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1.
Popul Health Metr ; 22(1): 23, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39223533

RESUMO

BACKGROUND: The Decade of Healthy Aging (2021-2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. METHODS: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. RESULTS: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. CONCLUSIONS: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence.


Assuntos
Envelhecimento Saudável , Humanos , México , Idoso , Nível de Saúde , Sistemas de Informação em Saúde , Envelhecimento , Idoso de 80 Anos ou mais
2.
Healthcare (Basel) ; 12(17)2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39273777

RESUMO

INTRODUCTION: Dementia, depression, and cardiovascular disease are major public health concerns for older adults, requiring early intervention. This study investigates whether a virtual reality cognitive remediation program (VR-CR) can improve cognitive function and depressive symptoms in older adults, and determines the necessary sample size for future studies. Integrated VR and CR interventions have shown promising outcomes in older adults with neurodegenerative and mental health disorders. METHODS: This secondary analysis of a randomized controlled trial involves adults aged 58-75 years with bipolar disorder, excluding those with acute episodes, epilepsy, or severe eye diseases. The experimental group received standard treatment plus VR-CR, while the control group received only standard treatment. RESULTS: No baseline differences were found between the experimental and control groups. No significant improvement was observed in the overall cognitive function test (p = 0.897) or in depressive symptoms (p = 0.322). A phase III efficacy study requires a sample size of 28 participants (alpha = 0.05, beta = 0.20). CONCLUSIONS: VR-CR can potentially treat depressive symptoms in adults and older adults, but the results support conducting phase III studies to further investigate these outcomes. However, the improvement in cognitive performance in the elderly is less pronounced than in younger individuals.

3.
Cureus ; 16(8): e66466, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39247039

RESUMO

A gastric rupture resulting from abdominal trauma is a rare occurrence with a frequency of less than 2% of blunt abdominal injuries. Furthermore, gastric perforation secondary to the Heimlich maneuver is even rarer, with only a handful of cases reported in the literature. Here, we present a case of isolated gastric rupture following a successful Heimlich maneuver. Laparotomy revealed a large perforation along the lesser curvature of the stomach. The perforation was repaired by primary closure and reinforced with omental patching.

4.
Behav Sleep Med ; : 1-11, 2024 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-39244666

RESUMO

OBJECTIVES: Insomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one study has examined the efficacy of brief behavioral treatment for insomnia (BBTI) in people with HIV. This study examined BBTI effects on sleep and pain in people with HIV. METHODS: Ten adults with HIV and chronic pain completed a 4-week, telephone-delivered BBTI treatment. A control group (n = 10) completed a brief mindfulness training (BMT). The Insomnia Severity Index and Brief Pain Inventory were used to assess insomnia severity and pain outcomes, respectively. RESULTS: There was a significant interaction between intervention and time on insomnia severity, F (2,14) = 5.7, p = .02, partial η2 = 0.45). The BBTI group demonstrated significant improvements in insomnia severity from pre- to post-intervention (p < .001) and from pre-intervention to one-month post-intervention (p = .001) compared to the BMT group. There was a significant interaction between intervention and time on pain interference, F (1,18) = 4.9, p = .02, partial η2 = 0.27). The BBTI group demonstrated a significant decrease in pain interference from pre- to post-intervention (p < .001) compared to the BMT group. CONCLUSIONS: This pilot study demonstrated that BBTI improved insomnia in people with HIV for up to one-month post-treatment. Novel preliminary evidence suggests that BBTI may also improve pain outcomes in people with HIV.

5.
Mayo Clin Proc Innov Qual Outcomes ; 8(5): 443-450, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39263427

RESUMO

Transgender and gender diverse (TGD) people experience disparities in cancer care, including more late-stage diagnoses, worse cancer-related outcomes, and an increased number of unaddressed and more severe symptoms related to cancer and cancer-directed therapy. This article outlines plans to address the unique needs of TGD people through a TGD-focused oncology clinic. Such a clinic could be structured by upholding the following tenets: (1) champion a supportive, gender-affirming environment that seeks to continuously improve, (2) include a transdisciplinary team of specialists who are dedicated to TGD cancer care, and (3) initiate and embrace TGD-patient-centric research on health outcomes and health care delivery.

6.
Int J Artif Organs ; : 3913988241274252, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39221571

RESUMO

Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant patients, affecting between 10% and 30% of candidates. Historically, HPS was considered a contraindication for liver transplantation due to its association with high mortality rates. However, recent studies have shown improvements in pulmonary function post-transplant, leading to the inclusion of these patients as candidates. Despite this progress, approximately one-fifth of liver transplant recipients develop severe postoperative hypoxia, further complicating their clinical course and contributing to increased mortality. The management of post-transplant HPS involves various strategies, including extracorporeal membrane oxygenation (ECMO), although its use remains infrequently reported. Theoretical models suggest that oxygenation typically improves within 10 days post-transplant, while resolution of HPS may take 6-12 months, making ECMO an attractive possibility as a bridge to recovery in this population. We present a case were ECMO was used in this context.

7.
J Clin Med ; 13(16)2024 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-39200856

RESUMO

Background: Bipolar disorder (BD) is a severe psychiatric illness characterized by a chronic course and recurrent episodes, including residual depressive symptoms even during euthymic phases. These symptoms, although not meeting criteria for a depressive episode, are linked to relapse risk and impaired social functioning. This study aims to assess whether Virtual Reality Cognitive Remediation Training reduces depressive symptoms below the clinical threshold in individuals with BD. Methods: This post hoc analysis focuses on the secondary outcome (PHQ9) of a randomized-controlled trial. Participants were recruited from the Center of Liaison Psychiatry and Psychosomatics in Italy. The experimental group received Virtual Reality Cognitive Remediation, while the control group received standard treatment Results: Data from 39 individuals in the experimental group and 25 in the control group were analyzed. A greater reduction in PHQ-9 scores (>9) was observed in the experimental group (71.8% to 48.7%) compared to the control group. Significant improvements in total PHQ-9 scores and specific symptoms were noted in the experimental group compared to the control group. Conclusions: The study highlights the significant impact of virtual reality intervention on reducing depressive symptoms in bipolar disorder. This promising outcome underscores the potential preventive role of cognitive stimulation in relapse prevention. The intervention could offer valuable benefits for both treatment and prevention strategies in bipolar disorder.

8.
J Clin Med ; 13(14)2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-39064048

RESUMO

Background: Fibromyalgia syndrome (FMs) is a chronic condition characterized by widespread musculoskeletal pain and a range of complex symptoms, with chronic fatigue being a central feature significantly impacting daily life. The aim of this study was to analyze the secondary outcomes, specifically those related to perceived energy and fatigue symptoms in a randomized controlled trial (RCT) assessing the efficacy of heart rate variability biofeedback (HRV-BF) as an adjunctive treatment for FMs. Methods: Sixty-four FMs patients were randomly assigned to either receive 10 HRV-BF training sessions alongside standard pharmacological therapy (experimental group) or standard therapy alone for 10 weeks (control group). For this secondary analysis, potential improvements in specific items were evaluated regarding perceived energy (Item 10 of the Short-Form Health Survey), the ability to walk and climb stairs (Item 7 and Item 11 of the Fibromyalgia Impact Questionnaire, respectively), and the impact of pain on movement ability (Item 17 of the Bodily and Emotional Perception of Pain). Results: The experimental group demonstrated an improvement in the perception of energy, the ability to walk, and the impact of pain on movement ability. However, the same improvement was not observed in the ability to climb stairs. Conclusions: Fatigue assessment has emerged as a crucial factor for evaluating treatment efficacy in FMs and related conditions linked to altered energy levels, such as bipolar depression, and can offer valuable insights for precisely guiding HRV-BF treatments. ClinicalTrials.gov with code: NCT04121832.

9.
J Clin Med ; 13(14)2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39064243

RESUMO

Background: The objective of this work is to investigate the effectiveness of a cognitive remediation intervention on anxiety symptoms in people with bipolar disorder and the therapeutic effect on people whose anxiety symptoms were above the threshold for a screener and whose comorbidity could be identified as an anxiety disorder. Methods: The experimental intervention included 24 sessions (around 45 min each), two for each week over three months. The entire program was inspired by user-centered rehabilitation principles in a recovery-oriented perspective and an approach to bipolar disorder in an evolutionary and non-discriminating vision. The primary outcomes measure the score of the Zung Self-Rating Anxiety Scale (SAS), hypothesizing a higher decrease in the experimental group than in the control group. The survey has been conducted per the CONSORT guidelines for feasibility studies. Results: We evaluate a decrease in the overall SAS score from T0 to T1 to be higher in the experimental group compared to the control group, indicating an improvement in anxiety symptoms (p < 0.0001). Conclusions: The study suggests that virtual reality could have a role in treating anxiety symptoms and disorders in young adults with bipolar disorders or anxiety symptoms in people with hyperactivity and novelty-seeking behaviorsunder stress and high risk for bipolar disorder.

10.
Healthcare (Basel) ; 12(13)2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38998863

RESUMO

AIM: The purpose of this study was to assess the reliability and validity of the Spanish version of the Health Promoting Lifestyle Profile II (HPLP-II) scale in Colombian university students. METHODS: This was a methodological study to verify reliability and construct validity. A total of 763 undergraduate university students in Cali, Colombia, agreed to participate in the study by filling out a form that included information on sociodemographic characteristics and the HPLP-II scale Spanish version. Data were collected between February and June 2021. To determine construct validity, a confirmatory factor analysis was performed, and internal consistency was determined through Cronbach's alpha. RESULTS: The confirmatory factor analysis of the proposed theoretical model showed that the goodness-of-fit indices of the scale demonstrated an acceptable level of validity nearing an excellent level of fit (χ2 = 7168.98; gl = 1268; p < 0.001; root mean square error of approximation = 0.08; normed fit index, adjusted goodness-of-fit index = 0.95). Cronbach's alpha coefficient of the scale was 0.94, and the subscales ranged from 0.68 to 0.89. CONCLUSIONS: The HPLP-II Spanish version is a valid and reliable instrument to assess the health-promoting lifestyle profile of university students.

11.
Cad Saude Publica ; 40(6): e00169423, 2024.
Artigo em Português | MEDLINE | ID: mdl-39082569

RESUMO

This is a documentary, exploratory, descriptive study, which is part of a multicenter international study assessing the national health systems with a care model based on primary health care of Brazil, Spain, Italy, and Portugal, funded by the Brazilian National Research Council (CNPq, acronym in Portuguese). It aims to identify the basic health legislation, the right to health, and the doctrinal and organizational principles of each country with a focus on the impact of social determinants of health on the national health systems. The results showed these countries have similar legislation and doctrinal principles, with a constitutional right to health, based on primary health care, and with a care model of the family health type. The challenges identified were low birth rate and high life expectancy at birth in European countries and criteria for access to medication and care financing. Based on our findings, the countries with higher investment in a structural basis, ensuring more dignified, solid, and vigilant socioeconomic and sanitary conditions, provide an important differentiation in responsiveness and sustainability of the national health system and direct impact on the quality of life.


Trata-se de uma pesquisa documental, exploratória, descritiva, partindo de um estudo multicêntrico e internacional entre Brasil, Espanha, Itália e Portugal sobre sistemas nacionais de saúde com modelo de atenção baseado na atenção primária à saúde e financiado pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) do Brasil. Tem como objetivo identificar as legislações de base da saúde, o direito à saúde e os princípios doutrinários e organizativos de cada país selecionado com ênfase no impacto dos determinantes sociais de saúde sobre os sistemas nacionais de saúde. Os resultados revelaram países com legislações e princípios doutrinários semelhantes, com direito à saúde constitucional, ancorados na atenção primária à saúde, e com modelo assistencial de acesso do tipo saúde da família. Os desafios encontrados foram a baixa natalidade e elevada expectativa de vida ao nascer em países europeus e critérios para acesso a medicamentos e financiamento assistencial. Com base nos nossos achados, os países que tiveram maior investimento em base estrutural, perpassando por assegurar condições socioeconômicas e sanitárias mais dignas, sólidas e vigilantes, garantiram importante diferenciação na capacidade de resposta e sustentabilidade do sistema nacional de saúde e no impacto direto na qualidade de vida das pessoas.


Se trata de una investigación documental, exploratoria, descriptiva, parte de un estudio multicéntrico, internacional entre Brasil, España, Italia y Portugal sobre los Sistemas Nacionales de Salud con un modelo de atención basado en la atención primaria de salud y financiado por el Consejo Nacional de Desarrollo Científico y Tecnológico (CNPq) de Brasil. Tiene como objetivo identificar la legislación de base de la salud, el derecho a la salud y los principios doctrinales y organizativos de cada país seleccionado con énfasis en el impacto de los determinantes sociales de la salud sobre los sistemas nacionales de salud. Los resultados revelaron países con legislaciones y principios doctrinales similares, con derecho a salud constitucional, anclados en la atención primaria de salud y con un modelo asistencial de acceso del tipo salud de la familia. Los desafíos encontrados fueron la baja tasa de natalidad y la alta esperanza de vida al nacer en países europeos y criterios para el acceso a medicamentos y financiación asistencial. Con base en nuestros hallazgos, los países que tuvieron mayor inversión en base estructural, asegurando condiciones socioeconómicas y sanitarias más dignas, sólidas y vigilantes, garantizan una diferenciación importante en la capacidad de respuesta y sostenibilidad del sistema nacional de salud y en el impacto directo en la calidad de vida de las personas.


Assuntos
Determinantes Sociais da Saúde , Humanos , Brasil , Portugal , Espanha , Itália , Programas Nacionais de Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Atenção Primária à Saúde/legislação & jurisprudência , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Fatores Socioeconômicos , Direito à Saúde/legislação & jurisprudência
12.
Rev Panam Salud Publica ; 48: e53, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39044774

RESUMO

Objective: To evaluate the implementation of HEARTS strategies in a community in the Bolivarian Republic of Venezuela. Methods: Quasi-experimental study evaluating the cascade of care, driving factors, and maturity and performance indicators four months after implementation of the HEARTS initiative in 52 patients with high blood pressure (BP) in the community of La Marroquina. The data were processed using SPSS® Statistics, version 25.0. Student's t-distribution and chi-square tests were applied to determine statistical significance. Results: Fifty patients, 63.5% of them with a low educational level and low or very low socioeconomic status, completed the four-month monitoring period. At baseline, 11.5% had controlled BP and 40.4% initiated monotherapy. By the fourth month, 100% of patients with high BP had been diagnosed, 92% had received treatment, and 52% had achieved control of their BP. Seventy-two percent were receiving combined therapy. Seventy percent of the hypertensive individuals maintained blood pressure levels <140/90 mmHg. The maturity index score was 4 of 5, and the performance index was classified as incipient. Conclusion: This work shows that, in a short time, a good maturity index was achieved through the implementation, by medical and supervised non-medical personnel, of a standardized protocol for diagnosis, treatment, and monitoring of high blood pressure in a rural population. Rates of diagnosis, treatment, and BP control improved, with incipient performance results. Sustaining this initiative will have a major impact on the health of this population. Its implementation as a national public health policy is recommended.


Objetivo: Avaliar a implementação das estratégias da iniciativa HEARTS em uma comunidade da República Bolivariana da Venezuela. Métodos: Estudo quase-experimental que avaliou a cascata de cuidados, fatores determinantes e índices de maturidade e desempenho quatro meses após a implementação da iniciativa HEARTS na comunidade de La Marroquina, Venezuela. Foram avaliados 52 pacientes com hipertensão arterial. A análise estatística foi realizada no software SPSS®, versão 25.0. O teste t de Student e o teste qui-quadrado foram usados para determinar a significância estatística. Resultados: Cinquenta pacientes completaram o acompanhamento de quatro meses. Desses, 63,5% tinham baixa escolaridade e nível socioeconômico baixo ou muito baixo. No início do estudo, 11,5% apresentavam doença controlada e 40,4% estavam em monoterapia. No quarto mês, 100% dos pacientes com hipertensão arterial haviam sido diagnosticados, 92% haviam recebido tratamento, 52% haviam atingido a meta de controle da hipertensão e 72% estavam recebendo terapia combinada. Dos pacientes com hipertensão, 70% mantinham níveis pressóricos <140 × 90 mmHg. O índice de maturidade foi avaliado como nível 4 (de 5), e o desempenho foi classificado como incipiente. Conclusão: Este estudo demonstra, após pouco tempo, um bom índice de maturidade na implementação de um protocolo padronizado de diagnóstico, tratamento e acompanhamento da hipertensão arterial em uma população rural atendida por pessoal médico e não médico supervisionado. Observa-se melhoria das taxas de diagnóstico, tratamento e controle dos pacientes com hipertensão, demonstrando de forma incipiente seu desempenho. Dar continuidade a essa iniciativa terá uma repercussão importante na saúde dessa população. Recomendando-se que a iniciativa seja implementada como política nacional de saúde pública.

13.
Pharmaceuticals (Basel) ; 17(7)2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-39065740

RESUMO

Malaria is an infectious disease caused by Plasmodium spp. parasites, with widespread drug resistance to most antimalarial drugs. We report the development of two 3D-QSAR models based on comparative molecular field analysis (CoMFA), comparative molecular similarity index analysis (CoMSIA), and a 2D-QSAR model, using a database of 349 compounds with activity against the P. falciparum 3D7 strain. The models were validated internally and externally, complying with all metrics (q2 > 0.5, r2test > 0.6, r2m > 0.5, etc.). The final models have shown the following statistical values: r2test CoMFA = 0.878, r2test CoMSIA = 0.876, and r2test 2D-QSAR = 0.845. The models were experimentally tested through the synthesis and biological evaluation of ten quinoline derivatives against P. falciparum 3D7. The CoMSIA and 2D-QSAR models outperformed CoMFA in terms of better predictive capacity (MAE = 0.7006, 0.4849, and 1.2803, respectively). The physicochemical and pharmacokinetic properties of three selected quinoline derivatives were similar to chloroquine. Finally, the compounds showed low cytotoxicity (IC50 > 100 µM) on human HepG2 cells. These results suggest that the QSAR models accurately predict the toxicological profile, correlating well with experimental in vivo data.

14.
Mayo Clin Proc ; 99(7): 1114-1126, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38960496

RESUMO

The terms transgender and gender diverse (TGD) describe persons whose gender is different from the sex assigned to them at birth. While TGD persons have experienced a rise in cultural and social visibility in recent decades, they continue to experience significant health inequities, including adverse health outcomes and multiple barriers to accessing medical care. Transgender and gender-diverse persons are at a higher risk for pain conditions than their cisgender counterparts, but research on chronic pain management for TGD persons is lacking. Clinicians from all disciplines must be informed of best practices for managing chronic pain in the TGD population. This includes all aspects of care including history, physical examination, diagnosis, treatment, and perioperative management. Many TGD persons report delaying or avoiding care because of negative interactions with medical practitioners who do not have sufficient training in navigating the specific health care needs of TGD patients. Furthermore, TGD persons who do seek care are often forced to educate their practitioners on their specific health care needs. This paper provides an overview of existing knowledge and recommendations for physicians to provide culturally and medically appropriate care for TGD persons.


Assuntos
Pessoas Transgênero , Humanos , Masculino , Feminino , Dor Crônica/terapia , Manejo da Dor/métodos , Acessibilidade aos Serviços de Saúde , Relações Médico-Paciente
15.
Cureus ; 16(6): e62238, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39006635

RESUMO

A 36-year-old female presented to the gynecology office eight weeks after the placement of a ParaGard intrauterine device (IUD). Upon gynecologic examination, the strings of the IUD were not found. Magnetic resonance imaging was performed which reported the IUD embedded in the sigmoid colon. Initial diagnostic laparoscopy was done without bowel preparation and revealed an IUD embedded within the sigmoid colon and mesocolon. Colonoscopy did not reveal any breach of the colonic lumen. A second diagnostic laparoscopy was planned with the robotic-assisted technique after bowel preparation. Intraoperative findings during the second operation identified the IUD embedded in the antimesenteric side of the sigmoid colon with surrounding scar tissue to the uterus. The IUD was sharply freed using robotic scissors and the resulting serosal defect was sutured in layers with buttress made of appendices epiploica. The patient recovered well and had an excellent outcome. Our article highlights the minimally invasive method of dealing with a displaced IUD. The use of the robotic technique was helpful in our case to achieve an excellent outcome.

16.
J Fungi (Basel) ; 10(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38921390

RESUMO

The genus Tarzetta is distributed mainly in temperate forests and establishes ectomycorrhizal associations with angiosperms and gymnosperms. Studies on this genus are scarce in México. A visual, morphological, and molecular (ITS-LSU) description of T. americupularis, T. cupressicola, T. davidii, T. durangensis, T. mesophila, T. mexicana, T. miquihuanensis, T. poblana, T. pseudobronca, T. texcocana, and T. victoriana was carried out in this work, associated with Abies, Quercus, and Pinus. The results of SEM showed an ornamented ascospores formation by Mexican Taxa; furthermore, the results showed that T. catinus and T. cupularis are only distributed in Europe and are not associated with any American host.

17.
JAMA Dermatol ; 160(7): 758-768, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38691347

RESUMO

Importance: Generalized pustular psoriasis (GPP) lacks internationally accepted definitions and diagnostic criteria, impeding timely diagnosis and treatment and hindering cross-regional clinical and epidemiological study comparisons. Objective: To develop an international consensus definition and diagnostic criteria for GPP using the modified Delphi method. Evidence Review: The rarity of GPP presents a challenge in acquiring comprehensive published clinical data necessary for developing standardized definition and criteria. Instead of relying on a literature search, 43 statements that comprehensively addressed the fundamental aspects of the definitions and diagnostic criteria for GPP were formulated based on expert reviews of 64 challenging GPP cases. These statements were presented to a panel of 33 global GPP experts for voting, discussion, and refinements in 2 virtual consensus meetings. Consensus during voting was defined as at least 80% agreement; the definition and diagnostic criteria were accepted by all panelists after voting and in-depth discussion. Findings: In the first and second modified Delphi round, 30 (91%) and 25 (76%) experts participated. In the initial Delphi round, consensus was achieved for 53% of the statements, leading to the approval of 23 statements that were utilized to develop the proposed definitions and diagnostic criteria for GPP. During the second Delphi round, the final definition established was, "Generalized Pustular Psoriasis is a systemic inflammatory disease characterized by cutaneous erythema and macroscopically visible sterile pustules." It can occur with or without systemic symptoms, other psoriasis types, and laboratory abnormalities. GPP may manifest as an acute form with widespread pustules or a subacute variant with an annular phenotype. The identified essential criterion was, "Macroscopically visible sterile pustules on erythematous base and not restricted to the acral region or within psoriatic plaques." Conclusions and Relevance: The achievement of international consensus on the definition and diagnostic criteria for GPP underscores the importance of collaboration, innovative methodology, and expert engagement to address rare diseases. Although further validation is needed, these criteria can serve as a reference point for clinicians, researchers, and patients, which may contribute to more accurate diagnosis and improved management of GPP.


Assuntos
Consenso , Técnica Delphi , Psoríase , Humanos , Psoríase/diagnóstico , Psoríase/patologia
18.
Sensors (Basel) ; 24(9)2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38732830

RESUMO

The BC501A sensor is a liquid scintillator frequently used in nuclear physics for detecting fast neutrons. This paper describes a hardware implementation of digital pulse shape analysis (DPSA) for real-time analysis. DPSA is an algorithm that extracts the physically relevant parameters from the detected BC501A signals. The hardware solution is implemented in a MicroTCA system that provides the physical, mechanical, electrical, and cooling support for an AMC board (NAMC-ZYNQ-FMC) with a Xilinx ZYNQ Ultrascale-MP SoC. The Xilinx FPGA programmable logic implements a JESD204B interface to high-speed ADCs. The physical and datalink JESD204B layers are implemented using hardware description language (HDL), while the Xilinx high-level synthesis language (HLS) is used for the transport and application layers. The DPSA algorithm is a JESD204B application layer that includes a FIR filter and a constant fraction discriminator (CFD) function, a baseline calculation function, a peak detection function, and an energy calculation function. This architecture achieves an analysis mean time of less than 100 µs per signal with an FPGA resource utilization of about 50% of its most used resources. This paper presents a high-performance DPSA embedded system that interfaces with a 1 GS/s ADC and performs accurate calculations with relatively low latency.

19.
Nanotechnology ; 35(35)2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38806004

RESUMO

Motivated by the recent interest in the hydrogen energy, we have carried out a complete study of the catalytic activity of a defective molybdenum disulfide monolayer (MoS2) by means of density functional theory (DFT) calculations. The MoS2monolayer is characterized by a nonreactive basal plane. In principle, its catalytic activity is concentrated at the edges, but an alternative way to increase such activity is obtained by creating active sites where the molecules can dissociate. These defects can be easily produced experimentally by different techniques. In our study, we have performed an atomic, energetic and electronic analysis of a hydrogen molecule adsorbed on a MoS2monolayer. In a first step, we have found that the H2molecule remains physisorbed over both doped-free and Nb-doped MoS2monolayers, showing that the Nb atom does not increase the poor reactivity of the clean MoS2layer. Interestingly, our energetic results suggest that the vacancies will prefer to be formed close to the Nb atoms in the doped monolayer, but the small energy difference would allow the formation in non-doped like sites. Theoretically, we found out the conditions for the molecular dissociation on a S vacancy. In both cases, with and without Nb, the molecule should rotate from the original perpendicular position to an almost parallel orientation jumping an energetic barrier. After that, the atoms are separated binding to the Mo atoms around the missing S atom. Ourab initiomolecular dynamics simulations show that for low pressure conditions (using one single molecule in the system) the H2prefers to desorb from the vacancy, while for larger pressures (when additional H2molecules are added to the system) the molecule is finally dissociated on the vacancy. Our long simulations confirm the great stability of the structure with the two H atoms binding to the Mo atoms close to the vacancy. Finally, the inclusion of a third (or a fourth) H atom in the vacancy leads to the formation and desorption of a H2molecule, leaving one (or two) atoms in the vacancy.

20.
Front Hum Neurosci ; 18: 1287544, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38638806

RESUMO

Introduction: Assistive technologies for learning are aimed at promoting academic skills, such as reading and mathematics. These technologies mainly embrace mobile and web apps addressed to children with learning difficulties. Nevertheless, most applications lack pedagogical foundation. Additionally, the task of selecting suitable technology for educational purposes becomes challenging. Hence, this protocol posits the psychophysiological assessment of an online method for learning (OML) named Smartick. This platform comprises reading and math activities for learning training. In this protocol, individual monitoring of each child is proposed to determine the progress in learning caused by Smartick. Methods and analysis: One hundred and twelve children aged between 8 and 12 who present reading or math difficulty after a rigorous psychometric evaluation will be recruited. The study comprises four sessions. In sessions 1 and 2, collective and individual psychometric evaluations will be performed, respectively. Reading and mathematical proficiency will be assessed, as well as attentional levels and intellectual quotient. Subsequently, each child will be semi-randomly assigned to either the experimental or control groups. Afterward, a first EEG will be collected for all children in session 3. Then, experimental groups will use Smartick for 3 months, in addition to their traditional learning method. In contrast, control groups will only continue with their traditional learning method. Finally, session 4 will consist of performing a second psychometric evaluation and another EEG, so that psychophysiological parameters can be encountered that indicate learning improvements due to the OML, regardless of the traditional learning method at hand. Discussion: Currently, few studies have validated learning improvement due to assistive technologies for learning. However, this proposal presents a psychophysiological evaluation addressed to children with reading or math difficulties who will be trained with an OML.

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