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1.
Sensors (Basel) ; 24(14)2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39066025

RESUMO

This paper presents a novel methodology to localise Unmanned Ground Vehicles (UGVs) using Unmanned Aerial Vehicles (UAVs). The UGVs are assumed to be operating in a Global Navigation Satellite System (GNSS)-denied environment. The localisation of the ground vehicles is achieved using UAVs that have full access to the GNSS. The UAVs use range sensors to localise the UGV. One of the major requirements is to use the minimum number of UAVs, which is two UAVs in this paper. Using only two UAVs leads to a significant complication that results an estimation unobservability under certain circumstances. As a solution to the unobservability problem, the main contribution of this paper is to present a methodology to treat the unobservability problem. A Constrained Extended Kalman Filter (CEKF)-based solution, which uses novel kinematics and heuristics-based constraints, is presented. The proposed methodology has been assessed based on the stochastic observability using the Posterior Cramér-Rao Bound (PCRB), and the results demonstrate the successful operation of the proposed localisation method.

2.
J Am Chem Soc ; 144(11): 4977-4988, 2022 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-35274938

RESUMO

Electron/proton transfers in water proceeding from ground/excited states are the elementary reactions of chemistry. These reactions of an iconic class of molecules─polypyridineRu(II)─are now controlled by capturing or releasing three of them with hosts that are shape-switchable. Reversible erection or collapse of the host walls allows such switchability. Some reaction rates are suppressed by factors of up to 120 by inclusive binding of the metal complexes. This puts nanometric coordination chemistry in a box that can be open or shut as necessary. Such second-sphere complexation can allow considerable control to be exerted on photocatalysis, electrocatalysis, and luminescent sensing involving polypyridineRu(II) compounds. The capturing states of hosts are symmetry-matched to guests for selective binding and display submicromolar affinities. A perching complex, which is an intermediate state between capturing and releasing states, is also demonstrated.


Assuntos
Complexos de Coordenação , Compostos Heterocíclicos , Rutênio , 2,2'-Dipiridil/química , Complexos de Coordenação/química , Rutênio/química , Água
3.
BMC Psychiatry ; 22(1): 400, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705927

RESUMO

BACKGROUND: Financial distress is thought to be a key reason why small-medium enterprise (SME) owners experience higher levels of mental health conditions compared with the broader population. Business advisors who form trusting, high-quality relationships with their SME clients, are therefore well placed to: (1) help prevent/reduce key sources of financial distress, (2) better understand the business and personal needs of their clients and, (3) recognise the signs and symptoms of mental health conditions and encourage help-seeking where appropriate. The aim of this study is to compare the effectiveness of relationship building training (RBT) combined with mental health first aid (MHFA) training for business advisors with MHFA alone, on the financial and mental health of their SME-owner clients. METHODS: This is a single blind, two-arm randomised controlled trial. Participants will be business advisors who provide information, guidance and/or assistance to SME owner clients and are in contact with them at least 3 times a year. The business advisors will invite their SME-owner clients to complete 3 online surveys at baseline, 6- and 12-months. Business advisors will be randomised to one of two conditions, using a 1:1 allocation ratio: (1) MHFA with RBT; or (2) MHFA alone, and complete 3 online surveys at baseline, 2- and 6-months. Primary outcomes will be measured in the business advisors and consist of the quality of the relationship, stigmatizing attitude, confidence to offer mental health first aid, quality of life and provision of mental health first aid. Secondary outcomes will be measured in the SME owners and includes trust in their business advisors, the quality of this relationship, financial wellbeing, financial distress, psychological distress, help-seeking behaviour, and quality of life. To complement the quantitative data, we will include a qualitative process evaluation to examine what contextual factors impacted the reach, effectiveness, adoption, implementation, and maintenance of the training. DISCUSSION: As there is evidence for the connections between client trust, quality of relationship and financial and mental wellbeing, we hypothesise that the combined RBT and MHFA training will lead to greater improvements in these outcomes in SME owners compared with MHFA alone. TRIAL REGISTRATION: ClinicalTrials.gov : NCT04982094 . Retrospectively registered 29/07/2021. The study started in February 2021 and the recruitment is ongoing.


Assuntos
Letramento em Saúde , Saúde Mental , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Confiança
4.
BMC Health Serv Res ; 22(1): 657, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35578247

RESUMO

BACKGROUND: The Southern Province of Sri Lanka is endemic with dengue, with frequent outbreaks and occurrence of severe disease. However, the economic burden of dengue is poorly quantified. Therefore, we conducted a cost analysis to assess the direct and indirect costs associated with hospitalized patients with dengue to households and to the public healthcare system. METHODS: From June 2017-December 2018, we prospectively enrolled children and adults with acute dengue hospitalized at the largest, public tertiary-care (1800 bed) hospital in the Southern Province, Sri Lanka. We administered a structured questionnaire to obtain information regarding direct costs spent by households on medical visits, medications, laboratory testing, and travel for seeking care for the illness. Indirect costs lost by households were estimated by identifying the days of work lost by patients and caregivers and school days lost by children. Direct hospital costs were estimated using gross costing approach and adjusted by multiplying by annual inflation rates in Sri Lankan rupees and converted to US dollars. RESULTS: A total of 1064 patients with laboratory-confirmed dengue were enrolled. The mean age (SD) was 35.9 years (15.6) with male predominance (66.2%). The mean durations of hospitalization for adults and paediatric patients were 3.86 (SD = 1.51) and 4 (SD = 1.32) days, respectively. The per-capita direct cost borne by the healthcare system was 233.76 USD, and was approximately 14 times greater than the per-capita direct cost borne by households (16.29 USD, SD = 14.02). The per-capita average number of loss of working days was 21.51 (SD = 41.71), with mean per-capita loss of income due to loss of work being 303.99 USD (SD = 569.77), accounting for over 70% of average monthly income. On average, 10.88 days (SD = 10.97) of school days were missed due to the dengue episode. School misses were expected to reduce future annual income of affected children by 0.44%. CONCLUSIONS: Dengue requiring hospitalization had a substantial economic burden on the public healthcare system in Sri Lanka and the affected households. These findings emphasize the importance of strengthening dengue control activities and improved use of hospital-based resources for care to reduce the economic impact of dengue in Sri Lanka.


Assuntos
Dengue , Hospitalização , Adulto , Criança , Dengue/epidemiologia , Dengue/terapia , Características da Família , Feminino , Custos Hospitalares , Humanos , Masculino , Sri Lanka/epidemiologia
5.
J Immunoassay Immunochem ; 43(2): 213-221, 2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-34724872

RESUMO

Dengue is among the deadliest insect-borne diseases circulating in Sri Lanka. Most of the infections that are diagnosed early are manageable. However, delays in diagnosis may cause fatalities. We evaluated the dengue NS1 antigen card and NS1 SD kit for early diagnosis of dengue using samples from 116 RT-PCR-positive patients admitted within 5 days of the fever onset. RT-PCR tests were performed as standard tests. IgM and IgG ELISA tests were carried out to identify primary and secondary infections. Of the 116 patients who tested positive for dengue using PCR, 48 were positive using NS1 antigen card and 45 were positive using NS1 SD. Patients with 100 copies or higher viral load showed a higher sensitivity in both antigen card and NS1 SD. Of 34 primary infections evaluated, 23 were positive by NS1 antigen card, while the positivity was 21 by NS1 SD. Of the 30 secondary infections evaluated, 15 were positive by NS1 antigen card while 14 by NS1 SD. Our findings showed that while the rapid tests are convenient and much easier to use than PCR, they are less sensitive and need improvement. Until then, clinical diagnosis should have more emphasis on the early diagnosis of dengue.


Assuntos
Dengue , Anticorpos Antivirais , Antígenos Virais , Dengue/diagnóstico , Diagnóstico Precoce , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina M , Kit de Reagentes para Diagnóstico , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Sri Lanka , Proteínas não Estruturais Virais/genética
6.
Phys Rev Lett ; 126(2): 023201, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33512178

RESUMO

Chirality causes symmetry breaks in a large variety of natural phenomena ranging from particle physics to biochemistry. We investigate one of the simplest conceivable chiral systems, a laser-excited, oriented, effective one-electron Li target. Prepared in a polarized p state with |m|=1 in an optical trap, the atoms are exposed to co- and counterrotating circularly polarized femtosecond laser pulses. For a field frequency near the excitation energy of the oriented initial state, a strong circular dichroism is observed and the photoelectron energies are significantly affected by the helicity-dependent Autler-Townes splitting. Besides its fundamental relevance, this system is suited to create spin-polarized electron pulses with a reversible switch on a femtosecond timescale at an energy resolution of a few meV.

7.
Chemistry ; 27(52): 13268-13274, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34233035

RESUMO

Temperature-driven fluorescent NOT logic is demonstrated by exploiting predissociation in a 1,3,5-trisubstituted Δ2 -pyrazoline on its own and when grafted onto silica microparticles. Related Δ2 -pyrazolines become proton-driven YES and NOT logic gates on the basis of fluorescent photoinduced electron transfer (PET) switches. Additional PASS 1 and YES+PASS 1 logic gates on silica are also demonstrated within the same family. Beside these small-molecule systems, a polymeric molecular thermometer based on a benzofurazan-derivatized N-isopropylacrylamide copolymer is attached to silica to produce temperature-driven fluorescent YES logic.


Assuntos
Lógica , Prótons , Transporte de Elétrons , Corantes Fluorescentes , Temperatura
8.
Physiol Plant ; 173(4): 2276-2290, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34609754

RESUMO

Increased atmospheric CO2 and consequent increases in temperature are two prominent features of climate change, a major challenge to crops. Here, our objectives were to determine: (1) the responses of sugarcane during the first 90 days of elevated CO2 (ECO2 ) and elevated temperature (ETem), both individually and together, and (2) the genotypic variation of these responses. Eight varieties were grown both in open-top chambers in a factorial combination of ambient/ECO2 concentrations (344-351/777-779 ppm) and ambient/ETem (34.9-35.6/36.6-38.4°C) and in open fields. Significant treatment × variety interaction effects were observed on leaf net photosynthetic rate (An ), stomatal conductance (gs ), transpiration rate (El ), and instantaneous transpiration efficiency (TE ). In most varieties, ECO2 alone did not affect An, but the combination of ECO2 and ETem decreased An . ECO2 decreased gs and El while increasing TE in all varieties. These effects were amplified when ETem was combined with ECO2 . ETem alone had variable effects on An and gs depending on variety, while it increased El and did not affect TE in a majority of varieties. Germination, tillering and stem diameter were not affected by treatments and did not show varietal variation. Leaf water potential, chlorophyll (spad), leaf area, and aboveground dry weight per plant showed varietal variations but were not affected by treatments. The variable responses to ETem and the significant genotypic variation to ECO2 and elevated temperature (ETem) observed in this work, both individually and together, demonstrate a considerable scope to breed sugarcane varieties for a future high-CO2 and warmer climate.


Assuntos
Dióxido de Carbono , Saccharum , Fotossíntese , Folhas de Planta/genética , Saccharum/genética , Temperatura
9.
BMC Gastroenterol ; 21(1): 71, 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33593289

RESUMO

BACKGROUND: Inflammatory bowel disease (IBD) is increasing in the Asia-Pacific region, with changes in disease phenotype and course. We aimed to assess the changing phenotypes of IBD over ten years, describe the early clinical course (ECC) and identify the clinical predictors (CP) of poor outcomes among a large, multi-centre, cohort of Sri Lankan IBD patients. METHODS: We included patients [diagnosed between June/2003-December/2009-Group-1(G1), January/2010-June/2016-Group-2(G2)] with ulcerative colitis (UC) and Crohn disease (CD) from five national-referral centres. Changing phenotype from G1 to G2, ECC (disease duration < 3-years) and CP of poor outcomes (disease duration ≥ 1-year) was assessed. Poor outcomes were complicated-disease (CompD-stricturing/penetrating-CD, extensive-UC/pancolitis, perforation/bleeding/colectomy/malignancy) and treatment-refractory disease (TRD-frequently-relapsing, steroid-dependent/refractory and biologic use). RESULTS: 375 (UC-227, CD-148) patients were recruited. Both G1/G2 had more UC than CD (77% vs 23%, 54.5 vs 45.5 respectively, p < 0.01). Increase of CD from G1-to-G2 was significant (23-45.4%, p < 0.001). In both groups, left-sided colitis (E2) and ileo-colonic (L3)/non-stricturing, non-penetrating disease behaviour (B1) CD predominated. Extensive-colitis (E3) (36.4% vs 22.7, p < 0.05) and stricturing-CD (B2) (26.1% vs 4.0%, p < 0.01) was commoner in G1. ECC was assessed in 173-patients (UC-94, CD-79). Aggressive disease behaviour and TRD were low among both UC and CD. Immunomodulator use was significantly higher among CD than UC (61.5% vs 29.0% respectively, p < 0.01). Anti-TNF use was low among both groups (UC-3.2%, CD-7.7%). Disease complications among UC [bleeding (2.1%), malignancy-(1.1%), surgery-(2.1%)] and CD [stricture-(3.9%), perforation-(1.3%), malignancy-(1.3%), surgery-(8.9%)] were generally low. CPs were assessed in 271-patients (UC-163, CD-108). Having a family history of IBD (for UC), extraintestinal manifestation (EIM), severe disease at presentation, being in younger age categories and severe disease at presentation, (for both UC and CD) predicted poor outcomes. CONCLUSION: There was an increase in CD over time without change in disease phenotype for both UC and CD. A relatively benign ECC was observed. Family history (UC), EIMs (UC/CD), severe disease at presentation (UC/CD), younger age (CD/UC) CPs of poor outcomes.


Assuntos
Colite Ulcerativa , Doenças Inflamatórias Intestinais , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/epidemiologia , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/epidemiologia , Fenótipo , Estudos Retrospectivos , Sri Lanka/epidemiologia , Atenção Terciária à Saúde , Fator de Necrose Tumoral alfa
10.
Anaesthesia ; 76(9): 1198-1206, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33440019

RESUMO

Published data suggest that the type of general anaesthesia used during surgical resection for cancer may impact on patient long-term outcome. However, robust prospective clinical evidence is essential to guide a change in clinical practice. We explored the feasibility of conducting a randomised controlled trial to investigate the impact of total intravenous anaesthesia with propofol vs. inhalational volatile anaesthesia on postoperative outcomes of patients undergoing major cancer surgery. We undertook a randomised, double-blind feasibility and pilot study of propofol total intravenous anaesthesia or volatile-based maintenance anaesthesia during cancer resection surgery at three tertiary hospitals in Australia and the USA. Patients were randomly allocated to receive propofol total intravenous anaesthesia or volatile-based maintenance anaesthesia. Primary outcomes for this study were successful recruitment to the study and successful delivery of the assigned anaesthetic treatment as per randomisation arm. Of the 217 eligible patients approached, 146 were recruited, a recruitment rate of 67.3% (95%CI 60.6-73.5%). One hundred and forty-five patients adhered to the randomised treatment arm, 99.3% (95%CI 96.2-100%). Intra-operative patient characteristics and postoperative complications were comparable between the two intervention groups. This feasibility and pilot study supports the viability of the protocol for a large, randomised controlled trial to investigate the effect of anaesthesia technique on postoperative cancer outcomes. The volatile anaesthesia and peri-operative outcomes related to cancer (VAPOR-C) study that is planned to follow this feasibility study is an international, multicentre trial with the aim of providing evidence-based guidelines for the anaesthetic management of patients undergoing major cancer surgery.


Assuntos
Anestesia por Inalação/métodos , Anestesia Intravenosa/métodos , Neoplasias/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Inalatórios , Anestésicos Intravenosos , Austrália/epidemiologia , Método Duplo-Cego , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Propofol , Estados Unidos/epidemiologia
11.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770525

RESUMO

This paper proposes an algorithm that will allow an autonomous aerial drone to approach and follow a steady or moving herd of cattle using only range measurements. The algorithm is also insensitive to the complexity of the herd's movement and the measurement noise. Once arrived at the herd of cattle, the aerial drone can follow it to a desired destination. The primary motivation for the development of this algorithm is to use simple, inexpensive and robust sensing hence range sensors. The algorithm does not depend on the accuracy of the range measurements, rather the rate of change of range measurements. The proposed method is based on sliding mode control which provides robustness. A mathematical analysis, simulations and experimental results with a real aerial drone are presented to demonstrate the effectiveness of the proposed method.


Assuntos
Algoritmos , Ruído , Animais , Bovinos
12.
Angew Chem Int Ed Engl ; 60(25): 13819-13823, 2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-33723888

RESUMO

A colorimetric indicator displacement assay (IDA) amenable to high-throughput experimentation was developed to determine the percentage of cis and trans alkenes. Using 96-well plates two steps are performed: a reaction plate for dihydroxylation of the alkenes followed by an IDA screening plate consisting of an indicator and a boronic acid. The dihydroxylation generates either erythro or threo vicinal diols from cis or trans alkenes, depending upon their syn- or anti-addition mechanisms. Threo diols preferentially associate with the boronic acid due to the creation of more stable boronate esters, thus displacing the indicator to a greater extent. The generality of the protocol was demonstrated using seven sets of cis and trans alkenes. Blind mixtures of cis and trans alkenes were made, resulting in an average error of ±2 % in the percentage of cis or trans alkenes, and implementing E2 and Wittig reactions gave errors of ±3 %. Furthermore, we developed variants of the IDA for which the color may be tuned to optimize the response for the human eye.


Assuntos
Alcenos/química , Colorimetria , Estrutura Molecular , Estereoisomerismo
13.
Scand J Gastroenterol ; 55(8): 1005-1011, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32650675

RESUMO

While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases.


Assuntos
Infecções por Coronavirus/epidemiologia , Gastroenterologia/organização & administração , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Controle de Infecções/organização & administração , Pandemias/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Pessoal de Saúde/organização & administração , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Estados Unidos
14.
Chemistry ; 25(36): 8522-8527, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-30947361

RESUMO

One of the challenges for fluorescent sensors is to reduce their target environment size from a micrometer scale, such as biological cells, to a nanometer scale. Proton maps near membranes are of importance in bioenergetics and are the first goal in nanometer-scale analysis with fluorescent sensors. Thirty-three fluorescent photoinduced-electron-transfer pH sensors bearing an environment-sensitive benzofurazan fluorophore and having different hydrophobicity/hydrophilicity and hydrogen-bonding abilities were prepared. These sensors were scattered in nanospaces associated with anionic and cationic micelles as model membranes to indicate proton availability and polarity in local spaces. Gathering the data from the sensors allowed the successful drawing of proton maps near anionic and cationic micelles, in which electrostatic attraction/repulsion of protons by the charged head groups of micelles and dielectric suppression of protons were clearly observed.


Assuntos
Corantes Fluorescentes/química , Micelas , Compostos de Bis-Trimetilamônio/química , Transporte de Elétrons , Concentração de Íons de Hidrogênio , Prótons , Dodecilsulfato de Sódio/química , Espectrometria de Fluorescência
15.
Crit Care ; 22(1): 18, 2018 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-29373996

RESUMO

BACKGROUND: Prognostic models-used in critical care medicine for mortality predictions, for benchmarking and for illness stratification in clinical trials-have been validated predominantly in high-income countries. These results may not be reproducible in low or middle-income countries (LMICs), not only because of different case-mix characteristics but also because of missing predictor variables. The study objective was to systematically review literature on the use of critical care prognostic models in LMICs and assess their ability to discriminate between survivors and non-survivors at hospital discharge of those admitted to intensive care units (ICUs), their calibration, their accuracy, and the manner in which missing values were handled. METHODS: The PubMed database was searched in March 2017 to identify research articles reporting the use and performance of prognostic models in the evaluation of mortality in ICUs in LMICs. Studies carried out in ICUs in high-income countries or paediatric ICUs and studies that evaluated disease-specific scoring systems, were limited to a specific disease or single prognostic factor, were published only as abstracts, editorials, letters and systematic and narrative reviews or were not in English were excluded. RESULTS: Of the 2233 studies retrieved, 473 were searched and 50 articles reporting 119 models were included. Five articles described the development and evaluation of new models, whereas 114 articles externally validated Acute Physiology and Chronic Health Evaluation, the Simplified Acute Physiology Score and Mortality Probability Models or versions thereof. Missing values were only described in 34% of studies; exclusion and or imputation by normal values were used. Discrimination, calibration and accuracy were reported in 94.0%, 72.4% and 25% respectively. Good discrimination and calibration were reported in 88.9% and 58.3% respectively. However, only 10 evaluations that reported excellent discrimination also reported good calibration. Generalisability of the findings was limited by variability of inclusion and exclusion criteria, unavailability of post-ICU outcomes and missing value handling. CONCLUSIONS: Robust interpretations regarding the applicability of prognostic models are currently hampered by poor adherence to reporting guidelines, especially when reporting missing value handling. Performance of mortality risk prediction models in LMIC ICUs is at best moderate, especially with limitations in calibration. This necessitates continued efforts to develop and validate LMIC models with readily available prognostic variables, perhaps aided by medical registries.


Assuntos
Países em Desenvolvimento , Prognóstico , Índice de Gravidade de Doença , APACHE , Cuidados Críticos/métodos , Cuidados Críticos/normas , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva/organização & administração , Modelos Estatísticos , Probabilidade
16.
JAMA ; 319(21): 2202-2211, 2018 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-29800114

RESUMO

Importance: The quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score has not been well-evaluated in low- and middle-income countries (LMICs). Objective: To assess the association of qSOFA with excess hospital death among patients with suspected infection in LMICs and to compare qSOFA with the systemic inflammatory response syndrome (SIRS) criteria. Design, Settings, and Participants: Retrospective secondary analysis of 8 cohort studies and 1 randomized clinical trial from 2003 to 2017. This study included 6569 hospitalized adults with suspected infection in emergency departments, inpatient wards, and intensive care units of 17 hospitals in 10 LMICs across sub-Saharan Africa, Asia, and the Americas. Exposures: Low (0), moderate (1), or high (≥2) qSOFA score (range, 0 [best] to 3 [worst]) or SIRS criteria (range, 0 [best] to 4 [worst]) within 24 hours of presentation to study hospital. Main Outcomes and Measures: Predictive validity (measured as incremental hospital mortality beyond that predicted by baseline risk factors, as a marker of sepsis or analogous severe infectious course) of the qSOFA score (primary) and SIRS criteria (secondary). Results: The cohorts were diverse in enrollment criteria, demographics (median ages, 29-54 years; males range, 36%-76%), HIV prevalence (range, 2%-43%), cause of infection, and hospital mortality (range, 1%-39%). Among 6218 patients with nonmissing outcome status in the combined cohort, 643 (10%) died. Compared with a low or moderate score, a high qSOFA score was associated with increased risk of death overall (19% vs 6%; difference, 13% [95% CI, 11%-14%]; odds ratio, 3.6 [95% CI, 3.0-4.2]) and across cohorts (P < .05 for 8 of 9 cohorts). Compared with a low qSOFA score, a moderate qSOFA score was also associated with increased risk of death overall (8% vs 3%; difference, 5% [95% CI, 4%-6%]; odds ratio, 2.8 [95% CI, 2.0-3.9]), but not in every cohort (P < .05 in 2 of 7 cohorts). High, vs low or moderate, SIRS criteria were associated with a smaller increase in risk of death overall (13% vs 8%; difference, 5% [95% CI, 3%-6%]; odds ratio, 1.7 [95% CI, 1.4-2.0]) and across cohorts (P < .05 for 4 of 9 cohorts). qSOFA discrimination (area under the receiver operating characteristic curve [AUROC], 0.70 [95% CI, 0.68-0.72]) was superior to that of both the baseline model (AUROC, 0.56 [95% CI, 0.53-0.58; P < .001) and SIRS (AUROC, 0.59 [95% CI, 0.57-0.62]; P < .001). Conclusions and Relevance: When assessed among hospitalized adults with suspected infection in 9 LMIC cohorts, the qSOFA score identified infected patients at risk of death beyond that explained by baseline factors. However, the predictive validity varied among cohorts and settings, and further research is needed to better understand potential generalizability.


Assuntos
Mortalidade Hospitalar , Escores de Disfunção Orgânica , Sepse/classificação , Síndrome de Resposta Inflamatória Sistêmica/classificação , Adulto , Área Sob a Curva , Estudos de Coortes , Países em Desenvolvimento , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Infecções/complicações , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Sepse/complicações , Síndrome de Resposta Inflamatória Sistêmica/mortalidade
17.
Cryo Letters ; 39(2): 121-130, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29734421

RESUMO

  BACKGROUND: The cryopreservation protocol that has been developed exclusively for the preservation of the sperm of the species different. OBJECTIVE: this study was to evaluate the effect of the association of 10% DMSO with trehalose, raffinose, sucrose and lactose concentrations on the sperm cells of Piaractus mesopotamicus. MATERIALS AND METHODS: Sperms were collected from the animals through abdominal massage. The samples were diluted in the Beltsville Thawing Solution without different concentrations of other sugars (test conditions). Sixty days after the cryopreservation, cell movement analysis was performed using CASA. RESULTS: The results revealed that the parameters for total motility and motility period were superior when 100mM raffinose (P <0.05). The lateral displacement of the head was observed to be improved was 100mM lactose, 150mM sucrose and 150mM raffinose (P <0.05) as compared to treatment wherein lactose (0mM) was omitted. CONCLUSION: the results of our study indicated that the ideal parameters for cryopreservation, were obtained when the cryopreservation fluid contained 100mM raffinose in association with DMSO.


Assuntos
Criopreservação/métodos , Crioprotetores/farmacologia , Peixes , Preservação do Sêmen/métodos , Animais , Dimetil Sulfóxido/farmacologia , Lactose/farmacologia , Masculino , Rafinose/farmacologia , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Sacarose/farmacologia , Açúcares/farmacologia , Trealose/farmacologia
18.
Int J Obes (Lond) ; 41(7): 1080-1090, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28321132

RESUMO

OBJECTIVE: The aim of this study is to evaluate the impact of the Health-Promoting Communities: Being Active Eating Well (HPC:BAEW, 2007-2010) initiative, which comprised community-based multi-component interventions adapted to community context in five separate communities. The intervention aimed to promote healthy eating, physical activity and stronger, healthier communities. METHODS: A mixed method and multilevel quasi-experimental evaluation of the HPC:BAEW initiative captured process, impact and outcome data. The evaluation involved both cross-sectional (children and adolescents) and longitudinal designs (adults) with data collected pre- and post-intervention in intervention (n=2408 children and adolescents from 18 schools, n=501 adults from 22 workplaces) and comparison groups (n=3163 children and adolescents from 33 schools, n=318 adults from seven workplaces). Anthropometry, obesity-related behavioural and environmental data, information regarding community context and implementation factors were collected. The primary outcomes were differences in anthropometry (weight, waist, body mass index (BMI) and standardised BMI (BMI z-score)) over time compared with comparison communities. Baseline data was collected 2008/2009 and post-intervention collected in 2010 with an average intervention time frame of approximately 12 months. RESULTS: The strategies most commonly implemented were related to social marketing, stakeholder engagement, network and partnership development, community-directed needs assessment and capacity building. Analysis of post-intervention data showed gains in community capacity, but few impacts on environments, policy or individual knowledge, skills, beliefs and perceptions. Relative to the comparison group, one community achieved a lower prevalence of overweight/obesity, lower weight, waist circumference and BMI (P<0.005). One community achieved a higher level of healthy eating policy implementation in schools; two communities achieved improved healthy eating-related behaviours (P<0.03); one community achieved lower sedentary behaviours; and one community achieved higher levels of physical activity in schools (P<0.05). All effect sizes were in the small-to-moderate range. CONCLUSIONS: This was a complex and ambitious initiative, which attempted to expand a previously successful community-based intervention in Victoria into five new contexts and communities. Overall, project success was quite inconsistent, and some significant differences were in the unanticipated direction. However, there are many important learnings that should inform future health-promotion activities. The heterogeneity of outcomes of HPC:BAEW communities reflects the reality of life whereby effectiveness of intervention strategies is dependent on individual and community factors. Future health promotion should consider a systems approach whereby existing systems are modified rather than relying heavily on the addition of new activities, with longer time frames for implementation.


Assuntos
Serviços de Saúde Comunitária , Dieta Saudável , Promoção da Saúde , Obesidade/prevenção & controle , Instituições Acadêmicas , Adolescente , Adulto , Criança , Estudos Transversais , Dieta , Exercício Físico , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Prevalência , Avaliação de Programas e Projetos de Saúde , População Rural , População Urbana , Vitória
19.
Bull World Health Organ ; 95(9): 646-651, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28867845

RESUMO

PROBLEM: In Sri Lanka, rabies prevention initiatives are hindered by fragmented and delayed information-sharing that limits clinicians' ability to follow patients and impedes public health surveillance. APPROACH: In a project led by the health ministry, we adapted existing technologies to create an electronic platform for rabies surveillance. Information is entered by trained clinical staff, and both aggregate and individual patient data are visualized in real time. An automated short message system (SMS) alerts patients for vaccination follow-up appointments and informs public health inspectors about incidents of animal bites. LOCAL SETTING: The platform was rolled out in June 2016 in four districts of Sri Lanka, linking six rabies clinics, three laboratories and the public health inspectorate. RELEVANT CHANGES: Over a 9-month period, 12 121 animal bites were reported to clinics and entered in the registry. Via secure portals, clinicians and public health teams accessed live information on treatment and outcomes of patients started on post-exposure prophylaxis (9507) or receiving deferred treatment (2614). Laboratories rapidly communicated the results of rabies virus tests on dead mammals (328/907 positive). In two pilot districts SMS reminders were sent to 1376 (71.2%) of 1933 patients whose contact details were available. Daily SMS reports alerted 17 public health inspectors to bite incidents in their area for investigation. LESSONS LEARNT: Existing technologies in low-resource countries can be harnessed to improve public health surveillance. Investment is needed in platform development and training and support for front-line staff. Greater public engagement is needed to improve completeness of surveillance and treatment.


Assuntos
Doenças do Cão/prevenção & controle , Doenças do Cão/virologia , Vigilância em Saúde Pública/métodos , Vacina Antirrábica/uso terapêutico , Raiva/epidemiologia , Raiva/prevenção & controle , Animais , Mordeduras e Picadas/epidemiologia , Mordeduras e Picadas/virologia , Cães , Promoção da Saúde/métodos , Humanos , Entrevistas como Assunto , Profilaxia Pós-Exposição/métodos , Administração em Saúde Pública , Raiva/tratamento farmacológico , Sri Lanka/epidemiologia , Envio de Mensagens de Texto , Resultado do Tratamento
20.
Chemphyschem ; 18(13): 1760-1766, 2017 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-28349591

RESUMO

Proton-driven YES and PASS 1 molecular logic tags based on anthracene and 4-aminonaphthalimide fluorophores, emitting blue and green, respectively, are employed on amino-terminated polyethylene glycol-polystyrene and aminopropyl silica particles. The (YES+PASS 1) logic combination is also a distinguishable tag in both colours. The scope of such tags is delineated.

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