140 research outputs found

    Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI

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    This descriptive article explores the use of smart devices for health and wellness in the context of telehealth, highlighting rapidly evolving technologies such as the Internet of Things (IoT) and Artificial Intelligence (AI). Key innovations, benefits, challenges, and opportunities related to the adoption of these technologies are outlined. The article provides a descriptive and accessible approach to understanding the evolution and impact of smart devices in the tele-exercise reality. Nowadays, technological advances provide solutions that were unthinkable just a few years ago. The habits of the general population have also changed over the past few years. Hence, there is a need to investigate this issue and draw the attention of the scientific community to this topic by describing the benefits and challenges associated with each topic. If individuals no longer go to exercise, the exercise must go to their homes instead

    Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

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    Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

    Global Resources Management: A Systematic Review and Framework Proposal for Collaborative Management of CPPS

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    Nowadays, global resources management intersects with collaboration and Industry 4.0 paradigms, namely for collaboratively managing cyber-physical systems. Only organizations that cooperate with their business partners, along with their suppliers and remaining stakeholders, including their clients, will be able to permit and promote the much-needed endowing of agility, effectiveness, and efficiency in their management processes. For that, suitable decision-making paradigms, along with underlying approaches, will be needed, in order to properly fulfil current companies’ decision requirements and practices. The main purpose of this paper is to show that this can be achieved by applying combined global resources management paradigms and approaches, to reach collaboration further supported by recent technology made available through Industry 4.0. In doing so, the interaction of companies and stakeholders, supported by appropriate networks, along with varying kind of other communication and problem-solving technology, will enable them to promote and reinforce interoperation to reach the best-suited management decisions, by considering each ones’ objectives and priorities, along with common goals. To this end, in this paper, a systematic literature review methodology is used to synthetize the main contributions about the relation of these domains. The study carried out and the results obtained permitted us to realize that dynamic, integrated, distributed, parallel, intelligent, predictive, and real-time-based decision paradigms are of the upmost importance currently, but are still just scarcely being combined, which is suggested though its encompassing through a proposed collaborative management framework that is recommended to be applied, either in industry or academia, to improve global resources management processes and practices

    A highly virulent variant of HIV-1 circulating in the Netherlands

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    We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence

    Exposure of the alga Pseudokirchneriella subcapitata to environmentally relevant concentrations of the herbicide metolachlor: Impact on the redox homeostasis

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    This study investigated the effect of the herbicide metolachlor (MET) on the redox homeostasis of the freshwater green alga Pseudokirchneriella subcapitata. At low MET concentrations (≀40 ÎŒg L−1), no effects on algal cells were detected. The exposure of P. subcapitata to 45–235 ÎŒg L−1 MET induced a significant increase of reactive oxygen species (ROS). The intracellular levels of ROS were particularly increased at high (115 and 235 ÎŒg L−1) but environmentally relevant MET concentrations. The exposure of algal cells to 115 and 235 ÎŒg L−1 MET originated a decrease in the levels of antioxidants molecules (reduced glutathione and carotenoids) as well as a reduction of the activity of scavenging enzymes (superoxide dismutase and catalase). These results suggest that antioxidant (non-enzymatic and enzymatic) defenses were affected by the excess of MET. As consequence of this imbalance (ROS overproduction and decline of the antioxidant system), ROS inflicted oxidative injury with lipid peroxidation and damage of cell membrane integrity. The results provide further insights about the toxic modes of action of MET on a non-target organism and emphasize the relevance of toxicological studies in the assessment of the impact of herbicides in freshwater environments.The authors gratefully acknowledge Professor Paula Tamagnini for providing FastPrep-24 bead beater equipment and Doctor Ângela Brito for help and advice on enzyme extraction assays.info:eu-repo/semantics/publishedVersio

    Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019