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1.
Rev. bras. med. esporte ; 29(spe1): e2022_0198, 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1394847

RESUMEN

ABSTRACT Introduction Many countries have increased their investments in human resources and technology for the internal development of competitive sports, leading the world sports scene to increasingly fierce competition. Coaches and research assistants must place importance on feedback tools for frequent training of college athletes, and deep learning algorithms are an important resource to consider. Objective To develop and validate a swarm algorithm to examine the fitness of athletes during periods of competition. Methods Based on the swarm intelligence algorithm, the concept, composition, and content of physical exercises were analyzed. Combined with the characteristics of events, the body function files and the comprehensive evaluation system for high-level athletes were established. Results The insight was obtained that the constant mastery of the most advanced techniques and tactics by athletes is an important feature of modern competitive sports. Physical fitness is not only a valuable asset for athletes but also one of the keys to success in competition. Conclusion Fitness has become an increasingly prominent issue in competition, and the scientific training of contemporary competitive sports has been increasingly refined. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução Muitos países aumentaram seus investimentos em recursos humanos e tecnologia para o desenvolvimento interno de esportes competitivos, levando o cenário esportivo mundial a uma disputa cada vez mais acirrada. Treinadores e assistentes de pesquisa devem dar importância às ferramentas de feedback para o treinamento frequente dos atletas universitários e os algoritmos de aprendizado profundo são um importante recurso a ser levado em consideração. Objetivo Desenvolver e validar um algoritmo de enxame para examinar o condicionamento físico dos atletas em períodos de competição. Métodos Com base no algoritmo de inteligência de enxame, o conceito, composição e conteúdo de exercícios físicos foram analisados. Combinado com as características dos eventos, os arquivos de funções corporais e o sistema abrangente de avaliação de atletas de alto nível foram estabelecidos. Resultados Obteve-se a percepção de que o constante domínio das técnicas e táticas mais avançadas pelos atletas é uma característica importante dos esportes competitivos modernos. A aptidão física não é apenas um ativo valioso para os atletas, mas também uma das chaves para o sucesso nas competições. Conclusão A aptidão física tem se tornado cada vez mais um problema proeminente na competição, sendo o treinamento científico dos esportes competitivos contemporâneos cada vez mais aperfeiçoado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción Muchos países han aumentado sus inversiones en recursos humanos y tecnología para el desarrollo interno del deporte de competición, lo que ha llevado al panorama deportivo mundial a una competencia cada vez más feroz. Los entrenadores y asistentes de investigación deben dar importancia a las herramientas de retroalimentación para el entrenamiento frecuente de los atletas universitarios y los algoritmos de aprendizaje profundo son un recurso importante a tener en cuenta. Objetivo Desarrollar y validar un algoritmo de enjambre para examinar el estado físico de los atletas durante los periodos de competición. Métodos A partir del algoritmo de inteligencia de enjambre, se analizó el concepto, la composición y el contenido de los ejercicios físicos. En combinación con las características de los eventos, se establecieron los archivos de funciones corporales y el sistema de evaluación integral de los atletas de alto nivel. Resultados Se obtuvo la conclusión de que el dominio constante de las técnicas y tácticas más avanzadas por parte de los atletas es una característica importante de los deportes de competición modernos. La forma física no sólo es un activo valioso para los deportistas, sino también una de las claves del éxito en las competiciones. Conclusión La aptitud física se ha convertido en una cuestión cada vez más importante en la competición, y el entrenamiento científico de los deportes de competición contemporáneos es cada vez mejor. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

2.
Sci Rep ; 12(1): 15694, 2022 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-36127382

RESUMEN

Rocky desertification is a serious ecological and environmental problem in Southwest China. Quickly and scientifically reveal the distribution and changes of ecological environment quality in rocky desertification areas, which is of great significance to rocky desertification restoration, ecological environment governance and sustainable development. Based on the remote sensing ecological index (RSEI), in addition to greenness, humidity, dryness, and heat, combined with the degree of rocky desertification, this study used the principal component analysis (PCA) method to construct a modified remote sensing ecological index (MRSEI). Then, the temporal and spatial variation characteristics and imaging factors of the ecological environment quality in the typical rocky desertification region of southeastern Chongqing from 2001 to 2021 were explored. The results revealed that the greenness and humidity indicators had a positive effect on the ecological quality, while the indicators of dryness, heat and rocky desertification had the opposite impact. From 2001 to 2021, the ecological environment quality in southeastern Chongqing showed a trend of gradual improvement, and the improvement area accounted for about 70% of the total area. The elevation, slope, monthly average precipitation, and land use pattern were the main factors influencing the quality of the ecological environment in the region.


Asunto(s)
Ecosistema , Tecnología de Sensores Remotos , China , Ambiente , Monitoreo del Ambiente/métodos
3.
J Manag Care Spec Pharm ; 28(10): 1190-1196, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36125060

RESUMEN

BACKGROUND: Recent attention to value frameworks has highlighted limitations of current conventional value and health technology assessment (V/HTA) methods (eg, cost-effectiveness). Multicriteria decision analysis (MCDA) has potential as a supplemental tool to incorporate additional value criteria into conventional value assessment. OBJECTIVE: To conduct a pilot study to illustrate the impact of an MCDA approach on the value perceptions of hypothetical treatment profiles from a multistakeholder panel. METHODS: Participants voted on value perceptions of 2 hypothetical treatments with similar cost-effectiveness evidence: Treatment A for aggressive B-cell non-Hodgkin lymphoma in adults and treatment B for episodic migraine in adults. Participants voted treatments A and B as low, intermediate, or high value before and after a weighting exercise on prespecified, additional value criteria. Weights from participants were used to calculate treatment-specific MCDA scores from 0 (least favorable) to 100 (most favorable) and were presented to participants for a second value-perception vote. Analyses compared changes in value perceptions within treatments A and B post-MCDA exercise. RESULTS: Before considering MCDA scores for treatment A, 0% of participants considered it to be low, 52% intermediate, and 48% high value. After considering MCDA scores for treatment A, 4% considered it low, 29% intermediate, and 67% high value. Both before and after considering MCDA scores for treatment B, 13%, considered it low, 57% intermediate, and 30% high value. Mean MCDA scores for treatments A and B were 67 and 63, respectively. Of all stakeholders, 41% altered their perception of value for treatment A (9% negatively and 32% positively) and, separately, 45% for treatment B (23% both negatively and positively) after considering MCDA scores. CONCLUSIONS: With nearly half of participants altering their perception of value after consideration of additional value criteria, findings support the need for a more inclusive and flexible value assessment process. DISCLOSURES: This study was funded by The National Pharmaceutical Council. Dr Perfetto was employed by the National Health Council (NHC) at the time this work was completed, and all honoraria and consulting and travel fees were paid to the NHC. The NHC is a not-for-profit, membership organization. It is supported through membership dues and sponsorship funds. The complete list of members and sponsors is located on the NHC's website at www.nationalhealthcouncil.org. She is also an advisor for the Brain Injury Association of America, Dan Lewis Foundation, and Canter for Medical Technology Policy.


Asunto(s)
Técnicas de Apoyo para la Decisión , Evaluación de la Tecnología Biomédica , Adulto , Femenino , Humanos , Percepción , Preparaciones Farmacéuticas , Proyectos Piloto , Evaluación de la Tecnología Biomédica/métodos , Estados Unidos
4.
PLoS One ; 17(9): e0274579, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36094948

RESUMEN

The Trail-Making-Test (TMT) is one of the most widely used neuropsychological tests for assessing executive functions, the brain functions underlying cognitively controlled thought and action. Obtaining a number of test scores at once, the TMT allows to characterize an assortment of executive functions efficiently. Critically, however, as most test scores are derived from test completion times, the scores only provide a summary measure of various cognitive control processes. To address this problem, we extended the TMT in two ways. First, using a computerized eye-tracking version of the TMT, we added specific eye movement measures that deliver a richer set of data with a higher degree of cognitive process specificity. Second, we included an experimental manipulation of a fundamental executive function, namely participants' ability to emphasize speed or accuracy in task performance. Our study of healthy participants showed that eye movement measures differed between TMT conditions that are usually compared to assess the cognitive control process of alternating between task sets for action control. This demonstrates that eye movement measures are indeed sensitive to executive functions implicated in the TMT. Crucially, comparing performance under cognitive control sets of speed vs. accuracy emphasis revealed which test scores primarily varied due to this manipulation (e.g., trial duration, number of fixations), and which were still more sensitive to other differences between individuals (e.g., fixation duration, saccade amplitude). This provided an experimental construct validation of the test scores by distinguishing scores primarily reflecting the executive function of emphasizing speed vs. accuracy and those independent from it. In sum, both the inclusion of eye movement measures and of the experimental manipulation of executive functions in the TMT enabled a more specific interpretation of the TMT in terms of cognitive functions and mechanisms, which offers more precise diagnoses in clinical applications and basic research.


Asunto(s)
Función Ejecutiva , Tecnología de Seguimiento Ocular , Cognición , Humanos , Pruebas Neuropsicológicas , Prueba de Secuencia Alfanumérica
5.
Artículo en Inglés | MEDLINE | ID: mdl-36141507

RESUMEN

The Health Technology Assessment is based on the evaluation of the characteristics and effects of health technologies to properly spend resources in healthcare. For the needs of hospitals, a special HTA department, Hospital-Based Health Technology Assessment (HB-HTA), has been established. The objective of the article is to assess the possibility of implementing a functional model with the coordinating role of Health Departments of the Voivodeship Offices with the support of the National Health Fund and the HTA Agency in Poland. Ten semi-structured interviews were conducted with representatives from eight Voivodeship Offices. The interviews consisted of nine questions related to the possibility of introducing a functional model with the participation of the Voivodeship Office. The material was divided into seven codes relating to the questions included in the topic guide. From the perspective of Voivodeship Offices, HB-HTA could contribute to the improvement of the methodology used in the Evaluation Instrument of Investment Motions in Health. The lack of personnel in the Voivodeship Offices was identified as one of the greatest barriers to the implementation of HB-HTA. These public administration units should not be involved in the hospital health technology assessment process.


Asunto(s)
Hospitales , Evaluación de la Tecnología Biomédica , Atención a la Salud , Polonia
6.
Artículo en Inglés | MEDLINE | ID: mdl-36141691

RESUMEN

Kazakhstan strives to obtain Universal Health Coverage (UHC) by using health technology assessment (HTA) for determining their health benefit package. This paper reports on employing evidence-informed deliberative processes (EDPs), a practical and stepwise approach to enhance legitimate health benefit package design in Kazakhstan. METHODS: The Ministry of Health of Kazakhstan approved the operationalization and application of EDPs during March 2019 and December 2020. We used a combination of desk research, conducting HTA, online surveys as well as a face-to-face workshop in Nur-Sultan, Kazakhstan, and two online workshops to prioritize 25 selected health technologies. During the latter, we tested two alternative approaches to prioritization: quantitative multicriteria decision analysis (MCDA) and the use of decision rules. RESULTS: For each of the HTA reports, evidence summaries were developed according to the decision criteria (safety, social priority disease, severity of disease, effectiveness, cost-effectiveness, level of evidence, financial risk protection and budget impact). When appraising the evidence, the advisory committee preferred using quantitative MCDA, and only when this would result in any controversy could decision rules be applied. CONCLUSIONS: Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the process will likely play a key role in determining an evidence-informed and transparent health benefit package.


Asunto(s)
COVID-19 , Pandemias , COVID-19/epidemiología , Humanos , Kazajstán , Evaluación de la Tecnología Biomédica , Cobertura Universal del Seguro de Salud
7.
Artículo en Inglés | MEDLINE | ID: mdl-36141990

RESUMEN

Parks are ideal places for promoting physical activity, which is vital for achieving and sustaining good health. Thus, it is important to develop and provide the best methods for assessing aspects of parks that could influence physical activity. This study examined the use of high-tech video capture for describing park quality. Videos were obtained with a wearable video device (WVD) and an unmanned aerial system (UAS) at 28 and 17 parks, respectively. In-person audits of park attributes were performed using the Physical Activity Readiness Assessment (PARA) instrument while video was simultaneously captured. The PARA provides quality ratings of park attributes that range from poor to good. Kappa statistics were calculated to compare in-person PARA outcomes with PARA outcomes obtained by reviewing the WVD and UAS videos. Substantial and almost-perfect agreements were found between WVD and in-person PARAs on the quality of features and amenities and the severity of incivilities. Agreements between UAS and in-person PARAs on feature and amenity quality and incivility severity were unacceptable (mostly fair and moderate). In conclusion, being able to reliably assess park quality using video provides advantages over in-person assessments (e.g., retrospective analysis). In addition, it sets up the possibility of utilizing computer vision to automate the video analysis process.


Asunto(s)
Parques Recreativos , Dispositivos Electrónicos Vestibles , Ambiente , Planificación Ambiental , Ejercicio Físico , Humanos , Instalaciones Públicas , Recreación , Características de la Residencia , Estudios Retrospectivos
8.
Ont Health Technol Assess Ser ; 22(4): 1-165, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36160757

RESUMEN

Background: Staphylococcus aureus (S. aureus) is the most common cause of surgical site infections, and the nose is the most common site for S. aureus colonization. Pre-surgical (in the days prior to surgery) nasal decolonization of S. aureus may reduce the bacterial load and prevent the organisms from being transferred to the surgical site, thus reducing the risk of surgical site infection. We conducted a health technology assessment of nasal decolonization of S. aureus (including methicillin-susceptible and methicillin-resistant strains) with or without topical antiseptic body wash to prevent surgical site infection in patients undergoing scheduled surgery, which included an evaluation of effectiveness, safety, cost-effectiveness, the budget impact of publicly funding nasal decolonization of S. aureus, and patient preferences and values. Methods: We performed a systematic literature search of the clinical evidence to retrieve systematic reviews and selected and reported results from one review that was recent, of high quality, and relevant to our research question. We complemented the chosen systematic review with a literature search to identify randomized controlled trials published since the systematic review was published in 2019. We used the Risk of Bias in Systematic Reviews (ROBIS) tool to assess the risk of bias of each included systematic review and the Cochrane risk-of-bias tool for randomized controlled trials to assess the risk of bias of each included primary study. We assessed the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We performed a systematic economic literature search and conducted both cost-effectiveness and cost-utility analyses using a decision-tree model with a 1-year time horizon from the perspective of Ontario's Ministry of Health. We also analyzed the budget impact of publicly funding nasal decolonization of S. aureus in pre-surgical patients in Ontario. To contextualize the potential value of nasal decolonization, we spoke with people who had recently undergone surgery, some of whom had received nasal decolonization, and one family member of a person who had recently had surgery. We also engaged participants through an online survey. Results: We included one systematic review and three randomized controlled trials in the clinical evidence review. In universal decolonization, compared with placebo or no intervention, nasal mupirocin alone may result in little to no difference in the incidence of overall and S. aureus-related surgical site infections in pre-surgical patients undergoing orthopaedic, cardiothoracic, general, oncologic, gynaecologic, neurologic, or abdominal digestive surgeries, regardless of S. aureus carrier status (GRADE: Moderate to Very low). Compared with placebo, nasal mupirocin alone may result in little to no difference in the incidence of overall and S. aureus-related surgical site infections in pre-surgical patients who are S. aureus carriers undergoing cardiothoracic, vascular, orthopaedic, gastrointestinal, general, oncologic, gynaecologic, or neurologic surgery (GRADE: Moderate to Very low). In targeted decolonization, compared with placebo, nasal mupirocin combined with chlorhexidine body wash lowers the incidence of S. aureus-related surgical site infection (risk ratio: 0.32 [95% confidence interval: 0.16-0.62]) in pre-surgical patients who are S. aureus carriers undergoing cardiothoracic, vascular, orthopaedic, gastrointestinal, or general surgery (GRADE: High). Compared with no intervention, nasal mupirocin combined with chlorhexidine body wash in pre-surgical patients who are not S. aureus carriers undergoing orthopaedic surgery may have little to no effect on overall surgical site infection, but the evidence is very uncertain (GRADE: Very low). Most included studies did not separate methicillin-susceptible and methicillin-resistant strains of S. aureus. No significant antimicrobial resistance was identified in the evidence reviewed; however, the existing literature was not adequately powered and did not have sufficient follow-up time to evaluate antimicrobial resistance.Our economic evaluation found that universal nasal decolonization using mupirocin combined with chlorhexidine body wash is less costly and more effective than both targeted and no nasal decolonization. Compared with no nasal decolonization treatment, universal and targeted nasal decolonization using mupirocin combined with chlorhexidine body wash would prevent 32 and 22 S. aureus-related surgical site infections, respectively, per 10,000 patients. Universal nasal decolonization would lead to cost savings, whereas targeted nasal decolonization would increase the overall cost for the health care system since patients must first be screened for S. aureus carrier status before receiving nasal decolonization with mupirocin. The annual budget impact of publicly funding universal nasal decolonization in Ontario over the next 5 years ranges from a savings of $2.98 million in year 1 to a savings of $15.09 million in year 5. The annual budget impact of publicly funding targeted nasal decolonization ranges from an additional cost of $0.08 million in year 1 to an additional cost of $0.39 million in year 5.Our interview and survey respondents felt strongly about the value of preventing surgical site infections, and most favoured a universal approach. Conclusions: Based on the best evidence available, decolonization of S. aureus using nasal mupirocin combined with chlorhexidine body wash prior to cardiothoracic, vascular, orthopaedic, gastrointestinal, or general surgery lowers the incidence of surgical site infection caused by S. aureus in patients who are S. aureus carriers (including methicillin-susceptible and methicillin-resistant strains) (i.e., targeted decolonization). However, nasal mupirocin alone may result in little to no difference in overall surgical site infections and S. aureus-related surgical site infections in pre-surgical patients prior to orthopaedic, cardiothoracic, general, oncologic, gynaecologic, neurologic, or abdominal digestive surgeries, regardless of their S. aureus carrier status (i.e., universal decolonization). No significant antimicrobial resistance was identified in the evidence reviewed.Compared with no nasal decolonization treatment, universal nasal decolonization with mupirocin combined with chlorhexidine body wash may reduce S. aureus-related surgical site infections and lead to cost savings. Targeted nasal decolonization with mupirocin combined with chlorhexidine body wash may also reduce S. aureus-related surgical site infections but increase the overall cost of treatment for the health care system. We estimate that publicly funding universal nasal decolonization using mupirocin combined with chlorhexidine body wash would result in a total cost savings of $45.08 million over the next 5 years, whereas publicly funding targeted nasal decolonization using mupirocin combined with chlorhexidine body wash would incur an additional cost of $1.17 million over the next 5 years.People undergoing surgery value treatments aimed at preventing surgical site infections.


Asunto(s)
Antiinfecciosos Locales , Infecciones Estafilocócicas , Antiinfecciosos Locales/uso terapéutico , Clorhexidina/uso terapéutico , Humanos , Meticilina , Mupirocina/uso terapéutico , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/prevención & control , Revisiones Sistemáticas como Asunto , Evaluación de la Tecnología Biomédica/métodos
9.
Syst Rev ; 11(1): 206, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-36167611

RESUMEN

BACKGROUND: A systematic review (SR) helps us make sense of a body of research while minimizing bias and is routinely conducted to evaluate intervention effects in a health technology assessment (HTA). In addition to the traditional de novo SR, which combines the results of multiple primary studies, there are alternative review types that use systematic methods and leverage existing SRs, namely updates of SRs and overviews of SRs. This paper shares guidance that can be used to select the most appropriate review type to conduct when evaluating intervention effects in an HTA, with a goal to leverage existing SRs and reduce research waste where possible. PROCESS: We identified key factors and considerations that can inform the process of deciding to conduct one review type over the others to answer a research question and organized them into guidance comprising a summary and a corresponding flowchart. This work consisted of three steps. First, a guidance document was drafted by methodologists from two Canadian HTA agencies based on their experience. Next, the draft guidance was supplemented with a literature review. Lastly, broader feedback from HTA researchers across Canada was sought and incorporated into the final guidance. INSIGHTS: Nine key factors and six considerations were identified to help reviewers select the most appropriate review type to conduct. These fell into one of two categories: the evidentiary needs of the planned review (i.e., to understand the scope, objective, and analytic approach required for the review) and the state of the existing literature (i.e., to know the available literature in terms of its relevance, quality, comprehensiveness, currency, and findings). The accompanying flowchart, which can be used as a decision tool, demonstrates the interdependency between many of the key factors and considerations and aims to balance the potential benefits and challenges of leveraging existing SRs instead of primary study reports. CONCLUSIONS: Selecting the most appropriate review type to conduct when evaluating intervention effects in an HTA requires a myriad of factors to be considered. We hope this guidance adds clarity to the many competing considerations when deciding which review type to conduct and facilitates that decision-making process.


Asunto(s)
Medicina Basada en la Evidencia , Evaluación de la Tecnología Biomédica , Tecnología Biomédica , Canadá , Humanos , Revisiones Sistemáticas como Asunto
10.
Health Econ ; 31 Suppl 1: 1-9, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36068719

RESUMEN

The field of medical devices has attracted considerable interest from scholarly research in health economics in recent years. Medical devices are indispensable tools for quality health care delivery, but their assessment and appropriate use pose significant challenges to healthcare systems. More research is needed to overcome existing gaps associated with evaluation of digital technologies, address challenges in the use of real-world data in generating evidence for decision-making and to uncover drivers of variation in access to medical devices across countries. Furthermore, the translation of the results and recommendations stemming from research projects into health technology assessment practices needs to be strengthened. The European Union (EU) project COMED aimed to address these gaps by improving existing research and developing new research streams on the methods for evaluation and diffusion of medical devices. The project also intended to provide directly applicable policy advice and tools to inform decision-making, with the aim of impacting public health in the EU. This Health Economics Supplement, together with references of other published outputs of the project, is intended to be the main source for researchers and policy makers seeking information on the COMED project.


Asunto(s)
Atención a la Salud , Evaluación de la Tecnología Biomédica , Economía Médica , Europa (Continente) , Unión Europea , Humanos , Evaluación de la Tecnología Biomédica/métodos
11.
J Ethnopharmacol ; 299: 115696, 2022 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-36087845

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: The rhizome of Pinellia ternata (Thunb.) Breit, called Pinelliae Rhizoma (PR) and Banxia in Chinese, is a well-known traditional Chinese medicine (TCM) with the functions of "removing dampness-phlegm" and "downbear counterflow and check vomiting". PR has potential toxic effects that can be detoxified by Fuzhi processing (repeated processing using one or multiple adjuvants) with specific adjuvants. AIM OF THE STUDY: This paper aims to provide a summary of traditional and current processing methods used to detoxify PR. MATERIALS AND METHODS: The available references of the processing methods of PR from the classic books of Materia Medica, literature, online databases and masters or doctoral theses are collected and summarized. We also discussed the possible processing mechanisms of how we can achieve a safer and effective application of PR via these processing methods. RESULTS: PR cannot be administered orally before processing. PR contains nucleoside alkaloids, cerebrosides, fatty acids, lectin, polysaccharides, and calcium oxalate crystals. To date, although the active substances of PR are still unclear, the toxic components are almost completely clarified as needle-like calcium oxalate crystals (NCOCs) and lectin proteins. Furthermore, the toxic effects of PR include causing death in animals, inflammation, conjunctival irritation, pregnancy toxicity, teratogenicity, visceral toxicity, aphonia and vomiting. From ancient times to now, Fuzhi methods have remained the predominant method for PR processing, and the main adjuvants used are ginger juice, alum, licorice and lime. In addition, detoxification mechanisms are related to removing or damaging the NCOC and lectin in PR based on processing with adjuvants. Currently, Fuzhi processing has been greatly improved, and novel processing technologies with novel adjuvants have been used for PR processing. However, there are still some flaws in PR processing, which should be urgently solved in the future, and clarifying the characteristic bioactive compounds in PR corresponding to its function or effects is the most important step for PR processing. CONCLUSION: Our present paper reviewed the previous literature regarding all aspects of the processing of PR, and this paper will be helpful for achieving a safer and effective application of PR and its processed products and will also be beneficial for the further optimization of processing technology and clinical medication safety of PR.


Asunto(s)
Alcaloides , Medicamentos Herbarios Chinos , Materia Medica , Pinellia , Adyuvantes Farmacéuticos , Alcaloides/análisis , Animales , Oxalato de Calcio , Cerebrósidos/análisis , Medicamentos Herbarios Chinos/química , Ácidos Grasos/análisis , Lectinas/análisis , Materia Medica/análisis , Medicina Tradicional China , Nucleósidos/análisis , Pinellia/química , Rizoma/química , Tecnología Farmacéutica/métodos , Vómitos
12.
Int J Nanomedicine ; 17: 4039-4057, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36105621

RESUMEN

Background: To improve the dissolution and bioavailability of the component-based Chinese medicine of Ginkgo biloba leaves (GBCCM), a novel nanocrystalline solid dispersion of GBCCM (GBCCM NC-SD) was first prepared. Methods: GBCCM mainly containing high pure flavonoid aglycones (FAs) and terpenoid lactones (TLs) was used as the model drug. PVP K30 and SDS were used as solubilizers, combined stabilizers and carriers, and GBCCM NC-SD was prepared by high-pressure homogenization combined with freeze-dryer. Morphology and crystal characteristic of GBCCM NC-SD were analyzed. The dissolution and bioavailability evaluation were performed to investigate the feasibility of GBCCM NC-SD by in vitro dissolution and in vivo integrated pharmacokinetic models. Results: After homogenizing for 30 cycles under the pressure of 650 bar and freeze-drying, GBCCM NC-SD with uniform quality would be obtained. The particle size, PDI and zeta potential were found to be 335.9 ± 32.8 nm, 0.29 ± 0.02 and -28.4 ± 0.7 mV respectively. Based on charged aerosol detector (CAD) technology, a new chromatographic method for simultaneous detection of eight components in GBCCM was developed. In vitro drug release study showed that the cumulative dissolution of FAs and TLs in GBCCM NC-SD increased from 12.77% to 52.92% (P < 0.01) and 90.91% to 99.21% (P < 0.05) respectively. In comparison with physical mixture of GBCCM and stabilizer (PM), the integrated pharmacokinetics AUC0-t of FAs and TLs in GBCCM NC-SD were significantly increased (P < 0.05), and the T1/2 of TLs was also significantly prolonged (P < 0.05). Conclusion: This study demonstrated that novel GBCCM NC-SD was prepared using Polyvinylpyrrolidone K30 (PVP K30) and Sodium dodecyl sulfate (SDS) as a synergetic stabilizer and also provided a feasible way to improve the dissolution and oral bioavailability of poorly soluble candidate antihypertensive drugs.


Asunto(s)
Ginkgo biloba , Medicina Tradicional China , Excipientes/química , Ginkgo biloba/química , Povidona/química , Solubilidad , Tecnología
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3281-3284, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36086143

RESUMEN

The Undergraduate Program in Biomedical Engineering ITB, Indonesia, introduce the Health Technology Assessment and Management as an elective course in 2021. This course is implemented to support the World Health Assembly that urges the member states to establish national strategies in health technology assessment and management, particularly medical devices. Furthermore, it is designed to give biomedical engineering students a broader insight into their career opportunities. Therefore, this course is delivered by the practitioner and guided by the main lecturer. The course syllabus is developed from the WHO Medical Devices Technical Series and European Network for Health Technology Assessment. It tries to implement HTA Core Model for Rapid Relative Effectiveness Assessments. A questionnaire is used to measure the students' perception of the course implementation. Moreover, it is used to obtain the students' comments and feedback. The course that is delivered by the practitioner not only gives the course content but also the context. After attending the course, students have a broader insight into the career opportunities as biomedical engineers in Indonesia.


Asunto(s)
Ingeniería Biomédica , Evaluación de la Tecnología Biomédica , Bioingeniería , Ingeniería Biomédica/educación , Curriculum , Humanos , Estudiantes
14.
Zhongguo Zhong Yao Za Zhi ; 47(15): 3977-3985, 2022 Aug.
Artículo en Chino | MEDLINE | ID: mdl-36046886

RESUMEN

As one of the most advanced technologies, single-cell omics technology develops rapidly in recent years. Based on different technical strategies, it enables unbiased and high-throughput access to multiple omics information at single-cell resolution. So far, single-cell omics technology, by virtue of its great powder in resolving tissue heterogeneity, has become a revolutionary tool to deeply understand the functional structure of tissues, reveal complex disease processes, and elucidate drug mechanisms of action. In view of the technical challenges in deconstructing the complexity of Chinese medicine and clarifying the modern scientific connotation of traditional Chinese medicine(TCM) theory, single-cell omics technology has huge application potential in the discovery of pharmacodynamic substances, construction of action networks, and elucidation of integrated regulatory mechanisms, which brings new opportunities for modern research in TCM. The present study briefly introduced three representative single-cell omics technologies, i.e., single-cell transcriptome sequencing, spatial transcriptomics, and single-cell multimodal omics, and their main application patterns. On this basis, an outlook was proposed on the strategies and applications for modern research in TCM using single-cell omics technology.


Asunto(s)
Medicamentos Herbarios Chinos , Medicina Tradicional China , Medicamentos Herbarios Chinos/farmacología , Tecnología
15.
Rev Panam Salud Publica ; 46, mayo 2022. Special Issue HEARTS
Artículo en Español | PAHO-IRIS | ID: phr-56414

RESUMEN

[RESUMEN]. Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.


[ABSTRACT]. The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive drugs and devices for measuring blood pressure in the countries of the Region of the Americas, supporting implementation of the HEARTS initiative; and to present the preliminary results of price analyses of antihypertensive drugs. The study methodology included a review of reports made by the Strategic Fund during 2019–2020, evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive drugs, and a comparison with the price obtained by the Strategic Fund. Differences ranging from 20% to 99% were identified, indicating significant opportunities for savings. Interprogrammatic actions in support of the HEARTS initiative are also presented, such as the inclusion of antihypertensive drugs recommended by the World Health Organization; consolidation of regional demand and establishment of competitive prices with long-term agreements to manage the procurement of quality generic products; and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. Through this mechanism, Member States can reduce their costs significantly, enabling them to extend treatment and diagnostic coverage to more people.


[RESUMO]. Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.


Asunto(s)
Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Antihipertensivos , Fondo Estratégico , Costos de los Medicamentos , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Antihipertensivos , Fondo Estratégico , Costos de los Medicamentos , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Antihipertensivos , Fondo Estratégico , Costos de los Medicamentos
16.
Lima; Perú. Ministerio de Salud; Set. 2022. 79 p. graf.
Monografía en Español | MINSAPERÚ | ID: biblio-1395605

RESUMEN

El documento establece las acciones y productos a desarrollar en el Pla de Implementación para la fase fundacional durante el año 2022, a su vez ésta se encuentra alineada a cada una de las dimensiones identificadas en la misma de modo que se alcancen los objetivos específicos propuestos, en una lógica de implementación progresiva y escalable con una metodología que apunta al logro de la salud que se dese al 2025


Asunto(s)
Telemedicina , Política Nacional de Ciencia, Tecnología e Innovación , Política de Innovación y Desarrollo , Metodología como un Tema , Estrategias de eSalud , Objetivos
17.
BMC Med Educ ; 22(1): 693, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-36167531

RESUMEN

AIM: In this study, we aimed to describe a multimedia-supported manikin system, compare the new manikin with the traditional manikin and evaluate its effectiveness in preclinical dentistry training. METHODS: A total of 150 students participated in this study. Amongst these students, 71 in the 2015-year group used traditional manikins (Group TM) for preclinical training courses (endodontics training courses and prosthodontics training courses), and 79 in the 2016-year group used manikins with a multimedia system (Group MM). The scores of the training courses between the two groups were compared. A questionnaire survey was used to collect opinions of the students in Group MM on their experience of using the multimedia-supported manikin system in the preclinical training. RESULTS: In the endodontics training courses, the scores of Group MM were higher than those of Group TM, but there was no significant difference (P = 0.379 > .05). However, the scores of prosthodontics training courses in Group MM were significantly higher than those in Group TM (P = 0.018 < .05). The questionnaire results indicated that the students in Group MM were satisfied with the device in usability, clarity, effectiveness and improvement in operation proficiency. CONCLUSIONS: In the groups studied, for preclinical dental training, the multimedia-supported manikin system was a good alternative to traditional manikin in preclinical dentistry training.


Asunto(s)
Maniquíes , Multimedia , Educación en Odontología/métodos , Evaluación Educacional , Humanos , Prostodoncia/educación
18.
Sensors (Basel) ; 22(18)2022 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-36146103

RESUMEN

Falls have been recognized as the major cause of accidental death and injury in people aged 65 and above. The timely prediction of fall risks can help identify older adults prone to falls and implement preventive interventions. Recent advancements in wearable sensor-based technologies and big data analysis have spurred the development of accurate, affordable, and easy-to-use approaches to fall risk assessment. The objective of this study was to systematically assess the current state of wearable sensor-based technologies for fall risk assessment among community-dwelling older adults. Twenty-five of 614 identified research articles were included in this review. A comprehensive comparison was conducted to evaluate these approaches from several perspectives. In general, these approaches provide an accurate and effective surrogate for fall risk assessment. The accuracy of fall risk prediction can be influenced by various factors such as sensor location, sensor type, features utilized, and data processing and modeling techniques. Features constructed from the raw signals are essential for predictive model development. However, more investigations are needed to identify distinct, clinically interpretable features and develop a general framework for fall risk assessment based on the integration of sensor technologies and data modeling.


Asunto(s)
Vida Independiente , Dispositivos Electrónicos Vestibles , Anciano , Humanos , Medición de Riesgo/métodos
19.
Sensors (Basel) ; 22(18)2022 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-36146314

RESUMEN

There has been a subsequent increase in the number of elderly people living alone, with contribution from advancement in medicine and technology. However, hospitals and nursing homes are crowded, expensive, and uncomfortable, while personal caretakers are expensive and few in number. Home monitoring technologies are therefore on the rise. In this study, we propose an anonymous elderly monitoring system to track potential risks in everyday activities such as sleep, medication, shower, and food intake using a smartphone application. We design and implement an activity visualization and notification strategy method to identify risks easily and quickly. For evaluation, we added risky situations in an activity dataset from a real-life experiment with the elderly and conducted a user study using the proposed method and two other methods varying in visualization and notification techniques. With our proposed method, 75.2% of the risks were successfully identified, while 68.5% and 65.8% were identified with other methods. The average time taken to respond to notification was 176.46 min with the proposed method, compared to 201.42 and 176.9 min with other methods. Moreover, the interface analyzing and reporting time was also lower (28 s) in the proposed method compared to 38 and 54 s in other methods.


Asunto(s)
Aplicaciones Móviles , Anciano , Humanos , Monitoreo Fisiológico/métodos , Casas de Salud , Medición de Riesgo , Tecnología
20.
BMC Health Serv Res ; 22(1): 1197, 2022 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-36151546

RESUMEN

OBJECTIVE: To evaluate the clinical and cost-effectiveness of preimplantation genetic testing for aneuploidy, social freezing, donor and autologous assisted reproductive technology (ART) treatment strategies for women aged 35-45 following 6-12 months of infertility. METHODS: Four Markov decision-analytic models comprising: (i) Preimplantation genetic testing for aneuploidy (PGT-A); (ii) autologous ART from age 40 using oocytes cryopreserved at age 32 (social freezing); (iii) ART using donated oocytes (donor ART); (iv) standard autologous ART treatment (standard care) were developed for a hypothetical cohort of 35 to 45 years old ART naïve women with 6-12 months of infertility. Input probabilities for key parameters including live birth rates were obtained from the available literature. Deterministic and probabilistic sensitivity analyses were conducted to address uncertainty in estimating the parameters and around the model's assumptions. Cost effectiveness was assessed from both societal and patient perspectives . RESULT(S): For infertile women at age 40 and above, social freezing is the most cost-saving strategy with the highest chance of a cumulative live birth at a lowest cost from a societal perspective. PGT-A and donor ART were associated with higher treatment costs and cumulative live-birth rates compared with the autologous ART. Among the four ART strategies, standard autologous ART has the lowest cumulative live birth rate of 45% at age 35 and decreasing to 1.6% by age 45 years. At a willingness-to-pay threshold of Australian dollars (A$)50,000, our model shows all alternative treatment strategies -PGT-A, social freezing and donor ART have a higher probability of being cost-effective compared to the standard autologous ART treatment. However, higher out-of-pocket expenditure may impede their access to these alternate strategies. CONCLUSION: Given current evidence, all alternate strategies have a higher probability of being cost-effective compared to the standard autologous ART treatment. Whether this represents value for money depends on societal and individual's willingness-to-pay for children conceived with ART treatment.


Asunto(s)
Infertilidad Femenina , Aneuploidia , Australia , Análisis Costo-Beneficio , Femenino , Humanos , Edad Materna , Técnicas Reproductivas Asistidas
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