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1.
Zhongguo Zhen Jiu ; 43(1): 3-7, 2023 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-36633231

RESUMO

This paper makes an interpretation of the collection Acupuncture: how to improve the evidence base published by BMJ & BMJ Open. Studies show that the quality of randomized controlled trial (RCT) of acupuncture is low, and multivariable Meta-regression analysis fails to confirm most factors commonly believed to influence the effect of acupuncture. The methodological challenges in design and conduct of RCT in acupuncture were analyzed, and a consensus on how to design high-quality acupuncture RCT was developed. The number of acupuncture systematic reviews was huge but the evidence was underused in clinical practice and health policy, and a large number of western clinical practice guidelines recommended acupuncture therapy, but the usefulness of recommendations needed to be improved. In view of the problems in clinical research on acupuncture mentioned in this collection, combined with the analysis of the purpose of clinical research on acupuncture, perspectives, study types, as well as the relationship between evidence and clinical decision-making, a five-stage study paradigm of clinical research on acupuncture is proposed.


Assuntos
Terapia por Acupuntura , Acupuntura , Projetos de Pesquisa , Consenso
2.
BMC Cancer ; 23(1): 21, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609248

RESUMO

BACKGROUND: The objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation. METHODS: A cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months. RESULTS: Twenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07-1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57-0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators' abilities to adapt their modus operandi, and facilitating attachment structure. CONCLUSION: The ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care. TRIAL REGISTRATION: clinicaltrials.gov NCT02369757 24/02/2015.


Assuntos
Neoplasias Colorretais , Navegação de Pacientes , Neoplasias Retais , Humanos , Pessoa de Meia-Idade , Idoso , Navegação de Pacientes/métodos , Detecção Precoce de Câncer/métodos , Projetos de Pesquisa , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Programas de Rastreamento
3.
Spine (Phila Pa 1976) ; 48(4): 270-277, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36692156

RESUMO

STUDY DESIGN: Retrospective study. OBJECTIVE: This study aimed to explore the additional value of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for the detection of early-stage and atypical spinal infections and to find the best combination of indicators from laboratory and imaging systems for higher diagnostic efficiency. SUMMARY OF BACKGROUND DATA: Diagnosis of early-stage and atypical spinal infections may be challenging for clinicians. It is particularly important to distinguish spinal infection from malignancy to develop a timely treatment strategy and avoid unnecessary biopsy or surgery. MATERIALS AND METHODS: All patients with a discharge diagnosis of spinal infection or malignancy who underwent 18F-FDG PET/CT scans before spinal biopsy between January 1, 2014, and July 30, 2021, were included. Laboratory and imaging data were assessed. A receiver operating characteristic (ROC) curve was created, and the best cut-off point and cumulated area under the curve (AUC) were obtained to distinguish between spinal infection and malignancy. Kappa values were used to assess the agreement between the 18F-FDG PET/CT and MRI findings. Binary logistic regression was used to screen for statistically significant indicators and imaging findings. RESULTS: A total of 71 patients with confirmed spinal infections (n=30) or malignancies (n=41) were included in this study. Elevated ESR and significantly elevated tumor biomarkers or positive FLCs assay were significantly different between the two groups. In addition to the total lesion glycolysis of the involved vertebral bodies derived from 18F-FDG PET/CT, four imaging findings (consecutive multilevel vertebral lesions, intervertebral disc, vertebral arch, and extraspinal involvement) also showed significant differences between the two groups (P≤0.010). A combined scoring method based on the above seven indicators was designed with an overall classification accuracy of 95.2%, and it identified all patients with spinal infections (100%, 28/28). In addition, moderate-to-excellent agreement could be reached for the involvement of intervertebral discs, paravertebral soft tissues, and vertebral arches derived from MRI and18F-FDG PET/CT. CONCLUSIONS: The combined scoring method based on 18F-FDG PET/CT provided excellent overall accuracy in distinguishing spinal infections from malignancies. This approach may prove useful for patients with MRI contraindications or with equivocal results following laboratory tests or traditional imaging when there is high suspicion for spinal infections or malignancy.


Assuntos
Fluordesoxiglucose F18 , Neoplasias , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Projetos de Pesquisa
5.
Clin Obstet Gynecol ; 66(1): 22-35, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36657045

RESUMO

Racial inequities are well-documented across the gynecologic oncology care continuum, including the representation of racial and ethnic minoritized groups (REMGs) in gynecologic oncology clinical trials. We specifically reviewed the scope of REMG disparities, contributing factors, and strategies to improve inclusion. We found systematic and progressively worsening under-enrollment of REMGs, particularly of Black and Latinx populations. In addition, race/ethnicity data reporting is poor, yet a prerequisite for accountability to recruitment goals. Trial participation barriers are multifactorial, and successful remediation likely requires multi-level strategies. More rigorous, transparent data on trial participants and effectiveness studies on REMG recruitment strategies are needed to improve enrollment.


Assuntos
Etnicidade , Neoplasias dos Genitais Femininos , Feminino , Humanos , Neoplasias dos Genitais Femininos/terapia , Grupos Raciais , Projetos de Pesquisa , Ensaios Clínicos como Assunto
7.
BMJ Open ; 13(1): e067661, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36657750

RESUMO

INTRODUCTION: Postpartum haemorrhage (PPH) is the most serious clinical problem of childbirth that contributes significantly to maternal mortality worldwide. This systematic review aims to identify predictors of PPH based on a machine learning (ML) approach. METHODS AND ANALYSIS: This review adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. The review is scheduled to begin on 10 January 2023 and end on 20 March 2023. The main objective is to identify and summarise the predictive factors associated with PPH and propose an ML-based predictive algorithm. From inception to December 2022, a systematic search of the following electronic databases of peer-reviewed journal articles and online search records will be conducted: Cochrane Central Register, PubMed, EMBASE (via Ovid), Scopus, WOS, IEEE Xplore and the Google Scholar search engine. All studies that meet the following criteria will be considered: (1) they include the general population with a clear definition of the diagnosis of PPH; (2) they include ML models for predicting PPH with a clear description of the ML models; and (3) they demonstrate the performance of the ML models with metrics, including area under the receiver operating characteristic curve, accuracy, precision, sensitivity and specificity. Non-English language papers will be excluded. Data extraction will be performed independently by two investigators. The PROBAST, which includes a total of 20 signallings, will be used as a tool to assess the risk of bias and applicability of each included study. ETHICS AND DISSEMINATION: Ethical approval is not required, as our review will include published and publicly accessible data. Findings from this review will be disseminated via publication in a peer-review journal. PROSPERO REGISTRATION NUMBER: The protocol for this review was submitted at PROSPERO with ID number CRD42022354896.


Assuntos
Hemorragia Pós-Parto , Gravidez , Feminino , Humanos , Hemorragia Pós-Parto/diagnóstico , Parto , Parto Obstétrico , Aprendizado de Máquina , Sensibilidade e Especificidade , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
8.
BMJ Open ; 13(1): e071118, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36657759

RESUMO

INTRODUCTION: The use of oral contraceptives (OCs) is linked to an increased risk of cardiovascular diseases (CVDs) in women of reproductive age. CVD remain one of the top causes of death worldwide, with at least three-quarters of deaths occurring in low-income and middle-income nations. The impact of various types of combined oral contraceptive (COC) on several modifiable risk factors associated with CVDs in premenopausal women is inconsistent regardless of genetic mutations. The aim of this systematic review will be to provide a comprehensive synthesis of the available evidence on the impact of COC usage on modifiable risk factors associated with CVDs and assess ethnic and geographic disparities in the reported prevalence of CVD. METHODS AND ANALYSIS: This systematic review protocol was prepared in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols 2015 statement. An extensive search on the Embase, MEDLINE and Cochrane Library will be conducted from inception until. Two reviewers will independently screen for eligible studies using a predefined criterion. The risk of bias and quality of included studies will be assessed using the modified Downs and Black's checklist. Whereas the overall quality of included studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation assessment tool. ETHICS AND DISSEMINATION: This is a review of existing studies and will not require ethical approval. The findings will be disseminated through peer-reviewed publication. The use of OC and the risk of CVDs including arterial and venous thrombosis remain a major concern among women of reproductive age. Thus, given the impact of COCs on the risk variables linked with CVDs, this review may provide an insight and assistance during COC use. PROSPERO REGISTRATION NUMBER: CRD42020216169.


Assuntos
Doenças Cardiovasculares , Humanos , Feminino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Anticoncepcionais Orais/efeitos adversos , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Fatores de Risco , Projetos de Pesquisa , Literatura de Revisão como Assunto
9.
BMJ Open ; 13(1): e068893, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36657764

RESUMO

INTRODUCTION: Ichthyoses comprise a heterogenous group of rare genetic skin disorders that involves the entire skin surface, often with additional syndromic features, and pose many clinical challenges. Without curative intervention, the mainstay of life-long symptom management is supportive in nature and can remain the responsibility of the caregiver. Although impact on the wider family is considered an important outcome of policies and services, there is a lack of caregiver consensus on what outcome domains to measure to fully assess the impact of ichthyosis on the patient and the caregiver. This project aims to identify a set of core outcome domains towards a core outcome set for ichthyosis that can measure all relevant concepts of ichthyosis in clinical practice, service delivery and research. METHODS AND ANALYSIS: Following the COMET (Core Outcome Measures in Effectiveness Trials) initiative, this project will employ a mixed-method study design which was developed using public and patient involvement and an international multidisciplinary expert group (clinical experts, patients and their representatives, policymakers, researchers and service providers). Experts by experience, or caregivers, will be recruited through online ichthyosis support groups. Phase one will focus on item generation and involve: (1) a systematic literature review, (2) a multimethods international qualitative study with ichthyosis caregivers and (3) co-development of items for an e-survey. Phase two, item refinement, will employ a novel four-pronged consensus approach: (1) an e-Delphi survey, (2) statistical analysis of e-Delphi survey results, (3) online qualitative feedback and (4) an online consensus discussion. All methodological considerations will be clearly linked with each Core Outcome Set-STAndards for Developing recommendation. ETHICS AND DISSEMINATION: Research Ethics Committee approval obtained from the School of Psychology, Ulster University (UK)(Ref:REC/20/0004). Results will be presented in published international peer-reviewed journals, at scientific meetings and support groups. REGISTRATION: COMET database (January 2019).


Assuntos
Ictiose , Dermatopatias , Humanos , Cuidadores , Técnica Delfos , Projetos de Pesquisa , Dermatopatias/terapia , Ictiose/terapia , Medidas de Resultados Relatados pelo Paciente , Resultado do Tratamento , Revisões Sistemáticas como Assunto
11.
BMJ Open ; 13(1): e067246, 2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36639208

RESUMO

INTRODUCTION: There is evidence to suggest that violence against paramedic personnel is increasing. Several authors report adverse effects linked to exposure to workplace violence. There remain gaps in the knowledge related to specific aspects of workplace violence experienced by paramedics in the prehospital setting. METHODS AND ANALYSIS: This scoping review will consider evidence relating to workplace violence against paramedic personnel. All types of evidence will be considered, including quantitative and qualitative studies, systematic reviews, opinion papers, grey literature, text and papers as well as unpublished materials. This scoping review will be designed and conducted in accordance with the JBI methodology for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews will guide the reporting process. Sources will include ERIC, Scopus, PubMed, CINAHL, Cochrane Library, ScienceDirect, Web of Science, Sabinet and the DOAJ as well as OpenGrey (https://opengrey.eu/). All sources published in English will be considered for inclusion and no date limit will be applied. The searching of the databases will begin 16 January 2023 and will be concluded by 30 January 2023. Three independent reviewers will conduct the study selection and data extraction process. In the event of disagreement related to a particular source, this will be resolved by discussion. The findings of the proposed review will be presented in a narrative style that uses diagrams and tables for reporting. ETHICS AND DISSEMINATION: This scoping review will use published literature available in the public domain and will involve no participants, meaning that ethical approval is not required. The findings of the proposed review will be published in topic relevant peer-reviewed journals and will be presented at associated conferences.


Assuntos
Violência no Trabalho , Humanos , Violência no Trabalho/prevenção & controle , Narração , Revisão por Pares , Pesquisa Qualitativa , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Literatura de Revisão como Assunto
12.
Int J Qual Stud Health Well-being ; 18(1): 2164948, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36606329

RESUMO

Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.


Assuntos
Projetos de Pesquisa , Resiliência Psicológica , Humanos , Pesquisa Qualitativa
13.
Pain ; 164(2): 325-335, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36638305

RESUMO

ABSTRACT: The National Institutes of Health (NIH) minimum dataset for chronic low back pain (CLBP) was developed in response to the challenge of standardizing measurements across studies. Although reference values are critical in research on CLBP to identify individuals and communities at risk of poor outcomes such as disability, no reference values have been published for the Quebec (Canada) context. This study was aimed to (1) provide reference values for the Canadian version of the NIH minimum dataset among individuals with CLBP in Quebec, both overall and stratified by gender, age, and pain impact stratification (PIS) subgroups, and (2) assess the internal consistency of the minimum data set domains (pain interference, physical function, emotional distress or depression, sleep disturbance, and PIS score). We included 2847 individuals living with CLBP who completed the baseline web survey of the Quebec Low Back Pain Study (age: 44.0 ± 11.2 years, 48.1% women) and were recruited through social media and healthcare settings. The mean score was 6.1 ± 1.8 for pain intensity. Pain interference, physical function, emotional distress or depression, sleep disturbance, and PIS scores were 12.9 ± 4.1, 14.4 ± 3.9, 9.8 ± 4.4, 13.0 ± 3.6, and 26.4 ± 6.6, respectively. Emotional distress or depression showed floor effects. Good-to-excellent internal consistency was found overall and by language, gender, and age subgroups for all domains (alpha: 0.81-0.93) and poor-to-excellent internal consistency for PIS subgroups (alpha: 0.59-0.91). This study presents reference values and recommendations for using the Canadian version of the NIH minimum dataset for CLBP that can be useful for researchers and clinicians.


Assuntos
Dor Crônica , Dor Lombar , Transtornos do Sono-Vigília , Estados Unidos , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Dor Crônica/diagnóstico , Dor Lombar/diagnóstico , Quebeque , Canadá , Comitês Consultivos , Projetos de Pesquisa , National Institutes of Health (U.S.)
14.
Anesth Analg ; 136(2): 262-269, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36638510

RESUMO

Currently, the quality of guidelines for the perioperative management of patients with obstructive sleep apnea (OSA) is unknown, leaving anesthesiologists to make perioperative management decisions with some degree of uncertainty. This study evaluated the quality of clinical practice guidelines regarding the perioperative management of patients with OSA. This study was reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of the MedlineALL (Ovid) database was conducted from inception to February 26, 2021, for clinical practice guidelines in the English language. Quality appraisal of guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework. Descriptive statistical analysis of each of the 6 domains was expressed as a percentage using the formula: (obtained score - minimum possible score)/(maximum possible score - minimum possible score). Of 192 articles identified in the search, 41 full texts were assessed for eligibility, and 10 articles were included in this review. Intraclass correlation coefficients of the AGREE II scores across the 7 evaluators for each guideline were each >0.9, suggesting that the consistency of the scores among evaluators was high. Sixty percent of recommendations were based on evidence using validated methods to grade medical literature, while the remainder were consensus based. The median and range scores of each domain were: (1) scope and purpose, 88% (60%-95%); (2) stakeholder involvement, 52% (30%-82%); (3) rigor of development, 67% (40%-90%); (4) clarity of presentation, 74% (57%-88%); (5) applicability, 46% (20%-73%); and (6) editorial independence, 67% (19%-83%). Only 4 guidelines achieved an overall score of >70%. This critical appraisal showed that many clinical practice guidelines for perioperative management of patients with OSA used validated methods to grade medical literature, such as Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and Oxford classification, with lower scores for stakeholder involvement due to lack of engagement of patient partners and applicability domain due to lack of focus on the complete perioperative period such as postdischarge counseling. Future efforts should be directed toward establishing higher focus on the quality of evidence, stakeholder involvement, and applicability to the wider perioperative patient experience.


Assuntos
Assistência ao Convalescente , Apneia Obstrutiva do Sono , Humanos , Alta do Paciente , Projetos de Pesquisa , Bases de Dados Factuais , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia
15.
Clin Radiol ; 78(2): 130-136, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36639172

RESUMO

DECIDE-AI is a new, stage-specific reporting guideline for the early and live clinical evaluation of decision-support systems based on artificial intelligence (AI). It answers a need for more attention to the human factors influencing clinical AI performance and more transparent reporting of clinical studies investigating AI systems. Given the rapid expansion of AI systems and the concentration of related studies in radiology, these new standards are likely to find a place in radiological literature in the near future. This review highlights some of the specificities of AI as complex intervention, why a new reporting guideline was needed for early stage, live evaluation of this technology, and how DECIDE-AI and other AI reporting guidelines can be useful to radiologists and researchers.


Assuntos
Inteligência Artificial , Radiologia , Humanos , Radiologistas , Radiografia , Projetos de Pesquisa
16.
BMJ Open ; 13(1): e064170, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36669835

RESUMO

OBJECTIVES: To evaluate the extent and quality of patient involvement reporting in examples of current practice in health research. DESIGN: Mixed-methods study. We used a targeted search strategy across three cohorts to identify health research publications that reported patient involvement: original research articles published in 2019 in the British Medical Journal (BMJ), articles listed in the Patient-Centered Outcomes Research Institute (PCORI) database (2019), and articles citing the GRIPP2 (Guidance for Reporting Involvement of Patients and Public) reporting checklist for patient involvement or a critical appraisal guideline for user involvement. Publications were coded according to three coding schemes: 'phase of involvement', the GRIPP2-Short Form (GRIPP2-SF) reporting checklist and the critical appraisal guideline. OUTCOME MEASURES: The phase of the study in which patients were actively involved. For the BMJ sample, the proportion of publications that reported patient involvement. The quality of reporting based on the GRIPP2-SF reporting guideline. The quality of patient involvement based on the critical appraisal guideline. Quantitative and qualitative results are reported. RESULTS: We included 86 publications that reported patient involvement. Patients were most frequently involved in study design (90% of publications, n=77), followed by study conduct (71%, n=61) and dissemination (42%, n=36). Reporting of patient involvement was often incomplete, for example, only 40% of publications (n=34) reported the aim of patient involvement. While the methods (57%, n=49) and results (59%, n=51) of involvement were reported more frequently, reporting was often unspecific and the influence of patients' input remained vague. Therefore, a systematic assessment of the quality and impact of patient involvement according to the critical appraisal guideline was not feasible across samples. CONCLUSIONS: As patient involvement is increasingly seen as an integral part of the research process and requested by funding bodies, it is essential that researchers receive specific guidance on how to report patient involvement activities. Complete reporting builds the foundation for assessing the quality of patient involvement and its impact on research.


Assuntos
Participação do Paciente , Projetos de Pesquisa , Humanos , Participação do Paciente/métodos , Publicações , Lista de Checagem
17.
BMJ Open ; 13(1): e064254, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36669844

RESUMO

OBJECTIVES: To explore factors associated with care burden and the self-described positive aspects of caring for a person living with amyotrophic lateral sclerosis (ALS) over time. DESIGN: Exploratory longitudinal mixed-methods study. SETTING: A national multidisciplinary tertiary clinic in Dublin, Ireland. PARTICIPANTS: Participants were informal caregivers of people living with ALS (plwALS) attending the national ALS/motor neuron disease Clinic Dublin. This study focuses on informal caregivers who completed five consecutive interviews (n = 17) as part of a larger multisite study, over the course of 2.5 years. Participants were over the age of 18. Formal paid caregivers were not included. OUTCOME MEASURES: Data were collected on demographic and well-being measures and an open-ended question asked about positive aspects of caregiving. Relevant statistical analysis was carried out on quantitative data and qualitative data were analysed thematically. RESULTS: The caregivers in this study were predominantly female and spouse/partners of the plwALS. Hours of care provided and self-assessed burden increased substantially over time, psychological distress reached clinical significance and quality of life remained relatively stable. Positive aspects identified were thematised as meaning in life and personal satisfaction and varied in relative frequency across phases of the caregiving trajectory. CONCLUSIONS: The co-occurrence of negative and positive factors influences the experiences of informal caregivers in ALS. It is important to explore and acknowledge positive aspects, how they develop and are sustained in order to inform supportive services. The cyclical adaptation identified in this study provides evidence for time sensitive targeted supports.


Assuntos
Esclerose Amiotrófica Lateral , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Esclerose Amiotrófica Lateral/terapia , Qualidade de Vida , Satisfação Pessoal , Projetos de Pesquisa , Cuidadores/psicologia
18.
Molecules ; 28(2)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36677576

RESUMO

The conversion of plant byproducts, which are phenolic-rich substrates, to valuable co-products by implementing non-conventional extraction techniques is the need of the hour. In the current study, ultrasound- (UAE) and microwave-assisted extraction (MAE) were applied for the recovery of polyphenols from peach byproducts. Two-level screening and Box-Behnken design were adopted to optimize extraction efficiency in terms of total phenolic content (TPC). Methanol:water 4:1% v/v was the extraction solvent. The optimal conditions of UAE were 15 min, 8 s ON-5 s OFF, and 35 mL g-1, while MAE was maximized at 20 min, 58 °C, and 16 mL g-1. Regarding the extracts' TPC and antioxidant activity, MAE emerged as the method of choice, whilst their antiradical activity was similar in both techniques. Furthermore, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated to determine chlorogenic acid and naringenin in byproducts' extracts. 4-Chloro-4'-hydroxybenzophenone is proposed as a new internal standard in LC-MS/MS analysis in foods and byproducts. Chlorogenic acid was extracted in higher yields when UAE was used, while MAE favored the extraction of the flavonoid compound, naringenin. To conclude, non-conventional extraction could be considered as an efficient and fast alternative for the recovery of bioactive compounds from plant matrices.


Assuntos
Prunus persica , Cromatografia Líquida , Espectrometria de Massas em Tandem/métodos , Micro-Ondas , Projetos de Pesquisa , Ácido Clorogênico , Extratos Vegetais/química , Fenóis/química , Antioxidantes/química
19.
Sensors (Basel) ; 23(2)2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36679545

RESUMO

Object detection and tracking is one of the key applications of wireless sensor networks (WSNs). The key issues associated with this application include network lifetime, object detection and localization accuracy. To ensure the high quality of the service, there should be a trade-off between energy efficiency and detection accuracy, which is challenging in a resource-constrained WSN. Most researchers have enhanced the application lifetime while achieving target detection accuracy at the cost of high node density. They neither considered the system cost nor the object localization accuracy. Some researchers focused on object detection accuracy while achieving energy efficiency by limiting the detection to a predefined target trajectory. In particular, some researchers only focused on node clustering and node scheduling for energy efficiency. In this study, we proposed a mobile object detection and tracking framework named the Energy Efficient Object Detection and Tracking Framework (EEODTF) for heterogeneous WSNs, which minimizes energy consumption during tracking while not affecting the object detection and localization accuracy. It focuses on achieving energy efficiency via node optimization, mobile node trajectory optimization, node clustering, data reporting optimization and detection optimization. We compared the performance of the EEODTF with the Energy Efficient Tracking and Localization of Object (EETLO) model and the Particle-Swarm-Optimization-based Energy Efficient Target Tracking Model (PSOEETTM). It was found that the EEODTF is more energy efficient than the EETLO and PSOEETTM models.


Assuntos
Algoritmos , Tecnologia sem Fio , Fenômenos Físicos , Análise por Conglomerados , Projetos de Pesquisa
20.
Sensors (Basel) ; 23(2)2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36679837

RESUMO

In order to address the shortcomings of the traditional bidirectional RRT* algorithm, such as its high degree of randomness, low search efficiency, and the many inflection points in the planned path, we institute improvements in the following directions. Firstly, to address the problem of the high degree of randomness in the process of random tree expansion, the expansion direction of the random tree growing at the starting point is constrained by the improved artificial potential field method; thus, the random tree grows towards the target point. Secondly, the random tree sampling point grown at the target point is biased to the random number sampling point grown at the starting point. Finally, the path planned by the improved bidirectional RRT* algorithm is optimized by extracting key points. Simulation experiments show that compared with the traditional A*, the traditional RRT, and the traditional bidirectional RRT*, the improved bidirectional RRT* algorithm has a shorter path length, higher path-planning efficiency, and fewer inflection points. The optimized path is segmented using the dynamic window method according to the key points. The path planned by the fusion algorithm in a complex environment is smoother and allows for excellent avoidance of temporary obstacles.


Assuntos
Robótica , Algoritmos , Simulação por Computador , Registros , Projetos de Pesquisa
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