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1.
Learn Mem ; 31(5)2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38862172

RESUMO

How does the brain translate sensory information into complex behaviors? With relatively small neuronal numbers, readable behavioral outputs, and an unparalleled genetic toolkit, the Drosophila mushroom body (MB) offers an excellent model to address this question in the context of associative learning and memory. Recent technological breakthroughs, such as the freshly completed full-brain connectome, multiomics approaches, CRISPR-mediated gene editing, and machine learning techniques, led to major advancements in our understanding of the MB circuit at the molecular, structural, physiological, and functional levels. Despite significant progress in individual MB areas, the field still faces the fundamental challenge of resolving how these different levels combine and interact to ultimately control the behavior of an individual fly. In this review, we discuss various aspects of MB research, with a focus on the current knowledge gaps, and an outlook on the future methodological developments required to reach an overall view of the neurobiological basis of learning and memory.


Assuntos
Drosophila , Corpos Pedunculados , Corpos Pedunculados/fisiologia , Animais , Drosophila/fisiologia , Memória/fisiologia , Aprendizagem por Associação/fisiologia
2.
Alcohol Clin Exp Res ; 46(10): 1857-1864, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36059261

RESUMO

BACKGROUND: Fetal alcohol spectrum disorders (FASD) are developmental disabilities that are estimated to occur in 2-5% of elementary school children and that negatively impact a child's ability to function without support. Timely diagnosis-informed interventions are crucial to optimizing the developmental trajectory of children with FASD. The true prevalence of FASD among children receiving services for developmental disabilities is unknown. METHODS: An FASD prevalence study was carried out between 2011 and 2014 among a sample of 5- to 7-year-old children who were receiving services provided by the California State Regional Center for Developmental Disabilities in San Diego County. Children whose parent or caregiver consented were evaluated using the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence study assessment protocol and classification criteria. RESULTS: Among 216 eligible caregiver-child dyads, 44 completed assessments that were sufficient to obtain a classification for FASD, including fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder, or no fetal alcohol spectrum disorder. Fifteen children were classified as meeting the criteria for an FASD. A minimum FASD prevalence rate of 69.4 per 1000 (6.9%) among all eligible children was estimated. None of the children classified as FASD were receiving services because of an FASD diagnosis, and none had previously been diagnosed with FASD. Autism was the most common qualifying diagnosis for which children classified as FASD were receiving services. CONCLUSIONS: The 6.9% prevalence estimate among Regional Center clients was higher than the prevalence estimate of 2.3% in the same community among 5- to 7-year-old children in the general population, though the estimate was based on only 20% of eligible dyads. All children in the sample were receiving Regional Center services for another diagnosis. Barriers to eligibility for services for children with FASD may lead to less than optimum care for these children. Study findings support the facilitation of access to developmental services for children with FASD.


Assuntos
Transtornos do Espectro Alcoólico Fetal , Gravidez , Feminino , Humanos , Criança , Pré-Escolar , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Transtornos do Espectro Alcoólico Fetal/terapia , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Troca Materno-Fetal , Prevalência
3.
Alcohol Clin Exp Res ; 44(9): 1769-1782, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32628778

RESUMO

BACKGROUND: The orbitofrontal cortex (OFC) encodes internal representations of outcomes and subjective value to facilitate flexible reward seeking. OFC activation is associated with drug seeking in both human subjects and animal models. OFC plays a role in alcohol use, but studies in animal models have produced conflicting results with some showing decreased seeking after OFC inactivation but others showing increased seeking or no changes. In part, this may be due to the different measures of alcohol seeking used (e.g., homecage drinking vs. operant seeking). METHODS: We characterized the impact of transient inactivation of OFC (primarily lateral and, to a lesser extent, ventral subregions) using inhibitory hM4Di designer receptors exclusively activated by designer drugs (DREADDs). OFC neurons were transiently inhibited during 10% and 20% alcohol (ethanol, EtOH) and sucrose homecage consumption, fixed ratio (FR1) operant self-administration, and cue-induced reinstatement of either 10% EtOH or sucrose in male and female rats. RESULTS: OFC inactivation did not affect sucrose or EtOH consumption in the homecage, nor did it influence seeking or consumption under FR1 operant conditions. In contrast, OFC inactivation suppressed cued-induced reinstatement for both EtOH and sucrose in both male and female rats. CONCLUSIONS: Our results are aligned with previous work indicating a selective suppressive effect of OFC inactivation on reinstatement for alcohol and other drugs of abuse. They extend these findings to demonstrate no effect on homecage consumption or FR1 seeking as well as showing an impact of sucrose reinstatement. These data indicate that OFC plays a uniquely important role when reward seeking is driven by associations between external stimuli and internal representations of reward value, both for natural and drug rewards. They further implicate the OFC as a key structure driving relapse-associated seeking and potentially contributing to alcohol use disorder and other diseases of compulsive reward seeking.


Assuntos
Depressores do Sistema Nervoso Central/administração & dosagem , Condicionamento Operante/fisiologia , Sinais (Psicologia) , Comportamento de Procura de Droga/fisiologia , Etanol/administração & dosagem , Córtex Pré-Frontal/fisiologia , Sacarose/administração & dosagem , Edulcorantes/administração & dosagem , Animais , Extinção Psicológica/fisiologia , Feminino , Masculino , Ratos , Autoadministração
5.
Environ Sci Technol ; 53(10): 5661-5670, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31038305

RESUMO

Temporal variability of toxins produced by cyanobacteria in lakes is relatively unknown at time scales relevant to public health (i.e., hourly). In this study, a water quality monitoring buoy was outfitted with an automated water sampler taking preserved samples every 6 h for 68.75 days over a drinking water intake. A total of 251 samples were analyzed by tandem mass spectrometry for 21 cyanotoxin congeners in 5 classes producing 5020 data points. Microcystins (MCs) were the most abundant toxins measured (mean ± sd = 3.9 ± 3.3 µg/L) followed by cyanopeptolins (CPs) (1.1 ± 1.5 µg/L), anabaenopeptins (APs) (1.0 ± 0.6 µg/L), anatoxin-a (AT-A) (0.03 ± 0.06 µg/L), and microginin-690 (MG-690) (0.002 ± 0.01 µg/L). Advanced time series analyses uncovered patterns in cyanotoxin production. The velocity of cyanotoxin concentration varied from -0.7 to 0.9 µg/L/h with a maximum positive velocity just prior to peak toxin concentration during nonbloom periods. A backward-looking moving window of variance analysis detected major increases in cyanotoxin concentration and predicted the two greatest increases in MC. A wavelet analysis identified a significant ( p < 0.01) 2.8-4.2 day periodicity in toxin concentration over a ∼25 day period during peak toxin production, which is partially explained by easterly wind velocity ( R = -0.2, p < 0.05). Diversity in congener profiles was explored with principle component analysis showing that cyanotoxin dynamics followed a seasonal trajectory where toxin profiles were significantly clustered (ANOSIM R = 0.7, p < 0.05) on a daily basis. Variability in toxin profiles was strongly correlated with time ( R = -0.8, p < 0.001) as well as the C:N ratio of the toxin pool ( R = 0.17, p < 0.05). The methods employed here should be useful for uncovering patterns in cyanotoxin dynamics in other systems.


Assuntos
Toxinas Bacterianas , Cianobactérias , Toxinas Marinhas , Toxinas de Cianobactérias , Microcistinas
6.
Learn Mem ; 24(6): 257-261, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28507035

RESUMO

In Aplysia, long-term sensitization (LTS) occurs concurrently with a suppression of feeding. At the cellular level, the suppression of feeding is accompanied by decreased excitability of decision-making neuron B51. We examined the contribution of voltage-gated Na+ and K+ channels to B51 decreased excitability. In a pharmacologically isolated Na+ channels environment, LTS training significantly increased B51 firing threshold, compared with untrained controls. Conversely, in a pharmacologically isolated K+ channels environment, no differences were observed between trained and untrained animals in either amplitude or area of B51 K+-dependent depolarizations. These findings suggest that Na+ channels contribute to the decrease in B51 excitability induced by LTS training.


Assuntos
Potenciais de Ação/fisiologia , Tomada de Decisões/fisiologia , Potenciação de Longa Duração/fisiologia , Neurônios Aferentes/fisiologia , Sódio/metabolismo , 4-Aminopiridina/farmacologia , Potenciais de Ação/efeitos dos fármacos , Animais , Aplysia/fisiologia , Estimulação Elétrica , Potenciação de Longa Duração/efeitos dos fármacos , Neurônios Aferentes/efeitos dos fármacos , Bloqueadores dos Canais de Potássio/farmacologia , Tetraetilamônio/farmacologia
7.
Catheter Cardiovasc Interv ; 89(6): 994-1002, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27527508

RESUMO

BACKGROUND: Second-generation drug eluting stents (DES) may reduce costs and improve clinical outcomes compared to first-generation DES with improved cost-effectiveness when compared to bare metal stents (BMS). We aimed to conduct an economic evaluation of a cobalt-chromium everolimus eluting stent (Co-Cr EES) compared with BMS in percutaneous coronary intervention (PCI). OBJECTIVE: To conduct a cost-effectiveness analysis (CEA) of a cobalt-chromium everolimus eluting stent (Co-Cr EES) versus BMS in PCI. METHODS: A Markov state transition model with a 2-year time horizon was applied from a US Medicare setting with patients undergoing PCI with Co-Cr EES or BMS. Baseline characteristics, treatment effects, and safety measures were taken from a patient level meta-analysis of 5 RCTs (n = 4,896). The base-case analysis evaluated stent-related outcomes; a secondary analysis considered the broader set of outcomes reported in the meta-analysis. RESULTS: The base-case and secondary analyses reported an additional 0.018 and 0.013 quality-adjusted life years (QALYs) and cost savings of $236 and $288, respectively with Co-Cr EES versus BMS. Results were robust to sensitivity analyses and were most sensitive to the price of clopidogrel. In the probabilistic sensitivity analysis, Co-Cr EES was associated with a greater than 99% chance of being cost saving or cost effective (at a cost per QALY threshold of $50,000) versus BMS. CONCLUSIONS: Using data from a recent patient level meta-analysis and contemporary cost data, this analysis found that PCI with Co-Cr EES is more effective and less costly than PCI with BMS. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.


Assuntos
Fármacos Cardiovasculares/administração & dosagem , Fármacos Cardiovasculares/economia , Ligas de Cromo/economia , Doença da Artéria Coronariana/economia , Doença da Artéria Coronariana/terapia , Stents Farmacológicos/economia , Everolimo/administração & dosagem , Everolimo/economia , Custos de Cuidados de Saúde , Intervenção Coronária Percutânea/economia , Intervenção Coronária Percutânea/instrumentação , Idoso , Fármacos Cardiovasculares/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Análise Custo-Benefício , Custos de Medicamentos , Everolimo/efeitos adversos , Feminino , Humanos , Masculino , Cadeias de Markov , Medicare/economia , Modelos Econômicos , Intervenção Coronária Percutânea/efeitos adversos , Desenho de Prótese , Anos de Vida Ajustados por Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento , Estados Unidos
8.
Catheter Cardiovasc Interv ; 88(7): 1017-1024, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26774951

RESUMO

OBJECTIVES: To study the contemporary, real-world clinical and economic burden associated with angina after percutaneous coronary intervention (PCI). BACKGROUND: Angina adversely affects quality of life and medical costs, yet data on real-world prevalence of angina following PCI and its associated economic consequences are limited. METHODS: In a multi-payer administrative claims database, we identified adults with incident inpatient PCI admissions between 2008 and 2011 who had at least 12 months of continuous medical and pharmacy benefits before and after the procedure. Patients were followed for up to 36 months. Using claims, we ascertained post-PCI outcomes: angina or chest pain, acute myocardial infarction, acute coronary syndrome, repeat PCI, healthcare service utilization, and costs. RESULTS: Among 51,710 study patients (mean age 61.8, 72% male), post-PCI angina or chest pain was present in 28% by 12 months and 40% by 36 months. Compared with patients who did not experience chest pain, angina or ACS, total healthcare costs in the first year after the index PCI were 1.8 times greater for patients with angina or chest pain ($32,437 vs. $17,913, P < 0.001). These cost differentials continued to 36 months. CONCLUSIONS: Angina after PCI is a frequent and expensive outcome. Further research is needed to identify risk factors and potentially improve outcomes for post-PCI angina. © 2016 Wiley Periodicals, Inc.


Assuntos
Angina Pectoris/economia , Angina Pectoris/terapia , Custos de Cuidados de Saúde , Recursos em Saúde/economia , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/economia , Síndrome Coronariana Aguda/economia , Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/terapia , Demandas Administrativas em Assistência à Saúde , Idoso , Assistência Ambulatorial/economia , Angina Pectoris/diagnóstico , Angina Pectoris/epidemiologia , Bases de Dados Factuais , Custos de Medicamentos , Feminino , Recursos em Saúde/estatística & dados numéricos , Custos Hospitalares , Humanos , Incidência , Masculino , Medicare/economia , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologia
9.
Nucleic Acids Res ; 40(17): 8607-21, 2012 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-22740655

RESUMO

Typical assays used to discover and analyze small molecules that inhibit the hepatitis C virus (HCV) NS3 helicase yield few hits and are often confounded by compound interference. Oligonucleotide binding assays are examined here as an alternative. After comparing fluorescence polarization (FP), homogeneous time-resolved fluorescence (HTRF®; Cisbio) and AlphaScreen® (Perkin Elmer) assays, an FP-based assay was chosen to screen Sigma's Library of Pharmacologically Active Compounds (LOPAC) for compounds that inhibit NS3-DNA complex formation. Four LOPAC compounds inhibited the FP-based assay: aurintricarboxylic acid (ATA) (IC50=1.4 µM), suramin sodium salt (IC50=3.6 µM), NF 023 hydrate (IC50=6.2 µM) and tyrphostin AG 538 (IC50=3.6 µM). All but AG 538 inhibited helicase-catalyzed strand separation, and all but NF 023 inhibited replication of subgenomic HCV replicons. A counterscreen using Escherichia coli single-stranded DNA binding protein (SSB) revealed that none of the new HCV helicase inhibitors were specific for NS3h. However, when the SSB-based assay was used to analyze derivatives of another non-specific helicase inhibitor, the main component of the dye primuline, it revealed that some primuline derivatives (e.g. PubChem CID50930730) are up to 30-fold more specific for HCV NS3h than similarly potent HCV helicase inhibitors.


Assuntos
Inibidores Enzimáticos/farmacologia , Hepacivirus/enzimologia , Ensaios de Triagem em Larga Escala , RNA Helicases/antagonistas & inibidores , Proteínas não Estruturais Virais/antagonistas & inibidores , DNA/metabolismo , Proteínas de Ligação a DNA/metabolismo , Ensaios Enzimáticos , Proteínas de Escherichia coli/metabolismo , Polarização de Fluorescência , RNA Helicases/metabolismo , Bibliotecas de Moléculas Pequenas , Proteínas não Estruturais Virais/metabolismo
10.
JMIR Res Protoc ; 13: e49189, 2024 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-38743938

RESUMO

BACKGROUND: The impact of digital device use on health and well-being is a pressing question. However, the scientific literature on this topic, to date, is marred by small and unrepresentative samples, poor measurement of core constructs, and a limited ability to address the psychological and behavioral mechanisms that may underlie the relationships between device use and well-being. Recent authoritative reviews have made urgent calls for future research projects to address these limitations. The critical role of research is to identify which patterns of use are associated with benefits versus risks and who is more vulnerable to harmful versus beneficial outcomes, so that we can pursue evidence-based product design, education, and regulation aimed at maximizing benefits and minimizing the risks of smartphones and other digital devices. OBJECTIVE: The objective of this study is to provide normative data on objective patterns of smartphone use. We aim to (1) identify how patterns of smartphone use impact well-being and identify groups of individuals who show similar patterns of covariation between smartphone use and well-being measures across time; (2) examine sociodemographic and personality or mental health predictors and which patterns of smartphone use and well-being are associated with pre-post changes in mental health and functioning; (3) discover which nondevice behavior patterns mediate the association between device use and well-being; (4) identify and explore recruitment strategies to increase and improve the representation of traditionally underrepresented populations; and (5) provide a real-world baseline of observed stress, mood, insomnia, physical activity, and sleep across a representative population. METHODS: This is a prospective, nonrandomized study to investigate the patterns and relationships among digital device use, sensor-based measures (including both behavioral and physiological signals), and self-reported measures of mental health and well-being. The study duration is 4 weeks per participant and includes passive sensing based on smartphone sensors, and optionally a wearable (Fitbit), for the complete study period. The smartphone device will provide activity, location, phone unlocks and app usage, and battery status information. RESULTS: At the time of submission, the study infrastructure and app have been designed and built, the institutional review board of the University of Oregon has approved the study protocol, and data collection is underway. Data from 4182 enrolled and consented participants have been collected as of March 27, 2023. We have made many efforts to sample a study population that matches the general population, and the demographic breakdown we have been able to achieve, to date, is not a perfect match. CONCLUSIONS: The impact of digital devices on mental health and well-being raises important questions. The Digital Well-Being Study is designed to help answer questions about the association between patterns of smartphone use and well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49189.


Assuntos
Smartphone , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Saúde Mental , Adulto Jovem , Aplicativos Móveis , Adolescente
11.
Nat Med ; 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39030265

RESUMO

Poor sleep health is associated with increased all-cause mortality and incidence of many chronic conditions. Previous studies have relied on cross-sectional and self-reported survey data or polysomnograms, which have limitations with respect to data granularity, sample size and longitudinal information. Here, using objectively measured, longitudinal sleep data from commercial wearable devices linked to electronic health record data from the All of Us Research Program, we show that sleep patterns, including sleep stages, duration and regularity, are associated with chronic disease incidence. Of the 6,785 participants included in this study, 71% were female, 84% self-identified as white and 71% had a college degree; the median age was 50.2 years (interquartile range = 35.7, 61.5) and the median sleep monitoring period was 4.5 years (2.5, 6.5). We found that rapid eye movement sleep and deep sleep were inversely associated with the odds of incident atrial fibrillation and that increased sleep irregularity was associated with increased odds of incident obesity, hyperlipidemia, hypertension, major depressive disorder and generalized anxiety disorder. Moreover, J-shaped associations were observed between average daily sleep duration and hypertension, major depressive disorder and generalized anxiety disorder. These findings show that sleep stages, duration and regularity are all important factors associated with chronic disease development and may inform evidence-based recommendations on healthy sleeping habits.

12.
BMC Complement Altern Med ; 13: 74, 2013 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-23552194

RESUMO

BACKGROUND: Several treatment alternatives are available for primary breast cancer, although those for metastatic disease or inflammation associated with tumor progression are ineffective. Therefore, there is a great need for new therapeutic alternatives capable of generating an immune response against residual tumor cells, thus contributing to eradication of micrometastases and cancer stem cells. The use of complex natural products is an excellent therapeutic alternative widely used by Chinese, Hindu, Egyptian, and ancestral Latin-American Indian populations. METHODS: The present study evaluated cytotoxic, antitumor, and tumor progression activities of a gallotannin-rich fraction derived from Caesalpinia spinosa (P2Et). The parameters evaluated in vitro were mitochondrial membrane depolarization, phosphatidylserine externalization, caspase 3 activation, DNA fragmentation, and clonogenic activity. The parameters evaluated in vivo were tumor growth, leukocyte number, metastatic cell number, and cytokine production by flow cytometry. RESULTS: The in vitro results showed that the P2Et fraction induced apoptosis with mitochondrial membrane potential loss, phosphatidylserine externalization, caspase 3 activation, DNA fragmentation, and decreased clonogenic capacity of 4T1 cells. In vivo, the P2Et fraction induced primary tumor reduction in terms of diameter and weight in BALB/c mice transplanted with 4T1 cells and decreased numbers of metastatic cells, mainly in the spleen. Furthermore, decreases in the number of peripheral blood leukocytes (leukemoid reaction) and interleukin 6 (IL-6) serum levels were found, which are events associated with a poor prognosis. The P2Et fraction exerts its activity on the primary tumor, reduces cell migration to distant organs, and decreases IL-6 serum levels, implying tumor microenvironment mechanisms. CONCLUSIONS: Overall, the P2Et fraction lessens risk factors associated with tumor progression and diminishes primary tumor size, showing good potential for use as an adjuvant in breast cancer ER(+) treatment.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Caesalpinia/química , Taninos Hidrolisáveis/administração & dosagem , Extratos Vegetais/administração & dosagem , Animais , Apoptose/efeitos dos fármacos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/fisiopatologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Humanos , Interleucina-6/sangue , Camundongos , Camundongos Endogâmicos BALB C , Prognóstico
13.
Learn Mem ; 20(1): 1-5, 2012 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-23242417

RESUMO

In Aplysia, repeated trials of aversive stimuli produce long-term sensitization (LTS) of defensive reflexes and suppression of feeding. Whereas the cellular underpinnings of LTS have been characterized, the mechanisms of feeding suppression remained unknown. Here, we report that LTS training induced a long-term decrease in the excitability of B51 (a decision-making neuron in the feeding circuit) that recovered at a time point in which LTS is no longer observed (72 h post-treatment). These findings indicate B51 as a locus of plasticity underlying feeding suppression. Finally, treatment with serotonin to induce LTS failed to alter feeding and B51 excitability, suggesting that serotonin does not mediate the effects of LTS training on the feeding circuit.


Assuntos
Aprendizagem da Esquiva/fisiologia , Córtex Cerebral/citologia , Comportamento Alimentar/fisiologia , Rede Nervosa/fisiologia , Neurônios/fisiologia , Reflexo/fisiologia , Animais , Aplysia , Aprendizagem da Esquiva/efeitos dos fármacos , Biofísica , Estimulação Elétrica/métodos , Potenciação de Longa Duração/efeitos dos fármacos , Potenciação de Longa Duração/fisiologia , Rede Nervosa/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Estimulação Física , Reflexo/efeitos dos fármacos , Serotonina/farmacologia , Fatores de Tempo
14.
Ophthalmol Ther ; 12(2): 1339-1357, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36841895

RESUMO

INTRODUCTION: Deep learning (DL) for screening diabetic retinopathy (DR) has the potential to address limited healthcare resources by enabling expanded access to healthcare. However, there is still limited health economic evaluation, particularly in low- and middle-income countries, on this subject to aid decision-making for DL adoption. METHODS: In the context of a middle-income country (MIC), using Thailand as a model, we constructed a decision tree-Markov hybrid model to estimate lifetime costs and outcomes of Thailand's national DR screening program via DL and trained human graders (HG). We calculated the incremental cost-effectiveness ratio (ICER) between the two strategies. Sensitivity analyses were performed to probe the influence of modeling parameters. RESULTS: From a societal perspective, screening with DL was associated with a reduction in costs of ~ US$ 2.70, similar quality-adjusted life-years (QALY) of + 0.0043, and an incremental net monetary benefit of ~ US$ 24.10 in the base case. In sensitivity analysis, DL remained cost-effective even with a price increase from US$ 1.00 to US$ 4.00 per patient at a Thai willingness-to-pay threshold of ~ US$ 4.997 per QALY gained. When further incorporating recent findings suggesting improved compliance to treatment referral with DL, our analysis models effectiveness benefits of ~ US$ 20 to US$ 50 depending on compliance. CONCLUSION: DR screening using DL in an MIC using Thailand as a model may result in societal cost-savings and similar health outcomes compared with HG. This study may provide an economic rationale to expand DL-based DR screening in MICs as an alternative solution for limited availability of skilled human resources for primary screening, particularly in MICs with similar prevalence of diabetes and low compliance to referrals for treatment.

15.
Sci Rep ; 13(1): 17579, 2023 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-37845334

RESUMO

Episodic memory is memory for experiences within a specific temporal and spatial context. Episodic memories decline early in Alzheimer's Disease (AD). Recollection of episodic memories can fail with both AD and aging, but familiarity and recollection memory uniquely fail in AD. Finding a means to differentiate specific memory failures in animal models is critical for translational research. Four cotton top tamarins participated in an object recognition test. They were exposed to two unique objects placed in a consistent context for 5 daily sessions. Next a delay of 1 day or 1 week was imposed. Subjects' memory of the objects was tested by replacing one of the familiarized objects with a novel one. The tamarins looked longer at the novel object after both delays, an indication of remembering the familiar object. In other tests, the test pair was relocated to a new location or presented at a different time of day. With context changes, tamarins showed greater interest in the novel object after a 1-week delay but not after a 1-day delay. It seems that context changes disrupted their recollection of recent events. But the monkeys showed accurate familiarity memory across context changes with longer delays.


Assuntos
Doença de Alzheimer , Memória Episódica , Humanos , Animais , Haplorrinos , Reconhecimento Psicológico , Rememoração Mental , Callitrichinae
16.
BMC Complement Altern Med ; 12: 38, 2012 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-22490328

RESUMO

BACKGROUND: Enhancement of tumor cell sensitivity may help facilitate a reduction in drug dosage using conventional chemotherapies. Consequently, it is worthwhile to search for adjuvants with the potential of increasing chemotherapeutic drug effectiveness and improving patient quality of life. Natural products are a very good source of such adjuvants. METHODS: The biological activity of a fraction enriched in hydrolysable polyphenols (P2Et) obtained from Caesalpinia spinosa was evaluated using the hematopoietic cell line K562. This fraction was tested alone or in combination with the conventional chemotherapeutic drugs doxorubicin, vincristine, etoposide, camptothecin and taxol. The parameters evaluated were mitochondrial depolarization, caspase 3 activation, chromatin condensation and clonogenic activity. RESULTS: We found that the P2Et fraction induced mitochondrial depolarization, activated caspase 3, induced chromatin condensation and decreased the clonogenic capacity of the K562 cell line. When the P2Et fraction was used in combination with chemotherapeutic drugs at sub-lethal concentrations, a fourfold reduction in doxorubicin inhibitory concentration 50 (IC50) was seen in the K562 cell line. This finding suggested that P2Et fraction activity is specific for the molecular target of doxorubicin. CONCLUSIONS: Our results suggest that a natural fraction extracted from Caesalpinia spinosa in combination with conventional chemotherapy in combination with natural products on leukemia cells may increase therapeutic effectiveness in relation to leukemia.


Assuntos
Antineoplásicos/uso terapêutico , Caesalpinia/química , Doxorrubicina/uso terapêutico , Taninos Hidrolisáveis/uso terapêutico , Leucemia/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adjuvantes Farmacêuticos , Antineoplásicos/farmacologia , Caspase 3/metabolismo , Linhagem Celular , Linhagem Celular Tumoral , Cromatina/efeitos dos fármacos , Doxorrubicina/farmacologia , Sinergismo Farmacológico , Hematopoese , Humanos , Taninos Hidrolisáveis/farmacologia , Concentração Inibidora 50 , Leucemia/metabolismo , Mitocôndrias/efeitos dos fármacos , Extratos Vegetais/farmacologia
17.
Cancers (Basel) ; 14(19)2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36230794

RESUMO

Chromosomal alterations have recurrently been identified in Wilms tumors (WTs) and some are associated with poor prognosis. Gain of 1q (1q+) is of special interest given its high prevalence and is currently actively studied for its prognostic value. However, the underlying mutational mechanisms and functional effects remain unknown. In a national unbiased cohort of 30 primary WTs, we integrated somatic SNVs, CNs and SVs with expression data and distinguished four clusters characterized by affected biological processes: muscle differentiation, immune system, kidney development and proliferation. Combined genome-wide CN and SV profiles showed that tumors profoundly differ in both their types of 1q+ and genomic stability and can be grouped into WTs with co-occurring 1p-/1q+, multiple chromosomal gains or CN neutral tumors. We identified 1q+ in eight tumors that differ in mutational mechanisms, subsequent rearrangements and genomic contexts. Moreover, 1q+ tumors were present in all four expression clusters reflecting activation of various biological processes, and individual tumors overexpress different genes on 1q. In conclusion, by integrating CNs, SVs and gene expression, we identified subgroups of 1q+ tumors reflecting differences in the functional effect of 1q gain, indicating that expression data is likely needed for further risk stratification of 1q+ WTs.

18.
Neuromodulation ; 14(4): 330-5; discussion 335-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21992427

RESUMO

OBJECTIVE: This paper presents the protocol of the EVIDENCE study, a multicenter multinational randomized controlled trial to assess the effectiveness and cost-effectiveness of spinal cord stimulation (SCS) with rechargeable pulse generator versus re-operation through 36-month follow-up in patients with failed back surgery syndrome. STUDY DESIGN: Study subjects have neuropathic radicular leg pain exceeding or equaling any low back pain and meet specified entry criteria. One-to-one randomization is stratified by site and by one or more prior lumbosacral operations. The sample size of 132 subjects may be adjusted to between 100 and 200 subjects using a standard adaptive design statistical method with pre-defined rules. Crossover treatment is possible. Co-primary endpoints are proportion of subjects reporting ≥ 50% leg pain relief without crossover at 6 and at 24 months after SCS screening trial or re-operation. Insufficient pain relief constitutes failure of randomized treatment, as does crossover. Secondary endpoints include cost-effectiveness; relief of leg, back, and overall pain; change in disability and quality of life; and rate of crossover. We are collecting data on subject global impression of change, patient satisfaction with treatment, employment status, pain/paresthesia overlap, SCS programming, and adverse events. DISCUSSION: As the first multicenter randomized controlled trial of SCS versus re-operation and the first to use only rechargeable SCS pulse generators, the EVIDENCE study will provide up-to-date evidence on the treatment of failed back surgery syndrome.


Assuntos
Terapia por Estimulação Elétrica/economia , Síndrome Pós-Laminectomia/terapia , Medula Espinal/fisiologia , Análise Custo-Benefício , Terapia por Estimulação Elétrica/métodos , Humanos , Reoperação/economia , Projetos de Pesquisa
19.
NPJ Digit Med ; 4(1): 132, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493770

RESUMO

Privacy protection is paramount in conducting health research. However, studies often rely on data stored in a centralized repository, where analysis is done with full access to the sensitive underlying content. Recent advances in federated learning enable building complex machine-learned models that are trained in a distributed fashion. These techniques facilitate the calculation of research study endpoints such that private data never leaves a given device or healthcare system. We show-on a diverse set of single and multi-site health studies-that federated models can achieve similar accuracy, precision, and generalizability, and lead to the same interpretation as standard centralized statistical models while achieving considerably stronger privacy protections and without significantly raising computational costs. This work is the first to apply modern and general federated learning methods that explicitly incorporate differential privacy to clinical and epidemiological research-across a spectrum of units of federation, model architectures, complexity of learning tasks and diseases. As a result, it enables health research participants to remain in control of their data and still contribute to advancing science-aspects that used to be at odds with each other.

20.
eNeuro ; 7(4)2020.
Artigo em Inglês | MEDLINE | ID: mdl-32661066

RESUMO

Orbitofrontal cortex (OFC) plays a key role in representation and regulation of reward value, preference, and seeking. OFC function is disrupted in drug use and dependence, but its specific role in alcohol use disorders has not been thoroughly studied. In alcohol-dependent humans OFC activity is increased by alcohol cue presentation. Ethanol (EtOH) also alters OFC neuron excitability in vitro, and OFC manipulation influences EtOH seeking and drinking in rodents. To understand the relationship between OFC function and individual alcohol use, we recorded OFC neuron activity in rats during EtOH self-administration, characterizing the neural correlates of individual preference for alcohol. After one month of intermittent access to 20% EtOH, male Long-Evans rats were trained to self-administer 20% EtOH, 10% EtOH, and 15% sucrose. OFC neuronal activity was recorded and associated with task performance and EtOH preference. Rats segregated into high and low EtOH drinkers based on homecage consumption and operant seeking of 20% EtOH. Motivation for 10% EtOH and sucrose was equally high in both groups. OFC neuronal activity was robustly increased or decreased during sucrose and EtOH seeking and consumption, and strength of changes in OFC activity was directly associated with individual preference for 20% EtOH. EtOH-associated OFC activity was more similar to sucrose-associated activity in high versus low EtOH drinkers. The results show that OFC neurons are activated during alcohol seeking based on individual preference, supporting this brain region as a potential substrate for alcohol motivation that may be dysregulated in alcohol misuse.


Assuntos
Alcoolismo , Consumo de Bebidas Alcoólicas , Animais , Condicionamento Operante , Etanol , Masculino , Córtex Pré-Frontal , Ratos , Ratos Long-Evans , Autoadministração
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