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1.
Urol Clin North Am ; 49(1): 11-22, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776045

RESUMO

BPH is a common disease in aging men which impacts quality of life. With advancing age expectation coupled with the rising demand for BPH therapy, new technologies have been developed that target rapid recovery and symptom relief, low complication rates, and the ability to perform the procedure in an outpatient setting with local anesthesia. MIST technologies have fostered BPH medical care with ejaculation preservation. Techniques and outcomes for BPH technologies including Aquablation, Rezum, UroLift, iTind, Optilume BPH, XFLO, Zenflow, and Butterfly are reviewed and evaluated. Given the novelty of these technologies, long-term data are required to assess safety and efficacy.


Assuntos
Técnicas de Ablação , Hiperplasia Prostática/cirurgia , Próteses e Implantes , Cateteres Urinários , Técnicas de Ablação/efeitos adversos , Ligas , Antineoplásicos Fitogênicos/uso terapêutico , Dilatação/instrumentação , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Paclitaxel/uso terapêutico , Próteses e Implantes/efeitos adversos , Procedimentos Cirúrgicos Robóticos , Vapor , Cateteres Urinários/efeitos adversos
2.
Urol Clin North Am ; 49(1): 119-128, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776046

RESUMO

Although percutaneous nephrolithotomy (PCNL) is less morbid than open surgery, it still carries risks of significant complications as well as injury to the renal parenchyma. Flexible ureteroscopic stone removal, although causes no appreciable damage to the renal parenchyma, has limitations, most notably, a lower stone-free rate than PCNL. Advances in our knowledge regarding ureteral physiology combined with technical developments applied to ureteral access sheath deployment and size may well propel retrograde intrarenal surgery to the forefront of kidney stone removal, regardless of stone size or location.


Assuntos
Cálculos Renais/cirurgia , Litotripsia a Laser , Nefrolitotomia Percutânea/efeitos adversos , Nefrolitotomia Percutânea/métodos , Ureteroscopia , Humanos , Ureteroscopia/instrumentação
3.
Urol Clin North Am ; 49(1): 185-196, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776051

RESUMO

Ureteral stents are an indispensable part of any (endo-) urologic practice. Despite the widely demonstrated advantages of stents, they also carry a considerable risk of side effects and complications, such as urinary symptoms, pain, hematuria, decreased quality of life, stent-related infection, and encrustation. Multiple pathways in preventing or mitigating these side effects and complications and improving stent efficacy have been and are being investigated, including stent architecture and design, biomaterials, and coatings. This article provides an update on currently researched and available stents as well as future perspectives.


Assuntos
Biofilmes , Desenho de Equipamento , Stents , Implantes Absorvíveis , Materiais Biocompatíveis , Drenagem/instrumentação , Humanos , Silicones , Stents/efeitos adversos , Ureter , Ureteroscopia/efeitos adversos
4.
J Sci Food Agric ; 102(1): 121-131, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34060085

RESUMO

BACKGROUND: The present study investigated the sensory acceptance, oxidative damage and protection, and possible anatomical-structural damage of cells from the surface of shapes of minimally processed yam. The tubers were minimally processed into the peeled rondelle, dice and 'chateau cut' (chateau) shapes, the latter of which was obtained after performing the abrasion technique. Control treatment corresponded to the rondelle shape with the periderm. The pieces were kept packed at 5 ± 2 °C for 14 days. RESULTS: Peeled rondelle and chateau were sensorially the most well-accepted yam shapes and achieved the highest purchase intention. The enzymes were partially modulated by the detected H2 O2 levels. Oxidative burst lasted longer in the minimally processed tissues than in the control. Polyphenol oxidase activity showed a clear difference in behavior between the minimally processed pieces and the control. Minimal processing induced transient increases in phenolic compounds, for which the expression was lowest in the abraded pieces. On the other hand, these pieces exhibited greater cell collapse on the surface of the amyliferous parenchyma. CONCLUSION: Based on the results of the trained panel, the abrasion technique is an alternative to provide shapes that are better accepted and marketable, more resistant to browning, and can be stored for up to 12 days. Resistance to browning may be related to a more efficient modulation of enzymatic antioxidant systems and intense deposition of cell debris on the surface of the amyliferous parenchyma. © 2021 Society of Chemical Industry.


Assuntos
Comportamento do Consumidor , Dioscorea/química , Manipulação de Alimentos/métodos , Catecol Oxidase/análise , Catecol Oxidase/metabolismo , Dioscorea/metabolismo , Manipulação de Alimentos/instrumentação , Humanos , Fenóis/análise , Fenóis/metabolismo , Tubérculos/química , Tubérculos/metabolismo
5.
J Sci Food Agric ; 102(1): 206-213, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34061354

RESUMO

BACKGROUND: Fish oil is an important source of healthy ω-3 fatty acids to be used in functional foods. However, its autoxidation susceptibility, aroma and solubility make it difficult to use. Its encapsulation could reduce these disadvantages. This manuscript focuses on the drying stage of the encapsulation process. Its objective was to study the encapsulation of fish oil with soy proteins by emulsification and lyophilization and compare microparticles characteristics with those processed identically but spray dried. RESULTS: Microparticles with different protein/oil ratios were prepared by emulsification and lyophilization. Soy proteins encapsulated fish oil in matrix-type microcapsules masking its typical odor and oily appearance. Microparticles dried by lyophilization showed a better solid recovery but lower encapsulation efficiency than those spray dried. Increasing protein/oil mass ratio of initial formulations seemed to favor initial lipid oxidation, but these differences were not appreciated when analyzing the oxidative stability over time (measured by Rancimat test). Porous structure and large surface area of lyophilized samples would favor oxygen easy penetration and exposition to free radicals, increasing lipid oxidation over time, while spray dried microparticles showed a good oxidative stability over time, like that of free oil. CONCLUSION: Drying processes were determinants in the morphology of microcapsules, the efficiency of encapsulation and protection exerted on the oil. Although emulsifying and drying processes caused certain initial oil oxidation, soy proteins managed to mask fish oil flavors and spray dried systems showed a good perspective of oxidative stability of fish oil over time, better than that of lyophilized microparticles. © 2021 Society of Chemical Industry.


Assuntos
Composição de Medicamentos/métodos , Óleos de Peixe/química , Proteínas de Soja/química , Cápsulas/química , Dessecação , Composição de Medicamentos/instrumentação , Estabilidade de Medicamentos , Liofilização , Oxirredução
6.
J Sci Food Agric ; 102(1): 214-222, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34061363

RESUMO

BACKGROUND: Fresh shiitake mushrooms are rich in nutrients, but have high water content, a fast metabolism after harvest, and deteriorate extremely easily. Therefore, the drying of shiitake mushrooms has become a research direction. However, the role of different drying techniques on shiitake mushroom quality is limited. Therefore, the purpose of this study was to investigate the effect of thermal and non-thermal drying on the drying kinetics, and the physicochemical properties of the end product. RESULTS: Results showed that shiitake mushroom treated with non-thermal drying (vacuum freeze-drying) had an attractive color, low shrinkage, and uniform honeycomb structure, while the drying time was the longest and not conducive to the formation of shiitake mushroom aroma. But shiitake mushroom treated with thermal drying presents an attractive fragrance. In thermal processing technology, compared with hot air convection drying (HAD), infrared hot air convection drying (IRHAD) shortens the drying time by 37.5%, and had the highest oxidation resistance, polysaccharide content and the lowest color change. Relative-humidity drying (RHD) samples had the lowest shrinkage compared with other thermal processing technology. The five polysaccharides exhibited similar preliminary structural characteristics, but the polysaccharides obtained by IRHAD have the highest antioxidant properties. CONCLUSION: These results showed that compared with thermal drying technology, non-thermal drying technology is not suitable for shiitake mushroom processing. In thermal processing technology, IRHAD is a potential drying method to obtain high-quality dried shiitake mushrooms and shiitake mushroom polysaccharide (SMP). However, it is necessary to increase the pretreatment technology to achieve the attractive appearance of non-thermal drying technology. © 2021 Society of Chemical Industry.


Assuntos
Dessecação/métodos , Conservação de Alimentos/métodos , Cogumelos Shiitake/química , Antioxidantes/química , Dessecação/instrumentação , Conservação de Alimentos/instrumentação , Temperatura Alta , Cinética , Água/química
7.
J Sci Food Agric ; 102(1): 425-433, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34143901

RESUMO

BACKGROUND: Apple wine is a popular alcoholic beverage for its nutrition and fresh taste. However, the methanol existing in apple wine restricts its quality. Unfortunately, there are no methods to reduce the methanol content in fruit wine. To this end, bentonite (B), calcium chloride (CC) and their combination (B&CC) were added into apple juice in this study. The treated juice (0) and supernatant obtained by standing the juice at 25 °C for 24 h were fermented at 25 °C and 10 °C, respectively. RESULTS: Bentonite was an excellent methanol interrupter, a pectin retainer and a wine quality defender both at 25 and 10 °C. The lowest methanol content of 1.41 mg L-1 and higher pectin content of 84.74 mg L-1 were reached in the finished wine by B0 at 10 °C. Calcium chloride decreased pectin content, elevated methanol content and changed the profile of individual organic acids. In fact, the wine by B&CC0 at 25 °C showed dramatic changes in individual organic acids. The content of l-malic acid and succinic acid was only 2.22% and 6.29% of the control, respectively, while the lactic acid content was 17.72 times that of the control. CONCLUSIONS: It is suggested that B0 and fermented at 10 °C was the most effective way to decrease methanol content, retain pectin content and defend wine quality. © 2021 Society of Chemical Industry.


Assuntos
Bebidas Alcoólicas/análise , Bentonita/química , Cloreto de Cálcio/química , Manipulação de Alimentos/métodos , Malus/química , Fermentação , Manipulação de Alimentos/instrumentação , Frutas/química , Metanol/química , Pectinas/química
8.
Breast Dis ; 41(1): 1-3, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34219707

RESUMO

During the first hit of SARS-COVID pandemic, an important reorganization of Healthcare Services has been done, and new protocols and pathways to protect frail patients like oncological patients were designed. The second hit of pandemic had stressed these new pathways and suggests to health-workers some improvements for safer management of patents.We reported our experience in organizing the clinical pathway of neoadjuvant therapy candidate patients based on the execution of sentinel lympho-node biopsy and the placement of implantable venous access port in the same access to operating room before neoadjuvant chemotherapy suggesting a possible organizational model. In the period October-December 2020 we have included in this new type of path twelve patients and we have not registered any cases of COVID among the patients included. We think this new path, adopted amid the second hit, will be useful for all Breast Units that are facing the challenge of guaranteeing the highest standards of care in a historical moment where the health emergency occupies the efforts of health workers and the economic resources of health systems.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , COVID-19/prevenção & controle , Cateterismo Venoso Central/métodos , Controle de Infecções/métodos , Segurança do Paciente , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/normas , Cateteres Venosos Centrais , Quimioterapia Adjuvante , Procedimentos Clínicos , Feminino , Humanos , Controle de Infecções/normas , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela/normas
9.
Anticancer Res ; 41(11): 5365-5375, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732406

RESUMO

Reconstructive breast surgery following total or partial mastectomy can be performed using autologous tissues or breast implants, and each has its own set of complications. Most women do not experience significant complications and are highly satisfied but breast reconstruction must consider potential complications from surgical techniques, as well as additional complications that may arise from oncological treatment modalities such as radiation therapy and chemotherapy. The aim of this article is to provide a systemic overview of possible complications that may arise in the course of reconstructive breast surgery. Complications associated with flap-based or implant-based breast reconstruction can be classified as: i) Complications inherent to surgery and common to all, including seroma, bleeding, and hematoma; skin necrosis; and infection, among others. ii) Complications specifically related to reconstruction, such as flap ischemia/necrosis/loss; fat necrosis; implant capsular contracture; implant failure, exposure, or malposition. In conclusion, this overview of possible complications is intended to improve the decision-making process when considering breast reconstruction.


Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Mastectomia , Complicações Pós-Operatórias/etiologia , Implante Mamário/instrumentação , Tomada de Decisão Clínica , Feminino , Humanos , Mamoplastia/instrumentação , Mastectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Desenho de Prótese , Qualidade de Vida , Medição de Risco , Fatores de Risco , Resultado do Tratamento
10.
Anticancer Res ; 41(11): 5821-5825, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732457

RESUMO

AIM: Anastomotic leakage (AL) in left-sided colorectal cancer is a serious complication, with an incidence rate of 6-18%. We developed a novel predictive model for AL in colorectal surgery with double-stapling technique (DST) anastomosis using auto-artificial intelligence (AI). PATIENTS AND METHODS: A total of 256 patients who underwent curative surgery for left-sided colorectal cancer between 2017 and 2021 were included. In addition to conventional clinicopathological factors, we included the type of circular stapler using DST, conventional double-row circular stapler (DCS) or EEA™ circular stapler with Tri-Staple™ technology, 28 mm Medium/Thick (Covidien, New Haven, CT, USA) which had triple-row circular stapler (TCS) as a covariate. Auto-AI software Prediction One (Sony Network Communications Inc.) was used to predict AL with 5-fold cross validation. Predictive accuracy was assessed using the area under the receiver operating characteristic curve. Prediction One also evaluated the 'importance of variables' (IOV) using a method based on permutation feature importance. RESULTS: The area under the curve of the AI model was 0.766. The type of circular stapler used was the most influential factor contributing to AL (IOV=0.551). CONCLUSION: This auto-AI predictive model demonstrated an improvement in accuracy compared to the conventional model. It was suggested that use of a TCS may contribute to a reduction in the AL rate.


Assuntos
Fístula Anastomótica/etiologia , Colectomia/efeitos adversos , Neoplasias Colorretais/cirurgia , Técnicas de Apoio para a Decisão , Aprendizado de Máquina , Grampeamento Cirúrgico/efeitos adversos , Idoso , Fístula Anastomótica/diagnóstico , Bases de Dados Factuais , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Grampeadores Cirúrgicos , Grampeamento Cirúrgico/instrumentação , Fatores de Tempo , Resultado do Tratamento
11.
J Infect Dev Ctries ; 15(10): 1376-1383, 2021 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-34780358

RESUMO

INTRODUCTION: The first case of severe acute respiratory syndrome 2 (SARS-CoV-2) was imported to Pakistan in February 2020, since then 8,260 deaths have been witnessed. The virus has been constantly mutating and local transmission cases from different countries vary due to host dependent viral adaptation. Many distinct clusters of variant SARS-CoV-2 have been defined globally. In this study, the epidemiology of SARS-CoV-2 was studied and locally transmitted SARS-CoV-2 isolates from Karachi were sequenced to compared and identify any possible variants. METHODOLOGY: The real time PCR was performed on nasopharyngeal specimen to confirm SARS-CoV-2 with Orf 1ab and E gene as targets. The virus isolates were sequenced through oxford nanopore technology MinION platform. Isolates from the first and second wave of COVID-19 outbreak in Karachi were compared. RESULTS: The overall positivity rate for PCR was 26.24% with the highest number of positive cases in June. Approximately, 37.45% PCR positive subjects aged between 19-40 years. All the isolates belonged to GH clade and shared missense mutation D614G in spike protein linked to increased transmission rate worldwide. Another spike protein mutation A222V coexisted with D614G in the virus from the second wave of COVID-19. CONCLUSIONS: Based on the present findings it is suggested that the locally transmitted virus from Karachi varies from those reported from other parts of Pakistan. Slight variability was also observed between viruses from the first and second wave. Variability in any potential vaccine target may result in failed trials, therefore information on any local viral variants is always useful for effective vaccine design and/or selection.


Assuntos
COVID-19/transmissão , Genoma Viral , Nanoporos , Nasofaringe/virologia , SARS-CoV-2/genética , Sequenciamento Completo do Genoma/métodos , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Paquistão , Filogenia , Reação em Cadeia da Polimerase , Sequenciamento Completo do Genoma/instrumentação , Adulto Jovem
12.
JAMA Netw Open ; 4(11): e2134315, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34767022

RESUMO

Importance: The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. Objective: To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. Design, Setting, and Participants: This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020. Exposures: Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scale. Main Outcomes and Measures: The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Results: Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (ß = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (ß = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (ß = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (ß = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86). Conclusions and Relevance: This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women's careers and well-being.


Assuntos
Transtornos Mentais/diagnóstico , Pais , Fatores Sexuais , Equilíbrio Trabalho-Vida/normas , Adulto , COVID-19/prevenção & controle , Relações Familiares/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários , Equilíbrio Trabalho-Vida/estatística & dados numéricos
14.
Am J Orthod Dentofacial Orthop ; 160(5): 648-658, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34752255

RESUMO

INTRODUCTION: The aim of this single-blinded, parallel-group, randomized clinical trial was to compare the efficacy of electric 3-dimensional (3D) toothbrushes and manual toothbrushes in removing plaque and reducing gingival inflammation in orthodontic patients. METHODS: Eighty adolescents with fixed orthodontic appliances in both arches were randomized at a 1:1 ratio, with an equal number of both sexes, in this examiner blinded, parallel clinical trial. Eligibility criteria included subjects aged between 12 and 16 years, good general health, nonextraction orthodontic treatment, and plaque-induced gingivitis, excluding patients with active caries or periodontitis, tooth agenesis, syndromes, disabilities, and craniofacial deformities, ≥2 cervical and/or proximal fillings, dental prostheses or dental implants, and subjects smoking or using antibiotics or medication predisposing to gingival enlargement. Patients were assigned to use either an electric 3D orthodontic toothbrush (Oral-B Pro-1000 with Oral-B Ortho head; Procter & Gamble, Cincinnati, Ohio) or a manual toothbrush (Oral-B Orthodontic brush; Procter & Gamble) and instructed to brush twice daily for 2 minutes. The main outcomes were: (1) plaque removal, assessed with the Modified Silness and Löe plaque index and the Modified Full Mouth Plaque Score, and (2) gingival inflammation reduction, assessed with the Modified Silness and Löe Gingival Index and the Modified Simplified Gingival Index. Measurements were taken at baseline, 1, 2, and 3 months. Randomization was achieved with 2 random sequences, one for each brush, written and sealed in opaque numbered envelopes. Blinding was possible for outcome assessment only. RESULTS: Considerable variability was observed among patients in the values of all dependent variables. There was no difference between interventions over time for any of the outcomes, and the main effects for treatment and time were also not statistically significant. For Modified Silness and Löe plaque index, the interaction was 0.001 (95% confidence interval, -0.011 to 0.013; P = 0.89). CONCLUSIONS: No difference in plaque removal efficacy and gingival inflammation reduction was found between the electric 3D and manual toothbrushes in adolescents with fixed orthodontic appliances. Therefore, orthodontists should focus on enhancing their patients' dental awareness and oral hygiene, along with professional prophylaxis and other oral hygiene aids, independently of the brush used. REGISTRATION: This trial was registered at ClinicalTrials.gov (Identifier: NCT02699931). PROTOCOL: The protocol was not published before trial commencement. FUNDING: Electric and manual toothbrushes and toothpastes for all participants were provided by Procter & Gamble (Oral-B). Miscellaneous costs were covered by the participating departments.


Assuntos
Gengivite , Saúde Bucal , Escovação Dentária , Adolescente , Criança , Índice de Placa Dentária , Desenho de Equipamento , Feminino , Gengivite/etiologia , Gengivite/prevenção & controle , Humanos , Masculino , Aparelhos Ortodônticos/efeitos adversos , Aparelhos Ortodônticos Fixos/efeitos adversos , Método Simples-Cego , Escovação Dentária/instrumentação , Escovação Dentária/métodos
15.
Glob Health Res Policy ; 6(1): 38, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593052

RESUMO

BACKGROUND: The onset of the COVID-19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in countries like Zambia. Thus, with the help of the Social Representation Theory (SRT), we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia. METHODS: We recruited our participants through convenient and purposive sampling techniques. This was done through the use of the ZAMTEL public phone records. Initial contact was made to potential participants, and they were asked of their availability and willingness to participate in the interview. Upon agreeing to participate, they were included in the sample. A total of 68 people were selected to take part in this study. Their age ranged from 20 to 76 years old. 33 of them were male and 35 females. After this, we conducted interviews with the 68 participants. Due to COVID-19 restrictions, our interviews were conducted via telephone in conformity with the recommendations from the IRB in Lusaka and the advice of the ministry of health. We anonymized the demographic characteristics and responses from our participants. Later, thematic analysis was used to analyze the data. RESULTS: The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender-based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to COVID-19 in Lusaka, Zambia. This observation demonstrates the folly of viewing, applying and characterizing the COVID-19 lockdown as a 'one-size-fits-all' approach in Lusaka, Zambia. CONCLUSION: Rather than establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Lusaka residents. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , COVID-19/psicologia , Cidades , Controle de Doenças Transmissíveis/instrumentação , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto Jovem , Zâmbia
16.
Sci Rep ; 11(1): 19910, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620887

RESUMO

Face masks are a primary preventive measure against airborne pathogens. Thus, they have become one of the keys to controlling the spread of the COVID-19 virus. Common examples, including N95 masks, surgical masks, and face coverings, are passive devices that minimize the spread of suspended pathogens by inserting an aerosol-filtering barrier between the user's nasal and oral cavities and the environment. However, the filtering process does not adapt to changing pathogen levels or other environmental factors, which reduces its effectiveness in real-world scenarios. This paper addresses the limitations of passive masks by proposing ADAPT, a smart IoT-enabled "active mask". This wearable device contains a real-time closed-loop control system that senses airborne particles of different sizes near the mask by using an on-board particulate matter (PM) sensor. It then intelligently mitigates the threat by using mist spray, generated by a piezoelectric actuator, to load nearby aerosol particles such that they rapidly fall to the ground. The system is controlled by an on-board micro-controller unit that collects sensor data, analyzes it, and activates the mist generator as necessary. A custom smartphone application enables the user to remotely control the device and also receive real-time alerts related to recharging, refilling, and/or decontamination of the mask before reuse. Experimental results on a working prototype confirm that aerosol clouds rapidly fall to the ground when the mask is activated, thus significantly reducing PM counts near the user. Also, usage of the mask significantly increases local relative humidity levels.


Assuntos
COVID-19/prevenção & controle , Exposição por Inalação/prevenção & controle , Máscaras , Material Particulado/isolamento & purificação , Dispositivos de Proteção Respiratória , SARS-CoV-2/isolamento & purificação , Aerossóis/isolamento & purificação , Microbiologia do Ar , Desenho de Equipamento , Filtração/instrumentação , Humanos , Aplicativos Móveis , Tamanho da Partícula , Materiais Inteligentes/química , Smartphone
17.
Sci Rep ; 11(1): 19930, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620923

RESUMO

Transmission of SARS-CoV-2 by aerosols has played a significant role in the rapid spread of COVID-19 across the globe. Indoor environments with inadequate ventilation pose a serious infection risk. Whilst vaccines suppress transmission, they are not 100% effective and the risk from variants and new viruses always remains. Consequently, many efforts have focused on ways to disinfect air. One such method involves use of minimally hazardous 222 nm far-UVC light. Whilst a small number of controlled experimental studies have been conducted, determining the efficacy of this approach is difficult because chamber or room geometry, and the air flow within them, influences both far-UVC illumination and aerosol dwell times. Fortunately, computational multiphysics modelling allows the inadequacy of dose-averaged assessment of viral inactivation to be overcome in these complex situations. This article presents the first validation of the WYVERN radiation-CFD code for far-UVC air-disinfection against survival fraction measurements, and the first measurement-informed modelling approach to estimating far-UVC susceptibility of viruses in air. As well as demonstrating the reliability of the code, at circa 70% higher, our findings indicate that aerosolized human coronaviruses are significantly more susceptible to far-UVC than previously thought.


Assuntos
Coronavirus Humano 229E/efeitos da radiação , Infecções por Coronavirus/prevenção & controle , Coronavirus Humano OC43/efeitos da radiação , Desinfecção/métodos , Raios Ultravioleta , Inativação de Vírus/efeitos da radiação , Aerossóis/isolamento & purificação , Microbiologia do Ar , COVID-19/prevenção & controle , Simulação por Computador , Coronavirus Humano 229E/isolamento & purificação , Coronavirus Humano 229E/fisiologia , Coronavirus Humano OC43/isolamento & purificação , Coronavirus Humano OC43/fisiologia , Desinfecção/instrumentação , Desenho de Equipamento , Humanos , Modelos Biológicos
18.
Sci Rep ; 11(1): 19470, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593848

RESUMO

The germicidal potential of specific wavelengths within the electromagnetic spectrum is an area of growing interest. While ultra-violet (UV) based technologies have shown satisfactory virucidal potential, the photo-toxicity in humans coupled with UV associated polymer degradation limit their use in occupied spaces. Alternatively, longer wavelengths with less irradiation energy such as visible light (405 nm) have largely been explored in the context of bactericidal and fungicidal applications. Such studies indicated that 405 nm mediated inactivation is caused by the absorbance of porphyrins within the organism creating reactive oxygen species which result in free radical damage to its DNA and disruption of cellular functions. The virucidal potential of visible-light based technologies has been largely unexplored and speculated to be ineffective given the lack of porphyrins in viruses. The current study demonstrated increased susceptibility of lipid-enveloped respiratory pathogens of importance such as SARS-CoV-2 (causative agent of COVID-19) and influenza A virus to 405 nm, visible light in the absence of exogenous photosensitizers thereby indicating a potential alternative porphyrin-independent mechanism of visible light mediated viral inactivation. These results were obtained using less than expected irradiance levels which are considered safe for humans and commercially achievable. Our results support further exploration of the use of visible light technology for the application of continuous decontamination in occupied areas within hospitals and/or infectious disease laboratories, specifically for the inactivation of respiratory pathogens such as SARS-CoV-2 and Influenza A.


Assuntos
Desinfecção/métodos , Vírus da Influenza A Subtipo H1N1/efeitos da radiação , SARS-CoV-2/efeitos da radiação , Desinfecção/instrumentação , Relação Dose-Resposta à Radiação , Vírus da Encefalomiocardite/efeitos da radiação , Luz , Fatores de Tempo , Inativação de Vírus/efeitos da radiação
19.
Nat Commun ; 12(1): 5804, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34608155

RESUMO

During the last decade, cardiac optogenetics has turned into an essential tool for investigating cardiac function in general and for assessing functional interactions between different myocardial cell types in particular. To advance exploitation of the unique research opportunities offered by this method, we develop a panoramic opto-electrical measurement and stimulation (POEMS) system for mouse hearts. The core of the experimental platform is composed of 294 optical fibers and 64 electrodes that form a cup which embraces the entire ventricular surface of mouse hearts and enables straightforward 'drop&go' experimentation. The flexible assignment of fibers and electrodes to recording or stimulation tasks permits a precise tailoring of experiments to the specific requirements of individual optogenetic constructs thereby avoiding spectral congestion. Validation experiments with hearts from transgenic animals expressing the optogenetic voltage reporters ASAP1 and ArcLight-Q239 demonstrate concordance of simultaneously recorded panoramic optical and electrical activation maps. The feasibility of single fiber optical stimulation is proven with hearts expressing the optogenetic voltage actuator ReaChR. Adaptation of the POEMS system to larger hearts and incorporation of additional sensors can be achieved by redesigning the system-core accordingly.


Assuntos
Coração/fisiologia , Optogenética/métodos , Animais , Técnicas Eletrofisiológicas Cardíacas , Frequência Cardíaca , Potenciais da Membrana , Camundongos , Camundongos Transgênicos , Miócitos Cardíacos/fisiologia , Optogenética/instrumentação , Imagens com Corantes Sensíveis à Voltagem
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