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This work established a quantitative method to access the shear stability of aerobic granular sludge (AGS) and validated its feasibility by using the mature AGS from a pilot-scale (50 tons/day) membrane bioreactor (MBR) for treating real municipal wastewater. The results showed that the changing rate (ΔS) of the peak area (S) of granule size distribution (GSD) exhibited an exponential relationship (R2≥0.76) with the shear time (y=a-b·cx), which was a suitable indicative index to reflect the shear stability of different AGS samples. The limiting granule size (LGS) was defined and proposed to characterize the equilibrium size for AGS after being sheared for a period of time, whose value in terms of Dv50 showed high correlation (R2=0.92) with the parameter a. The free Ca2+ (28.44-34.21 mg/L) in the influent specifically interacted with polysaccharides (PS) in the granule's extracellular polymeric substance (EPS) as a nucleation site, thereby inducing the formation of Ca precipitation to enhance its Young's modulus, while Ca2+ primarily interacted with PS in soluble metabolic product (SMP) during the initial granulation process. Furthermore, the Young's modulus significantly affected the parameter a related to shear stability (R2=0.99). Since the parameter a was more closely related (R2=1.00) to ΔS than that of the parameter b or c, the excellent correlation (R2=0.99) between the parameter a and the wet density further verified the feasibility of this method.
Assuntos
Reatores Biológicos , Esgotos , Eliminação de Resíduos Líquidos , Eliminação de Resíduos Líquidos/métodos , Projetos Piloto , Águas Residuárias/química , Membranas Artificiais , AerobioseRESUMO
Sewage sludge in cities of Yangzi River Belt, China, generally exhibits a lower organic content and higher silt contentdue to leakage of drainage system, which caused low bioenergy recovery and carbon emission benefits in conventional anaerobic digestion (CAD). Therefore, this paper is on a pilot scale, a bio-thermophilic pretreatment anaerobic digestion (BTPAD) for low organic sludge (volatile solids (VS) of 4%) was operated with a long-term continuous flow of 200 days. The VS degradation rate and CH4 yield of BTPAD increased by 19.93% and 53.33%, respectively, compared to those of CAD. The analysis of organic compositions in sludge revealed that BTPAD mainly improved the hydrolysis of proteins in sludge. Further analysis of microbial community proportions by high-throughput sequencing revealed that the short-term bio-thermophilic pretreatment was enriched in Clostridiales, Coprothermobacter and Gelria, was capable of hydrolyzing acidified proteins, and provided more volatile fatty acid (VFA) for the subsequent reaction. Biome combined with fluorescence quantitative polymerase chain reaction (PCR) analysis showed that the number of bacteria with high methanogenic capacity in BTPAD was much higher than that in CAD during the medium temperature digestion stage, indicating that short-term bio-thermophilic pretreatment could provide better methanogenic conditions for BTPAD. Furthermore, the greenhouse gas emission footprint analysis showed that short-term bio-thermophilic pretreatment could reduce the carbon emission of sludge anaerobic digestion system by 19.18%.
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Esgotos , Eliminação de Resíduos Líquidos , Esgotos/microbiologia , Anaerobiose , Eliminação de Resíduos Líquidos/métodos , Projetos Piloto , Reatores Biológicos/microbiologia , Metano/metabolismo , Metano/análise , Carbono/metabolismo , Carbono/análise , China , BiocombustíveisRESUMO
OBJECTIVES: To develop and validate a web-based ecological momentary assessment (EMA) tool to enhance symptoms monitoring among patients with Sjögren's disease (SjD). METHODS: Consecutive adults with SjD were enrolled in this pilot observational study. Participants used the WebApp over a 3-month period, for the daily collection of individual EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) scales and separate assessment of eyes and mouth dryness, using 0-10 numerical scales. Primary outcome was the measure of the interdaily variability of symptoms. Data collected through the WebApp were compared with those obtained with paper-based questionnaires administered during a final visit, using distinct approaches (predicted error, maximum negative error and maximum positive error). User experience was assessed using the System Usability Scale (SUS) score. RESULTS: Among the 45 participants, 41 (91.1%) were women. Median age was 57 years (IQR: 49-66). Daily variability of symptoms ranged between 0.5 and 0.8 points across the scales. Over the 3-month period, the predicted error ranged between -1.2 and -0.3 points of the numerical scales. The greatest differences were found for fatigue (-1.2 points (IQR: -2.3 to -0.2)) and ESSPRI score (-1.2 points (IQR: -1.7 to -0.3)). Over the last 2 weeks, the predicted error ranged between - 1.2 and 0.0 points. Maximum negative error ranged between -2.0 and -1.0 points, and maximum positive error between -0.3 and 0.0 points. Median SUS score was 90 (IQR: 85-95). CONCLUSION: Our results demonstrate the usability and the relevance of our web-based EMA tool for capturing data that closely reflects daily experiences of patients with SjD.
Assuntos
Avaliação Momentânea Ecológica , Internet , Síndrome de Sjogren , Humanos , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/complicações , Feminino , Pessoa de Meia-Idade , Masculino , Idoso , Projetos Piloto , Inquéritos e Questionários , Índice de Gravidade de Doença , Medidas de Resultados Relatados pelo Paciente , Avaliação de SintomasRESUMO
STUDY DESIGN: Longitudinal observational study. Measurements were undertaken between weeks 4-6 post-spinal cord injury (SCI), repeated at week 8 and every 4 weeks thereafter until week 20 or rehabilitation discharge, whichever occurred first. OBJECTIVES: Observe variation in measured resting energy expenditure (REE) and body composition in males undergoing SCI rehabilitation, compare REE with SCI-specific prediction equations incorporating fat-free mass (FFM), and explore the prevalence of clinical factors that may influence individual REE. SETTING: Spinal Injuries Unit, Brisbane, Queensland, Australia. METHODS: Indirect calorimetry was used to measure REE and bioimpedance spectroscopy to assess body composition. Four SCI-specific FFM-based REE and basal metabolic rate (BMR) prediction equations were compared to measured REE. A clinically significant change in REE was defined as +/- 10% difference from the week 4-6 measurement. Clinical factors that may affect REE variations were collected including infection, pressure injuries, autonomic dysreflexia, spasticity, and medications. RESULTS: Fifteen people participated (mean age 35 ± 13 years, 67% paraplegic). There was no statistically significant change in mean REE, weight, or body composition, and the Chun and Nightingale BMR prediction equations performed best (rc > 0.8 at all time points). One-third of participants had >10% change in REE on 11 occasions, with clinical factors not consistently associated with the observed changes. CONCLUSION: During SCI rehabilitation, mean REE, weight, and body composition remain unchanged, and FFM-based BMR prediction equations may be an acceptable alternative to indirect calorimetry. Future research designs should avoid single indirect calorimetry measures as snapshot data may not represent typical REE in this population.
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Composição Corporal , Calorimetria Indireta , Metabolismo Energético , Traumatismos da Medula Espinal , Humanos , Traumatismos da Medula Espinal/reabilitação , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/fisiopatologia , Masculino , Adulto , Projetos Piloto , Metabolismo Energético/fisiologia , Composição Corporal/fisiologia , Pessoa de Meia-Idade , Estudos Longitudinais , Metabolismo Basal/fisiologia , Adulto Jovem , Descanso/fisiologiaRESUMO
BACKGROUND: Acute kidney injury (AKI) represents a significant post-cardiac surgery complication, particularly prevalent among individuals with pre-existing renal dysfunction. Chronic kidney disease (CKD) is frequently accompanied by persistent, low-grade inflammation, which is known to exacerbate systemic stress responses during surgical procedures. This study hypothesizes that these inflammatory responses might influence the incidence and severity of postoperative acute kidney injury (AKI), potentially serving as a protective mechanism by preconditioning the kidney to stress. METHODS: This retrospective study enrolled patients with preoperative renal dysfunction (eGFR between 15 and 60 ml/min/1.73 m²) who underwent cardiac surgery between January 2020 and December 2022. Preoperative inflammatory biomarkers were evaluated. The primary outcome was the incidence of postoperative AKI, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariate regression models and sensitivity analyses were conducted to ascertain the relationship between inflammatory biomarkers and AKI. Restricted cubic spines (RCS) was conducted to explore nonlinear associations between inflammatory biomarkers and AKI. RESULTS: AKI occurred in 53.4% (392/734) of patients, accompanied by significant mortality and length of hospital stay increases in cases of AKI (P < 0.005). After full adjustment of confounders, neutrophil percentage-to-albumin ratio (OR = 0.28), systemic inflammation response index (OR = 0.70), systemic immune inflammation index (OR = 0.69), neutrophil-to-lymphocyte ratio (OR = 0.70), monocyte/high-density lipoprotein cholesterol ratio (OR = 0.53), neutrophil/high-density lipoprotein cholesterol ratio (OR = 0.43) demonstrated an inverse association with AKI. Sensitivity analyses revealed that patients in the highest quartile of these biomarkers exhibited a significantly lower prevalence of AKI compared to those in the lowest quartile (p for trend < 0.05). The RCS analysis suggested an "Inverted U-shaped" association of both LnNPAR and LnSIRI with AKI. CONCLUSIONS: This study identified an inverse association between preoperative inflammatory biomarkers and postoperative AKI in patients with preoperative renal dysfunction. The findings implied that preoperative inflammation may play a protective role against postoperative AKI in this patient population undergoing cardiac surgery.
Assuntos
Injúria Renal Aguda , Biomarcadores , Procedimentos Cirúrgicos Cardíacos , Inflamação , Complicações Pós-Operatórias , Humanos , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/sangue , Injúria Renal Aguda/epidemiologia , Masculino , Estudos Retrospectivos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Feminino , Biomarcadores/sangue , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/epidemiologia , Idoso , Pessoa de Meia-Idade , Inflamação/sangue , Projetos Piloto , Incidência , Taxa de Filtração Glomerular , Fatores de Risco , Período Pré-OperatórioRESUMO
In persons with a spinal cord injury (SCI), resistance training using neuromuscular electrical stimulation (NMES-RT) increases lean mass in the lower limbs. However, whether protein supplementation in conjunction with NMES-RT further enhances this training effect is unknown. In this randomized controlled pilot trial, 15 individuals with chronic SCI engaged in 3 times/week NMES-RT, with (NMES+PRO, n = 8) or without protein supplementation (NMES, n = 7), for 12 weeks. Before and after the intervention, whole body and regional body composition (DXA) and fasting glucose and insulin concentrations were assessed in plasma. Adherence to the intervention components was ≥96%. Thigh lean mass was increased to a greater extent after NMES+PRO compared to NMES (0.3 (0.2, 0.4) kg; p < 0.001). Furthermore, fasting insulin concentration and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were decreased similarly in both groups (fasting insulin: 1 [-9, 11] pmolâL-1; HOMA-IR: 0.1 [-0.3, 0.5] AU; both p ≥ 0.617). Twelve weeks of home-based NMES-RT increased thigh lean mass, an effect that was potentiated by protein supplementation. In combination with the excellent adherence and apparent improvement in cardiometabolic health outcomes, these findings support further investigation through a full-scale randomized controlled trial.
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Composição Corporal , Terapia por Estimulação Elétrica , Treinamento Resistido , Traumatismos da Medula Espinal , Humanos , Traumatismos da Medula Espinal/terapia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Masculino , Treinamento Resistido/métodos , Feminino , Adulto , Projetos Piloto , Terapia por Estimulação Elétrica/métodos , Pessoa de Meia-Idade , Suplementos Nutricionais , Resistência à Insulina , Insulina/sangue , Proteínas Alimentares/administração & dosagem , Glicemia/metabolismo , Músculo Esquelético/metabolismoRESUMO
The often poor oral health status of socioeconomically vulnerable adults is widely recognised. Nevertheless, research on it is scarce. To address this gap, this exploratory pilot study aimed to report on the prevalence of untreated caries and its clinical odontogenic consequences, as well as the associated Oral Health Related Quality of Life (OHRQoL) in a marginalised adult Dutch population. The Dutch department of Médecins du Monde (Doctors of the World) included socioeconomically vulnerable (low socioeconomic position [SEP]) adults in the Netherlands through community organisations. The validated Deprivation in Primary Care Questionnaire (DiPCare-Q) was translated in Dutch and used to characterise the SEP of the population. To document untreated caries and severe odontogenic consequences, the DMFT (Decayed, Missing, Filled Permanent Teeth) and PUFA (Pulpal, Fistula, Ulceration, Abscess) index were used. The validated Dutch Oral Health Impact Profile questionnaire (OHIP-14) was used to document the impact of these issues on OHRQoL. Data analysis was conducted in SPSS® (Statistical Package for the Social Sciences) statistics (Kruskal-Wallis, Mann-Whitney-U-test) and STATA software. Data from 59 adult participants were analysed. The prevalence of untreated caries (DT ≥ 1) was 65.5%, 57.9% of which experienced severe odontogenic consequences (DT+PUFA). The prevalence of severe odontogenic consequences (PUFA ≥ 1) was 45.5%. The mean OHIP-14 score of 17.7 ± 13.4 (25th-75th percentile: 6-26) illustrated that untreated caries may have impact on OHRQoL. Individuals who experienced any severe odontogenic consequences from untreated caries reported significantly higher OHIP-14 scores (mean ± s.d.: 21.8 ± 14.8 vs.11.1 ± 7.2). The untreated caries and severe odontogenic consequences seen in a large number of the socioeconomically vulnerable adult participants seemed to have an impact on OHRQoL. These findings emphasise the urgency of including these adults in the professional oral health system for treatment and prevention, and may emphasise the necessity of improving the socioeconomic circumstances of this population. Further exploration of the exact barriers and facilitators to oral healthcare access for socioeconomically vulnerable adults is necessary.
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Cárie Dentária , Qualidade de Vida , Populações Vulneráveis , Humanos , Países Baixos/epidemiologia , Projetos Piloto , Cárie Dentária/epidemiologia , Cárie Dentária/complicações , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Populações Vulneráveis/estatística & dados numéricos , Inquéritos e Questionários , Sorriso , Saúde Bucal/estatística & dados numéricos , Prevalência , IdosoRESUMO
BACKGROUND: Aging is a risk factor for falls, frailty, and disability. The utility of wearables to screen for physical performance and frailty at the population level is an emerging research area. To date, there is a limited number of devices that can measure frailty and physical performance simultaneously. OBJECTIVE: The aim of this study is to evaluate the accuracy and validity of a continuous digital monitoring wearable device incorporating gait mechanics and heart rate recovery measurements for detecting frailty, poor physical performance, and falls risk in older adults at risk of falls. METHODS: This is a substudy of 156 community-dwelling older adults ≥60 years old with falls or near falls in the past 12 months who were recruited for a fall prevention intervention study. Of the original participants, 22 participants agreed to wear wearables on their ankles. An interview questionnaire involving demographics, cognition, frailty (FRAIL), and physical function questions as well as the Falls Risk for Older People in the Community (FROP-Com) was administered. Physical performance comprised gait speed, timed up and go (TUG), and the Short Physical Performance Battery (SPPB) test. A gait analyzer was used to measure gait mechanics and steps (FRAIL-functional: fatigue, resistance, and aerobic), and a heart rate analyzer was used to measure heart rate recovery (FRAIL-nonfunctional: weight loss and chronic illness). RESULTS: The participants' mean age was 74.6 years. Of the 22 participants, 9 (41%) were robust, 10 (46%) were prefrail, and 3 (14%) were frail. In addition, 8 of 22 (36%) had at least one fall in the past year. Participants had a mean gait speed of 0.8 m/s, a mean SPPB score of 8.9, and mean TUG time of 13.8 seconds. The sensitivity, specificity, and area under the curve (AUC) for the gait analyzer against the functional domains were 1.00, 0.84, and 0.92, respectively, for SPPB (balance and gait); 0.38, 0.89, and 0.64, respectively, for FRAIL-functional; 0.45, 0.91, and 0.68, respectively, for FROP-Com; 0.60, 1.00, and 0.80, respectively, for gait speed; and 1.00, 0.94, and 0.97, respectively, for TUG. The heart rate analyzer demonstrated superior validity for the nonfunctional components of frailty, with a sensitivity of 1.00, specificity of 0.73, and AUC of 0.83. CONCLUSIONS: Agreement between the gait and heart rate analyzers and the functional components of the FRAIL scale, gait speed, and FROP-Com was significant. In addition, there was significant agreement between the heart rate analyzer and the nonfunctional components of the FRAIL scale. The gait and heart rate analyzers could be used in a screening test for frailty and falls in community-dwelling older adults but require further improvement and validation at the population level.
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Acidentes por Quedas , Fragilidade , Marcha , Frequência Cardíaca , Dispositivos Eletrônicos Vestíveis , Humanos , Idoso , Masculino , Projetos Piloto , Feminino , Frequência Cardíaca/fisiologia , Fragilidade/diagnóstico , Fragilidade/fisiopatologia , Marcha/fisiologia , Acidentes por Quedas/prevenção & controle , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Idoso Fragilizado , Avaliação Geriátrica/métodos , Vida IndependenteRESUMO
BACKGROUND: Advances in plasma biomarkers to detect Alzheimer's disease (AD) biology allows researchers to improve the efficiency of participant recruitment into preclinical trials. Recently, protein levels of plasma amyloid-beta and tau proteins have been shown to be predictive of elevated amyloid in brain. Online registries, such as the Alzheimer's Prevention Trials (APT) Webstudy, include and follow participants using remote assessments to facilitate efficient screening and enrollment of large numbers of individuals who may be at higher risk for AD. OBJECTIVES: The AlzMatch Pilot Study investigated the feasibility of recruiting individuals from an online registry for blood sample collection at community-based phlebotomy centers and plasma biomarker quantification to assess an individual's eligibility for AD preclinical trials. DESIGN: Pilot feasibility study with co-primary outcomes. SETTING: This pilot feasibility study included participants from the APT Webstudy, the remote assessment arm of the Trial-ready cohort for Preclinical and Prodromal AD (TRC-PAD) Platform. Novel design included collection of electronic consent, use of community laboratories for plasma collection, mass spectrometry-based biomarker assay, and telephone communication of plasma biomarker screening eligibility. PARTICIPANTS: Participants invited to the AlzMatch pilot feasibility study were active in the APT Webstudy, 50 years of age or older, resided within 50 miles of both a Quest Diagnostics Patient Services Center (a national diagnostic laboratory with convenient locations for sample collection and processing) and one of six TRC-PAD vanguard clinical trial sites, had no self-reported dementia diagnosis, were able to communicate in English and engaged with the APT Webstudy within the prior 6 months. MEASUREMENTS: Primary feasibility outcomes were completion of electronic consent (e-consent) for invited participants and collection of usable blood samples. Additional feasibility outcomes included invitation response rate, plasma biomarker eligibility status (based on amyloid beta-42/40 [Aß42/40] concentration ratio), ApoE proteotype, and trial inclusion criterion),â¯and completion of telephone contact to learn eligibility to screen for a study. RESULTS: 300 APT Webstudy participants were invited to consent to the AlzMatch study. The AlzMatch e-consent rate was 39% (n=117) (95% CI of 33.5%-44.5%) overall, which was higher than the expected rate of 25%. Similar consent rates were observed across participants based on self-defined sex (41% Female (n=75), 37% Male (n=42)) and race and ethnicity (37% from underrepresented groups (URG) (n=36), 40% not from URG (n=79)). Among those that consented (n=117), plasma was successfully collected from 74% (n=87) (95% CI of 66%-82%), with similar rates across sex (76% Female (n=57), 71% Male (n=30)) and race and ethnicity (75% URG (n=27) and 75% not from URG (n=59)). 60% (n=51) of participants with plasma biomarker results were eligible to screen for future preclinical AD trials. CONCLUSION: Electronic consent of participants through an online registry, blood sample collection at community-based centers, plasma biomarker quantification and reporting, and biomarker assessments for study eligibility were all feasible with similar engagement rates across demographic groups. Although this pilot was a small and selective sample, participants engaged and consented at higher than expected rates. We conclude that collecting blood at community laboratories for biomarker analyses may improve accessibility beyond research, and may facilitate broader access for clinical use of AD plasma biomarkers. Based on our results, an expanded version of the AlzMatch study is underway, which involves expanding invitations to additional APT Webstudy participants and clinical trial sites.
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Doença de Alzheimer , Peptídeos beta-Amiloides , Biomarcadores , Estudos de Viabilidade , Humanos , Doença de Alzheimer/sangue , Doença de Alzheimer/diagnóstico , Projetos Piloto , Biomarcadores/sangue , Feminino , Masculino , Idoso , Peptídeos beta-Amiloides/sangue , Proteínas tau/sangue , Coleta de Amostras Sanguíneas/métodos , Seleção de Pacientes , Sintomas Prodrômicos , Pessoa de Meia-Idade , Sistema de Registros , Ensaios Clínicos como AssuntoRESUMO
BACKGROUND: Little is known about the impact of short, low-intensity multidomain dementia risk reduction interventions in older adults. OBJECTIVES: To examine the effectiveness and feasibility of a low-intensity multidomain lifestyle intervention on dementia risk and dementia literacy in Australian older adults. DESIGN: Single-group pre-post design. SETTING: Community-dwelling. PARTICIPANTS: A total of 853 older Australians (Mean age=73.3 years, SD=6.1) recruited from the community. INTERVENTION: A 3-month dementia risk reduction program, BRAIN BOOTCAMP, including education, personalised risk information, physical cues for healthier choices and goal setting and planning to target four modifiable risk factors of diet, exercise, cognitive activity and social interaction in older adults. MEASUREMENTS: The 'LIfestyle for BRAin health' (LIBRA) index was used to assess participants' modifiable dementia risk based on 12 factors, with higher scores indicating greater risk. Dementia literacy was measured using a modified questionnaire derived from Dutch and British surveys, encompassing knowledge, risk reduction, and awareness aspects. Paired t-tests were used to compare dementia risk scores and dementia literacy before and after the program. Multivariate regressions were performed to identify sociodemographic and psychological factors associated with change in the LIBRA index. RESULTS: Program attrition was high (58.3%). Participants who completed the program had decreased dementia risk scores (Cohen's d=0.59, p<0.001), increased dementia literacy and awareness (Cohen's d=0.64, p<0.001) and increased motivation to change lifestyle behaviors (Cohen's d=0.25-0.52, p<0.016). Participants with higher motivational beliefs had greater dementia risk reduction. CONCLUSIONS: Improving older adults' motivation and knowledge may help modify lifestyle behaviors to reduce dementia risk. However, program attrition remains a challenge, suggesting the need for strategies to enhance participant engagement and retention in such interventions.
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Demência , Dieta , Exercício Físico , Comportamento de Redução do Risco , Interação Social , Humanos , Idoso , Projetos Piloto , Demência/prevenção & controle , Masculino , Feminino , Austrália , Cognição/fisiologia , Idoso de 80 Anos ou mais , Fatores de Risco , Letramento em Saúde , Vida Independente , Estilo de VidaRESUMO
Misinformation related to vaccines has been shown to potentially negatively impact public perceptions and intentions to vaccinate in many contexts including COVID-19 vaccination in Ghana. Psychological inoculation - where recipients are warned about the misleading techniques used in misinformation - is a potential intervention which could preemptively boost public resistance against misinformation. Cranky Uncle Vaccine is an interactive, digital game that applies inoculation, offering a scalable tool building public resilience against vaccine misinformation and promoting positive health-related behaviors. In this study, we document the process of developing and testing a West African version of Cranky Uncle Vaccine, with co-design workshops and a pilot test conducted in urban and peri-urban areas of the Greater Accra region of Ghana with 829 young people who had access to mobile and computer devices. The average age was 21.8 and participants were highly educated (median education level "Some/all university") with slightly more females (51.2%) than males (48.4%). Pilot participants filled out surveys before and after playing the game, measuring vaccine attitudes (pre-game M = 3.4, post-game M = 3.6), intent to get vaccinated (pre-game M = 3.5, post-game M = 3.6), and discernment between vaccine facts and fallacies (pre-game AUC = 0.72, post-game AUC = 0.75). We observed a significant improvement in attitudes toward vaccines, with players demonstrating increased likelihood to get vaccinated after completing the game. Among players who indicated that they were unlikely to get vaccinated in the pre-game survey (N = 52, or 6.3% of participants), just over half of these participants (53%) switched to likely to get vaccinated after playing the game. Perceived reliability of vaccine facts remained the same, while perceived reliability of vaccine fallacies significantly decreased, indicating improved ability to spot misleading arguments about vaccines. These results demonstrate the effectiveness of a digital game in building public resilience against vaccine misinformation as well as improving vaccine attitudes and intent to get vaccinated.
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Vacinas contra COVID-19 , Comunicação , Humanos , Gana , Masculino , Feminino , Adulto Jovem , Projetos Piloto , Vacinas contra COVID-19/administração & dosagem , Adolescente , COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Jogos de Vídeo , Vacinação/psicologia , Adulto , Inquéritos e Questionários , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricosRESUMO
BACKGROUND: Trigeminal herpetic neuralgia (THN) presents with severe pain hyperalgesia and is a high-risk factor for postherpetic neuralgia (PHN). The current clinical treatments for THN are unsatisfactory, and new treatments are desperately required. OBJECTIVES: This pilot study aimed to evaluate the efficacy of short-term trigeminal ganglion stimulation in treating patients with multi-branch THN. STUDY DESIGN: A prospective pilot study. SETTING: Multi-center study in 3 academic hospitals. METHODS: From July 2021 to October 2022, we enrolled 20 patients with multi-branch THN who received short-term trigeminal ganglion stimulation under general anesthesia from 3 hospitals. All patients completed a 12-month follow-up. The visual analog scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess patients' pain and quality of sleep. The Barrow Neurological Institute (BNI) score was used to determine the global outcome of pain relief, and complications were recorded. RESULTS: Significant and sustained pain relief and sleep improvement were achieved by all the patients who underwent trigeminal ganglion electrode stimulation in the present study. Respective BNI scores of 80% and 85% at 3 and 12 months after surgery were considered good. There were no other serious complications except for 2 patients' experiences of transient trigeminal cardiac reflex during the surgery and transient numbness deterioration in one patient's V3 sensory area. LIMITATIONS: The present study is a pilot study. We expect prospective multi-center, large-sample studies in the future. CONCLUSION: Short-term trigeminal ganglion stimulation can be used safely and effectively to treat patients with multi-branch THN and significantly reduce the occurrence of PHN.
Assuntos
Terapia por Estimulação Elétrica , Gânglio Trigeminal , Neuralgia do Trigêmeo , Humanos , Projetos Piloto , Estudos Prospectivos , Neuralgia do Trigêmeo/terapia , Terapia por Estimulação Elétrica/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neuralgia Pós-Herpética/terapia , Medição da Dor , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the use of antigen-based rapid diagnostic tests (Ag-RDTs) alongside a digital tool to deliver household-level COVID-19 testing by community health workers (CHWs), in line with Rwanda's ambition to decentralise COVID-19 testing. DESIGN: This was an operational pilot study to evaluate the impact and operational characteristics of using the digital e-ASCov tool combined with Ag-RDTs to support COVID-19 symptom screening and rapid testing by CHWs across eight districts in Rwanda. A total of 800 CHWs selected from both rural and urban areas were trained in delivering Ag-RDTs for COVID-19 testing and using the e-ASCOV application for data capture on a smartphone. Laboratory technicians repeated a subset of Ag-RDTs to assess the concordance of results obtained by CHWs. The study also assessed CHWs' experience of the intervention using a mixed-methods approach. SETTING: Eight rural, urban and semiurban districts in Rwanda. PARTICIPANTS: A total of 19 544 individuals were enrolled and screened for signs and symptoms of COVID-19. INTERVENTIONS: Community-based screening for COVID-19 by CHWs using the digital tool e-ASCov combined with rapid testing using Ag-RDTs. MAIN OUTCOME MEASURES: Number of participants screened and tested; concordance of Ag-RDT results between CHWs and laboratory technicians; feasibility of study procedures by CHWs and CHWs perceptions of the digital tool and Ag-RDT testing. RESULTS: From February to May 2022, CHWs screened 19 544 participants, of whom 4575 (23.4%) had COVID-19-related symptoms or a history of exposure to the infection. Among them, 86 (1.9%) were positive on Ag-RDTs. Concordance of Ag-RDT results between CHWs and laboratory technicians was 100%. Of the 800 trained CHWs, 746 (93.3%) were independently able to conduct household-based COVID-19 screening, perform the Ag-RDTs and send data to the central server. Most CHWs (>80%) found Ag-RDTs and e-ASCOV easy to use. CONCLUSIONS: This study demonstrated the feasibility of deploying a digital tool and Ag-RDTs for household-level SARS-CoV-2 detection in Rwanda. The findings support a broader roll-out of digitally supported rapid testing by CHWs to broaden access to testing for priority diseases.
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COVID-19 , Agentes Comunitários de Saúde , SARS-CoV-2 , Humanos , Ruanda/epidemiologia , Projetos Piloto , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Adulto , Masculino , SARS-CoV-2/isolamento & purificação , Pessoa de Meia-Idade , Teste para COVID-19/métodos , Programas de Rastreamento/métodos , Adulto JovemRESUMO
BACKGROUND: In edentulous jaws, factors such as the number of implants, cross-arch distribution, and the angle among implants may affect the accuracy of the implant impression. This study explored factors influencing the accuracy of implant abutment-level digital impressions using stereophotogrammetry in edentulous jaws. METHODS: Two standard all-on-4 and all-on-6 models of edentulous jaws were constructed in vitro. In the stereophotogrammetry group (PG), the implant digital impression was made using stereophotogrammetry and saved as an STL file. In the conventional group (CNV), the impression was made using the open-tray splint impression technique. An electronic and optical 3D measuring instrument was used to scan the standard model and the conventional plaster model to obtain STL files. Using 3D data processing software (GOM Inspect Pro, Zeiss), the distance and angle between the abutments in the CNV impression and the PG impression were measured and compared with the data from the standard model. RESULTS: The distance deviation in the PG and the CNV was 145 ± 196 µm and 96 ± 150 µm, respectively, with a significant difference (P < 0.001). The angle deviation in the PG and the CNV was 0.82 ± 0.88° and 0.74 ± 0.62°, respectively, with no significant difference (P = 0.267). In the PG, the distance deviation was negatively correlated with the distance between implants (r = -0.145, P = 0.028) and positively correlated with the angle of implants (r = 0.205, P = 0.002). The angle deviation was negatively correlated with the distance between implants (r = -0.198, P = 0.003) and positively correlated with the angle of implants (r = 0.172, P = 0.009). In the CNV, the effect of inter-implant distance on impression accuracy was also shown by Spearman correlation analysis: r = 0.347 (P < 0.001) for distance deviation and r = -0.012 (P = 0.859) for angle deviation. The effect of inter-implant angulation on impression accuracy deviation was r = -0.026 (P = 0.698) for distance deviation and r = 0.056 (P = 0.399) for angle deviation. CONCLUSIONS: The CNV method is closer to the real value of the original model. The distance between implants and the distribution angle had a weak correlation with the accuracy of digital impressions but no significant correlation with the accuracy of traditional impressions.
Assuntos
Técnica de Moldagem Odontológica , Imageamento Tridimensional , Arcada Edêntula , Fotogrametria , Fotogrametria/métodos , Projetos Piloto , Humanos , Arcada Edêntula/diagnóstico por imagem , Arcada Edêntula/patologia , Imageamento Tridimensional/métodos , Dente Suporte , Desenho Assistido por Computador , Modelos Dentários , Técnicas In Vitro , Projeto do Implante Dentário-Pivô/métodos , Implantes DentáriosRESUMO
BACKGROUND: Stainless steel crowns (SSCs) are commonly employed to restore the posterior teeth of children and over the years, they are available with improved anatomical shapes. This study was conducted to evaluate and assess the effect of the placement of SSCs on the masticatory efficiency of children. METHODS: This pilot cross-sectional split-mouth study assessed masticatory efficiency in children aged 6-11 years. Fifteen participants, each with stainless-steel crowns placed unilaterally at least one month prior, were included. This study utilized two flavours of trident chewing gum (red and green) to measure masticatory efficiency. The child was asked to chew half a strip of red and green chewing gum placed one on top of the other using either the noncrown or crown side 15 times. Another set of chewing gum was given to the child to chew 20 times on the same side. The chewing exercise was repeated using teeth on the other side. Chewed gum samples were collected, photographed, and analysed via ImageJ software to determine the red and green areas. Masticatory efficiency was subsequently calculated with the help of a formula in which the red areas and green areas were calculated via ImageJ software. The data were analysed with paired t tests via SPSS (version 20.0). RESULTS: When the mean values of the crown side were compared with those of the noncrown side following 15 chewing cycles, the chewing efficiency on the noncrown side was greater, with a difference of 0.303, whereas the chewing efficiency following 20 chewing cycles was greater on the crown side, with a difference of 0.814. However, both differences were statistically nonsignificant, with t values of -0.07 and 0.26, respectively, and p values of 0.94 and 0.8, respectively. CONCLUSION: The presence of SSCs on the molars of children did not affect masticatory efficiency.
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Coroas , Mastigação , Aço Inoxidável , Humanos , Mastigação/fisiologia , Estudos Transversais , Criança , Projetos Piloto , Aço Inoxidável/química , Masculino , Feminino , Goma de MascarRESUMO
BACKGROUND: The Cardio-Thoracic (CT) professional group experienced a significant increase in stress and workload during and after the COVID-19 pandemic. The Society for Cardiothoracic Surgery (SCTS) in Great Britain and Ireland with the aim of endorsing positive change. Aim of this project was to understand the Mental Health (MH) and wellbeing status of the CT professionals and to explore Virtual Reality Mindfulness as an intervention to improve MH and wellbeing. METHODS: In February 2022, the SCTS created a Mental Health and Wellbeing Working Group to identify the problem and find solutions. This exploratory project was carried out in two stages. Stage one was an online survey conducted in March 2022 and stage two was a Virtual Reality (VR) mindfulness workshop in March 2023, using the Rescape™ VR mindfulness tool. RESULTS: Stage one: An online QR code survey was sent out to 150 members with 129 (86%) completed responses. 92% expressed that SCTS should create awareness about mental health and wellbeing. 99% said that they should be allowed to speak up and create interventions for members to access, support and relax. Three main themes identified about why CT staff do not discuss their Mental Health problems were fear of lack of awareness (72%), lack of confidentiality (60%) and impact on career (60%). Stage two: 88 members attended the VR session of which 76 (86%) completed the anonymous questionnaire. 97% reported usage was a pleasurable experience, 91% felt more relaxed, 82% felt less stressed, 90% felt calmer and 89% had their mood enhanced. CONCLUSION: Our study findings indicate that CT staff experience considerable effects on their mental health and wellbeing. However, there is a hesitancy to recognise and seek assistance due to concerns about confidentiality and career repercussions. The virtual reality mindfulness session served as a beneficial supplement, with a positive impact in this pilot cohort.
Assuntos
COVID-19 , Saúde Mental , Atenção Plena , Realidade Virtual , Humanos , Atenção Plena/métodos , Projetos Piloto , COVID-19/epidemiologia , COVID-19/psicologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Cirurgia Torácica , Reino Unido , SARS-CoV-2RESUMO
OBJECTIVE: Local governments have an important role to play in creating healthy, equitable and environmentally sustainable food systems. This study aimed to develop and pilot a tool and process for local governments in Australia to benchmark their policies for creating healthy, equitable and environmentally sustainable food systems. DESIGN: The Healthy Food Environment Policy Index (Food-EPI), developed in 2013 for national governments, was tailored to develop the Local Food Systems Policy Index (Local Food-EPI+) tool for local governments. To incorporate environmental sustainability and the local government context, this process involved a literature review and collaboration with an international and domestic expert advisory committee (n 35) and local government officials. SETTING: Local governments. RESULTS: The tool consists of sixty-one indicators across ten food policy domains (weighted based on relative importance): leadership; governance; funding and resources; monitoring and intelligence; food production and supply chain; food promotion; food provision and retail in public facilities and spaces; supermarkets and food sources in the community; food waste reuse, redistribution and reduction; and support for communities. Pilot implementation of the tool in one local government demonstrated that the assessment process was feasible and likely to be helpful in guiding policy implementation. CONCLUSION: The Local Food-EPI+ tool and assessment process offer a comprehensive mechanism to assist local governments in benchmarking their actions to improve the healthiness, equity and environmental sustainability of food systems and prioritise action areas. Broad use of this tool will identify and promote leading practices, increase accountability for action and build capacity and collaborations.
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Benchmarking , Abastecimento de Alimentos , Governo Local , Política Nutricional , Humanos , Austrália , Abastecimento de Alimentos/normas , Abastecimento de Alimentos/métodos , Desenvolvimento Sustentável , Projetos Piloto , Dieta Saudável/normas , Dieta Saudável/métodosRESUMO
BACKGROUND: The use of simulation to enhance knowledge translation and bridge the theoretical-clinical gap to enhance clinical training and competency in health professions has received mixed reviews in the literature. OBJECTIVES: This research examined student perspectives of a simulation laboratory in speech therapy to improve students' clinical competency when working with adults with communication and dysphagia impairments. METHOD: An exploratory descriptive pilot study was conducted in 2022 with 16 third-year speech-language therapy students. This mixed-methods study involved students completing purposefully developed pre-and post-surveys to explore their experiences with simulated teaching and learning and their perceptions of confidence. Data were analysed using an independent t-test. Following the surveys, the students participated in a focus group discussion about their simulation experience, and data were analysed using thematic analysis. RESULTS: Student ratings of clinical skills improved from pre to post-simulation significantly overall and across six out of the eight items. The focus group revealed insights into students' experiences, highlighting increased confidence, the benefits of making mistakes in a safe environment and improved preparedness to work with dysphagia in patients. CONCLUSION: While simulation serves as a valuable tool in enhancing clinical skills and building confidence, it must be used as an adjunct to real-life exposure and not as a replacement.Contribution: The integration of both simulated and real-life experiences is essential to provide a comprehensive and practical learning environment for students.
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Competência Clínica , Transtornos de Deglutição , Grupos Focais , Treinamento por Simulação , Humanos , Transtornos de Deglutição/terapia , Projetos Piloto , Treinamento por Simulação/métodos , Patologia da Fala e Linguagem/educação , Masculino , Feminino , Adulto , Fonoterapia/educação , Fonoterapia/métodosRESUMO
Background: In this pilot safety study, we hypothesized that a human bone marrow stem cell-derived extracellular vesicle (hBM-MSC EV) investigational product (IP) would be safe and exhibit potential efficacy in amyotrophic lateral sclerosis (ALS) patients.Methods: Ten ALS patients received two 10-ml intravenous infusions of the IP given 1 month apart and evaluated over 3 months.Results: There were no serious adverse events or adverse events related to the IP and 30% of subjects' ALS functional rating scale-revised (ALSFRS-R) scores did not decline.Conclusion: HBM-MSC EVs appear safe in ALS patients. This early investigation suggests a controlled study of EVs for the treatment of ALS is warranted.
Amyotrophic lateral sclerosis (ALS) is a nervous system disease that affects the brain and spinal cord, causing the loss of muscle control. Currently, there is no cure for ALS and the disease gets worse over time. A potential new treatment is being investigated using mesenchymal stem cell extracellular vesicles (MSC EVs). MSC EVs are small structures that contain useful molecules and proteins that can be transported to cells affected by the disease, helping to reduce inflammation and encouraging repair. This 3-month study looked at the safety of human bone marrow MSC-EVs (hBM-MSC EVs) given as treatment to ten ALS patients, as well as how well it worked at delaying worsening of the disease. They found that there were no serious side effects caused by the treatment and that hBM-MSC EVs may have the potential for delaying the progression of ALS. This indicates that more, larger studies need to be carried out to find out treatment specifics, such as dose (how much of the treatment to give) and frequency (how often to give the treatment), and how they could be related to patient outcomes.