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1.
Acta Ortop Mex ; 35(1): 3-10, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34480432

RESUMO

INTRODUCTION: Healthcare pressure has changed the acquisition of knowledge during residency training. The aim of this study was to analyze the clinical and research training, and level of satisfaction, during orthopedic and traumatology residency in different hospitals of the Spanish National Health Service. MATERIAL AND METHODS: An online survey was distributed between 06/25/2020 and 07/31/2020. Demographic, institution, clinical and research variables were analyzed. Satisfaction was graded in a scale from 0 to 5. RESULTS: 120 residents answered the survey, having a mean age of 27 years and being 58% male. Distribution of residents by year was 26 R5 (21.7%), 24 R4 (20.0%), 45 R3 (37.5%), 25 R2 (20.9%). Only 37.5% answered that they did not have any clinical activity the next day after medical guard, and 45% answered that they performed clinical activity outside of working hours. A total of 56.7% answered that their orthopedic training program did not include research training. No resident had specific time assigned to research activities. Mean satisfaction value was 2.4 points. CONCLUSIONS: Clinical activity shows aspects incompatible with current legislation. Orthopedic programs need improvements with regard to research training. A significant percentage of residents are unsatisfied with their training.


Assuntos
Procedimentos Ortopédicos , Traumatologia , Adulto , Feminino , Hospitais , Humanos , Masculino , Satisfação Pessoal , Pesquisa , Espanha , Medicina Estatal
2.
Croat Med J ; 62(4): 353-359, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34472738

RESUMO

AIM: To report on patients who underwent surgical treatment of arteriovenous malformations (AVMs) at our institution. METHODS: This retrospective single-center case series enrolled the patients who underwent surgical treatment of pial AVM at the Department of Neurosurgery, University Hospital Brno, between 2005 and 2019. The data are summarized as descriptive statistics presenting basic characteristics in all the patients and in sex or age subgroups. RESULTS: Fifty patients were enrolled. The majority of AVMs were of Spetzler-Martin grade II (n=27; 54%), localized supratentorialy (n=43; 86%), and half of AVMs were ruptured. A total resection was performed in 48 patients (96%), and a good overall outcome was achieved in 44 patients (88%). Surgery-associated morbidity was 2%, and the mortality rate was 0% due to meticulous selection of patients for surgical treatment. CONCLUSION: Microsurgery is an appropriate method of treatment for S-M grade I-III pial AVMs. Microsurgery may be used to treat the majority of small-nidus AVMs with a low mortality and morbidity, when precisely planned and performed by an expert vascular team. The meticulous selection of patients for surgical treatment is crucial.


Assuntos
Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Humanos , Malformações Arteriovenosas Intracranianas/cirurgia , Microcirurgia , Pesquisa , Estudos Retrospectivos , Resultado do Tratamento
3.
Zhongguo Zhong Yao Za Zhi ; 46(12): 3150-3155, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34467707

RESUMO

In recent years, only a small number of new Chinese medicines have been approved for marketing, which has embodied the bottleneck in the development of the Chinese medicine industry. To tackle this problem, the National Medical Products Administration has issued a series of regulations and technical requirements. In the context of new regulations, this study deeply explored the research and development strategies of new Chinese medicines under the guidance of the new classification of drug registration, and discussed the key technical issues in the research and development.


Assuntos
Medicamentos de Ervas Chinesas , Preparações Farmacêuticas , China , Medicina Tradicional Chinesa , Pesquisa
5.
Sensors (Basel) ; 21(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502731

RESUMO

As a sub-direction of image retrieval, person re-identification (Re-ID) is usually used to solve the security problem of cross camera tracking and monitoring. A growing number of shopping centers have recently attempted to apply Re-ID technology. One of the development trends of related algorithms is using an attention mechanism to capture global and local features. We notice that these algorithms have apparent limitations. They only focus on the most salient features without considering certain detailed features. People's clothes, bags and even shoes are of great help to distinguish pedestrians. We notice that global features usually cover these important local features. Therefore, we propose a dual branch network based on a multi-scale attention mechanism. This network can capture apparent global features and inconspicuous local features of pedestrian images. Specifically, we design a dual branch attention network (DBA-Net) for better performance. These two branches can optimize the extracted features of different depths at the same time. We also design an effective block (called channel, position and spatial-wise attention (CPSA)), which can capture key fine-grained information, such as bags and shoes. Furthermore, based on ID loss, we use complementary triplet loss and adaptive weighted rank list loss (WRLL) on each branch during the training process. DBA-Net can not only learn semantic context information of the channel, position, and spatial dimensions but can integrate detailed semantic information by learning the dependency relationships between features. Extensive experiments on three widely used open-source datasets proved that DBA-Net clearly yielded overall state-of-the-art performance. Particularly on the CUHK03 dataset, the mean average precision (mAP) of DBA-Net achieved 83.2%.


Assuntos
Processamento de Imagem Assistida por Computador , Pedestres , Algoritmos , Humanos , Pesquisa , Semântica
7.
Ann Intern Med ; 174(8): JC93, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34339223

RESUMO

SOURCE CITATION: Hillier TA, Pedula KL, Ogasawara KK, et al. A pragmatic, randomized clinical trial of gestational diabetes screening. N Engl J Med. 2021;384:895-904. 33704936.


Assuntos
Diabetes Gestacional , Diabetes Gestacional/diagnóstico , Feminino , Humanos , Programas de Rastreamento , Gravidez , Pesquisa
9.
PLoS One ; 16(8): e0256871, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34464430

RESUMO

BACKGROUND: Clinical research has been central to the global response to COVID-19, and the United Kingdom (UK), with its research system embedded within the National Health Service (NHS), has been singled out globally for the scale and speed of its COVID-19 research response. This paper explores the impacts of COVID-19 on clinical research in an NHS Trust and how the embedded research system was adapted and repurposed to support the COVID-19 response. METHODS AND FINDINGS: Using a multi-method qualitative case study of a research-intensive NHS Trust in London UK, we collected data through a questionnaire (n = 170) and semi-structured interviews (n = 24) with research staff working in four areas: research governance; research leadership; research delivery; and patient and public involvement. We also observed key NHS Trust research prioritisation meetings (40 hours) and PPI activity (4.5 hours) and analysed documents produced by the Trust and national organisation relating to COVID-19 research. Data were analysed for a descriptive account of the Trust's COVID-19 research response and research staff's experiences. Data were then analysed thematically. Our analysis identifies three core themes: centralisation; pace of work; and new (temporary) work practices. By centralising research prioritisation at both national and Trust levels, halting non-COVID-19 research and redeploying research staff, an increased pace in the setup and delivery of COVID-19-related research was possible. National and Trust-level responses also led to widescale changes in working practices by adapting protocols and developing local processes to maintain and deliver research. These were effective practical solutions borne out of necessity and point to how the research system was able to adapt to the requirements of the pandemic. CONCLUSION: The Trust and national COVID-19 response entailed a rapid large-scale reorganisation of research staff, research infrastructures and research priorities. The Trust's local processes that enabled them to enact national policy prioritising COVID-19 research worked well, especially in managing finite resources, and also demonstrate the importance and adaptability of the research workforce. Such findings are useful as we consider how to adapt our healthcare delivery and research practices both at the national and global level for the future. However, as the pandemic continues, research leaders and policymakers must also take into account the short and long term impact of COVID-19 prioritisation on non-COVID-19 health research and the toll of the emergency response on research staff.


Assuntos
COVID-19/epidemiologia , Pesquisa/estatística & dados numéricos , COVID-19/virologia , Tomada de Decisões , Humanos , Entrevistas como Assunto , Pesquisadores/psicologia , SARS-CoV-2/isolamento & purificação , Reino Unido/epidemiologia
11.
Sensors (Basel) ; 21(16)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34451017

RESUMO

With the improvement of the quality and resolution of remote sensing (RS) images, scene recognition tasks have played an important role in the RS community. However, due to the special bird's eye view image acquisition mode of imaging sensors, it is still challenging to construct a discriminate representation of diverse and complex scenes to improve RS image recognition performance. Capsule networks that can learn the spatial relationship between the features in an image has a good image classification performance. However, the original capsule network is not suitable for images with a complex background. To address the above issues, this paper proposes a novel end-to-end capsule network termed DS-CapsNet, in which a new multi-scale feature enhancement module and a new Caps-SoftPool method are advanced by aggregating the advantageous attributes of the residual convolution architecture, Diverse Branch Block (DBB), Squeeze and Excitation (SE) block, and the Caps-SoftPool method. By using the residual DBB, multiscale features can be extracted and fused to recover a semantic strong feature representation. By adopting SE, the informative features are emphasized, and the less salient features are weakened. The new Caps-SoftPool method can reduce the number of parameters that are needed in order to prevent an over-fitting problem. The novel DS-CapsNet achieves a competitive and promising performance for RS image recognition by using high-quality and robust capsule representation. The extensive experiments on two challenging datasets, AID and NWPU-RESISC45, demonstrate the robustness and superiority of the proposed DS-CapsNet in scene recognition tasks.


Assuntos
Diagnóstico por Imagem , Pesquisa , Progressão da Doença , Humanos
12.
Immunity ; 54(8): 1636-1651, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34348117

RESUMO

The development of effective vaccines to combat infectious diseases is a complex multi-year and multi-stakeholder process. To accelerate the development of vaccines for coronavirus disease 2019 (COVID-19), a novel pathogen emerging in late 2019 and spreading globally by early 2020, the United States government (USG) mounted an operation bridging public and private sector expertise and infrastructure. The success of the endeavor can be seen in the rapid advanced development of multiple vaccine candidates, with several demonstrating efficacy and now being administered around the globe. Here, we review the milestones enabling the USG-led effort, the methods utilized, and ensuing outcomes. We discuss the current status of COVID-19 vaccine development and provide a perspective for how partnership and preparedness can be better utilized in response to future public-health pandemic emergencies.


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pesquisa , SARS-CoV-2/imunologia , Bioengenharia , Biotecnologia , Vacinas contra COVID-19/administração & dosagem , Humanos , Modelos Moleculares , Avaliação de Resultados em Cuidados de Saúde , Vigilância em Saúde Pública , Pesquisa/estatística & dados numéricos , Pesquisa/tendências , Estados Unidos/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Vacinologia
13.
Sci Total Environ ; 791: 148257, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34412378

RESUMO

Rare earth elements (REEs) are one of the most important elements used for transformation of the fossil era into a decarbonized future. REEs are essential for wind, electric and hybrid vehicles, and low-energy lighting. However, there is a general understanding that REEs come along with multiple environmental problems during their extraction and processing. Life cycle assessment (LCA) is a well-established method for a holistic evaluation of environmental effects of a product system considering the entire life cycle. This paper reviews LCA studies for determining the environmental impacts of rare earth oxide (REO) production from Bayan Obo and ion adsorption clays (IAC) in China, and shows why some studies lead to over- and underestimated results. We found out that current LCA studies of REE production provide a good overall understanding of the underlying process chains, which are mainly located in China. However, life cycle inventories (LCI) appear often not complete. Several lack accuracy, consistency, or transparency. Hence, resulting environmental impacts are subject to great uncertainty. This applies in particular to radioactivity and the handling of wastewater and slurry in tailing ponds, which have often been neglected. This article reviews 35 studies to identify suitable LCAs for comparison. The assessment covers the world's largest REO production facility, located in Bayan Obo, as well as in-situ leaching of IACs in the Southern Provinces of China. A total of 12 studies are selected, 8 for Bayan Obo and IACs each. The LCIs of these studies are reviewed in detail. The effects of over- and underestimated LCIs on the life cycle impact assessment (LCIA) are investigated. The partly controversial results of existing LCAs are analyzed thoroughly and discussed. Our results show that an increased consistency in LCA studies on REO production is needed.


Assuntos
Metais Terras Raras , Animais , China , Meio Ambiente , Estágios do Ciclo de Vida , Metais Terras Raras/análise , Pesquisa
16.
F1000Res ; 10: 190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33953909

RESUMO

Background: The past two decades have witnessed significant growth in non-commercial research and development (R&D) initiatives, particularly for neglected diseases, but there is limited understanding of the ways in which they compare with traditional commercial R&D. This study analyses costs, timeframes, and attrition rates of non-commercial R&D across multiple initiatives and how they compare to commercial R&D using the Portfolio-to-Impact (P2I) model as parameter of comparison. Methods: This is a mixed-method, observational, descriptive and analytic study. We contacted 48 non-commercial R&D initiatives and received quantitative data from 8 organizations on 83 candidate products, and qualitative data through 14 interviews from 12 organizations. Results: The quantitative data suggested that non-commercial R&D for new chemical entities is largely in line with P2I averages regarding total costs and timeframes, with variation by phase. The qualitative data identified more reasons why non-commercial R&D costs would be lower than commercial R&D, timeframes would be longer and attrition rates would be equivalent or higher, though the magnitude of effect is not known. The overall emerging hypothesis is that direct costs of non-commercial R&D are expected to be equivalent or somewhat lower than commercial, timeframes are expected to be equivalent or somewhat longer and attrition rates would be equivalent. Conclusions: The study found that non-commercial R&D differs in many significant ways from commercial R&D. However, it is possible that the sum of these differences cancelled each other out such that total costs, timeframes and attrition rates were largely in line with P2I averages. Given the nascent area, with almost no prior literature focusing on costs, timeframes or attrition rates of non-commercial R&D initiatives, we see the merits of this study as generating hypotheses for further testing against a larger sample of quantitative data, and for understanding reasons underlying any significant differences between non-commercial and commercial initiatives.


Assuntos
Doenças Negligenciadas , Preparações Farmacêuticas , Humanos , Pesquisa
17.
PLoS One ; 16(8): e0256099, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34383861

RESUMO

BACKGROUND: The remarkable progress seen in maternal and child health (MCH) in India over the past two decades has been impacted by the COVID-19 pandemic. We aimed to undertake a rapid assessment to identify key priorities for public health research in MCH in India within the context and aftermath of the COVID-19 pandemic. METHODS: A web-based survey was developed to identify top research priorities in MCH. It consisted of 26 questions on six broad domains: vaccine preventable diseases, outbreak preparedness, primary healthcare integration, maternal health, neonatal health, and infectious diseases. Key stakeholders were invited to participate between September and November 2020. Participants assigned importance on a 5-point Likert scale, and assigned overall ranks to each sub-domain research priority. Descriptive statistics were used to examine Likert scale responses, and a ranking analysis was done to obtain an "average ranking score" and identify the top research priority under each domain. RESULTS: Amongst the 84 respondents from across 15 Indian states, 37% were public-health researchers, 25% healthcare providers, 20% academic faculty and 13% were policy makers. Most respondents considered conducting systems strengthening research as extremely important. The highest ranked research priorities were strengthening the public sector workforce (vaccine preventable diseases), enhancing public-health surveillance networks (outbreak preparedness), nutrition support through community workers (primary care integration), encouraging at least 4-8 antenatal visits (maternal health), neonatal resuscitation to reduce birth asphyxia (neonatal health) and screening and treatment of tuberculosis (infectious diseases). Common themes identified through open-ended questions primarily included systems strengthening priorities across domains. CONCLUSIONS: The overall focus for research priorities in MCH in India during the COVID-19 pandemic is on strengthening existing services and service delivery, rather than novel research. Our results highlight pivotal steps within the roadmap for advancing and sustaining maternal and child health gains during the ongoing COVID-19 pandemic and beyond.


Assuntos
COVID-19 , Saúde da Criança , Saúde Materna , Pesquisa , Criança , Feminino , Humanos , Índia , Pandemias , Gravidez , Saúde Pública
18.
BJOG ; 128(10): 1561-1562, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34396679
20.
BMJ Open ; 11(8): e047589, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34462280

RESUMO

BACKGROUND: Major improvements in breast cancer treatment in the last decade include advancements in postmastectomy breast reconstruction (PMBR). Unfortunately, the studies in PMBR are primarily researcher or industry led with minimal input from patients and caregivers. The aim of this study is to use the James Lind Alliance (JLA) approach to bring together the patients, caregivers and clinicians in a priority setting partnership to identify the most important unanswered research questions in PMBR. METHODS: The JLA priority setting methodology involved four key stages: gathering research questions on PMBR from patients, caregivers and clinicians; checking these research questions against existing evidence; interim prioritisation and a final consensus meeting to determine the top 10 unanswered research questions using the modified nominal group methodology. RESULTS: In stage 1, 3168 research questions were submitted from 713 respondents across Canada, of which 73% of the participants were patients or caregivers. Stage 2 confirmed that there were a total of 48 unique unanswered questions. In stage three, 488 individuals completed the interim prioritisation survey and the top 25 questions were taken to a final consensus meeting. In the final stage, the top 10 unanswered research questions were determined. They cover a breadth of topics including personalised surgical treatment, safety of implants and newer techniques, access to PMBR, breast cancer recurrence and rehabilitation. INTERPRETATION: Identification of the top 10 unanswered research questions is an important first step to generating relevant and impactful research that will ultimately improve the PMBR experience for patients with breast cancer.


Assuntos
Neoplasias da Mama , Mamoplastia , Neoplasias da Mama/cirurgia , Feminino , Prioridades em Saúde , Humanos , Mastectomia , Recidiva Local de Neoplasia , Pesquisa
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