RESUMEN
BACKGROUND: Viral respiratory infections may precipitate type 1 diabetes (T1D). A possible association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, and the incidence of T1D is being determined. This study was carried out using Portuguese registries, aiming at examining temporal trends between COVID-19 and T1D. METHODS: Hospital data, comparing the incidence before and during the COVID-19 pandemic, from children and young adults diagnosed with new-onset T1D, was acquired beginning in 2017 and until the end of 2022. Data was obtained from nine different Portuguese hospital units. The impact of the COVID-19 pandemic, beginning in March 2020, was assessed comparing the annual numbers of new-onset T1D cases. The annual median levels of glucose, glycated hemoglobin (HbA1c) and fasting C-peptide at T1D diagnosis were compared. The annual number of diabetic ketoacidosis (DKA) episodes among new T1D cases was also assessed at two centers. RESULTS: In total, data from 574 newly diagnosed T1D patients was analyzed, including 530 (92.3%) children. The mean ages for child and adult patients were 9.1 (SD 4.4) and 32.8 (SD 13.6) years, respectively. 57.8% (331/573) were male, one patient had unknown sex. The overall median (25-75 percentiles) levels of glucose, HbA1c and fasting C-peptide at diagnosis were 454 mg/dL (356-568), 11.8% (10.1-13.4) and 0.50 µg/L (0.30-0.79), respectively. DKA at T1D diagnosis was present in 48.4% (76/157). For eight centers with complete 2018 to 2021 data (all calendar months), no overall significant increase in T1D cases was observed during the COVID-19 pandemic, i.e. 90 cases in 2018, 90 cases in 2019, 112 in 2020 and 100 in 2021 (P for trend = 0.36). Two of the centers, Faro (CHUA) and Dona Estefânia (CHULC) hospitals, did however see an increase in T1D from 2019 to 2020. No significant changes in glucose (P = 0.32), HbA1c (P = 0.68), fasting C-peptide (P = 0.20) or DKA frequency (P = 0.68) at the time of T1D diagnosis were observed over the entire study period. CONCLUSION: The T1D incidence did not increase significantly, when comparing the years before and during the COVID-19 pandemic, nor did key metabolic parameters or number of DKA episodes change.
Asunto(s)
COVID-19 , Diabetes Mellitus Tipo 1 , Sistema de Registros , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/complicaciones , Masculino , Portugal/epidemiología , Femenino , Incidencia , Niño , Adulto , Adolescente , Adulto Joven , Preescolar , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , SARS-CoV-2 , Cetoacidosis Diabética/epidemiología , Glucemia/análisis , Glucemia/metabolismoRESUMEN
The aim of this study was to investigate the mechanisms by which yeasts (Saccharomyces cerevisiae) control the toxic effects of aflatoxins, which are not yet fully understood. Radiolabeled aflatoxin B1 (AFB13H) was administered by gavage to Wistar rats fed with aflatoxin (AflDiet) and aflatoxin supplemented with active dehydrated yeast Y904 (AflDiet + Yeast). The distribution of AFB13H and its metabolites were analyzed at 24, 48 and 72 h by tracking back of the radioactivity. No significant differences were observed between the AflDiet and AflDiet + Yeast groups in terms of the distribution of labeled aflatoxin. At 72 h, for the AflDiet group the radiolabeled aflatoxin was distributed as following: feces (79.5%), carcass (10.5%), urine (1.7%), and intestine (7.4%); in the AflDiet + Yeast the following distribution was observed: feces (76%), carcass (15%), urine (2.9%), and intestine (4.9%). These values were below 1% in other organs. These findings indicate that even after 72 h considerable amounts of aflatoxins remains in the intestines, which may play a significant role in the distribution and metabolism of aflatoxins and its metabolites over time. The presence of yeast may not significantly affect this process. Furthermore, histopathological examination of hepatic tissues showed that the presence of active yeast reduced the severity of liver damage caused by aflatoxins, indicating that yeasts control aflatoxin damage through biochemical mechanisms. These findings contribute to a better understanding of the mechanisms underlying the protective effects of yeasts against aflatoxin toxicity.
Asunto(s)
Aflatoxinas , Saccharomyces cerevisiae , Ratas , Animales , Ratas Wistar , Aflatoxinas/toxicidad , Suplementos Dietéticos , HecesRESUMEN
INTRODUCTION: Imperial College Teddy Bear Hospital (ICSM-TBH) is a student-led volunteering group, which uses interactive, play-based teaching to educate school pupils aged 5-7 years about healthy lifestyles and healthcare. During the COVID-19 pandemic, volunteering sessions shifted online. The aim of this study was to compare the value of online and in-person ICSM-TBH volunteering for volunteers and school pupils. METHODS: Undergraduate university students at Imperial College London (medicine can be taken as a first degree in the UK) who volunteered with ICSM-TBH between 2019 and 22 were invited to complete an anonymous online questionnaire evaluating their experiences of volunteering online and in-person through Likert-scale questions. Those who completed the questionnaire were also invited to an interview. Teachers who hosted online ICSM-TBH sessions were also invited to an in-person interview, exploring their view of their pupils' experiences with these sessions. Questionnaire results were analysed through descriptive statistics. Interviews were analysed through inductive thematic analysis. RESULTS: Thirty-two university students completed the questionnaire. Of these, 9 experienced both in-person and online volunteering, all of whom preferred in-person volunteering. For those who only volunteered in-person, 92% reported that ICSM-TBH sessions were a positive experience, compared to 100% who volunteered online; 92% in person volunteers agreed or strongly agreed that ICSM-TBH volunteering in person improved their mood, compared to 89% online; and 100% agreed or strongly agreed that ICSM-TBH volunteering in person helped them feel part of a community, compared to 84% online. A total of 12 volunteers and 4 teachers were interviewed, from whom five themes emerged: interaction and engagement (interaction and engagement between pupils and volunteers was more readily achieved in-person); personal and professional development (both online and in-person sessions enabled volunteers to gain valuable skills); community and social (greater sense of community was established in-person); emotional wellbeing and enjoyment (both modalities were enjoyed by volunteers and pupils); and workload (online sessions were more convenient for volunteers but with risk of screen fatigue). CONCLUSION: Overall, both in-person and online volunteering were of substantial benefit to volunteers and school pupils. However, most teachers and volunteers preferred in-person volunteering.
Asunto(s)
COVID-19 , Estudiantes de Medicina , Humanos , Pandemias , COVID-19/epidemiología , Universidades , Voluntarios/psicologíaRESUMEN
BACKGROUND: Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors' training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical education to prevent such attitudes propagating into clinical practice. Thus, this study explores whether stigmatising attitudes are detectable amongst medical students in London and Singapore and examines whether they are ameliorated by specific curricular and welfare features of formal medical education, utilising the Mental Illness Stigma Framework (MISF). METHODS: A mixed-methods approach was adopted. Medical students at Imperial College London (UK; n = 211) and Nanyang Technological University (Singapore; n = 141) completed a validated scale (the OMS-HC-15) to assess attitudes towards mental illness. Semi-structured interviews were conducted (Imperial: n = 12, NTU: n = 8) until theoretical saturation was reached. Quantitative data were analysed descriptively and comparatively using SPSS and interview data subjected to inductive thematic analysis. RESULTS: Total OMS-HC-15 scores ranged from 19-51 for Imperial (n = 211) and 16-53 for NTU (n = 141). No significant differences in overall stigma scores were found between the two schools (p = 0.24), nor when comparing year groups within each school. Four themes were identified across interview data: student perceptions, impacts of medical school culture, university support, and curricular impacts on mental illness perceptions. Themes allowed identification of aspects of medical school that were well-received and warranted further emphasis by students, alongside areas for improvement. CONCLUSION: Mental health stigma was identified in two medical schools, with differing cultures. Mean stigma scores obtained were comparable between both UK and Singaporean medical students. Nuanced differences were identified via subgroup analysis, and the MISF identified both shared and country-specific drivers for this stigma across the qualitative data. Actionable recommendations to mitigate this were hypothesised. Curricular improvements such as earlier psychiatric teaching and sharing of personal stories may improve future stigma scores as students' progress through the course. Specific welfare-based changes to formal support systems were also deemed to be beneficial by students. The impacts of welfare and curricular redesign in relation to societal influence on students' attitudes warrants further investigation, as does medical students' self-stigma.
Asunto(s)
Trastornos Mentales , Estudiantes de Medicina , Humanos , Estudiantes de Medicina/psicología , Facultades de Medicina , Estudios Transversales , Actitud del Personal de Salud , Estigma Social , Trastornos Mentales/terapia , Trastornos Mentales/psicologíaRESUMEN
BACKGROUND: In 2019 a new Lifestyle Medicine (LM) module was introduced to the undergraduate medical curriculum at Imperial College London. Lifestyle Medicine is an emergent discipline which aims to tackle the increasing burden of non-communicable disease. Previous work has suggested that students value clinical teaching over traditional Public Health topics. Taking a constructivist view of learning, this paper assesses changes in medical students' attitudes towards Public Health and LM in response to living through a pandemic. We then make suggestions as to how this lived experience might be useful in teaching LM, and discuss the interaction between teaching, behaviour, and experience with consideration of self-determination theories in learning. METHODS: First-year medical students were surveyed at the end of their first year of teaching and asked if living during the COVID-19 pandemic had changed the value they place on LM and if so, how. Thematic analysis was conducted on responses representing 71% (n = 216) of the year group. RESULTS: Four themes were defined in the data: acknowledging importance; impact on behaviour; health inequalities and the wider determinants; and promoting Public Health and prevention. These themes highlight the distinct levels through which the pandemic has had an impact: from personal behaviour to population health. CONCLUSIONS: This is the first study to look at the impact of living through a pandemic on attitudes to LM. Our results suggest that the pandemic has led to increased reflection on health behaviours. The lived-experience of COVID-19 may facilitate a better understanding of health inequalities and their impact, alongside the opportunities presented by effective LM interventions.
Asunto(s)
COVID-19 , Salud Poblacional , Estudiantes de Medicina , Humanos , Estilo de Vida , Pandemias , AutocuidadoRESUMEN
BACKGROUND: Imperial College London launched a new, spiral undergraduate medical curriculum in September 2019. Clinical & Scientific Integrative cases (CSI) is an innovative, flagship module, which uses pioneering methodology to provide early-years learning that [1] is patient-centred, [2] integrates clinical and scientific curriculum content, [3] develops advanced team-work skills and [4] provides engaging, student-driven learning. These aims are designed to produce medical graduates equipped to excel in a modern healthcare environment. METHODS: CSI has adopted a novel educational approach which utilises contemporary digital resources to deliver a collaborative case-based learning (CBL) component, paired with a team-based learning (TBL) component that incorporates both learning and programmatic assessment. This paper serves to explore how first-year students experienced CSI in relation to its key aims, drawing upon quantitative and qualitative data from feedback surveys from CSI's inaugural year. It provides a description and analysis of the module's design, delivery, successes and challenges. RESULTS: Our findings indicate that CSI has been extremely well-received and that the majority of students agree that it met its aims. Survey outputs indicate success in integrating multiple elements of the curriculum, developing an early holistic approach towards patients, expediting the development of important team-working skills, and delivering authentic and challenging clinical problems, which our students found highly relevant. Challenges have included supporting students to adapt to a student-driven, deep learning approach. CONCLUSIONS: First-year students appear to have adopted a patient-centred outlook, the ability to integrate knowledge from across the curriculum, an appreciation for other team members and the self-efficacy to collaboratively tackle challenging, authentic clinical problems. Ultimately, CSI's innovative design is attractive and pertinent to the needs of modern medical students and ultimately, future doctors.
Asunto(s)
Educación de Pregrado en Medicina , Prácticas Interdisciplinarias , Estudiantes de Medicina , Curriculum , Retroalimentación , Humanos , AutoeficaciaRESUMEN
BACKGROUND: During COVID-19 pandemic, children are confined at home, with changes in family routines. AIM: Evaluate sleep disorders among Brazilian and Portuguese children during social distancing, and its association with parental perception of child's oral hygiene. DESIGN: In this cross-sectional study, Portuguese and Brazilian parents/caregivers of 3- to 15-year-old children, practicing social distancing due to COVID-19 pandemic, answered an online questionnaire, from April 24-26, 2020, evaluating sociodemographic characteristics, child's school activities online, child's sleep quality during social distancing. Two questions from the questionnaire, developed based on previous studies, evaluated the parental perception of child's oral hygiene quality and routine changes during social distancing. Parents/caregivers answered five domains of the Portuguese-language version of the Sleep Disturbances Scale for Children, evaluating sleep-breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence and sleep hyperhidrosis. Descriptive, Linear-by-linear association, Kruskal-Wallis and post hoc analysis were performed (P ≤ .05). RESULTS: Participated in the study 253 parents/caregivers, 50.2% from Brazil. Most parents (72.2%) reported changes in child's routine during social distancing. Sleep breathing disorders (P = .019), sleep-wake transition disorders (P = .022), and disorders of excessive somnolence (P < .001) were associated with poor oral hygiene during social distancing. CONCLUSION: Sleep disorders are associated with poor oral hygiene during social distancing.
Asunto(s)
COVID-19 , Pandemias , Adolescente , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Humanos , Higiene Bucal , Padres , SARS-CoV-2 , Sueño , Encuestas y CuestionariosRESUMEN
Salmonella food poisoning is a public health problem. Feed withdrawal from broiler chickens before slaughter can favor the multiplication of Salmonella in the cecum and crop of contaminated animals and subsequently lead to contamination of carcasses in the processing plant. In the present study, a cocktail of lytic bacteriophages isolated from sewage water was orally administered to 45-d-old broiler chickens 1 h after they received an oral dose of 10(7) cfu/mL Salmonella enterica subspecies enterica serotype Enteritidis. Immediately after phage administration and 30 min, 1, 3, 6, and 12 h thereafter, groups of chicken were killed. Ceca and crops were analyzed for the presence of Salmonella. At 3 h posttreatment, there were 10(3) cfu/g and 10(1) cfu/g of cecal and crop suspension, respectively. At 6 h after treatment, the number of Salmonella was 10(3) cfu/g in the cecal suspension, but below the detection limit in the crops. Our results suggest that bacteriophage therapy may be able to reduce the contamination of chicken carcasses by reducing the preslaughter load of Salmonella in the birds.
Asunto(s)
Pollos , Buche de las Aves/microbiología , Privación de Alimentos , Enfermedades de las Aves de Corral/microbiología , Fagos de Salmonella/fisiología , Salmonella enteritidis/virología , Mataderos , Animales , Salmonelosis AnimalRESUMEN
PURPOSE: This paper presents the results of an online survey and subsequent interviews investigating whether, how, and why public administrations of Brazilian states and the federal district (Federation Units) use open government data. According to the literature reviewed, the questions were categorized into four big groups: benefits, barriers, enablers, and drivers. DESIGN/METHODOLOGY/APPROACH: The Survey method, based on a questionnaire followed by interviews, was used to collect and analyze data from the open data officers of 26 Brazilian Federation Units. FINDINGS: The use of open government data is controversial as responses from the questionnaires and interviews do not match and raise questions about how well-represented each Federation Unit was. Evidence of open government data use was found. Among others, findings showed that political leadership committed to using open data facilitates and motivates public agents to use these data. Additionally, interviews indicated that the lack of human resources with the knowledge, skills, and capabilities to use open data is a relevant barrier to data use. Findings also revealed that open government data mainly support policy and decision-making processes. PRACTICAL IMPLICATIONS: This research contributed to the open data and public administration fields. It portrays diverse realities of open government data use and institutionalization in Brazilian state and district public administrations. In addition, it provides lists of open government data use benefits, barriers, drivers, and enablers from the perspective of these administrations so that they can benchmark against each other and improve their OGD use. ORIGINALITY AND RESEARCH IMPLICATIONS: For academia, this research provides empirical evidence of the factors influencing public administrations' use of open government data at the subnational level in Brazil. Even though Brazil ranks high on OGD global assessments, few studies on its use and reuse in the public sector were identified. This is one of the first academic studies focusing on open government data use in the country. It also contributes by offering to the academic community two instruments, a questionnaire and an interview protocol, which can be applied to other public settings to expand this study's results or open new research paths by applying them to other contexts.
Asunto(s)
Gobierno , Sector Público , Humanos , Brasil , Benchmarking , InstitucionalizaciónRESUMEN
Cardiovascular disease and cancer constitute the most prevalent illnesses worldwide. Cancer patients show an increased risk of coronary artery disease not only due to shared cardiovascular risk factors, a pro-inflammatory and prothrombotic state induced by cancer itself, the cardiovascular toxicity of cancer therapy, or rarely, due to extrinsic compression of a coronary artery by the primary tumor or a metastatic lesion. Here, we present the case of a 59-year-old man with squamous cell carcinoma of the lung presented with asymptomatic diffuse ST segment depression and troponin T increase. Echocardiography revealed a large mass adjacent to the right atrium, atrioventricular groove, and basal segment of the anterior wall of the left ventricle, which the computed tomography scan showed to encase and probably compress the anterior descending coronary artery. Thus, the patient was diagnosed with acute coronary syndrome due to anterior descendent coronary artery compression by a neoplastic lung mass.
RESUMEN
This study explores a method that has the potential to be cost effective in inhibiting biofilm formation on metallic prostheses, thereby preventing rejection or the requirement for replacement. A cost-effective metal alloy used in biomedical implants was chosen as the substrate, and ibuprofen (Ibu), a well-known anti-inflammatory drug, was selected for drug release tests for its widespread availability and accessibility. Multilayer coatings consisting of cellulose acetate (CA), polycaprolactone (PCL), and chitosan (CHI), with or without ibuprofen (Ibu) content, were applied onto medical-grade stainless steel (SS-316 type) through electrospinning, electrospray, or blow spinning. The adhesion of the CA, PCL, and layered CA/PCL membranes, with thicknesses ranging from 20 to 100 µm, to SS substrates varied between 0.15 N and 0.22 N without CHI, which increased to 0.21 and 0.74 N, respectively, when a CHI interlayer was introduced by electrospraying between the SS and the coatings. Although drug release in a simulated body fluid (SBF) medium is predominantly governed by diffusion-driven mechanisms in all single- and multilayer coatings, a delayed release was noted in CA coatings containing Ibu when overlaid with a PCL coating produced by blow spinning. This suggests avenues for further investigations into combinations of multilayer coatings, both with and without drug-imbued layers.
RESUMEN
The Advancing Climate Justice in Climate Adaptation Strategies for New York City (Equity) chapter of NPCC4 builds on the findings and recommendations from NPCC3 to identify additional metrics and adaptation efforts that can advance climate justice. First, the chapter assesses the efforts of the City to incorporate equity into climate adaptation efforts since NPCC3 and describes how the communities profiled in NPCC3 have implemented and evolved their approaches to addressing the intersecting climate, environmental, and social stressors that they continue to face. Second, it adds to the historical context of climate inequity by linking the bioregion's history of colonization, land dispossession, and slavery building on emerging evidence demonstrating how historical and contemporary land use patterns and decisions shape present and future climate risks and social vulnerability, including climate displacement. Third, it recommends a NYC-focused metric to identify areas of the city that are most vulnerable to the intersection of climate hazards, social vulnerability, and displacement. Finally, it highlights approaches to more equitable and just climate adaptation drawn from local, national, and international examples. As such, the chapter offers best practices that prioritize community-driven climate resilience approaches that are integrated, more equitable, and racially just.
RESUMEN
Technological solutions for emerging e-textiles are being sought to enable e-wear technology to be self-sustaining and lightweight. A rippling 1D carbon fiber capacitor design was made with commercial carbon threads as electrodes using simulated sweat solution as the electrolyte. This is particularly relevant for potential sports textile applications in which sweat could serve as an electrochemical energy source. An electrospun cellulose acetate fiber membrane and a commercially available felt were used as separators capable of soaking the electrolyte. These were tested in braided and woven electrode configurations, respectively. Functionalizing the carbon wires with polypyrrole (PPy) enhanced the surface area and significantly increased the specific capacity by approximately an order of magnitude (0.62 F/g). Cyclic voltammetry and charge-discharge tests confirmed the washability and durability of the devices for at least 1000 cycles.
RESUMEN
Deoxynivalenol (DON) is a predisposing factor for necrotic enteritis. This study aimed to investigate the effects of a DON and Clostridium perfringens (CP) challenge on the intestinal morphology, morphometry, oxidative stress, and immune response of broilers. Additionally, we evaluated the potential of a Lactobacillus spp. mixture as an approach to mitigate the damage induced by the challenge. One-day-old broiler chickens (n = 252) were divided into seven treatment groups: Control, DON, CP, CP + DON, VL (DON + CP + viable Lactobacillus spp. mixture), HIL (DON + CP + heat-inactivated Lactobacillus spp. mixture), and LCS (DON + CP + Lactobacillus spp. mixture culture supernatant). Macroscopic evaluation of the intestines revealed that the CP + DON group exhibited the highest lesion score, while the VL and HIL groups showed the lowest scores. Microscopically, all Lactobacillus spp. treatments mitigated the morphological changes induced by the challenge. DON increased levels of reactive oxygen species (ROS) in the jejunum, and CP increased ROS levels in the jejunum and ileum. Notably, the Lactobacillus spp. treatments did not improve the antioxidant defense against CP-induced oxidative stress. In summary, a Lactobacillus spp. mixture, whether used as a probiotic, paraprobiotic, or postbiotic, exerted a partially protective effect in mitigating most of the intestinal damage induced by DON and CP challenges.
Asunto(s)
Pollos , Probióticos , Tricotecenos , Animales , Clostridium perfringens , Especies Reactivas de Oxígeno , Intestinos , Lactobacillus , Probióticos/farmacologíaRESUMEN
BACKGROUND: Gene rearrangements affecting KMT2A are frequent in acute myeloid leukemia (AML) and are often associated with a poor prognosis. KMT2A gene fusions are often detected by chromosome banding analysis and confirmed by fluorescence in situ hybridization. However, small intragenic insertions, termed KMT2A partial tandem duplication (KMT2A-PTD), are particularly challenging to detect using standard molecular and cytogenetic approaches. METHODS: We have validated the use of a custom hybrid-capture-based next-generation sequencing (NGS) panel for comprehensive profiling of AML patients seen at our institution. This NGS panel targets the entire consensus coding DNA sequence of KMT2A. To deduce the presence of a KMT2A-PTD, we used the relative ratio of KMT2A exons coverage. We sought to corroborate the KMT2A-PTD NGS results using (1) multiplex-ligation probe amplification (MLPA) and (2) optical genome mapping (OGM). RESULTS: We analyzed 932 AML cases and identified 41 individuals harboring a KMT2A-PTD. MLPA, NGS, and OGM confirmed the presence of a KMT2A-PTD in 22 of the cases analyzed where orthogonal testing was possible. The two false-positive KMT2A-PTD calls by NGS could be explained by the presence of cryptic structural variants impacting KMT2A and interfering with KMT2A-PTD analysis. OGM revealed the nature of these previously undetected gene rearrangements in KMT2A, while MLPA yielded inconclusive results. MLPA analysis for KMT2A-PTD is limited to exon 4, whereas NGS and OGM resolved KMT2A-PTD sizes and copy number levels. CONCLUSIONS: KMT2A-PTDs are complex gene rearrangements that cannot be fully ascertained using a single genomic platform. MLPA, NGS panels, and OGM are complementary technologies applied in standard-of-care testing for AML patients. MLPA and NGS panels are designed for targeted copy number analysis; however, our results showed that integration of concurrent genomic alterations is needed for accurate KMT2A-PTD identification. Unbalanced chromosomal rearrangements overlapping with KMT2A can interfere with the diagnostic sensitivity and specificity of copy-number-based KMT2A-PTD detection methodologies.
RESUMEN
This chapter provides an overview of the major themes, findings, and recommendations from NPCC4. It presents summary statements from each chapter of the assessment which identify salient and pressing issues raised and provides recommendations for future research and for enhancement of climate resiliency. The chapter also outlines a set of broader recommendations for future NPCC work and identifies some key topics for the next assessment.
RESUMEN
We present a case of acute heart failure as the first manifestation of Graves' disease. It illustrates some of its cardiovascular complications, particularly atrial fibrillation, pulmonary hypertension and heart failure. This case report highlights the importance of considering hyperthyroidism as a cause of idiopathic pulmonary hypertension, and demonstrates the potential reversibility of its complications.
Asunto(s)
Insuficiencia Cardíaca/complicaciones , Hipertensión Pulmonar/complicaciones , Hipertiroidismo/complicaciones , Adulto , Femenino , HumanosRESUMEN
Flexible microelectronic devices have seen an increasing trend toward development of miniaturized, portable, and integrated devices as wearable electronics which have the requirement for being light weight, small in dimension, and suppleness. Traditional three-dimensional (3D) and two-dimensional (2D) electronics gadgets fail to effectively comply with these necessities owing to their stiffness and large weights. Investigations have come up with a new family of one-dimensional (1D) flexible and fiber-based electronic devices (FBEDs) comprising power storage, energy-scavenging, implantable sensing, and flexible displays gadgets. However, development and manufacturing are still a challenge owing to their small radius, flexibility, low weight, weave ability and integration in textile electronics. This paper will provide a detailed review on the importance of substrates in electronic devices, intrinsic property requirements, fabrication classification and applications in energy harvesting, energy storage and other flexible electronic devices. Fiber- and textile-based electronic devices for bulk/scalable fabrications, encapsulation, and testing are reviewed and presented future research ideas to enhance the commercialization of these fiber-based electronics devices.
RESUMEN
BACKGROUND: This study aims to evaluate the knowledge and the attitude in oral health (OH) of nurses (NUR) and auxiliary health technicians (AHT) belonging to the Long-term Care Units (LTC). METHODS: Observational cross-sectional study. A survey was applied in five MLTC in Porto (Portugal) to 145 healthcare works (HCW). Data were collected using structured questionnaires with questions about knowledge and attitude regarding oral care. Data analysis comparison was performed using non-parametric tests (α = 0.05). RESULTS: Out of a total of 259 HCW, 145 responses were obtained (55.98% response rate). The median number of correct answers was significantly different for NUR and AHT without oral health training (OHT) (p = .035).AHT with OHT had a significantly lower number of correct answers compared to NUR with OHT (7 vs. 9, p < .001). There was no significant difference in the number of correct answers in NUR with or without OHT (p = .391) and that the AHT without OHT have a median of correct answers significantly higher than those who they have OHT (8 vs. 7, p = .020) CONCLUSIONS: Despite the positive attitude of the HCW, the knowledge is scarce. HCW recognized the urgence to update the protocols. PRACTICAL IMPLICATIONS: Integrating dentists in the LTC team, implementation of OH protocols and providing OH training should be considered to bridge existing gaps.