On the experimental intradiscal pressure measurement techniques : a review

Series : Mechanisms and machine science, ISSN 2211-0984, vol. 24The intradiscal pressure has been essential for prevent the spinal complaints by forming a basis for clinical advice to promote the correct sitting postures. As a consequence, it is evident the need of an accurate method for measure the intradiscal pressure, to better understand the disc response to hydorstatic pressure fluctuations. Numerous reviews regarding disc mechanics are available, including intradiscal pressure benchmarks; however, an analysis on the techniques of intradiscal pressure measurement is needed. Therefore, this review will remain focused on the methodologies adopted for measure the intradiscal pressure in several conditions: for different daily activities, under external loads and for values where occurs annulus fibrosus disruption. The importance of the intradiscal pressure on disc function will be discussed as well as the some guidelines for design new measurement techniques will be defined

Experienced-based co-design for cardiovascular and chronic disease research.

The participatory co-design method has received significant attention recently. Experience-based co-design is an approach that enables patients (service users) and healthcare providers (service delivers) to co-design services and care pathways in partnership to improve health outcomes based on their experience. Traditionally, it was used as a quality improvement technique. Yet, it is a valuable participatory research design that can help improve health outcomes and be applied in nursing research. This paper will discuss its application in research among people living with cardiovascular multimorbidity and its practicalities, usability, and impact on cardiovascular and chronic disease research and models of care

Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review.

Purpose: The burden of cardiovascular diseases (CVD) is high in low- and middle-income countries (LMICs). Medications are integral to the management and control of CVD; however, suboptimal adherence impacts health outcomes. This systematic review aims to critically examine interventions targeted at improving medication adherence among persons with CVD in LMICs. Methods: In this systematic review, we searched online databases PubMed, Embase, and CINAHL for studies that evaluated a medication adherence intervention for CVD, reported adherence as an outcome measure, were conducted in LMICs and reported the strategy or tool used to measure adherence. We included articles published in English, available in full text, peer-reviewed, and published between 2010 and 2020. Results: We included 45 articles in this review. The majority of the studies implemented counseling and educational interventions led by nurses, pharmacists, or community health workers. Many of the studies delivered medication-taking reminders in the form of phone calls, text messages, short message services (SMS), and in-phone calendars. Multi-component interventions were more effective than unifocal interventions. Interventions involving technology, such as mobile phone calls, electronic pillboxes, and interactive phone SMS reminders, were more effective than generic reminders. The outcomes reported in the studies varied based on the complexity and combination of strategies. When interventions were implemented at both the patient level, such as reminders, and at the provider level, such as team-based care, the effect on medication adherence was larger. Conclusion: In LMICs, medication adherence interventions among persons with CVD included a combination of patient education, reminders, fixed-dose combination therapy and team-based care approach were generally more effective than singular interventions. Among patients who had CVD, the medication adherence interventions were found to be moderately effective. Future studies focusing on improving medication adherence in LMICs should consider non-physician-led interventions and appropriately adapt the interventions to the local context

Risk factors for incident falls in older men and women:The English longitudinal study of ageing

Background: falls are a major cause of disability and death in older people, particularly women. Cross-sectional surveys suggest that some risk factors associated with a history of falls may be sex-specific, but whether risk factors for incident falls differ between the sexes is unclear. We investigated whether risk factors for incident falls differ between men and women.Methods: participants were 3298 people aged ≥60 who took part in the Waves 4-6 surveys of the English Longitudinal Study of Ageing. At Wave 4, they provided information about sociodemographic, lifestyle, behavioural and medical factors and had their physical and cognitive function assessed. Data on incident falls during the four-year follow-up period was collected from them at Waves 5 and 6. Poisson regression with robust variance estimation was used to derive relative risks (RR) for the association between baseline characteristics and incident falls.Results: in multivariable-adjusted models that also controlled for history of falls, older age was the only factor associated with increased risk of incident falls in both sexes. Some factors were only predictive of falls in one sex, namely more depressive symptoms (RR (95% CI) 1.03 (1.01,1.06)), incontinence (1.12 (1.00,1.24)) and never having married in women (1.26 (1.03,1.53)), and greater comorbidity (1.04 (1.00,1.08)), higher levels of pain (1.10 (1.04,1.17) and poorer balance, as indicated by inability to attempt a full-tandem stand, (1.23 (1.04,1.47)) in men. Of these, only the relationships between pain, balance and comorbidity and falls risk differed significantly by sex.Conclusions: there were some differences between the sexes in risk factors for incident falls. Our observation that associations between pain, balance and comorbidity and incident falls risk varied by sex needs further investigation in other cohorts. <br/

Depth-specific fluctuations of gene expression and protein abundance modulate the photophysiology in the seagrass Posidonia oceanica

Here we present the results of a multiple organizational level analysis conceived to identify acclimative/adaptive strategies exhibited by the seagrass Posidonia oceanica to the daily fluctuations in the light environment, at contrasting depths. We assessed changes in photophysiological parameters, leaf respiration, pigments, and protein and mRNA expression levels. The results show that the diel oscillations of P. oceanica photophysiological and respiratory responses were related to transcripts and proteins expression of the genes involved in those processes and that there was a response asynchrony between shallow and deep plants probably caused by the strong differences in the light environment. The photochemical pathway of energy use was more effective in shallow plants due to higher light availability, but these plants needed more investment in photoprotection and photorepair, requiring higher translation and protein synthesis than deep plants. The genetic differentiation between deep and shallow stands suggests the existence of locally adapted genotypes to contrasting light environments. The depth-specific diel rhythms of photosynthetic and respiratory processes, from molecular to physiological levels, must be considered in the management and conservation of these key coastal ecosystems.Portuguese funds from FCT - Foundation for Science and Technology [UID/Multi/04326/2013]; SZN PhD fellowship via the Open University; ESF COST Action Seagrass Productivity: From Genes to Ecosystem Management [ES0906]info:eu-repo/semantics/publishedVersio

Patient Portals and Shared Decision-Making in US Adults With or at Risk of Cardiovascular Diseases: A Cross-Sectional Study.

BACKGROUND: Patient portals are secure online platforms that have shown potential to facilitate shared decision-making (SDM) in cardiovascular disease risk reduction. However, the role of health care providers (HCPs) in offering patient portals within the context of SDM remains poorly understood. This study aimed to examine the relationship between patient portal access offered by HCPs and patient engagement in SDM among adults with or at risk of cardiovascular disease in the United States (US). METHODS: This population-based cross-sectional study included a nationally representative sample of US adults from the 2022 Health Information National Trends Survey. We performed weighted multivariable logistic regression analyses to examine the association between patient portal access offered by HCPs and patient engagement in SDM. RESULTS: The study included a representative sample of 4234 adults with or at risk of cardiovascular disease. The mean age of the participants was 48.5 years (SD, 17.1), with 50.6% female and 62.8% White. Adults who were offered access to patient portals by HCPs (adjusted odds ratio, 2.11 [95% CI, 1.34-3.32]) and encouraged to use them (adjusted odds ratio, 1.68 [95% CI, 1.15-2.45]) were more likely to engage in SDM than their counterparts, adjusting for covariates. The extent of this association varied by demographics and social determinants of health. CONCLUSIONS: Offering access to patient portals and encouragement to use them by HCPs was associated with high SDM among US adults with or at risk of cardiovascular disease. Future research is needed to explore the possible causal relationship between patient portal use and access and patient engagement in SDM

Exploring new physics frontiers through numerical relativity

The demand to obtain answers to highly complex problems within strong-field gravity has been met with significant progress in the numerical solution of Einstein's equations - along with some spectacular results - in various setups. We review techniques for solving Einstein's equations in generic spacetimes, focusing on fully nonlinear evolutions but also on how to benchmark those results with perturbative approaches. The results address problems in high-energy physics, holography, mathematical physics, fundamental physics, astrophysics and cosmology

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

What drives older adults’ acceptance of virtual humans? A conjoint and latent class analysis on virtual exercise coach attributes for a community-based exercise program

As an example of health-enhancing physical activities (HEPA), structured physical exercise is valuable in promoting healthy lifestyles among community-dwelling older adults. Technology-driven virtual coaches have the potential to enhance and improve exercise programs, but the preferences of the aging population were not previously explored. This study examined and analyzed the attributes and levels related to the acceptance of virtual coaches among the aging cohort via experience-based conjoint and latent class analysis. Purposively selected respondents (n = 232) from two senior centers in the Philippines completed a conjoint activity followed by a computer-based survey focusing on attributes related to platform, appearance, gender, language, and music. Results revealed the subjects' inclination to a humanlike, feminine, local language-speaking virtual coach projected through a mixed reality platform with a contemporary music background. Additionally, latent class analysis outcomes produced three subgroups based on the pattern of preferences among the technology users. Study outcomes reinforce the importance of human-centered design and multidisciplinary approaches to health technology development

Implementing a digital intervention for managing uncontrolled hypertension in Primary Care: a mixed methods process evaluation

Background: A high proportion of hypertensive patients remain above the target threshold for blood pressure, increasing the risk of adverse health outcomes. A digital intervention to facilitate healthcare practitioners (hereafter practitioners) to initiate planned medication escalations when patients’ home readings were raised was found to be effective in lowering blood pressure over 12 months. This mixed-methods process evaluation aimed to develop a detailed understanding of how the intervention was implemented in Primary Care, possible mechanisms of action and contextual factors influencing implementation. Methods: One hundred twenty-five practitioners took part in a randomised controlled trial, including GPs, practice nurses, nurse-prescribers, and healthcare assistants. Usage data were collected automatically by the digital intervention and antihypertensive medication changes were recorded from the patients’ medical notes. A sub-sample of 27 practitioners took part in semi-structured qualitative process interviews. The qualitative data were analysed using thematic analysis and the quantitative data using descriptive statistics and correlations to explore factors related to adherence. The two sets of findings were integrated using a triangulation protocol. Results: Mean practitioner adherence to escalating medication was moderate (53%), and the qualitative analysis suggested that low trust in home readings and the decision to wait for more evidence influenced implementation for some practitioners. The logic model was partially supported in that self-efficacy was related to adherence to medication escalation, but qualitative findings provided further insight into additional potential mechanisms, including perceived necessity and concerns. Contextual factors influencing implementation included proximity of average readings to the target threshold. Meanwhile, adherence to delivering remote support was mixed, and practitioners described some uncertainty when they received no response from patients