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1.
Artigo em Inglês | MEDLINE | ID: mdl-34068705

RESUMO

The concentration of negative air ions (NAIs) is an important indicator of air quality. Here, we analyzed the distribution patterns of negative air ion (NAI) concentrations at different time scales using statistical methods; then described the contribution of meteorological factors of the different season to the concentration of NAIs using correlation analysis and regression analysis; and finally made the outlook for the trends of NAI concentrations in the prospective using the auto regressive integrated moving average (ARIMA) models. The dataset of NAI concentrations and meteorological factors measured at the fixed stations in the Mountain Wuyi National Park were obtained from the Fujian Provincial Meteorological Bureau. The study showed that NAI concentrations were correlated with relative humidity spanning all seasons. Water was an important factor affecting the distribution of NAI concentrations in different time series. Compared with other ARIMA models, the outlook value of the ARIMA (0,1, 1) model was closer to the original data and the errors were smaller. This article provided a unique perspective on the study of the distribution of negative air oxygen ions over time series.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ar/análise , Poluentes Atmosféricos/análise , Íons , Parques Recreativos , Estudos Prospectivos , Estações do Ano
2.
Cochrane Database Syst Rev ; 5: CD013621, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-34097765

RESUMO

BACKGROUND: Pressure ulcers (also known as pressure injuries) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Foam surfaces (beds, mattresses or overlays) are widely used with the aim of preventing pressure ulcers. OBJECTIVES: To assess the effects of foam beds, mattresses or overlays compared with any support surface on the incidence of pressure ulcers in any population in any setting. SEARCH METHODS: In November 2019, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials that allocated participants of any age to foam beds, mattresses or overlays. Comparators were any beds, mattresses or overlays. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed studies using predetermined inclusion criteria. We carried out data extraction, 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool, and the certainty of the evidence assessment according to Grading of Recommendations, Assessment, Development and Evaluations methodology. If a foam surface was compared with surfaces that were not clearly specified, then the included study was recorded and described but not considered further in any data analyses. MAIN RESULTS: We included 29 studies (9566 participants) in the review. Most studies were small (median study sample size: 101 participants). The average age of participants ranged from 47.0 to 85.3 years (median: 76.0 years). Participants were mainly from acute care settings. We analysed data for seven comparisons in the review: foam surfaces compared with: (1) alternating pressure air surfaces, (2) reactive air surfaces, (3) reactive fibre surfaces, (4) reactive gel surfaces, (5) reactive foam and gel surfaces, (6) reactive water surfaces, and (7) another type of foam surface. Of the 29 included studies, 17 (58.6%) presented findings which were considered at high overall risk of bias. PRIMARY OUTCOME: pressure ulcer incidence Low-certainty evidence suggests that foam surfaces may increase the risk of developing new pressure ulcers compared with (1) alternating pressure (active) air surfaces (risk ratio (RR) 1.59, 95% confidence interval (CI) 0.86 to 2.95; I2 = 63%; 4 studies, 2247 participants), and (2) reactive air surfaces (RR 2.40, 95% CI 1.04 to 5.54; I2 = 25%; 4 studies, 229 participants). We are uncertain regarding the difference in pressure ulcer incidence in people treated with foam surfaces and the following surfaces: (1) reactive fibre surfaces (1 study, 68 participants); (2) reactive gel surfaces (1 study, 135 participants); (3) reactive gel and foam surfaces (1 study, 91 participants); and (4) another type of foam surface (6 studies, 733 participants). These had very low-certainty evidence. Included studies have data on time to pressure ulcer development for two comparisons. When time to ulcer development is considered using hazard ratios, the difference in the risk of having new pressure ulcers, over 90 days' follow-up, between foam surfaces and alternating pressure air surfaces is uncertain (2 studies, 2105 participants; very low-certainty evidence). Two further studies comparing different types of foam surfaces also reported time-to-event data, suggesting that viscoelastic foam surfaces with a density of 40 to 60 kg/m3 may decrease the risk of having new pressure ulcers over 11.5 days' follow-up compared with foam surfaces with a density of 33 kg/m3 (1 study, 62 participants); and solid foam surfaces may decrease the risk of having new pressure ulcers over one month's follow-up compared with convoluted foam surfaces (1 study, 84 participants). Both had low-certainty evidence. There was no analysable data for the comparison of foam surfaces with reactive water surfaces (one study with 117 participants). Secondary outcomes Support-surface-associated patient comfort: the review contains data for three comparisons for this outcome. It is uncertain if there is a difference in patient comfort measure between foam surfaces and alternating pressure air surfaces (1 study, 76 participants; very low-certainty evidence); foam surfaces and reactive air surfaces (1 study, 72 participants; very low-certainty evidence); and different types of foam surfaces (4 studies, 669 participants; very low-certainty evidence). All reported adverse events: the review contains data for two comparisons for this outcome. We are uncertain about differences in adverse effects between foam surfaces and alternating pressure (active) air surfaces (3 studies, 2181 participants; very low-certainty evidence), and between foam surfaces and reactive air surfaces (1 study, 72 participants; very low-certainty evidence). Health-related quality of life: only one study reported data on this outcome. It is uncertain if there is a difference (low-certainty evidence) between foam surfaces and alternating pressure (active) air surfaces in health-related quality of life measured with two different questionnaires, the EQ-5D-5L (267 participants) and the PU-QoL-UI (233 participants). Cost-effectiveness: one study reported trial-based cost-effectiveness evaluations. Alternating pressure (active) air surfaces are probably more cost-effective than foam surfaces in preventing pressure ulcer incidence (2029 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: Current evidence suggests uncertainty about the differences in pressure ulcer incidence, patient comfort, adverse events and health-related quality of life between using foam surfaces and other surfaces (reactive fibre surfaces, reactive gel surfaces, reactive foam and gel surfaces, or reactive water surfaces). Foam surfaces may increase pressure ulcer incidence compared with alternating pressure (active) air surfaces and reactive air surfaces. Alternating pressure (active) air surfaces are probably more cost-effective than foam surfaces in preventing new pressure ulcers. Future research in this area should consider evaluation of the most important support surfaces from the perspective of decision-makers. Time-to-event outcomes, careful assessment of adverse events and trial-level cost-effectiveness evaluation should be considered in future studies. Trials should be designed to minimise the risk of detection bias; for example, by using digital photography and by blinding adjudicators of the photographs to group allocation. Further review using network meta-analysis will add to the findings reported here.


Assuntos
Roupas de Cama, Mesa e Banho , Leitos , Lesão por Pressão/prevenção & controle , Substâncias Viscoelásticas , Idoso , Idoso de 80 Anos ou mais , Ar , Viés , Feminino , Géis , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Cochrane Database Syst Rev ; 5: CD013624, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33969896

RESUMO

BACKGROUND: Pressure ulcers (also known as pressure injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Beds, overlays or mattresses are widely used with the aim of treating pressure ulcers. OBJECTIVES: To assess the effects of beds, overlays and mattresses on pressure ulcer healing in people with pressure ulcers of any stage, in any setting. SEARCH METHODS: In November 2019, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials that allocated participants of any age to pressure-redistributing beds, overlays or mattresses. Comparators were any beds, overlays or mattresses that were applied for treating pressure ulcers. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed studies using predetermined inclusion criteria. We carried out data extraction, 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool, and the certainty of the evidence assessment according to Grading of Recommendations, Assessment, Development and Evaluations methodology. MAIN RESULTS: We included 13 studies (972 participants) in the review. Most studies were small (median study sample size: 72 participants). The average age of participants ranged from 64.0 to 86.5 years (median: 82.7 years) and all studies recruited people with existing pressure ulcers (the baseline ulcer area size ranging from 4.2 to 18.6 cm2,median 6.6 cm2). Participants were recruited from acute care settings (six studies) and community and long-term care settings (seven studies). Of the 13 studies, three (224 participants) involved surfaces that were not well described and therefore could not be classified. Additionally, six (46.2%) of the 13 studies presented findings which were considered at high overall risk of bias. We synthesised data for four comparisons in the review: alternating pressure (active) air surfaces versus foam surfaces; reactive air surfaces versus foam surfaces; reactive water surfaces versus foam surfaces, and a comparison between two types of alternating pressure (active) air surfaces. We summarise key findings for these four comparisons below. (1) Alternating pressure (active) air surfaces versus foam surfaces: we are uncertain if there is a difference between alternating pressure (active) air surfaces and foam surfaces in the proportion of participants whose pressure ulcers completely healed (two studies with 132 participants; the reported risk ratio (RR) in one study was 0.97, 95% confidence interval (CI) 0.26 to 3.58). There is also uncertainty for the outcomes of patient comfort (one study with 83 participants) and adverse events (one study with 49 participants). These outcomes have very low-certainty evidence. Included studies did not report time to complete ulcer healing, health-related quality of life, or cost effectiveness. (2) Reactive air surfaces versus foam surfaces: it is uncertain if there is a difference in the proportion of participants with completely healed pressure ulcers between reactive air surfaces and foam surfaces (RR 1.32, 95% CI 0.96 to 1.80; I2 = 0%; 2 studies, 156 participants; low-certainty evidence). When time to complete pressure ulcer healing is considered using a hazard ratio, data from one small study (84 participants) suggests a greater hazard for complete ulcer healing on reactive air surfaces (hazard ratio 2.66, 95% CI 1.34 to 5.17; low-certainty evidence). These results are sensitive to the choice of outcome measure so should be interpreted as uncertain. We are also uncertain whether there is any difference between these surfaces in patient comfort responses (1 study, 72 participants; very low-certainty evidence) and in adverse events (2 studies, 156 participants; low-certainty evidence). There is low-certainty evidence that reactive air surfaces may cost an extra 26 US dollars for every ulcer-free day in the first year of use (1 study, 87 participants). Included studies did not report health-related quality of life. (3) Reactive water surfaces versus foam surfaces: it is uncertain if there is a difference between reactive water surfaces and foam surfaces in the proportion of participants with healed pressure ulcers (RR 1.07, 95% CI 0.70 to 1.63; 1 study, 101 participants) and in adverse events (1 study, 120 participants). All these have very low-certainty evidence. Included studies did not report time to complete ulcer healing, patient comfort, health-related quality of life, or cost effectiveness. (4) Comparison between two types of alternating pressure (active) air surfaces: it is uncertain if there is a difference between Nimbus and Pegasus alternating pressure (active) air surfaces in the proportion of participants with healed pressure ulcers, in patient comfort responses and in adverse events: each of these outcomes had four studies (256 participants) but very low-certainty evidence. Included studies did not report time to complete ulcer healing, health-related quality of life, or cost effectiveness. AUTHORS' CONCLUSIONS: We are uncertain about the relative effects of most different pressure-redistributing surfaces for pressure ulcer healing (types directly compared are alternating pressure air surfaces versus foam surfaces, reactive air surfaces versus foam surfaces, reactive water surfaces versus foam surfaces, and Nimbus versus Pegasus alternating pressure (active) air surfaces). There is also uncertainty regarding the effects of these different surfaces on the outcomes of comfort and adverse events. However, people using reactive air surfaces may be more likely to have pressure ulcers completely healed than those using foam surfaces over 37.5 days' follow-up, and reactive air surfaces may cost more for each ulcer-free day than foam surfaces. Future research in this area could consider the evaluation of alternating pressure air surfaces versus foam surfaces as a high priority. Time-to-event outcomes, careful assessment of adverse events and trial-level cost-effectiveness evaluation should be considered in future studies. Further review using network meta-analysis will add to the findings reported here.


Assuntos
Roupas de Cama, Mesa e Banho , Leitos , Lesão por Pressão/terapia , Idoso , Idoso de 80 Anos ou mais , Ar , Viés , Elasticidade , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Substâncias Viscoelásticas , Cicatrização
4.
Cochrane Database Syst Rev ; 5: CD013620, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33969911

RESUMO

BACKGROUND: Pressure ulcers (also known as pressure injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Alternating pressure (active) air surfaces are widely used with the aim of preventing pressure ulcers. OBJECTIVES: To assess the effects of alternating pressure (active) air surfaces (beds, mattresses or overlays) compared with any support surface on the incidence of pressure ulcers in any population in any setting. SEARCH METHODS: In November 2019, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials that allocated participants of any age to alternating pressure (active) air beds, overlays or mattresses. Comparators were any beds, overlays or mattresses. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed studies using predetermined inclusion criteria. We carried out data extraction, 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool, and the certainty of the evidence assessment according to Grading of Recommendations, Assessment, Development and Evaluations methodology. MAIN RESULTS: We included 32 studies (9058 participants) in the review. Most studies were small (median study sample size: 83 participants). The average age of participants ranged from 37.2 to 87.0 years (median: 69.1 years). Participants were largely from acute care settings (including accident and emergency departments). We synthesised data for six comparisons in the review: alternating pressure (active) air surfaces versus: foam surfaces, reactive air surfaces, reactive water surfaces, reactive fibre surfaces, reactive gel surfaces used in the operating room followed by foam surfaces used on the ward bed, and another type of alternating pressure air surface. Of the 32 included studies, 25 (78.1%) presented findings which were considered at high overall risk of bias. PRIMARY OUTCOME: pressure ulcer incidence Alternating pressure (active) air surfaces may reduce the proportion of participants developing a new pressure ulcer compared with foam surfaces (risk ratio (RR) 0.63, 95% confidence interval (CI) 0.34 to 1.17; I2 = 63%; 4 studies, 2247 participants; low-certainty evidence). Alternating pressure (active) air surfaces applied on both operating tables and hospital beds may reduce the proportion of people developing a new pressure ulcer compared with reactive gel surfaces used on operating tables followed by foam surfaces applied on hospital beds (RR 0.22, 95% CI 0.06 to 0.76; I2 = 0%; 2 studies, 415 participants; low-certainty evidence). It is uncertain whether there is a difference in the proportion of people developing new pressure ulcers between alternating pressure (active) air surfaces and the following surfaces, as all these comparisons have very low-certainty evidence: (1) reactive water surfaces; (2) reactive fibre surfaces; and (3) reactive air surfaces. The comparisons between different types of alternating pressure air surfaces are presented narratively. Overall, all comparisons suggest little to no difference between these surfaces in pressure ulcer incidence (7 studies, 2833 participants; low-certainty evidence). Included studies have data on time to pressure ulcer incidence for three comparisons. When time to pressure ulcer development is considered using a hazard ratio (HR), it is uncertain whether there is a difference in the risk of developing new pressure ulcers, over 90 days' follow-up, between alternating pressure (active) air surfaces and foam surfaces (HR 0.41, 95% CI 0.10 to 1.64; I2 = 86%; 2 studies, 2105 participants; very low-certainty evidence). For the comparison with reactive air surfaces, there is low-certainty evidence that people treated with alternating pressure (active) air surfaces may have a higher risk of developing an incident pressure ulcer than those treated with reactive air surfaces over 14 days' follow-up (HR 2.25, 95% CI 1.05 to 4.83; 1 study, 308 participants). Neither of the two studies with time to ulcer incidence data suggested a difference in the risk of developing an incident pressure ulcer over 60 days' follow-up between different types of alternating pressure air surfaces. Secondary outcomes The included studies have data on (1) support-surface-associated patient comfort for comparisons involving foam surfaces, reactive air surfaces, reactive fibre surfaces and alternating pressure (active) air surfaces; (2) adverse events for comparisons involving foam surfaces, reactive gel surfaces and alternating pressure (active) air surfaces; and (3) health-related quality of life outcomes for the comparison involving foam surfaces. However, all these outcomes and comparisons have low or very low-certainty evidence and it is uncertain whether there are any differences in these outcomes. Included studies have data on cost effectiveness for two comparisons. Moderate-certainty evidence suggests that alternating pressure (active) air surfaces are probably more cost-effective than foam surfaces (1 study, 2029 participants) and that alternating pressure (active) air mattresses are probably more cost-effective than overlay versions of this technology for people in acute care settings (1 study, 1971 participants). AUTHORS' CONCLUSIONS: Current evidence is uncertain about the difference in pressure ulcer incidence between using alternating pressure (active) air surfaces and other surfaces (reactive water surfaces, reactive fibre surfaces and reactive air surfaces). Alternating pressure (active) air surfaces may reduce pressure ulcer risk compared with foam surfaces and reactive gel surfaces used on operating tables followed by foam surfaces applied on hospital beds. People using alternating pressure (active) air surfaces may be more likely to develop new pressure ulcers over 14 days' follow-up than those treated with reactive air surfaces in the nursing home setting; but as the result is sensitive to the choice of outcome measure it should be interpreted cautiously. Alternating pressure (active) air surfaces are probably more cost-effective than reactive foam surfaces in preventing new pressure ulcers. Future studies should include time-to-event outcomes and assessment of adverse events and trial-level cost-effectiveness. Further review using network meta-analysis will add to the findings reported here.


Assuntos
Ar , Roupas de Cama, Mesa e Banho , Leitos , Lesão por Pressão/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Viés , Elasticidade , Humanos , Incidência , Pessoa de Meia-Idade , Pressão , Lesão por Pressão/epidemiologia , Lesão por Pressão/etiologia , Viés de Publicação , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
5.
Cochrane Database Syst Rev ; 5: CD013622, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33999463

RESUMO

BACKGROUND: Pressure ulcers (also known as pressure injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Reactive air surfaces (beds, mattresses or overlays) can be used for preventing pressure ulcers. OBJECTIVES: To assess the effects of reactive air beds, mattresses or overlays compared with any support surface on the incidence of pressure ulcers in any population in any setting. SEARCH METHODS: In November 2019, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials that allocated participants of any age to reactive air beds, overlays or mattresses. Comparators were any beds, overlays or mattresses that were applied for preventing pressure ulcers. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed studies using predetermined inclusion criteria. We carried out data extraction, 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool, and the certainty of the evidence assessment according to Grading of Recommendations, Assessment, Development and Evaluations methodology. If a reactive air surface was compared with surfaces that were not clearly specified, then we recorded and described the concerned study but did not included it in further data analyses. MAIN RESULTS: We included 17 studies (2604 participants) in this review. Most studies were small (median study sample size: 83 participants). The average participant age ranged from 56 to 87 years (median: 72 years). Participants were recruited from a wide range of care settings with the majority being acute care settings. Almost all studies were conducted in the regions of Europe and America. Of the 17 included studies, two (223 participants) compared reactive air surfaces with surfaces that were not well described and therefore could not be classified. We analysed data for five comparisons: reactive air surfaces compared with (1) alternating pressure (active) air surfaces (seven studies with 1728 participants), (2) foam surfaces (four studies with 229 participants), (3) reactive water surfaces (one study with 37 participants), (4) reactive gel surfaces (one study with 66 participants), and (5) another type of reactive air surface (two studies with 223 participants). Of the 17 studies, seven (41.2%) presented findings which were considered at high overall risk of bias. PRIMARY OUTCOME: Pressure ulcer incidence Reactive air surfaces may reduce the proportion of participants developing a new pressure ulcer compared with foam surfaces (risk ratio (RR) 0.42; 95% confidence interval (CI) 0.18 to 0.96; I2 = 25%; 4 studies, 229 participants; low-certainty evidence). It is uncertain if there is a difference in the proportions of participants developing a new pressure ulcer on reactive air surfaces compared with: alternating pressure (active) air surfaces (6 studies, 1648 participants); reactive water surfaces (1 study, 37 participants); reactive gel surfaces (1 study, 66 participants), or another type of reactive air surface (2 studies, 223 participants). Evidence for all these comparisons is of very low certainty. Included studies have data on time to pressure ulcer incidence for two comparisons. When time to pressure ulcer incidence is considered using a hazard ratio (HR), low-certainty evidence suggests that in the nursing home setting, people on reactive air surfaces may be less likely to develop a new pressure ulcer over 14 days' of follow-up than people on alternating pressure (active) air surfaces (HR 0.44; 95% CI 0.21 to 0.96; 1 study, 308 participants). It is uncertain if there is a difference in the hazard of developing new pressure ulcers between two types of reactive air surfaces (1 study, 123 participants; very low-certainty evidence). Secondary outcomes Support-surface-associated patient comfort: the included studies have data on this outcome for three comparisons. We could not pool any data as comfort outcome measures differed between included studies; therefore a narrative summary is provided. It is uncertain if there is a difference in patient comfort responses between reactive air surfaces and foam surfaces over the top of an alternating pressure (active) air surfaces (1 study, 72 participants), and between those using reactive air surfaces and those using alternating pressure (active) air surfaces (4 studies, 1364 participants). Evidence for these two comparisons is of very low certainty. It is also uncertain if there is a difference in patient comfort responses between two types of reactive air surfaces (1 study, 84 participants; low-certainty evidence). All reported adverse events: there were data on this outcome for one comparison: it is uncertain if there is a difference in adverse events between reactive air surfaces and foam surfaces (1 study, 72 participants; very low-certainty evidence). The included studies have no data for health-related quality of life and cost-effectiveness for all five comparisons. AUTHORS' CONCLUSIONS: Current evidence is uncertain regarding any differences in the relative effects of reactive air surfaces on ulcer incidence and patient comfort, when compared with reactive water surfaces, reactive gel surfaces, or another type of reactive air surface. Using reactive air surfaces may reduce the risk of developing new pressure ulcers compared with using foam surfaces. Also, using reactive air surfaces may reduce the risk of developing new pressure ulcers within 14 days compared with alternating pressure (active) air surfaces in people in a nursing home setting. Future research in this area should consider evaluation of the most important support surfaces from the perspective of decision-makers. Time-to-event outcomes, careful assessment of adverse events and trial-level cost-effectiveness evaluation should be considered in future studies. Trials should be designed to minimise the risk of detection bias; for example, by using digital photography and adjudicators of the photographs being blinded to group allocation. Further review using network meta-analysis will add to the findings reported here.


Assuntos
Ar , Roupas de Cama, Mesa e Banho , Leitos , Elasticidade , Lesão por Pressão/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Viés , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Substâncias Viscoelásticas , Água
6.
Molecules ; 26(5)2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33804584

RESUMO

Surface bubbles are present in many industrial processes and in nature, as well as in carbonated beverages. They have motivated many theoretical, numerical and experimental works. This paper presents the current knowledge on the physics of surface bubbles lifetime and shows the diversity of mechanisms at play that depend on the properties of the bath, the interfaces and the ambient air. In particular, we explore the role of drainage and evaporation on film thinning. We highlight the existence of two different scenarios depending on whether the cap film ruptures at large or small thickness compared to the thickness at which van der Waals interaction come in to play.


Assuntos
Microbolhas , Água/química , Ar , Propriedades de Superfície
7.
Sensors (Basel) ; 21(6)2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33809293

RESUMO

This work concerns the performance analysis of the sensors contained in a victim detection system. The system is a mobile platform with gas sensors utilized for real time victim localization in urban environments after a disaster has caused the entrapment of people in partially collapsed building structures. The operating principle of the platform is the sampling of air from potential survival spaces (voids) and the measurement of the sampled air's temperature and concentration of CO2 and O2. Humans in a survival space are modelled as sources of CO2 and heat and sinks of O2. The physical openings of a survival space are modelled as sources of fresh air and sinks of the internal air. These sources and sinks dynamically affect the monitored properties of the air inside a survival space. In this paper, the effects of fresh air sources and internal air sinks are first examined in relation to local weather conditions. Then, the effect of human sources of CO2 and sinks of O2 in the space are examined. A model is formulated in order to reliably estimate the concentration of CO2 and O2 as a function of time for given reasonable entrapment scenarios. The input parameters are the local weather conditions, the openings of the survival space, and the number and type of entrapped humans. Three different tests successfully verified the presented theoretical estimations. A detection system with gas sensors of specified or measured capabilities, by utilizing this model and based on the expected concentrations, may inform the operator of the minimum required presence of humans in a survival space that can be detected after "some time".


Assuntos
Ar , Dióxido de Carbono , Dióxido de Carbono/análise , Humanos
8.
Int J Mol Sci ; 22(7)2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33805474

RESUMO

Understanding the interaction of ions with organic receptors in confined space is of fundamental importance and could advance nanoelectronics and sensor design. In this work, metal ion complexation of conformationally varied thiacalix[4]monocrowns bearing lower-rim hydroxy (type I), dodecyloxy (type II), or methoxy (type III) fragments was evaluated. At the liquid-liquid interface, alkylated thiacalixcrowns-5(6) selectively extract alkali metal ions according to the induced-fit concept, whereas crown-4 receptors were ineffective due to distortion of the crown-ether cavity, as predicted by quantum-chemical calculations. In type-I ligands, alkali-metal ion extraction by the solvent-accessible crown-ether cavity was prevented, which resulted in competitive Ag+ extraction by sulfide bridges. Surprisingly, amphiphilic type-I/II conjugates moderately extracted other metal ions, which was attributed to calixarene aggregation in salt aqueous phase and supported by dynamic light scattering measurements. Cation-monolayer interactions at the air-water interface were monitored by surface pressure/potential measurements and UV/visible reflection-absorption spectroscopy. Topology-varied selectivity was evidenced, towards Sr2+ (crown-4), K+ (crown-5), and Ag+ (crown-6) in type-I receptors and Na+ (crown-4), Ca2+ (crown-5), and Cs+ (crown-6) in type-II receptors. Nuclear magnetic resonance and electronic absorption spectroscopy revealed exocyclic coordination in type-I ligands and cation-π interactions in type-II ligands.


Assuntos
Complexos de Coordenação/química , Éteres de Coroa/química , Íons/metabolismo , Fenóis/química , Sulfetos/química , Ar , Alquilação , Cálcio/metabolismo , Complexos de Coordenação/metabolismo , Éteres de Coroa/síntese química , Éteres de Coroa/metabolismo , Difusão Dinâmica da Luz , Íons/química , Extração Líquido-Líquido , Espectroscopia de Ressonância Magnética , Metais/química , Conformação Molecular , Fenóis/metabolismo , Solventes/química , Espectrofotometria Ultravioleta , Sulfetos/metabolismo , Água/química
10.
Sci Adv ; 7(10)2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33674320

RESUMO

The COVID-19 (coronavirus disease 2019) pandemic has resulted in a marked slowdown in greenhouse gas and aerosol emissions. Although the resulting emission reductions will continue to evolve, this will presumably be temporary. Here, we provide estimates of the potential effect of such short-term emission reductions on global and regional temperature and precipitation by analyzing the response of an Earth System Model to a range of idealized near-term emission pathways not considered in available model intercomparison projects. These estimates reveal the modest impact that temporary emission reductions associated with the COVID-19 pandemic will have on global and regional climate. Our simulations suggest that the impact of carbon dioxide and aerosol emission reductions is actually a temporary enhancement in warming rate. However, our results demonstrate that even large emission reductions applied for a short duration have only a small and likely undetectable impact.


Assuntos
Clima , Efeito Estufa/prevenção & controle , Ar , Dióxido de Carbono/análise , Internacionalidade , Chuva , Temperatura , Fatores de Tempo
11.
J Chromatogr A ; 1642: 462025, 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33721815

RESUMO

In this study, an elevated temperature liquid-liquid extraction combined method with successive air-assisted liquid-liquid microextraction has been proposed for the extraction of four phytosterols in cow milk butter and animal oil samples prior to gas chromatography-flame ionization detector. The method is started by combining a few grams of the melted butter or oil samples with ethanol. The mixture is vortexed and placed into a water-bath adjusted at 50 °C. After a few minutes, the mixture is allowed to cool at room temperature. In this step, the butter or oil is become stiff and ethanol is collected on top of the sample. The separated ethanol phase is collected and mixed with deionized water to obtain a homogenous solution. After that, a few microliters of ethyl methyl ammonium chloride: pivalic acid deep eutectic solvent is added into the solution and the mixture was pulled into a glass test tube and pushed back to the tube for five times. After centrifugation, whole of the collected phase at the bottom of tube was withdrawn and transferred into a microtube and contacted with sodium hydroxide solution. The mixture is withdrawn and released to the tube 2 times to remove the extracted fatty acids. The validation data verified that high enrichment factors (385-450) and extraction recoveries (77-90%), low limits of quantification (2.6-5.2 ng g-1) and detection (0.73-1.5 ng g-1), and satisfactory relative standard deviations (≤ 9.3%) can be obtained with this method. At last, the developed method was successfully used for the analysis of phytosterols in various butter and oil samples marketed in Tabriz, Iran.


Assuntos
Ar , Manteiga/análise , Microextração em Fase Líquida/métodos , Óleos/análise , Fitosteróis/análise , Animais , Cromatografia Gasosa , Ácidos Graxos/análise , Leite/química , Reprodutibilidade dos Testes , Solventes/análise , Temperatura , Fatores de Tempo , Água/análise
12.
Food Chem ; 354: 129579, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-33773479

RESUMO

Sugar plays an important role in both the flavour and structure of confectionery. Targets have been set to reduce sugar; however, common strategies often result in changes in flavour and consumer rejection. In this study, an approach was developed to reduce sugar in confectionery gels by aeration, without significantly affecting perceived chewiness. Gelatine based gels with a 23% and 38% reduction in density were formulated using aeration. Mean bubble size was consistent across all gels (0.05-0.06 mm). Time-intensity sensory evaluation was carried out by a trained sensory panel (n = 10). With aeration, no significant difference in overall flavour perception was observed in the 23% and 38% reduced sugar and aroma gels. Air inclusions create a greater surface area, therefore accelerating mass transfer of volatiles and release of sucrose at the food-saliva interface. Consequently, we propose that less calorie dense products can be produced without compromising flavour by using gel aeration technologies.


Assuntos
Ar , Doces/análise , Odorantes/análise , Açúcares/análise , Paladar , Géis , Humanos
13.
Vet Rec ; 188(5): e73, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33666960

RESUMO

BACKGROUND: Nematodirus battus infection is a major health concern in lambs. Development and hatch of infective larvae on pastures is temperature dependent, making model-based risk forecasting a useful tool for disease control. METHODS: Air and 30 cm soil temperature-based risk models were used to predict hatch dates using meteorological data from 2019 and compared to infection dates, estimated from the first appearance of N. battus eggs, on 18 sheep farms distributed across Great Britain. RESULTS: The air temperature model was more accurate in its predictions than the soil temperature model on 12 of the 18 farms, but tended to predict late hatch dates in the early part of the season. CONCLUSION: Overall, the air temperature model appears the more appropriate choice for predicting N. battus peak hatch in the UK in terms of accuracy and practicality, but some adjustment might be needed to account for microclimatic variations at the soil-air interface.


Assuntos
Modelos Estatísticos , Nematodirus , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/parasitologia , Infecções por Strongylida/veterinária , Ar , Animais , Fazendas , Larva/crescimento & desenvolvimento , Reprodutibilidade dos Testes , Risco , Estações do Ano , Ovinos , Solo , Infecções por Strongylida/epidemiologia , Temperatura , Reino Unido/epidemiologia
14.
Anal Chem ; 93(9): 4270-4276, 2021 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-33635067

RESUMO

Airborne pathogens have been considered as highly infectious and transmittable between humans. With the pandemic outbreak of the coronavirus disease 2019 (COVID-19), an on-site diagnostic system-integrated airborne pathogen-monitoring machine is recommended by experts for preventing and controlling the early stage ß-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread. In this work, a small-volume rotating microfluidic fluorescence chip-integrated aerosol SARS-CoV-2 sampling system was constructed to satisfy the demand for rapid on-site sample collection and detection of SARS-CoV-2. The rotating microfluidic fluorescence system with small volume has very high sensitivity in the detection of SARS-CoV-2 (detection limit of 10 copies/µL with the shortest Ct value of 15 min), which is comparable to reverse transcription polymerase chain reaction (RT-PCR). The precision variation coefficients within/between batches are very low [coefficient of variation (CV) % ≤ 5.0%]. Our work has passed the comprehensive inspection of the microfluidic chip performance by the Shanghai Medical Device Testing Institute [National Medical Inspection (Design) no. 4408] and successfully tested 115 clinical samples. The integrated system exhibits 100% specificity, high sensitivity (10 copies/µL), and good precision (CV % ≤ 5.0%) in the rapid detection of SARS-CoV-2, thus realizing rapid monitoring and diagnostics of SARS-CoV-2 nucleic acid on-site.


Assuntos
Teste para COVID-19/instrumentação , Teste para COVID-19/métodos , COVID-19/diagnóstico , COVID-19/virologia , Dispositivos Lab-On-A-Chip , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Aerossóis/análise , Ar , Fluorescência , Humanos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade
15.
Clin Biomech (Bristol, Avon) ; 82: 105282, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33548767

RESUMO

BACKGROUND: The conductive mechanisms of olfaction are typically given little priority in the evaluation of olfactory function. The objective of this study is to investigate the role of nasal vestibule morphological variations on airflow volume at the olfactory recess in healthy subjects. METHODS: Anatomically realistic three-dimensional nasal airway models were constructed from computed tomography scans in five subjects. Each individual's unilateral nasal cavity (10 total) was classified according to the shape of their nasal vestibule: Standard, Notched, or Elongated. Nasal airflow simulations were performed using computational fluid dynamics modeling at two inspiratory flow rates (15 L/min and 30 L/min) to reflect resting and moderate breathing rates. Olfactory airflow volume and cross-sectional flow resistance were computed. FINDINGS: Average olfactory airflow volumes (and percent airflow in olfactory) were: 0.25 L/min to 0.64 L/min (3.0%-7.7%; 15 L/min simulations) and 0.53 L/min to 1.30 L/min (3.2%-7.8%; 30 L/min simulations) for Standard; 0.13 L/min - 0.47 L/min (2.0%-6.8%; 15 L/min simulations) and 0.06 L/min - 0.82 L/min (1.7%-6.1%; 30 L/min simulations) for Notched; and 0.07 L/min - 0.39 L/min (1.2%-5.4%; 15 L/min simulations) and 0.30 L/min - 0.99 L/min (2.1%-6.7%; 30 L/min simulations) for Elongated. On average, relative difference in olfactory resistance between left and right sides was 141.5% for patients with different unilateral phenotypes and 82.2% for patients with identical unilateral phenotype. INTERPRETATION: Olfactory cleft airflow volume was highest in the Standard nasal vestibule phenotype, followed by Notched phenotype for 15 L/min simulations and Elongated phenotype for 30 L/min simulations. Further, intra-patient variation in olfactory cleft airflow resistance differs greatly for patients with different unilateral phenotypes compared to patients with identical unilateral phenotype.


Assuntos
Ar , Cavidade Nasal/fisiologia , Olfato/fisiologia , Estudos Transversais , Feminino , Humanos , Hidrodinâmica , Masculino , Modelos Anatômicos , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
J Colloid Interface Sci ; 590: 38-49, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33524719

RESUMO

HYPOTHESIS: The secondary structure of proteins affects their functionality and performance in physiological environments or industrial applications. Change of the solution pH or the presence of protein denaturants are the main chemical means that can alter the secondary structure of proteins or lead to protein denaturation. Since proteins in the bulk solution and those residing at the solution/air interface experience different local environments, their response to chemical denaturation can be different. EXPERIMENTS: We utilize circular dichroism and chiral/achiral sum frequency generation spectroscopy to study the secondary structure of selected proteins as a function of the solution pH or in the presence of 8 M urea in the bulk solution and at the solution/air interface, respectively. FINDINGS: The liquid/air interface can enhance or decrease protein conformation stability. The change in the secondary structure of the surface adsorbed proteins in alkaline solutions occurs at pH values lower than those denaturing the studied proteins in the bulk solution. In contrast, while 8 M urea completely denatures the studied proteins in the bulk solution, the liquid/air interface prevents the urea-induced denaturation of the surface adsorbed proteins by limiting the access of urea to the hydrophobic side chains of proteins protruding to air.


Assuntos
Ureia , Água , Ar , Dicroísmo Circular , Concentração de Íons de Hidrogênio , Desnaturação Proteica , Propriedades de Superfície
17.
ACS Appl Mater Interfaces ; 13(3): 4545-4552, 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33459023

RESUMO

In this study, polydimethylsiloxane (PDMS)/polythiourethane (PTU) composite reinforced with tetrapodal shaped micro-nano ZnO particles (t-ZnO) was successfully produced by a versatile, industrially applicable polymer blending process. On the surface of this composite, PDMS is distributed in the form of microdomains embedded in a PTU matrix. The composite inherited not only good mechanical properties originating from PTU but also promising fouling-release (FR) properties due to the presence of PDMS on the surface. It was shown that the preferential segregation of PDMS domains at the polymer/air interface could be attributed to the difference in the surface free energy of PDMS and PTU. The PDMS microdomains at the PTU/air interface significantly reduced the barnacle adhesion strength on the composite. Both the pseudo- and natural barnacle adhesion strength on the composite was approximately 0.1 MPa, similar to that on pure PDMS. The pseudo-barnacle adhesion on reference surfaces AlMg3 and PTU reached approximately 4 and 6 MPa, respectively. Natural barnacles could not be removed intact from AlMg3 and PTU surfaces without breaking the shell, indicating that the adhesion strength was higher than the mechanical strength of a barnacle shell (approximately 0.4 MPa). The integrity of PDMS microdomains was maintained after 12 months of immersion in seawater and barnacle removal. No surface deteriorations were found. In short, the composite showed excellent potential as a long-term stable FR coating for marine applications.


Assuntos
Incrustação Biológica/prevenção & controle , Dimetilpolisiloxanos/química , Poliuretanos/química , Thoracica/citologia , Óxido de Zinco/química , Ar/análise , Animais , Nanopartículas/química , Transição de Fase , Propriedades de Superfície
18.
Nature ; 590(7845): 284-289, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33461212

RESUMO

Lungfishes belong to lobe-fined fish (Sarcopterygii) that, in the Devonian period, 'conquered' the land and ultimately gave rise to all land vertebrates, including humans1-3. Here we determine the chromosome-quality genome of the Australian lungfish (Neoceratodus forsteri), which is known to have the largest genome of any animal. The vast size of this genome, which is about 14× larger than that of humans, is attributable mostly to huge intergenic regions and introns with high repeat content (around 90%), the components of which resemble those of tetrapods (comprising mainly long interspersed nuclear elements) more than they do those of ray-finned fish. The lungfish genome continues to expand independently (its transposable elements are still active), through mechanisms different to those of the enormous genomes of salamanders. The 17 fully assembled lungfish macrochromosomes maintain synteny to other vertebrate chromosomes, and all microchromosomes maintain conserved ancient homology with the ancestral vertebrate karyotype. Our phylogenomic analyses confirm previous reports that lungfish occupy a key evolutionary position as the closest living relatives to tetrapods4,5, underscoring the importance of lungfish for understanding innovations associated with terrestrialization. Lungfish preadaptations to living on land include the gain of limb-like expression in developmental genes such as hoxc13 and sall1 in their lobed fins. Increased rates of evolution and the duplication of genes associated with obligate air-breathing, such as lung surfactants and the expansion of odorant receptor gene families (which encode proteins involved in detecting airborne odours), contribute to the tetrapod-like biology of lungfishes. These findings advance our understanding of this major transition during vertebrate evolution.


Assuntos
Adaptação Fisiológica/genética , Evolução Biológica , Peixes/genética , Marcha/genética , Genoma/genética , Pulmão , Vertebrados/genética , Ar , Nadadeiras de Animais/anatomia & histologia , Animais , Teorema de Bayes , Cromossomos/genética , Extremidades/anatomia & histologia , Feminino , Peixes/fisiologia , Regulação da Expressão Gênica no Desenvolvimento , Genes Homeobox/genética , Genômica , Humanos , Elementos Nucleotídeos Longos e Dispersos/genética , Pulmão/anatomia & histologia , Pulmão/fisiologia , Camundongos , Anotação de Sequência Molecular , Filogenia , Respiração , Olfato/fisiologia , Sintenia , Vertebrados/fisiologia , Órgão Vomeronasal/anatomia & histologia
19.
Carbohydr Polym ; 255: 117328, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33436171

RESUMO

In crystalline cellulose I, all glucan chains are ordered from reducing ends to non-reducing ends. Thus, the polarity of individual chains is added forming a large dipole within the crystal. If one can engineer unidirectional alignment (parallel packing) of cellulose crystals, then it might be possible to utilize the material properties originating from polar crystalline structures. However, most post-synthesis manipulation methods reported so far can only achieve the uniaxial alignment with bi-directionality (antiparallel packing). Here, we report a method to induce the parallel packing of bacterial cellulose microfibrils by applying unidirectional shear stress during the synthesis and deposition through the rising bubble stream in a culture medium. Driving force for the alignment is explained with mathematical estimation of the shear stress. Evidences of the parallel alignment of crystalline cellulose Iα domains were obtained using nonlinear optical spectroscopy techniques.


Assuntos
Acetobacteraceae/química , Celulose/química , Microfibrilas/química , Acetobacteraceae/fisiologia , Ar/análise , Fenômenos Biomecânicos , Reatores Biológicos , Celulose/ultraestrutura , Cristalização , Glucanos/química , Microfibrilas/ultraestrutura , Reologia , Estresse Mecânico
20.
Food Chem ; 348: 129106, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-33516999

RESUMO

Deep eutectic solvents (DESs) are a new class of green "designer solvent"; its physicochemical properties can be easily tuned by adjusting DES' constituents, chemical ratio and water content. In this study, three hydrophobic DESs with low viscosity, low density, and melting points close to room temperature were designed and synthesized. Based on these DESs, an air-assisted liquid-liquid microextraction technique was developed based on the solidification of floating DESs for the simultaneous determination of bisphenols and polycyclic aromatic hydrocarbons (PAHs) via HPLC. The microextraction parameters were optimized via the Plackett-Burman design and response surface methodologies. The method shows satisfactory linearity (R2 ≥ 0.9928), a low limit of detection (0.16-0.75 µg L-1) and satisfactory precision (≤2.3%), and was successfully applied for the simultaneous determination of bisphenols and PAHs from tea infusions with satisfactory recoveries (82.0-116.6%). This method is simple, rapid, economical, environmentally compatible, dispersive solvent-frees and centrifugation-free, and has promising applications in food safety.


Assuntos
Ar , Compostos Benzidrílicos/análise , Microextração em Fase Líquida/métodos , Fenóis/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Solventes/química , Chá/química , Água/química , Compostos Benzidrílicos/química , Compostos Benzidrílicos/isolamento & purificação , Cromatografia Líquida de Alta Pressão , Análise de Alimentos , Contaminação de Alimentos/análise , Interações Hidrofóbicas e Hidrofílicas , Limite de Detecção , Fenóis/química , Fenóis/isolamento & purificação , Fenômenos Físicos , Hidrocarbonetos Policíclicos Aromáticos/química , Hidrocarbonetos Policíclicos Aromáticos/isolamento & purificação , Viscosidade , Poluentes Químicos da Água/análise
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