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1.
BMC Musculoskelet Disord ; 22(1): 533, 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34118925

RESUMO

BACKGROUND: With a rapidly aging population in Japan, locomotive syndrome is becoming an increasingly serious social problem. Exercise therapy using the lumbar type HAL, which is a wearable robot suit that can assist voluntary hip joint motion, would be expected to cause some beneficial effects for people with locomotive syndrome. The purpose of this study was to assess whether the deterioration of low back pain and any other adverse events would occur following HAL exercise therapy. Moreover, the changes of motor ability variables were evaluated. METHODS: We enrolled 33 participants (16 men, 17 women) with locomotive syndrome in this study. They received exercise training (sit-to-stand, lumbar flexion-extension, and gait training) with HAL (in total 12 sessions). We assessed the change of low back pain (lumbar VAS). More than 50% and 25 mm increase compared to baseline was defined as adverse events. One-leg standing time (OLST), 10-m walking test (10MWT), Timed Up and Go test (TUG), 1-min sit-to-stand test (1MSTS), FIM mobility scores and EQ-5D were measured. RESULTS: Of the 33 participants, 32 (16 men, 16 women) (97.0%) completed all 12 exercise training sessions using the lumbar type HAL. One woman aged 82 years withdrew because of right upper limb pain after the second session regardless of the use of HAL. There was no participant who had deterioration of low back pain. Any other adverse events including external injuries and/or falling, skin disorders, uncontrollable cardiovascular or respiratory disorders, and other health disorders directly related to this exercise therapy did not occur. Several outcome measures of motion ability including OLST, TUG and 1MSTS, EQ VAS and lumbar pain improved significantly after this HAL training. CONCLUSIONS: Almost all patients with locomotive syndrome completed this exercise training protocol without any adverse events related to HAL. Furthermore, balance function variables including OLST, TUG and 1MSTS improved after this HAL exercise therapy even though mobility function variables including 10MWT and FIM mobility scores did not show any significant change. These findings suggest that the exercise therapy using the lumbar type HAL would be one of the options for the intervention in locomotive syndrome.


Assuntos
Terapia por Exercício , Equilíbrio Postural , Idoso , Exercício Físico , Feminino , Humanos , Japão , Masculino , Projetos Piloto , Estudos de Tempo e Movimento
2.
Endocr Pract ; 27(6): 545-551, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34120699

RESUMO

OBJECTIVE: Many youth do not use the hybrid closed-loop system for type 1 diabetes effectively. This study evaluated the impact of financial incentives for diabetes-related tasks on use of the 670G hybrid closed-loop system and on glycemia. METHODS: At auto mode initiation and for 16 weeks thereafter, participants received a flat rate for wearing and calibrating the sensor ($1/day), administering at least 3 mealtime insulin boluses per day ($1/day), and uploading ($5/week). Weekly bonuses were given for maintaining at least 70% of the time in auto mode, which were increased for persistent auto mode use from $3/week to a maximum of $13/week. If a participant failed to maintain auto mode for a week, the rewards were reset to baseline. Data from 17 participants aged 15.9 years ± 2.5 years (baseline hemoglobin A1c [HbA1c] 8.6% ± 1.1%) were collected at 6, 12, and 16 weeks. The reinforcers were withdrawn at 16 weeks, with a follow-up assessment at 24 weeks. RESULTS: With reinforcers, the participants administered an average of at least 3 mealtime insulin boluses per day and wore the sensor over 70% of the time. However, auto mode use waned. HbA1c levels decreased by 0.5% after 6 weeks, and this improvement was maintained at 12 and 16 weeks (P < .05). Upon withdrawal of reinforcers, HbA1c levels increased back to baseline at 24 weeks. CONCLUSION: Compensation for diabetes-related tasks was associated with lower HbA1c levels, consistent administration of mealtime insulin boluses, and sustained sensor use. These results support the potential of financial rewards for improving outcomes in youth with type 1 diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Glicemia , Automonitorização da Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Economia Comportamental , Hemoglobina A Glicada/análise , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Sistemas de Infusão de Insulina , Projetos Piloto
3.
Int J Mol Sci ; 22(9)2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-34064456

RESUMO

Primary Sjögren's syndrome (pSS) is a complex heterogeneous disease characterized by a wide spectrum of glandular and extra-glandular manifestations. In this pilot study, a SWATH-MS approach was used to monitor extracellular vesicles-enriched saliva (EVs) sub-proteome in pSS patients, to compare it with whole saliva (WS) proteome, and assess differential expressed proteins between pSS and healthy control EVs samples. Comparison between EVs and WS led to the characterization of compartment-specific proteins with a moderate degree of overlap. A total of 290 proteins were identified and quantified in EVs from healthy and pSS patients. Among those, 121 proteins were found to be differentially expressed in pSS, 82% were found to be upregulated, and 18% downregulated in pSS samples. The most representative functional pathways associated to the protein networks were related to immune-innate response, including several members of S100 protein family, annexin A2, resistin, serpin peptidase inhibitors, azurocidin, and CD14 monocyte differentiation antigen. Our results highlight the usefulness of EVs for the discovery of novel salivary-omic biomarkers and open novel perspectives in pSS for the identification of proteins of clinical relevance that could be used not only for the disease diagnosis but also to improve patients' stratification and treatment-monitoring. Data are available via ProteomeXchange with identifier PXD025649.


Assuntos
Vesículas Extracelulares/metabolismo , Redes Reguladoras de Genes , Proteoma/genética , Saliva/metabolismo , Síndrome de Sjogren/genética , Adulto , Idoso , Anexina A2/genética , Anexina A2/metabolismo , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/metabolismo , Biomarcadores/metabolismo , Proteínas Sanguíneas/genética , Proteínas Sanguíneas/metabolismo , Estudos de Casos e Controles , Vesículas Extracelulares/química , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Humanos , Receptores de Lipopolissacarídeos/genética , Receptores de Lipopolissacarídeos/metabolismo , Masculino , Espectrometria de Massas/métodos , Pessoa de Meia-Idade , Projetos Piloto , Mapeamento de Interação de Proteínas , Proteoma/classificação , Proteoma/metabolismo , Proteômica/instrumentação , Proteômica/métodos , Resistina/genética , Resistina/metabolismo , Proteínas S100/genética , Proteínas S100/metabolismo , Saliva/química , Serpinas/genética , Serpinas/metabolismo , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/metabolismo , Síndrome de Sjogren/patologia
4.
J Pak Med Assoc ; 71(6): 1627-1632, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111086

RESUMO

OBJECTIVE: To explore current evidence on the effectiveness of shockwave therapy in patients with rotator cuff tendinopathy. METHODS: The meta-analysis study was conducted at University of Lahore from May 2019 to December 2019 and comprised search on Cochrane, Medline, Embase, Physiotherapy Evidence Databasedatabases and other sources as well as unpublished grey literature related to shockwave therapy in patients with rotator cuff tendinopathy published between 2000 and 2019. Methodological quality assessment was performed using Cochrane risk of bias tool and the included studies were critically appraised using the Physiotherapy Evidence Databasescale. RESULTS: Of the 11 studies shortlisted, data was not extractable from 2(18%). Of the 9(82%) studies analysed, 8(89%) were randomised trials and 1(11%) was randomised pilot study. Overall, 4(44.4%) studies had high quality and 5(55.6%) fell in the fair category. CONCLUSIONS: There was no consensus found on the efficacy of extracorporeal shockwave therapy compared to traditional rehabilitation among patients with rotator cuff tendinopathy.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Tendinopatia , Humanos , Modalidades de Fisioterapia , Projetos Piloto , Manguito Rotador , Tendinopatia/terapia
5.
Pol J Pathol ; 72(1): 75-83, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34060290

RESUMO

In our pilot study we have aimed to assess interlaboratory variability of cytological diagnoses in selected laboratories participating in the Polish Cervical Cancer Screening Programme (CCSP) to establish grounds for certification system for cytodiagnosticians and to monitor the quality of services. Set of 50 selected Pap smears, previously reassessed by an expert on the grounds of clinical, colposcopic and histological data was blinded and sent to 15 laboratories in Poland with request for evaluation according to routine practice according to the Bethesda 2001 system. Concordance with expert diagnoses reached a median of 82% (range: 66% to 92%), with median unweighted κ coefficient at κ = 0.67 (range 0.40 to 0.86) depending on laboratory. This indicates substantial agreement among laboratories, however with essential differences in proper evaluation in some outlying laboratories. Agreement was highest in samples with high-grade, lower for low-grade abnormalities. Slides with ASC-US and ASC-H expert diagnoses were most troubling for cytodiagnosticians. Sets of highly selected cytological slides with expert diagnoses may serve as a tool in the process of comprehensive periodic recertification of cytodiagnosticians in the screening programme. A benchmark level of agreement with expert diagnoses should be established to guide corrective actions for cytodiagnosticians with lowest agreement.


Assuntos
Neoplasias do Colo do Útero , Detecção Precoce de Câncer , Feminino , Humanos , Projetos Piloto , Polônia , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal
6.
F1000Res ; 10: 89, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34055314

RESUMO

Background: The University was among the first structures to be hit by the health emergency, transferring all its teaching and research activities remotely. It was not easy for teachers and students to find themselves suddenly shifted into different teaching and socializing context. Results: This article describes and analyzes the online teaching experience carried out for the course of Microscopy Techniques for Forensic Biology offered as a part of the Master's degree program in Biology at the University of Calabria (Italy). A cross-sectional survey (pilot study) was designed to investigate the accessibility of distance learning along with an evaluation of adjustments needed for the conversion from offline to online instruction. Particular attention has been paid to learning material and lesson duration, with specific emphasis on practical activities. Conclusions: The author's intent is that of opening a comparison between the strengths and weaknesses that emerged in this experience, highlighting, in particular, how the educational relationship between teacher and student has changed.


Assuntos
Biologia , Estudos Transversais , Humanos , Itália , Microscopia , Projetos Piloto
7.
BMC Pediatr ; 21(1): 263, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090369

RESUMO

BACKGROUND: Wheezing is common in younger children and often related to viral infection. It is lack of reliable indicators for asthma prediction. OBJECTIVE: To evaluate the relationship between circulation CD4+CCR6+CRTh2+ memory Th2 cells and asthma diagnosis in wheezing children. METHODS: A prospective study was performed in children under 5 years old presented with wheezing or at last one episode of documented wheezing history. After inclusion, the level of serum allergen-specific serum IgE (sIgE) and circulating CD4+CCR6+CRTh2+cells were detected. The patients' personal and family histories of allergic disease were acquired by questionnaire. The children were followed up over 2 years. Diagnosis of asthma was assessed at the end follow-up. The risk factors in predicting asthma diagnosis were evaluated. RESULTS: A total of 43 children completed follow-up. Higher wheezing frequency were found in children with asthma diagnosis. The mean of circulating CD4+CCR6+CRTh2+cells in children diagnosed with or without asthma was 1.6 %±0.8 and 0.8 %±0.6 %, respectively, and was significantly higher in children diagnosed with asthma (p < 0.01). There was no significant difference between children with and without allergic diseases history or family allergic diseases in level of circulating CD4+CCR6+CRTh2+ cells. Logistic regression analysis indicated that circulating CD4+CCR6+CRTh2+ cells (EXP, 8.986; 95 % CI,1.886-42.816) and wheezing frequency(EXP, 0.127; 95 % CI, 0.023-0.703)were high risk factors for asthma. CONCLUSIONS: Our exploratory study shown that circulating CD4+CCR6+CRTh2+ memory Th2 cells increased in asthma diagnosed children and it was a high-risk factor for asthma. Detection of this type of cells could be helpful in predicting the risk of asthma in wheezing children.


Assuntos
Asma , Sons Respiratórios , Asma/diagnóstico , Asma/etiologia , Linfócitos T CD4-Positivos , Criança , Pré-Escolar , Humanos , Projetos Piloto , Estudos Prospectivos , Receptores CCR6 , Sons Respiratórios/etiologia
8.
BMC Infect Dis ; 21(1): 536, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098889

RESUMO

BACKGROUND: At present, no agents are known to be effective at preventing COVID-19. Based on current knowledge of the pathogenesis of this disease, we suggest that SARS-CoV-2 infection might be attenuated by directly maintaining innate pulmonary redox, metabolic and dilation functions using well-tolerated medications that are known to serve these functions, specifically, a low-dose aerosolized combination of glutathione, inosine and potassium. METHODS: From June 1 to July 10, 2020, we conducted a pilot, prospective, open-label, single-arm, single-center study to evaluate the safety and efficacy of preexposure prophylaxis (PrEP) with aerosolized combination medication (ACM) on the incidence of SARS-CoV-2 positivity in 99 healthcare workers (HCWs) at a hospital designated for treating COVID-19 patients. We compared SARS-CoV-2 positivity in ACM users to retrospective data collected from 268 untreated HCWs at the same hospital. Eligible participants received an aerosolized combination of 21.3 mg/ml glutathione and 8.7 mg/ml inosine in 107 mM potassium solution for 14 days. The main outcome was the frequency of laboratory-confirmed SARS-CoV-2 cases, defined as individuals with positive genetic or immunological tests within 28 days of the study period. RESULTS: SARS-CoV-2 was detected in 2 ACM users (2, 95% CI: 0.3 to 7.1%), which was significantly less than the incidence in nonusers, at 24 (9, 95% CI: 5.8 to 13.0%; P = 0.02). During the PrEP period, solicited adverse events occurred in five participants; all were mild and transient reactions. CONCLUSIONS: Our findings might be used either to prevent SARS-CoV-2 infection or to support ongoing and new research into more effective treatments for COVID-19. TRIAL REGISTRATION: ISRCTN, ISRCTN34160010 . Registered 14 September 2020 - Retrospectively registered.


Assuntos
COVID-19/tratamento farmacológico , COVID-19/prevenção & controle , Pessoal de Saúde , Profilaxia Pré-Exposição , Adulto , Aerossóis/farmacologia , Feminino , Hospitais , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
9.
J Spec Oper Med ; 21(2): 54-60, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105122

RESUMO

BACKGROUND: While the US military has relied on the "Golden Hour" for casualty evacuation in Iraq and Afghanistan during most of the last two decades, Special Operations Forces (SOF) personnel have found themselves operating further outside of this established medical infrastructure. This has required prolonged casualty care beyond doctrinal timelines. Telemedicine is increasingly used by medical personnel to bridge this gap, augmenting the local staff with the expertise of a distant consultant. This pilot study was launched to establish a baseline of current SOF telemedical capabilities. METHODS: This is a cross-sectional study of a 292 Department of Defense (DoD) SOF medical personnel via an online questionnaire during the period of October 2018-May 2019. RESULTS: Approximately 16.1% of the 292 respondents stated they received telemedicine equipment, 51.1% of respondents who received telemedicine equipment reported also receiving training on their equipment. Overall, 40.6% of respondents were "actively looking to add telemedicine to their practice," with prolonged field care as the primary intended use. Ideal characteristics of telemedicine equipment were described as a device weighing 6 lb or less, with real-time video and ultrasound transmission capabilities. DISCUSSION: The data demonstrated a gap between provider demand for telemedicine capabilities and their comfort to employ these capabilities downrange. CONCLUSIONS: This study suggests a need to increase the self-reported telemedicine competency of deployed local providers. Authors believe that this is best accomplished through incorporation of early integration of teleconsulting systems into mission rehearsals and unit exercises. Further study should be considered to investigate the efficacy of ongoing acquisition and training programs, along with how telemedicine is being incorporated in the unit during the predeployment training period.


Assuntos
Militares , Telemedicina , Afeganistão , Estudos Transversais , Humanos , Iraque , Projetos Piloto
10.
Sensors (Basel) ; 21(11)2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34070583

RESUMO

Interpersonal rehabilitation games, compared to single-player games, enhance motivation and intensity level. Usually, it is complicated to restrict the use of the system to pairs of impaired patients who have a similar skill level. Thus, such games must be dynamically adapted. Difficulty-adaptation algorithms are usually based only on performance parameters. In this way, the patient's condition cannot be considered when adapting the game. Introducing physiological reactions could help to improve decision-making. However, it is difficult to control how social interaction influences physiological reactions, making it difficult to interpret physiological responses. This article aimed to explore the changes in physiological responses due to the social interaction of a competitive game modality. This pilot study involved ten unimpaired participants (five pairs). We defined different therapy sessions: (i) a session without a competitor; (ii) two sessions with a virtual competitor with different difficulty levels; (iii) a competitive game. Results showed a difference in the physiological response in the competitive mode concerning single-player mode only due to the interpersonal game modality. In addition, feedback from participants suggested that it was necessary to keep a certain difficulty level to make the activity more challenging, and therefore be more engaging and rewarding.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Jogos de Vídeo , Terapia por Exercício , Humanos , Motivação , Projetos Piloto
11.
Sensors (Basel) ; 21(11)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34073020

RESUMO

One of the main preventable leading causes of death after a trauma injury is the hemorrhagic shock. Therefore, it is extremely important to learn how to control hemorrhages. In this paper, a hemorrhagic trauma simulator for lower limb has been developed and a pilot study has been accomplished to trail the simulator. Four different bleeding scenarios have been tested per participant, gathering information about the manual pressure exerted to control the bleeding. Data, altogether, from 54 hemorrhagic scenarios managed by final year medical students and doctors were gathered. Additionally, a post-simulation questionnaire, related to the usability of the simulator, was completed. All the participants managed to control the simulated bleeding scenarios, but the pressure exerted to control the four different scenarios is different depending if the trainee is a student or a doctor, especially in deep venous hemorrhages. This research has highlighted the different approach to bleeding control treatment between medical students and doctors. Moreover, this pilot study demonstrated the need to deliver a more effective trauma treatment teaching for hemorrhagic lesions and that hemorrhagic trauma simulators can be used to train and evaluate different scenarios.


Assuntos
Hemorragia , Extremidade Inferior , Simulação por Computador , Humanos , Projetos Piloto
12.
Nat Commun ; 12(1): 3294, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078892

RESUMO

Experimental manipulation of gut microbes in animal models alters fear behavior and relevant neurocircuitry. In humans, the first year of life is a key period for brain development, the emergence of fearfulness, and the establishment of the gut microbiome. Variation in the infant gut microbiome has previously been linked to cognitive development, but its relationship with fear behavior and neurocircuitry is unknown. In this pilot study of 34 infants, we find that 1-year gut microbiome composition (Weighted Unifrac; lower abundance of Bacteroides, increased abundance of Veillonella, Dialister, and Clostridiales) is significantly associated with increased fear behavior during a non-social fear paradigm. Infants with increased richness and reduced evenness of the 1-month microbiome also display increased non-social fear. This study indicates associations of the human infant gut microbiome with fear behavior and possible relationships with fear-related brain structures on the basis of a small cohort. As such, it represents an important step in understanding the role of the gut microbiome in the development of human fear behaviors, but requires further validation with a larger number of participants.


Assuntos
Bacteroides/genética , Clostridiales/genética , Medo/psicologia , Microbioma Gastrointestinal/genética , Veillonella/genética , Veillonellaceae/genética , Adulto , Bacteroides/classificação , Bacteroides/isolamento & purificação , Encéfalo/fisiologia , Aleitamento Materno , Clostridiales/classificação , Clostridiales/isolamento & purificação , Fezes/microbiologia , Feminino , Humanos , Lactente , Fórmulas Infantis , Estudos Longitudinais , Masculino , Projetos Piloto , RNA Ribossômico 16S/genética , Veillonella/classificação , Veillonella/isolamento & purificação , Veillonellaceae/classificação , Veillonellaceae/isolamento & purificação
13.
BMC Surg ; 21(1): 286, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103032

RESUMO

BACKGROUND: To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse. METHODS: This was a retrospective study of patients with severe prolapse (≥ stage 3) who underwent vNOTES for USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES for USLS. RESULTS: A total of 35 patients were included. The mean operative duration was 111.7 ± 39.4 min. The mean blood loss was 67.9 ± 35.8 ml. Statistically significant differences were observed between before and after vNOTES USLS in Aa (+ 0.6 ± 1.7 versus - 2.9 ± 0.2), Ba (+ 1.9 ± 2.2 versus - 2.9 ± 0.3), C (+ 1.5 ± 2.2 versus - 6.9 ± 0.9), Ap (- 1.4 ± 1.0 versus - 3.0 ± 0.1) and Bp (- 1.1 ± 1.4 versus - 2.9 ± 0.1) (P < 0.05 for all). The mean pre- and postoperative PFDI-20 score was 19.9 ± 6.7 and 3.2 ± 5.4, respectively, and the mean pre- and postoperative PISQ-12 score was 24.8 ± 2.3 and 38.3 ± 4.1, respectively (P < 0.05 for both). During 1-13 months of follow-up, there were no cases of severe complications or recurrence. CONCLUSIONS: vNOTES for USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety. Larger studies with more patients and longer follow-up periods should be performed to evaluate the long-term efficacy and safety profile of vNOTES for USLS.


Assuntos
Cirurgia Endoscópica por Orifício Natural , Prolapso de Órgão Pélvico , Feminino , Humanos , Ligamentos/cirurgia , Prolapso de Órgão Pélvico/cirurgia , Projetos Piloto , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
14.
BMC Musculoskelet Disord ; 22(1): 526, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103040

RESUMO

BACKGROUND: Exercise-based approaches have been a cornerstone of physiotherapy management of knee osteoarthritis for many years. However, clinical effects are considered small to modest and the need for continued adherence identified as a barrier to clinical efficacy. While exercise-based approaches focus on muscle strengthening, biomechanical research has identified that people with knee osteoarthritis over activate their muscles during functional tasks. Therefore, we aimed to create a new behavioural intervention, which integrated psychologically informed practice with biofeedback training to reduce muscle overactivity, and which was suitable for delivery by a physiotherapist. METHODS: Through literature review, we created a framework linking theory from pain science with emerging biomechanical concepts related to overactivity of the knee muscles. Using recognised behaviour change theory, we then mapped a set of intervention components which were iteratively developed through ongoing testing and consultation with patients and physiotherapists. RESULTS: The underlying framework incorporated ideas related to central sensitisation, motor responses to pain and also focused on the idea that increased knee muscle overactivity could result from postural compensation. Building on these ideas, we created an intervention with five components: making sense of pain, general relaxation, postural deconstruction, responding differently to pain and functional muscle retraining. The intervention incorporated a range of animated instructional videos to communicate concepts related to pain and biomechanical theory and also used EMG biofeedback to facilitate visualization of muscle patterns. User feedback was positive with patients describing the intervention as enabling them to "create a new normal" and to be "in control of their own treatment." Furthermore, large reductions in pain were observed from 11 patients who received a prototype version of the intervention. CONCLUSION: We have created a new intervention for knee osteoarthritis, designed to empower individuals with capability and motivation to change muscle activation patterns and beliefs associated with pain. We refer to this intervention as Cognitive Muscular Therapy. Preliminary feedback and clinical indications are positive, motivating future large-scale trials to understand potential efficacy. It is possible that this new approach could bring about improvements in the pain associated with knee osteoarthritis without the need for continued adherence to muscle strengthening programmes. TRIAL REGISTRATION: ISRCTN51913166 (Registered 24-02-2020, Retrospectively registered).


Assuntos
Terapia Comportamental , Osteoartrite do Joelho , Terapia por Exercício , Humanos , Articulação do Joelho , Motivação , Osteoartrite do Joelho/terapia , Medição da Dor , Projetos Piloto , Resultado do Tratamento
15.
Rev Med Suisse ; 17(742): 1106-1107, 2021 Jun 09.
Artigo em Francês | MEDLINE | ID: mdl-34106533

RESUMO

On March 31, 2021, the Swiss Federal Council accepted the Ordinance on Pilot Trials under the Narcotics Law, which will come into force on May 15, 2021 and will authorize pilot trials of recreational cannabis use by adults. The purpose of these trials will be to provide a scientific basis for future policy decisions on cannabis regulation. This ordinance is based on the idea that the legislator must give himself the possibility to experiment, as it was already the case in the 1990s with the pilot projects of heroin prescription, which proved to be useful in the legislative process, leading to changes of opinion among specialists, as well as in the general public - and thus in politics.


Assuntos
Cannabis , Alucinógenos , Adulto , Humanos , Legislação de Medicamentos , Projetos Piloto , Suíça
16.
Sensors (Basel) ; 21(9)2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-34068804

RESUMO

Fall-related information can help clinical professionals make diagnoses and plan fall prevention strategies. The information includes various characteristics of different fall phases, such as falling time and landing responses. To provide the information of different phases, this pilot study proposes an automatic multiphase identification algorithm for phase-aware fall recording systems. Seven young adults are recruited to perform the fall experiment. One inertial sensor is worn on the waist to collect the data of body movement, and a total of 525 trials are collected. The proposed multiphase identification algorithm combines machine learning techniques and fragment modification algorithm to identify pre-fall, free-fall, impact, resting and recovery phases in a fall process. Five machine learning techniques, including support vector machine, k-nearest neighbor (kNN), naïve Bayesian, decision tree and adaptive boosting, are applied to identify five phases. Fragment modification algorithm uses the rules to detect the fragment whose results are different from the neighbors. The proposed multiphase identification algorithm using the kNN technique achieves the best performance in 82.17% sensitivity, 85.74% precision, 73.51% Jaccard coefficient, and 90.28% accuracy. The results show that the proposed algorithm has the potential to provide automatic fine-grained fall information for clinical measurement and assessment.


Assuntos
Acidentes por Quedas , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas/prevenção & controle , Algoritmos , Teorema de Bayes , Humanos , Projetos Piloto , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-34076638

RESUMO

It was hypothesized that hyperbaric oxygen (HBO) could increase bone healing efficiency according to a protocol with a special window of healing time when maxillary sinus lateral augmentation is performed with only xenograft. The histomorphometric efficiency of HBO on the maxillary sinus lateral augmentation was examined by designing five different in vivo healing periods. Five patients receiving maxillary sinus lateral augmentation with xenograft each received a different treatment healing protocol: 6 weeks natural healing (control [Ctl]), 5 weeks with HBO (T1), 6 weeks with HBO (T2), 9 weeks with HBO (T3), and 13 months natural healing (TM). Biopsy samples were harvested, and quantitative histomorphometric analysis was performed regarding key factors BMP-2 and RUNX2. Analysis of variance and Tukey test were used for pairwise comparisons. Time-dependent relationships of the factors' expression densities were conducted using quadratic regression fitting. There were statistically significant differences among the groups, except for T2/T3 and T2/TM for BMP-2 and for T2/T3 and TM/Ctl for RUNX2. Both BMP-2 and RUNX2 showed quadratic trends, presenting an initial upward trend and eventually a downward trend depending on T1, T2, and T3 groups. Early stimulation, achieved by keeping HBO until 6 to 9 weeks after maxillary sinus lateral augmentation with xenograft, seemed to be the time window that benefitted bone healing efficiency the most.


Assuntos
Substitutos Ósseos , Oxigenação Hiperbárica , Levantamento do Assoalho do Seio Maxilar , Transplante Ósseo , Xenoenxertos , Humanos , Seio Maxilar , Projetos Piloto
18.
Med Probl Perform Art ; 36(2): 103-107, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34079983

RESUMO

BACKGROUND: Despite growing participation in circus arts, little is known about associated injuries. Understanding injury patterns is critical for developing interventions to decrease injury risk and guiding rehabilitation. OBJECTIVE: The purpose of this pilot prospective cohort study was to describe injury frequency and characteristics in adolescent and adult circus artists using a surveillance method derived from dance. METHODS: Participants included 14 adolescent [mean age 14.7 yrs (1.3); 100% female] and 10 adult circus artists [mean age 30.7 yrs (3.1); 60% female]. Circus training exposure (single session of one circus discipline) and injuries were tracked for 1 year using a dance-derived injury surveillance guideline. A regression analysis was run using total session exposures, age (in years), and years of circus experience as predictor variables for injury rate. RESULTS: Twenty-one of 24 participants completed the study. Forty-seven injuries were reported (53.2% time loss; 46.8% non-time loss). Joint injuries were most common for both groups. The injury rate per 1,000 exposures was 3 (95%CI 0.6-8.7) for adolescents and 13 (95%CI 6.9-22.01) for adults. The overall regression was significant (F(3,13)=6.66, p=0.006). The only significant predictor was age (beta=0.82, p=0.003). Total session exposures and years of circus experience had betas close to 0 (-0.11 and -0.04, respectively). CONCLUSION: This pilot study comparing injuries in adolescent and adult circus artists found age but not exposure was predictive of injury risk. Use of a standardized injury surveillance guideline in circus, similar to the one used in this study, will provide greater insight into injury patterns by allowing between-study comparison.


Assuntos
Arte , Traumatismos em Atletas , Adolescente , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos
19.
Stud Health Technol Inform ; 282: 137-143, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085964

RESUMO

We present a pilot study on three Italian Universities using a multi-domain set of indicators for Inclusion. The indicators are expressed in the coding system of the International Classification of Functioning Disability and Health - ICF - (World Health Organization, 2001). We selected three medium-sized Italian Universities: Brescia, Trieste and Venice. We combined a student-centered Universal Design philosophy for the built environment and Universal Design for Learning for the instructional environment. We identified four ICF Environmental Chapters (E1, E3, E4 and E5) and made them specific to the Academic context. Within the four Environmental Chapters targeting the physical, instructional, cultural, communicative, social and recreational domains we developed a 35-item checklist to fill out. The indicators were qualitative, quantitative or a mixture of the two. The three Universities shared the same instruments. Our main finding is that, although accommodations for students with disabilities exist as mandated by Italian law, the prevailing implementation is an individual accommodation based approach, rather than a universal design approach for the benefit to the greatest extent of the student population.


Assuntos
Pessoas com Deficiência , Universidades , Saúde Global , Humanos , Projetos Piloto , Estudantes
20.
Stud Health Technol Inform ; 282: 361-373, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085981

RESUMO

Children's independent mobility (CIM) is associated with improved physical activity and social competence among children. Despite such benefits, there is a worldwide decline in overall CIM levels, owing to the multi-factors of the insufficient supportive built environment, traffic and negative parental perception. This paper attempts to make a unique case of relooking children's everyday mobility experiences by adopting a universal design (UD) approach. The key objectives are to (i) discuss the global evolution of CIM in comparison to UD from an Indian narrative, (ii) understand CIM though parental concerns and children's perspective, and (iii) develop a shared connection between UD goals and CIM. These objectives were achieved by a desk-based literature review followed by a qualitative pilot study within an urban neighbourhood of Delhi. Focus group discussion with twenty children in the age group of 7-12 years and personal interview sessions with fifteen parents were conducted, which were analysed using content analysis method. The literature suggests that to date, CIM has been majorly looked upon from the two-point perspective of urban planning and health. Whereas UD provides an opportunity for bringing in the dimension of 'culture' into the discussion. Especially in a culturally diverse country like India, where children and parental discussions reveal concerns of safety, familiarity and proximity to child-specific destinations as a precursor for CIM levels. Overall, this study emphasises that both CIM and UD form a complementary process overarching the aim of empowering children to move freely, promoting their health, social participation and inclusion.


Assuntos
Exercício Físico , Características de Residência , Ambiente Construído , Criança , Humanos , Índia , Projetos Piloto
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