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1.
J Contemp Dent Pract ; 21(6): 651-656, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025934

RESUMO

AIM: This study relates the average number of nucleolar organizing regions (NORs) obtained in a series of cases of oral leukoplakia, with three methods of histopathological classification of such lesion. MATERIALS AND METHODS: This is a histopathological-histochemical laboratory cross-sectional study. The 18 cases of leukoplakia analyzed were filed at Pathology Service of the Biological Sciences Institute of the University of Passo Fundo, Rio Grande do Sul, Brazil (SDH/ICB/UPF) (2017 and 2018), from which epidemiological data were extracted. New histological sections were performed for impregnation by the argyrophilic nucleolar organizer regions (AgNOR) technique. The histopathological slides were analyzed by photon microscopy (1,000×), and the nuclei of 100 epithelial cells were photographed to count the number of NORs. Three methods were used for the lesions' histopathological classification [World Health Organization (WHO), Brothwell, and binary system]. The means of NORs were compared with the three histopathological classifications by means of the t or analysis of variance (ANOVA) statistical tests, at a significance level of 5%. RESULTS: According to the WHO classification method, most cases (11-61.1%) had a moderate classification. Evaluations by the Brothwell method showed moderate and mild classification in 50 and 38.9% of cases, respectively. According to the binary system, most cases (10-55.6%) had low risk. The average NORs found in 100 nuclei of each of the 18 lesions ranged from 2 to 4. When crossing the average NORs with the histopathological classification methods of the lesions by means of the t test or ANOVA, no significant relationship was noted. CONCLUSION: The average of NORs is not associated with the histological classifications of leukoplakias. Thus, the AgNOR method should be used with caution when differentiating different histological grades of leukoplakias. CLINICAL SIGNIFICANCE: The AgNOR method should be used with caution to determine the clinical treatment of oral leukoplakias, since no agreement was observed between this method and the histopathological classifications available for such lesion.


Assuntos
Leucoplasia Oral , Região Organizadora do Nucléolo , Análise de Variância , Brasil , Estudos Transversais , Humanos , Leucoplasia Oral/genética
2.
An. psicol ; 36(2): 188-199, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192055

RESUMO

El objetivo de este trabajo es evaluar empíricamente la eficacia de un programa de intervención con mujeres víctimas de violencia de género. El programa en conjunto se enmarca dentro de las Terapias Contextuales, específicamente se ha utilizado la Psicoterapia Analítica Funcional, combinada con la Terapia de Aceptación y Compromiso y la Activación Conductual. Se ha llevado a cabo en formato grupal, durante 11 sesiones de 2 horas cada una. Participaron un total de 21 mujeres (de una media de edad de 45 años), que habían sufrido violencia física y/o abuso emocional por parte de sus parejas, en diferente grado e intensidad, y en diferentes momentos en sus vidas. Se ha utilizado un diseño intragrupo con medidas pre-post. Se realizaron tres grupos de tratamiento en diferentes ciudades con 6 a 8 mujeres cada uno. Para medir la intervención se ha aplicado el cuestionario Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). Los resultados han mostrado una disminución estadísticamente significativa en la severidad del malestar, han disminuido los indicadores de riesgo de suicidio, y han mejorado las conductas problemáticas dentro y fuera de las sesiones, además de incrementarse la apertura hacia los demás. Se discute la utilidad de las terapias contextual es para mejorar la calidad de vida de mujeres maltratadas, y su utilidad de aplicación en grupos en las instituciones públicas


The goal of this study is to empirically evaluate the efficacy of an intervention program with women victims of gender violence. Specifically, Functional Analytical Psychotherapy has been used, combined with Acceptance and Commitment Therapy, and Behavioral Activation. It has been carried out in group format, during 11 sessions of 2 hours each. A total of 21 women participated (an average of 45 years-old), who had suffered physical violence and/or emotional abuse by their partners, with different degrees and intensity, and at different moments of their lives. An intra-group design with pre-post measures was used. Three treatment groups were carried out in different cities with 6 to 8 women each one. To measure the intervention, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire was applied. The results has shown a statistically significant decrease in the severity of discomfort, decreased suicide risk indicators, improved problem behavior inside and outside sessions, and increased openness to others. The usefulness of contextual therapies to improve the quality of life of battered women and their usefulness for application in groups in public institutions are discussed


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Violência de Gênero/psicologia , Resultado do Tratamento , Psicoterapia de Grupo/métodos , Psicometria/instrumentação , Inquéritos e Questionários , Abuso Físico/psicologia , Qualidade de Vida/psicologia , Apoio Social , Escalas de Graduação Psiquiátrica/normas , Análise de Variância , Maus-Tratos Conjugais/psicologia
3.
An. psicol ; 36(2): 232-241, mayo 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192059

RESUMO

BACKGROUND: The cardinal aim of the present study was to assess the level of social support, self esteem and quality of life among people living with HIV/AIDS in Jammu and Kashmir State of India. Further, the study strived to explore the relationship between independent and dependent variables. METHOD: The study consists a sample of 460 AIDS patients selected through purposive sampling technique, out of them 177 (38.3%) were male, 283 (61.5%) were female patients; 295 (64.1%) were married and 165 (35.9%) were unmarried. Measures included Enriched Social Support Inventory by Mitchell et al., (2003), Rosenberg's Self-Esteem Scale (1965) and Quality of Life Scale by Sharma & Nasreen (2014). For the statistical analysis of data Mean, Standard deviation, Frequency distribution, t-test, one way analysis of variance, correlation analysis and Scheffe's post hoc test was applied by SPSS 20.0 version. Findings: The findings illustrated that majority of patients have poor social support, lower self-esteem and poor quality of life; also it reveals that patient's social support, and self-esteem differs by age, occupation, duration of illness, gender, and marital status. However their quality of life differs only by their age, occupation, duration of illness, and marital status. Further the result shows social support and self-esteem are positively correlated with quality of life


ANTECEDENTES: El objetivo principal del presente estudio fue evaluar el nivel de apoyo social, autoestima y calidad de vida entre las personas que viven con el VIH / SIDA en Jammu y el Esta do de Cachemira de la India. Además, el estudio se esforzó por explorar la relación entre variables independientes y dependientes. Método: El estudio consiste en una muestra de 460 pacientes con SIDA seleccionados mediante una técnica de muestreo intencional, de ellos 177 (38.3%) eran hombres, 283 (61.5%) eran pacientes femeninas; 295 (64.1%) estaban casados y 165 (35.9%) no estaban casados. Las medidas incluyeron el Inventario de apoyo social enriquecido de Mitchell et al. (2003), la Escala de autoestima de Rosenberg (1965) y la Escala de calidad de vida de Sharma y Nasreen (2014). Para el análisis estadístico de los datos, la versión SPSS 20.0 aplicó la media, la desviación estándar, la distribución de frecuencia, la prueba t, el análisis de varianza unidireccional, el cuadrado de eta, el análisis de correlación y la prueba post hoc de Scheffe. Hallazgos: Los hallazgos ilustran que la mayoría de los pacientes tienen poco apoyo social, baja autoestima y mala calidad de vida; también revela que el apoyo social y la autoestima del paciente difieren según la edad, la ocupación, la duración de la enfermedad, el género y el estado civil. Sin embargo, su calidad de vida difiere solo por su edad, ocupación, duración de la enfermedad y estado civil. Además, el resultado muestra que el apoyo social y la autoestima se correlacionan positivamente con la calidad de vida


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Apoio Social , Qualidade de Vida/psicologia , Autoimagem , Infecções por HIV/psicologia , Índia/epidemiologia , Análise de Variância
4.
Respir Res ; 21(1): 245, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962703

RESUMO

BACKGROUND: The COVID-19 pandemic has led to more than 760,000 deaths worldwide (correct as of 16th August 2020). Studies suggest a hyperinflammatory response is a major cause of disease severity and death. Identitfying COVID-19 patients with hyperinflammation may identify subgroups who could benefit from targeted immunomodulatory treatments. Analysis of cytokine levels at the point of diagnosis of SARS-CoV-2 infection can identify patients at risk of deterioration. METHODS: We used a multiplex cytokine assay to measure serum IL-6, IL-8, TNF, IL-1ß, GM-CSF, IL-10, IL-33 and IFN-γ in 100 hospitalised patients with confirmed COVID-19 at admission to University Hospital Southampton (UK). Demographic, clinical and outcome data were collected for analysis. RESULTS: Age > 70 years was the strongest predictor of death (OR 28, 95% CI 5.94, 139.45). IL-6, IL-8, TNF, IL-1ß and IL-33 were significantly associated with adverse outcome. Clinical parameters were predictive of poor outcome (AUROC 0.71), addition of a combined cytokine panel significantly improved the predictability (AUROC 0.85). In those ≤70 years, IL-33 and TNF were predictive of poor outcome (AUROC 0.83 and 0.84), addition of a combined cytokine panel demonstrated greater predictability of poor outcome than clinical parameters alone (AUROC 0.92 vs 0.77). CONCLUSIONS: A combined cytokine panel improves the accuracy of the predictive value for adverse outcome beyond standard clinical data alone. Identification of specific cytokines may help to stratify patients towards trials of specific immunomodulatory treatments to improve outcomes in COVID-19.


Assuntos
Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Citocinas/análise , Mortalidade Hospitalar , Mediadores da Inflamação/sangue , Pandemias/estatística & dados numéricos , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Fatores Etários , Análise de Variância , Área Sob a Curva , Técnicas de Laboratório Clínico/métodos , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Universitários , Humanos , Incidência , Masculino , Pandemias/prevenção & controle , Fenótipo , Pneumonia Viral/fisiopatologia , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Sexuais , Reino Unido
5.
Ann Glob Health ; 86(1): 119, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32983915

RESUMO

Background: Disease control involves multiple actions overtime to halt the spread of COVID-19. The role of a country's governance in slowing the spread of COVID-19 has not yet been well investigated. Objective: This study aims to investigate the association between governance and the trend of COVID-19 incidence in countries with the highest prevalence. We hypothesized that countries with better governance are more likely to mitigate the spread of COVID-19 than countries with worse governance. Methods: We analyzed 62 most prevalent countries with at least 10,000 accumulative confirmed cases from January 22 to June 15, 2020. Countries were further grouped into three different levels of governance (25 better governance, 24 fair governance, and 13 worse governance), identified outbreak and mitigation periods using the joinpoint regression model, and compared the number of days and average daily percent change in incidence in two periods by governance level using the one-way analysis of variance. Findings: The average outbreak period in the 62 countries lasted 84.0 days. Sixty percent of countries (N = 37) had experienced outbreak periods, followed by a mitigation period. In contrast, the rest forty percent of countries (N = 25) still had a rising trend. In the outbreak period, better governance countries had a more rapid increase but a shorter outbreak period (71.2 days) than countries with fair (93.5 days) and worse (90.8 days) governance. Most countries with better governance (84.0%) revealed a declining trend in COVID-19 incidence, while such a trend was less than half of fair and worse governance countries (38.5%-41.7%). Conclusions: Countries with better governance are more resilient during the COVID-19 crisis. While the mitigation of COVID-19 is observed in most better governance countries, the incidence of COVID-19 is still surging in most fair and worse governance countries, and the possibility of a recurring epidemic of COVID-19 in countries cannot be ignored.


Assuntos
Gestão de Mudança , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Transmissão de Doença Infecciosa , Saúde Global/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral , Análise de Variância , Betacoronavirus/isolamento & purificação , Defesa Civil/métodos , Defesa Civil/organização & administração , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prevalência , Resiliência Psicológica , Controle Social Formal
6.
Sci Rep ; 10(1): 14568, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32884016

RESUMO

Magnetic resonance neurography (MRN) has been used extensively to study pathological conditions affecting the peripheral nervous system (PNS). However, tissue damage is assessed qualitatively with little information regarding the underlying pathophysiological processes involved. Magnetisation transfer ratio (MTR) is a quantitative magnetic resonance imaging method which is sensitive to tissue macromolecular content and may therefore have an important role in the study of pathologies affecting the PNS. This study explored the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus of healthy volunteers using MRN to identify and segment each lumbar segment (L2-L5) and regions (preganglionic, ganglionic and postganglionic). Reproducibility of the MTR measurements and of the segmentation method were assessed from repeated measurements (scan-rescan), and from the reanalysis of images (intra- and inter-rater assessment), by calculating the coefficient of variation (COV). In all segments combined (L2-L5), mean (± SD) MTR was 30.5 (± 2.4). Scan-rescan, intra- and inter-rater COV values were 3.2%, 4.4% and 5.3%, respectively. One-way analysis of variance revealed a statistically significant difference in MTR between the preganglionic and postganglionic regions in all lumbar segments. This pilot study in healthy volunteers demonstrates the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus, opening up the possibility of studying a broad spectrum of neurological conditions in vivo.


Assuntos
Imageamento Tridimensional/métodos , Plexo Lombossacral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adulto , Análise de Variância , Estudos de Viabilidade , Feminino , Voluntários Saudáveis , Humanos , Região Lombossacral/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes
7.
Hypertension ; 76(5): 1526-1536, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32981365

RESUMO

ACE2 (angiotensin-converting enzyme 2) is a key component of the renin-angiotensin-aldosterone system. Yet, little is known about the clinical and biologic correlates of circulating ACE2 levels in humans. We assessed the clinical and proteomic correlates of plasma (soluble) ACE2 protein levels in human heart failure. We measured plasma ACE2 using a modified aptamer assay among PHFS (Penn Heart Failure Study) participants (n=2248). We performed an association study of ACE2 against ≈5000 other plasma proteins measured with the SomaScan platform. Plasma ACE2 was not associated with ACE inhibitor and angiotensin-receptor blocker use. Plasma ACE2 was associated with older age, male sex, diabetes mellitus, a lower estimated glomerular filtration rate, worse New York Heart Association class, a history of coronary artery bypass surgery, and higher pro-BNP (pro-B-type natriuretic peptide) levels. Plasma ACE2 exhibited associations with 1011 other plasma proteins. In pathway overrepresentation analyses, top canonical pathways associated with plasma ACE2 included clathrin-mediated endocytosis signaling, actin cytoskeleton signaling, mechanisms of viral exit from host cells, EIF2 (eukaryotic initiation factor 2) signaling, and the protein ubiquitination pathway. In conclusion, in humans with heart failure, plasma ACE2 is associated with various clinical factors known to be associated with severe coronavirus disease 2019 (COVID-19), including older age, male sex, and diabetes mellitus, but is not associated with ACE inhibitor and angiotensin-receptor blocker use. Plasma ACE2 protein levels are prominently associated with multiple cellular pathways involved in cellular endocytosis, exocytosis, and intracellular protein trafficking. Whether these have a causal relationship with ACE2 or are relevant to novel coronavirus-2 infection remains to be assessed in future studies.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Progressão da Doença , Insuficiência Cardíaca/enzimologia , Insuficiência Cardíaca/fisiopatologia , Peptidil Dipeptidase A/sangue , Pneumonia Viral/epidemiologia , Centros Médicos Acadêmicos , Análise de Variância , Biomarcadores/metabolismo , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prognóstico , Modelos de Riscos Proporcionais , Proteômica/métodos , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Estados Unidos
8.
PLoS One ; 15(8): e0236877, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760136

RESUMO

OBJECTIVE: To identify current maternal and infant predictors of infant mortality, including maternal sociodemographic and economic status, maternal perinatal smoking and obesity, mode of delivery, and infant birthweight and gestational age. METHODS: This retrospective study analyzed data from the linked birth and infant death files (birth cohort) and live births from the Birth Statistical Master files (BSMF) in California compiled by the California Department of Public Health for 2007-2015. The birth cohort study comprised 4,503,197 singleton births including 19,301 infant deaths during the nine-year study period. A subpopulation to study fetal growth consisted of 4,448,300 birth cohort records including 13,891 infant deaths. RESULTS: The infant mortality rate (IMR) for singleton births decreased linearly (p <0.001) from 4.68 in 2007 to 3.90 (per 1,000 live births) in 2015. However, significant disparities in IMR were uncovered in different population groups depending upon maternal sociodemographic and economic characteristics and maternal characteristics during pregnancy. Children of African American women had almost twice the risk of infant mortality when compared with children of White women (AOR 2.12; 95% CI, 1.98-2.27; p<0.001). Infants of women with Bachelor's degrees or higher were 89% less likely to die (AOR 1.89; 95% CI, 1.76-2.04; p<0.001) when compared to infants of women with education less than high school. Infants of maternal smokers were 75% more likely to die (AOR 1.75; 95% CI, 1.58-1.93; p<0.001) than infants of nonsmokers. Infants of women who were overweight and obese during pregnancy accounted for 55% of IMR over all women in the study. More than half of the infant deaths were to children of women with lower socioeconomic status; infants of WIC participants were 59% more likely to die (AOR 1.59; 95% CI, 1.52-1.67; p<0.001) than infants of non-WIC participants. With respect to infant predictors, infants born with LBW or PTB were more than six times (AOR 6.29; 95% CI, 5.90-6.70; p<0.001) and almost four times (AOR 3.95; 95% CI, 3.73-4.19; p<0.001) more likely to die than infants who had normal births, respectively. SGA and LGA infants were more than two times (AOR 2.03; 95% CI, 1.92-2.15; p<0.001) and 41% (AOR 1.41; 95% CI, 1.32-1.52; p<0.001) more likely to die than AGA infants, respectively. CONCLUSIONS: While the overall IMR in California is declining, wide disparities in death rates persist in different groups, and these disparities are increasing. Our data indicate that maternal sociodemographic and economic factors, as well as maternal prepregnancy obesity and smoking during pregnancy, have a prominent effect on IMR though no causality can be inferred with the current data. These predictors are not typically addressed by direct medical care. Infant factors with a major effect on IMR are birthweight and gestational age-predictors that are addressed by active medical services. The highest value interventions to reduce IMR may be social and public health initiatives that mitigate disparities in sociodemographic, economic and behavioral risks for mothers.


Assuntos
Mortalidade Infantil , Mães , Adulto , Análise de Variância , California/epidemiologia , Estudos de Coortes , Grupos de Populações Continentais/estatística & dados numéricos , Escolaridade , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Saúde Pública/estatística & dados numéricos , Estudos Retrospectivos , Fumar/epidemiologia , Fatores Socioeconômicos , Adulto Jovem
9.
PLoS One ; 15(8): e0237834, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853269

RESUMO

Water deficit is one of the major limitations to food production worldwide and most climate change scenarios predict an aggravation of the situation. To face the expected increase in drought stress in the coming years, breeders are working to elucidate the genetic control of barley growth and productivity traits under water deficit. Barley is known as a relatively drought tolerant crop and genetic variability was observed for drought tolerance traits. The objectives of the present study were the quantification of morphological and physiological responses in a collection of 209 spring barley genotypes to drought stress, and the genetic analysis by genome-wide association study to find quantitative trait loci (QTL) and the allele contributions for each of the investigated traits. In six pot experiments, 209 spring barley genotypes were grown under a well-watered and water-limited regime. Stress phases were initiated individually for each genotype at the beginning of tillering and spiking for the vegetative- and the generative stage experiments, respectively, and terminated when the transpiration rates of stress treatments reached 10% of the well-watered control. After the stress phase, a total of 42 productivity related traits such as the dry matter of plant organs, tiller number, leaf length, leaf area, amount of water soluble carbohydrates in the stems, proline content in leaves and osmotic adjustment of corresponding well-watered and stressed plants were analysed, and QTL analyses were performed to find marker-trait associations. Significant water deficit effects were observed for almost all traits and significant genotype x treatment interactions (GxT) were observed for 37 phenotypic traits. Genome-wide association studies (GWAS) revealed 77 significant loci associated with 16 phenotypic traits during the vegetative stage experiment and a total of 85 significant loci associated with 13 phenotypic traits during the generative stage experiment for traits such as leaf area, number of green leaves, grain yield, harvest index and stem length. For traits with significant GxT interactions, genotypic differences for relative values were analysed using one way ANOVA. More than 110 loci for GxT interaction were found for 17 phenotypic traits explaining in many cases more than 50% of the genetic variance.


Assuntos
Hordeum/genética , Hordeum/fisiologia , Locos de Características Quantitativas/genética , Estações do Ano , Água , Adaptação Fisiológica , Análise de Variância , Biomassa , Desidratação , Secas , Variação Genética , Genótipo , Hordeum/anatomia & histologia , Padrões de Herança/genética , Fenótipo , Análise de Regressão
10.
Cochrane Database Syst Rev ; 8: CD004398, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32748975

RESUMO

BACKGROUND: Printed educational materials are widely used dissemination strategies to improve the quality of healthcare professionals' practice and patient health outcomes. Traditionally they are presented in paper formats such as monographs, publication in peer-reviewed journals and clinical guidelines. This is the fourth update of the review. OBJECTIVES: To assess the effect of printed educational materials (PEMs) on the practice of healthcare professionals and patient health outcomes. To explore the influence of some of the characteristics of the printed educational materials (e.g. source, content, format) on their effect on healthcare professionals' practice and patient health outcomes. SEARCH METHODS: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), HealthStar, CINAHL, ERIC, CAB Abstracts, Global Health, and EPOC Register from their inception to 6 February 2019. We checked the reference lists of all included studies and relevant systematic reviews. SELECTION CRITERIA: We included randomised trials (RTs), controlled before-after studies (CBAs) and interrupted time series studies (ITSs) that evaluated the impact of PEMs on healthcare professionals' practice or patient health outcomes. We included three types of comparisons: (1) PEM versus no intervention, (2) PEM versus single intervention, (3) multifaceted intervention where PEM is included versus multifaceted intervention without PEM. Any objective measure of professional practice (e.g. prescriptions for a particular drug), or patient health outcomes (e.g. blood pressure) were included. DATA COLLECTION AND ANALYSIS: Two reviewers undertook data extraction independently. Disagreements were resolved by discussion. For analyses, we grouped the included studies according to study design, type of outcome and type of comparison. For controlled trials, we reported the median effect size for each outcome within each study, the median effect size across outcomes for each study and the median of these effect sizes across studies. Where data were available, we re-analysed the ITS studies by converting all data to a monthly basis and estimating the effect size from the change in the slope of the regression line between before and after implementation of the PEM. We reported median changes in slope for each outcome, for each study, and then across studies. We standardised all changes in slopes by their standard error, allowing comparisons and combination of different outcomes. We categorised each PEM according to potential effects modifiers related to the source of the PEMs, the channel used for their delivery, their content, and their format. We assessed the risks of bias of all the included studies. MAIN RESULTS: We included 84 studies: 32 RTs, two CBAs and 50 ITS studies. Of the 32 RTs, 19 were cluster RTs that used various units of randomisation, such as practices, health centres, towns, or areas. The majority of the included studies (82/84) compared the effectiveness of PEMs to no intervention. Based on the RTs that provided moderate-certainty evidence, we found that PEMs distributed to healthcare professionals probably improve their practice, as measured with dichotomous variables, compared to no intervention (median absolute risk difference (ARD): 0.04; interquartile range (IQR): 0.01 to 0.09; 3,963 healthcare professionals randomised within 3073 units). We could not confirm this finding using the evidence gathered from continuous variables (standardised mean difference (SMD): 0.11; IQR: -0.16 to 0.52; 1631 healthcare professionals randomised within 1373 units ), from the ITS studies (standardised median change in slope = 0.69; 35 studies), or from the CBA study because the certainty of this evidence was very low. We also found, based on RTs that provided moderate-certainty evidence, that PEMs distributed to healthcare professionals probably make little or no difference to patient health as measured using dichotomous variables, compared to no intervention (ARD: 0.02; IQR: -0.005 to 0.09; 935,015 patients randomised within 959 units). The evidence gathered from continuous variables (SMD: 0.05; IQR: -0.12 to 0.09; 6,737 patients randomised within 594 units) or from ITS study results (standardised median change in slope = 1.12; 8 studies) do not strengthen these findings because the certainty of this evidence was very low. Two studies (a randomised trial and a CBA) compared a paper-based version to a computerised version of the same PEM. From the RT that provided evidence of low certainty, we found that PEM in computerised versions may make little or no difference to professionals' practice compared to PEM in printed versions (ARD: -0.02; IQR: -0.03 to 0.00; 139 healthcare professionals randomised individually). This finding was not strengthened by the CBA study that provided very low certainty evidence (SMD: 0.44; 32 healthcare professionals). The data gathered did not allow us to conclude which PEM characteristics influenced their effectiveness. The methodological quality of the included studies was variable. Half of the included RTs were at risk of selection bias. Most of the ITS studies were conducted retrospectively, without prespecifying the expected effect of the intervention, or acknowledging the presence of a secular trend. AUTHORS' CONCLUSIONS: The results of this review suggest that, when used alone and compared to no intervention, PEMs may slightly improve healthcare professionals' practice outcomes and patient health outcomes. The effectiveness of PEMs compared to other interventions, or of PEMs as part of a multifaceted intervention, is uncertain.


Assuntos
Disseminação de Informação/métodos , Manuais como Assunto , Avaliação de Processos e Resultados em Cuidados de Saúde , Prática Profissional , Análise de Variância , Estudos Controlados Antes e Depois , Difusão de Inovações , Análise de Séries Temporais Interrompida , Publicações Periódicas como Assunto , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Melhoria de Qualidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
11.
Exp Parasitol ; 217: 107965, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32818513

RESUMO

Saturated salt floatation method is widely used for coccidian oocyst purification. However, the repeated procedures and inefficient oocysts recovery rate are a continuous challenge. This study aimed to investigate the best suitable floatation solution, along with optimal centrifugation speed and time for Eimeria tenella (E. tenella) oocyst and sporocyst purification. Different floatation solutions i-e, saturated salt, Sheather's sugar and sodium hypochlorite (NaClO) at 20-60% concentrations were used to purify oocyst. It was found that about 96.99% oocysts (8609×g for 10 min) were recovered under these conditions without any effect on the viability of sporocysts. The recovery rate of oocysts using 50% NaClO (V/V) was significantly higher than 35% saturated salt flotation solution (P < 0.05). The optimal method for purification of oocysts based our experimentation was centrifugation at 8609×g for 3 min using 50% NaClO floatation solution, and the optimized centrifugation conditions for improved recovery of sporocysts (about 99.3%) were at 2152×g for 5 min. The present study provided a better method for the coccidian oocyst purification, which could be successfully adopted as a better alternative to existing techniques commonly used for investigations/research pertaining to coccidia.


Assuntos
Centrifugação/normas , Eimeria tenella/isolamento & purificação , Análise de Variância , Animais , Galinhas , Eimeria tenella/crescimento & desenvolvimento , Fezes/parasitologia , Oocistos/isolamento & purificação , Oxidantes/administração & dosagem , Distribuição Aleatória , Hipoclorito de Sódio/administração & dosagem , Organismos Livres de Patógenos Específicos , Fatores de Tempo
12.
J Chromatogr A ; 1628: 461437, 2020 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-32822977

RESUMO

During stoppers production, large amounts of cork by-products (CBPs) are generated, being used as low-value material. This project aims to turn CBPs into smart, natural and sustainable materials (sorbent) for solid-phase extraction (SPE) of pesticides from water. The study describes the use of CBPs for the extraction of 17 fungicides (metalaxyl, cyprodinil, tolylfluanid, procymidone, folpet, fludioxonil, myclobutanil, kresoxim methyl, iprovalicarb, benalaxyl, trifloxystrobin, fenhexamid, tebuconazole, iprodione, pyraclostrobin, azoxystrobin and dimethomorph) followed by gas chromatography-tandem mass spectrometry (GC-MS/MS) analysis. The most critical parameters affecting SPE were optimized by experimental design methodology. Under the optimal conditions, the method was successfully validated in terms of linearity, repeatability, and intermediate precision. Fungicide recovery was assessed in different real water samples including river, fountain, rainwater and spring water at 3 concentration levels (0.1, 0.5 and 10 µg L-1). Recoveries ranged between 70-118% with RSD values lower than 20%, and matrix effects were not observed. Finally, the method was applied to samples from irrigation, rain, and river water, all collected in vineyards areas, revealing the presence of 10 of the 17 fungicides, at concentration up to hundreds of µg L-1. The use of CBPs seems to be a promising low-cost and ecofriendly alternative to be employed as sorbent in SPE techniques to extract fungicides from the aquatic environment.


Assuntos
Fungicidas Industriais/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Extração em Fase Sólida/métodos , Poluentes Químicos da Água/análise , Adsorção , Análise de Variância , Tamanho da Partícula , Chuva , Rios/química , Espectrometria de Massas em Tandem/métodos , Água/química
13.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(6): 374-382, jun.-jul. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193362

RESUMO

BACKGROUND: The role of ADIPOQ gene rs266729 variants on weight loss after a dietary intervention are still unclear. OBJECTIVE: To analyze the effects of the ADIPOQ gene rs266729 variant n weight loss, cardiovascular risk factors, and adiponectin levels after two hypocaloric diets with different dietary fatty profiles. DESIGN: A population of 362 obese patients was enrolled in a randomized clinical trial with two diets (Diet M, monounsaturated fat-enriched diet, and Diet P, polyunsaturated-fat enriched diet). Anthropometric measurements, an assessment of nutritional intake, and biochemical tests were performed at baseline and after 12 weeks. RESULTS: Weight loss was similar with both diets. After Diet M, only subjects with CC genotype showed significant improvements in total cholesterol (CC vs. CG ± GG) -9.0 ±1.1 mU/L vs. -4.5 ± 2.4 mg/dL, p = 0.01), LDL cholesterol (-6.0 ± 1.1 mg/dL vs. -3.0 ± 0.9 mg/dL, p = 0.03), glucose (-4.7 ± 1.1 mg/dL vs. -0.6 ± 0.5 mg/dL, p = 0.01), and insulin levels (-2.6 ±1.0 mU/L vs. -0.7 ± 0.3 mU/L, p = 0.02) and in HOMA-IR (-0.5 ± 0.2 units vs. -0.2 ± 0.4 units, p = 0.03). The same improvement was reported after Diet P in all parameters, including total cholesterol (CC vs. CG±GG) (-8.0 ± 1.2mU/L vs. -2.1 ± 1.4 mg/dL, p = 0.02), LDL cholesterol (-7.3 ± 1.2 mg/dL vs. -2.1 ± 0.8 mg/dL, p = 0.02), glucose (-3.2 ± 0.1mg/dL vs. -0.2 ± 0.5 mg/dL, p = 0.01), and insulin levels (-2.5 ± 1.0 mU/L vs. -1 ± 0.6 mU/L, p = 0.02) and HOMA-IR (-0.5 ± 0.1 units vs. −0.3 ± 0.4 units, p = 0.02). Only subjects with CC genotype showed significant increases in adiponectin levels after both diets: (Diet M: 10.3 ± 2.0 ng/dL vs. Diet P: 9.3 ± 2.9 ng/dL, p = 0.43). CONCLUSION: The CC genotype of ADIPOQ gene rs266729 variant is associated to increased adiponectin levels and decreases in LDL cholesterol, glucose, insulin, and HOMA-IR levels after weight loss


ANTECEDENTES: El papel de las variantes del gen ADIPOQ en la pérdida de peso después de una intervención dietética sigue sin estar claro. OBJETIVO: Nuestro objetivo fue analizar los efectos de la variante rs266729 del gen ADIPOQ sobre la pérdida de peso, los factores de riesgo cardiovascular y los niveles de adiponectina después de 2 dietas hipocalóricas con diferentes perfiles de grasas en la dieta. DISEÑO: Una población de 362 pacientes obesos se incluyeron en un ensayo clínico aleatorizado con 2 dietas (dieta M: dieta enriquecida con grasas monoinsaturadas y dieta P: dieta enriquecida con grasas poliinsaturadas). Antes y tras 12 semanas, se realizó una evaluación antropométrica, evaluación de la ingesta nutricional y un análisis bioquímico. RESULTADOS: La pérdida de peso fue similar con ambas dietas. Después de la dieta M, solo los sujetos con genotipo CC mostraron una mejoría significativa en el colesterol total (CC vs. CG±GG) (-9,0 ± 1,1 mU/l vs. - 4,5 ± 2,4 mg/dl; p = 0,01), colesterol LDL (-6,0 ± 1,1 mg/dl vs. - 3,0 ± 0,9 mg/dl; p = 0,03), glucosa (-4,7 ± 1,1 mg/dl vs. -0,6 ± 0,5 mg/dl; p = 0,01), niveles de insulina (-2,6 ± 1,0 mU/l vs. -0,7± 0,3 mU/l; p = 0,02) y HOMA-IR (- 0,5 ± 0,2 unidades vs. -0,2 ± 0,4 unidades; p = 0,03). La misma mejora en todos los parámetros se informó después de la dieta P; niveles de colesterol total (CC vs. CG ± GG) (-8,0 ± 1,2 mU/l vs. -2,1 ± 1,4 mg/dl; p = 0,02), colesterol LDL (-7,3 ± 1,2 mg/dl vs. -2,1 ±0,8 mg/dl; p = 0,02), glucosa (-3,2 ± 0,1 mg/dl vs. -0,2 ± 0,5 mg/dl; p = 0,01), niveles de insulina (-2,5 ±1,0 mU/l vs. -1 ±0,6 mU/l; p = 0,02) y HOMA-IR (-0,5 ± 0,1 unidades vs. -0,3 ± 0,4 unidades; p = 0,02). Solo los sujetos con genotipo CC mostraron un aumento significativo de los niveles de adiponectina después de ambas dietas: (dieta M: 10,3 ± 2,0 ng/dl vs. dieta P: 9,3 ± 2,9 ng/dl; p = 0,43). CONCLUSIÓN: El genotipo CC de la variante rs266729 del gen ADIPOQ se asocia con aumentos en los niveles de adiponectina y disminución del colesterol LDL, glucosa, insulina y HOMA-IR tras la pérdida de peso


Assuntos
Humanos , Ácidos Graxos/sangue , Adiponectina/genética , Dieta Redutora/métodos , Perda de Peso , Gorduras na Dieta/uso terapêutico , Adiponectina/sangue , Obesidade/dietoterapia , Antropometria , LDL-Colesterol , Genótipo , Estudos Prospectivos , Adiponectina/metabolismo , Receptores de Adipocina/sangue , Análise de Variância
14.
Cuad. psicol. deporte ; 20(3): 65-73, jul. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193541

RESUMO

En la actualidad las organizaciones están implementando acciones de gestión de la salud por medio de la actividad física repercutiendo en beneficios físicos, psicológicos y sociales en los empleados y en económicos en las empresas. Este hecho hace que las organizaciones dispongan de empleados saludables que se relacionan con variables organizaciones positivas, como la satisfacción laboral (Gómez, Morales, Hernández y Muñoz, 2018), por lo que el objetivo del trabajo es conocer la relación entre la práctica de actividad física y los empleados saludables. Los participantes fueron los empleados de una entidad deportivo-social de la provincia de Sevilla utilizándose con n = 56, de los cuales 29 hombres y 27 mujeres entre 18 y 60 años, encontrándose 18 entre 18-30 años, 30 entre 30-45 años y 8 entre 45 y 60 años, además se utilizó el cuestionario internacional de actividad física (IPAQ) y el cuestionario del empleado saludable, y analizando si existían diferencias significativas entre las variables del empleado saludable y la cantidad de práctica de actividad física de los empleados. Los resultados concluyen que los empleados que realizan actividad física moderada y alta presentan un promedio significativamente mayor en emociones positivas, engagement y resiliencia respecto al grupo de actividad física baja o no práctica de actividad física, mientras que los empleados que realizan actividad física moderada y alta presentan un promedio mayor, pero no significativo en autoeficacia y competencia respecto al grupo de actividad física baja o no práctica de actividad física


Organisations are currently implementing health management actions through physical activity, impacting physical, psychological and social benefits for employees and economic benefits for companies. This fact makes organizations have healthy employees that are related to positive organizational variables, such as job satisfaction, so the objective of the work is to know the relationship between the practice of physical activity and healthy employees. Participants were employees of a sports-social entity in the province of Seville with n = 56, of whom 29 were men and 27 women, and the International Physical Activity Questionnaire (IPAQ) and the Healthy Employees Questionnaire were also used. analyzing if there were significant differences between the variables of the healthy employee and the amount of physical activity practice of the employees. The results conclude that the employees who carry out moderate and high physical activity present a significantly higher average in positive emotions, commitment and resistance compared to the group of low physical activity or who do not practice physical activity, while employees who carry out moderate physical activity and high have a higher average, but not significant in self-efficacy and competence with respect to the group of low physical activity or that does not practice physical activity


Atualmente, as organizações estão implementando ações de gestão de saúde por meio da atividade física, com impacto nos benefícios físicos, psicológicos e sociais dos funcionários e nos benefícios econômicos das empresas. Este fato faz com que as organizações têm empregados saudáveis ​​que se relacionam com variáveis ​​organizações positivos, tais como a satisfação no trabalho (Gómez, Morales Hernández e Muñoz, 2018), de modo que o objetivo do estudo foi determinar a relação entre a prática de atividade funcionários físicos e saudáveis. Os participantes eram funcionários de Esportes e entidade social na província de Sevilla usados ​​com n = 56, dos quais 29 homens e 27 mulheres com idades entre 18 a 60 anos, sendo 18 entre 18-30, 30 entre 30-45 anos e 8 entre 45 e 60 anos, além questionário internacional de atividade física (IPAQ) e questionário empregado saudável foi usado, e analisar se houve diferenças significativas entre as variáveis ​​do empregado saudável e da quantidade de atividade física de funcionários . Os resultados concluem que os funcionários que realizam atividade física moderada e alta têm uma média significativamente maior de emoções positivas, engajamento e resiliência em comparação com o grupo de baixa atividade física ou sem atividade física, enquanto os funcionários que realizam atividade física moderada e alta apresentam média maior, mas não significativa em autoeficácia e competência em relação ao grupo de baixa atividade física ou não prática de atividade física


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Saúde do Trabalhador , Centros de Convivência e Lazer , Instalações Esportivas e Recreacionais , Inquéritos e Questionários , Saúde do Trabalhador/estatística & dados numéricos , Análise de Variância
15.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609445

RESUMO

BACKGROUND: Over the past 20 years, China has experienced an increased popularity of Western medicine. The impact of Western medicine in China on the field of dermatology is not well characterized. OBJECTIVE: To assess the impact China has had on the field of dermatology by analyzing the total publications to six dermatological journals, compared to two other Asian countries: Japan and Korea. METHODS: PubMed was utilized to search for publications from China, Japan, and Korea within the past 20 years. Descriptive statistics were used to determine the average percentage change in publications during this 20-year period, and the average annual increase in total number of publications from each country. Comparisons were made using one-way ANOVA and two-group t-tests. RESULTS: From 1998 to 2019, there was a 24% average annual increase in publications from China (M=24.4, SD=24.5), compared to a 6% increase from Japan (M=5.6, SD=25.4, P=0.02) and 8% increase from Korea (M=7.8, SD=23.4, P=0.03). CONCLUSION: For the past 20 years, there has been a strong positive trend regarding the total number of publications from China. This finding might be related in part to an increased acceptance of Western medicine, which follows a similar trend during the time period we analyzed.


Assuntos
Bibliometria , Dermatologia , Publicações Periódicas como Assunto/tendências , Análise de Variância , China , Japão , Fator de Impacto de Revistas , República da Coreia
16.
Medicine (Baltimore) ; 99(29): e21083, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702852

RESUMO

Compassion fatigue has emerged as a detrimental consequence of experiencing work-related stress among psychiatric nurses, and affected the job performance, emotional and physical health of psychiatric nurses. However, researches on Chinese psychiatric nurses' compassion fatigue are dearth. This cross-sectional study aimed to investigate the prevalence and factors of compassion fatigue among Chinese psychiatric nurses.All participants completed the demographic questionnaire and the Chinese version of Professional Quality of Life Scale (ProQOL-CN). One-way ANOVA, t-tests, Levene test and multiple linear regression analysis were conducted to evaluate factors associated with compassion fatigue.A total of 352 psychiatric nurses in 9 psychiatric hospitals from the Chengdu, Wuhan, and Hefei were surveyed. The mean scores of compassion satisfaction, burnout and secondary traumatic stress were 32.59 ±â€Š7.124, 26.92 ±â€Š6.003 and 25.97 ±â€Š5.365, respectively. Four variables of job satisfaction, exercise, had children, and age range from 36 to 50 years explained 30.7% of the variance in compassion satisfaction. Job satisfaction, sleeping quality, and marital status accounted for 40.4% variables in burnout. Furthermore, job satisfaction, average sleeping quality, and years of nursing experience remained significantly associated with secondary trauma stress, explaining 10.9% of the variance.Compassion satisfaction, burnout and secondary traumatic stress among Chinese psychiatric nurses were at the level of moderate. The higher job satisfaction, healthy lifestyle (high sleep quality and regular exercise), and family support (children, stable and harmonious marital status) positively influenced compassion satisfaction and negatively associated with burnout or secondary traumatic stress.


Assuntos
Fadiga por Compaixão/etiologia , Enfermeiras e Enfermeiros/psicologia , Enfermagem Psiquiátrica/normas , Adolescente , Adulto , Análise de Variância , China/epidemiologia , Fadiga por Compaixão/epidemiologia , Fadiga por Compaixão/psicologia , Estudos Transversais , Feminino , Humanos , Satisfação no Emprego , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/tendências , Prevalência , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/tendências , Qualidade de Vida/psicologia , Inquéritos e Questionários
17.
Ann Surg ; 272(2): 241-247, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32675536

RESUMO

OBJECTIVE: To determine whether absorbable or nonabsorbable mesh repair of large hiatus hernias is followed by less recurrences at late follow-up compared to sutured repair. SUMMARY OF BACKGROUND DATA: Radiological recurrences have been reported in up to 30% of patients after repair of large hiatus hernias, and mesh repair has been proposed as a solution. Earlier trials have revealed mixed outcomes and early outcomes from a trial reported previously revealed no short-term advantages for mesh repair. METHODS: Multicentre prospective double-blind randomized controlled trial of 3 methods of hiatus hernia repair; sutures versus absorbable mesh versus nonabsorbable mesh. Primary outcome - hernia recurrence assessed by barium meal X-ray and endoscopy at 3-4 years. Secondary outcomes - clinical symptom scores at 2, 3, and 5 years. RESULTS: 126 patients were enrolled - 43 sutures, 41 absorbable mesh, and 42 nonabsorbable mesh. Clinical outcomes were obtained at 5 years in 89.9%, and objective follow-up was obtained in 72.3%. A recurrent hernia (any size) was identified in 39.3% after suture repair, 56.7% - absorbable mesh, and 42.9% - nonabsorbable mesh (P = 0.371). Clinical outcomes were similar at 5 years, except chest pain, diarrhea, and bloat symptoms which were more common after repair with absorbable mesh. CONCLUSIONS: No advantages were demonstrated for mesh repair at up to 5 years follow-up, and symptom outcomes were worse after repair with absorbable mesh. The longer-term results from this trial do not support mesh repair for large hiatus hernias.


Assuntos
Hérnia Hiatal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Telas Cirúrgicas/efeitos adversos , Técnicas de Sutura , Implantes Absorvíveis , Adulto , Análise de Variância , Austrália , Distribuição de Qui-Quadrado , Método Duplo-Cego , Feminino , Seguimentos , Hérnia Hiatal/diagnóstico por imagem , Herniorrafia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Reoperação/métodos , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Cicatrização/fisiologia
18.
Ann Surg ; 272(2): 384-392, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32675553

RESUMO

OBJECTIVE: To demonstrate the noninferiority of the fundamentals of robotic surgery (FRS) skills curriculum over current training paradigms and identify an ideal training platform. SUMMARY BACKGROUND DATA: There is currently no validated, uniformly accepted curriculum for training in robotic surgery skills. METHODS: Single-blinded parallel-group randomized trial at 12 international American College of Surgeons (ACS) Accredited Education Institutes (AEI). Thirty-three robotic surgery experts and 123 inexperienced surgical trainees were enrolled between April 2015 and November 2016. Benchmarks (proficiency levels) on the 7 FRS Dome tasks were established based on expert performance. Participants were then randomly assigned to 4 training groups: Dome (n = 29), dV-Trainer (n = 30), and DVSS (n = 32) that trained to benchmarks and control (n = 32) that trained using locally available robotic skills curricula. The primary outcome was participant performance after training based on task errors and duration on 5 basic robotic tasks (knot tying, continuous suturing, cutting, dissection, and vessel coagulation) using an avian tissue model (transfer-test). Secondary outcomes included cognitive test scores, GEARS ratings, and robot familiarity checklist scores. RESULTS: All groups demonstrated significant performance improvement after skills training (P < 0.01). Participating residents and fellows performed tasks faster (DOME and DVSS groups) and with fewer errors than controls (DOME group; P < 0.01). Inter-rater reliability was high for the checklist scores (0.82-0.97) but moderate for GEARS ratings (0.40-0.67). CONCLUSIONS: We provide evidence of effectiveness for the FRS curriculum by demonstrating better performance of those trained following FRS compared with controls on a transfer test. We therefore argue for its implementation across training programs before surgeons apply these skills clinically.


Assuntos
Competência Clínica , Simulação por Computador , Procedimentos Cirúrgicos Robóticos/educação , Treinamento por Simulação/métodos , Especialidades Cirúrgicas/educação , Análise de Variância , Currículo , Feminino , Humanos , Masculino , Medição de Risco , Método Simples-Cego , Resultado do Tratamento
19.
Rev Esp Quimioter ; 33(4): 267-273, 2020 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-32657550

RESUMO

OBJECTIVE: Identify which biomarkers performed in the first emergency analysis help to stratify COVID-19 patients according to mortality risk. METHODS: Observational, descriptive and cross-sectional study performed with data collected from patients with suspected COVID-19 in the Emergency Department from February 24 to March 16, 2020. The univariate and multivariate study was performed to find independent mortality markers and calculate risk by building a severity score. RESULTS: A total of 163 patients were included, of whom 33 died and 29 of them were positive for the COVID-19 PCR test. We obtained as possible factors to conform the Mortality Risk Score age> 75 years ((adjusted OR = 12,347, 95% CI: 4,138-36,845 p = 0.001), total leukocytes> 11,000 cells / mm3 (adjusted OR = 2,649, 95% CI: 0.879-7.981 p = 0.083), glucose> 126 mg / dL (adjusted OR = 3.716, 95% CI: 1.247-11.074 p = 0.018) and creatinine> 1.1 mg / dL (adjusted OR = 2.566, 95% CI: 0.889- 7.403, p = 0.081) This score was called COVEB (COVID, Age, Basic analytical profile) with an AUC 0.874 (95% CI: 0.816-0.933, p <0.001; Cut-off point = 1 (sensitivity = 89.66 % (95% CI: 72.6% -97.8%), specificity = 75.59% (95% CI: 67.2% -82.8%). A score <1 has a negative predictive value = 100% (95% CI: 93.51% -100%) and a positive predictive value = 18.59% (95% CI: 12.82% -25.59%). CONCLUSIONS: Clinical severity scales, kidney function biomarkers, white blood cell count parameters, the total neutrophils / total lymphocytes ratio and procalcitonin are early risk factors for mortality. The variables age, glucose, creatinine and total leukocytes stand out as the best predictors of mortality. A COVEB score <1 indicates with a 100% probability that the patient with suspected COVID-19 will not die in the next 30 days.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Infecções por Coronavirus/mortalidade , Pneumonia Viral/sangue , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Análise de Variância , Área Sob a Curva , Biomarcadores/sangue , Glicemia/análise , Infecções por Coronavirus/diagnóstico , Creatinina/sangue , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Humanos , Hipertensão/mortalidade , Contagem de Leucócitos , Masculino , Razão de Chances , Pandemias , Pneumonia Viral/diagnóstico , Valor Preditivo dos Testes , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Medição de Risco/métodos , Sensibilidade e Especificidade
20.
Nat Commun ; 11(1): 3524, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32665559

RESUMO

Eye movements are inhibited prior to the onset of temporally-predictable visual targets. This oculomotor inhibition effect could be considered a marker for the formation of temporal expectations and the allocation of temporal attention in the visual domain. Here we show that eye movements are also inhibited before predictable auditory targets. In two experiments, we manipulate the period between a cue and an auditory target to be either predictable or unpredictable. The findings show that although there is no perceptual gain from avoiding gaze-shifts in this procedure, saccades and blinks are inhibited prior to predictable relative to unpredictable auditory targets. These findings show that oculomotor inhibition occurs prior to auditory targets. This link between auditory expectation and oculomotor behavior reveals a multimodal perception action coupling, which has a central role in temporal expectations.


Assuntos
Atenção/fisiologia , Movimentos Oculares/fisiologia , Músculos Oculomotores/fisiologia , Adulto , Análise de Variância , Feminino , Humanos , Tempo de Reação/fisiologia , Percepção Visual/fisiologia , Adulto Jovem
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