Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 36
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
2.
Macromol Rapid Commun ; 36(21): 1891-1896, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26310821

RESUMO

Triggering the release of cargo from a polymer network by ultrasonication as an external, noninvasive stimulus can be an interesting concept for on-demand release. Here, it is shown that, in pH- and thermosensitive microgels, the ultrasound sensitivity of the polymer network depends on the external conditions. Crosslinked poly[(N-isopropylacrylamide)-co-(vinyl imidazole)] microgels showed a volume phase transition temperature (VPTT) of 25-50 °C, which increases with decreasing pH. Above the VPTT the polymer chains are collapsed, while below VPTT they are extended. Only in the case of maximum observed swelling, where the polymer chains are expanded, the microgels are mechanically fragmented through ultrasonication. In contrast, when the polymer chains are partially collapsed it is not possible to manipulate the microgels by ultrasound. Additionally, the ultrasound-induced on-demand release of wheat germ lipase from the microgels could be demonstrated successfully. The principle of conditional ultrasound sensitivity is likely to be general and can be used for selection of matrix-cargo combinations.

3.
Angew Chem Int Ed Engl ; 54(37): 10980-4, 2015 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-26216251

RESUMO

Mimicking the binding epitopes of protein-protein interactions by using small peptides is important for generating modular biomimetic systems. A strategy is described for the design of such bioactive peptides without accessible structural data for the targeted interaction, and the effect of incorporating such adhesion peptides in complex biomaterial systems is demonstrated. The highly repetitive structure of decorin was analyzed to identify peptides that are representative of the inner and outer surface, and it was shown that only peptides based on the inner surface of decorin bind to collagen. The peptide with the highest binding affinity for collagen I, LHERHLNNN, served to slow down the diffusion of a conjugated dye in a collagen gel, while its dimer could physically crosslink collagen, thereby enhancing the elastic modulus of the gel by one order of magnitude. These results show the potential of the identified peptides for the design of biomaterials for applications in regenerative medicine.


Assuntos
Materiais Biocompatíveis , Moléculas de Adesão Celular/química , Colágeno Tipo I/química , Decorina/química , Peptídeos/química
4.
BMJ Open Respir Res ; 11(1)2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575338

RESUMO

BACKGROUND: We assessed the effectiveness of sotrovimab vs no early COVID-19 treatment in highest-risk COVID-19 patients during Omicron predominance. METHODS: Retrospective cohort study using the Discover dataset in North West London. Included patients were non-hospitalised, aged ≥12 years and met ≥1 National Health Service highest-risk criterion for sotrovimab treatment. We used Cox proportional hazards models to compare HRs of 28-day COVID-19-related hospitalisation/death between highest-risk sotrovimab-treated and untreated patients. Age, renal disease and Omicron subvariant subgroup analyses were performed. RESULTS: We included 599 sotrovimab-treated patients and 5191 untreated patients. Compared with untreated patients, the risk of COVID-19 hospitalisation/death (HR 0.50, 95% CI 0.24, 1.06; p=0.07) and the risk of COVID-19 hospitalisation (HR 0.43, 95% CI 0.18, 1.00; p=0.051) were both lower in the sotrovimab-treated group; however, statistical significance was not reached. In the ≥65 years and renal disease subgroups, sotrovimab was associated with a significantly reduced risk of COVID-19 hospitalisation, by 89% (HR 0.11, 95% CI 0.02, 0.82; p=0.03) and 82% (HR 0.18, 95% CI 0.05, 0.62; p=0.007), respectively. CONCLUSIONS: Risk of COVID-19 hospitalisation in sotrovimab-treated patients aged ≥65 years and with renal disease was significantly lower compared with untreated patients. Overall, risk of hospitalisation was also lower for sotrovimab-treated patients, but statistical significance was not reached.


Assuntos
Anticorpos Monoclonais Humanizados , Anticorpos Neutralizantes , Tratamento Farmacológico da COVID-19 , COVID-19 , Humanos , Londres/epidemiologia , Estudos Retrospectivos , Medicina Estatal
5.
Curr Med Res Opin ; 40(8): 1323-1334, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38975862

RESUMO

OBJECTIVE: To describe characteristics and acute clinical outcomes for patients with COVID-19 treated with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or untreated patients at highest risk per National Health Service (NHS) criteria. METHODS: Retrospective study of non-hospitalized patients between 1 December 2021 and 31 May 2022, using data from the Discover-NOW dataset (North-West London). Included patients were aged ≥12 years and treated with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or untreated but expected to be eligible for early treatment per NHS highest-risk criteria. COVID-19-related and all-cause hospitalizations were reported for 28 days from COVID-19 diagnosis (index). Subgroup analyses were conducted in patients with advanced renal disease, those aged 18-64 and ≥65 years, and by period of Omicron BA.1, BA.2 and BA.5 (post-hoc exploratory) predominance. RESULTS: Overall, 1503 treated and 4044 eligible high-risk untreated patients were included. A high proportion of patients on sotrovimab had advanced renal disease (29.3%), ≥3 high-risk comorbidities (47.6%) and were aged ≥65 years (36.9%). Five of 696 (0.7%) patients on sotrovimab, <5/337 (0.3-1.2%) on nirmatrelvir/ritonavir, 10/470 (2.1%) on molnupiravir and 114/4044 (2.8%) untreated patients were hospitalized with COVID-19. Similar results were observed across all subgroups. The proportion of patients dying within 28 days of the index period was similarly low across all cohorts (<2%). CONCLUSION: Patients receiving sotrovimab appeared to show evidence of multiple high-risk comorbidities. Low hospitalization rates were observed for all treated cohorts across subgroups and periods of predominant variants of concern. These results require confirmation with comparative effectiveness analyses adjusting for differences in underlying patient characteristics.


Assuntos
Antivirais , Tratamento Farmacológico da COVID-19 , COVID-19 , Progressão da Doença , SARS-CoV-2 , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Masculino , Antivirais/uso terapêutico , Antivirais/administração & dosagem , Feminino , Adulto , Idoso , COVID-19/epidemiologia , SARS-CoV-2/isolamento & purificação , Adolescente , Adulto Jovem , Inglaterra/epidemiologia , Hospitalização/estatística & dados numéricos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Resultado do Tratamento , Ritonavir/uso terapêutico , Ritonavir/administração & dosagem , Betacoronavirus , Administração Oral , Citidina/análogos & derivados , Hidroxilaminas
6.
BMJ Open Diabetes Res Care ; 12(4)2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39122365

RESUMO

INTRODUCTION: The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes. RESEARCH DESIGN AND METHODS: The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM. RESULTS: The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM. CONCLUSION: Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Multimorbidade , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Masculino , Feminino , Londres/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Hiperglicemia/epidemiologia , Idoso , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Prevalência , Seguimentos
7.
Am Psychol ; 2023 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-37471008

RESUMO

Bots are automated software programs that pose an ongoing threat to psychological research by invading online research studies and their increasing sophistication over time. Despite this growing concern, research in this area has been limited to bot detection in existing data sets following an unexpected encounter with bots. The present three-condition, quasi-experimental study aimed to address this gap in the literature by examining the efficacy of three types of bot screening tools across three incentive conditions ($0, $1, and $5). Data were collected from 444 respondents via Twitter advertisements between July and September 2021. The efficacy of five task-based (i.e., anagrams, visual search), question-based (i.e., attention checks, ReCAPTCHA), and data-based (i.e., consistency, metadata) tools was examined with Bonferroni-adjusted univariate and multivariate logistic regression analyses. In general, study results suggest that bot screening tools function similarly for participants recruited across incentive conditions. Moreover, the present analyses revealed heterogeneity in the efficacy of bot screening tool subtypes. Notably, the present results suggest that the least effective bot screening tools were among the most commonly used tools in existing literature (e.g., ReCAPTCHA). In sum, the study findings revealed highly effective and highly ineffective bot screening tools. Study design and data integrity recommendations for researchers are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

8.
Hum Vaccin Immunother ; 19(2): 2240690, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37553178

RESUMO

We report the screening and enrollment process for a phase I vaccine trial in Masaka, Uganda that investigated the safety and immunogenicity of a self-amplifying SARS-CoV-2 RNA vaccine amongst individuals with and without antibodies to SARS-CoV-2. Participant screening and enrollment were conducted between December 2021 and April 2022. Individuals were eligible if they were aged between 18 and 45 years, healthy, and never vaccinated against COVID-19. SARS-CoV-2 antibody status was determined using two point-of-care rapid tests, i.e. Multi G (MGFT3) and Standard Q (Standard Q COVID-19 IgM/IgG Plus). Data were entered and managed in OpenClinica. Analyses were performed and presented descriptively. A total of 212 individuals were screened and 43(20.3%) enrolled. The most common reasons for exclusion were ≥ grade 1 laboratory abnormalities (39, 18.4%), followed by discordant SARS-CoV-2 antibody results (23, 10.9%). While the first 38 participants were quickly enrolled over a period of 9 weeks, it took another 9 weeks to enroll the remaining five, as antibody negative participants became scarce during the surge of the Omicron variant. The SARS-CoV-2 antibody positivity rate was determined to be 60.8% and 84.4% in each half of the 18 months of screening respectively. The mean age (±Standard Deviation, SD) of screened and enrolled participants was 27.7 (±8.1) and 30.2 (±8.3) years respectively. We demonstrated that it is feasible to successfully screen and enroll participants for COVID-19 vaccine trials in Uganda in the time of a pandemic. Our experiences may be useful for investigators planning to undertake similar work in Africa.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Uganda , RNA Viral , Anticorpos Antivirais , Imunogenicidade da Vacina
9.
Artigo em Inglês | MEDLINE | ID: mdl-34982001

RESUMO

BACKGROUND AND OBJECTIVE: To report the impact of prophylactic laser retinopexy in the prevention of retinal detachments (RDs) in patients with Stickler syndrome. PATIENTS AND METHODS: This was a retrospective, comparative case series of patients with Stickler syndrome from the year 2000 to 2019. We compared the rate of RDs between individuals who did and did not receive prophylactic laser therapy. In patients with an RD, we compared the rate of RD in the fellow eye with and without prophylactic laser treatment. RESULTS: A total of 95 eyes were identified. Fifty-four percent of the overall population was female. The RD rate was 26.7% among eyes without previous prophylactic laser retinopexy and 4.6% among eyes with previous prophylactic laser retinopexy. A Cox proportional model revealed that laser prophylaxis treatment had a statistically significant effect on the risk of RD or retinal tear during the 25-year survival period from birth (P = .034). Eyes receiving treatment were 70% less likely to experience RD or retinal tear (hazard ratio, 0.297; 95% CI, 0.097 to 0.913). CONCLUSIONS: This study's results suggest a potential role for prophylactic laser retinopexy in the prevention of rhegmatogenous RD among patients with a clinical diagnosis of Stickler syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:7-11.].


Assuntos
Doenças do Tecido Conjuntivo , Oftalmopatias Hereditárias , Descolamento Retiniano , Perfurações Retinianas , Artrite , Doenças do Tecido Conjuntivo/complicações , Feminino , Perda Auditiva Neurossensorial , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/prevenção & controle , Perfurações Retinianas/diagnóstico , Estudos Retrospectivos
10.
Assessment ; 29(8): 1901-1916, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34372690

RESUMO

Intraindividual change over time is commonly used to estimate treatment effectiveness. However, patients may not respond similarly to a scale after treatment, rendering pre-post change an unreliable metric. The current objective was to investigate longitudinal measurement invariance of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 among 4,323 patients completing a partial hospital program. We used confirmatory factor analysis to determine (1) factor structure at pretreatment and posttreatment and (2) longitudinal invariance, accounting for dependent observations, using both classical and approximate measurement invariance approaches. Results indicated a two-factor solution for both scales. Longitudinal invariance was not established for either scale, thus, using raw score differences from the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 for measuring symptom change over time may be problematic. The most longitudinally consistent items captured somatic as opposed to affective/cognitive symptoms. We discuss the potential use of these measures for diagnostic screening and between-group comparisons and suggest alternative ways to monitor client progress over time. Limitations included a majority White sample and uniqueness of a partial hospital setting.


Assuntos
Programas de Rastreamento , Questionário de Saúde do Paciente , Humanos , Análise Fatorial
11.
Front Psychiatry ; 13: 1018111, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36793783

RESUMO

Introduction: Approximately half of individuals with posttraumatic stress disorder (PTSD) may meet criteria for other psychiatric disorders, and PTSD symptoms are associated with diminished health and psychosocial functioning. However, few studies examine the longitudinal progression of PTSD symptoms concurrent with related symptom domains and functional outcomes, such that may neglect important longitudinal patterns of symptom progression beyond PTSD specifically. Methods: Therefore, we used longitudinal causal discovery analysis to examine the longitudinal interrelations among PTSD symptoms, depressive symptoms, substance abuse, and various other domains of functioning in five longitudinal cohorts representing veterans (n = 241), civilians seeking treatment for anxiety disorders (n = 79), civilian women seeking treatment for post-traumatic stress and substance abuse (n = 116), active duty military members assessed 0-90 days following TBI (n = 243), and civilians with a history of TBI (n = 43). Results: The analyses revealed consistent, directed associations from PTSD symptoms to depressive symptoms, independent longitudinal trajectories of substance use problems, and cascading indirect relations from PTSD symptoms to social functioning through depression as well as direct relations from PTSD symptoms to TBI outcomes. Discussion: Our findings suggest PTSD symptoms primarily drive depressive symptoms over time, tend to show independence from substance use symptoms, and may cascade into impairment in other domains. The results have implications for refining conceptualization of PTSD co-morbidity and can inform prognostic and treatment hypotheses about individuals experiencing PTSD symptoms along with co-occurring distress or impairment.

12.
Biomacromolecules ; 12(1): 75-81, 2011 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-21141880

RESUMO

The single and triple helical organization of protein chains strongly influences the mechanical properties of gelatin-based materials. A chemical method for obtaining different degrees of helical organization in gelatin is covalent functionalization, while a physical method for achieving the same goal is the variation of the drying conditions of gelatin solutions. Here we explored how the introduction of desaminotyrosine (DAT) and desaminotyrosyl tyrosine (DATT) linked to lysine residues of gelatin influenced the kinetics and thermodynamic equilibrium of the helicalization process of single and triple helices following different drying conditions. Drying at a temperature above the helix-to-coil transition temperature of gelatin (T > T(c), called v(short)) generally resulted in gelatins with relatively lower triple helical content (X(c,t) = 1-2%) than lower temperature drying (T < T(c), called v(long)) (X(c,t) = 8-10%), where the DAT(T) functional groups generally disrupted helix formation. While different helical contents affected the thermal transition temperatures only slightly, the mechanical properties were strongly affected for swollen hydrogels (E = 4-13 kPa for samples treated by v(long) and E = 120-700 kPa for samples treated by v(short)). This study shows that side group functionalization and different drying conditions are viable options to control the helicalization and macroscopic properties of gelatin-based materials.


Assuntos
Dessecação , Gelatina/química , Tirosina/análogos & derivados , Tirosina/química , Cinética , Estrutura Secundária de Proteína , Termodinâmica , Tirosina/síntese química
13.
J Neurotrauma ; 38(2): 261-271, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33023400

RESUMO

Traumatic brain injury (TBI) is a complex injury that has a multi-faceted recovery process. The current "gold standard" for classifying severity of TBI symptoms is the Glasgow Outcome Scale (GOSE), a crude measure of overall dysfunction after TBI. Exploratory factor analysis performed on TRACK-TBI Pilot (N = 297) identified candidate multi-variate outcome measures of neuropsychological impairment and cognitive speed and flexibility at 6 months post-TBI that were confirmed in data from the COBRIT study (N = 645) using confirmatory factor analysis. These new outcome measures were used as the dependent variables in an ordinal logistic regression model, using common data elements (CDE) collected in the emergency department as independent variables, including basic demographics, socioeconomic status, medical history, and measures of blood alcohol and blood pressure. We directly compared these prediction models with the GOSE as the 6-month outcome variable and found that in both the TRACK-TBI pilot and COBRIT studies, both neuropsychiatric complications (approx. 36.0% and 22.3% variance explained) and cognitive speed and flexibility (approx. 33.9% and 24.5% variance explained) were better explained by the prediction model, compared with GOSE (approx. 19.9% and 14.4% variance explained), respectively. While differences in overall distributions of impairment between TRACK-TBI pilot and COBRIT exist and should be explored further for applications of these prediction models, we think these multi-variate end-points more accurately characterize patients' functioning at six-months post-TBI. A multi-variate assessment of end-points seems especially important for characterizing TBI outcomes in cases where gross impairment, such as those measured by the GOSE, may be less evident.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Transtornos Cognitivos/etiologia , Cognição/fisiologia , Satisfação Pessoal , Adulto , Lesões Encefálicas Traumáticas/psicologia , Transtornos Cognitivos/psicologia , Feminino , Escala de Resultado de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Tempo de Reação/fisiologia , Adulto Jovem
14.
Nat Rev Immunol ; 21(10): 626-636, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34373623

RESUMO

Where 2020 saw the development and testing of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at an unprecedented pace, the first half of 2021 has seen vaccine rollout in many countries. In this Progress article, we provide a snapshot of ongoing vaccine efficacy studies, as well as real-world data on vaccine effectiveness and the impact of virus variants of concern. Where they have been deployed in a high proportion of the adult population, the currently approved vaccines have been extremely effective in preventing COVID-19, particularly severe disease. Nonetheless, there are still significant challenges in ensuring equitable vaccine access around the globe and lessons that can be learned for controlling this pandemic and for the next pandemic.


Assuntos
Vacinas contra COVID-19/efeitos adversos , SARS-CoV-2/genética , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/classificação , Vacinas contra COVID-19/imunologia , Ensaios Clínicos como Assunto , Acessibilidade aos Serviços de Saúde , Humanos , SARS-CoV-2/classificação , SARS-CoV-2/imunologia , Organização Mundial da Saúde
15.
PLoS One ; 16(5): e0251992, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34043693

RESUMO

BACKGROUND: Healthcare workers (HCWs) are at high risk of acquiring SARS-CoV-2 and COVID-19 and may therefore be a suitable population for COVID-19 vaccine trials. We conducted a survey to evaluate willingness-to-participate in COVID-19 vaccine trials in a population of HCWs at three hospitals in Uganda. METHODS: The survey was conducted between September and November 2020. Using a standardised questionnaire, data were collected on socio-demographics, previous participation in health research, COVID-19 information sources, underlying health conditions, and willingness-to-participate in COVID-19 vaccine trials. Data were analysed descriptively and a binomial generalised linear model with a log link function used to investigate factors associated with unwillingness to participate. RESULTS: 657 HCWs (female, 63%) were enrolled with a mean age of 33 years (Standard Deviation, 10). Overall willingness-to-participate was 70.2%. Key motivating factors for participation were: hope of being protected against COVID-19 (81.1%), altruism (73.3%), and the opportunity to get health care (26.0%). Selected hypothetical trial attributes reduced willingness-to-participate as follows: weekly-quarterly study visits over a 12-month period (70.2%-63.2%, P = 0.026); provision of approximately 50ml of blood at each study visit (70.2%-63.2%, P = 0.026); risk of mild-moderate local adverse reactions (70.2%-60.3%, P<0.001); chance of receiving candidate vaccine or placebo (70.2%-56.9%, P<0.001); and delay of pregnancy [Overall, 70.2%-57.1% P<0.001); Female, 62.8%-48.4% (P = 0.002); Male, 82.5%-71.5% (P = 0.003)]. Collectively, these attributes reduced willingness-to-participate from [70.2%-42.2% (P<0.001) overall; 82.5%-58.1% (P<0.001) in men; 62.8%-32.6% (P<0.001) in women]. Among individuals that were unwilling to participate, the commonest barriers were concerns over vaccine safety (54.6%) and fear of catching SARS-CoV-2 (31.6%). Unwillingness to participate was associated with being female (aRR 1.97, CI 1.46-2.67, P<0.001) and having university or other higher-level education (aRR 1.52, CI 1.05-2.2, P = 0.026). CONCLUSIONS: Willingness-to-participate in COVID-19 vaccine trials among HCWs in Uganda is high but may be affected by vaccine trial requirements and concerns about the safety of candidate vaccines.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Pessoal de Saúde , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , SARS-CoV-2 , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Uganda/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-34208959

RESUMO

Healthcare workers (HCWs) are at high risk of COVID-19. However, data on HCWs' knowledge, attitudes, and practices (KAP) toward COVID-19 are limited. Between September and November 2020, we conducted a questionnaire-based COVID-19 KAP survey among HCWs at three hospitals in Uganda. We used Bloom's cut-off of ≥80% to determine sufficient knowledge, good attitude, and good practice, and multivariate Poisson regression with robust variance for statistical analysis. Of 717 HCWs invited to participate, 657 (91.6%) agreed and were enrolled. The mean age (standard deviation) of enrollees was 33.2 (10.2) years; most were clinical HCWs (64.7%) and had advanced secondary school/other higher-level education (57.8%). Overall, 83.9% had sufficient knowledge, 78.4% had a positive attitude, and 37.0% had good practices toward COVID-19. Factors associated with KAP were: Knowledge: being a clinical HCW (aRR: 1.12; 95% CI: 1.02-1.23) and previous participation in health research (aRR: 1.10; 95% CI: 1.04-1.17); Attitude: age > 35 years (aRR: 0.88; 95% CI: 0.79-0.98); Practice: being a clinical HCW (aRR: 1.91; 95% CI: 1.41-2.59). HCWs in Uganda have good knowledge and positive attitude but poor practices towards COVID-19. Differences in COVID-19 KAP between clinical and non-clinical HCWs could affect uptake of COVID-19 interventions including vaccination.


Assuntos
COVID-19 , Adulto , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , SARS-CoV-2 , Inquéritos e Questionários , Uganda
17.
Macromol Rapid Commun ; 31(17): 1534-9, 2010 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-21567563

RESUMO

Molecular models of gelatin-based materials formed the basis for the knowledge-based design of a physically cross-linked polymer system. The computational models with 25 wt.-% water content were validated by comparison of the calculated structural properties with experimental data and were then used as predictive tools to study chain organization, cross-link formation, and estimation of mechanical properties. The introduced tyrosine-derived side groups, desaminotyrosine (DAT) and desaminotyrosyl tyrosine (DATT), led to the reduction of the residual helical conformation and to the formation of physical net-points by π-π interactions and hydrogen bonds. At 25 wt.-% water content, the simulated and experimentally determined mechanical properties were in the same order of magnitude. The degree of swelling in water decreased with increasing the number of inserted aromatic functions, while Young's modulus, elongation at break, and maximum tensile strength increased.

18.
Psychol Addict Behav ; 34(3): 421-433, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31999171

RESUMO

People who drink alcohol to cope with negative affect tend to drink more and experience more frequent negative alcohol-related consequences. Experiential avoidance-the tendency to avoid, suppress, or otherwise attempt to control unwanted inner experiences-is a largely pathological process that may help account for how negative affect is linked to increased alcohol consumption. However, research to-date has typically used global, trait-like measures, which limit our understanding of the conditions under which experiential avoidance is problematic. The current study tested both between-person (trait) and within-person (daily) variation in experiential avoidance and negative affect as predictors of solitary and social drinking in a sample of 206 adult drinkers who completed daily diaries for 21 days. Participants higher in trait experiential avoidance drank alone more often, whereas those higher in trait negative affect consumed greater quantities when drinking alone. Although daily fluctuations in experiential avoidance did not predict solitary drinking, there was a significant interaction between daily experiential avoidance and trait negative affect. For participants high in trait negative affect, greater experiential avoidance on a given day predicted consuming more when drinking alone. For participants low in trait negative affect, greater experiential avoidance on a given day predicted drinking alone more often, but consuming fewer drinks on these occasions. Experiential avoidance did not predict social drinking in any model. Overall, results suggest that a broader tendency to experience negative affect sets the context for experiential avoidance to be linked to more harmful patterns of drinking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Afeto , Consumo de Bebidas Alcoólicas/psicologia , Aprendizagem da Esquiva , Depressão/psicologia , Aprendizagem Baseada em Problemas , Adolescente , Adulto , Idoso , Alcoolismo/psicologia , Caráter , Etanol , Feminino , Humanos , Individualidade , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Social , Isolamento Social , Inquéritos e Questionários , Adulto Jovem
19.
Behav Res Ther ; 126: 103557, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32014692

RESUMO

This dismantling trial compared the effects of a full online Acceptance and Commitment Therapy (ACT) intervention to the isolated effects of the Open (i.e., acceptance, cognitive defusion) and Engaged (i.e., values, committed action) components of ACT. A sample of 181 distressed college students were randomized to one of four conditions: a 12-session full ACT website (Full), a version targeting the Open components (Open), a version targeting the Engaged components (Engaged), or waitlist. Participants in active conditions were also randomized to receive phone coaching or just email prompts to increase program adherence. All three ACT conditions significantly improved over time relative to the waitlist condition on the primary outcome of mental health symptoms. The Engaged and Full conditions had greater rates of reliable change on the primary outcome relative to waitlist, but not the Open condition. Similarly, only Engaged and Full conditions improved on positive mental health relative to waitlist. The Full condition had greater improvements on a few ACT process measures relative to Engaged and Open conditions, particularly cognitive fusion. Overall, results indicate targeting only the Open components of ACT was somewhat less effective, and that including both the Open and Engaged components led to greater decreases in cognitive fusion.


Assuntos
Intervenção Baseada em Internet , Saúde Mental , Angústia Psicológica , Estresse Psicológico/terapia , Estudantes/psicologia , Terapia de Aceitação e Compromisso , Adolescente , Adulto , Feminino , Humanos , Masculino , Estresse Psicológico/psicologia , Universidades , Adulto Jovem
20.
J Surg Res ; 153(1): 83-94, 2009 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-18541265

RESUMO

INTRODUCTION: Decompression illness (DCI) results from sudden changes in ambient pressure leading to super-saturation and bubble formation in tissues and the blood stream. Perfluorocarbon emulsions (PFC) increase both oxygen and nitrogen solubility when infused into the blood stream. This study hypothesized that PFC would increase N(2) removal as well as O(2) delivery to tissues. MATERIALS AND METHODS: Juvenile swine (20 kg) were anesthetized and highly instrumented with arterial monitoring, pulmonary artery catheterization, EDAC ultrasound bubble detection, and end tidal N(2) by mass spectrometry. Blood gases were monitored in both the mixed venous and arterial circulation. Full hemodynamics were calculated using standard equations. Four groups of animals were randomized to be either sham controls or compressed and to receive either saline or PFC at 4.5 ml/kg. Animals were dry compressed to 6.8 ATA for 30 minutes of time on the bottom and then rapidly decompressed. Animals were monitored for 120 minutes after surfacing, then euthanized. RESULTS: DCI was created by the dive profile but the severity was variable. Sham animals had no significant changes except that those who received PFC developed significant pulmonary hypertension and decreased cardiac output. This held true for those that also underwent DCI. Respiratory N(2) washout was not significantly different with and without PFC. However, O(2) delivery to tissues was improved with PFC and EDAC bubble count was dramatically less with PFC. CONCLUSIONS: PFC decreased bubble generation but the data was confounded by a species specific pulmonary hypertensive response. Even with this as a problem O(2) delivery to tissues was enhanced by PFC. Future work with PFC in different species will help to further understand the contribution of these two mechanisms to treatment efficacy by PFC in DCI.


Assuntos
Substitutos Sanguíneos/administração & dosagem , Doença da Descompressão/tratamento farmacológico , Fluorocarbonos/administração & dosagem , Animais , Modelos Animais de Doenças , Emulsões , Feminino , Masculino , Nitrogênio/sangue , Oxigênio/sangue , Suínos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA