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1.
Healthcare (Basel) ; 12(17)2024 Aug 26.
Article in English | MEDLINE | ID: mdl-39273729

ABSTRACT

BACKGROUND: Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. METHODS: This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). RESULTS: Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. CONCLUSIONS: These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

2.
World J Hepatol ; 16(8): 1099-1110, 2024 Aug 27.
Article in English | MEDLINE | ID: mdl-39221093

ABSTRACT

BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a codominant autosomal hereditary condition that predisposes patients to the development of lung and/or liver disease, and Pi*Z allele is the most clinically relevant mutation. AIM: To evaluate the impact of clinical parameters and AATD phenotypes, particularly the Pi*Z allele, in liver fibrosis. METHODS: Cross-sectional cohort study including consecutive patients with AATD followed in Pulmonology or Hepatology consultation. RESULTS: Included 69 patients, 49.3% had Pi*MZ phenotype and 10.1% Pi*ZZ. An age ≥ 55 years, age at diagnosis ≥ 41 years and AAT at diagnosis < 77 mg/dL predicted a nonalcoholic fatty liver disease fibrosis score (NFS) not excluding advanced fibrosis [area under the curve (AUC) = 0.840, P < 0.001; AUC = 0.836, P < 0.001; AUC = 0.681, P = 0.025]. An age ≥ 50 years and age at diagnosis ≥ 41 years predicted a fibrosis-4 index of moderate to advanced fibrosis (AUC = 0.831, P < 0.001; AUC = 0.795, P < 0.001). Patients with hypertension, type 2 diabetes mellitus (DM), dyslipidaemia, metabolic syndrome, and regular alcohol consumption were more likely to have a NFS not excluding advanced fibrosis (P < 0.001, P = 0.002, P = 0.008, P < 0.001, P = 0.033). Patients with at least one Pi*Z allele and type 2 DM were 8 times more likely to have liver stiffness measurement ≥ 7.1 kPa (P = 0.040). CONCLUSION: Risk factors for liver disease in AATD included an age ≥ 50 years, age at diagnosis ≥ 41 years, metabolic risk factors, regular alcohol consumption, at least one Pi*Z allele, and AAT value at diagnosis < 77 mg/dL. We created an algorithm for liver disease screening in AATD patients to use in primary care, selecting those to be referred to Hepatology consultation.

4.
J Sci Food Agric ; 2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39149869

ABSTRACT

BACKGROUND: Cachaça (Brazilian spirit) is an alcoholic beverage of cultural and economic importance in Brazil. Its artisanal production is usually conducted in copper alembics, which results in contamination. The development of effective biosorbents from cheap matrices is an alternative to minimize both solid waste generation and copper levels in cachaça. The present work evaluates the obtention of nanocellulose-based materials from the major residue generated during the processing of palm heart from the Brazilian peach palm, through different processing techniques. Materials were characterized by physicochemical composition and their sorbent capacities for copper removal from aqueous solutions, and a simulation was conducted to evaluate potential application in the adequacy of cachaça to meet Brazilian legislation requirements. RESULTS: The different processing methods resulted in different cellulose concentrations, with the highest concentration in the bleached material (B3, 694 g kg-1 of cellulose), and different specific surface areas (1.02-12.4 m2 g-1). Copper adsorption onto nanocellulose obtained from peach palm external sheath is fast, with a predominance of a chemisorption mechanism. Isotherms were best represented by Langmuir's model, suggesting a monolayer adsorption. Simulations indicate that B3 is a suitable material for the removal of copper from cachaça, and small amounts of biosorbent (733.5 g) are required for the reduction of copper concentrations (10 to 3 mg L-1) in 1000 L of cachaça. CONCLUSION: This study demonstrated that the obtention of biosorbents from peach palm solid residues is promising and this nanocellulose-based material can be used for copper removal from contaminated cachaça. © 2024 Society of Chemical Industry.

5.
J Neurochem ; 2024 Aug 18.
Article in English | MEDLINE | ID: mdl-39155518

ABSTRACT

As one of the most important cellular housekeepers, autophagy directly affects cellular health, homeostasis, and function. Even though the mechanisms behind autophagy are well described, how molecular alterations and dysfunctions can lead to pathology in disease contexts still demands deeper investigation. Proteomics is a widely employed tool used to investigate molecular alterations associated with pathological states and has proven useful in identifying alterations in protein expression levels and post-translational modifications in autophagy. In this narrative review, we expand on the molecular mechanisms behind autophagy and its regulation, and further compile recent literature associating autophagy disturbances in context of brain disorders, utilizing discoveries from varying models and species from rodents and cellular models to human post-mortem brain samples. To outline, the canonical pathways of autophagy, the effects of post-translational modifications on regulating each step of autophagy, and the future directions of proteomics in autophagy will be discussed. We further aim to suggest how advancing proteomics can help further unveil molecular mechanisms with regard to neurological disorders.

6.
Pharmaceuticals (Basel) ; 17(8)2024 Jul 31.
Article in English | MEDLINE | ID: mdl-39204114

ABSTRACT

Opioids are the strongest analgesics available and are crucial in the treatment of acute and chronic pain. The line between these critical medications and how they are used beyond standard therapeutics in cases such as abuse, misuse, and medication errors needs to be understood, as it affects their safety, efficacy, and manner of use. The aim of this systematic review was to identify what is known about the adverse events resulting from the abuse, misuse, and medication errors associated with opioid use. A systematic search was conducted in the PubMed®, Scopus® and, EBSCO® databases to retrieve studies from the inception to December 2023 reporting abuse, misuse, and medication errors associated with medicinal opioid use. Two authors independently screened titles and abstracts and full text according to eligibility using Covidence® software. Full articles were examined by two independent reviewers, and disagreements were resolved by a third reviewer. The risk of bias was assessed by the JBI's critical appraisal tools. A total of 934 articles were screened by their title and abstract. Then, 151 articles were selected for full text screening. Of these, 34 studies were eligible for inclusion in this review. The included studies varied significantly in their population sizes, ranging from 9 individuals to 298,433 patients, and encompassed a diverse demographic, including all ages and both sexes. The studies consistently reported a range of adverse events associated with opioid use. Fentanyl, morphine, oxycodone, tramadol, and hydrocodone were frequently implicated. The data heterogeneity in this field resulted in challenges in drawing conclusions. The review highlights that some opioids, particularly fentanyl, morphine, and oxycodone, are frequently associated with preventable adverse drug reactions, abuse, and medication errors, underscoring the need for robust preventative measures and ongoing research to mitigate opioid-related harm.

7.
mSystems ; : e0057724, 2024 Aug 27.
Article in English | MEDLINE | ID: mdl-39191378

ABSTRACT

The introduction of solid foods to infants, also known as weaning, is a critical point for the development of the complex microbial community inhabiting the human colon, impacting host physiology in infancy and later in life. This research investigated in silico the impact of food-breastmilk combinations on growth and metabolite production by colonic microbes of New Zealand weaning infants using the metagenome-scale metabolic model named Microbial Community. Eighty-nine foods were individually combined with breastmilk, and the 12 combinations with the strongest influence on the microbial production of short-chain fatty acids (SCFAs) and branched-chain fatty acids (BCFAs) were identified. Fiber-rich and polyphenol-rich foods, like pumpkin and blackcurrant, resulted in the greatest increase in predicted fluxes of total SCFAs and individual fluxes of propionate and acetate when combined, respectively, with breastmilk. Identified foods were further combined with other foods and breastmilk, resulting in 66 multiple food-breastmilk combinations. These combinations altered in silico the impact of individual foods on the microbial production of SCFAs and BCFAs, suggesting that the interaction between the dietary compounds composing a meal is the key factor influencing colonic microbes. Blackcurrant combined with other foods and breastmilk promoted the greatest increase in the production of acetate and total SCFAs, while pork combined with other foods and breastmilk decreased the production of total BCFAs.IMPORTANCELittle is known about the influence of complementary foods on the colonic microbiome of weaning infants. Traditional in vitro and in vivo microbiome methods are limited by their resource-consuming concerns. Modeling approaches represent a promising complementary tool to provide insights into the behavior of microbial communities. This study evaluated how foods combined with other foods and human milk affect the production of short-chain fatty acids and branched-chain fatty acids by colonic microbes of weaning infants using a rapid and inexpensive in silico approach. Foods and food combinations identified here are candidates for future experimental investigations, helping to fill a crucial knowledge gap in infant nutrition.

8.
Fish Physiol Biochem ; 2024 Jul 27.
Article in English | MEDLINE | ID: mdl-39066863

ABSTRACT

This study evaluated the supplementation of iron and copper nanoparticles in channel catfish diets and their influences on growth and health. A comparative feeding trial was carried out for 9 weeks to evaluate combinations of iron and copper nanoparticles: only iron nanoparticles (IronNP), only copper nanoparticles (CopperNP), CopperNP + IronNP, and a control diet supplemented with inorganic iron and copper (FeSO4 and CuSO4). After a 9-week feeding trial, growth performance, hematological parameters, whole-body proximate composition, and intestinal microbiota were evaluated, and fish were subjected to a bacterial challenge against Edwardsiella ictaluri to evaluate the contribution of the experimental treatments to fish health status. No statistical differences were detected for catfish fed the various diets in terms of production performance or survival after bacterial challenge. The hematocrit and RBC counts from fish fed the diet containing copper nanoparticles were significantly lower than the control group. A higher relative abundance of gram-positive bacteria was found in the digesta of catfish fed diets containing copper nanoparticles. Furthermore, in the context of hematology, iron nanoparticles did not impact the blood parameters of channel catfish; however, reduced hematocrits were observed in fish fed the copper nanoparticle diet, which lacked supplemental dietary iron, thus reinforcing the importance of dietary iron to catfish hematopoiesis. Nonetheless, additional studies are needed to investigate the effects of dietary copper nanoparticle supplementation in catfish diets to better illuminate its effects on the intestinal microbiota.

9.
PLoS One ; 19(7): e0304955, 2024.
Article in English | MEDLINE | ID: mdl-38990936

ABSTRACT

This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms "pregnant women" AND "delivery" AND "autonomy" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman's autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician's recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman's choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.


Subject(s)
Cesarean Section , Delivery, Obstetric , Parturition , Personal Autonomy , Pregnant Women , Humans , Female , Pregnancy , Pregnant Women/psychology , Delivery, Obstetric/methods , Choice Behavior
10.
PLoS Pathog ; 20(7): e1012336, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39018347

ABSTRACT

Cullin-1-RING ubiquitin ligases (CRL1) or SCF1 (SKP1-CUL1-RBX1) E3 ubiquitin ligases are the largest and most extensively investigated class of E3 ligases in mammals that regulate fundamental processes, such as the cell cycle and proliferation. These enzymes are multiprotein complexes comprising SKP1, CUL1, RBX1, and an F-box protein that acts as a specificity factor by interacting with SKP1 through its F-box domain and recruiting substrates via other domains. E3 ligases are important players in the ubiquitination process, recognizing and transferring ubiquitin to substrates destined for degradation by proteasomes or processing by deubiquitinating enzymes. The ubiquitin-proteasome system (UPS) is the main regulator of intracellular proteolysis in eukaryotes and is required for parasites to alternate hosts in their life cycles, resulting in successful parasitism. Leishmania UPS is poorly investigated, and CRL1 in L. infantum, the causative agent of visceral leishmaniasis in Latin America, is yet to be described. Here, we show that the L. infantum genes LINF_110018100 (SKP1-like protein), LINF_240029100 (cullin-like protein-like protein), and LINF_210005300 (ring-box protein 1 -putative) form a LinfCRL1 complex structurally similar to the H. sapiens CRL1. Mass spectrometry analysis of the LinfSkp1 and LinfCul1 interactomes revealed proteins involved in several intracellular processes, including six F-box proteins known as F-box-like proteins (Flp) (data are available via ProteomeXchange with identifier PXD051961). The interaction of LinfFlp 1-6 with LinfSkp1 was confirmed, and using in vitro ubiquitination assays, we demonstrated the function of the LinfCRL1(Flp1) complex to transfer ubiquitin. We also found that LinfSKP1 and LinfRBX1 knockouts resulted in nonviable L. infantum lineages, whereas LinfCUL1 was involved in parasite growth and rosette formation. Finally, our results suggest that LinfCul1 regulates the S phase progression and possibly the transition between the late S to G2 phase in L. infantum. Thus, a new class of E3 ubiquitin ligases has been described in L. infantum with functions related to various parasitic processes that may serve as prospective targets for leishmaniasis treatment.


Subject(s)
Cullin Proteins , Leishmania infantum , Leishmania infantum/metabolism , Leishmania infantum/enzymology , Cullin Proteins/metabolism , Cullin Proteins/genetics , Protozoan Proteins/metabolism , Protozoan Proteins/genetics , Ubiquitination , Leishmaniasis, Visceral/parasitology , Leishmaniasis, Visceral/metabolism , Humans , Ubiquitin-Protein Ligases/metabolism , Ubiquitin-Protein Ligases/genetics , Proteasome Endopeptidase Complex/metabolism
11.
Article in English | MEDLINE | ID: mdl-38656040

ABSTRACT

Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.


Subject(s)
Antibodies, Viral , BNT162 Vaccine , COVID-19 Vaccines , COVID-19 , Immunocompromised Host , Immunogenicity, Vaccine , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Viral/blood , BNT162 Vaccine/immunology , BNT162 Vaccine/administration & dosage , COVID-19/prevention & control , COVID-19/immunology , COVID-19 Vaccines/immunology , COVID-19 Vaccines/administration & dosage , Immunization, Secondary , Immunocompetence/immunology , Immunocompromised Host/immunology , Vaccines, Inactivated/immunology , Vaccines, Inactivated/administration & dosage
12.
Fish Shellfish Immunol ; 149: 109534, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38575040

ABSTRACT

Zinc is one of the essential microelements for the metabolism of animals. Zinc nanoparticles may have higher bioavailability due to their low specific surface area, facilitating absorption by fish. The present study aimed to evaluate the effects of supplementation with different zinc-based products on the growth and health of Nile tilapia Oreochromis niloticus. Zinc, in different sizes (nanoparticles or bulk) and forms (inorganic or organic), were used as a supplement in the tilapia diet at a dose of 15 mg kg feed-1 for 60 days. At the end of the feeding trial, production performance, hemato-immunological parameters, activity of antioxidant system enzymes, exposure to Streptococcus agalactiae and zinc concentration in the muscle were examined. After the bacterial challenge, the mean corpuscular hemoglobin concentration (MCHC) significantly increased in the fish treated with organic zinc, inorganic nano zinc, and organic nano zinc, while in the control group (inorganic zinc), MCHC remained unchanged. Regarding defense cells, dietary inorganic nano zinc increased the number of basophils (1.50 ± 1.10) compared to organic zinc (0.80 ± 0.90). Lymphocyte count increased after the challenge only in the organic zinc treatments (bulk and nanoparticles). Neutrophils decreased in the control (inorganic zinc) (2.20 ± 1.70) and inorganic nano zinc (2.60 ± 2.70) treatments after the challenge. When compared before and after the bacterial challenge, the plasma antimicrobial titer significantly increased after the bacterial challenge in all treatments. No significant differences were observed for total proteins, enzymes (SOD and CAT), cumulative survival and zinc deposition on fillet. In conclusion, organic zinc in nanoparticles or bulk size increased Nile tilapia innate defense during bacterial infection. However, the other parameters evaluated were not affected by zinc particle size or form (organic or inorganic), indicating that further evaluations should be conducted with organic zinc in nanoparticles or bulk size in the tilapia diet.


Subject(s)
Animal Feed , Cichlids , Diet , Dietary Supplements , Fish Diseases , Streptococcal Infections , Streptococcus agalactiae , Zinc , Animals , Cichlids/immunology , Cichlids/growth & development , Dietary Supplements/analysis , Zinc/administration & dosage , Animal Feed/analysis , Diet/veterinary , Streptococcal Infections/veterinary , Streptococcal Infections/immunology , Streptococcus agalactiae/physiology , Fish Diseases/immunology , Random Allocation , Immunity, Innate/drug effects
13.
GE Port J Gastroenterol ; 31(2): 89-100, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38572440

ABSTRACT

Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (pan-enteric capsule endoscopy [PCE]). Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn's disease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syndromes with simultaneous involvement of the small intestine and colon. Key Messages: PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.


Introdução: O papel da endoscopia por cápsula na avaliação do intestino delgado encontra-se bem estabelecido, e as orientações atuais posicionam-na como um teste de primeira linha numa variedade de cenários clínicos. O advento das cápsulas de dupla câmara permitiu expandir a sua aplicação para a avaliação endoscópica da mucosa do cólon, oferecendo a oportunidade de um exame não invasivo de todo o intestino (endoscopia pan-entérica por cápsula, PCE). Sumário: Procedemos a uma revisão de vários aspectos do procedimento e preparação dos doentes para a PCE, bem como as aplicações clínicas atuais e as perspetivas futuras das cápsulas de dupla câmara. Na doença de Crohn não estenosante e não penetrante localizada ao intestino delgado e cólon, a PCE permite monitorizar a atividade da doença e avaliar a cicatrização da mucosa, um indicador importante da eficácia da terapêutica, com um rendimento de diagnóstico superior aos métodos convencionais, nomeadamente os exames imagiológicos ou a colonoscopia invasiva. Também na colite ulcerosa, as cápsulas de dupla câmara têm sido utilizadas para monitorizar a atividade da doença de forma não invasiva. Existem índices endoscópicos validados e especificamente concebidos para as cápsulas de dupla câmara, que permitem uma avaliação sistematizada e quantificação objetiva da atividade inflamatória. Na suspeita de hemorragia digestiva média ou baixa, alguns estudos exploratórios demonstraram a aplicabilidade e o elevado rendimento diagnóstico da PCE, podendo funcionar como um filtro de modo a permitir indicar quais os doentes que mais irão beneficiar de um procedimento invasivo subsequente, nomeadamente para a realização de procedimentos hemostáticos dirigidos. A possibilidade de utilização da PCE é também discutida no contexto das síndromes de polipose com envolvimento simultâneo do intestino delgado e do cólon. Mensagens-chave: A PCE é um procedimento diagnóstico eficaz e seguro para avaliar diretamente a mucosa do intestino delgado e cólon. A sua aplicação tem vindo a expandir-se no contexto das Doenças Inflamatórias Intestinais e, mais recentemente, na suspeita de hemorragia digestiva média ou baixa. Existe a expectativa de que no futuro próximo possamos assistir a uma redução substancial da demanda por procedimentos endoscópicos invasivos, face à utilização crescente da PCE enquanto método de diagnóstico pan-intestinal não invasivo.

14.
Clin Transl Oncol ; 2024 Apr 24.
Article in English | MEDLINE | ID: mdl-38658461

ABSTRACT

INTRODUCTION: Treatment of cancer has been improved with the discovery of biological drugs that act as immune checkpoint inhibitors. In 2017, FDA designated pembrolizumab, an immune checkpoint inhibitor employed in immunotherapy, as the first tissue-agnostic cancer treatment. OBJECTIVES: To review pembrolizumab's use in oncology, gather and examine the latest discoveries regarding the effectiveness of pembrolizumab in cancer treatment. METHODOLOGY: A literature review was conducted through PubMed(Medline) from January 2015 to December 2023 using "pembrolizumab", "cancer" and "treatment" as search terms. RESULTS: Pembrolizumab demonstrated effectiveness as primary treatment for metastatic nonsmall cell lung cancer, unresectable esophageal cancer, head and neck squamous cell carcinoma and alternative treatment for notable triple-negative breast cancer, biliary, colorectal, endometrial, renal cell, cervical carcinoma, and high microsatellite instability or mismatch repair deficiencies tumors. Pediatric applications include treatment for refractory Hodgkin lymphoma. CONCLUSION: Evolving research on pembrolizumab allows a deeper clinical understanding, despite challenges as variable patient responses. Pembrolizumab has emerged as a pivotal breakthrough in cancer treatment, improving patient outcomes and safety.

15.
Pensar Prát. (Online) ; 27abr.2024. Tab, Ilus
Article in Portuguese, French | LILACS | ID: biblio-1556331

ABSTRACT

A equidade é um dos princípios constitucionais e doutrinários do Sistema Único de Saúde (SUS), assim como da Política Nacional de Promoção da Saúde, principal marco das Práticas Corporais e Atividades Físicas (PCAF) no referido sistema. Considerando as desigualdades sociais gerais e as iniquidades em saúde, a equidade deve ser prioritária. Assim, o trabalho, de caráter ensaístico, teve como objetivo apresentar a experiência do Serviço de Orientação ao Exercício na operacionalização deste princípio. Foram abordados aspectos relacionados ao acesso, recursos, resultados e desafios para indicar possibilidades e caminhos para a efetivação da equidade na promoção das PCAF no SUS, visando o seu fortalecimento e qualificação como sistema de saúde universal, integral e equânime (AU).


Equity is one of the constitutional and doctrinal principles of the Unified Health System (SUS), as well as of the National Health Promotion Policy, the main framework for Body Practices and Physical Activities (PCAF) in this system. Considering the general social inequalities and inequities in health, equity must be a priority. The aim of this essay was to present the experience of the Exercise Guidance Service in operationalizing this principle. Aspects related to access, resources, results and challenges were addressed in order to indicate possibilities and paths towards the realization of equity in the promotion of PCAF in the SUS, with a view to strengthening and qualifying it as a universal, comprehensive and equitable health system (AU).


La equidad es uno de los principios constitucionales y doctrinales del Sistema Único de Salud (SUS), así como de la Política Nacional de Promoción de la Salud, marco principal de las Prácticas Corporales y Actividades Físicas (PCAF) de este sistema. Considerando las desigualdades sociales generales y las inequidades en salud, la equidad debe ser priorizada. El objetivo de este ensayo era, por tanto, presentar la experiencia del Servicio de Orientación para el Ejercicio en la puesta en práctica de este principio. Se analizaron aspectos relacionados con el acceso, los recursos, los resultados y los desafíos, a fin de indicar posibilidades y formas de hacer realidad la equidad en la promoción del PCAF en el SUS, con miras a fortalecerlo y calificarlo como sistema de salud universal, integral y equitativo (AU).


Subject(s)
Humans
16.
Pensar Prát. (Online) ; 27: 76978, 20240417.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1566819

ABSTRACT

A equidade é um dos princípios constitucionais e dou-trinários do Sistema Único de Saúde (SUS), assim como da Política Nacional de Promoção da Saúde, principal marco das Práticas Corporais e Atividades Físicas (PCAF) no referido sistema. Considerando as desigualdades sociais gerais e as iniquidades em saúde, a equidade deve ser prioritária. Assim, o trabalho, de caráter ensaístico, teve como objetivo apresentar a experiência do Serviço de Orientação ao Exercício na operacionalização des-te princípio. Foram abordados aspectos relacionados ao acesso, recursos, resultados e desafios para indicar possibilidades e ca-minhos para a efetivação da equidade na promoção das PCAF no SUS, visando o seu fortalecimento e qualificação como sistema de saúde universal, integral e equânime.


Equity is one of the constitutional and doctrinal principles of the Unified Health System (SUS), as well as of the National Health Promotion Policy, the main framework for Body Practices and Physical Activities (PCAF) in this system. Considering the general social inequalities and inequities in health, equity must be a priority. The aim of this essay was to present the experience of the Exercise Guidance Service in operationalizing this principle. Aspects related to access, resources, results and challenges were addressed in order to indicate possibilities and paths towards the realization of equity in the promotion of PCAF in the SUS, with a view to strengthening and qualifying it as a universal, comprehensive and equitable health system.


La equidad es uno de los principios constitucionales y doctrinales del Sistema Único de Salud (SUS), así como de la Política Nacional de Promoción de la Salud, marco principal de las Prácticas Corporales y Actividades Físicas (PCAF) de este sistema. Considerando las desigualdades sociales generales y las inequidades en salud, la equidad debe ser priorizada. El objetivo de este ensayo era, por tanto, presentar la experiencia del Servicio de Orientación para el Ejercicio en la puesta en práctica de este principio. Se analizaron aspectos relacionados con el acceso, los recursos, los resultados y los desafíos, a fin de indicar posibilidades y formas de hacer realidad la equidad en la promoción del PCAF en el SUS, con miras a fortalecerlo y calificarlo como sistema de salud universal, integral y equitativo.

17.
Entropy (Basel) ; 26(3)2024 Feb 20.
Article in English | MEDLINE | ID: mdl-38539689

ABSTRACT

Since financial assets on stock exchanges were created, investors have sought to predict their future values. Currently, cryptocurrencies are also seen as assets. Machine learning is increasingly adopted to assist and automate investments. The main objective of this paper is to make daily predictions about the movement direction of financial time series through classification models, financial time series preprocessing methods, and feature selection with genetic algorithms. The target time series are Bitcoin, Ibovespa, and Vale. The methodology of this paper includes the following steps: collecting time series of financial assets; data preprocessing; feature selection with genetic algorithms; and the training and testing of machine learning models. The results were obtained by evaluating the models with the area under the ROC curve metric. For the best prediction models for Bitcoin, Ibovespa, and Vale, values of 0.61, 0.62, and 0.58 were obtained, respectively. In conclusion, the feature selection allowed the improvement of performance in most models, and the input series in the form of percentage variation obtained a good performance, although it was composed of fewer attributes in relation to the other sets tested.

18.
J Environ Radioact ; 274: 107413, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38484579

ABSTRACT

This study explores the impact of a simulated radiological dispersal device (RDD) event in an urban area on young adults around 20 years old. The RDD releases radioactive Cs-137 (7.0E+3 Ci), a common industrial sterilization source. The study aims to demonstrate that combining computational codes and epidemiological models can produce valuable data to guide initial actions when confronting a hostile radioactive environment. The HotSpot Health Physics and RESRAD-RDD codes were used in the simulation to evaluate the event's initial phase. The codes were executed together, and the HotSpot output data was input into RESRAD-RDD. Based on simulated radiation dose levels, estimated doses were incorporated into radioepidemiological models proposed by the Committee on Biological Effects of Ionizing Radiation (BEIR V or VII report). Despite limitations, data transfer between the models revealed no discontinuities or antagonisms. Radiation doses were simulated under three exposure conditions and two atmospheric release modes (day or night), suggesting that atmospheric conditions, sex, and exposure routine can strongly influence the perception of radiation impacts. This combination of methods can increase situational awareness and help with decision-making and developing coping strategies.


Subject(s)
Radiation Monitoring , Radioactive Hazard Release , Young Adult , Humans , Adult , Cesium Radioisotopes , Radiation Monitoring/methods , Awareness , Radiation Dosage
20.
Dig Dis Sci ; 69(4): 1372-1379, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38353789

ABSTRACT

BACKGROUND: Delayed bleeding (DB) is a possible adverse event following gastric endoscopic submucosal dissection (ESD). The BEST-J score was created as a risk prediction model for DB following gastric ESD, but is yet to be validated in Western populations. AIMS: We aimed to validate the BEST-J score on a European sample and to perform a subgroup analysis according to histological classification. METHODS: Retrospective study of all consecutive patients undergoing gastric ESD on a European Endoscopic Unit. DB was defined as hemorrhage with clinical symptoms and confirmed by emergency endoscopy from the time of completion to 28 days after ESD. BEST-J score was calculated in each patient and confronted with the outcome (DB). RESULTS: Final sample included 161 patients. From these, 10 (6.2%) presented DB following ESD, with a median time to bleeding of 7 days (IQR 6.8). BEST-J score presented an excellent accuracy predicting DB in our sample, with an AUC = 0.907 (95%CI 0.801-1.000; p < 0.001). Subgroup analysis by histological classification proved that the discriminative power was still excellent for each grade: low-grade dysplasia-AUC = 0.970 (p < 0.001); high-grade dysplasia-AUC = 0.874 (p < 0.001); early gastric cancer-AUC = 0.881 (p < 0.001). The optimal cut-off value to predict DB was a BEST-J score ≥ 3, which matches the cut-off value for high-risk of bleeding in the original investigation. CONCLUSIONS: The BEST-J score still presents excellent accuracy in risk stratification for post-ESD bleeding in European individuals. Thus, this score may help to guide which patients benefit the most from prophylactic therapies following gastric ESD in this setting.


Subject(s)
Endoscopic Mucosal Resection , Stomach Neoplasms , Humans , Endoscopic Mucosal Resection/adverse effects , Retrospective Studies , Postoperative Hemorrhage/etiology , Gastric Mucosa/pathology , Risk Factors , Endoscopy, Gastrointestinal , Stomach Neoplasms/pathology
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