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1.
Front Psychiatry ; 12: 665019, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34335323

RESUMO

Objectives: To synthesize the prevalence of mental and substance use disorders in countries of the Eastern Mediterranean Region (EMR) of the World Health Organization. Methods: The literature search was conducted across several databases in two phases. First, we searched for systematic reviews and/or meta-analyses published before 2014, reporting prevalence estimates for mental disorders in the EMR. Then, we identified new primary cross-sectional or longitudinal studies published between 2014 and 2020. Studies were included if they had a sample size of ≥ 450 and were conducted among the general adult population. Current, period and lifetime prevalence estimates for each disorder were pooled using random-effects meta-analyses, and subgroup analyses and meta-regressions were conducted. Findings: Prevalence estimates were extracted from 54 cross-sectional studies across 15 countries within the EMR. Pooled analyses of current, period and lifetime prevalence showed the highest prevalence for depression (14.8%, 95% confidence interval, CI: 10.7-20.1%), followed by generalized anxiety disorder (GAD) (10.4%, 95% CI: 7.1-14.7%), post-traumatic stress disorder (7.2%, 95% CI: 2.9-16.6%), substance use (4.0%, 95% CI: 3.1-5.2%), obsessive compulsive disorder (2.8%, 95% CI: 1.6-4.9%), phobic disorders (1.8%, 95% CI: 1.1-2.8%), panic disorders (1.1%, 95% CI: 0.6-2.2%), bipolar disorders (0.7%, 95% CI: 0.3-1.6%), and psychosis (0.5%, 95% CI: 0.3-0.9%). Populations exposed to adverse events had higher prevalence of mental disorders than the general population. Period and lifetime prevalence showed little difference across mental disorders. More pronounced differences in prevalence were seen for depression and GAD, specifically between current and lifetime prevalence (depression: current prevalence 20.5% (95% CI: 14.9-27.4%), vs. lifetime prevalence: 4.2% (95%CI: 1.8-9.6%); GAD: current prevalence 10.3% (95% CI: 6.1-17.0), vs. lifetime prevalence: 4.5% (95% CI: 2.4-8.3%). Differences between current and lifetime prevalence of mental disorders may be due to the use of different screening instruments and thresholds being applied. Conclusion: The prevalence of mental and substance use disorders in the EMR is high. Despite substantial inter-survey heterogeneity, our estimates align with previous global and regional data on mental disorders. Our meta-review provides new evidence on the burden of mental health problems in the EMR. Systematic Review Registration: PROSPERO, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020187388.

2.
Sci Prog ; 104(3): 368504211033677, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34293964

RESUMO

The consequences of double-diffusivity convection on the peristaltic transport of Sisko nanofluids in the non-uniform inclined channel and induced magnetic field are discussed in this article. The mathematical modeling of Sisko nanofluids with induced magnetic field and double-diffusivity convection is given. To simplify PDEs that are highly nonlinear in nature, the low but finite Reynolds number, and long wavelength estimation are used. The Numerical solution is calculated for the non-linear PDEs. The exact solution of concentration, temperature and nanoparticle are obtained. The effect of various physical parameters of flow quantities is shown in numerical and graphical data. The outcomes show that as the thermophoresis and Dufour parameters are raised, the profiles of temperature, concentration, and nanoparticle fraction all significantly increase.

4.
Sensors (Basel) ; 21(5)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801361

RESUMO

This paper presents an algorithm for segmentation and shape analysis of erythrocyte images collected using an optical microscope. The main objective of the proposed approach is to compute statistical object values such as the number of erythrocytes in the image, their size, and width to height ratio. A median filter, a mean filter and a bilateral filter were used for initial noise reduction. Background subtraction using a rolling ball filter removes background irregularities. Combining the distance transform with the Otsu and watershed segmentation methods allows for initial image segmentation. Further processing steps, including morphological transforms and the previously mentioned segmentation methods, were applied to each segmented cell, resulting in an accurate segmentation. Finally, the noise standard deviation, sensitivity, specificity, precision, negative predictive value, accuracy and the number of detected objects are calculated. The presented approach shows that the second stage of the two-stage segmentation algorithm applied to individual cells segmented in the first stage allows increasing the precision from 0.857 to 0.968 for the artificial image example tested in this paper. The next step of the algorithm is to categorize segmented erythrocytes to identify poorly segmented and abnormal ones, thus automating this process, previously often done manually by specialists. The presented segmentation technique is also applicable as a probability map processor in the deep learning pipeline. The presented two-stage processing introduces a promising fusion model presented by the authors for the first time.


Assuntos
Algoritmos , Microscopia , Eritrócitos , Processamento de Imagem Assistida por Computador
5.
Psychiatr Serv ; 72(6): 729-731, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33502220

RESUMO

Children are likely to struggle with mental health consequences relating to the COVID-19 pandemic. School closures and home confinement increase the risk for emotional distress, domestic violence and abuse, and social isolation, as well as for disruption of sleep-wake and meal cycles, physical exercise routines, and health care access. As schools reopen, school mental health programs (SMHPs) incorporating universal approaches will be important for all children, and targeted approaches will be necessary for those more severely affected. Using their experience in Pakistan, the authors provide a roadmap for extending the World Health Organization's eastern Mediterranean region's SMHP to address the mental health consequences of COVID-19 among children globally.


Assuntos
COVID-19 , Saúde Mental/estatística & dados numéricos , Pandemias , Distanciamento Físico , Serviços de Saúde Mental Escolar/organização & administração , Instituições Acadêmicas , COVID-19/epidemiologia , Criança , Humanos , Serviços de Saúde Mental Escolar/economia , Instituições Acadêmicas/organização & administração
6.
J Environ Health Sci Eng ; 18(2): 1473-1489, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33312656

RESUMO

Background: Photodegradation of organic pollutants is considered to be the most suitable and cheaper technique to counter the decontamination issues. Metal nanoparticles are considered to be the most effective heterogeneous photocatalysts for photodegradation of organic pollutants. Besides, iron oxide nanoparticles are well-known photocatalysts for degrading organic pollutants. Methods: We reported the synthesis of neat iron oxide nanoparticles (Fe3O4 NPs) and zirconia supported iron oxide nanoparticles (Fe3O4/ZrO2 NPs) by facile chemical reduction technique for photodegradation ofa toxic azo dye namely methyl red. Results: The XRD and FTIR analysis has demonstrated a crystalline phase Fe3O4 NPs. The morphological features via scanning electronic microscopy (FESEM) suggested agglomerated morphology of neat Fe3O4 NPs with 803.54 ± 5.11 nm average particle size and revealed the uniform morphology and homogenous dispersion of Fe3O4 NPs over ZrO2 surface in Fe3O4/ZrO2 nanocomposite. A polydispersity index (PDI) of 0.47 showed sufficient variations in the particle size of neat Fe3O4 NPs, which is also supported by the results obtained from atomic force microscopy (AFM), FESEM and Transmission Electron Microscopy (TEM). Fe3O4/ZrO2 NPs demonstrated efficient methyl red degradation over a short period of time under simulated light and degraded about ~ 91.0 ± 1.0% and 87.0 ± 1.0% dye in 40 min, under UV and visible light, respectively. Conclusion: The excellent photodegradation efficacy and sustainability of Fe3O4/ZrO2 NPs can be attributed to the homogenous distribution of Fe3O4 NPs over ZrO2, which facilitates the generation of photoexcitons (electrons and holes), enhanced charge transfer and minimize the charge recombination.

7.
Health Policy Plan ; 35(Supplement_2): ii112-ii123, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33156933

RESUMO

Globally there is a substantial burden of mental health problems among children and adolescents. Task-shifting/task-sharing mental health services to non-specialists, e.g. teachers in school settings, provide a unique opportunity for the implementation of mental health interventions at scale in low- and middle-income countries (LMICs). There is scant information to guide the large-scale implementation of school-based mental health programme in LMICs. This article describes pathways for large-scale implementation of a School Mental Health Program (SMHP) in the Eastern Mediterranean Region (EMR). A collaborative learning group (CLG) comprising stakeholders involved in implementing the SMHP including policymakers, programme managers and researchers from EMR countries was established. Participants in the CLG applied the theory of change (ToC) methodology to identify sets of preconditions, assumptions and hypothesized pathways for improving the mental health outcomes of school-aged children in public schools through implementation of the SMHP. The proposed pathways were then validated through multiple regional and national ToC workshops held between January 2017 and September 2019, as the SMHP was being rolled out in three EMR countries: Egypt, Pakistan and Iran. Preconditions, strategies and programmatic/contextual adaptations that apply across these three countries were drawn from qualitative narrative summaries of programme implementation processes and facilitated discussions during biannual CLG meetings. The ToC for large-scale implementation of the SMHP in the EMR suggests that identifying national champions, formulating dedicated cross-sectoral (including the health and education sector) implementation teams, sustained policy advocacy and stakeholders engagement across multiple levels, and effective co-ordination among education and health systems especially at the local level are among the critical factors for large-scale programme implementation. The pathways described in this paper are useful for facilitating effective implementation of the SMHP at scale and provide a theory-based framework for evaluating the SMHP and similar programmes in the EMR and other LMICs.


Assuntos
Saúde Mental , Instituições Acadêmicas , Adolescente , Criança , Humanos , Irã (Geográfico) , Região do Mediterrâneo , Paquistão
8.
East Mediterr Health J ; 26(10): 1148-1150, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33103740

RESUMO

The global COVID-19 pandemic has demonstrated the impact of a major public health emergency on mental health, and the ways that individuals, communities, professionals and systems can react positively to such a crisis. The Eastern Mediterranean Region (EMR) has substantial experience in mental health and psychosocial support (MHPSS) in crises, and COVID-19 has driven further innovation to support mental health and well-being.Global and regional guidance has been developed quickly, applying lessons learnt from previous disease outbreaks to respond to the pandemic at a systems level, for different population groups, and for countries of different income levels. Preliminary results from a global rapid assessment survey to assess the impact of COVID-19 on MHPSS services, indicate that 20 of the 22 EMR Member States have MHPSS as integral components of national COVID-19 response plans; one-third have allocated additional funding. However, MHPSS services have been severely impacted by the pandemic, including psychotherapy, psychosocial interventions, community services, and services for children/adolescents. Innovative solutions such as crisis hotlines, tele-consultations, digital self-help platforms, novel approaches to ensure supply of psychotropic medicines, and task sharing/shifting for basic psychosocial support, are being used in many countries to overcome service disruptions and maintain care for those with mental conditions.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Serviços de Saúde Mental/organização & administração , Saúde Mental , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , África do Norte/epidemiologia , Betacoronavirus , COVID-19 , Desastres , Saúde Global , Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Humanos , Oriente Médio/epidemiologia , Pandemias , Resiliência Psicológica , SARS-CoV-2 , Determinantes Sociais da Saúde , Fatores Socioeconômicos
9.
BJPsych Open ; 6(6): e130, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33121559

RESUMO

BACKGROUND: Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists' mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown. AIMS: We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia. METHOD: Participants included PCPs who completed questionnaires before (n = 112), immediately after (n = 88) and 18 months after (n = 59) training. Multivariable analyses with linear mixed models accounting for the correlation among participants were performed with the SAS version 9.4 PROC MIXED procedure. The significance level was α < 0.05. RESULTS: Data show a significant interaction between time and mental health attitudes on referrals to specialised mental health services per week. Higher scores on the attitude scale were associated with more referrals to specialised services before and 18 months after training, compared with immediately after training. CONCLUSION: Findings indicate that, in parallel to mental health training, considering structural/organisational supports to bring about a sustainable change in the influence of PCPs' mental health attitudes on referrals is important. Our results will inform the scale-up of an initiative to further integrate mental health into primary care settings across Tunisia, and potentially other countries with similar profiles interested in further developing task-sharing initiatives.

10.
Behav Res Ther ; 130: 103402, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31146889

RESUMO

BACKGROUND: Adolescence represents an unprecedented opportunity to invest in health. Individual adolescent life skills programs in low- and middle-income countries (LMICs) have demonstrated success but neither their relative effectiveness across multiple health arenas, including mental health, nor their key ingredients have been examined. METHODS: We conducted a systematic review and meta-analysis to identify key implementation processes and effectiveness of life skills programs among adolescents in LMICs which targeted at least one mental health outcome, as well as their relative effectiveness. Six academic databases, including PubMed and PsychInfo and bibliographies of related reviews, were systematically searched until July 1, 2016, with no restrictions on language or publication year. Studies were excluded if they were conducted in HIC settings, among chronically ill populations or lacking adolescents aged 10-19 years. Data from published reports related to the characteristics of RCTs and their implementation processes related to 'who, what, how and where' were extracted, including the development of a taxonomy to determine which life skills constituted each program. Meta-analyses with random effects models examined the overall trial effectiveness, as determined by their primary outcomes. Subsequent exploratory analyses determined which implementation processes predicted trial effectiveness (PROSPERO CRD42016043448). RESULTS: We included 50 eligible RCTs from 45 articles with a focus on an adolescent health program, which targeted at least one or more mental health outcomes. Most of the RCTs, conducted across 19 LMICs, targeted students (82%) and refugees (7%), and both genders (71%). Most of the interventions were delivered by teachers (n = 12), and specialist providers (n = 11), and most were focused on high-risk groups rather than clinically-disordered populations. These interventions were effective in reducing symptoms of anger (SMD = 1.234), improving life skills (SMD = 0.755) and functioning (SMD = 0.491), and decreasing PTSD (SMD = 0.327), depression and anxiety (SMD = 0.305). Trial effectiveness was positively associated with the following life skills: interventions focused on parent-child interactions (ß = 0.557, p < 0.05), assessing interpersonal relations (ß = 0.204, p < 0.05) and stress management (ß = 0.216, p < 0.05). DISCUSSION: Our results demonstrate the benefits of life skills programs targeting one or more mental health outcomes and co-occurring risk factors in school and community settings. Comprehensive programs focusing on multiple life skills related to the individual, his or her social environment and, in particular, interventions promoting parent-child interactions may hold particular promise in LMICs to address the burden of poor mental health and other health arenas.


Assuntos
Saúde do Adolescente , Países em Desenvolvimento , Transtornos Mentais/terapia , Relações Pais-Filho , Autogestão , Habilidades Sociais , Adolescente , Ira , Ansiedade/psicologia , Ansiedade/terapia , Depressão/psicologia , Depressão/terapia , Humanos , Ciência da Implementação , Transtornos Mentais/psicologia , Saúde Mental , Refugiados , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico , Estudantes
11.
Chem Res Toxicol ; 33(6): 1292-1311, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-31884781

RESUMO

The optoelectrical and magnetic characteristics of naturally existing iron-based nanostructures, especially hematite and magnetite nanoparticles (H-NPs and M-NPs), gained significant research interest in various applications, recently. The main purpose of this Review is to provide an overview of the utilization of H-NPs and M-NPs in various environmental remediation. Iron-based NPs are extensively explored to generate green energy from environmental friendly processes such as water splitting and CO2 conversion to hydrogen and low molecular weight hydrocarbons, respectively. The latter part of the Review provided a critical overview to use H-NPs and M-NPs for the detection and decontamination of inorganic and organic contaminants to counter the environmental pollution and toxicity challenge, which could ensure environmental sustainability and hygiene. Some of the future perspectives are comprehensively presented in the final portion of the script, optimiztically, and it is supported by some relevant literature surveys to predict the possible routes of H-NPs and M-NPs modifications that could enable researchers to use these NPs in more advanced environmental applications. The literature collection and discussion on the critical assessment of reserving the environmental sustainability challenges provided in this Review will be useful not only for experienced researchers but also for novices in the field.


Assuntos
Recuperação e Remediação Ambiental , Compostos Férricos , Óxido Ferroso-Férrico , Nanoestruturas , Poluição Ambiental/prevenção & controle , Compostos Férricos/química , Óxido Ferroso-Férrico/química , Nanoestruturas/química , Energia Renovável
12.
Blood ; 135(9): 597-609, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-31830245

RESUMO

Chimeric antigen receptor (CAR) T-cell therapy has proven effective in relapsed and refractory B-cell malignancies, but resistance and relapses still occur. Better understanding of mechanisms influencing CAR T-cell cytotoxicity and the potential for modulation using small-molecule drugs could improve current immunotherapies. Here, we systematically investigated druggable mechanisms of CAR T-cell cytotoxicity using >500 small-molecule drugs and genome-scale CRISPR-Cas9 loss-of-function screens. We identified several tyrosine kinase inhibitors that inhibit CAR T-cell cytotoxicity by impairing T-cell signaling transcriptional activity. In contrast, the apoptotic modulator drugs SMAC mimetics sensitized B-cell acute lymphoblastic leukemia and diffuse large B-cell lymphoma cells to anti-CD19 CAR T cells. CRISPR screens identified death receptor signaling through FADD and TNFRSF10B (TRAIL-R2) as a key mediator of CAR T-cell cytotoxicity and elucidated the RIPK1-dependent mechanism of sensitization by SMAC mimetics. Death receptor expression varied across genetic subtypes of B-cell malignancies, suggesting a link between mechanisms of CAR T-cell cytotoxicity and cancer genetics. These results implicate death receptor signaling as an important mediator of cancer cell sensitivity to CAR T-cell cytotoxicity, with potential for pharmacological targeting to enhance cancer immunotherapy. The screening data provide a resource of immunomodulatory properties of cancer drugs and genetic mechanisms influencing CAR T-cell cytotoxicity.


Assuntos
Citotoxicidade Imunológica/imunologia , Resistencia a Medicamentos Antineoplásicos/imunologia , Ensaios de Seleção de Medicamentos Antitumorais/métodos , Imunoterapia Adotiva/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Linfócitos T Citotóxicos/imunologia , Linhagem Celular Tumoral , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Testes Imunológicos de Citotoxicidade/métodos , Humanos , Ativação Linfocitária/imunologia , Linfoma Difuso de Grandes Células B/imunologia , Receptores de Antígenos Quiméricos
13.
Eur J Obstet Gynecol Reprod Biol ; 240: 256-260, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31344664

RESUMO

OBJECTIVE: To determine the rate and associated risk factors for incisional surgical site infection following cesarean section in Ireland. STUDY DESIGN: This study was a retrospective population-based cohort study, conducted using the Hospital In-Patient Enquiry database (HIPE) for the period 2005-2016. All women who underwent cesarean section between 2005 and 2016 in Ireland were included. Potential risk factors for incisional surgical site infection were selected based on the existing literature and their availability within the HIPE database. The risk of incisional surgical site infection following cesarean section with exact Poisson 95% confidence intervals were reported. Multivariable Poisson regression included all potential risk factors simultaneously. Risk ratios are reported with their 95% confidence intervals and P-values. RESULTS: There were 802,182 deliveries during the study period, 219,859 of which (27.4%) were by cesarean section. There were 1396 cases of incisional surgical site infection, a risk of 0.63% (95% confidence interval: 0.60-0.67%). Public patients had approximately 20% higher risk and the risk was almost 40% higher among women aged over 35 years compared with those aged under 25 years. Most notable, related to the morbidities assessed, was the twofold increased risk of incisional surgical site infection associated with pre-existing diabetes and with urinary tract infection in pregnancy. Premature rupture of membranes, pyrexia during labour and postpartum haemorrhage each increased risk by 40-60%. Hematoma of a cesarean section wound remained by far the strongest risk factor for incisional surgical site infection. CONCLUSION: Of all the risk factors we studied, hematoma had the strongest association with development of incisional surgical site infection. Of all women birthing by cesarean section in Ireland during 2005-2016, 25% had at least one of the risk factors identified by our study. Approximately 40% of the incisional surgical site infection cases came from this 25%. This might suggest that a universal approach to reducing risk of surgical site infection is warranted.


Assuntos
Cesárea/efeitos adversos , Infecção da Ferida Cirúrgica/epidemiologia , Adulto , Fatores Etários , Feminino , Humanos , Incidência , Irlanda/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/etiologia , Adulto Jovem
14.
Nanomaterials (Basel) ; 9(5)2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31126109

RESUMO

Although the origin and possible mechanisms for green and yellow emission from different zinc oxide (ZnO) forms have been extensively investigated, the same for red/orange PL emission from ZnO nanorods (nR) remains largely unaddressed. In this work, vertically aligned zinc oxide nanorods arrays (ZnO nR) were produced using hydrothermal process followed by plasma treatment in argon/sulfur hexafluoride (Ar/SF6) gas mixture for different time. The annealed samples were highly crystalline with ~45 nm crystallite size, (002) preferred orientation, and a relatively low strain value of 1.45 × 10-3, as determined from X-ray diffraction pattern. As compared to as-deposited ZnO nR, the plasma treatment under certain conditions demonstrated enhancement in the room temperature photoluminescence (PL) emission intensity, in the visible orange/red spectral regime, by a factor of 2. The PL intensity enhancement induced by SF6 plasma treatment may be attributed to surface chemistry modification as confirmed by X-ray photoelectron spectroscopy (XPS) studies. Several factors including presence of hydroxyl group on the ZnO surface, increased oxygen level in the ZnO lattice (OL), generation of F-OH and F-Zn bonds and passivation of surface states and bulk defects are considered to be active towards red/orange emission in the PL spectrum. The PL spectra were deconvoluted into component Gaussian sub-peaks representing transitions from conduction-band minimum (CBM) to oxygen interstitials (Oi) and CBM to oxygen vacancies (VO) with corresponding photon energies of 2.21 and 1.90 eV, respectively. The optimum plasma treatment route for ZnO nanostructures with resulting enhancement in the PL emission offers strong potential for photonic applications such as visible wavelength phosphors.

15.
East Mediterr Health J ; 25(2): 80-81, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30942470

RESUMO

The Global Burden of Disease study shows that the burden from mental and substance use disorders, measured in Disability Adjusted Life Years (DALYs), has steadily risen in the Eastern Mediterranean Region (EMR) over the last three decades and is higher than the global average for almost all EMR countries). Even more alarming is the finding that depression, self-harm, anxiety and conduct disorders constitute four of the top 10 causes of DALYs among girls and boys aged 15-19 years and suicide is a leading cause of adolescent mortality.More than 70% of all mental disorders begin before the age of 25 years old. Risk factors for mental disorders include genetic pre-disposition, deficiencies in psychosocial or educational environments, alcohol and drug misuse, and family, peer or school problems.


Assuntos
Serviços de Saúde Mental , Adolescente , Feminino , Humanos , Masculino , Região do Mediterrâneo/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Oriente Médio/epidemiologia , Adulto Jovem
16.
Sensors (Basel) ; 19(3)2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30744032

RESUMO

Hard exudates are one of the most characteristic and dangerous signs of diabetic retinopathy. They can be marked during the routine ophthalmological examination and seen in color fundus photographs (i.e., using a fundus camera). The purpose of this paper is to introduce an algorithm that can extract pathological changes (i.e., hard exudates) in diabetic retinopathy. This was a retrospective, nonrandomized study. A total of 100 photos were included in the analysis-50 sick and 50 normal eyes. Small lesions in diabetic retinopathy could be automatically diagnosed by the system with an accuracy of 98%. During the experiments, the authors used classical image processing methods such as binarization or median filtration, and data was read from the d-Eye sensor. Sixty-seven patients (39 females and 28 males with ages ranging between 50 and 64) were examined. The results have shown that the proposed solution accuracy level equals 98%. Moreover, the algorithm returns correct classification decisions for high quality images and low quality samples. Furthermore, we consider taking retina photos using mobile phones rather than fundus cameras, which is more practical. The paper presents an innovative approach. The results are introduced and the algorithm is described.


Assuntos
Técnicas de Diagnóstico Oftalmológico/instrumentação , Exsudatos e Transudatos/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Retina/diagnóstico por imagem , Telemedicina/instrumentação , Algoritmos , Retinopatia Diabética/diagnóstico por imagem , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
Environ Sci Pollut Res Int ; 26(5): 5140-5154, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30607840

RESUMO

Manganese dioxide nanoparticles/activated carbon (MnO2/AC) composites and manganese dioxide nanoparticles (MnO2 NPs) are prepared through chemical reduction method. Morphological study shows that MnO2 NPs had cylindrical and spherical shape. The morphological study also revealed that MnO2 NPs were well dispersed on AC while neat Mn NPs present both in dispersed and in agglomerated form. The FT-IR study confirms the synthesis of MnO2 NPs. Zetasizer study presented that the Mn NPs had uniform size and below 100 nm in size and had zeta potential of - 20 mV, which represent its stability in the suspension form. The synthesized Mn/AC composite and Mn NPs were utilized as photocatalysts for the photodegradation of Congo red (CR) dye. The degradation study shows that MnO2/AC composite degraded CR dye more efficiently than MnO2 NPs under UV and normal light irradiation. The efficient degradation of dye by Mn/AC composite is due to the synergistic effect between dye adsorption on AC and rapid photodegradation by supported MnO2 NPs. The results revealed that Mn/AC composite degraded about 98.53% of CR dye within 5 min while MnO2 NPs degraded 66.57% of dye within the same irradiation time. The recycled catalyst also significantly degraded dye which verifies its sustainability. The effect of catalyst dosage and initial dye concentration was conducted. The degradation rate of dye was found drastically faster in tap water (in presence of catalyst), which might be due to the presence of various mineral ions in the tap water.


Assuntos
Carvão Vegetal/química , Vermelho Congo/análise , Luz , Compostos de Manganês/química , Nanocompostos/química , Óxidos/química , Poluentes Químicos da Água/análise , Adsorção , Catálise , Vermelho Congo/efeitos da radiação , Nanopartículas/química , Fotólise , Raios Ultravioleta , Poluentes Químicos da Água/efeitos da radiação , Purificação da Água/métodos
18.
Front Psychiatry ; 10: 986, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32116815

RESUMO

Background: E-mental health is an established mode of delivering treatment for common mental disorders in many high income countries. However, evidence of its effectiveness in lower income countries is lacking. This mixed methods study presents lessons learned and preliminary data on the feasibility of a minimally guided e-mental health intervention in Lebanon. The aim was to pilot test Step-by-Step, a WHO guided e-mental health intervention, and research methods prior to future, controlled testing. Methods: Participants were recruited using social media and advertisements in primary care clinics. Participants completed baseline and post-intervention questionnaires on depression symptoms (primary outcome, PHQ-8), anxiety symptoms, well-being, disability and self-perceived problem severity, and a client satisfaction questionnaire. In addition, seven completers, four drop-outs, 11 study staff, and four clinic managers were interviewed with responses thematically analyzed. Website analytics were used to understand participant behavior when using the website. Results: A total of 129 participants signed up via the Step-by-Step website. Seventy-four participants started session 1 after completing pre-test questionnaires and 26 completed both baseline and post-intervention data. Among those who completed post-assessments, depression symptoms improved (PHQ-8 scores (t=5.62, p < 0.001 two-tailed, df = 25). Wilcoxon signed ranks tests showed a significant difference between baseline and post-Step-by-Step scores on all secondary outcome measures. Client satisfaction data was positive. Interview responses suggested that the intervention could be made more appropriate for younger, single people, more motivating, and easier to use. Those who utilized the support element of the intervention were happy with their relationship with the non-specialist support person (e-helper), though some participants would have preferred specialist support. E-helpers would have liked more training on complex cases. Website analytics showed that many users dropped out before intervention start, and that some re-entered screening data having been excluded from the study. Conclusion: Step-by-Step skills and techniques, model of service integration, and its non-specialist support element are acceptable. Though the sample was small and non-controlled and drop-out was high, results suggest that it may be effective in reducing depression and anxiety symptoms and increasing well-being. Lessons learned will inform content revision, the development of an app version of Step-by-Step, and the research methodology of upcoming effectiveness studies.

19.
Parasitology ; 146(2): 129-141, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30068403

RESUMO

Parasites reside inside or outside their hosts and get host nutrition and blood. Here, we have emphasized economic losses in cattle caused by parasitic diseases due to ecto- and endo- parasites (flies, ticks, mites and helminths). We have outlined different methods/models including economic evaluation techniques and dynamic analysis as a major class, used for the calculation of economic losses caused by parasites in cattle. According to already conducted studies, a decrease in production is mentioned in quantity and percentage while financial losses are expressed in the form of account with respect to per head, herd or for the specific study area. The parasites cause the reduced production and financial losses due to control, treatment and mortality costs. We calculated the average decrease in milk production and organ condemnation as 1.16 L animal-1 day-1 and 12.95%, respectively, from overall cattle parasitic infections. Moreover, the average calculated financial and percentage losses were US$ 50.67 animal-1 year-1 and 17.94%, respectively. Economically important parasitic diseases mentioned here are caused by specific spp. of protozoans and helminths according to data collected from the literature. Protozoan diseases include tick-borne diseases, coccidiosis, neosporosis, trypanosomiasis and cryptosporidiosis. Losses due to tick-borne infections were encountered for decreased milk production, mortality, treatment and control. Losses from coccidiosis were due to decreased weight gain, treatment costs and mortality. While abortion losses were encountered in neosporosis. Trypanosomiasis caused losses due to a decrease in milk yield. Moreover, only diagnostic (conventional or molecular techniques) cost was taken into account for cryptosporidiosis. Economically important nematode parasites are Oesophagostomum spp., Cooperia spp., Trichostrongylus spp., Strongyloides spp., Ostertagia spp. and Haemonchus placei. Due to the zoonotic importance of echinococcosis, Echinococcus granulosus is the most economically important cestode parasite. Losses caused by echinococcosis were due to organ condemnation, carcass weight loss and decreases hide value, milk production and fecundity. While, fascioliasis is one of the most economically important trematodal disease, which causes cirrhosis of the liver due to parasite migration, and thus, the organ becomes inedible. So, it would be helpful for farmers and researchers to approach these methods/models for calculation of parasitic losses and should adopt suitable measures to avoid long-term economic losses.


Assuntos
Doenças dos Bovinos/economia , Ectoparasitoses/veterinária , Modelos Econômicos , Doenças Parasitárias em Animais/economia , Animais , Bovinos , Doenças dos Bovinos/parasitologia , Análise Custo-Benefício , Ectoparasitoses/economia , Helmintíase Animal/economia , Software , Processos Estocásticos
20.
Am J Infect Control ; 47(2): 164-169, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30253904

RESUMO

BACKGROUND: The cesarean delivery (CD) rate is increasing worldwide. Surgical site infection (SSI) incidence is likely to follow an upward trajectory. We examined the incidence and risk factors for SSI after CD. METHODS: A case-control study of women who had a lower-segment CD during the study period was performed at Ireland's Cork University Maternity Hospital. Cases were patients who presented to the hospital with SSI and who met the criteria of the U.S. Centers for Disease Control and Prevention. Controls were randomly selected from the discharge register of CDs at a ratio of 2:1. Data were extracted from the medical records. A multivariable stepwise logistic regression model approach was used, and the results were expressed as adjusted odds ratios (aORs). RESULTS: The SSI rate was 2%. The greatest contribution to risk of SSI was associated with maternal obesity (aOR, 4.76; 95% confidence interval [CI], 2.00-11.32) and hypertensive disorders (aOR, 6.67; 95% CI, 1.54-28.99]. There was also an increased risk for women who underwent an emergency CD (aOR, 3.50; 95% CI, 1.09-11.30), for women who had ≥5 vaginal examinations (aOR, 3.24; 95% CI, 0.92-11.41), and for women without hypertensive disorders who delivered a baby weighing <3,500 g (aOR, 2.18; 95% CI, 1.08-4.37). CONCLUSIONS: Obesity, hypertensive disorders, emergency CD, and multiple vaginal examinations were independent risk factors for SSI after CD.


Assuntos
Cesárea/efeitos adversos , Infecção da Ferida Cirúrgica/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Recém-Nascido , Irlanda/epidemiologia , Fatores de Risco , Adulto Jovem
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