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1.
Br J Ophthalmol ; 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38777389

RESUMO

Myopia has long been a global threat to public health. Timely interventions are likely to reduce the risk of vision-threatening complications. There are both established and rapidly evolving therapeutic approaches to slow myopia progression and/or delay its onset. The effective methods for slowing myopia progression include atropine eye-drops, defocus incorporated multiple segments (DIMS) spectacle lenses, spectacle lenses with highly aspherical lenslets target (HALT), diffusion optics technology (DOT) spectacle lenses, red light therapy (RLT), multifocal soft contact lenses and orthokeratology. Among these, 0.05% atropine, HALT lenses, RLT and +3.00 peripheral addition soft contact lenses yield over 60% reduction in myopia progression, whereas DIMS, DOT and MiSight contact lenses demonstrate at least 50% myopia control efficacy. 0.05% atropine demonstrates a more optimal balance of efficacy and safety than 0.01%. The efficacy of 0.01% atropine has not been consistent and requires further validation across diverse ethnicities. Combining atropine 0.01% with orthokeratology or DIMS spectacles yields better outcomes than using these interventions as monotherapies. Increased outdoor time is an effective public health strategy for myopia prevention while recent studies suggest that 0.05% low-concentration atropine and RLT therapy have promising potential as clinical myopia prevention interventions for high-risk groups. Myopia control spectacle lenses, being the least invasive, are safe for long-term use. However, when considering other approaches, it is essential to ensure proper instruction and regular follow-ups to maintain safety and monitor any potential complications. Ultimately, significant advances have been made in myopia control strategies, many of which have shown meaningful clinical outcomes. However, regular use and adequate safety monitoring over extended durations are imperative to foster confidence that can only come from extensive clinical experience.

2.
Anal Chem ; 96(15): 5807-5814, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38573874

RESUMO

Understanding the reactivity of metal cations with various reaction gases in inductively coupled plasma tandem mass spectrometry (ICP-MS/MS) is important to determine the best gas to use for a given analyte/interference pair. In this study, nitric oxide (NO) was investigated as the reaction gas following previous experimental designs. The reactions with 50 elements were investigated to examine periodic trends in reactivity, validate theoretical modeling of reaction enthalpies as a method to screen reactant gases, and provide a baseline data set for potential in-line gas separation methods. ICP-MS/MS studies involving actinides are typically limited to Th, U, and Pu, with analyses of Np and Am rarely reported in the literature. To date, only two previous methods have investigated the use of NO in ICP-MS/MS analyses. To showcase the utility of NO, a method was developed to measure 239Pu in the presence of environmental matrix constituent and other actinides, like what could be expected from postdetonation debris, with no chemical separation prior to analysis. 239Pu+ was reacted to form 239Pu16O+, eliminating interferences derived from the sample matrix by measuring the 239Pu+ intensity at m/z = 255 (239Pu16O+). To validate NO for 238U1H+ interference removal in environmental matrices, standard reference materials were diluted to 1 mg/g of solution and spiked to 0.05 pg/g of 239Pu and 1 µg/g 238U (Pu/U = 5 × 10-8). Measured 239Pu concentrations were within 6% of the spiked value. These results demonstrate that reliable 239Pu measurements can be made at levels relevant to nuclear forensics without the need for extensive chemical matrix separation prior to analysis.

3.
J Pediatr Adolesc Gynecol ; 37(3): 311-314, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38432289

RESUMO

Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as both adolescent medicine and PAG fellowship programs. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG trainee education by creating and maintaining this Short Curriculum. The curriculum outlines specific learning objectives central to PAG education and lists high-yield, concise resources for learners. This updated curriculum replaces the previous 2021 publication with a new focus toward accessible online content and updated resources.


Assuntos
Currículo , Ginecologia , Internato e Residência , Pediatria , Ginecologia/educação , Humanos , Internato e Residência/métodos , Pediatria/educação , Adolescente , Medicina do Adolescente/educação , Feminino , Educação de Pós-Graduação em Medicina/métodos
4.
J Pediatr Adolesc Gynecol ; 37(3): 371-374, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38342296

RESUMO

Pediatric and adolescent gynecology (PAG) is a unique subspecialty for which accessible educational resources and clinical exposure have historically been limited; surveys show that trainees in both obstetrics and gynecology and pediatrics agree. In 2014, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) introduced PAG WebEd, an original and interactive online case-based curriculum designed to bridge this learning gap. As of 2023, there are 35 published PAG WebEd clinical cases with key learning points that present, test, and discuss a variety of current PAG topics. The NASPAG Resident Education Committee (REC) compiled and reviewed administrative data from the module platform to investigate trainee utilization and performance. The activity data and assessment scores for 161 registered users are included and reported in this article. This brief report highlights that a relatively small number of medical trainees use PAG WebEd and aims to raise awareness of this resource through publication. There is potential for many more users to benefit from this resource; its efficacy as an examination and clinical practice tool could also be measured. The NASPAG REC hopes to ultimately show, with increased utilization, that PAG WebEd deserves to be a key piece of PAG-focused medical education. For PAG WebEd information and faculty registration, as well as a link that allows faculty to submit new learners, please visit https://www.naspag.org/pagwebed-information.


Assuntos
Currículo , Educação a Distância , Ginecologia , Internet , Pediatria , Humanos , Ginecologia/educação , Pediatria/educação , Educação a Distância/métodos , Adolescente , Internato e Residência/métodos , Feminino , Educação de Pós-Graduação em Medicina/métodos , Medicina do Adolescente/educação
5.
Talanta ; 272: 125799, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38422903

RESUMO

The effect of ion kinetic energy on gas phase ion reactivity with ICP-MS/MS was investigated in order to explore tuning strategies for interference removal. The collision/reaction gases CO2, N2O and O2 were used to observe the ion product distribution for 48 elements using an Agilent tandem ICP-MS (ICP-MS/MS) as a function of reaction gas flow rate (pressure) and ion kinetic energy. The kinetic energy of the incident ion was varied by adjusting the octopole bias (Voct). The three gases all form oxides (MO+) as the primary product with differing reaction enthalpies that result in distinct differences in the ion energies required for reaction with product ion distributions that vary with Voct. Consequently, by varying the ion kinetic energy (i.e., Voct), differences in interference reactivity can be used to achieve maximum separation. Three practical application examples were reported to demonstrate how the ion kinetic energy can be varied to achieve the ideal ion product distribution for interference resolution: CO2 for the removal of 238U in Pu analyses, CO2 for the removal of 40Ar16O vs. 56Fe, and O2 for the removal of Sm in Eu analyses, analogous to Pu/Am. The results demonstrate how the starting ion energy defined by Voct is an important factor to fully leverage the utility of any given reaction gas to remove interferences in the mass spectrum using ICP-MS/MS.

6.
Clin J Oncol Nurs ; 28(1): 95-100, 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38252858

RESUMO

Cancer cachexia is characterized by metabolic dysregulation, inflammation, and reduced food intake, and it results in loss of skeletal muscle. Although cachexia is pervasive in patients with advanced cancer, comprehensive cac.


Assuntos
Caquexia , Neoplasias , Humanos , Caquexia/etiologia , Inflamação , Neoplasias/complicações
7.
Br Ir Orthopt J ; 20(1): 16-30, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38187095

RESUMO

Aims: To survey orthoptists' confidence in communicating with patients with communication impairments and to investigate resources orthoptists are currently using to aid assessment and management and to explore future resources that may be beneficial. Methods and Procedures: Practicing orthoptists (n = 63; median age range: 31-35 years old) completed an online survey with quantitative and qualitative questions which investigated approaches to adult and paediatric patients with communication impairments and any communication tools used. Analysis of quantitative survey responses was conducted using IBM SPSS v27. Content analysis of qualitative responses was done. Outcomes and Results: Simple communication strategies (e.g., eye contact and body language, repeating/rephrasing sentences) were commonly used with both adult and paediatric patients while more complex strategies (e.g., electronic visual aids, writing key words/concepts) were rarely used. Usage of communication strategies was not affected by length of work experience, workplace clinical speciality or training during their clinical degree or after graduation (p < 0.05). Most participants (71.2%) reported being unaware of resources available for orthoptists to assist in the assessment and management of patients with communication impairments. Conclusions and Implications: Orthoptists have adopted some communication strategies to improve their interactions with patients with communication impairments, despite limited resources. With proper resources, such as training in supportive communication techniques, they can provide optimal patient care, making it essential to identify what kind of resources would be most appropriate.

8.
Biol Trace Elem Res ; 202(2): 754-764, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37119341

RESUMO

This study investigated the potential of utilising the elemental fingerprinting of honey to differentiate New Zealand (NZ) honey from that of international origin. Twenty elements were analysed by ICP-MS in 352 honeys from 34 various countries. Of these, 323 honeys (245 New Zealand honeys, 78 international) and two subsets of data (NZ and European origin, n = 306, and, NZ and Denmark/Germany, n = 280) were visualised using principal component analysis (PCA). For the NZ/Europe subset, 42.2% of data was explained in the first two principal components. Statistical classification rules were also derived using linear discriminant analysis (LDA) and decision tree analysis. Various combinations of elements were explored for classification, considering the effect of soil-derived elements and those from anthropogenic sources. A high degree of accuracy (at least 90%) for the characterisation of New Zealand honey was observed for all statistical models, showing the robustness of these analyses. When using decision tree analysis to distinguish New Zealand samples from international samples, a tree with five terminal nodes (using Cs, Ba and Rb) was created with 92.4% accuracy. This work has demonstrated that elemental fingerprints of honey are a promising tool for categorising New Zealand honey from other geographical locations.


Assuntos
Mel , Mel/análise , Nova Zelândia , Análise Espectral , Análise Discriminante , Análise de Componente Principal
9.
Phys Chem Chem Phys ; 26(1): 209-218, 2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38054255

RESUMO

f-Block chemistry offers an opportunity to test current knowledge of chemical reactivity. The energy dependence of lanthanide cation (Ln+ = Ce+, Pr+, Nd+-Eu+) and actinide cation (An+ = Th+, U+-Am+) oxidation reactions by CO2, was observed by inductively coupled plasma tandem mass spectrometry. This reaction is commonly spin-unallowed because the neutral reactant (CO2, 1Σ+g) and product (CO, 1Σ+) require the metal and metal oxide cations to have the same spin state. Correlation of the promotion energy (Ep) to the first state with two free d-electrons with the reaction efficiency indicates that spin conservation is not a primary factor in the reaction rate. The Ep likely influences the reaction rate by partially setting the crossing between the ground and reactive states. Comparison of Ln+ and An+ congener reactivity indicates that the 5f-orbitals play a small role in the An+ reactions.

10.
Nat Commun ; 14(1): 5697, 2023 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-37709741

RESUMO

The winter and summer monsoons in Southeast Asia are important but highly variable sources of rainfall. Current understanding of the winter monsoon is limited by conflicting proxy observations, resulting from the decoupling of regional atmospheric circulation patterns and local rainfall dynamics. These signals are difficult to decipher in paleoclimate reconstructions. Here, we present a winter monsoon speleothem record from Southeast Asia covering the Holocene and find that winter and summer rainfall changed synchronously, forced by changes in the Pacific and Indian Oceans. In contrast, regional atmospheric circulation shows an inverse relation between winter and summer controlled by seasonal insolation over the Northern Hemisphere. We show that disentangling the local and regional signal in paleoclimate reconstructions is crucial in understanding and projecting winter and summer monsoon variability in Southeast Asia.

11.
Disabil Rehabil ; : 1-8, 2023 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-37227234

RESUMO

PURPOSE: Determine current vision care pathways and practices for stroke survivors in Australia and internationally, focusing on identifying reoccurring gaps in these pathways and unmet care needs. METHOD: A scoping narrative review was conducted to identify literature related to post-stroke vision care practices and perspectives of patients and health professionals. RESULTS: A total of 16193 articles were retrieved and 28 deemed eligible for inclusion. Six were Australian, 14 from the UK, four from the USA, and four from within Europe. Post-stroke vision care is largely unstandardized, with substantial inconsistency in the use of vision care protocols, who executes them and at what point in post-stroke care they are utilised. Health professionals and stroke survivors expressed that unmet care needs were primarily a result of lack of education and awareness regarding post-stroke eye problems. Other gaps in care pathways related to the timing of vision assessment, provision of ongoing support, and the integration of eye-care specialists into the stroke team. CONCLUSION: Further research is needed into current Australian post-stroke vision care to accurately assess whether the needs of stroke survivors are being met. Available evidence indicates that in Australia, there is a requirement for well-defined protocols for vision screening, education, management, and referral of stroke survivors.Implications for RehabilitationPost-stroke vision care in Australia is unstandardised, which may cause inequities in vision care provision to Australian stroke survivors in different regions and/or care facilities.Education and training pertaining to stroke-related vision conditions for stroke healthcare professionals and the inclusion of eye-care professionals in stroke care teams is likely to improve gaps in care practice/pathways identified in the current evidence base.Management of stroke-related visual conditions should be inclusive of detailed information provision that is specific to the patients condition(s) and circumstances, as well as ongoing, long-term management strategies/support services to better aid stroke survivor"s reintegration into the community.

12.
Ophthalmol Ther ; 12(2): 925-938, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36574139

RESUMO

INTRODUCTION: This study aimed to evaluate the habitual reading distance among non-myopic children and also myopic children with undercorrection and with full correction. METHODS: This was a population-based cross-sectional study with a total of 2363 children aged 6-8 years who were recruited from the Hong Kong Children Eye Study. Cycloplegic autorefraction, subjective refraction, habitual visual acuity, and best corrected visual acuity were measured. The entire reading process (9 min) was recorded using a hidden video camera placed 5 m away from the reading desk. Reading distances were taken at 6, 7, 8, and 9 min after the child began reading and were measured using a customized computer program developed in MATLAB. The main outcome was the association of habitual reading distances with refraction status. Habitual reading distances of children were documented via video camera footage. RESULTS: The habitual reading distances of undercorrected myopic children (23.37 ± 4.31 cm) were the shortest when compared to non-myopic children (24.20 ± 4.73 cm, P = 0.002) and fully corrected myopic children (24.81 ± 5.21 cm, P < 0.001), while there was no significant difference between the last two children groups (P = 0.17). A shorter reading distance was associated with myopia (OR 1.67; 95% CI 1.11-2.51; P = 0.013) after adjusting for age, sex, height, near work time, outdoor time, and parental myopia. The association of reading distance with myopia did not hold after undercorrected myopic children were excluded (OR 0.97, 95% CI 0.55-1.73; P = 0.92). A shorter reading distance correlated with poorer vision under habitual correction (ß = - 0.003, P < 0.001). CONCLUSION: A shorter reading distance was present among undercorrected myopic children. Myopia undercorrection is not recommended as a strategy for slowing myopic progression.

13.
Anal Chem ; 94(50): 17467-17476, 2022 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-36480638

RESUMO

Online spectroscopic measurements can be used to provide unique insight into complex chemical systems, enabling new understanding and optimization of chemical processes. A key example of this is discussed here with the monitoring of pH of various acid systems in real-time. In this work the acids used in multiple chemical separations processes, such as TALSPEAK (Trivalent Actinide-Lanthanide Separation by Phosphorus reagent Extraction from Aqueous Komplexes) and oxalate precipitation, were characterized. Raman spectroscopy, a robust optical approach that can be integrated in corrosive processes, was used to follow the unique fingerprints of the various protonated and deprotonated acid species. This data was analyzed using a hierarchical modeling approach to build a consolidated model scheme using optical fingerprints from all weak acids to measure pH associated with any of the weak acid systems studied here. Validation of system performance included utilizing Raman spectroscopy under dynamic flow conditions to monitor solution pH under changing process conditions in-line. Overall, the Raman based approach provided accurate analysis of weak acid solution pH.


Assuntos
Oxalatos , Análise Espectral Raman , Análise Espectral Raman/métodos , Quimiometria , Ácido Cítrico , Ácidos , Concentração de Íons de Hidrogênio
14.
Asia Pac J Ophthalmol (Phila) ; 11(5): 425-433, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36179336

RESUMO

PURPOSE: The aim was to investigate universality of access, screening rate, and outcomes from the New South Wales (NSW) Statewide Eyesight Preschooler Screening (StEPS) over the period of 2009 to 2016. DESIGN: Cross-sectional, observational study. METHODS: The StEPS program provides vision screening to 4-year-old children residing in NSW and is administered within Local Health Districts (LHDs). Visual acuity (VA) was examined by trained lay and nurse screeners using HOTV logMAR. Children who had VA <6/9-2 were referred to local practitioners while those with VA <6/18 were referred to public hospital pediatric ophthalmic outpatient clinics where available. Activity data were collected by NSW Health and screening rates determined from population projections of 4-year-olds per LHD based on adjusted 2014 Census data. To determine factors impacting screening and referral rates, a random effects panel analysis was undertaken. RESULTS: A total of 719,686 (96.4%) NSW 4-year-old children were offered StEPS vision screening between 2009 and 2016, 84% accepted and 564,825 children (75.6%) were screened. The screening rate increased from 67.3% in 2009 to 74.5% in 2016, with an 80% target reached for 3 consecutive years from 2013 to 2015. Of those screened, 19.2% were referred to an eye health professional or advised to have a vision retest in 12 months. This referral rate remained steady over the period studied, with little variation between metropolitan, and rural and regional LHDs. CONCLUSIONS: StEPS is an ideal service model for preschool vision screening providing coverage that is comparable to school-based screening programs and at an age likely to facilitate optimal treatment outcomes.


Assuntos
Seleção Visual , Pré-Escolar , Estudos Transversais , Humanos , New South Wales/epidemiologia , Encaminhamento e Consulta , Acuidade Visual
17.
J Pediatr Adolesc Gynecol ; 35(3): 249-259, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34999228

RESUMO

In 2015, the Resident Education Committee of the North American Society for Pediatric and Adolescent Gynecology published the Long Curriculum in Resident Education to provide educators with a comprehensive document to be used in postgraduate medical education. The original curriculum was designed to meet the resident learning objectives for the Council on Resident Education in Obstetrics and Gynecology, the American Board of Pediatrics, and the Royal College of Physicians and Surgeons of Canada and to provide a more intensive, broader learning experience. The curriculum was updated in 2018. This Committee Document is the third updated version (3.0) of the Long Curriculum in Resident Education.


Assuntos
Medicina do Adolescente , Ginecologia , Internato e Residência , Obstetrícia , Pediatria , Adolescente , Medicina do Adolescente/educação , Criança , Currículo , Feminino , Ginecologia/educação , Humanos , Obstetrícia/educação , Pediatria/educação , Gravidez , Estados Unidos
18.
J Pediatr Adolesc Gynecol ; 35(4): 512-515, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34871792

RESUMO

BACKGROUND: Ovarian teratomas are common, as is use of topical hemostatic agents in ovarian surgery. CASE: Following laparoscopic right ovarian cystectomy, a flowable hemostatic agent was placed in the ovarian bed. Postoperative ultrasound demonstrated an enlarged heterogeneous right ovary with solid and cystic components interpreted as residual or recurrent teratoma. Visual inspection during repeat laparoscopy revealed an irregularly shaped, enlarged right ovary with a smooth cortex. A cavity inside the ovary contained brown, shaggy material. Pathological evaluation demonstrated normal ovary and fibrin. SUMMARY AND CONCLUSION: We report the first case of a hemostatic agent routinely used in ovarian cystectomy postoperatively, mimicking a teratoma. Consideration of this finding is important when planning surgery in adolescent patients to optimize fertility preservation and minimize ovarian follicle damage.


Assuntos
Hemostáticos , Laparoscopia , Neoplasias Ovarianas , Teratoma , Adolescente , Feminino , Hemostáticos/uso terapêutico , Humanos , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/cirurgia , Teratoma/diagnóstico por imagem , Teratoma/cirurgia
19.
J Pediatr Adolesc Gynecol ; 34(6): 780-782, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34284081

RESUMO

Pediatric gynecologic malignancies are rare, present with diverse pathologic findings, and can be associated with genetic syndromes such as Peutz-Jeghers, Lynch, and Li-Fraumeni. DICER1 mutation is an emerging entity that has been demonstrated to cause a hereditary tumor predisposition syndrome. Previously, gynecologic manifestations of DICER1 syndrome have been described in single or small case reports with an array of pathologic findings. Here, we discuss pediatric and adolescent patients with gynecologic DICER1-associated tumors, outline the significance of DICER1, and suggest points of care where the syndrome may be diagnosed in the context of routine obstetric and gynecology practice. Patients presenting with a personal or family history suspicious for DICER1 syndrome should undergo both germline and somatic testing, as the presence of DICER1 mutations will have an impact on both treatment and surveillance strategies.


Assuntos
Ginecologia , Síndromes Neoplásicas Hereditárias , Obstetrícia , Adolescente , Criança , RNA Helicases DEAD-box/genética , Feminino , Humanos , Anamnese , Mutação , Síndromes Neoplásicas Hereditárias/diagnóstico , Síndromes Neoplásicas Hereditárias/genética , Gravidez , Ribonuclease III/genética
20.
Food Chem ; 361: 130110, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34033993

RESUMO

Determination of geographical origin of honey is important to consumers to confirm authenticity. This study investigated the elemental fingerprint of 181 honey samples collected from apiary sites in six regions of North Island, New Zealand to determine if differences were observed due to region of collection or land use surrounding the hive (e.g. agricultural, rural, urban). Using principal component analysis, soil related elements (Ca, K, Mg, Mn, Na) provided 75.2% discrimination of samples in the first two principal components. Overall, low concentrations of heavy metals were observed; lead was present in close proximity to highly trafficked roads (28.1% of samples; 9.50-76.5 µg kg-1) and cadmium was primarily present in honey collected from agricultural land in the Waikato (<51.6 µg kg-1). The use of an elemental fingerprint of New Zealand honey may be advantageous to determine the geographical origin compared to honey produced from other countries.


Assuntos
Análise de Alimentos , Mel/análise , Compostos Inorgânicos/análise , Geografia , Nova Zelândia , Análise de Componente Principal , Solo/química
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