scholarly journals Adherence and sustainability of interventions informing optimal control against the COVID-19 pandemic

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Laura Di Domenico ◽  
Chiara E. Sabbatini ◽  
Pierre-Yves Boëlle ◽  
Chiara Poletto ◽  
Pascal Crépey ◽  
...  
Keyword(s):  
Optimal Strategies ◽  
Data Driven ◽  
Third Wave ◽  
Additional Risk ◽  
Mobility Data ◽  
Stop And Go ◽  
Alpha Variant ◽  
One Year

Abstract Background After one year of stop-and-go COVID-19 mitigation, in the spring of 2021 European countries still experienced sustained viral circulation due to the Alpha variant. As the prospect of entering a new pandemic phase through vaccination was drawing closer, a key challenge remained on how to balance the efficacy of long-lasting interventions and their impact on the quality of life. Methods Focusing on the third wave in France during spring 2021, we simulate intervention scenarios of varying intensity and duration, with potential waning of adherence over time, based on past mobility data and modeling estimates. We identify optimal strategies by balancing efficacy of interventions with a data-driven “distress” index, integrating intensity and duration of social distancing. Results We show that moderate interventions would require a much longer time to achieve the same result as high intensity lockdowns, with the additional risk of deteriorating control as adherence wanes. Shorter strict lockdowns are largely more effective than longer moderate lockdowns, for similar intermediate distress and infringement on individual freedom. Conclusions Our study shows that favoring milder interventions over more stringent short approaches on the basis of perceived acceptability could be detrimental in the long term, especially with waning adherence.

scholarly journals Adherence and sustainability of interventions informing optimal control against COVID-19 pandemic

2021 ◽  
Author(s):  
Laura Di Domenico ◽  
Chiara E Sabbatini ◽  
Pierre-Yves Boëlle ◽  
Chiara Poletto ◽  
Pascal Crépey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Optimal Control ◽  
High Intensity ◽  
Data Driven ◽  
Individual Freedom ◽  
Additional Risk ◽  
Stop And Go ◽  
One Year

After one year of stop-and-go COVID-19 mitigation, some European countries still experience sustained viral circulation due to the B.1.1.7 variant. As the prospect of phasing out this stage through vaccination draws closer, it is critical to balance the efficacy of long-lasting interventions and their impact on the quality of life. Focusing on the current situation in France, we show that moderate interventions require a much longer time to achieve the same result as high intensity lockdowns, with the additional risk of deteriorating control as adherence wanes. Integrating intensity and duration of social distancing in a data-driven "distress" index, we show that shorter strict lockdowns are largely more performant than longer moderate lockdowns, for similar intermediate distress and infringement on individual freedom. Our study shows that favoring milder interventions over more stringent short approaches on the basis of perceived acceptability could be detrimental in the long term, especially with waning adherence.

scholarly journals Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

2018 ◽  
Vol 44 (5) ◽  
pp. 390-397 ◽  
Author(s):  
Carolina Bonfanti Mesquita ◽  
Caroline Knaut ◽  
Laura Miranda de Oliveira Caram ◽  
Renata Ferrari ◽  
Silmeia Garcia Zanati Bazan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oxygen Therapy ◽  
Severe Hypoxemia ◽  
Bode Index ◽  
One Year ◽  
Long Term Oxygen Therapy ◽  
Minute Walk

ABSTRACT Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br])

scholarly journals One-Year Follow-Up of Spa Treatment in Older Patients with Osteoarthritis: A Prospective, Single Group Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jolanta Zwolińska ◽  
Aneta Weres ◽  
Justyna Wyszyńska
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Mineral Waters ◽  
Spa Therapy ◽  
Spa Treatment ◽  
Short And Long Term ◽  
One Year

Introduction. Few studies evaluated the effects of spa therapy on pain perception and quality of life in older people with osteoarthritis. Therefore, the aim of the study was to evaluate the short- and long-term effects of spa therapy on quality of life and pain in patients aged 60 years and older with osteoarthritis. Materials and Methods. 70 patients with generalized osteoarthritis were enrolled in the study. Spa treatment lasted 3 weeks (15 days of treatment) and was applied during a session lasting 120 to 150 minutes a day. All the patients benefited from kinesiotherapy, physical agent modalities, massage, peloid therapy, hydrotherapy with mineral waters, and crenotherapy. Visual Analogue Scale (VAS) for pain, the Laitinen scale, and WHOQOL-BREF questionnaire were used to assess the condition of the patients. The examinations were performed three times: at the beginning of the spa treatment, after three months, and one year after the first examinations. Results. Statistically significant improvements were observed in pain (VAS) between consecutive assessments (p <.001). Laitinen scale also reported beneficial, statistically significant changes in the level of pain (p <.001). The WHOQOL-BREF questionnaire reported a statistically significant improvement in the domain of social relations in 2-3 and 1-3 periods (p = .025 and p = .011, resp.). A significant improvement was recorded in the domain of environment between 2-3 and 1-3 periods (p <.001). Conclusion. Spa treatment reduced the level of pain in majority of the patients in short- and long-term follow-up and contributed to improving the quality of life in the domain of social relations and environment. To confirm the results of this study, there is a need for a randomized controlled trial comparing spa treatment with usual care in the older population with osteoarthritis. Trial Registration Number. This trial was retrospectively registered on 3 January 2018 with NCT03388801.

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

2016 ◽  
Vol 82 (7) ◽  
pp. 613-621 ◽  
Author(s):  
Steven A. Groene ◽  
Davis W. Heniford ◽  
Tanushree Prasad ◽  
Amy E. Lincourt ◽  
Vedra A. Augenstein
Keyword(s):  
Umbilical Hernia ◽  
Defect Size ◽  
Long Term Outcomes ◽  
Preoperative Pain ◽  
The Mean ◽  
The Difference ◽  
One Year

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

scholarly journals Body-monitoring with photonic textiles: a reflective heartbeat sensor based on polymer optical fibres

2017 ◽  
Vol 14 (128) ◽  
pp. 20170060 ◽  
Author(s):  
Brit M. Quandt ◽  
Fabian Braun ◽  
Damien Ferrario ◽  
René M. Rossi ◽  
Anke Scheel-Sailer ◽  
...  
Keyword(s):  
Pressure Ulcer ◽  
Wearable Sensors ◽  
Skin Condition ◽  
Optical Fibres ◽  
Sensitive Skin ◽  
Additional Risk ◽  
Skin Conditions ◽  
Static Coefficient Of Friction

Knowledge of an individual's skin condition is important for pressure ulcer prevention. Detecting early changes in skin through perfusion, oxygen saturation values, and pressure on tissue and subsequent therapeutic intervention could increase patients' quality of life drastically. However, most existing sensing options create additional risk of ulcer development due to further pressure on and chafing of the skin. Here, as a first component, we present a flexible, photonic textile-based sensor for the continuous monitoring of the heartbeat and blood flow. Polymer optical fibres (POFs) are melt-spun continuously and characterized optically and mechanically before being embroidered. The resulting sensor shows flexibility when embroidered into a moisture-wicking fabric, and withstands disinfection with hospital-type laundry cycles. Additionally, the new sensor textile shows a lower static coefficient of friction (COF) than conventionally used bedsheets in both dry and sweaty conditions versus a skin model. Finally, we demonstrate the functionality of our sensor by measuring the heartbeat at the forehead in reflection mode and comparing it with commercial finger photoplethysmography for several subjects. Our results will allow the development of flexible, individualized, and fully textile-integrated wearable sensors for sensitive skin conditions and general long-term monitoring of patients with risk for pressure ulcer.

scholarly journals Long-Term Clinical Outcomes of Patients with no-significant of Transplanted Renal Artery Stenosis  

2021 ◽  
Author(s):  
Manoela Linhares Machado Barteczko ◽  
Henry Campos Orellana ◽  
Gustavo Rocha Feitosa Santos ◽  
Attílio Galhardo ◽  
Gabriel Kanhouche ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Transplantation ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Deceased Donor ◽  
Vascular Complication ◽  
Artery Stenosis ◽  
One Year

Abstract Background: Transplant Renal Artery Stenosis (TRAS) is the main vascular complication of kidney transplantation. For research and treatment purposes, several authors consider critical renal artery stenosis to be greater than 50%, and percutaneous intervention is indicated in this scenario. However, there are no reports in the current literature on the evolution of patients with less than 50% stenosis.Method: Retrospective study includes data from all patients that were submitted to kidney transplantation and were suspected TRAS after transplantation with stenosis under 50% independent on age, who were referred for angiography at a single center between January 2007 and December 2014. Results: During this period, 6,829 kidney transplants were performed at Hospital do Rim, 313 of them had clinical suspicion of TRAS and 54 were those who presented no-significant stenosis. The average age was 35.93 years old, the predominant gender was male and most individuals (94.4%) were submitted to dialysis before transplantation. Transplants, in most cases in this group, occurred from a deceased donor, 66.7%. The time between transplantation and angiography was less than one year in 79.6% of patients and all presented no-significant TRAS. Creatinine levels, Systolic Blood Pressure, Diastolic Blood Pressure and the glomerular filtration rate improved over the long term. The outcomes found were death and renal loss.Conclusion: Age, sex and ethnic group of patients are factors that did not interfere with the frequency of renal artery stenosis. The outcomes showed that in the long term most patients evolve well, and have improved quality of life and kidney function, although there are cases of death and kidney loss.

scholarly journals Original Article. Effectiveness of Hemorrhagic Fever with Renal Syndrome Bivalent Vaccine in China: A Metaanalysis

2012 ◽  
Vol 1 (1) ◽  
pp. 46-50
Author(s):  
Xiao-xia Huang ◽  
Lei Yan ◽  
Shi-wen Wang
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Hemorrhagic Fever ◽  
Biomedical Literature ◽  
Quality Of Data ◽  
Bivalent Vaccine ◽  
Knowledge Database ◽  
One Year

Abstract Objective To evaluate the effectiveness of Hemorrhagic Fever with Renal Syndrome (HFRS) bivalent vaccine in field. Methods The articles on effectiveness of HFRS bivalent vaccine were retrieved from Vip Database, China Journal Full-text Database, Wanfang database, China Hospital Knowledge Database, Chinese Biomedical Literature Database, MEDLINE and ProQuest. Two persons extracted data and evaluated the quality of data together for meta-analysis. Results Seven articles were included into the analysis, and two articles were random clinical trials, five were quasi-trials. Meta-analysis showed that the overall effectiveness of HFRS bivalent vaccine was 85% (95% confidence interval: 53%-95%) within one year after vaccination, and the effectiveness in two-dose recipients and three-dose recipients was 87% (95% confidence interval: 54%-96%) and 60%, respectively; it was 96% (95% confidence interval: 78%-99%) within 2-5 years after vaccination, and the effectiveness in two-dose recipients and three-dose recipients was 95% (95% confidence interval: 19%-100%) and 96% (95% confidence interval: 70%-99%), respectively; it was 100% (only one article included) within 6-9.6 years after vaccination. The effectiveness in two-dose recipients was 88% (95% confidence interval: 62%-96%) during 1-2.5 years after vaccination, and that in three-dose recipients was 94% (95% confidence interval: 70%-99%) during 1-5 years after vaccination. Conclusions HFRS bivalent vaccine is effective in field, and there is no difference between two-dose recipients and three-dose recipients. We should do some further studies on the long-term effectiveness of HFRS bivalent vaccine and on the age of vaccine reception.

L'impegno nucleare di Edf in Francia e nel mondo

2009 ◽  
pp. 91-97
Author(s):  
Bruno D'Onghia
Keyword(s):  
Best Practices ◽  
Legal Framework ◽  
Nuclear Program ◽  
The Public ◽  
Stop And Go ◽  
Single European Market ◽  
European Standards ◽  
To Come

- The success of the French nuclear program can suggest valuable lessons to Italy if she wants to come back to this technology: - nuclear is a choice of long-term that requires stable and long lasting strategies and does not tolerate "stop-and-go" and change of mind according to the pace of change of political majorities and governments; - in order to be competitive, a number of standardized reactors not too distant in time has to be realized; - the "country system" must be able to manage a complex industrial program, not in autarky, but in the framework of the single European market; - the public acceptance attitude should be developed and consolidated over time through the quality of industrial initiatives and demonstration of knowing how to achieve to announced targets; - the legal framework for the authorization process and the organization of the security authority should be guided by the international "best practices". The adoption of European standards and a European "design certification" should also be promoted.Key words: Nuclear energy, Edf strategies, nuclear waste.JEL classifications: G11, L20, L94

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