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1.
Sci Adv ; 10(14): eadn3784, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38569040

RESUMEN

Conventional power-integrated wireless neural recording devices suffer from bulky, rigid batteries in head-mounted configurations, hindering the precise interpretation of the subject's natural behaviors. These power sources also pose risks of material leakage and overheating. We present the direct printing of a power-integrated wireless neural recording system that seamlessly conforms to the cranium. A quasi-solid-state Zn-ion microbattery was 3D-printed as a built-in power source geometrically synchronized to the shape of a mouse skull. Soft deep-brain neural probes, interconnections, and auxiliary electronics were also printed using liquid metals on the cranium with high resolutions. In vivo studies using mice demonstrated the reliability and biocompatibility of this wireless neural recording system, enabling the monitoring of neural activities across extensive brain regions without notable heat generation. This all-printed neural interface system revolutionizes brain research, providing bio-conformable, customizable configurations for improved data quality and naturalistic experimentation.


Asunto(s)
Encéfalo , Cabeza , Animales , Ratones , Reproducibilidad de los Resultados , Cráneo , Electrónica , Tecnología Inalámbrica
2.
Artículo en Inglés | MEDLINE | ID: mdl-38529210

RESUMEN

Background: Academic medical centers greatly benefit from retaining their physicians; that ensures continuity in patient care, enhances resident education, and maintains a pool of experienced clinicians and researchers. Despite its importance, little research has been published on the retainment of academic faculty in orthopaedics. To address this gap, this study investigates the demographic trends of academic orthopaedic surgeons from 2016 to 2022. By analyzing data pertaining to gender distribution, years of practice, research productivity, and institutional rankings, we aimed to gain insights into the factors influencing faculty retainment, institution changes, and new entrants into academic orthopaedics. Methods: A retrospective cross-sectional analysis of U.S. academic orthopaedic surgeons affiliated with programs under the Accreditation Council for Graduate Medical Education (ACGME) in 2016 and 2022 was performed. Faculty present in both the 2016 and the 2022 data were classified as being "retained" in academia; those present only in 2016, as having "left" academia; and those present only in 2022, as being "new" to academia. The retained group was then divided into movers (those who moved to other institutions) and non-movers. Results: Retained orthopaedists had fewer years of practice, a higher h-index (Hirsch index), and more publications. Non-fellowship-trained orthopaedists had less retainment in academia, and orthopaedists with fellowships in oncology had more retainment in academia. Additionally, movers also had fewer years in practice but an equal level of scholarly productivity when compared with non-movers. Lastly, higher-ranked academic programs retained a greater proportion of orthopaedic surgeons. Conclusions: Over the study period, a majority of orthopaedists (56.99%) chose to remain in academia. Those retained tended to be in the earlier stages of their careers, yet demonstrated higher research output. Notably, the representation of female orthopaedists in academic orthopaedics is on the rise. Conversely, lower-ranked programs faced higher turnover rates, highlighting the challenges that they encounter in retaining faculty members. Clinical Relevance: Academic medical centers benefit from retaining orthopaedic surgeons by maintaining patient relationships, having consistency in resident education, and building on clinical and research expertise. Likewise, orthopaedists benefit from understanding the trends in current academic employment, in order to optimize career planning decisions.

3.
J Orthop Res ; 2024 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-38433389

RESUMEN

"Top 20" status on Doximity, an online networking service for medical professionals, is an indicator of the reputation of a residency program. The study assesses how training at a Top 20 (T20) orthopaedic residency program impacts career productivity and funding. Fellowship and Residency Electronic Interactive Database was used in 2022 to identify active orthopaedic residency programs. Demographic and training data was collected for each orthopaedic surgeon using institutional websites and Doximity. The Residency Navigator feature on Doximity was used to rank residency programs by "reputation." Programs were categorized as either T20 or non-T20. The relative citation ratio (RCR) was calculated using the NIH iCite tool and Hirsch index (h-index) was calculated using Scopus. Industry funding was collected from the Centers for Medicare & Medicaid Services Open Payments Program (CMS) for all available years (2014-2020). A total of 2812 academic orthopaedic surgeons were included in the study. Among academic orthopaedic surgeons in the United States, T20 trained orthopedists had more publications and citations (p < 0.001), along with higher h-indices (p < 0.001), RCR (p < 0.001), and industry funding (p = 0.043). Additionally, T20 trained orthopedists were 1.375 times more likely to obtain professor status (95% confidence interval: 1.150-1.645, p < 0.001). Even after propensity-matched analysis, T20 trained orthopedists maintained these differences. Training at a T20 residency program is associated with promotion, productivity, and funding. These findings are especially of concern to medical students who must consider the importance of a residency program's reputation when deciding where to apply for residency.

4.
Artículo en Inglés | MEDLINE | ID: mdl-37406178

RESUMEN

INTRODUCTION: Quantification of a researcher's productivity relies on objective bibliometric measurements, such as the Hirsch index (h-index). However, h-index is not field and time-normalized and possesses bias against newer researchers. Our study is the first to compare the relative citation ratio (RCR), a new article-level metric developed by the National Institutes of Health, with h-index in academic orthopaedics. METHODS: Academic orthopaedic programs in the United States were identified using the 2022 Fellowship and Residency Electronic Interactive Database. Available demographic and training data for surgeons were collected. RCR was calculated using the National Institutes of Health iCite tool, and h-index was calculated using Scopus. RESULTS: Two thousand eight hundred twelve academic orthopaedic surgeons were identified from 131 residency programs. H-index, weighted RCR (w-RCR), and mean RCR (m-RCR) all significantly differed by faculty rank and career duration. However, while h-index and w-RCR varied between sexes (P < 0.001), m-RCR did not (P = 0.066), despite men having a longer career duration (P < 0.001). DISCUSSION: We propose that m-RCR be used in conjunction with w-RCR or h-index to promote a fairer, comprehensive depiction of an orthopaedic surgeon's academic effect and productivity. Use of m-RCR may reduce the historic bias against women and younger surgeons in orthopaedics, which has implications in employment, promotion, and tenure.


Asunto(s)
Cirujanos Ortopédicos , Ortopedia , Masculino , Humanos , Femenino , Estados Unidos , Eficiencia , Docentes , Bibliometría
5.
Endocr Pract ; 29(10): 830-847, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37460058

RESUMEN

Increasingly, people with diabetes (PWD) are using wearable and other devices to support self-management. During air travel, there are 4 stakeholders involved in maximizing the safety of wireless devices for diabetes care used in flight: (1) manufacturers of the devices, (2) airlines, (3) the Transportation Security Administration, and (4) the U.S. Food and Drug Administration. These stakeholders have all developed technologies and policies that assist PWD who prepare for and take appropriate actions during long-haul flights. This article discusses the performance and use of 6 classes of specific wireless diabetes devices during an airplane flight, including the following: (1) blood glucose monitors, (2) continuous glucose monitors, (3) insulin pumps, (4) smart pens for dosing insulin injections, (5) advanced hybrid closed-loop systems, and (6) spinal cord stimulators for painful diabetic neuropathy. Through the policies and safeguards of the 4 stakeholders and the proper self-care measures that insulin-using PWD can take, it is possible to maintain safe glycemic levels on flights across multiple time zones.

6.
J Orthop Res ; 41(7): 1494-1504, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36515300

RESUMEN

The effects of locally applied zinc chloride (ZnCl2 ) on early and late-stage parameters of fracture healing were evaluated in a diabetic rat model. Type 1 Diabetes has been shown to negatively impact mechanical parameters of bone as well as biologic markers associated with bone healing. Zinc treatments have been shown to reverse those outcomes in tests of nondiabetic and diabetic animals. This study is the first to assess the efficacy of a noncarrier mediated ZnCl2 on bony healing in diabetic animals. This is a promising basic science approach which may lead to benefits for diabetic patients in the future. Treatment and healing were assessed through quantification of callus zinc, radiographic scoring, microcomputed tomography (µCT), histomorphometry, and mechanical testing. Local ZnCl2 treatment increased callus zinc levels at 1 and 3 days after fracture (p ≤ 0.025). Femur fractures treated with ZnCl2 showed increased mechanical properties after 4 and 6 weeks of healing. Histomorphometry of the ZnCl2 -treated fractures found increased callus cartilage area at Day 7 (p = 0.033) and increased callus bone area at Day 10 (p = 0.038). In contrast, callus cartilage area was decreased (p < 0.01) after 14 days in the ZnCl2 -treated rats. µCT analysis showed increased bone volume in the fracture callus of ZnCl2 -treated rats at 6 weeks (p = 0.0012) with an associated increase in the proportion of µCT voxel axial projections (Z-rays) spanning the fracture site. The results suggest that local ZnCl2 administration improves callus chondrogenesis leading to greater callus bone formation and improved fracture healing in diabetic rats.


Asunto(s)
Diabetes Mellitus Experimental , Fracturas del Fémur , Ratas , Animales , Zinc/farmacología , Diabetes Mellitus Experimental/complicaciones , Microtomografía por Rayos X , Callo Óseo , Curación de Fractura , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/tratamiento farmacológico , Fracturas del Fémur/complicaciones
7.
J Diabetes Sci Technol ; 17(5): 1226-1242, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-35348391

RESUMEN

BACKGROUND: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data. METHODS: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation. RESULTS: The analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals. CONCLUSION: The GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.


Asunto(s)
Hiperglucemia , Hipoglucemia , Adulto , Humanos , Glucemia , Automonitorización de la Glucosa Sanguínea , Hipoglucemia/diagnóstico , Hiperglucemia/diagnóstico , Glucosa
8.
J Diabetes Sci Technol ; 16(4): 1016-1056, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35499170

RESUMEN

Diabetes Technology Society hosted its annual Diabetes Technology Meeting on November 4 to November 6, 2021. This meeting brought together speakers to discuss various developments within the field of diabetes technology. Meeting topics included blood glucose monitoring, continuous glucose monitoring, novel sensors, direct-to-consumer telehealth, metrics for glycemia, software for diabetes, regulation of diabetes technology, diabetes data science, artificial pancreas, novel insulins, insulin delivery, skin trauma, metabesity, precision diabetes, diversity in diabetes technology, use of diabetes technology in pregnancy, and green diabetes. A live demonstration on a mobile app to monitor diabetic foot wounds was presented.


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus , Glucemia , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Femenino , Humanos , Insulina/uso terapéutico , Sistemas de Infusión de Insulina , Embarazo , Tecnología
9.
Curr Opin Endocrinol Diabetes Obes ; 29(1): 17-22, 2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-34878413

RESUMEN

PURPOSE OF REVIEW: As smartphones have become deeply integrated into our daily lives, diabetes apps have emerged as valuable tools for people living with diabetes (PWD's). Whether as standalone apps or companion apps to diabetes devices such as glucose meters or insulin pumps, they aim to help patients better manage their diabetes. However, with almost a half million health apps available, it is important to have a framework for understanding their benefits and disadvantages. RECENT FINDINGS: 2020 was the first year that every insulin pump and continuous glucose monitor manufacturer in the United States offered a smartphone companion app for their flagship products. These companion apps enabled cloud-based data synchronization, which in turn proved to be extremely timely as the COVID-19 pandemic shifted many diabetes clinic appointments to the telemedicine format. The American Diabetes Association and European Association for the Study of Diabetes Diabetes Technology Working Group recently published a consensus report highlighting the current state of diabetes digital app technology. SUMMARY: While diabetes apps offer unique conveniences and advantages for PWD's, it is equally important to fully understand their potential pitfalls to better inform all diabetes stakeholders: patients, healthcare professionals, regulatory agencies, researchers, and policy makers.


Asunto(s)
COVID-19 , Aplicaciones Móviles , Telemedicina , Humanos , Pandemias , Medición de Riesgo , SARS-CoV-2 , Estados Unidos
10.
J Diabetes Sci Technol ; 16(3): 605-609, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34933594

RESUMEN

Although automated bolus calculators (ABCs) have become a mainstay in insulin pump therapy, they have not achieved similar levels of adoption by persons with diabetes (PWD) using multiple daily injections of insulin (MDI). Only a small number of blood glucose meters (BGMs) have incorporated ABC functionality and the proliferation of unregulated ABC smartphone apps raised safety concerns and eventually led to Food and Drug Administration (FDA)-mandated regulatory oversight for these types of apps. With the recent introduction of smartphone-connected insulin pens, manufacturer-supported companion ABC apps may offer an ideal solution for PWD and health care professionals that reduces errors of mental math when calculating bolus insulin dosing, increases the quality of diabetes data reporting, and improves glycemic outcomes.


Asunto(s)
Diabetes Mellitus Tipo 1 , Hipoglucemiantes , Glucemia , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Humanos , Insulina , Sistemas de Infusión de Insulina
11.
Contemp Clin Trials ; 108: 106526, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34371162

RESUMEN

While low-income midlife and older adults are disproportionately affected by non-communicable diseases that can be alleviated by regular physical activity, few physical activity programs have been developed specifically with their needs in mind. Those programs that are available typically do not address the recognized local environmental factors that can impact physical activity. The specific aim of the Steps for Change cluster-randomized controlled trial is to compare systematically the initial (one-year) and sustained (two-year) multi-level impacts of an evidence-based person-level physical activity intervention (Active Living Every Day [ALED] and age-relevant health education information), versus the ALED program in combination with a novel neighborhood-level citizen science intervention called Our Voice. The study sample (N = 300) consists of insufficiently active adults ages 40 years and over living in or around affordable senior public housing settings. Major study assessments occur at baseline, 12, and 24 months. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of physical activity, assessed via validated self-report measures supported by accelerometry, and physical function and well-being variables. Additional intervention impacts are assessed at 24 months. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. TRIAL REGISTRATION: clinicaltrial.gov Identifier = NCT03041415.


Asunto(s)
Ciencia Ciudadana , Equidad en Salud , Acelerometría , Adulto , Anciano , Ejercicio Físico , Humanos , Persona de Mediana Edad , Características de la Residencia
12.
J Diabetes Sci Technol ; 15(2): 478-514, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33476193

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has rapidly involved the entire world and exposed the pressing need for collaboration between public health and other stakeholders from the clinical, scientific, regulatory, pharmaceutical, and medical device and technology communities. To discuss how to best protect people with diabetes from serious outcomes from COVID-19, Diabetes Technology Society, in collaboration with Sansum Diabetes Research Institute, hosted the "International COVID-19 and Diabetes Virtual Summit" on August 26-27, 2020. This unique, unprecedented real-time conference brought together physicians, scientists, government officials, regulatory experts, industry representatives, and people with diabetes from six continents to review and analyze relationships between COVID-19 and diabetes. Over 800 attendees logged in. The summit consisted of five sessions: (I) Keynotes, (II) Preparedness, (III) Response, (IV) Recovery, and (V) Surveillance; eight parts: (A) Background, (B) Resilience, (C) Outpatient Care, (D) Inpatient Care, (E) Resources, (F) High-Risk Groups, (G) Regulation, and (H) The Future; and 24 sections: (1) Historic Pandemics and Impact on Society, (2) Pathophysiology/Risk Factors for COVID-19, (3) Social Determinants of COVID-19, (4) Preparing for the Future, (5) Medications and Vaccines, (6) Psychology of Patients and Caregivers, (7) Outpatient Treatment of Diabetes Mellitus and Non-Pharmacologic Intervention, (8) Technology and Telehealth for Diabetes Outpatients, (9) Technology for Inpatients, (10) Management of Diabetes Inpatients with COVID-19, (11) Ethics, (12) Accuracy of Diagnostic Tests, (13) Children, (14) Pregnancy, (15) Economics of Care for COVID-19, (16) Role of Industry, (17) Protection of Healthcare Workers, (18) People with Diabetes, (19) International Responses to COVID-19, (20) Government Policy, (21) Regulation of Tests and Treatments, (22) Digital Health Technology, (23) Big Data Statistics, and 24) Patient Surveillance and Privacy. The two keynote speeches were entitled (1) COVID-19 and Diabetes-Meeting the Challenge and (2) Knowledge Gaps and Research Opportunities for Diabetes and COVID-19. While there was an emphasis on diabetes and its interactions with COVID-19, the panelists also discussed the COVID-19 pandemic in general. The meeting generated many novel ideas for collaboration between experts in medicine, science, government, and industry to develop new technologies and disease treatment paradigms to fight this global pandemic.


Asunto(s)
COVID-19/epidemiología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/terapia , COVID-19/complicaciones , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/prevención & control , Geografía , Salud Global , Historia del Siglo XX , Humanos , Influenza Pandémica, 1918-1919/historia , Cooperación Internacional , Pandemias , Sociedades Médicas , Telemedicina/tendencias
13.
Small ; 16(44): e2002837, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33030299

RESUMEN

Despite their potential as a next-generation alternative to current state-of-the-art lithium (Li)-ion batteries, rechargeable aqueous zinc (Zn)-ion batteries still lag in practical use due to their low energy density, sluggish redox kinetics, and limited cyclability. In sharp contrast to previous studies that have mostly focused on materials development, herein, a new electrode architecture strategy based on a 3D bicontinuous heterofibrous network scaffold (HNS) is presented. The HNS is an intermingled nanofibrous mixture composed of single-walled carbon nanotubes (SWCNTs, for electron-conduction channels) and hydrophilic cellulose nanofibers (CNFs, for electrolyte accessibility). As proof-of-concept for the HNS electrode, manganese dioxide (MnO2 ) particles, one of the representative Zn-ion cathode active materials, are chosen. The HNS allows uniform dispersion of MnO2 particles and constructs bicontinuous electron/ion conduction pathways over the entire HNS electrode (containing no metallic foil current collectors), thereby facilitating the redox kinetics (in particular, the intercalation/deintercalation of Zn2+ ions) of MnO2 particles. Driven by these advantageous effects, the HNS electrode enables substantial improvements in the rate capability, cyclability (without structural disruption and aggregation of MnO2 ), and electrode sheet-based energy (91 Wh kgelectrode -1 )/power (1848 W kgelectrode -1 ) densities, which lie far beyond those achievable with conventional Zn-ion battery technologies.

14.
JAMA Intern Med ; 180(11): 1481-1490, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-32986075

RESUMEN

Importance: Effective and practical treatments are needed to increase physical activity among those at heightened risk from inactivity. Walking represents a popular physical activity that can produce a range of desirable health effects, particularly as people age. Objective: To test the hypothesis that counseling by a computer-based virtual advisor is no worse than (ie, noninferior to) counseling by trained human advisors for increasing 12-month walking levels among inactive adults. Design, Setting, and Participants: A cluster-randomized, noninferiority parallel trial enrolled 245 adults between July 21, 2014, and July 29, 2016, with follow-up through September 15, 2017. Data analysis was performed from March 15 to December 20, 2018. The evidence-derived noninferiority margin was 30 minutes of walking per week. Participants included inactive adults aged 50 years and older, primarily of Latin American descent and capable of walking without significant limitations, from 10 community centers in Santa Clara and San Mateo counties, California. Interventions: All participants received similar evidence-based, 12-month physical activity counseling at their local community center, with the 10 centers randomized to a computerized virtual advisor program (virtual) or a previously validated peer advisor program (human). Main Outcomes and Measures: The primary outcome was change in walking minutes per week over 12 months using validated interview assessment corroborated with accelerometry. Both per-protocol and intention-to-treat analysis was performed. Results: Among the 245 participants randomized, 193 were women (78.8%) and 241 participants (98.4%) were Latino. Mean (SD) age was 62.3 (8.4) years (range, 50-87 years), 107 individuals (43.7%) had high school or less educational level, mean BMI was 32.8 (6.8), and mean years residence in the US was 47.4 (17.0) years. A total of 231 participants (94.3%) completed the study. Mean 12-month change in walking was 153.9 min/wk (95% CI, 126.3 min/wk to infinity) for the virtual cohort (n = 123) and 131.9 min/wk (95% CI, 101.4 min/wk to infinity) for the human cohort (n = 122) (difference, 22.0, with lower limit of 1-sided 95% CI, -20.6 to infinity; P = .02); this finding supports noninferiority. Improvements emerged in both arms for relevant clinical risk factors, sedentary behavior, and well-being measures. Conclusions and Relevance: The findings of this study indicate that a virtual advisor using evidence-based strategies produces significant 12-month walking increases for older, lower-income Latino adults that are no worse than the significant improvements achieved by human advisors. Changes produced by both programs are commensurate with those reported in previous investigations of these behavioral interventions and provide support for broadening the range of light-touch physical activity programs that can be offered to a diverse population. Trial Registration: ClinicalTrials.gov Identifier: NCT02111213.


Asunto(s)
Terapia Conductista/métodos , Computadores , Consejo/métodos , Ejercicio Físico/fisiología , Promoción de la Salud/métodos , Grupo Paritario , Caminata/fisiología , Acelerometría , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Conducta Sedentaria , Método Simple Ciego
15.
Contemp Clin Trials ; 95: 106084, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32659437

RESUMEN

Physical inactivity is a key risk factor for a range of chronic diseases and conditions, yet, approximately 50% of U.S. adults fall below recommended levels of regular aerobic physical activity (PA). This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. Text messaging (SMS) represents a convenient and accessible communication channel for delivering targeted PA information and support, but has not been rigorously evaluated against standard telehealth advising programs. The objective of the On The Move randomized controlled trial is to test the effectiveness of a linguistically and culturally targeted SMS PA intervention (SMS PA Advisor) versus two comparison conditions: a) a standard, staff-delivered phone PA intervention (Telephone PA Advisor) and b) an attention-control arm consisting of a culturally targeted SMS intervention to promote a healthy diet (SMS Nutrition Advisor). The study sample (N = 350) consists of generally healthy, insufficiently active Latino adults ages 35 years and older living in five northern California counties. Study assessments occur at baseline, 6, and 12 months, with a subset of participants completing 18-month assessments. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of PA, assessed via validated self-report measures and supported by accelerometry, and physical function and well-being variables. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. Trial Registration: clinicaltrial.gov Identifier = NCT02385591.


Asunto(s)
Envío de Mensajes de Texto , Etnicidad , Ejercicio Físico , Hispánicos o Latinos , Humanos , Recién Nacido , Grupos Minoritarios
17.
J Oral Maxillofac Surg ; 78(8): 1297-1303, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32360574

RESUMEN

PURPOSE: The purpose of the present study was to correlate specific arthroscopic findings in temporomandibular joint (TMJ) arthroscopy and histologic results from arthroscopic-guided synovial biopsy. PATIENTS AND METHODS: A retrospective cohort study was completed of patients who had undergone arthroscopy and arthroscopic synovial biopsy from January 1, 2011 to March 31, 2016 at the senior author's practice in Miami, Florida. The demographic, arthroscopic, histologic, serologic, and historical variables were recorded by electronic medical record review. Two-tailed Fisher's exact tests were used to test the correlation of the arthroscopic and histologic variables. RESULTS: A total of 210 patients were included in the present study. The mean age was 43.1 ± 18.8 years, and the study population included 91.7% women. The following histologic findings had significant associations: lymphoplasmacytic infiltrate with petechiae synovitis (P = .0018), chronic inflammation with joint stenosis (P = .019), and crystal deposition with visualization of crystals (P = .0472). Hyperplastic synovium found on histologic examination was associated with both petechiae synovitis and adhesions. Histologic vascular proliferation was associated with synovial plica and joint stenosis. CONCLUSIONS: The findings from the present study indicated an association between specific findings during arthroscopy and histologic findings. A prospective study is required to validate the findings to evaluate their utility in patient care.


Asunto(s)
Sinovitis , Trastornos de la Articulación Temporomandibular , Adulto , Artroscopía , Femenino , Florida , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Membrana Sinovial , Articulación Temporomandibular , Adulto Joven
18.
J Oral Maxillofac Surg ; 78(8): 1343-1348, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32360235

RESUMEN

Angiofibromas located in the maxillofacial region are rare and almost exclusively occur in adolescent males. These benign tumors are highly vascular, locally invasive, and commonly found in the nasopharyngeal space. In the present report, we describe a very rare case of an intraosseous mandibular angiofibroma in a 23-year-old male patient with histomorphologic and molecular confirmation. This type of tumor occurring in the mandible has been reported previously only once, to the best of our knowledge.


Asunto(s)
Angiofibroma/diagnóstico por imagen , Angiofibroma/diagnóstico , Angiofibroma/cirugía , Neoplasias de Cabeza y Cuello , Neoplasias Nasofaríngeas , Adolescente , Adulto , Humanos , Masculino , Mandíbula , Nasofaringe , Adulto Joven
19.
Sci Adv ; 6(10): eaaz1692, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32181360

RESUMEN

Microsupercapacitors (MSCs) have garnered considerable attention as a promising power source for microelectronics and miniaturized portable/wearable devices. However, their practical application has been hindered by the manufacturing complexity and dimensional limits. Here, we develop a new class of ultrahigh areal number density solid-state MSCs (UHD SS-MSCs) on a chip via electrohydrodynamic (EHD) jet printing. This is, to the best of our knowledge, the first study to exploit EHD jet printing in the MSCs. The activated carbon-based electrode inks are EHD jet-printed, creating interdigitated electrodes with fine feature sizes. Subsequently, a drying-free, ultraviolet-cured solid-state gel electrolyte is introduced to ensure electrochemical isolation between the SS-MSCs, enabling dense SS-MSC integration with on-demand (in-series/in-parallel) cell connection on a chip. The resulting on-chip UHD SS-MSCs exhibit exceptional areal number density [36 unit cells integrated on a chip (area = 8.0 mm × 8.2 mm), 54.9 cells cm-2] and areal operating voltage (65.9 V cm-2).

20.
Chem Sci ; 11(43): 11692-11698, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-34123199

RESUMEN

Despite their potential as promising alternatives to current state-of-the-art lithium-ion batteries, aqueous rechargeable Zn-ion batteries are still far away from practical applications. Here, we present a new class of single-ion conducting electrolytes based on a zinc sulfonated covalent organic framework (TpPa-SO3Zn0.5) to address this challenging issue. TpPa-SO3Zn0.5 is synthesised to exhibit single Zn2+ conduction behaviour via its delocalised sulfonates that are covalently tethered to directional pores and achieve structural robustness by its ß-ketoenamine linkages. Driven by these structural and physicochemical features, TpPa-SO3Zn0.5 improves the redox reliability of the Zn metal anode and acts as an ionomeric buffer layer for stabilising the MnO2 cathode. Such improvements in the TpPa-SO3Zn0.5-electrode interfaces, along with the ion transport phenomena, enable aqueous Zn-MnO2 batteries to exhibit long-term cyclability, demonstrating the viability of COF-mediated electrolytes for Zn-ion batteries.

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