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Medicina 2021Last decades, a broad spectrum of inhaled devices (ID) had been developed to enhance efficacy and reduce adverse events. The correct use of IDs is a critical issue for...
Last decades, a broad spectrum of inhaled devices (ID) had been developed to enhance efficacy and reduce adverse events. The correct use of IDs is a critical issue for controlling obstructive respiratory diseases. There is no recommendation on inhalation therapy in Argentina. This document aims to issue local recommendations about the prescription of IDs. Each device was reviewed regarding biophysical laws, indication, strength, limitations, correct technique of use, frequent mistakes, and device cleaning and maintenance. Nebulization should be restricted to drugs that are not available in other IDs (for example, for treatment of cystic fibrosis) or where other devices fail. Nebulization is not recommended during the SARS-CoV2 pandemic. A metered-dose inhaler must always be used with an aerochamber. Aerochambers reduce the incidence of adverse events and improve lung deposition. Metered-dose inhalers must be prescribed to patients who cannot generate a high inspiratory flow and dry powders to those who can generate an energetic inspiratory flow. We reviewed the use of different IDs in patients with cystic fibrosis and under mechanical ventilation. The individual choice of an ID will be based on several variables like clinical status, age, previous experience, patient preference, drug availability, and correct use of the device.
Topics: Argentina; Asthma; COVID-19; Humans; Pulmonary Disease, Chronic Obstructive; RNA, Viral; SARS-CoV-2
PubMed: 34724622
DOI: No ID Found -
The Journal of Infectious Diseases May 2022Cases of coronavirus disease 2019 (COVID-19) have been reported in more than 200 countries. Thousands of health workers have been infected, and outbreaks have occurred... (Review)
Review
Cases of coronavirus disease 2019 (COVID-19) have been reported in more than 200 countries. Thousands of health workers have been infected, and outbreaks have occurred in hospitals, aged care facilities, and prisons. The World Health Organization (WHO) has issued guidelines for contact and droplet precautions for healthcare workers caring for suspected COVID-19 patients, whereas the US Centers for Disease Control and Prevention (CDC) has initially recommended airborne precautions. The 1- to 2-meter (≈3-6 feet) rule of spatial separation is central to droplet precautions and assumes that large droplets do not travel further than 2 meters (≈6 feet). We aimed to review the evidence for horizontal distance traveled by droplets and the guidelines issued by the WHO, CDC, and European Centre for Disease Prevention and Control on respiratory protection for COVID-19. We found that the evidence base for current guidelines is sparse, and the available data do not support the 1- to 2-meter (≈3-6 feet) rule of spatial separation. Of 10 studies on horizontal droplet distance, 8 showed droplets travel more than 2 meters (≈6 feet), in some cases up to 8 meters (≈26 feet). Several studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) support aerosol transmission, and 1 study documented virus at a distance of 4 meters (≈13 feet) from the patient. Moreover, evidence suggests that infections cannot neatly be separated into the dichotomy of droplet versus airborne transmission routes. Available studies also show that SARS-CoV-2 can be detected in the air, and remain viable 3 hours after aerosolization. The weight of combined evidence supports airborne precautions for the occupational health and safety of health workers treating patients with COVID-19.
Topics: Aerosols; Aged; COVID-19; Health Personnel; Humans; Infection Control; SARS-CoV-2
PubMed: 32301491
DOI: 10.1093/infdis/jiaa189 -
Sensors (Basel, Switzerland) Jan 2021To meet password selection criteria of a server, a user occasionally needs to provide multiple choices of password candidates to an on-line password meter, but such...
To meet password selection criteria of a server, a user occasionally needs to provide multiple choices of password candidates to an on-line password meter, but such user-chosen candidates tend to be derived from the user's previous passwords-the meter may have a high chance to acquire information about a user's passwords employed for various purposes. A third party password metering service may worsen this threat. In this paper, we first explore a new on-line password meter concept that does not necessitate the exposure of user's passwords for evaluating user-chosen password candidates in the server side. Our basic idea is straightforward; to adapt fully homomorphic encryption (FHE) schemes to build such a system but its performance achievement is greatly challenging. Optimization techniques are necessary for performance achievement in practice. We employ various performance enhancement techniques and implement the NIST (National Institute of Standards and Technology) metering method as seminal work in this field. Our experiment results demonstrate that the running time of the proposed meter is around 60 s in a conventional desktop server, expecting better performance in high-end hardware, with an FHE scheme in HElib library where parameters support at least 80-bit security. We believe the proposed method can be further explored and used for a password metering in case that password secrecy is very important-the user's password candidates should not be exposed to the meter and also an internal mechanism of password metering should not be disclosed to users and any other third parties.
PubMed: 33419094
DOI: 10.3390/s21020345 -
Sensors (Basel, Switzerland) Mar 2023Chlorophyll meters are portable devices used to assess and improve plants' nitrogen management and to help farmers in the determination of the health condition of plants...
Chlorophyll meters are portable devices used to assess and improve plants' nitrogen management and to help farmers in the determination of the health condition of plants through leaf greenness measurements. These optical electronic instruments can provide an assessment of chlorophyll content by measuring the light passing through a leaf or by measuring the light radiation reflected from its surface. However, independently of the main principle of operation and use (e.g., absorbance vs. reflectance measurements), commercial chlorophyll meters usually cost hundreds or even thousands of euros, making them inaccessible to growers and ordinary citizens who are interested in self-cultivation, farmers, crop researchers, and communities lacking resources in general. A low-cost chlorophyll meter based on light-to-voltage measurements of the remaining light after two LED light emissions through a leaf is designed, constructed, evaluated, and compared against two well-known commercial chlorophyll meters, the SPAD-502 and the atLeaf CHL Plus. Initial tests of the proposed device on lemon tree leaves and on young Brussels sprouts plant leaves revealed promising results compared to the commercial instruments. The coefficient of determination, R2, was estimated to be 0.9767 for the SPAD-502 and 0.9898 for the atLeaf-meter in lemon tree leaves samples compared to the proposed device, while for the Brussels sprouts plant, R2 was estimated to be 0.9506 and 0.9624, respectively. Further tests conducted as a preliminary evaluation of the proposed device are also presented.
Topics: Chlorophyll; Plant Leaves; Nitrogen
PubMed: 36904902
DOI: 10.3390/s23052699 -
Diabetes Spectrum : a Publication of... Feb 2022To demonstrate the clinical value of OneTouch (OT) Verio Flex glucose meter used in combination with a Spanish-language version of the OT Reveal mobile application (app)...
Use of a Meter With Color-Range Indicators and a Mobile Diabetes Management App Improved Glycemic Control and Patient Satisfaction in an Underserved Hispanic Population: "Tu Salud"-A Randomized Controlled Partial Cross-Over Clinical Study.
OBJECTIVE
To demonstrate the clinical value of OneTouch (OT) Verio Flex glucose meter used in combination with a Spanish-language version of the OT Reveal mobile application (app) to support diabetes care and improve glycemic control in an underserved Hispanic population with type 2 diabetes.
RESEARCH DESIGN AND METHODS
Test subjects ( = 81) used the meter and app for 12 weeks, while a randomized control group ( = 39) used their own glucose meters without connection to an app. Thereafter, test subjects continued the same regimen for an additional 12 weeks to determine the durability of effect, and control subjects crossed over to use the new meter and app.
RESULTS
Test subjects experienced a mean reduction in A1C of 1.0% after 12 weeks ( <0.001), a statistically significant greater reduction than in control subjects ( = 0.045). The improvement in A1C in test subjects was sustained over the next 12 weeks. Crossed-over subjects also demonstrated significant improvements in A1C ( <0.001). Mean blood glucose was reduced significantly without an increase in hypoglycemia, and results in range increased over 12 weeks of meter and mobile app use. Results were independent of subjects' numeracy skills. Subjects using the new meter and app reacted favorably to the tools and expressed improvements in their diabetes treatment satisfaction based on Diabetes Treatment Satisfaction Questionnaire-Change scores.
CONCLUSION
Use of the OT meter and a Spanish-language version of its diabetes management app in an underserved population helped participants achieve a sustained improvement in glycemic control. The tools were well received by the subjects and may have important utility in other low-numeracy, low-literacy populations.
PubMed: 35308153
DOI: 10.2337/ds20-0101 -
Archivos Espanoles de Urologia Sep 2021Portable pH meters are robust and reliable tools for measuring urinary pH bypatients at home. This study evaluated the usability of a prototype smart Lit-Control® pH...
OBJECTIVES
Portable pH meters are robust and reliable tools for measuring urinary pH bypatients at home. This study evaluated the usability of a prototype smart Lit-Control® pH Meter and an associated mobile medical app, with the aim of identifying possible design and functionality issues along with usability problems among non-expert voluntary users.
MATHERIALS AND METHODS
Twenty-one individuals of both genders, between 26 and 61 years old, tested the dyad pH meter/app for 14 days (three readings per day). The participants were asked to carry out a sequence of use of the system equivalent to what an intended user would do for urinary pH self-monitoring. At the end of the trial period, each participant filled out study questionnaires regarding the learning times, i.e. the time used by a new user to perform a task with the technology, usability, errors detected, and suggestions for improvement. RESULTS: The mean age of participants was 35.4 (range, 26 to 61) years. The readings from the pH meter yielded average values of 5.72 (SD = 0.26), 6.13 (SD= 0.43), and 5.47 (SD = 1.27) for the morning, evening, and night micturitions, respectively. The time of the day with greater adherence was the morning (49.7% of all readings). The learning times were in general short as reported by the participants: 73.7% were able to register in the App, rated as the least easy task, in less than two and a half minutes. The task of uploading the pH readings, both manually and automatically, was mostly performed in less than 35 seconds.
CONCLUSION
This pilot study of real-world usage pattern shows that the dyad smart Lit-Control pH meter/Appwas perceived as fit for purpose by non-expert volunteers and had no relevant functionality or usability issues that would pose a significant barrier to the intended users. New studies are ongoing in order to test the usability by patients with lithiasis history.
Topics: Adult; Female; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Mobile Applications; Pilot Projects; Surveys and Questionnaires
PubMed: 34472438
DOI: No ID Found -
Nature Communications Feb 2023Electron beam quality is paramount for X-ray pulse production in free-electron-lasers (FELs). State-of-the-art linear accelerators (linacs) can deliver multi-GeV...
Electron beam quality is paramount for X-ray pulse production in free-electron-lasers (FELs). State-of-the-art linear accelerators (linacs) can deliver multi-GeV electron beams with sufficient quality for hard X-ray-FELs, albeit requiring km-scale setups, whereas plasma-based accelerators can produce multi-GeV electron beams on metre-scale distances, and begin to reach beam qualities sufficient for EUV FELs. Here we show, that electron beams from plasma photocathodes many orders of magnitude brighter than state-of-the-art can be generated in plasma wakefield accelerators (PWFAs), and then extracted, captured, transported and injected into undulators without significant quality loss. These ultrabright, sub-femtosecond electron beams can drive hard X-FELs near the cold beam limit to generate coherent X-ray pulses of attosecond-Angstrom class, reaching saturation after only 10 metres of undulator. This plasma-X-FEL opens pathways for advanced photon science capabilities, such as unperturbed observation of electronic motion inside atoms at their natural time and length scale, and towards higher photon energies.
Topics: Electrons; Particle Accelerators; X-Rays; Lasers; Photons
PubMed: 36828817
DOI: 10.1038/s41467-023-36592-z -
PloS One 2021Dietary acrylamide is found in certain foods, such as deep frying, baking and roasting, and is associated with higher inflammatory and oxidative stress parameters. The...
BACKGROUND
Dietary acrylamide is found in certain foods, such as deep frying, baking and roasting, and is associated with higher inflammatory and oxidative stress parameters. The association between dietary acrylamide and physical performance has not yet been explored. The aim of the study was to investigate the relationship between dietary acrylamide intake and physical performance tests in a large cohort of North American individuals affected by knee osteoarthritis or at high risk for this condition.
METHODS
Dietary acrylamide intake was obtained through a food frequency questionnaire and reported in quartiles and as an increase in deciles. Physical performance was explored using the 20-meter usual pace test, the 400-meter walking distance, and the chair stands time. The association between dietary acrylamide and physical performance tests was explored using linear regression analysis, adjusted for potential confounders.
RESULTS
4,436 participants (2,578 women, mean age: 61.3) were enrolled. People in the highest quartile of dietary acrylamide reported significantly longer 20-meter walking (15.53±3.32 vs. 15.15±2.91 s), 400-meter walking (312±54 vs. 305±58 s) and chair stands (11.36±4.08 vs. 10.67±3.50 s) times than their counterparts in Q1. In adjusted linear regression analyses, each increase in one decile in dietary acrylamide was associated with a longer time in walking for 20 meters (beta = 0.032; 95%CI: 0.016-0.048; p = 0.04), 400 meters (beta = 0.048; 95%CI: 0.033-0.063; p = 0.002) and chair stands (beta = 0.016; 95%CI: 0.005-0.037; p = 0.04) times.
CONCLUSION
Higher dietary acrylamide intake was significantly associated with poor physical performance, also after accounting for potential confounders, suggesting a role for this food contaminant as a possible risk factor for sarcopenia.
Topics: Acrylamide; Adult; Aged; Cross-Sectional Studies; Humans; Middle Aged
PubMed: 34727127
DOI: 10.1371/journal.pone.0259320 -
Animals : An Open Access Journal From... Dec 2021The use of precision farming technologies, such as milking robots, automated calf feeders, wearable sensors, and others, has significantly increased in dairy operations...
The use of precision farming technologies, such as milking robots, automated calf feeders, wearable sensors, and others, has significantly increased in dairy operations over the last few years. The growing interest in farming technologies to reduce labor, maximize productivity, and increase profitability is becoming noticeable in several countries, including Brazil. Information regarding technology adoption, perception, and effectiveness in dairy farms could shed light on challenges that need to be addressed by scientific research and extension programs. The objective of this study was to characterize Brazilian dairy farms based on technology usage. Factors such as willingness to invest in precision technologies, adoption of sensor systems, farmer profile, farm characteristics, and production indexes were investigated in 378 dairy farms located in Brazil. A survey with 22 questions was developed and distributed via Google Forms from July 2018 to July 2020. The farms were then classified into seven clusters: (1) top yield farms; (2) medium-high yield, medium-tech; (3) medium yield and top high-tech; (4) medium yield and medium-tech; (5) young medium-low yield and low-tech; (6) elderly medium-low yield and low-tech; and (7) low-tech grazing. The most frequent technologies adopted by producers were milk meters systems (31.7%), milking parlor smart gate (14.5%), sensor systems to detect mastitis (8.4%), cow activity meter (7.1%), and body temperature (7.9%). Based on a scale containing numerical values (1-5), producers indicated "available technical support" (mean; σ) (4.55; 0.80) as the most important decision criterion involved in adopting technology, followed by "return on investment-ROI" (4.48; 0.80), "user-friendliness" (4.39; 0.88), "upfront investment cost" (4.36; 0.81), and "compatibility with farm management software" (4.2; 1.02). The most important factors precluding investment in precision dairy technologies were the need for investment in other sectors of the farm (36%), the uncertainty of ROI (24%), and lack of integration with other farm systems and software (11%). Farmers indicated that the most useful technologies were automatic milk meters systems (mean; σ) (4.05; 1.66), sensor systems for mastitis detection (4.00; 1.57), automatic feeding systems (3.50; 2.05), cow activity meter (3.45; 1.95), and in-line milk analyzers (3.45; 1.95). Overall, the concerns related to data integration, ROI, and user-friendliness of technologies are similar to those of dairy farms located in other countries. Increasing available technical support for sensing technology can have a positive impact on technology adoption.
PubMed: 34944264
DOI: 10.3390/ani11123488 -
Annals of the American Thoracic Society Jan 2021Inhaler misuse is highly prevalent and associated with high morbidity and costs. For metered dose inhalers, proper use can be supported with devices such as... (Review)
Review
Inhaler misuse is highly prevalent and associated with high morbidity and costs. For metered dose inhalers, proper use can be supported with devices such as spacers/valved holding chambers (VHCs) and masks to effectively deliver inhaled medication to the lungs. However, guidelines are vague about which children with asthma should use spacers/VHCs with masks to deliver medication from metered dose inhalers as well as when they should transition to spacers/VHCs with mouthpieces. In this paper, we provide a focused review of the evidence for mask use, highlighting unclear and conflicting information in guidelines and studies. We synthesize the differences in recommendations and practice. Based on these findings, we call for future research to determine the appropriate age and necessary skills for transitioning children from using metered dose inhalers with spacers/VHCs and masks to using spacers/VHCs and mouthpieces. Guidelines about mask use should be standardized to help ensure optimal medical delivery for patients, provide consistent inhaler prescriptions and education across settings, and support team-based care to help lower pediatric asthma morbidity and costs.
Topics: Asthma; Child; Equipment Design; Humans; Inhalation Spacers; Metered Dose Inhalers; Nebulizers and Vaporizers
PubMed: 33052700
DOI: 10.1513/AnnalsATS.202005-522CME