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1.
BMJ Open Sport Exerc Med ; 10(2): e001974, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38974095

RESUMO

Objectives: Gaelic football requires ball handling, such as bouncing, fist passing and catching. To date, no research has examined the types of injuries sustained to the hand in this sport. This study aims to establish the types of orthopaedic hand injuries sustained in Gaelic football. Methods: This was a retrospective descriptive epidemiology study of Gaelic football-related hand injuries treated at a hand therapy unit. The nature of injuries was categorised along with collated variables on player demographics and injury profiles. Potential correlations between injury and continuous demographic data were analysed using the Mann-Whitney U and Kruskal-Wallis tests. Pearson's χ2 test was used for categorical data (p<0.05). Results: 287 referrals were identified. Most players were men (n=189; 65.9%), and the average age was 17 (IQR 14-25). Most fractures were to the volar base of the middle phalanx (n=110; 42.8%). Significant differences were found between the age of male and female players with fractures under 18 (p<0.05), the distribution of left and right-hand fractures by age (p<0.05), the distribution of fractures by bone type (p<0.05) and also between sex and affected ray (p<0.05), bone type (p<0.05) and mechanism of injury (p=0.05). Conclusion: This study established the types of musculoskeletal hand injuries sustained by players in Gaelic football. Considering developmental, anthropometric and rule differences between male and female players across the age range may explain variations in injuries. This data can help devise injury prevention and management strategies for Gaelic football.

2.
Toxicology ; 506: 153835, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38857863

RESUMO

Next Generation Risk Assessment (NGRA) is an exposure-led approach to safety assessment that uses New Approach Methodologies (NAMs). Application of NGRA has been largely restricted to assessments of consumer use of cosmetics and is not currently implemented in occupational safety assessments, e.g. under EU REACH. By contrast, a large proportion of regulatory worker safety assessments are underpinned by toxicological studies using experimental animals. Consequently, occupational safety assessment represents an area that would benefit from increasing application of NGRA to safety decision making. Here, a workflow for conducting NGRA under an occupational safety context was developed, which is illustrated with a case study chemical; sodium 2-hydroxyethane sulphonate (sodium isethionate or SI). Exposures were estimated using a standard occupational exposure model following a comprehensive life cycle assessment of SI and considering factory-specific data. Outputs of this model were then used to estimate internal exposures using a Physiologically Based Kinetic (PBK) model, which was constructed with SI specific Absorption, Distribution, Metabolism and Excretion (ADME) data. PBK modelling indicated a worst-case plasma maximum concentration (Cmax) of 0.8 µM across the SI life cycle. SI bioactivity was assessed in a battery of NAMs relevant to systemic, reproductive, and developmental toxicity; a cell stress panel, high throughput transcriptomics in three cell lines (HepG2, HepaRG and MCF-7 cells), pharmacological profiling and specific assays relating to developmental toxicity (Reprotracker and devTOX quickPredict). Points of Departure (PoDs) for SI ranged from 104 to 5044 µM. Cmax values obtained from PBK modelling of occupational exposures to SI were compared with PoDs from the bioactivity assays to derive Bioactivity Exposure Ratios (BERs) which demonstrated the safety for workers exposed to SI under current levels of factory specific risk management. In summary, the tiered and iterative workflow developed here represents an opportunity for integrating non animal approaches for a large subset of substances for which systemic worker safety assessment is required. Such an approach could be followed to ensure that animal testing is only conducted as a "last resort" e.g. under EU REACH.

3.
Opt Express ; 32(11): 20385-20400, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38859151

RESUMO

The holographic recording of gratings that have very large diffraction angles and/or slants is challenging because recording requires beam angles that are not possible without the use of prisms. However, by using a recording wavelength that is different from (usually shorter than) the intended operating wavelength, it is possible to record with less challenging beam angles. In this paper, a recently developed model that allows systematic investigation of the potential and limits of this wavelength-shift recording technique is extended to include a reflection format. Transmission and reflection recording options are compared systematically for the first time, and it is shown that in reflection recording, some couplers can be recorded more easily when the recording wavelength is longer than the operating wavelength. This opens up new design options for previously challenging regions of the spectrum. Experimental validation of the reflection version of the model is carried out by holographic recording in reflection mode at 532 nm in Bayfol HX 200 photopolymer, demonstrating the coupling of blue light.

4.
Hand Ther ; 29(1): 30-40, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38434187

RESUMO

Introduction: Innovative instruments have been designed to assess forearm rotation, an anatomically challenging motion to measure. This study assessed the concurrent validity, interrater reliability and responsiveness of a novel goniometer watch (GoWatch) to measure pure forearm rotation. The modified finger goniometer (MFG) was the criterion reference. Methods: Forty participants with restricted forearm rotation were recruited. Two raters measured supination and pronation using the GoWatch and MFG before and after a hand therapy session. Repeated-measures ANOVA assessed for systematic bias with an apriori residual error of 5° deemed as acceptable. Secondary analysis used intraclass coefficients (ICCs) to categorise interrater reliability. Responsiveness of the GoWatch was calculated using Cohen's d. Results: The GoWatch demonstrated acceptable agreement with the MFG with a mean difference for supination 1.19° and pronation 0.20°. Interrater reliability was also within acceptable limits with a mean difference GoWatch supination 4.43° and pronation 2.23°. Interrater reliability for GoWatch supination and pronation were categorized as excellent (ICC = 0.94) and good (ICC = 0.85) respectively. Systematic bias was observed in the instrument by rater interaction with rater two consistently underestimating GoWatch measures (p<.05). GoWatch supination showed small to medium responsiveness (Rater 1: d = 0.14; Rater 2: d = 0.29) and pronation very small to medium responsiveness (Rater 1: d = 0.29; Rater 2: d = 0.05). Conclusion: The GoWatch is a viable and user-friendly alternative to measure forearm rotation with demonstrable validity, interrater reliability and responsiveness. Further research is required to ensure systematic bias is not endemic when used across multiple raters.

5.
Toxicol Sci ; 199(2): 227-245, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38335931

RESUMO

Chemicals in the systemic circulation can undergo hepatic xenobiotic metabolism, generate metabolites, and exhibit altered toxicity compared with their parent compounds. This article describes a 2-chamber liver-organ coculture model in a higher-throughput 96-well format for the determination of toxicity on target tissues in the presence of physiologically relevant human liver metabolism. This 2-chamber system is a hydrogel formed within each well consisting of a central well (target tissue) and an outer ring-shaped trough (human liver tissue). The target tissue chamber can be configured to accommodate a three-dimensional (3D) spheroid-shaped microtissue, or a 2-dimensional (2D) cell monolayer. Culture medium and compounds freely diffuse between the 2 chambers. Human-differentiated HepaRG liver cells are used to form the 3D human liver microtissues, which displayed robust protein expression of liver biomarkers (albumin, asialoglycoprotein receptor, Phase I cytochrome P450 [CYP3A4] enzyme, multidrug resistance-associated protein 2 transporter, and glycogen), and exhibited Phase I/II enzyme activities over the course of 17 days. Histological and ultrastructural analyses confirmed that the HepaRG microtissues presented a differentiated hepatocyte phenotype, including abundant mitochondria, endoplasmic reticulum, and bile canaliculi. Liver microtissue zonation characteristics could be easily modulated by maturation in different media supplements. Furthermore, our proof-of-concept study demonstrated the efficacy of this coculture model in evaluating testosterone-mediated androgen receptor responses in the presence of human liver metabolism. This liver-organ coculture system provides a practical, higher-throughput testing platform for metabolism-dependent bioactivity assessment of drugs/chemicals to better recapitulate the biological effects and potential toxicity of human exposures.


Assuntos
Técnicas de Cocultura , Hepatócitos , Ensaios de Triagem em Larga Escala , Fígado , Humanos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Testes de Toxicidade/métodos , Linhagem Celular , Biomarcadores/metabolismo , Xenobióticos/toxicidade
6.
Trials ; 25(1): 26, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38183121

RESUMO

BACKGROUND: Motivation and a therapeutic alliance are crucial for successful therapy. It is assumed that dogs can increase motivation and help support therapeutic relationships. This is one of the reasons for including dogs in psychotherapy. While the positive effects of psychotherapy with dogs have been documented over the past years, little is known about the underlying mechanisms of animal-assisted psychotherapy. This study therefore aims to investigate whether and how the presence of a dog affects motivation and the therapeutic alliance in child and adolescent psychotherapy. METHODS: The study is a randomized controlled trial assessing motivation and the therapeutic alliance during the first five sessions of psychotherapy attended by children and adolescents with different psychiatric disorders. We will recruit 150 children and adolescents and randomly assign them to one of three conditions: (a) a dog is present but not integrated in the therapeutic narrative, (b) a dog is actively integrated in the therapeutic narrative, and (c) no dog is present. The children's and adolescents' evaluations of the therapeutic alliance and of their motivation will be assessed as the primary outcomes using standardized questionnaires before and after the first five therapy sessions as well as at follow-up. Further outcomes include the therapists' evaluations of the therapeutic alliance and their motivation, treatment adherence of the children and adolescents, and treatment satisfaction of the children and adolescents, their parents, and of the therapists. Interventions are conducted by experienced therapists who regularly work with their dogs. Outcomes will be analyzed using general linear models, with the treatment group as a fixed factor and the baseline values as covariates. DISCUSSION: This study provides information on the possible motivation and alliance-enhancing effects of integrating a dog into child and adolescent psychotherapy. This is relevant for practice, as these two components are strong predictors of therapy outcome. Moreover, the study will contribute to a better understanding of how a dog should be incorporated into psychotherapeutic settings. This can lead to a more purposeful inclusion of dogs in psychotherapy for children and adolescents. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov, NCT05384808, on 20 May 2022.


Assuntos
Aliança Terapêutica , Criança , Adolescente , Cães , Humanos , Animais , Motivação , Psicoterapia , Pessoal Técnico de Saúde , Modelos Lineares , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
J Appl Biomech ; 40(2): 155-165, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38016463

RESUMO

Biomechanics as a discipline is ideally placed to increase awareness and participation of girls and women in science, technology, engineering, and mathematics. A nationwide Biomechanics and Research Innovation Challenge (BRInC) centered on mentoring and role modeling was developed to engage high school girls (mentees) and early-mid-career women (mentors) in the field of biomechanics through the completion of a 100-day research and/or innovation project. This manuscript describes the development, implementation, and uptake of the inaugural BRInC program and synthesizes the research and innovation projects undertaken, providing a framework for adoption of this program within the global biomechanics community. Eighty-seven high school girls in years 9 and 10 (age range: 14-16 y) were mentored in teams (n = 17) by women in biomechanics (n = 24). Using a design thinking approach, teams generated solutions to biomechanics-based problem(s)/research question(s). Eight key reflections on program strengths, as well as areas for improvement and planned changes for future iterations of the BRInC program, are outlined. These key reflections highlight the innovation, impact, and scalability of the program; the importance of a program framework and effective communication tools; and implementation of strategies to sustain the program as well as the importance of diversity and building a sense of community.


Assuntos
Tutoria , Humanos , Feminino , Adolescente , Fenômenos Biomecânicos , Mentores
8.
PLoS One ; 18(9): e0276999, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37703264

RESUMO

BACKGROUND: To step over an unexpected obstacle, individuals adapt gait; they adjust step length in the anterior-posterior direction prior to the obstacle and minimum toe clearance height in the vertical direction during obstacle avoidance. Inability to adapt gait may lead to falls in older adults with diabetes as the results of the effects of diabetes on the sensory-motor control system. Therefore, this study aimed to investigate gait adaptability in older adults with diabetes. RESEARCH QUESTION: Would diabetes impair gait adaptability and increase sagittal foot adjustment errors? METHODS: Three cohorts of 16 people were recruited: young adults (Group I), healthy older adults (Group II), and older adults with diabetes (Group III). Participants walked in baseline at their comfortable speeds. They then walked and responded to what was presented in gait adaptability tests, which included 40 trials with four random conditions: step shortening, step lengthening, obstacle avoiding, and walking through. Virtual step length targets were 40% of the baseline step length longer or shorter than the mean baseline step length; the actual obstacle was a 5-cm height across the walkway. A Vicon three-dimensional motion capture system and four A.M.T.I force plates were used to quantify spatiotemporal parameters of a gait cycle and sagittal foot adjustment errors (differences between desired and actual responses). Analyses of variance (ANOVA) repeated measured tests were used to investigate group and condition effects on dependent gait parameters at a significance level of 0.05. RESULTS: Statistical analyses of Group I (n = 16), Group II (n = 14) and Group III (n = 13) revealed that gait parameters did not differ between groups in baseline. However, they were significantly different in adaptability tests. Group III significantly increased their stance and double support times in adaptability tests, but these adaptations did not reduce their sagittal foot adjustment errors. They had the greatest step length errors and lowest toe-obstacle clearance, which could cause them to touch the obstacle more. SIGNIFICANCE: The presented gait adaptability tests may serve as entry tests for falls prevention programs.


Assuntos
Diabetes Mellitus Tipo 2 , Adulto Jovem , Humanos , Idoso , Diabetes Mellitus Tipo 2/complicações , Marcha , Caminhada , , Extremidade Inferior
9.
Bioengineering (Basel) ; 10(7)2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37508800

RESUMO

The aim of this review article is to appraise the design and functionality of above-knee prosthetic legs. So far, various transfemoral prosthetic legs are found to offer a stable gait to amputees but are limited to laboratories. The commercially available prosthetic legs are not reliable and comfortable enough to satisfy amputees. There is a dire need for creating a powered prosthetic knee joint that could address amputees' requirements. To pinpoint the gap in transfemoral prosthetic legs, prosthetic knee unit model designs, control frameworks, kinematics, and gait evaluations are concentrated. Ambulation exercises, ground-level walking, running, and slope walking are considered to help identify research gaps and areas where existing prostheses can be ameliorated. The results show that above-knee amputees can more effectively manage their issues with the aid of an active prosthesis, capable of reliable gait. To accomplish the necessary control, closed loop controllers and volitional control are integral parts. Future studies should consider designing a transfemoral electromechanical prosthesis based on electromyographic (EMG) signals to better predict the amputee's intent and control in accordance with that intent.

10.
Biomed Opt Express ; 14(7): 3279-3293, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37497485

RESUMO

Amblyopia is a significant issue for children worldwide, and current treatment methods have drawbacks that can hinder treatment effectiveness and/or patient experience. This study proposes a new treatment method using holographic diffusers while also comparing their optical characteristics to a current treatment method (Bangerter foils). Holographic diffusers were developed by optically patterning thin polymer layers on a micron scale. Two compositions of photopolymer (acrylamide and diacetone acrylamide based) are analysed herein. Characterisation shows that holographic diffusers of either composition can achieve a wide range of on-axis intensity reductions, allowing for precise and customisable treatment levels by altering recording exposure time in a low-cost and durable manner.

11.
Biomed Eng Online ; 22(1): 43, 2023 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-37165365

RESUMO

BACKGROUND: Adaptive gait involves the ability to adjust the leading foot in response to the requirement of dynamic environments during walking. Accurate adjustments of the minimum toe clearance (MTC) height and step length can prevent older people from falling when walking and responding to hazards. Although older people with diabetes fall more frequently than healthy older adults, no previous studies have quantified their adaptive gait abilities. This study aimed to investigate the effects of diabetes mellitus on step length and MTC height adjustments using a non-immersive virtual-reality system. METHODS: Sixteen young adults (26 ± 5 years, 7 females), 16 healthy older adults (68 ± 5 years, 6 females), and 16 older adults with diabetes (70 ± 5 years, 6 females) completed adaptability tests while walking on a treadmill. A computer system visualised a continuous real-time signal of absolute step length and MTC on a monitor. Each person responded to four discrete participant-specific step length and MTC visual targets that were presented on the same signal. Tasks were to match the peaks of interest on each signal to presented targets. Targets were 10% longer or shorter than the mean baseline step length, and 2.5 cm, and 3.5 cm higher than the mean baseline MTC. When a target was displayed, it remained unchanged for 10 consecutive foot displacement adaptation attempts. Then, the target was removed and a new target or the same target was present after 10 consecutive steps and remained for 10 steps. Each target was randomly presented three times (3 × 10). Step length and MTC height adjustments in response to targets were measured and compared among groups. RESULTS: Mean preferred walking speeds were not different among groups significantly when no targets were presented on the monitor in baseline walking. However, when participants walked on a treadmill while attempting to match step lengths or MTC heights to displayed targets on the monitor, the group with diabetes had reduced step length and MTC adjustments compared with other groups significantly. They showed greater errors (differences between their step lengths/MTC heights and presented targets) on the monitor. CONCLUSIONS: This study quantified reduced abilities for older individuals with diabetes to adjust both step length and MTC in response to stimuli compared to healthy older counterparts. Reduced step length and MTC height adjustments can increase falls in at risk populations. The presented virtual-reality system has merits for assessing and training step and MTC adaptation.


Assuntos
Diabetes Mellitus , Dedos do Pé , Feminino , Adulto Jovem , Humanos , Idoso , Dedos do Pé/fisiologia , Marcha/fisiologia , Caminhada/fisiologia ,
12.
Opt Express ; 31(6): 9466-9480, 2023 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-37157517

RESUMO

An analog holographic wavefront sensor (AHWFS), for measurement of low and high order (defocus and spherical aberration) aberration modes has been developed as volume phase holograms in a photopolymer recording medium. This is the first time that high order aberrations such as spherical aberration can be sensed using a volume hologram in a photosensitive medium. Both defocus and spherical aberration were recorded in a multi-mode version of this AHWFS. Refractive elements were used to generate a maximum and minimum phase delay of each aberration which were multiplexed as a set of volume phase holograms in an acrylamide based-photopolymer layer. The single-mode sensors showed a high degree of accuracy in determining various magnitudes of defocus and spherical aberration generated refractively. The multi-mode sensor also exhibited promising measurement characteristics and similar trends to the single-mode sensors were observed. The method of quantifying defocus was improved upon and a brief study into material shrinkage and sensor linearity is presented.

13.
Sensors (Basel) ; 23(9)2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37177479

RESUMO

Volume reflection hologram-based sensors are designed to visibly change colour in response to a target stressor or analyte. However, reflection holograms fabricated in thick photopolymer films are highly angularly selective, making these sensors challenging to view and interpret by non-experts. Here, the use of speckle holography to improve the visibility of reflection holograms is presented. A novel recording approach combining speckle recording techniques with Denisyuk reflection recording geometry is described. The recorded speckle reflection grating operates as a series of multiplexed reflection gratings with a range of spatial frequencies, capable of reflecting light at a wider range of angles. A comparative study of the angular and wavelength selectivity of speckle and standard reflection gratings was conducted. The FWHM of the angular selectivity curves of the speckle reflection gratings is doubled (4°) in comparison to standard 4500 lines/mm reflection gratings (2°). The wavelength selectivity FWHM is also doubled from 4.2 to 8.6 nm. The comparative ability of the speckle and standard reflection gratings to act as colour-changing compressional pressure sensors in the 0.88-5.31 MPa range is described. Finally, we present a prototype reflection hologram viewer which enables the easy observation of angularly specific reflection holograms by non-experts.

14.
Expert Rev Hematol ; 16(sup1): 19-37, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36920859

RESUMO

BACKGROUND: Decades of research have transformed hemophilia from severely limiting children's lives to a manageable disorder compatible with a full, active life, for many in high-income countries. The direction of future research will determine whether exciting developments truly advance health equity for all people with hemophilia (PWH). National Hemophilia Foundation (NHF) and American Thrombosis and Hemostasis Network conducted extensive inclusive all-stakeholder consultations to identify the priorities of people with inherited bleeding disorders and those who care for them. RESEARCH DESIGN AND METHODS: Working group (WG) 1 of the NHF State of the Science Research Summit distilled the community-identified priorities for hemophilia A and B into concrete research questions and scored their feasibility, impact, and risk. RESULTS: WG1 defined 63 top priority research questions concerning arthropathy/pain/bone health, inhibitors, diagnostics, gene therapy, the pediatric to adult transition of care, disparities faced by the community, and cardiovascular disease. This research has the potential to empower PWH to thrive despite lifelong comorbidities and achieve new standards of wellbeing, including psychosocial. CONCLUSIONS: Collaborative research and care delivery will be key to capitalizing on current and horizon treatments and harnessing technical advances to improve diagnostics and testing, to advance health equity for all PWH.


Hemophilia is the best known of the inherited bleeding disorders (BD). This is a rare condition that causes disproportionate bleeding, often into joints and vital organs. Factor replacement, injecting recombinant or plasma-based clotting factor products directly into the vein, became commonplace to control the disorder in the 1990s and 2000s. Prophylaxis, or injecting replacement factor every few days into people with hemophilia (PWH), has revolutionized patients' lives. In the last few years, other advances in new therapies have entered this space, such as non-factor replacement therapies and gene therapy. With many more research advances on the horizon, the National Hemophilia Foundation (NHF) initiated a State of the Science Research Summit in 2020. This event was attended by over 880 interested parties to help design an agenda of research priorities for inherited BDs for the next decade, based on community consultations. NHF formed multiple Working Groups (WG), each exploring a theme resulting from the community consultations, and presenting their results at the Summit. Led by 2 hematologists who manage and treat PWH daily, the 21-community member WG1 assigned to hemophilia A and B divided into 7 subgroups to identify and organize research priorities for different topic areas. The outcomes focused on prioritizing patients' needs, technological advances, and research in the areas of greatest potential for PWH and those who care for them. The results are a roadmap for the future execution of a research plan that truly serves the community.


Assuntos
Hemofilia A , Medicina , Adulto , Humanos , Criança , Estados Unidos , Hemofilia A/diagnóstico , Hemofilia A/terapia , Atenção à Saúde , Pesquisa
15.
BMC Geriatr ; 23(1): 62, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36726077

RESUMO

BACKGROUND: Technology innovation provides an opportunity to support the rising number of people living with dementia globally. The present study examines experiences of people who have dementia and live in technology enriched supported care models. Additionally, it explores caregiver's attitudes towards technology use with the housing scheme. METHODS: A qualitative research design was adopted, and eight housing schemes consented to take part in the study. A technology audit was undertaken in addition to participant interviews and caregiver survey. Seven peer researchers conducted semi-structured interviews with 22 people living with dementia. Interviews were analysed using thematic analysis. Informal and formal caregivers were invited to complete a survey to capture their attitudes towards technology use. A total of 20 informal and 31 formal caregiver surveys were returned. All surveys were input into Survey Monkey and downloaded into excel for analysis. Closed questions were analysed using descriptive statistics and open-ended questions were organised into themes and described descriptively. RESULTS: The technology audit identified that technologies were in place from as early as 2002. Technology heterogeneity of, both passive and active devices, was found within the housing schemes. Technologies such as wearable devices were reportedly used according to need, and mobile phone use was widely adopted. The themes that developed out of the tenant interviews were: Attitudes and Engagement with Technology; Technology Enhancing Tenants Sense of Security; Seeking Support and Digital Literacy; and Technology Enabled Connection. A lack of awareness about living alongside technology was a major finding. Technologies enabled a sense of reassurance and facilitated connections with the wider community. The interaction with technology presented challenges, for example, remembering passwords, access to Wi-Fi and the identification of its use in an emergency. The caregiver survey reported a range of facilitators and barriers for the use of technology within care. Both types of caregivers held relatively similar views around the benefits of technology, however their views on issues such as privacy and consent varied. Safety was considered more important than right to privacy by family caregivers. CONCLUSIONS: The present study provides new insight into stakeholder's experiences of living, working and caregiving alongside technology in supported living environments. As the generation of people living with dementia become more tech savvy, harnessing everyday technologies to support care could enable holistic care and support the transition through the care continuum. Advance care planning and technology assessments are at the very core of future technology provision. It is evident that a paternalistic attitudes towards technology use could impact the multitude of benefits technology can play in both health and leisure for people living with dementia and their caregivers.


Assuntos
Demência , Psicoterapia de Grupo , Humanos , Demência/terapia , Cuidadores , Pesquisa Qualitativa , Tecnologia
16.
World J Virol ; 12(5): 286-295, 2023 Dec 25.
Artigo em Inglês | MEDLINE | ID: mdl-38187498

RESUMO

BACKGROUND: Studies have shown elevated C-reactive protein (CRP) to predict mechanical ventilation (MV) in patients with coronavirus disease 2019 (COVID-19). Its utility is unknown in patients with chronic kidney disease (CKD), who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance. AIM: To assess whether an association exists between elevated inflammatory markers and MV rate in patients with stages IIIb-V CKD and COVID-19. METHODS: We conducted a retrospective cohort study on patients with COVID-19 and stages IIIb-V CKD. The primary outcome was the rate of invasive MV, the rate of noninvasive MV, and the rate of no MV. Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables. Cutoffs for variables were CRP: 100 mg/L, ferritin: 530 ng/mL, D-dimer: 0.5 mg/L, and lactate dehydrogenase (LDH): 590 U/L. RESULTS: 290 were screened, and 118 met the inclusion criteria. CRP, D-dimer, and ferritin were significantly different among the three groups. On univariate analysis for invasive MV (IMV), CRP had an odds ratio (OR)-5.44; ferritin, OR-2.8; LDH, OR-7.7; D-dimer, OR-3.9, (P < 0.05). The admission CRP level had an area under curve-receiver operator characteristic (AUROC): 0.747 for the IMV group (sensitivity-80.8%, specificity-50%) and 0.663 for the non-IMV (NIMV) group (area under the curve, sensitivity-69.2%, specificity-53%). CONCLUSION: Our results demonstrate a positive correlation between CRP, ferritin, and D-dimer levels and MV and NIMV rates in CKD patients. The AUROC demonstrates a good sensitivity for CRP levels in detecting the need for MV in patients with stages IIIb-V CKD. This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation and reduced clearance due to CKD alone.

17.
Ann Rheum Dis ; 81(12): 1695-1703, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35973806

RESUMO

OBJECTIVES: Type-I interferons (IFNs-I) have potent antiviral effects. IFNs-I are also overproduced in patients with systemic lupus erythematosus (SLE). Autoantibodies (AAbs) neutralising IFN-α, IFN-ß and/or IFN-ω subtypes are strong determinants of hypoxemic COVID-19 pneumonia, but their impact on inflammation remains unknown. METHODS: We retrospectively analysed a monocentric longitudinal cohort of 609 patients with SLE. Serum AAbs against IFN-α were quantified by ELISA and functionally assessed by abolishment of Madin-Darby bovine kidney cell protection by IFN-α2 against vesicular stomatitis virus challenge. Serum-neutralising activity against IFN-α2, IFN-ß and IFN-ω was also determined with a reporter luciferase activity assay. SARS-CoV-2 antibody responses were measured against wild-type spike antigen, while serum-neutralising activity was assessed against the SARS-CoV-2 historical strain and variants of concerns. RESULTS: Neutralising and non-neutralising anti-IFN-α antibodies are present at a frequency of 3.3% and 8.4%, respectively, in individuals with SLE. AAbs neutralising IFN-α, unlike non-neutralising AAbs, are associated with reduced IFN-α serum levels and a reduced likelihood to develop active disease. However, they predispose patients to an increased risk of herpes zoster and severe COVID-19 pneumonia. Severe COVID-19 pneumonia in patients with SLE is mostly associated with combined neutralisation of different IFNs-I. Finally, anti-IFN-α AAbs do not interfere with COVID-19 vaccine humoral immunogenicity. CONCLUSION: The production of non-neutralising and neutralising anti-IFN-I antibodies in SLE is likely to be a consequence of SLE-associated high IFN-I serum levels, with a beneficial effect on disease activity, yet a greater viral risk. This finding reinforces the recommendations for vaccination against SARS-CoV-2 in SLE.


Assuntos
COVID-19 , Herpes Zoster , Lúpus Eritematoso Sistêmico , Humanos , Bovinos , Animais , Autoanticorpos , Vacinas contra COVID-19 , Estudos Retrospectivos , SARS-CoV-2 , Interferon-alfa , Interferon beta
18.
Polymers (Basel) ; 14(9)2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35567027

RESUMO

Functionalised holograms are important for applications utilising smart diffractive optical elements for light redirection, shaping and in the development of sensors/indicators. This paper reports on holographic recording in novel magnetic nanocomposites and the observed temperature change in dry layers and liquid samples exposed to alternating magnetic field (AMF). The nanocomposite consists of N-isopropylacrylamide (NIPA)-based polymer doped with magnetic nanoparticles (MNPs), and local heating is achieved through magnetic induction. Here, volume transmission holographic gratings (VTHGs) are recorded with up to 24% diffraction efficiency (DE) in the dry layers of magnetic nanocomposites. The dry layers and liquid samples are then exposed to AMF. Efficient heating was observed in the liquid samples doped with Fe3O4 MNPs of 20 nm average size where the temperature increased from 27 °C to 64 °C after 300 s exposure to 111 mT AMF. The temperature increase in the dry layers doped with the same nanoparticles after exposure to 4.4 mT AMF was observed to be 6 °C. No temperature change was observed in the undoped layers. Additionally, we have successfully recorded Denisyuk holograms in the magnetic nanocomposite materials. The results reveal that the magnetic nanocomposite layers are suitable for recording holograms and need further optimisation in developing holographic indicators for mapping AMFs.

20.
Artigo em Inglês | MEDLINE | ID: mdl-35409642

RESUMO

Public health restrictions, in response to the COVID-19 pandemic, have had potentially wide-ranging, unintended effects on health-related behaviours such as diet and physical activity and also affected mental health due to reduced social interactions. This study explored how health-related behaviours and mental health were impacted in a sample of the UK public during the first set of COVID-19 public health restrictions. Two online surveys were administered in the UK, one within the first three months of the restrictions (Timepoints 1 (T1­involving pre-pandemic recall) and 2/T2) and another ten weeks later (Timepoint 3/T3). Moderate−vigorous physical activity (MVPA), outdoor time, sitting time, screen time and sexual activity were self-reported. Diet was assessed using the Dietary Instrument for Nutrition Education questionnaire. Mental health was measured using the short-form Warwick−Edinburgh Mental Wellbeing Scale and Becks' Anxiety and Depression Inventories. Differences between timepoints were explored using the Friedman, Wilcoxon signed-rank, McNemar and McNemar−Bowker tests. Two hundred and ninety-six adults (74% under 65 years old; 65% female) provided data across all timepoints. Between T1 and T2, MVPA, time outdoors and sexual activity decreased while sitting, and screen time increased (p < 0.05). Between T2 and T3, saturated fat intake, MVPA, time outdoors, and mental wellbeing increased while sitting, screen time and anxiety symptoms decreased (p < 0.05). This study found that depending on the level of COVID-19 public health restrictions in place, there appeared to be a varying impact on different health-related behaviours and mental health. As countries emerge from restrictions, it is prudent to direct necessary resources to address these important public health issues.


Assuntos
COVID-19 , Adulto , Idoso , COVID-19/epidemiologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Saúde Mental , Pandemias , SARS-CoV-2 , Autorrelato , Reino Unido/epidemiologia
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