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2.
Nano Lett ; 2024 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-39356872

RESUMO

Nonlinear optical materials of atomic thickness, such as non-centrosymmetric 2H transition metal dichalcogenide monolayers, have a second-order nonlinear susceptibility (χ(2)) whose intensity can be tuned by strain. However, whether χ(2) is enhanced or reduced by tensile strain is a subject of conflicting reports. Here, we grow high-quality MoSe2 monolayers under controlled biaxial strain created by two different substrates and study their linear and nonlinear optical responses with a combination of experimental and theoretical approaches. Up to a 15-fold overall enhancement in second-harmonic generation (SHG) intensity is observed from MoSe2 monolayers grown on SiO2 when compared to its value on a Si3N4 substrate. By considering an interference contribution from different dielectrics and their thicknesses, a factor of 2 enhancement of χ(2) was attributed to the biaxial strain: substrate interference and strain are independent handles to engineer the SHG strength of non-centrosymmetric 2D materials.

3.
Cureus ; 16(9): e69741, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39429426

RESUMO

Morphea, or localized scleroderma, is a chronic inflammatory condition that unequivocally affects the dermis and subcutaneous connective tissue. It undeniably causes significant disfigurement in approximately half of patients, profoundly impacting their self-esteem. The available treatment options include corticosteroids (taken orally or administered subcutaneously), phototherapy, CO2 fractional laser treatment, and biologically mediated medications. It is crucial to note that using fillers as adjuvant therapy for inflammatory diseases indisputably raises concerns due to the potential to trigger inflammation and lead to disease reactivation. In one case, a 24-year-old patient with morphea on her face underwent a combined approach involving plastic surgery, dermatology, and regenerative aesthetics treatment with lipo-filling initially by an expert plastic surgeon. Then, after reviewing the literature and consensus from the dermatologist, aesthetics physician, and alternative medicine expert, it was decided to use calcium hydroxylapatite-carboxymethylcellulose (Radiesse, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in the affected area. After a year of follow-up, there was a significant improvement in the appearance of her face and skin, as confirmed by a 10-point improvement on an activity measuring scale. Additional research will solidify whether calcium hydroxylapatite (CaHA) is the optimal injectable for treating dermal autoimmune diseases. Our initial approach demonstrates significant promise for regenerative biostimulation. Through collaboration, we have effectively integrated plastic surgery techniques, fillers, dermatologists, and alternative medicine perspectives to treat inflammatory diseases, providing a comprehensive and robust exploration of morphea treatment.

4.
Front Public Health ; 12: 1465837, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39430713

RESUMO

Volcanic eruptions pose significant health risks to inhabitants of affected regions, with volcanic gases, including carbon dioxide (CO2), being a notable concern. This review examines the implications of long-term exposure to volcanic CO2 emissions on public health, highlighting the shift in understanding from acute to chronic health effects. Recent studies have underscored the need to reevaluate the adverse health impacts of CO2 beyond acute toxicity symptoms. While previous guidelines deemed an indoor (residential) acceptable long-term exposure range (ALTER) of ≤3,000 parts per million (ppm) in residential housing areas, emerging evidence suggests that even concentrations within the range of 3,000 to 1,000 ppm may induce deleterious health effects. International agencies now advocate for lower safe indoor CO2 levels (600-1,000 ppm), necessitating a reassessment of public health strategies in volcanic areas. This review argues for increased awareness among local and public health authorities about the chronic toxicity of CO2 exposure and emphasizes the importance of safeguarding populations from the adverse health effects induced by CO2 exposure.


Assuntos
Dióxido de Carbono , Exposição Ambiental , Saúde Pública , Erupções Vulcânicas , Humanos , Erupções Vulcânicas/efeitos adversos , Dióxido de Carbono/análise , Dióxido de Carbono/efeitos adversos , Exposição Ambiental/efeitos adversos , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/efeitos adversos
5.
Data Brief ; 57: 110928, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39376481

RESUMO

Urochloa grasses are widely used forages in the Neotropics and are gaining importance in other regions due to their role in meeting the increasing global demand for sustainable agricultural practices. High-throughput phenotyping (HTP) is important for accelerating Urochloa breeding programs focused on improving forage and seed yield. While RGB imaging has been used for HTP of vegetative traits, the assessment of phenological stages and seed yield using image analysis remains unexplored in this genus. This work presents a dataset of 2,400 high-resolution RGB images of 200 Urochloa hybrid genotypes, captured over seven months and covering both vegetative and reproductive stages. Images were manually labelled as vegetative or reproductive, and a subset of 255 reproductive stage images were annotated to identify 22,340 individual racemes. This dataset enables the development of machine learning and deep learning models for automated phenological stage classification and raceme identification, facilitating HTP and accelerated breeding of Urochloa spp. hybrids with high seed yield potential.

6.
Gut ; 2024 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-39461739

RESUMO

BACKGROUND: Bismuth quadruple therapies (BQTs) including bismuth, a proton pump inhibitor (PPI) and two antibiotics have been shown to be highly effective for treating Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. OBJECTIVE: To describe the time trends of use, effectiveness and safety of BQT in Europe using the European Registry on Helicobacter pylori Management (Hp-EuReg). DESIGN: Patients registered in the Hp-EuReg from 2013 to 2021 who had received BQT were included. The regimens prescribed, the number of eradication attempts, effectiveness, adherence and safety were analysed. The effectiveness was assessed by modified intention to treat (mITT). Time-trend and multivariate analyses were performed to determine variables that predicted treatment success. RESULTS: Of the 49 690 patients included in the Hp-EuReg, 15 582 (31%) had received BQT. BQT use increased from 8.6% of all treatments in 2013 to 39% in 2021. Single-capsule BQT-containing bismuth, metronidazole and tetracycline-plus a PPI (single-capsule BQT, ScBQT) was the most frequent treatment mode (43%). Schemes that obtained an effectiveness above 90% were the 10-day ScBQT and 14-day BQT using tetracycline plus metronidazole, or amoxicillin plus either clarithromycin or metronidazole. Only ScBQT achieved above 90% cure rates in all the geographical areas studied. Using the ScBQT scheme, adherence, the use of standard or high-dose PPIs, 14-day prescriptions and the use of BQT as first-line treatment were significantly associated with higher mITT effectiveness. CONCLUSION: The use of BQT increased notably in Europe over the study period. A 10-day ScBQT was the scheme that most consistently achieved optimal effectiveness. TRIAL REGISTRATION NUMBER: NCT02328131.

7.
Molecules ; 29(18)2024 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-39339496

RESUMO

Trypanosoma cruzi is a protozoan parasite that causes Chagas disease in humans. The current antichagasic drugs nifurtimox and benznidazole have inconveniences of toxicity; therefore, the search for alternative therapeutic strategies is necessary. The present study reports the synthesis, drug-likeness predictions, and in vitro anti-trypanosome activity of a series of 14 quinazoline 2,4,6-triamine derivatives. All compounds were tested against T. cruzi (epimastigotes and trypomastigotes) and in HFF1 human foreskin fibroblasts. The bioassays showed that compounds 2-4 containing nitrobenzoyl substituents at 6-position of the quinazoline 2,4,6-triamine nucleus were the most potent on its antiprotozoal activity. The effect was observed at 24 h and it was preserved for at least 5 days. Also, compounds 2-4 were not toxic to the human control cells, showing high selectivity index. The quinazoline nitro derivatives have potential use as antichagasic agents.


Assuntos
Quinazolinas , Tripanossomicidas , Trypanosoma cruzi , Quinazolinas/farmacologia , Quinazolinas/química , Quinazolinas/síntese química , Humanos , Trypanosoma cruzi/efeitos dos fármacos , Tripanossomicidas/farmacologia , Tripanossomicidas/síntese química , Tripanossomicidas/química , Relação Estrutura-Atividade , Fibroblastos/efeitos dos fármacos , Doença de Chagas/tratamento farmacológico , Estrutura Molecular , Linhagem Celular
8.
Environ Pollut ; 362: 125034, 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-39341407

RESUMO

The global impact of anticoagulant rodenticides (ARs) on non-target species is well-recognized. Birds of prey, as apex predators, are highly vulnerable to AR exposure and are widely used as biomonitors for priority pollutants in Europe. This study investigates differential SGAR exposure in raptors from insular versus continental regions, hypothesizing greater exposure in insular areas due to ecological factors like reduced prey diversity, intensive rodenticide use, and resistant rodent populations. We analyzed the livers of 190 common kestrels (Falco tinnunculus) and 104 common buzzards (Buteo buteo) across the Iberian Peninsula and its archipelagos using LC-MS/MS to assess their role as AR sentinels and the differences between insular and continental areas. Results revealed a high prevalence (>80%) of second-generation anticoagulant rodenticides (SGARs), with brodifacoum and bromadiolone, being the most frequent. Multiple SGAR detections were also common (≈50%). A binomial logistic regression showed that species and region significantly influence the likelihood of SGAR exposure. Kestrels had a greater probability of exceeding 100 ng/g wet weight (ww) compared to buzzards. Raptors from insular territories were ten times more likely to have higher SGAR concentrations than those from continental areas. However, the legal restriction on SGAR bait concentrations that came into effect in 2018 did not significantly impact exposure levels. This study highlights the need for targeted conservation efforts to mitigate AR exposure risk in vulnerable island ecosystems.

9.
New Phytol ; 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39238145

RESUMO

Arsenic poses a global threat to living organisms, compromising crop security and yield. Limited understanding of the transcriptional network integrating arsenic-tolerance mechanisms with plant developmental responses hinders the development of strategies against this toxic metalloid. Here, we conducted a high-throughput yeast one-hybrid assay using as baits the promoter region from the arsenic-inducible genes ARQ1 and ASK18 from Arabidopsis thaliana, coupled with a transcriptomic analysis, to uncover novel transcriptional regulators of the arsenic response. We identified the GLABRA2 (GL2) transcription factor as a novel regulator of arsenic tolerance, revealing a wider regulatory role beyond its established function as a repressor of root hair formation. Furthermore, we found that ANTHOCYANINLESS2 (ANL2), a GL2 subfamily member, acts redundantly with this transcription factor in the regulation of arsenic signaling. Both transcription factors act as repressors of arsenic response. gl2 and anl2 mutants exhibit enhanced tolerance and reduced arsenic accumulation. Transcriptional analysis in the gl2 mutant unveils potential regulators of arsenic tolerance. These findings highlight GL2 and ANL2 as novel integrators of the arsenic response with developmental outcomes, offering insights for developing safer crops with reduced arsenic content and increased tolerance to this hazardous metalloid.

10.
Data Brief ; 56: 110857, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39281012

RESUMO

This dataset results from controlled experiments that assess the tolerance of Urochloa spp. and Megathyrsus maximus grasses to nymphal and adult spittlebug damage, particularly from Aeneolamia varia, which significantly impacts forage production in Neotropical regions. Data were collected under standardized conditions using high-throughput phenotyping methods, integrating image-capture techniques and analyses to ensure precise and consistent data acquisition. The dataset serves as a foundational resource for developing and validating computer vision models aimed at automated phenotyping, enabling accurate and high-throughput assessment of plant tolerance to spittlebug damage. Researchers can use the dataset to benchmark and compare different methodologies for plant damage assessment, fostering standardization and reproducibility in phenotyping studies.

11.
Vet Res Commun ; 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39287896

RESUMO

Anxiety affects 14-20% of dogs. Pharmacological treatments often fail. Psychedelics have shown to be useful for anxiety and depression in humans, but their veterinary use remains unexplored. We aimed to determine the effects of low-dose 1-cyclopropionyl-d-lysergic acid diethylamide (1cp-LSD) administered in a single dose to a dog, to observe the effect and establish the safety of the substance. The patient was a 13-year-old female dog, weighing 13 kg, mixed breed, and spayed. A total of 5 µg was administered orally, equivalent to 0.38 µg/kg. The animal has had a history of separation related behavioral problems throughout her life. To objectively assess the degree of anxiety in the dog, a validated scale was utilized. The trial was scheduled at the house where the animal lives. The owner was present throughout the experience. Informed consent was obtained prior to the assay. The trial began at 12:15 p.m. on January 10, 2024, lasting for 5 and a half hours. The response to anxiety-inducing stimuli was equally anxious during the first two hours. From that point onwards, a significant change in the animal's behavior was observed, with no signs/mild signs of anxiety. The trial concluded without any adverse effects on the animal. The patient did not show signs of having a psychedelic experience. This is the first time that a study of this nature has been conducted and reported in the canine species. 1cp-LSD proved to be safe and exerted the desired effect on the animal's behavior, significantly reducing the patient's anxiety.

12.
J Thorac Dis ; 16(8): 5042-5049, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39268096

RESUMO

Background: Lung cancer is the most common cause of cancer death in the UK resulting in 21% of all cancer deaths. In 2016, local lung cancer surgery services required improvement due to under-representation in cancer resections and resource scarcity during the pandemic, which affected critical care bed availability and extended postoperative stays. The aim of this service improvement was to increase the number of lung cancer resection; develop minimally invasive techniques and reduce the use of Critical Care Unit beds by 35% (a subsequent goal). Methods: A five-year plan, guided by Kotter's 8-step change model, was initiated to address these issues. This model promotes sustainable change by setting clear goals, effective communication, and stakeholder involvement. Initial changes included hiring a thoracic surgeon experienced in uniportal video assisted thoracoscopy and enhanced recovery protocols. The team grew to three thoracic surgeons by 2020. The service increased operating theatre days and adopted new postoperative practices to reduce complications and hospital stays. Lung Cancer Multidisciplinary Team Meetings were consistently covered by thoracic surgeons, ensuring comprehensive care. Data on surgical activity were collected from departmental databases and national audits, with internal audits conducted regularly. Statistical significance was tested using chi-square tests with P values <0.05. Results: The number of surgical procedures more than doubled, with primary lung cancer resections increasing nearly three-fold from 12.8% to 29.8% over six years. Postoperative complications and mortality rates remained low. Critical care bed usage dropped significantly during the pandemic, with new protocols enabling safe recovery in general surgical areas. Conclusions: The successful expansion of thoracic surgical services was attributed to the dedicated minimally invasive surgeons, enhanced recovery measures, and skilled staff. The change model facilitated efficient and dynamic progress. With the introduction of lung cancer screening programs, the demand for surgical services is expected to rise. The effective change model will be re-applied to meet this demand. The organizational change model, focused on patients and staff, achieved sustained quality improvement in lung cancer care despite challenging conditions like the coronavirus disease 2019 pandemic.

13.
Comput Biol Med ; 181: 108983, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39173483

RESUMO

BACKGROUND: Knee ligament rupture is one of the most common injuries, but the diagnosis of its severity tends to require the use of complex methods and analyses that are not always available to patients. AIM: The objective of this research is the investigation and development of a diagnostic aid system to analyze and determine patterns that characterize the presence of the injury and its degree of severity. METHODS: Implement a novel proposal of a framework based on stacked auto-encoder (SAE) for ground reaction force (GRF) signals analysis, coming from the GaitRec database. Analysis of the raw data is used to determine the main features that allow us to diagnose the presence of a knee ligament rupture and classify its severity as high, mid or mild. RESULTS: The process is divided into two stages to determine the presence of the lesion and, if necessary, evaluate variations in features to classify the degree of severity as high, mid, and mild. The framework presents an accuracy of 87 % and a F1-Score of 90 % for detecting ligament rupture and an accuracy of 86.5 % and a F1-Score of 87 % for classifying severity. CONCLUSION: This new methodology aims to demonstrate the potential of SAE in physiotherapy applications as an evaluation and diagnostic tool, identifying irregularities associated with ligament rupture and its degree of severity, thus providing updated information to the specialist during the rehabilitation process.


Assuntos
Traumatismos do Joelho , Humanos , Ruptura , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/classificação , Masculino , Feminino , Adulto , Processamento de Sinais Assistido por Computador
14.
bioRxiv ; 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39211113

RESUMO

Cancer cell proliferation requires precise control of E2F1 activity; excess activity promotes apoptosis. Here, we developed cell-permeable and bioavailable macrocycles that selectively kill small cell lung cancer (SCLC) cells with inherent high E2F1 activity by blocking RxL-mediated interactions of cyclin A and cyclin B with select substrates. Genome-wide CRISPR/Cas9 knockout and random mutagenesis screens found that cyclin A/B RxL macrocyclic inhibitors (cyclin A/Bi) induced apoptosis paradoxically by cyclin B- and Cdk2-dependent spindle assembly checkpoint activation (SAC). Mechanistically, cyclin A/Bi hyperactivate E2F1 and cyclin B by blocking their RxL-interactions with cyclin A and Myt1, respectively, ultimately leading to SAC activation and mitotic cell death. Base editor screens identified cyclin B variants that confer cyclin A/Bi resistance including several variants that disrupted cyclin B:Cdk interactions. Unexpectedly but consistent with our base editor and knockout screens, cyclin A/Bi induced the formation of neo-morphic Cdk2-cyclin B complexes that promote SAC activation and apoptosis. Finally, orally-bioavailable cyclin A/Bi robustly inhibited tumor growth in chemotherapy-resistant patient-derived xenograft models of SCLC. This work uncovers gain-of-function mechanisms by which cyclin A/Bi induce apoptosis in cancers with high E2F activity, and suggests cyclin A/Bi as a therapeutic strategy for SCLC and other cancers driven by high E2F activity.

15.
Brain ; 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39167538

RESUMO

The development and maintenance of chronic pain involves the reorganization of spinal nociceptive circuits. The mechanistic target of rapamycin complex 2 (mTORC2), a central signaling hub that modulates both actin-dependent structural changes and mTORC1-dependent mRNA translation, plays key roles in hippocampal synaptic plasticity and memory formation. However, its function in spinal plasticity and chronic pain is poorly understood. Here we show that pharmacological activation of spinal mTORC2 induces pain hypersensitivity, whereas its inhibition, using downregulation of the mTORC2-defining component Rictor, alleviates both inflammatory and neuropathic pain. Cell-type-specific deletion of Rictor showed that the selective inhibition of mTORC2 in a subset of excitatory neurons impairs spinal synaptic potentiation and alleviates inflammation-induced mechanical and thermal hypersensitivity, and nerve injury-induced heat hyperalgesia. The ablation of mTORC2 in inhibitory interneurons strongly alleviated nerve injury-induced mechanical hypersensitivity. Our findings reveal the role of mTORC2 in chronic pain and highlight its cell-type-specific functions in mediating pain hypersensitivity in response to peripheral inflammation and nerve injury.

16.
J Comp Eff Res ; 13(9): e240061, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39132748

RESUMO

Aim: Regulatory and health technology assessment (HTA) agencies have increasingly published frameworks, guidelines, and recommendations for the use of real-world evidence (RWE) in healthcare decision-making. Variations in the scope and content of these documents, with updates running in parallel, may create challenges for their implementation especially during the market authorization and reimbursement phases of a medicine's life cycle. This environmental scan aimed to comprehensively identify and summarize the guidance documents for RWE developed by most well-established regulatory and reimbursement agencies, as well as other organizations focused on healthcare decision-making, and present their similarities and differences. Methods: RWE guidance documents, including white papers from regulatory and HTA agencies, were reviewed in March 2024. Data on scope and recommendations from each body were extracted by two reviewers and similarities and differences were summarized across four topics: study planning, choosing fit-for-purpose data, study conduct, and reporting. Post-authorization or non-pharmacological guidance was excluded. Results: Forty-six documents were identified across multiple agencies; US FDA produced the most RWE-related guidance. All agencies addressed specific and often similar methodological issues related to study design, data fitness-for-purpose, reliability, and reproducibility, although inconsistency in terminologies on these topics was noted. Two HTA bodies (National Institute for Health and Care Excellence [NICE] and Canada's Drug Agency) each centralized all related RWE guidance under a unified framework. RWE quality tools and checklists were not consistently named and some differences in preferences were noted. European Medicines Agency, NICE, Haute Autorité de Santé, and the Institute for Quality and Efficiency in Health Care included specific recommendations on the use of analytical approaches to address RWE complexities and increase trust in its findings. Conclusion: Similarities in agencies' expectations on RWE studies design, quality elements, and reporting will facilitate evidence generation strategy and activities for manufacturers facing multiple, including global, regulatory and reimbursement submissions and re-submissions. A strong preference by decision-making bodies for local real-world data generation may hinder opportunities for data sharing and outputs from international federated data networks. Closer collaboration between decision-making agencies towards a harmonized RWE roadmap, which can be centrally preserved in a living mode, will provide manufacturers and researchers clarity on minimum acceptance requirements and expectations, especially as novel methodologies for RWE generation are rapidly emerging.


Assuntos
Avaliação da Tecnologia Biomédica , Avaliação da Tecnologia Biomédica/métodos , Humanos , Tomada de Decisões , Pesquisa Comparativa da Efetividade , Medicina Baseada em Evidências , Estados Unidos
17.
Front Endocrinol (Lausanne) ; 15: 1412261, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39104810

RESUMO

Introduction: Obesity is a pathological state that involves the dysregulation of different metabolic pathways and adipose tissue cells, constituting a risk factor for the development of other diseases. Bariatric surgery is the most effective treatment. The study of the behavior of pollutants in situations of extreme weight loss can provide biomonitoring information and tools to manage diseases of environmental etiology. Aim: To determine the prevalence of serum persistent and non-persistent pollutants in obese patients subjected to bariatric surgery and analyze the impact of sociodemographic variables on these changes. Methods: GC-MS/MS and UHPLC-MS/MS were utilized to determine the detection rates and concentrations of 353 compounds, including persistent organic pollutants (POPs), pesticides, pharmaceuticals, and rodenticide, in serum samples of 59 obese patients before and after undergoing bariatric surgery. Results: Detection rates of p,p'-DDE, HCB, ß-HCH, naphthalene, phenanthrene and PCB congeners 138, 153 and 180 significantly increased due to surgery-induced weight loss. Serum levels of p,p'-DDE, PCB-138, PCB-153 and PCB-180 also increased after surgery. Correlations between naphthalene levels, weight loss, variation of total lipids and time after surgery were found. Additionally, correlations were observed between concentrations of PCB-138 and weight loss, and between phenanthrene levels and reduction of total lipids. No statistically significant differences were observed for other groups of contaminants, pharmaceuticals and other chemicals included in the quantification methods. Conclusions: Increment of POPs was observed after bariatric surgery. Serum concentrations of POPs after surgery were influenced by adiposity-related variables. Although biomonitoring studies show a decreasing tendency of exposure, rapid weight loss leads to an increase of circulating POPs. Further research on the interplay between adipose tissue, POPs and peripheral organs is required.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Feminino , Masculino , Obesidade Mórbida/cirurgia , Obesidade Mórbida/sangue , Adulto , Estudos Longitudinais , Pessoa de Meia-Idade , Poluentes Orgânicos Persistentes/sangue , Carga Corporal (Radioterapia) , Poluentes Ambientais/sangue , Redução de Peso , Estudos de Coortes , Espectrometria de Massas em Tandem
18.
J Med Econ ; 27(1): 1076-1085, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39102473

RESUMO

AIMS: Fruquintinib is a selective small molecule tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3 recently approved in the United States (US) for the treatment of adult patients with metastatic colorectal cancer (CRC) who have previously been treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type and medically appropriate, anti-epidermal growth factor receptor therapy. This study aimed to estimate the 5-year budget impact of fruquintinib from a US payer perspective (commercial and Medicare). MATERIALS AND METHODS: A budget impact model was developed to compare two scenarios: a reference scenario in which patients received regorafenib, trifluridine/tipiracil, or trifluridine/tipiracil with bevacizumab and an alternative scenario in which patients received reference scenario treatments or fruquintinib. Market shares were evenly divided across available options. A 5-year time horizon and a hypothetical health plan of 1 million members was assumed. The model included epidemiological inputs to estimate the eligible population; clinical inputs for treatment duration, progression-free survival, overall survival, and adverse event (AE) frequency; and cost inputs for treatment, AEs, disease management, subsequent therapy, and terminal care costs. Budget impact was reported as total, per member per year (PMPY), and per member per month (PMPM). RESULTS: The model estimated an eligible population of 194 patients (39 per year) over 5 years. In the base case, the estimated 5-year budget impact of fruquintinib was $4,077,073 ($0.82 PMPY and 0.07 PMPM) for a commercial health plan. During the first year, the estimated budget impact was $627,570 ($0.63 PMPY and 0.05 PMPM). Results were robust across sensitivity analyses. PMPM costs from the Medicare perspective were greater than the base-case (commercial) ($0.17 vs. $0.07) due to higher incidence of CRC in that population. CONCLUSIONS: Fruquintinib is associated with a low budget impact for payers based on proposed thresholds in the US.


Fruquintinib is a treatment for metastatic colorectal cancer that has progressed after or not responded to multiple guideline-recommended therapies. This budget impact analysis was conducted to estimate the added costs a health plan would incur over a 5-year period if it chose to cover this therapy. The analysis found that the per plan member per month cost of covering fruquintinib was $0.07 for a United States commercial health plan and $0.17 for Medicare.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Benzofuranos , Bevacizumab , Neoplasias Colorretais , Piridinas , Timina , Humanos , Neoplasias Colorretais/tratamento farmacológico , Benzofuranos/uso terapêutico , Benzofuranos/economia , Estados Unidos , Bevacizumab/uso terapêutico , Bevacizumab/economia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Piridinas/uso terapêutico , Piridinas/economia , Trifluridina/uso terapêutico , Trifluridina/economia , Orçamentos , Quinazolinas/uso terapêutico , Quinazolinas/economia , Compostos de Fenilureia/uso terapêutico , Compostos de Fenilureia/economia , Uracila/análogos & derivados , Uracila/uso terapêutico , Uracila/economia , Compostos Organoplatínicos/uso terapêutico , Compostos Organoplatínicos/economia , Análise Custo-Benefício , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Camptotecina/economia , Antineoplásicos/economia , Antineoplásicos/uso terapêutico , Irinotecano/uso terapêutico , Irinotecano/economia , Medicare , Fluoruracila/uso terapêutico , Fluoruracila/economia , Oxaliplatina/uso terapêutico , Oxaliplatina/economia , Receptores de Fatores de Crescimento do Endotélio Vascular , Modelos Econômicos , Combinação de Medicamentos , Pirrolidinas
19.
J Am Chem Soc ; 146(33): 22970-22981, 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39120593

RESUMO

Mixed tin-lead (Sn-Pb) halide perovskites stand out as promising materials for next-generation photovoltaics and near-infrared optoelectronics. However, their sensitivity to oxidative degradation remains a major hurdle toward their widespread deployment. A holistic understanding of their oxidation processes considering all their constituent ions is therefore essential to stabilize these materials. Herein, we reveal that A-site cation choice plays an inconspicuous yet crucial role in determining Sn-Pb perovskite stability toward oxidation. Comparing typical A-site compositions, we show that thin films and solar cells containing cesium are more resistant to oxidative stress relative to their methylammonium analogs. We identify degradation in these compositions to be closely linked to the presence of triiodide, a harmful species evolving from native I2 oxidants. We find that hydrogen bonding between methylammonium and I2 promotes triiodide formation, while the strong polarizing character of cesium limits this process by capturing I2. Inspired from these findings, we design two strategies to boost stability of sensitive methylammonium-based Sn-Pb perovskite films and devices against oxidation. Specifically, we modulate the polarizing character of surface A-sites in perovskite via CsI and RbI coatings, and we incorporate Na2S2O3 as an I2 scavenging additive. These crucial mechanistic insights will pave the way for the design of highly efficient and stable Sn-Pb perovskite optoelectronics.

20.
Int J Food Microbiol ; 425: 110894, 2024 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-39216361

RESUMO

The life cycle of most non-conventional yeasts, such as Torulaspora delbrueckii (Td), is not as well-understood as that of Saccharomyces cerevisiae (Sc). Td is generally assumed to be haploid, which detracts from some biotechnological properties compared to diploid Sc strains. We analyzed the life cycle of several Td wine strains and found that they were mainly diploid during exponential growth in rich medium. However, most cells became haploid in stationary phase, as observed for Sc haploid heterothallic strains. When transferred and incubated in nutrient-deficient media, these haploid cells became polymorphic, enlarged, and transitioned to diploid or polyploid states. The increased ploidy, that mainly results from supernumerary mitosis without cytokinesis, was followed by sporulation. A similar response was observed in yeasts that remained alive during the second fermentation of base wine for sparkling wine making, or during growth in ethanol-supplemented medium. This response was not observed in the Sc yeast populations under any of the experimental conditions assayed, which suggests that it is a specific adaptation of Td to the stressful fermentation conditions. This response allows Td yeasts to remain alive and metabolically active longer during wine fermentation. Consequently, we designed procedures to increase the cell size and ploidy of haploid Td strains. Td inocula with increased ploidy showed enhanced fermentation efficiency compared to haploid inocula of the same strains.


Assuntos
Fermentação , Ploidias , Torulaspora , Vinho , Vinho/microbiologia , Torulaspora/genética , Torulaspora/metabolismo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/crescimento & desenvolvimento , Haploidia , Microbiologia de Alimentos , Esporos Fúngicos/genética , Esporos Fúngicos/crescimento & desenvolvimento , Esporos Fúngicos/metabolismo
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