Simulated Real-life Conditions Research Articles

Durability assessment of LC3-based reinforced concrete under combined chloride-sulfate environment via the EIS technique

Concrete technology has significantly advanced towards alternative sustainable and eco-friendly cement-based materials. Accordingly, the durability of real-life blended concrete under realistic exposure aggressive conditions needs to be explored in depth. This study evaluates the effect of local raw clay on the durability performance of underground reinforced concrete in a simulated real-life aggressive environment with combined chloride-sulfate attack. Blended limestone cement (LC) containing calcined clay (LC3) or fly ash (LCF) with 40% replacement by cement mass, were prepared concurrently to compare the results with the traditional OPC. Assessment of durability performance of reinforced blended concrete was performed using non-destructive electrochemical impedance spectroscopy technique (EIS), and compressive strength. Characterization and elaboration of electrochemical phases were monitored by X-ray diffraction (XRD), thermo-gravimetric analysis (TGA), and SEM/EDS analysis. Electrochemical measurements showed that the diameter of the impedance semi-circle in both high and low-frequency regions of LC3-based reinforced concrete increases as corrosion progresses, while that of LCF and OPC decreases. LC3 showed the best corrosion resistance marked by a lower corrosion rate and comparable strength. Furthermore, LC3 binder exhibited a good hydration degree, with higher CH and Friedel’s salt content. Ultimately, the LC3 technology improves the durability performance of reinforced concrete structures in simulated real-life conditions which could advance its application on the industrial scale.

Personal care formulations demonstrate virucidal efficacy against multiple SARS-CoV-2 variants of concern: Implications for hand hygiene and public health.

Despite considerable progress being made on vaccine roll out, practicing proper hand hygiene has been advocated as a consistent precautionary intervention against the circulating and emerging variants of SARS-CoV-2. Two variants of concern, namely beta and delta, have been shown to exhibit enhanced transmissibility, high viral load, and ability to escape antibody-mediated neutralization. In this report we have empirically determined the efficacy of selected personal care formulations from Unilever in inactivating the beta and delta variants of SARS-CoV-2 under simulated real-life conditions. All the formulations demonstrated greater than 99.9% reduction in viral infective titres which is comparable to inactivation of the original strain of SARS-CoV-2 virus tested under the same conditions. Therefore, it can be concluded that well-designed personal care formulations when tested under consumer-centric conditions, and with proven efficacy against the parent strain of SARS-CoV-2 will continue to be effective against extant and emerging variants of SARS-CoV-2.

Assessing the quality of drug information provided by hospital pharmacies using a fictitious enquiry and simulated real-life conditions

ObjectivesGuidelines for drug information (DI) provided by hospital pharmacists call for quality assurance procedures; however, no method of evaluation is internationally agreed on. The procedure should be feasible, reproducible and...

Maternal report underestimates the amount of dentifrice used by children during toothbrushing: a cross-sectional study

This study investigated whether the report of mothers about the amount of dentifrice applied on a toothbrush could be a reliable method to estimate the inadvertent use of dentifrices. A cross-sectional study was conducted in a randomly selected sample of 334 mothers of children enrolled in public day care centres of a city in the Brazilian northeast. Initially, the mothers chose the figure corresponding to the amount of dentifrice used during their children's daily toothbrushing. Then, they simulated real-life conditions with the toothbrush routinely used to brush the children's teeth. The amount of dentifrice on toothbrush was weighted using an analytical scale. Data were analysed by the Kruskal-Wallis followed by the Dunn test (α = 0.05). The weight of dentifrice on the toothbrush was high (> 0.3g), mainly considering the categories 'covered only' and 'completely covered' that showed no statistical difference (p > 0.05). The proportion of agreement between the mothers' reports and the weight of dentifrice on the toothbrush was 0.23 (CI 0.18-0.28). The mothers' report regarding the amount of dentifrice on the toothbrush by demonstrative figures was not a reliable method to estimate the inadvertent ingestion of fluoride from dentifrices.

An expandable approach for design and personalization of digital, just-in-time adaptive interventions.

ObjectiveWe aim to deliver a framework with 2 main objectives: 1) facilitating the design of theory-driven, adaptive, digital interventions addressing chronic illnesses or health problems and 2) producing personalized intervention delivery strategies to support self-management by optimizing various intervention components tailored to people’s individual needs, momentary contexts, and psychosocial variables.Materials and MethodsWe propose a template-based digital intervention design mechanism enabling the configuration of evidence-based, just-in-time, adaptive intervention components. The design mechanism incorporates a rule definition language enabling experts to specify triggering conditions for interventions based on momentary and historical contextual/personal data. The framework continuously monitors and processes personal data space and evaluates intervention-triggering conditions. We benefit from reinforcement learning methods to develop personalized intervention delivery strategies with respect to timing, frequency, and type (content) of interventions. To validate the personalization algorithm, we lay out a simulation testbed with 2 personas, differing in their various simulated real-life conditions.ResultsWe evaluate the design mechanism by presenting example intervention definitions based on behavior change taxonomies and clinical guidelines. Furthermore, we provide intervention definitions for a real-world care program targeting diabetes patients. Finally, we validate the personalized delivery mechanism through a set of hypotheses, asserting certain ways of adaptation in the delivery strategy, according to the differences in simulation related to personal preferences, traits, and lifestyle patterns.ConclusionWhile the design mechanism is sufficiently expandable to meet the theoretical and clinical intervention design requirements, the personalization algorithm is capable of adapting intervention delivery strategies for simulated real-life conditions.

PO-168 Reliability and validity of a new accelerometer-based device for detecting physical activities and energy expenditure

Objective Objective assessments of sedentary behavior, physical activity (PA) and the associated energy expenditure (EE) using accelerometer-based wearable devices are ever expanding, given their importance in the global context of health maintenance. However, among these numerous devices, the different underlying algorithms and available output parameters make it difficult to determine their accuracy. Furthermore, the function and accuracy of those devices may significantly differ between the different wearing locations (i.e., wrist-worn, waist-worn or thigh-based), where the center of the body (hip or thigh) is the optimal recommendation. Thus, a thigh-based device that has the possibility to differentiate between sedentary behavior, PAs, and EE is required to optimize research in PA. This study aimed to determine the reliability and validity of a new accelerometer-based analyzer (Fibion) with two-fold: First, to assess the reliability of the Fibion as compared to a designed repeated protocol and ActiGraph GT9X (one of the most widely used devices with favorable validity and reliability) in a laboratory re-test protocol; Second, to determine the validity of the Fibion in differentiating PAs and estimating EE throughout a simulated 12-hour free-living day.
 Methods Fibion (Fibion Inc, Jyväskylä, Finland) is a new 3-axial lightweight (20g, L•W•T = 30•32•10mm) accelerometer-based device, which was designed to follow the orientation and movement of the thigh. Thus, it can be worn either on the thigh (FT) or in the front pocket of the trousers (FP). According to information provided by the manufacturer, it is able to detect no-wear time and differentiates between different types (sitting, long sitting, standing, walking, and cycling) and intensities (LPA, MVPA, and VPA) of PA and the associated EE through the use of proprietary algorithms.
 The study consisted of two parts: a reliability (n=18) and validity (n=19) test, respectively. All 37 participants were young and healthy volunteers, who were normal weight (i.e., BMI < 25 kg/m2) and recreationally physically active. Exclusion criteria included acute and chronic diseases, which would prevent participants from prolonged sitting and/or standing or would interfere with the basic metabolic rate. All participants were informed about the study procedures and provided written informed consent prior to commencing with testing. The study was carried out in accordance with the Declaration of Helsinki and the local Ethical Committee (ML16027).
 Reliability was assessed by a designed 15-min protocol by repeating sitting, standing, and walking (a total of 90 min = 15 min *3 types * 2 repeats) using both Fibion (FT) and ActiGraph. Validity was assessed by a prolonged 12-h protocol which was designed as simulated free-living conditions with two criteria. Criterion 1: Direct observation of the 12-h continuous sequence of tasks with measurement logs, to determine the duration of different types (sitting, standing, walking, and cycling) and intensities (light [LPA], moderate-to-vigorous [MVPA], and vigorous [VPA])) of PA. Indirect calorimetry served as the criterion 2 for EE estimation. Pulmonary gas exchange of the participants was continuously measured throughout the 12-h guided sequence of tasks by a portable breath-by-breath gas analyzer (Cosmed K4b2, Rome, Italy). During the entire 12-h protocol, two Fibion devices (worn both on the thigh (FT) and in the pocket (FP), respectively) and K4b2 were used simultaneously. 
 Results Reliability. Fibion located on the thigh (FT) (ICCs: 0.687-0.806) provided similar reliability for EE estimation as the Actigraph (ICCs: 0.661-0.806). However, the measurement error for FT indicated an underestimation of activity times by 5.1 ± 1.2%, 3.8 ± 0.3% and 14.9 ± 2.6% during sitting, walking, and standing, respectively. Furthermore, low correlations were observed between subsequent measurements with both devices (ICCs 0.189-0.459), especially in low intensities (sitting). Validity. During the prolonged 12-h simulated real-life conditions, FT but not FP showed a moderate agreement with the direct observation in assessing the duration of sitting, long sitting, LPA, MVPA, and VPA (p>0.05, ICCs: 0.071-0.537), but the low correlations between Fibion and the criteria (ICCs FT: 0.016-0.638; FP: -0.046 to 0.650) indicate that the measurement error is random. Similarly, FT but not FP showed a moderate agreement with the K4b2 for EE estimation of standing, LPA, MVPA, and VPA (p>0.05, ICCs: 0.673-0.894). 
 Conclusions In summary, the location of the accelerometer is essential for accurately assessing PA and EE. FT appeared to detect sitting and walking with a small measurement error, similar to that of the Actigraph. Considering the random error observed in our study, further studies with larger populations are needed to confirm the practical usability of Fibion (FT) for estimating different types and intensities of PA.

Dose uniformity of budesonide Easyhaler® under simulated real-life conditions and with low inspiration flow rates.

Budesonide Easyhaler® multidose dry powder inhaler is approved for the treatment of asthma. Objectives were to determine the delivered dose (DD) uniformity of budesonide Easyhaler® in simulated real-world conditions and with different inspiration flow rates (IFRs). Three dose delivery studies were performed using 100, 200, and 400 µg/dose strengths of budesonide. Dose uniformity was assessed during in-use periods of 4–6 months after exposure to high temperature (30°C) and humidity (60% relative humidity) and after dropping and vibration testing. The influence of various IFRs (31, 43, and 54 L/min) on the DD was also investigated. Acceptable dose uniformity was declared when mean DD were within 80–120% of expected dose; all data reported descriptively. DD was constant (range: 93–109% of expected dose) at all in-use periods and after exposure to high temperature and humidity for a duration of up to 6 months. DD post-dropping and -vibration were unaffected (range 98–105% of expected dose). Similarly, DD was constant and within 10% of expected dose across all IFRs. Results indicate that budesonide Easyhaler® delivers consistently accurate doses in various real-life conditions. Budesonide Easyhaler® can be expected to consistently deliver a uniform dose and improve asthma control regardless of high temperature and humidity or varying IFR.

Storage effect in the quality of different methyl esters and blends with diesel

Storage stability is an important aspect in the commercialization of biodiesel. Due to the chemical structure of methyl ester, long-term storage may lead to the degradation of fuel properties that can make it difficult to meet the EN 14214 Standard.This paper examines the degradation of several biofuels (sunflower methyl esters, used cooking oil methyl esters and blends with commercial diesel) under different storage conditions over a 6-month period. The storage conditions simulated real-life conditions by using similar temperatures to those found in commercial tanks, with little air turnover and in the absence of light. Extreme temperature conditions were also studied to determine if this variable has an effect on storage stability. Opaque glass or stainless steel storage containers were used to check the interaction between metal and biofuel.The results show that temperature plays an important role in the degradation of methyl esters. On the other hand, stainless steel was found to be a suitable material for the commercial storage tanks as the effect of this material on stability was almost negligible. The blends with commercial diesel performed better in long-term storage. This was probably due to the effect of the ester dilution and the presence of additives in commercial diesel.

Videotaped simulated interviews to improve medical students' skills in disclosing a diagnosis of cancer

To assess the performance of the training course on the disclosure of a diagnosis of cancer intended for fifth year medical students of the University of Nantes. The course comprised three sessions: (1) a group discussion that taught a six-point protocol (SPIKES) for delivering a diagnosis, (2) a videotaped simulated interview to assess protocol implementation and communication skills, and (3) feedback from a senior physician. The learning objectives were memorisation and implementation of the protocol, use of appropriate communication techniques to deal with the patient's response, and identifying one's own reactions in a stressful situation. Two types of assessments were performed before and after each session: self-assessments by the students and a quantitative and qualitative external assessment by a psychologist and senior physician. In addition, recall of the six-point protocol was assessed during the end-of-the-year examination. Overall, 108 students took part in the course during the 2004-2005 academic year. They felt that their competence improved after each session in terms of the three learning objectives. However, recall of the six-point protocol was inadequate. It was best among students who considered they had progressed most. Our training course on communication techniques helps students acquire confidence in their skills in breaking bad news by backing theory with practice and feedback. The students make progress despite the psychological stress generated by simulated real-life conditions.

Omeprazole, ranitidine, and cimetidine have no effect on peak blood ethanol concentrations, first pass metabolism or area under the time-ethanol curve under 'real-life' drinking conditions.

Considerable controversy persists over the influence of H2-receptor antagonists on the first pass clearance of ethanol. The majority of previously published studies have studied the effects of the drugs on low-dose ethanol in the fasting state. We elected to study the possible interaction under simulated real-life conditions. Twenty-three volunteers were given 0.6 g/kg body weight ethanol in the form of 4.8% beer following a standardized meal. Blood ethanol levels were measured over the next 3 h. Studies were repeated using ethanol administered as an intravenous infusion while subjects consumed the same volume of de-alcoholized beer. The effects of a minimum of 2 weeks of dosing with cimetidine, ranitidine and omeprazole were examined. Following food, and with ethanol taken in the form of beer, mean first pass metabolism of ethanol was 58% (range 34-78%). No statistically significant difference was found following drug treatment in either percentage first pass metabolism, peak blood ethanol concentration or area under the time-blood ethanol curve. Under these 'real-life' conditions, the concomitant administration of cimetidine, ranitidine or omeprazole is unlikely to have significant physical, social or forensic implications, since they do not significantly change ethanol elimination.