Mobility

机动性
  • 文章类型: Journal Article
    小巴出租车,一种非正式的共享出行方式,最多可搭载16名乘客,是撒哈拉以南非洲的主要公共交通方式,鉴于全球趋势,在未来几十年里,电力辅助运输的大规模转移迫在眉睫。对电动汽车(EV)车队的能耗(kWh/km)进行建模是规划车队部署的先决条件,尤其是在能量受限的情况下。鉴于撒哈拉以南非洲电动汽车的匮乏,对于许多发展中的环境,不存在关于电力辅助运行能耗的地面实况数据。因此,这些车辆的内燃机(ICE)版本的GPS跟踪数据通常用于估计电动等效物的能量消耗。迄今为止,这些车辆上只有每分钟的GPS跟踪数据被捕获并用于能耗估算。但是这种采样频率不足以进行准确的能耗估算,特别是考虑到小巴出租车独特的微移动模式,其特点是快速连续发生许多快速加速/减速事件。尽管模拟器可用于在数据集之间进行插值,在区域背景下,它们被证明是不准确的。本文介绍了在四种典型路线类型上的小巴出租车上捕获的高保真微移动性数据集:城际,城市内部,上坡,下坡。主要目的是估计这些车辆最终电气化的能量需求,因此,数据根据电动力学模型进行处理。这种高保真移动性数据是由“标准化乘客”使用定制的GPS位置记录设备以1Hz的频率采样捕获的。四种路线类型的行程被记录并保存在六个文件夹中-三条路线,每个方向都有两个方向,一条路线在一个方向上坡,在另一个方向下坡。六个文件夹中的每一个都有一天早上的子文件夹,下午,和晚上。总共记录了62次不同持续时间的行程,取决于交通和路线长度。
    Minibus taxis, a form of informal shared mobility that carries up to 16 passengers, is the main mode of public transport in sub-Saharan Africa, and given global trends, a large-scale shift to electric paratransit is imminent in the coming decades. Modeling the energy consumption (kWh/km) of electric vehicle (EV) fleets is a pre-requisite for planning for fleet deployment, especially in energy-constrained contexts. Given the paucity of EVs in sub-Saharan Africa, ground-truth data on the energy consumption of electric paratransit does not exist for many developing contexts. Consequently, GPS tracking data on internal combustion engine (ICE) versions of these vehicles is often used to estimate the energy consumption of an electric equivalent. To date, only per-minute GPS tracking data has been captured on these vehicles and used for energy consumption estimates. But this sampling frequency is insufficient for accurate energy consumption estimates, especially given the unique micro-mobility patterns of minibus taxis that are characterized by many rapid acceleration/deceleration events in quick succession. Although simulators can be used to interpolate between the dataset, they have been shown to be inaccurate in the regional context. This article presents a dataset of high-fidelity micromobility data captured on minibus taxis in transit on four typical route types: inter-city, intra-city, uphill, and downhill. The main objective was to estimate energy requirements for the eventual electrification of these vehicles, the data was thus processed according to an electro-kinetic model. This high-fidelity mobility data was captured by \"standardised passengers\" with bespoke GPS-location logging devices sampling at 1 Hz. Trips on the four route types were recorded and saved in six folders - three routes, each in two directions, with one route being uphill in one direction and downhill in another. Each of the six folders have subfolders for time of day - morning, afternoon, and evening. In total 62 trips were recorded with varying durations, depending on the traffic and route length.
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  • 文章类型: Journal Article
    早期研究表明,物理治疗与机器人助行器的使用相结合,为患有严重行动不便的儿童提供了一个新的机会来体验主动行走。TrexoPlus是安装在轮式助行器框架上的小儿下肢外骨骼,并且可以调整以适合孩子的位置和步态要求。它以个性化的方式引导和驱动孩子的腿部运动,以适应他们的运动潜力和直立支持需求,并且可以为基于物理治疗的运动学习治疗范式中的行走提供渐进的挑战。
    该方案概述了一项单组混合方法研究,该研究评估了在为期6周的物理治疗期间在学校和门诊环境中使用物理治疗辅助地面Trexo的可行性。3-6岁儿童(n=10;脑瘫或相关疾病,粗大运动功能分类系统IV级)将通过护理邀请圈招募参加。研究指标/结果将侧重于评估:(I)临床可行性,安全,和干预的可接受性;(ii)干预前的运动/功能结果;(iii)干预前的脑结构表征和静息状态脑连通性;(iv)Trexo辅助步态和自然辅助步态期间的肌肉活动表征;(v)Trexo辅助步态和自然辅助步态期间的心率;(vi)物理治疗师的用户体验和感知,孩子们,和父母。
    这将是第一个调查可行性指标的研究,结果,以及在学校和门诊环境中对行动不便的儿童进行基于Trexo的物理治疗的经验。它将在步态康复的背景下探索经验依赖性神经可塑性的可能性,以及相关的功能和肌肉结果。最后,该研究将从物理治疗师的角度解决有关该设备的临床实用性和未来采用的重要问题,从儿童的角度来看,舒适和参与,以及父母对引入这项技术作为早期干预的价值的印象。
    https://clinicaltrials.gov,标识符NCT05463211。
    UNASSIGNED: Early phase research suggests that physiotherapy paired with use of robotic walking aids provides a novel opportunity for children with severe mobility challenges to experience active walking. The Trexo Plus is a pediatric lower limb exoskeleton mounted on a wheeled walker frame, and is adjustable to fit a child\'s positional and gait requirements. It guides and powers the child\'s leg movements in a way that is individualized to their movement potential and upright support needs, and can provide progressive challenges for walking within a physiotherapy-based motor learning treatment paradigm.
    UNASSIGNED: This protocol outlines a single group mixed-methods study that assesses the feasibility of physiotherapy-assisted overground Trexo use in school and outpatient settings during a 6-week physiotherapy block. Children ages 3-6 years (n = 10; cerebral palsy or related disorder, Gross Motor Function Classification System level IV) will be recruited by circle of care invitations to participate. Study indicators/outcomes will focus on evaluation of: (i) clinical feasibility, safety, and acceptability of intervention; (ii) pre-post intervention motor/functional outcomes; (iii) pre-post intervention brain structure characterization and resting state brain connectivity; (iv) muscle activity characterization during Trexo-assisted gait and natural assisted gait; (v) heart rate during Trexo-assisted gait and natural assisted gait; and (vi) user experience and perceptions of physiotherapists, children, and parents.
    UNASSIGNED: This will be the first study to investigate feasibility indicators, outcomes, and experiences of Trexo-based physiotherapy in a school and outpatient context with children who have mobility challenges. It will explore the possibility of experience-dependent neuroplasticity in the context of gait rehabilitation, as well as associated functional and muscular outcomes. Finally, the study will address important questions about clinical utility and future adoption of the device from the physiotherapists\' perspective, comfort and engagement from the children\'s perspective, and the impressions of parents about the value of introducing this technology as an early intervention.
    UNASSIGNED: https://clinicaltrials.gov, identifier NCT05463211.
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  • 文章类型: Journal Article
    少数老年髋部骨折患者寻求非手术治疗。与手术患者相比,非手术患者死亡率较高。然而,非手术与手术治疗后的患者满意度尚未得到广泛调查。这项研究的目的是比较非手术和手术治疗的髋部骨折患者的满意度。
    我们确定了60岁以上的股骨近端骨折患者,治疗时间为10年。排除了孤立的大/小转子骨折患者。要求患者或亲属完成有关其治疗满意度的6个问题的调查。
    记录了56名手术患者和28名非手术患者的调查反应。总的来说,91.1%的手术患者和82.1%的非手术患者对治疗过程满意(P=0.260)。然而,只有71.4%的非手术患者对治疗方案解释满意,而手术患者为83.9%(P=0.014).虽然只有64.3%的非手术受访者对最终治疗结果感到满意(相比之下,85.7%的手术患者,P=0.025),每个队列中89.3%的患者会再次选择相同的治疗方案。
    我们的研究结果突出了定义患者满意度的复杂性,特别是在老年髋部骨折人群中。与以往的研究不同,我们选择了一种直接量化患者满意度的方法,具体询问参与者对治疗结果和整个疗程的满意度.然后纳入其他调查问题,以评估治疗满意度中被认为重要的因素,例如医疗保健提供者的治疗解释,治疗后的流动性,和姑息治疗服务的参与。
    我们发现了非手术和手术治疗的老年髋部骨折患者在对治疗方案的解释满意度方面的显著差异。和最终的治疗结果。对疗程的总体满意度或再次选择相同治疗的可能性没有显着差异。需要进一步研究老年髋部骨折治疗后患者的满意度。
    UNASSIGNED: A minority of geriatric hip fracture patients pursue non-operative treatment. Compared with surgical patients, non-operative patients have higher mortality rates. However, patient satisfaction following non-operative vs operative treatment has not been investigated extensively. The purpose of this study was to compare satisfaction among non-operatively vs operatively treated hip fracture patients.
    UNASSIGNED: We identified patients aged 60+ years with proximal femur fractures treated over a 10-year period. Excluded were patients with isolated greater/lesser trochanteric fractures. Patients or relatives were asked to complete a 6-question survey about their treatment satisfaction.
    UNASSIGNED: Survey responses from 56 operative and 28 non-operative patients were recorded. Overall, 91.1% of operative and 82.1% of non-operative patients were satisfied with their treatment course (P = 0.260). However, only 71.4% of non-operative patients were satisfied with treatment option explanations vs 83.9% of operative patients (P = 0.014). While only 64.3% of non-operative respondents were satisfied with the ultimate treatment outcome (vs 85.7% of operative patients, P = 0.025), 89.3% of patients in each cohort would choose the same treatment plan again.
    UNASSIGNED: Our findings highlight the complexity of defining patient satisfaction, particularly in a geriatric hip fracture population. Unlike previous studies, we chose a direct approach to quantifying patient satisfaction by asking participants specifically about satisfaction with treatment outcome and the overall treatment course. Additional survey questions were then included to assess factors considered important in treatment satisfaction, such as health care provider treatment explanations, post-treatment mobility, and palliative care service involvement.
    UNASSIGNED: We identified significant differences between non-operatively and operatively treated geriatric hip fracture patients regarding satisfaction with the explanation of treatment options, and ultimate treatment outcomes. There was no significant difference in overall satisfaction with the treatment course or likelihood of choosing the same treatment again. Further research investigating patient satisfaction following geriatric hip fracture treatment is warranted.
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  • 文章类型: Journal Article
    背景:老年人口的增长导致骨盆环骨折的数量增加。这些通常涉及耻骨分支和骶骨骨折的组合,如在外侧压缩类型1(LC1)和2(LC2)骨折或更精确地分类为骨盆脆性骨折(FFP)中所见。对前后环的综合影响带来了长时间疼痛的风险,导致活动性下降和并发症增加。鉴于该人群的多发病率较高,手术治疗会增加术中和术后并发症的风险.因此,这种特殊类型骨折的处理和治疗仍然具有挑战性.
    方法:对2017年至2020年期间保守治疗低能量LC1或LC2骨折的41例患者(F/M;27/14)进行回顾性资料分析。使用Rommens\'FFP分类法对骨折进行分类。主要结果是2周和6周的流动性,通过图表分析和电话采访进行评估。为了确定影响患者预后的因素,通过X射线分析评估了骨折固结。作为次要结果,进行了逻辑回归和决策树分析。
    结果:骨折时的平均年龄为79.8±12.5(SD)岁。32例患者在2周后恢复活动能力(F/M;25/7)。另外7例患者在6周后移动(F/M;2/5)。两名男性患者没有恢复活动能力。男性在2周时成为非活动性的唯一独立预测因子(p=0.0037)。年龄,BMI,耻骨支骨折脱位>5毫米,镇痛剂的使用,皮质类固醇治疗,酒精和吸烟与行动能力恢复无关.73.2%的患者出现骨折巩固(F/M;21/9),而一名女性没有巩固。10例患者(F/M;5/5)失访。
    结论:我们的研究表明,LC1(FFPIIb,IIc)和LC2(FFPIIIc,IVb)骨折可有效保守治疗,在6周内成功重新动员。早期动员的唯一独立阴性预测因子是男性。阴枝位移>5mm不影响结果。因此,保守治疗被证明是低能量LC1或LC2骨折的可行选择。
    方法:IV(回顾性研究)。
    BACKGROUND: The growing population of elderly people is leading to a rising number of pelvic ring fractures. These often involve combinations of pubic branch and sacrum fractures, as seen in lateral compression type 1 (LC1) and 2 (LC2) fractures or more precisely classified as fragility fractures of the pelvis (FFP). The combined impact on the anterior and posterior ring brings the risk of prolonged pain, resulting in decreased mobility and increased complications. Given the higher multimorbidity of this population, surgical treatment poses a greater risk of intra- and post-operative complications. Hence, the management and treatment of this particular type of fracture remain challenging.
    METHODS: A retrospective data analysis of 41 patients (F/M; 27/14) treated conservatively for low-energy LC1 or LC2 fractures was performed between 2017 and 2020. The fractures were classified using Rommens\' FFP classification. The primary outcome was mobility at 2 and 6 weeks, assessed through chart analysis and phone interviews. To determine factors influencing patient outcomes fracture consolidation was assessed via X-ray analysis. As a secondary outcome logistic regression and decision tree analyzes were conducted.
    RESULTS: The mean age at the time of fracture was 79.8 ± 12.5 (SD) years. Thirty-two patients regained mobility (F/M; 25/7) after 2 weeks. Another 7 patients were mobile after 6 weeks (F/M; 2/5). Two male patients did not regain mobility. Male sex emerged as the sole independent predictor of non-mobility at 2 weeks (p = 0.0037). Age, BMI, pubic branch fracture dislocation >5 mm, analgesic use of opiates, corticosteroid therapy, alcohol and smoking showed no association with mobility recovery. Fracture consolidation was observed in 73.2 % of patients (F/M; 21/9), while one female had no consolidation. Ten patients (F/M; 5/5) were lost to follow-up.
    CONCLUSIONS: Our study shows that LC1 (FFP IIb, IIc) and LC2 (FFP IIIc, IVb) fractures can be effectively treated conservatively, with successful remobilization within 6 weeks. The only independent negative predictor of early mobilization was male sex. Pubic branch displacement >5 mm did not affect the outcome. Therefore, conservative management proves to be a viable option for low-energy LC1 or LC2 fractures.
    METHODS: IV (retrospective study).
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  • 文章类型: Journal Article
    背景:衰弱是影响老年人的常见综合征,使他们有住院的风险。需要照顾或死亡。虚弱的最初迹象包括肌肉力量下降和活动能力下降。随着年龄增长,活动能力下降的主要原因是肌肉减少症(与年龄相关的肌肉力量和质量降低)。营养不良会导致肌肉减少症。蛋白质的短缺与肌肉质量和力量的减少有关。这可能是由于摄入不足,也是因为老年人对蛋白质的需求较高,尤其是那些多重性的。我们需要开发有效的治疗方法来减少或减缓虚弱和活动能力下降的发生。锻炼是一种推荐的治疗方法。解决蛋白质不足的蛋白质补充剂有可能增强虚弱或虚弱前老年人定期运动的益处。这一点尚未得到明确证明。目的建立对60岁以上体弱或体弱且蛋白质摄入量低的人进行RCT评估有或没有蛋白质补充剂的移动性和力量训练的可行性。方法多中心,平行,2组,可行性RCT。参与者(招募目标=50)行走有问题,将从四个NHS物理治疗社区服务中招募低蛋白质摄入量并分类为虚弱或虚弱前。参与者将被随机分配(安全计算机生成:1:1)接受24周的流动性和力量训练(以16组课程和家庭练习进行)或24周的流动性和力量训练,每天补充蛋白质。主要可行性目标是估计1)筛选和招募合格参与者的能力,2)干预保真度,坚持,和耐受性,以及3)参与者在随访中的保留。次要目标是1)测试数据收集程序,2)评估数据的完整性和3)确认确定的RCT的样本量计算。注册ISRCTN注册(ISRCTN30405954;18/10/2022)。
    随着年龄的增长,他们可能会变得虚弱,无法应对疾病或伤害。虚弱的人更有可能跌倒或需要护理。我们需要找到方法来阻止人们变得虚弱或减缓虚弱的进展,以便老年人能够独立生活。运动是一种治疗虚弱的方法,可以改善肌肉力量和行走。在老年人的饮食中加入额外的蛋白质也可能有所帮助。蛋白质为肌肉提供了基石,但是许多老年人没有吃足够的蛋白质。运动时摄入额外的蛋白质可能会增加运动的好处,但是我们不知道它是否可以减少虚弱或改善步行和生活质量。我们希望进行一项大型临床试验,将移动性和力量训练加上额外的蛋白质与单独训练进行比较。这项研究旨在通过以下发现来测试是否可以进行大型试验:•我们可以招募足够的蛋白质摄入量低的参与者吗?•参与者是否参加了运动课程并服用了蛋白质补充剂?•参与者是否参加了后续评估?我们的目标是招募多达50名虚弱/有虚弱风险且蛋白质摄入量低的老年人。我们将通过NHS社区信托基金确定参与者,从现有的队列研究和社区广告。参与者被随机分配到训练加蛋白质或仅训练。训练包括肌肉加强,balance,步行练习。参与者将与物理治疗师一起参加每周一次的运动课程,为期16周,并每周在家锻炼一次。然后要求他们每周两次在家锻炼,再持续8周。一半的参与者在运动时会摄取额外的蛋白质。入学时和8个月后,我们收集关于脆弱的信息,行走能力,肌肉力量和生活质量。
    Background Frailty is a common syndrome affecting older people and puts them at risk of hospitalisation, needing care or death. First signs of frailty include reduced muscle strength and mobility decline. A key cause of mobility decline as we age is sarcopenia (age related reduction in muscle strength and mass). Poor nutrition contributes to sarcopenia. A shortfall in protein is associated with reduced muscle mass and strength. This may be due to inadequate intake but also because older people have higher protein needs, especially those with multimorbidity. We need to develop effective treatment to reduce or slow the onset of frailty and mobility decline. Exercise is a recommended treatment. Protein supplements to address the shortfall in protein have the potential to enhance the benefit of regular exercise in frail or pre-frail older adults. This has yet to be definitively demonstrated. Aim To establish the feasibility of conducting an RCT evaluating mobility and strength training with or without protein supplements for people over 60 years old who are frail or pre-frail with a low protein intake. Methods A multicentre, parallel, 2-group, feasibility RCT. Participants (recruitment target = 50) with problems walking, low protein intake and classified as frail or pre-frail will be recruited from four NHS Physiotherapy community services. Participants will be randomised (secure computer-generated: 1:1) to receive 24 weeks of mobility and strength training (delivered in 16 group sessions plus home exercises) or 24 weeks of mobility and strength training with daily protein supplements. Primary feasibility objectives are to estimate 1) ability to screen and recruit eligible participants, 2) intervention fidelity, adherence, and tolerance and 3) retention of participants at follow up. Secondary objectives are to 1) test data collection procedures, 2) assess data completeness and 3) confirm sample size calculation for a definitive RCT. Registration ISRCTN Registry (ISRCTN30405954; 18/10/2022).
    As people get older, they may become frail and become less able to deal with illness or injury. People with frailty are more likely to fall or need care. We need to find ways to stop people becoming frail or slow the progress of frailty so older people can live independently. Exercise is a treatment for frailty that can improve muscle strength and walking. Including extra protein in an older person’s diet may also help. Protein provides the building blocks for muscles, but many older people do not eat enough protein. Taking extra protein while exercising may increase the benefits of exercise, but we do not know if it reduces frailty or improves walking and quality of life. We want to conduct a large clinical trial comparing mobility and strength training plus extra protein to training alone. This study aims to test if it is possible to carry out a large trial by finding out:       •   Can we recruit enough participants with low protein intake?       •   Do participants attend the exercise classes and take the protein supplements?       •   Do participants attend follow-up assessments? We aim to recruit up to 50 older people who are frail/at risk of frailty and have low protein intake. We will identify participants via NHS Community Trusts, from an existing cohort study and by advertising in the community. Participants are randomly allocated to training plus protein or training only. Training involves muscle strengthening, balance, and walking exercises. Participants will attend a weekly exercise class with a physiotherapist for 16 weeks and do exercises at home once/week. They are then asked to exercise at home twice weekly for a further 8 weeks. Half the participants will take extra protein while exercising. At enrolment and 8 months later, we collect information on frailty, walking ability, muscle strength and quality of life.
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  • 文章类型: Journal Article
    《了不起的盖茨比曲线》衡量了收入不平等与代际收入持续性之间的关系。通过使用超过245,000个导师-学员对的家谱数据及其来自22个不同学科的学术出版物,这项研究表明,学术上也存在一个伟大的盖茨比曲线,学术影响不平等与跨学术世代的持续影响之间呈正相关。我们还提供了详细的学术坚持分类,表明导师和受训者的影响之间的相关性随着时间的推移而增加,表明学术代际流动性总体下降。我们分析了不同维度的这种持久性,包括导师类型,性别和制度声望。
    The Great Gatsby Curve measures the relationship between income inequality and intergenerational income persistence. By using genealogical data of over 245 000 mentor-mentee pairs and their academic publications from 22 different disciplines, this study demonstrates that an academic Great Gatsby Curve exists as well, in the form of a positive correlation between academic impact inequality and the persistence of impact across academic generations. We also provide a detailed breakdown of academic persistence, showing that the correlation between the impact of mentors and that of their mentees has increased over time, indicating an overall decrease in academic intergenerational mobility. We analyse such persistence across a variety of dimensions, including mentorship types, gender and institutional prestige.
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  • 文章类型: Journal Article
    目的:在印度和其他低收入国家的研究发现,男性的流动性/迁移与性传播感染(STIs)之间存在不一致的关联。这项研究全面检查了印度男性的流动性与性传播感染之间的关系。它还评估了流动性的异质关联,酒精消费,使用交互分析与性传播感染的危险性行为。
    方法:我们使用了来自2019-21年全国家庭健康调查-5的71,128名15-54岁的性活跃男性样本。采用二元逻辑回归模型研究其相关性。
    结果:在研究参与者中,在过去的12个月里,16%的人是流动的,离家一个月或更长时间。大约29%的男性报告饮酒,6%的男性有危险的性行为(与非婚姻/非同居伴侣性交)。回归结果表明,流动性(AOR:1.41,95%CI:1.29-1.55[短期];AOR:1.95,95%CI:1.77-2.13[长期])和饮酒(AOR:1.32,95%CI:1.24-1.40)与性传播感染风险增加显着相关,即使在控制了社会人口统计学协变量之后。互动分析进一步表明,饮酒并从事危险性行为的流动男性感染STI的可能性要高得多,在短期流动性的情况下,性传播感染的可能性要高两倍,而在长期流动性的情况下,性传播感染的可能性要高三倍。
    结论:我们的研究表明,短期和长期活动与男性性传播感染风险增加显著相关。饮酒和危险的性行为进一步加剧了流动男性性传播感染的风险。在男子中预防性传播感染/艾滋病毒的举措必须特别注意短期和长期的临时流动男子。
    OBJECTIVE: Studies in India and other low-income countries find an inconsistent association between mobility/migration and sexually transmitted infections (STIs) among men. This study comprehensively examined the association between mobility and STIs among men in India. It also assessed heterogeneous associations of mobility, alcohol consumption, and risky sexual behavior with STIs using interaction analysis.
    METHODS: We utilized a sample of 71,128 sexually active men aged 15-54 years from the 2019-21 National Family Health Survey-5. Binary logistic regression models were employed to study the associations.
    RESULTS: Among the study participants, 16% were mobile and away from home for a month or more in the last 12 months. Around 29% of men reported alcohol consumption and 6% had risky sexual behavior (sexual intercourse with a non-marital/non-cohabitating partner). Regression results suggest that mobility (AOR: 1.41, 95% CI: 1.29-1.55 [short-duration]; AOR: 1.95, 95% CI: 1.77-2.13 [long-duration]) and alcohol consumption (AOR: 1.32, 95% CI: 1.24-1.40) were significantly associated with an increased risk of STIs, even after controlling for socio-demographic covariates. Interaction analysis further reveals that mobile men who consumed alcohol and engaged in risky sexual behavior had a significantly higher likelihood of contracting an STI-twice as high in cases of short-duration mobility and three times higher in cases of long-duration mobility.
    CONCLUSIONS: Our study indicates that both short and long-duration mobility are significantly associated with an increased risk of STIs among men. Alcohol consumption and risky sexual behavior further exacerbate the risk of STIs in mobile men. Initiatives for STI/HIV prevention among men must pay particular attention to temporary mobile men for both short and long durations.
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  • 文章类型: Journal Article
    背景:多发性硬化症(MS)患者的脚下降通常会导致活动性和生活质量(QOL)下降。腓骨神经的功能性电刺激(FES)可以改善足下垂患者的步态,然而,各种障碍限制了广泛的使用。本病例系列的目的是检查远程康复监测的FES设备的可行性,并报告中度MS相关残疾患者的功能移动性和生活质量的变化。
    方法:通过3次远程康复治疗,FES的使用在8周内进行。通过完成的远程康复访问百分比和参与者报告的满意度来评估远程康复的可行性。在基线和研究完成时,通过定时25英尺步行(T25FW)评估有和没有FES的功能移动性,定时和去(TUG),和2分钟步行测试(2MWT),多发性硬化影响量表(MSIS-29),和12项多发性硬化步行量表(MSWS-12)。在干预前后,通过改良的疲劳影响量表(MFIS)评估疲劳。
    结果:11名参与者(平均年龄=50.4岁[SD10.8];2名男性)完成了研究。所有(33/33)远程康复访视均已完成,参与者满意度较高,无不良事件。在8周的时候,与基线相比,T25FW有临床意义的改善,2MWT,和TUG为45%,55%,82%的参与者,分别。MSIS-29和MSWS-12的临床上有意义的改善也记录了64%和36%的参与者。分别。
    结论:远程康复对于FES干预是安全可行的,并观察到功能移动性和生活质量的改善。监测FES的远程康复可能会改善访问并减轻患者负担;因此,研究其功效是有必要的。
    BACKGROUND: Foot drop in people with multiple sclerosis (MS) commonly leads to decreased mobility and quality of life (QOL). Functional electrical stimulation (FES) of the peroneal nerve can improve the gait of people with foot drop, yet various barriers restrict widespread use. The purpose of this case series was to examine the feasibility of a telerehabilitation-monitored FES device and report changes in functional mobility and QOL in people with moderate MS-related disability.
    METHODS: FES use was progressed over 8 weeks via 3 telerehabilitation sessions. Feasibility of telerehabilitation was assessed by percentage of telerehabilitation visits completed and participant-reported satisfaction. At baseline and study completion, functional mobility with and without FES were assessed by the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), and 2-Minute Walk Test (2MWT), Multiple Sclerosis Impact Scale (MSIS-29), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was assessed via the Modified Fatigue Impact Scale (MFIS) before and after the intervention.
    RESULTS: Eleven participants (mean age = 50.4 years [SD 10.8]; 2 males) completed the study. All (33/33) telerehabilitation visits were completed and participants attained high levels of satisfaction with no adverse events. At 8 weeks, compared to baseline, there were clinically meaningful improvements on the T25FW, 2MWT, and TUG for 45%, 55%, and 82% of participants, respectively. Clinically meaningful improvements on the MSIS-29 and MSWS-12 were also recorded for 64% and 36% of participants, respectively.
    CONCLUSIONS: Telerehabilitation was safe and feasible for FES intervention, and improvements in functional mobility and QOL were observed. Telerehabilitation to monitor FES may improve access and reduce patient burden; therefore, studying its efficacy is warranted.
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  • 文章类型: Journal Article
    流动性是理解流行病传播链可能扩大的关键因素。在最初的阶段,遏制案件的策略可以直接与人口流动限制联系在一起,特别是当只有非药物措施可用时。在巴西COVID-19大流行期间,流动性限制措施受到很大一部分人口的强烈反对。假设,如果民众支持这些措施,病例数量的急剧上升本可以得到抑制。在这种情况下,计算模型提供了系统的方法来分析有关流行病学情况发展的情景,同时考虑到特定条件。在这项研究中,我们研究了巴西州际交通的影响。要做到这一点,我们开发了一个考虑室内和室间动态的元人口模型,利用图论。我们使用参数估计技术,该技术使我们能够推断每个状态下的有效再现数并估计时变传输速率。这使得调查与流动性相关的情景成为可能,并量化人们在各州之间流动的影响,以及限制流动的某些措施如何减少大流行的影响。我们的结果表明病例数和流动性之间有明显的关联,当各州彼此更接近时,这种情况会加剧。这可以作为概念的证明,并表明如何减少交通繁忙地区的流动性可以更有效。
    Mobility is a crucial element in comprehending the possible expansion of the transmission chain in an epidemic. In the initial phases, strategies for containing cases can be directly linked to population mobility restrictions, especially when only non-pharmaceutical measures are available. During the pandemic of COVID-19 in Brazil, mobility limitation measures were strongly opposed by a large portion of the population. Hypothetically, if the population had supported such measures, the sharp rise in the number of cases could have been suppressed. In this context, computational modeling offers systematic methods for analyzing scenarios about the development of the epidemiological situation taking into account specific conditions. In this study, we examine the impacts of interstate mobility in Brazil. To do so, we develop a metapopulational model that considers both intra and intercompartmental dynamics, utilizing graph theory. We use a parameter estimation technique that allows us to infer the effective reproduction number in each state and estimate the time-varying transmission rate. This makes it possible to investigate scenarios related to mobility and quantify the effect of people moving between states and how certain measures to limit movement might reduce the impact of the pandemic. Our results demonstrate a clear association between the number of cases and mobility, which is heightened when states are closer to each other. This serves as a proof of concept and shows how reducing mobility in more heavily trafficked areas can be more effective.
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  • 文章类型: Journal Article
    轻型可穿戴机器人有可能通过补偿与年龄相关的下肢力量下降来帮助日常生活中行动不便的老年人。物理治疗师可能是老年人与这些设备的第一个接触点。
    这项研究的目的是探索老年人和物理治疗师对可穿戴机器人作为日常生活辅助设备的看法,并确定其使用的障碍和促进因素。
    六个老年人(72-88岁)测试了可穿戴机器人(Myosit),并参加了半结构化访谈。进行了一个由6名物理治疗师组成的焦点小组,这些物理治疗师至少有5年的专业经验,专门从事老年病学。使用主题定性文本分析对数据进行分析。
    老年人察觉到好处,并有积极的使用经验,然而,许多人认为没有必要为自己使用这项技术。使用它的主要障碍和促进因素是对有用性的认识,对技术的态度,易用性,和环境因素,如获得的支持。物理治疗师命名为成本,报销计划,和技术的复杂性是限制因素。
    发现一种轻型可穿戴机器人-Myosuit-被认为可以作为辅助设备来研究参与者。虽然技术的特点很重要,老年人的使用和接受在很大程度上取决于感知的有用性和需求。
    UNASSIGNED: Light wearable robots have the potential to assist older adults with mobility impairments in daily life by compensating for age-related decline in lower extremity strength. Physiotherapists may be the first point of contact for older adults with these devices.
    UNASSIGNED: The aims of this study were to explore views of older adults and physiotherapists on wearable robots as assistive devices for daily living and to identify the barriers and facilitators to their use.
    UNASSIGNED: Six older adults (aged 72-88 years) tested a wearable robot (Myosuit) and participated in semistructured interviews. A focus group with 6 physiotherapists who had a minimum of 5 years of professional experience and specialized in geriatrics was conducted. Data were analyzed using thematic qualitative text analysis.
    UNASSIGNED: Older adults perceived benefits and had positive use experiences, yet many saw no need to use the technology for themselves. Main barriers and facilitators to its use were the perception of usefulness, attitudes toward technology, ease of use, and environmental factors such as the support received. Physiotherapists named costs, reimbursement schemes, and complexity of the technology as limiting factors.
    UNASSIGNED: A light wearable robot-the Myosuit-was found to be acceptable to study participants as an assistive device. Although characteristics of the technology are important, the use and acceptance by older adults heavily depend on perceived usefulness and need.
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