 (0.635 to 0.943) mm. This study demonstrates that a highly precise duplication of PSIs can be achieved using this template-molding workflow. Thus, virtually planned implants can be accurately transferred into haptic PSIs. This workflow appears to offer a sophisticated solution for craniofacial reconstruction and continues to prove itself in daily clinical practice.

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