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1.
Opt Express ; 32(11): 20385-20400, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38859151

RESUMEN

The holographic recording of gratings that have very large diffraction angles and/or slants is challenging because recording requires beam angles that are not possible without the use of prisms. However, by using a recording wavelength that is different from (usually shorter than) the intended operating wavelength, it is possible to record with less challenging beam angles. In this paper, a recently developed model that allows systematic investigation of the potential and limits of this wavelength-shift recording technique is extended to include a reflection format. Transmission and reflection recording options are compared systematically for the first time, and it is shown that in reflection recording, some couplers can be recorded more easily when the recording wavelength is longer than the operating wavelength. This opens up new design options for previously challenging regions of the spectrum. Experimental validation of the reflection version of the model is carried out by holographic recording in reflection mode at 532 nm in Bayfol HX 200 photopolymer, demonstrating the coupling of blue light.

2.
J Appl Biomech ; 40(2): 155-165, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38016463

RESUMEN

Biomechanics as a discipline is ideally placed to increase awareness and participation of girls and women in science, technology, engineering, and mathematics. A nationwide Biomechanics and Research Innovation Challenge (BRInC) centered on mentoring and role modeling was developed to engage high school girls (mentees) and early-mid-career women (mentors) in the field of biomechanics through the completion of a 100-day research and/or innovation project. This manuscript describes the development, implementation, and uptake of the inaugural BRInC program and synthesizes the research and innovation projects undertaken, providing a framework for adoption of this program within the global biomechanics community. Eighty-seven high school girls in years 9 and 10 (age range: 14-16 y) were mentored in teams (n = 17) by women in biomechanics (n = 24). Using a design thinking approach, teams generated solutions to biomechanics-based problem(s)/research question(s). Eight key reflections on program strengths, as well as areas for improvement and planned changes for future iterations of the BRInC program, are outlined. These key reflections highlight the innovation, impact, and scalability of the program; the importance of a program framework and effective communication tools; and implementation of strategies to sustain the program as well as the importance of diversity and building a sense of community.


Asunto(s)
Tutoría , Humanos , Femenino , Adolescente , Fenómenos Biomecánicos , Mentores
3.
Opt Express ; 31(6): 9466-9480, 2023 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-37157517

RESUMEN

An analog holographic wavefront sensor (AHWFS), for measurement of low and high order (defocus and spherical aberration) aberration modes has been developed as volume phase holograms in a photopolymer recording medium. This is the first time that high order aberrations such as spherical aberration can be sensed using a volume hologram in a photosensitive medium. Both defocus and spherical aberration were recorded in a multi-mode version of this AHWFS. Refractive elements were used to generate a maximum and minimum phase delay of each aberration which were multiplexed as a set of volume phase holograms in an acrylamide based-photopolymer layer. The single-mode sensors showed a high degree of accuracy in determining various magnitudes of defocus and spherical aberration generated refractively. The multi-mode sensor also exhibited promising measurement characteristics and similar trends to the single-mode sensors were observed. The method of quantifying defocus was improved upon and a brief study into material shrinkage and sensor linearity is presented.

4.
Biomed Eng Online ; 22(1): 43, 2023 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-37165365

RESUMEN

BACKGROUND: Adaptive gait involves the ability to adjust the leading foot in response to the requirement of dynamic environments during walking. Accurate adjustments of the minimum toe clearance (MTC) height and step length can prevent older people from falling when walking and responding to hazards. Although older people with diabetes fall more frequently than healthy older adults, no previous studies have quantified their adaptive gait abilities. This study aimed to investigate the effects of diabetes mellitus on step length and MTC height adjustments using a non-immersive virtual-reality system. METHODS: Sixteen young adults (26 ± 5 years, 7 females), 16 healthy older adults (68 ± 5 years, 6 females), and 16 older adults with diabetes (70 ± 5 years, 6 females) completed adaptability tests while walking on a treadmill. A computer system visualised a continuous real-time signal of absolute step length and MTC on a monitor. Each person responded to four discrete participant-specific step length and MTC visual targets that were presented on the same signal. Tasks were to match the peaks of interest on each signal to presented targets. Targets were 10% longer or shorter than the mean baseline step length, and 2.5 cm, and 3.5 cm higher than the mean baseline MTC. When a target was displayed, it remained unchanged for 10 consecutive foot displacement adaptation attempts. Then, the target was removed and a new target or the same target was present after 10 consecutive steps and remained for 10 steps. Each target was randomly presented three times (3 × 10). Step length and MTC height adjustments in response to targets were measured and compared among groups. RESULTS: Mean preferred walking speeds were not different among groups significantly when no targets were presented on the monitor in baseline walking. However, when participants walked on a treadmill while attempting to match step lengths or MTC heights to displayed targets on the monitor, the group with diabetes had reduced step length and MTC adjustments compared with other groups significantly. They showed greater errors (differences between their step lengths/MTC heights and presented targets) on the monitor. CONCLUSIONS: This study quantified reduced abilities for older individuals with diabetes to adjust both step length and MTC in response to stimuli compared to healthy older counterparts. Reduced step length and MTC height adjustments can increase falls in at risk populations. The presented virtual-reality system has merits for assessing and training step and MTC adaptation.


Asunto(s)
Diabetes Mellitus , Dedos del Pie , Femenino , Adulto Joven , Humanos , Anciano , Dedos del Pie/fisiología , Marcha/fisiología , Caminata/fisiología , Pie
5.
BMC Geriatr ; 23(1): 62, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36726077

RESUMEN

BACKGROUND: Technology innovation provides an opportunity to support the rising number of people living with dementia globally. The present study examines experiences of people who have dementia and live in technology enriched supported care models. Additionally, it explores caregiver's attitudes towards technology use with the housing scheme. METHODS: A qualitative research design was adopted, and eight housing schemes consented to take part in the study. A technology audit was undertaken in addition to participant interviews and caregiver survey. Seven peer researchers conducted semi-structured interviews with 22 people living with dementia. Interviews were analysed using thematic analysis. Informal and formal caregivers were invited to complete a survey to capture their attitudes towards technology use. A total of 20 informal and 31 formal caregiver surveys were returned. All surveys were input into Survey Monkey and downloaded into excel for analysis. Closed questions were analysed using descriptive statistics and open-ended questions were organised into themes and described descriptively. RESULTS: The technology audit identified that technologies were in place from as early as 2002. Technology heterogeneity of, both passive and active devices, was found within the housing schemes. Technologies such as wearable devices were reportedly used according to need, and mobile phone use was widely adopted. The themes that developed out of the tenant interviews were: Attitudes and Engagement with Technology; Technology Enhancing Tenants Sense of Security; Seeking Support and Digital Literacy; and Technology Enabled Connection. A lack of awareness about living alongside technology was a major finding. Technologies enabled a sense of reassurance and facilitated connections with the wider community. The interaction with technology presented challenges, for example, remembering passwords, access to Wi-Fi and the identification of its use in an emergency. The caregiver survey reported a range of facilitators and barriers for the use of technology within care. Both types of caregivers held relatively similar views around the benefits of technology, however their views on issues such as privacy and consent varied. Safety was considered more important than right to privacy by family caregivers. CONCLUSIONS: The present study provides new insight into stakeholder's experiences of living, working and caregiving alongside technology in supported living environments. As the generation of people living with dementia become more tech savvy, harnessing everyday technologies to support care could enable holistic care and support the transition through the care continuum. Advance care planning and technology assessments are at the very core of future technology provision. It is evident that a paternalistic attitudes towards technology use could impact the multitude of benefits technology can play in both health and leisure for people living with dementia and their caregivers.


Asunto(s)
Demencia , Psicoterapia de Grupo , Humanos , Demencia/terapia , Cuidadores , Investigación Cualitativa , Tecnología
6.
Sensors (Basel) ; 23(9)2023 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-37177479

RESUMEN

Volume reflection hologram-based sensors are designed to visibly change colour in response to a target stressor or analyte. However, reflection holograms fabricated in thick photopolymer films are highly angularly selective, making these sensors challenging to view and interpret by non-experts. Here, the use of speckle holography to improve the visibility of reflection holograms is presented. A novel recording approach combining speckle recording techniques with Denisyuk reflection recording geometry is described. The recorded speckle reflection grating operates as a series of multiplexed reflection gratings with a range of spatial frequencies, capable of reflecting light at a wider range of angles. A comparative study of the angular and wavelength selectivity of speckle and standard reflection gratings was conducted. The FWHM of the angular selectivity curves of the speckle reflection gratings is doubled (4°) in comparison to standard 4500 lines/mm reflection gratings (2°). The wavelength selectivity FWHM is also doubled from 4.2 to 8.6 nm. The comparative ability of the speckle and standard reflection gratings to act as colour-changing compressional pressure sensors in the 0.88-5.31 MPa range is described. Finally, we present a prototype reflection hologram viewer which enables the easy observation of angularly specific reflection holograms by non-experts.

7.
Ann Rheum Dis ; 81(12): 1695-1703, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35973806

RESUMEN

OBJECTIVES: Type-I interferons (IFNs-I) have potent antiviral effects. IFNs-I are also overproduced in patients with systemic lupus erythematosus (SLE). Autoantibodies (AAbs) neutralising IFN-α, IFN-ß and/or IFN-ω subtypes are strong determinants of hypoxemic COVID-19 pneumonia, but their impact on inflammation remains unknown. METHODS: We retrospectively analysed a monocentric longitudinal cohort of 609 patients with SLE. Serum AAbs against IFN-α were quantified by ELISA and functionally assessed by abolishment of Madin-Darby bovine kidney cell protection by IFN-α2 against vesicular stomatitis virus challenge. Serum-neutralising activity against IFN-α2, IFN-ß and IFN-ω was also determined with a reporter luciferase activity assay. SARS-CoV-2 antibody responses were measured against wild-type spike antigen, while serum-neutralising activity was assessed against the SARS-CoV-2 historical strain and variants of concerns. RESULTS: Neutralising and non-neutralising anti-IFN-α antibodies are present at a frequency of 3.3% and 8.4%, respectively, in individuals with SLE. AAbs neutralising IFN-α, unlike non-neutralising AAbs, are associated with reduced IFN-α serum levels and a reduced likelihood to develop active disease. However, they predispose patients to an increased risk of herpes zoster and severe COVID-19 pneumonia. Severe COVID-19 pneumonia in patients with SLE is mostly associated with combined neutralisation of different IFNs-I. Finally, anti-IFN-α AAbs do not interfere with COVID-19 vaccine humoral immunogenicity. CONCLUSION: The production of non-neutralising and neutralising anti-IFN-I antibodies in SLE is likely to be a consequence of SLE-associated high IFN-I serum levels, with a beneficial effect on disease activity, yet a greater viral risk. This finding reinforces the recommendations for vaccination against SARS-CoV-2 in SLE.


Asunto(s)
COVID-19 , Herpes Zóster , Lupus Eritematoso Sistémico , Humanos , Bovinos , Animales , Autoanticuerpos , Vacunas contra la COVID-19 , Estudios Retrospectivos , SARS-CoV-2 , Interferón-alfa , Interferón beta
8.
J Interprof Care ; 36(5): 651-659, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34582727

RESUMEN

In the United Kingdom, the onset of the COVID-19 pandemic placed great pressures on universities to ensure final year health care students completed their studies earlier than planned in order to join the National Health Service workforce. This study aimed to explore the anticipations and support needs of final year allied health profession students transitioning to practice during a pandemic. Final year university students across seven healthcare professions were asked to complete an online survey. Demographic data were analyzed by descriptive statistics and responses to open questions were explored using content analysis. Sixty participants completed the survey. Content analysis regarding students' anticipations, fears, and support needs identified the following themes: professional identity and growth; opportunities for improvement; preparedness for transition from university to the workplace, the workplace environment; COVID-19; support from lecturers; daily support within the workplace and innovative methods of support. Although the transition from student to practitioner continues to be a stressful period, only a minority of participants reported COVID-19 as an explicit stressor. However, as the effects of COVID-19 continue to evolve in the United Kingdom, universities and healthcare trusts must ensure adequate supports are in place for recent graduates navigating this transition during a healthcare crisis.


Asunto(s)
COVID-19 , Estudiantes del Área de la Salud , Empleos en Salud , Humanos , Relaciones Interprofesionales , Pandemias , Medicina Estatal , Recursos Humanos
9.
Health Expect ; 24(5): 1879-1889, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34337838

RESUMEN

BACKGROUND: The term peer researcher describes the role of a person who has similar characteristics and can identify with the participant group in a research study. This paper describes the methodological approach and experiences of older people who were peer researchers on a study that explored the lived experience of people with dementia who lived in technology-enriched housing. METHODS: Nine people responded to a public recruitment campaign through nongovernment organisations using multiple methods such as seniors' forums, development officers and social media. Mandatory training across 2 days was provided and seven peer researchers successfully completed the training. A total of 22 interviews were undertaken by the seven peer researchers. The data collected from the training feedback proforma (N = 7), interview debrief forms (N = 22) and final evaluation forms (N = 5) were analysed using content analysis and triangulated. RESULTS: Five core themes emerged from the data using a content analysis approach to examine the peer researchers' experience: (1) skill development; (2) recognition of competencies; (3) connection; (4) supplementary information; and (5) the triad dynamic. CONCLUSIONS: Considerations to enhance the peer researcher experience emerged including enhanced communication training, consideration of the optimum number of peer researchers to balance workload and identification of the characteristics that enable people to connect as peer researchers. Future research should consider the impact that experiential skill development has on the data collected. PUBLIC CONTRIBUTION: Older people conducted qualitative interviews as peer researchers with people living with dementia to cocreate knowledge.


Asunto(s)
Grupo Paritario , Investigadores , Anciano , Comunicación , Humanos
10.
J Transl Med ; 18(1): 457, 2020 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272291

RESUMEN

BACKGROUND: Although immune modulation is a promising therapeutic avenue in coronavirus disease 2019 (COVID-19), the most relevant targets remain to be found. COVID-19 has peculiar characteristics and outcomes, suggesting a unique immunopathogenesis. METHODS: Thirty-six immunocompetent non-COVID-19 and 27 COVID-19 patients with severe pneumonia were prospectively enrolled in a single center, most requiring intensive care. Clinical and biological characteristics (including T cell phenotype and function and plasma concentrations of 30 cytokines) and outcomes were compared. RESULTS: At similar baseline respiratory severity, COVID-19 patients required mechanical ventilation for significantly longer than non-COVID-19 patients (15 [7-22] vs. 4 (0-15) days; p = 0.0049). COVID-19 patients had lower levels of most classical inflammatory cytokines (G-CSF, CCL20, IL-1ß, IL-2, IL-6, IL-8, IL-15, TNF-α, TGF-ß), but higher plasma concentrations of CXCL10, GM-CSF and CCL5, compared to non-COVID-19 patients. COVID-19 patients displayed similar T-cell exhaustion to non-COVID-19 patients, but with a more unbalanced inflammatory/anti-inflammatory cytokine response (IL-6/IL-10 and TNF-α/IL-10 ratios). Principal component analysis identified two main patterns, with a clear distinction between non-COVID-19 and COVID-19 patients. Multivariate regression analysis confirmed that GM-CSF, CXCL10 and IL-10 levels were independently associated with the duration of mechanical ventilation. CONCLUSION: We identified a unique cytokine response, with higher plasma GM-CSF and CXCL10 in COVID-19 patients that were independently associated with the longer duration of mechanical ventilation. These cytokines could represent the dysregulated immune response in severe COVID-19, as well as promising therapeutic targets. ClinicalTrials.gov: NCT03505281.


Asunto(s)
COVID-19/diagnóstico , COVID-19/inmunología , Inmunidad Innata/fisiología , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Anciano , Anciano de 80 o más Años , COVID-19/mortalidad , COVID-19/terapia , Cuidados Críticos , Femenino , Francia/epidemiología , Humanos , Inmunofenotipificación , Activación de Linfocitos/fisiología , Masculino , Persona de Mediana Edad , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Pronóstico , Respiración Artificial , SARS-CoV-2/fisiología , Índice de Severidad de la Enfermedad
11.
Ann Rheum Dis ; 78(12): 1669-1676, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31570366

RESUMEN

OBJECTIVES: Maintenance of remission has become central in the management of systemic lupus erythematosus (SLE). The importance of interferon-alpha (IFN-α) in the pathogenesis of SLE notwithstanding, its expression in remission has been poorly studied as yet. To study its expression in remission and its prognostic value in the prediction of a disease relapse, serum IFN-α levels were determined using an ultrasensitive single-molecule array digital immunoassay which enables the measurement of cytokines at physiological concentrations. METHODS: A total of 254 SLE patients in remission, according to the Definition of Remission in SLE classification, were included in the study. Serum IFN-α concentrations were determined at baseline and patients were followed up for 1 year. Lupus flares were defined according to the Safety of Estrogens in Lupus Erythematosus: National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index Flare Index, whereas the Kaplan-Meier analysis and Cox regression analysis were used to estimate the time to relapse and to identify baseline factors associated with time to relapse, respectively. RESULTS: Of all patients in remission, 26% displayed abnormally high IFN-α serum levels that were associated with the presence of antibodies specific for ribonucleoprotein (RNP), double stranded (ds)DNA and Ro/SSA60, as well as young age. Importantly, elevated-baseline IFN-α serum levels and remission duration were associated in an independent fashion, with shorter time to relapse, while low serum levels of complement component 3 and anti-dsDNA Abs were not. CONCLUSION: Direct serum IFN-α assessment with highly sensitive digital immunoassay permits clinicians to identify a subgroup of SLE patients, clinically in remission, but at higher risk of relapse.


Asunto(s)
Interferón-alfa/sangre , Lupus Eritematoso Sistémico/sangre , Adulto , Autoanticuerpos/inmunología , Biomarcadores/sangre , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Inmunoensayo , Interferón-alfa/inmunología , Lupus Eritematoso Sistémico/inmunología , Masculino , Recurrencia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad
12.
J Neuroeng Rehabil ; 16(1): 10, 2019 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-30646915

RESUMEN

BACKGROUND: Assistive technologies aim to increase quality of life, reduce dependence on care giver and on the long term care system. Several studies have demonstrated the effectiveness in the use of assistive technology for environment control and communication systems. The progress of brain-computer interfaces (BCI) research together with exoskeleton enable a person with motor impairment to interact with new elements in the environment. This paper aims to evaluate the environment control interface (ECI) developed under the AIDE project conditions, a multimodal interface able to analyze and extract relevant information from the environments as well as from the identification of residual abilities, behaviors, and intentions of the user. METHODS: This study evaluated the ECI in a simulated scenario using a two screen layout: one with the ECI and the other with a simulated home environment, developed for this purpose. The sensorimotor rhythms and the horizontal oculoversion, acquired through BCI2000, a multipurpose standard BCI platform, were used to online control the ECI after the user training and system calibration. Eight subjects with different neurological diseases and spinal cord injury participated in this study. The subjects performed simulated activities of daily living (ADLs), i.e. actions in the simulated environment as drink, switch on a lamp or raise the bed head, during ten minutes in two different modes, AIDE mode, using a prediction model, to recognize the user intention facilitating the scan, and Manual mode, without a prediction model. RESULTS: The results show that the mean task time spent in the AIDE mode was less than in the Manual, i.e the users were able to perform more tasks in the AIDE mode during the same time. The results showed a statistically significant differences with p<0.001. Regarding the steps, i.e the number of abstraction levels crossed in the ECI to perform an ADL, the users performed one step in the 90% of the tasks using the AIDE mode and three steps, at least, were necessary in the Manual mode. The user's intention prediction was performed through conditional random fields (CRF), with a global accuracy about 87%. CONCLUSIONS: The environment analysis and the identification of the user's behaviors can be used to predict the user intention opening a new paradigm in the design of the ECIs. Although the developed ECI was tested only in a simulated home environment, it can be easily adapted to a real environment increasing the user independence at home.


Asunto(s)
Interfaces Cerebro-Computador , Programas Informáticos , Traumatismos de la Médula Espinal , Actividades Cotidianas , Adulto , Electroencefalografía/métodos , Electrooculografía , Dispositivo Exoesqueleto , Femenino , Humanos , Masculino , Proyectos Piloto , Calidad de Vida , Interfaz Usuario-Computador
13.
Opt Express ; 26(7): 8916-8922, 2018 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-29715852

RESUMEN

A method for fabricating diffractive holographic optical diffusers is reported, allowing a high degree of control of the resulting diffuser characteristics. The method consists of recording a laser speckle pattern using a single carrier beam, with controlled speckle size and shape, in an acrylamide-based volume photopolymer. The multiple interferences that create the speckle pattern form the hologram. Results are presented verifying the diffusers are volume holographic in nature and the speckle pattern is recorded accurately in the photopolymer. Diffusers recorded by this method are analysed to characterise the optical performance of the diffusers and to illustrate their beam-shaping capabilities, particularly in producing asymmetric beam outputs.

14.
Appl Opt ; 57(22): E163-E172, 2018 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30117852

RESUMEN

A holographic optical element (HOE) was developed to collimate a monochromatic light-emitting diode (LED). The fabrication was achieved by the interference of collimated and diverging beams from a 532 nm laser to produce the required photonic structure in a self-developing photopolymer material. The experimental values of diffraction efficiency and spatial period across the HOE were compared with their expected theoretical values. Good agreement was found for the spatial period; however, the diffraction efficiency varied significantly across the lens. In this paper, two approaches have been taken to address this variation: (1) modification of recording geometry and (2) optimization of recording intensity and exposure time at constant energy. The performance of an optimized HOE (cylindrical holographic lens) was then demonstrated using a 532 nm laser beam. The optimized conditions for the cylindrical holographic lens were used to fabricate a spherical holographic lens of the same numerical aperture for LED applications. This type of lens has the potential to be used in combination with LED sources.

15.
Appl Opt ; 57(22): E173-E183, 2018 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30117858

RESUMEN

The aim of this paper is to discuss the benefits as well as the limitations of utilizing photopolymer materials in the design of holograms that are responsive to changes in their environment, such as changes in the concentration of a specific substance, temperature, and pressure. Three different case studies are presented, including both surface and volume phase holograms, in order to demonstrate the flexibility in the approach of utilizing holographic photopolymers for the design of sensors and interactive optical devices. First, a functionalized surface relief hologram is demonstrated to operate as an optical sensor for the detection of metal ions in water. The sensitivity and selectivity of the sensor are investigated. The second example demonstrates a volume transmission hologram recorded in a temperature-sensitive photopolymer and the memory effects of its exposure to elevated temperature. Finally, a pressure-sensitive reflection hologram that changes color under application of pressure is characterized, and its potential application in document authentication is described.

16.
Appl Opt ; 57(22): E131-E137, 2018 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30117909

RESUMEN

The problems presented by counterfeit products and documentation are discussed. Limitations of existing holograms for anti-counterfeit applications are described. We describe the advantages of full holographic serialization and the requirements in terms of materials and techniques for mass production of true serialized holograms. These requirements having been met, we report for the first time the mass production of fully serialized holograms. The novelty of the approach consists of the direct use of the product manufacturer's information as the object in a holographic recording system along with a self-processing photopolymer and modular optical system to facilitate mass production of truly serialized volume holograms. Various types of serialized holograms for overt and covert authentication are described. We discuss briefly the application of Optrace's manufacturing methods for future generation holographic devices.

17.
J Community Health ; 43(4): 756-760, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29453619

RESUMEN

This pilot study aims to improve HPV vaccination for college aged males at a student health center. The first part of the study consisted of a focus group that assessed the barriers and facilitators of HPV vaccination among healthcare providers and clinic staff (N = 16). Providers reported missed opportunities for HPV vaccination. For the second part of the study, providers and staff reviewed medical records of patients ages 18-26 with student health insurance and with < 3 doses of the HPV vaccine at baseline (12/1/2014 to 7/31/2015) and follow-up (12/1/2015 to 7/31/2016). A computer-automated EMR alert was generated in the medical record of eligible male patients (N = 386). Z-scores were estimated for two-sample proportions to measure change in HPV vaccine rates at baseline and follow-up for males and females. HPV vaccine initiation rates increased among males (baseline: 5.2% follow-up: 25.1%, p < 0.001). This study shows that EMR alerts improved HPV vaccine initiation rates among insured college-aged males.


Asunto(s)
Registros Electrónicos de Salud/organización & administración , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Servicios de Salud para Estudiantes/organización & administración , Adolescente , Adulto , Humanos , Masculino , Salud del Hombre , Proyectos Piloto , Adulto Joven
18.
Cochrane Database Syst Rev ; 4: CD008427, 2017 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-28387447

RESUMEN

BACKGROUND: Fatigue and unintentional weight loss are two of the commonest symptoms experienced by people with advanced progressive illness. Appropriate interventions may bring considerable improvements in function and quality of life to seriously ill people and their families, reducing physical, psychological and spiritual distress. OBJECTIVES: To conduct an overview of the evidence available on the efficacy of interventions used in the management of fatigue and/or unintentional weight loss in adults with advanced progressive illness by reviewing the evidence contained within Cochrane reviews. METHODS: We searched the Cochrane Database of Systematic Reviews (CDSR) for all systematic reviews evaluating any interventions for the management of fatigue and/or unintentional weight loss in adults with advanced progressive illness (The Cochrane Library 2010, Issue 8). We reviewed titles of interest by abstract. Where the relevance of a review remained unclear we reached a consensus regarding the relevance of the participant group and the outcome measures to the overview. Two overview authors extracted the data independently using a data extraction form. We used the measurement tool AMSTAR (Assessment of Multiple SysTemAtic Reviews) to assess the methodological quality of each systematic review. MAIN RESULTS: We included 27 systematic reviews (302 studies with 31,833 participants) in the overview. None of the included systematic reviews reported quantitative data on the efficacy of interventions to manage fatigue or weight loss specific to people with advanced progressive illness. All of the included reviews apart from one were deemed of high methodological quality. For the remaining review we were unable to ascertain the methodological quality of the research strategy as it was described. None of the systematic reviews adequately described whether conflict of interests were present within the included studies. Management of fatigueAmyotrophic lateral sclerosis/motor neuron disease (ALS/MND) - we identified one systematic review (two studies and 52 participants); the intervention was exercise.Cancer - we identified five systematic reviews (116 studies with 17,342 participants); the pharmacological interventions were eicosapentaenoic acid (EPA) and any drug therapy for the management of cancer-related fatigue and the non pharmacological interventions were exercise, interventions by breast care nurses and psychosocial interventions.Chronic obstructive pulmonary disease (COPD) - we identified three systematic reviews (59 studies and 4048 participants); the interventions were self management education programmes, nutritional support and pulmonary rehabilitation.Cystic fibrosis - we identified one systematic review (nine studies and 833 participants); the intervention was physical training.Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) - we identified two systematic reviews (21 studies and 748 participants); the interventions were progressive resistive exercise and aerobic exercise.Multiple sclerosis (MS) - we identified five systematic reviews (23 studies and 1502 participants); the pharmacological interventions were amantadine and carnitine. The non pharmacological interventions were diet, exercise and occupational therapy.Mixed conditions in advanced stages of illness - we identified one systematic review (five studies and 453 participants); the intervention was medically assisted hydration. Management of weight lossALS/MND - we identified one systematic review but no studies met the inclusion criteria for the systematic review; the intervention was enteral tube feeding.Cancer - we identified three systematic reviews with a fourth systematic review also containing extractable data on cancer (66 studies and 5601 participants); the pharmacological interventions were megestrol acetate and eicosapentaenoic acid (EPA) (this systematic review is also included in the cancer fatigue section above). The non pharmacological interventions were enteral tube feeding and non invasive interventions for patients with lung cancer.COPD - we identified one systematic review (59 studies and 4048 participants); the intervention was nutritional support. This systematic review is also included in the COPD fatigue section.Cystic fibrosis - we identified two systematic reviews (three studies and 131 participants); the interventions were enteral tube feeding and oral calorie supplements.HIV/AIDS - we identified four systematic reviews (42 studies and 2071 participants); the pharmacological intervention was anabolic steroids. The non pharmacological interventions were nutritional interventions, progressive resistive exercise and aerobic exercise. Both of the systematic reviews on exercise interventions were also included in the HIV/AIDS fatigue section.MS - we found no systematic reviews which considered interventions to manage unintentional weight loss for people with a clinical diagnosis of multiple sclerosis at any stage of illness.Mixed conditions in advanced stages of illness - we identified two systematic reviews (32 studies and 4826 participants); the interventions were megestrol acetate and medically assisted nutrition. AUTHORS' CONCLUSIONS: There is a lack of robust evidence for interventions to manage fatigue and/or unintentional weight loss in the advanced stage of progressive illnesses such as advanced cancer, heart failure, lung failure, cystic fibrosis, multiple sclerosis, motor neuron disease, Parkinson's disease, dementia and AIDS. The evidence contained within this overview provides some insight into interventions which may prove of benefit within this population such as exercise, some pharmacological treatments and support for self management.Researchers could improve the methodological quality of future studies by blinding of outcome assessors. Adopting uniform reporting mechanisms for fatigue and weight loss outcome measures would also allow the opportunity for meta-analysis of small studies.Researchers could also improve the applicability of recommendations for interventions to manage fatigue and unintentional weight loss in advanced progressive illness by including subgroup analysis of this population within systematic reviews of applicable interventions.More research is required to ascertain the best interventions to manage fatigue and/or weight loss in advanced illness. There is a need for standardised reporting of these symptoms and agreement amongst researchers of the minimum duration of studies and minimum percentage change in symptom experience that proves the benefits of an intervention. There are, however, challenges in providing meaningful outcome measurements against a background of deteriorating health through disease progression. Interventions to manage these symptoms must also be mindful of the impact on quality of life and should be focused on patient-orientated rather than purely disease-orientated experiences for patients. Systematic reviews and primary intervention studies should include the impact of the interventions on standardised validated quality of life measures.


Asunto(s)
Emaciación/terapia , Fatiga/terapia , Pérdida de Peso , Adulto , Esclerosis Amiotrófica Lateral/complicaciones , Fibrosis Quística/complicaciones , Progresión de la Enfermedad , Emaciación/etiología , Fatiga/etiología , Infecciones por VIH/complicaciones , Humanos , Esclerosis Múltiple/complicaciones , Neoplasias/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Literatura de Revisión como Asunto
19.
Appl Opt ; 56(22): 6348-6356, 2017 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-29047834

RESUMEN

In recent years, functionalized photopolymer systems capable of holographic recording are in great demand due to their potential use in the development of holographic sensors. This work presents a newly developed N-isopropylacrylamide (NIPA)-based photopolymer for holographic recording in reflection and transmission modes. The optimized composition of the material is found to reach refractive index modulation of up to 5×10-3 and 1.6×10-3 after recording in transmission and reflection mode, respectively. In addition to fulfilling the requirements for holographic recording materials, the NIPA-based photopolymer is sensitive to temperature and has lower toxicity than acrylamide-based photopolymers. Possible application of the NIPA-based photopolymer in the development of a holographic temperature sensor is discussed.

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