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1.
Sci Rep ; 14(1): 16617, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39026008

RESUMO

Gas stations distributed around densely populated areas are responsible for toxic pollutant emissions such as volatile organic compounds (VOCs). This study aims to measure VOCs emission from three different kinds of gas stations to determine the extent of pollution from the gas stations and the most frequent type of VOC compound emitted. The concentrations of ambient VOCs at three refueling stations with a different type of fuels in Mashhad were monitored. The result of this study showed that CNG fuel stations are less polluting than petrol stations. In all the studied sites, the highest concentrations were related to xylene isomers, irrespective of the fuel type. Total VOCs at the supply of both compressed natural gas (CNG) and gasoline stations was 482.36 ± 563.45 µg m-3. At a CNG station and a gasoline station, total VOC concentrations were 1363.4 ± 1975 µg m-3 and 410.29 ± 483.37 µg m-3, respectively. The differences in concentrations of toluene and m,p-xylene between the fuel stations can be related to the quality and type of fuel, vapor recovery technology, fuel reserves, dripless nozzles, traffic density in these stations, meteorological conditions and the location of sampling sites. The combination of a sine function and a quadratic function could model the fluctuation behavior of air pollutants like m,p-xylene. In all the sites, the highest concentrations were related to xylene isomers, irrespective of the type of fuel. The changing rate of m,p-xylene pollutant in each station was also modeled in this study.

2.
Front Artif Intell ; 7: 1381455, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38774833

RESUMO

This research investigates the application of machine learning to improve the diagnosis of tinnitus using high-frequency audiometry data. A Logistic Regression (LR) model was developed alongside an Artificial Neural Network (ANN) and various baseline classifiers to identify the most effective approach for classifying tinnitus presence. The methodology encompassed data preprocessing, feature extraction focused on point detection, and rigorous model evaluation through performance metrics including accuracy, Area Under the ROC Curve (AUC), precision, recall, and F1 scores. The main findings reveal that the LR model, supported by the ANN, significantly outperformed other machine learning models, achieving an accuracy of 94.06%, an AUC of 97.06%, and high precision and recall scores. These results demonstrate the efficacy of the LR model and ANN in accurately diagnosing tinnitus, surpassing traditional diagnostic methods that rely on subjective assessments. The implications of this research are substantial for clinical audiology, suggesting that machine learning, particularly advanced models like ANNs, can provide a more objective and quantifiable tool for tinnitus diagnosis, especially when utilizing high-frequency audiometry data not typically assessed in standard hearing tests. The study underscores the potential for machine learning to facilitate earlier and more accurate tinnitus detection, which could lead to improved patient outcomes. Future work should aim to expand the dataset diversity, explore a broader range of algorithms, and conduct clinical trials to validate the models' practical utility. The research highlights the transformative potential of machine learning, including the LR model and ANN, in audiology, paving the way for advancements in the diagnosis and treatment of tinnitus.

3.
Micromachines (Basel) ; 15(3)2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38542653

RESUMO

Graphene, renowned for its exceptional electrical, optical, and mechanical properties, takes center stage in the realm of next-generation electronics. In this paper, we provide a thorough investigation into the comprehensive fabrication process of graphene field-effect transistors. Recognizing the pivotal role graphene quality plays in determining device performance, we explore many techniques and metrological methods to assess and ensure the superior quality of graphene layers. In addition, we delve into the intricate nuances of doping graphene and examine its effects on electronic properties. We uncover the transformative impact these dopants have on the charge carrier concentration, bandgap, and overall device performance. By amalgamating these critical facets of graphene field-effect transistors fabrication and analysis, this study offers a holistic understanding for researchers and engineers aiming to optimize the performance of graphene-based electronic devices.

4.
Nanomaterials (Basel) ; 13(14)2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37513117

RESUMO

Metalenses are emerging as an alternative to digital micromirror devices (DMDs), with the advantages of compactness and flexibility. The exploration of metalenses has ignited enthusiasm among optical engineers, positioning them as the forthcoming frontier in technology. In this paper, we advocate for the implementation of the phase-change material, Sb2Se3, capable of providing swift, reversible, non-volatile focusing and defocusing within the 1550 nm telecom spectrum. The lens, equipped with a robust ITO microheater, offers unparalleled functionality and constitutes a significant step toward dynamic metalenses that can be integrated with beamforming applications. After a meticulously conducted microfabrication process, we showcase a device capable of rapid tuning (0.1 MHz level) for metalens focusing and defocusing at C band communication, achieved by alternating the PCM state between the amorphous and crystalline states. The findings from the experiment show that the device has a high contrast ratio for switching of 28.7 dB.

5.
Res Social Adm Pharm ; 19(1): 180-183, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36333228

RESUMO

INTRODUCTION: Social determinants of health (SDoH) are non-medical factors that impact individuals' health. SDoH can be documented in claims data using International Classification of Disease (ICD) 10th revision codes Z55 - Z65. The study objective was to describe the documentation of SDoH Z-codes among Medicaid beneficiaries in Texas. METHODS: Texas Medicaid medical and enrollment claims data were utilized. Beneficiaries with at least one claim associated with SDoH Z-codes between 2016 and 2019 were identified excluding those 65+ years of age and others dually eligible for Medicare. RESULTS: SDoH Z-code documentation was associated with approximately 1.2 million claims for 181,136 unique beneficiaries. Females (54.3%) and Hispanics (47.9%) comprised a majority of beneficiaries with Z-code documentation, and the average age was 14.2 ± 13.4 years. Nearly 40% had Z-code documentation of "problems related to upbringing" (Z62) (N = 68,478, 37.8%), followed by "problems related to primary support group including family circumstances" (Z63) (N = 42,378, 23.4%), and "problems related to education and literacy" (Z55) (N = 28,848, 15.9%). SDoH Z-code documentation increased slightly over the years from 1% of Medicaid beneficiaries in 2016 to 1.3% in 2019. CONCLUSION: A steady increase in SDoH Z-code documentation was observed among Medicaid beneficiaries but represented a relatively small proportion of the beneficiaries overall.


Assuntos
Medicaid , Medicare , Idoso , Feminino , Estados Unidos , Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Determinantes Sociais da Saúde , Serviços de Saúde , Documentação
6.
J Clin Med ; 11(21)2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36362544

RESUMO

BACKGROUND: Mutations in spike glycoprotein, a critical protein of SARS-CoV-2, could directly impact pathogenicity and virulence. The D614G mutation, a non-synonymous mutation at position 614 of the spike glycoprotein, is a predominant variant circulating worldwide. This study investigated the occurrence of mutations in the crucial zone of the spike gene and the association of clinical symptoms with spike mutations in isolated viruses from Iranian patients infected with SARS-CoV-2 during the second and third waves of the COVID-19 epidemic in Isfahan, the third-largest city in Iran. METHODS: The extracted RNA from 60 nasopharyngeal samples of COVID-19 patients were subjected to cDNA synthesis and RT-PCR (in three overlapping fragments). Each patient's reverse transcriptase polymerase chain reaction (RT-PCR) products were assembled and sequenced. Information and clinical features of all sixty patients were collected, summarized, and analyzed using the GENMOD procedure of SAS 9.4. RESULTS: Analysis of 60 assembled sequences identified nine nonsynonymous mutations. The D614G mutation has the highest frequency among the amino acid changes. In our study, in 31 patients (51.66%), D614G mutation was determined. For all the studied symptoms, no significant relationship was observed with the incidence of D614G mutation. CONCLUSIONS: D614G, a common mutation among several of the variants of SARS-CoV-2, had the highest frequency among the studied sequences and its frequency increased significantly in the samples of the third wave compared to the samples of the second wave of the disease.

7.
J Manag Care Spec Pharm ; 28(12): 1429-1438, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36427337

RESUMO

BACKGROUND: COVID-19 vaccine hesitancy for adults and children varies depending on societal factors, race, and trust ascribed to the source of vaccine information. OBJECTIVE: To assess COVID-19 vaccination rates and trust levels for vaccine information by race at 2 time points. METHODS: Online cross-sectional data from US adults were collected in February/March 2021 (T1) and November 2021 (T2). Questions included vaccination status, reasons for vaccine refusal, trust levels for vaccine information and the Wake Forest Physician Trust Scale. At T2, parents were asked about vaccination status of children aged 12-18 years and intent for children aged 5-11 years. Vaccination rates and trust levels for vaccine information were measured. Multivariable logistic regression was used to identify characteristics predictive of receiving COVID-19 vaccination. RESULTS: Vaccination rates were 20.2% and 70.8% at T1 and T2, respectively. At T1 and T2, higher proportions of White (23.2% and 72.0%) and Other race (14.4% and 75.2%) respondents were vaccinated relative to Black respondents (9.6% and 64.4%) (P < 0.05). In descending order, respondents' doctors, family members, and pharmacists were the most trusted information sources. Black parents, relative to White and Other parents with unvaccinated children aged 12-18 years or who were not very likely to vaccinate younger children, reported lowest physician trust (P < 0.01). At T1, being married, college educated, and older and having greater Wake Forest Physician Trust Scale scores and a higher number of comorbidities predicted a higher likelihood of being vaccinated. Being Black, having a median household income less than $100,000, and residing in the Northeast or Midwest, relative to the West, predicted a decreased likelihood of being vaccinated. At T2, race and comorbidities were no longer predictive of vaccination. CONCLUSIONS: Racial variation in vaccination status decreased from T1 to T2. Physician trust predicted vaccination status and intent regardless of race. Respondents' doctors, family members, and pharmacists are trusted sources of vaccine information, and targeting these influencers may reduce vaccination hesitancy. DISCLOSURES: Dr Brown reports personal fees from Taiho Oncology, outside the submitted work. Dr Morlock reports personal fees from Johnson and Johnson, Heron Therapeutics, Evofem Biosciences, Horizon Therapeutics, and Taiho Oncology, outside the submitted work. Amy Morlock reports personal fees from both AbbVie (formerly Allergan) and Ironwood, outside the submitted work. Drs Blakolmer and Heidari have nothing to disclose.


Assuntos
COVID-19 , Intenção , Adulto , Criança , Humanos , Confiança , Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Estudos Transversais , Vacinação , Inquéritos e Questionários
8.
J Manag Care Spec Pharm ; 28(5): 538-543, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35471072

RESUMO

BACKGROUND: A growing body of evidence supports the need for health systems to shift towards addressing social determinants of health (SDoH) as part of routine care. However, little is known about the state of the industry in terms of procurement and use of SDoH data. OBJECTIVES: To assess stakeholders' perceptions and experiences in collecting and utilizing SDoH data. METHODS: A prospective, cross-sectional study was conducted using a 24-item electronic survey. The pilot-tested survey was distributed to a diverse convenience sample of 94 health care stakeholder organizations that are members of the Pharmacy Quality Alliance organization. Survey responses were collected from November to December 2020. Descriptive statistics were used to analyze responses. RESULTS: A total of 25 respondents completed the survey (response rate = 26.6%). More than half (n = 14, 56.0%) collected and tracked SDoH data, and of those, most (n = 6, 42.85%) reported using organization-specific tools instead of standardized SDoH tools. Economic stability and health and health care indicators were the most frequently identified types of SDoH data collected. Participants reported that both identifying (mean = 3.88 ± SD = 0.88; 1 = not important to 5 = extremely important) and addressing (3.88 ± 0.93) patients' SDoH were moderately important to their organization. Lack of standard data format (72.0%), lack of time (52.0%), and lack of technological capabilities (44.0%) were the most commonly reported barriers to collecting SDoH data. However, value-based payment programs that reward addressing SDoH needs (76.0%) and a coding structure or reimbursement mechanism for identification and management of SDoH (60.0%) were most commonly reported as mechanisms to overcome SDoH data collection barriers. CONCLUSIONS: Health care stakeholders consider patient SDoH indicators important but report significant challenges in collecting these data. Solutions that address data standardization, time burden, technological barriers, and the offering of incentives could facilitate its collection and effective use. DISCLOSURES: Pharmacy Quality Alliance received an unrestricted grant from Pfizer, Inc, to support this work.


Assuntos
Farmácias , Determinantes Sociais da Saúde , Estudos Transversais , Atenção à Saúde , Humanos , Estudos Prospectivos
9.
Artigo em Inglês | MEDLINE | ID: mdl-35254739

RESUMO

Objective: To explore important themes in patient experiences with migraine and to understand the relationship of these themes with external factors such as the health care system and societal influences.Methods: This qualitative study was part of a larger online survey (conducted for a period of 2 months from March 1, 2013, to April 30, 2013) that recruited participants with migraine through nonprobability-based sampling techniques. Respondents were asked an open-ended question to describe their experience with migraine. A codebook was developed based on existing literature and new categories that emerged from the responses. Deductive and inductive content analysis was conducted followed by axial coding of the themes based on the codebook.Results: The open-ended question resulted in 154 eligible responses. The final codebook contained 28 categories. The categories were combined into 6 distinct themes. The 6 themes included quality of life and health status, disease condition, societal response to disease, health care and medications, support, and patient response to disease. The most frequently occurring categories were pain and quality of life (QoL) (work functioning). The least frequent themes were cognitive symptoms, QoL economic functioning, and caregiver burden. Axial coding of the themes showed that QoL was the central theme. Aspects of the disease condition and negative societal responses were found to substantially affect QoL, leading to caregiver burden and absence/presence of social support.Conclusions: The findings demonstrate that pain and QoL are central to patient experience with migraine. Attention should be paid to improve the treatment and social support provided to patients and reduce stigma and invalidation.


Assuntos
Transtornos de Enxaqueca , Qualidade de Vida , Humanos , Transtornos de Enxaqueca/psicologia , Transtornos de Enxaqueca/terapia , Avaliação de Resultados da Assistência ao Paciente , Qualidade de Vida/psicologia , Apoio Social , Inquéritos e Questionários
10.
Educ Inf Technol (Dordr) ; 27(5): 6599-6620, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35075344

RESUMO

Given the importance of digital communication during the COVID-19 pandemic, the need for advancing academic goals through online social capital is more tangibly felt. This study examined the hypothesis that online social capital can improve the students' academic performance, as one of the main academic goals, through the mediation of knowledge sharing in the online environment. Participants in the study were 376 graduate engineering students from five universities in Iran. The findings indicated that the bridging of online social capital had a positive and significant effect on the cognitive and social integrative benefits of online knowledge sharing. Besides, the social integrative benefits and personal integrative benefits of online knowledge sharing influenced academic performance. Finally, the social integrative benefits and personal integrative benefits had a mediating role in the relationship between the bridging of online social capital and academic performance. Implications of the findings are discussed for the students' academic performance and suggestions are provided for future research.

11.
J Comput Assist Learn ; 37(4): 1154-1166, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34230741

RESUMO

During the COVID-19 crisis, digital informal learning is important for students' academic engagement. Although scholars have highlighted the importance of students' digital competence in improving digital informal learning (DIL), the mediating role of DIL between digital competence and academic engagement has remained ambiguous. The purpose of this study is to investigate the relationship between students' digital competence and their academic engagement with the mediating role of DIL in the higher education context. This study used a descriptive correlational design, and the data were analyzed using structural equation modelling (SEM). The study sample included 308 students from Shiraz University, Iran. The results showed that digital competence positively and significantly correlated with students' DIL and their academic engagement. Furthermore, DIL, as the mediator variable, was found to mediate the relationship between students' digital competence and their academic engagement. Since higher education institutions have a key role in improving students' academic engagement, particularly in the COVID-19 pandemic, academic administrators should pay more attention to students' digital competencies and provide them with efficient and user-friendly DIL platforms that can increase their academic engagement.

12.
Sci Rep ; 11(1): 1287, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33446735

RESUMO

Densely integrated active photonics is key for next generation on-chip networks for addressing both footprint and energy budget concerns. However, the weak light-matter interaction in traditional active Silicon optoelectronics mandates rather sizable device lengths. The ideal active material choice should avail high index modulation while being easily integrated into Silicon photonics platforms. Indium tin oxide (ITO) offers such functionalities and has shown promising modulation capacity recently. Interestingly, the nanometer-thin unity-strong index modulation of ITO synergistically combines the high group-index in hybrid plasmonic with nanoscale optical modes. Following this design paradigm, here, we demonstrate a spectrally broadband, GHz-fast Mach-Zehnder interferometric modulator, exhibiting a high efficiency signified by a miniscule VπL of 95 V µm, deploying a one-micrometer compact electrostatically tunable plasmonic phase-shifter, based on heterogeneously integrated ITO thin films into silicon photonics. Furthermore we show, that this device paradigm enables spectrally broadband operation across the entire telecommunication near infrared C-band. Such sub-wavelength short efficient and fast modulators monolithically integrated into Silicon platform open up new possibilities for high-density photonic circuitry, which is critical for high interconnect density of photonic neural networks or applications in GHz-fast optical phased-arrays, for example.

13.
Int J Prev Med ; 11: 54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32577184

RESUMO

BACKGROUND: Asthma is a chronic inflammatory airway disease with regressive episodic symptoms. This study aimed to assess the prevalence of asthma ever (lifetime prevalence of asthma) and the associated factors among newly entered students in public universities in Iran. METHODS: This population-based cross-sectional study was part of the "Mental and Physical Health Assessment of University Students in Iran." The target population included all newly admitted students (N = 151,671) in 74 public universities in 28 provinces (out of the 31 provinces) in Iran. STATA version 12 was used for calculating the descriptive statistics. Univariate and multivariate logistic regression models were employed to identify relationships between asthma and socioeconomic variables. The level of significance was set at 95% confidence interval. RESULTS: Of a total of 79,277 participants, 55.23% (n = 43,785) and 44.77% (n = 35,492) were female and male, respectively. The prevalence of ever asthma among studied student was 1.89%. Of all the participants with asthma, 88.43% (85.49%-90.84%) were nonsmokers. More than 20% of the subjects were physically inactive. The respondents who revealed smoking >10 cigarettes/week were about 1.22 (1.036-1.437) times more likely to suffer from asthma disease (0.017), as compared with those who were not smoking. CONCLUSIONS: Our study provides valuable information about the prevalence of asthma ever symptoms among university students in Iran. In fact, the results of this study can fill information gaps concerning the affected groups in Iran, and even worldwide.

15.
East Mediterr Health J ; 25(7): 473-480, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31612979

RESUMO

BACKGROUND: The global and national burden of noncommunicable diseases continues to rise, thus making access to medicines increasingly important. AIMS: The objective of this study was to evaluate the availability, pricing, and affordability of selected medicines for noncommunicable diseases in the Islamic Republic of Iran used in 2014 based on the World Health Organization (WHO)/Health Action International (HAI) methodology. METHODS: The price and availability data for 54 selected medicines were collected from public and private retail pharmacies as well as private pharmacies located in public hospitals in six cities of the Islamic Republic of Iran on the basis of the standardized methodology developed by WHO and HAI. The outcome measures were percentage availability of medicines, ratios of medicine prices to the international reference prices, and the affordability. Affordability was defined as the number of days' wages needed by the lowest-paid unskilled government worker to afford one month of chronic treatment. RESULTS: The procurement price of the surveyed Lowest Priced Generic and Most Sold Generic medicines was 1.19 times the international reference price. The patient price was not significantly different among different pharmacy retail settings compared with the international reference prices. Moreover, the overall mean availability of the surveyed Lowest Priced Generic medicines in public, private, and other settings was 75.5%, 83.3% and 80.3%, respectively. All the treatment costs for the high burden noncommunicable diseases were less than one day's wages of the lowest-paid government worker. CONCLUSIONS: This study indicated that procurement prices of the surveyed medicines were reasonable in comparison with the international reference price. Moreover, the availability of generic forms of the surveyed medicines was good but originator brand medicines were significantly low in all the three settings.


Assuntos
Custos e Análise de Custo/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/economia , Doenças não Transmissíveis/tratamento farmacológico , Medicamentos Genéricos/economia , Humanos , Irã (Geográfico) , Setor Privado , Setor Público
16.
East Mediterr Health J ; 25(1): 47-57, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30919925

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. AIMS: To synthesize data on the worldwide prevalence and severity of COPD by geographical region, age groups, and smoking status in a systematic review. METHODS: A systematic search was performed following Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. International databases including PubMed, Scopus and Web of Science were searched for population- based studies published between January 2004 and May 2015 that reported the prevalence of COPD anywhere in the world. The prevalence of COPD was calculated based on World Health Organization (WHO) regions and sex and severity stages using metaprop. Meta-regression and subgroup analysis were applied to determine the sources of heterogeneity. RESULTS: Sixty papers were screened with a combined subject sample size of 127 598. The prevalence of post-bronchodilator COPD was 12.16% (10.91-13.40%). The pooled prevalence of COPD was 15.70% (13.80-18.59%) in men and 9.93% (8.73- 11.13%) in women. Among all WHO regions, the highest prevalence was recorded in the Region of the Americas (14.53%), and the lowest was recorded in the South-East Asia Region/Western Pacific Region (8.80%). Meta-regression model variables were: sample size, WHO region, study quality score, level of gathering data, publication year, and sampling methods that justified 29.82% of heterogeneity detected among COPD prevalence rates worldwide. CONCLUSIONS: Global prevalence of COPD among men is about 5% higher than among women. The most prevalent stage of COPD is stage 1.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Saúde Global/estatística & dados numéricos , Humanos , Prevalência , Índice de Gravidade de Doença
17.
Support Care Cancer ; 27(5): 1613-1637, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30737578

RESUMO

PURPOSE: Shared decision-making (SDM) is a strategy to facilitate patient-centered care and is increasingly important in oncology, where patients are faced with complicated treatment decisions that require them to weigh efficacy and safety, quality of life, and cost. Understanding the contributors to the use of SDM may provide insight to its further implementation. Therefore, the objective of the study was to examine the patient-related barriers/facilitators to SDM in oncology care. METHODS: A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was executed. A search strategy composed of cancer, decision-making, and patient-centered terms was conducted utilizing PubMed, EBSCO MEDLINE, Scopus, CINAHL, and the Cochrane Library databases between January 2007 and November 2017. Full-text, US-based, English language articles describing the patient perspective of SDM in oncology care were included. Relevant data from articles were reviewed in a qualitative synthesis. RESULTS: From 3435 potential citations, a total of 35 articles were included. The most common cancers studied were breast (n = 22; 62.9%) and prostate (n = 9; 25.7%). The identified themes for barriers to SDM were uncertainty in the treatment decision, concern regarding adverse effects, and poor physician communication. Themes for facilitators for SDM included physician consideration of patient preferences, positive physician actions and behaviors, and use or encouragement of support systems. CONCLUSION: As SDM gains use within oncology practice, understanding key influences will allow for more effective implementation of strategies to increase patient engagement and improve care and value in the treatment process.


Assuntos
Tomada de Decisões , Oncologia/métodos , Neoplasias/terapia , Participação do Paciente , Assistência Centrada no Paciente/métodos , Humanos , Oncologia/normas , Neoplasias/psicologia , Assistência Centrada no Paciente/normas , Qualidade de Vida
18.
J Cell Physiol ; 234(6): 7811-7827, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30480819

RESUMO

Pancreatic ß-cells are destroyed by the immune system, in type 1 diabetes (T1D) and are impaired by glucose insensitivity in type 2 diabetes (T2D). Islet-cells transplantation is a promising therapeutic approach based on in vitro differentiation of pluripotent stem cells (PSCs) to insulin-producing cells (IPCs). According to evolutionary stages in ß-cell development, there are several distinct checkpoints; each one has a unique characteristic, including definitive endoderm (DE), primitive gut (PG), posterior foregut (PF), pancreatic epithelium (PE), endocrine precursor (EP), and immature ß-cells up to functional ß-cells. A better understanding of the gene regulatory networks (GRN) and associated transcription factors in each specific developmental stage, guarantees the achievement of the next successful checkpoints and ensures an efficient ß-cell differentiation procedure. The new findings in signaling pathways, related to the development of the pancreas are discussed here, including Wnt, Activin/Nodal, FGF, BMP, retinoic acid (RA), sonic hedgehog (Shh), Notch, and downstream regulators, required for ß-cell commitment. We also summarized different approaches in the IPCs protocol to conceptually define a standardized system, leading to the creation of a reproducible method for ß-cell differentiation. To normalize blood glucose level in diabetic mice, the replacement therapy in the early differentiation stage, such as EP stages was associated with better outcome when compared with the fully differentiated ß-cells' graft.


Assuntos
Diferenciação Celular/genética , Células Secretoras de Insulina/metabolismo , Pâncreas/crescimento & desenvolvimento , Células-Tronco Pluripotentes/metabolismo , Animais , Glicemia/genética , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/terapia , Redes Reguladoras de Genes/genética , Humanos , Células Secretoras de Insulina/transplante , Transplante das Ilhotas Pancreáticas , Camundongos , Camundongos Endogâmicos NOD , Pâncreas/metabolismo , Pâncreas/patologia , Células-Tronco Pluripotentes/transplante
19.
Int J Technol Assess Health Care ; 34(6): 576-583, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30560749

RESUMO

OBJECTIVES: This study aimed to assess the cost-effectiveness of ivabradine plus standard of care (SoC) in comparison with current SoC alone from the Iranian payer perspective. METHODS: A cohort-based Markov model was developed to assess the incremental cost-effectiveness ratio (ICER) over a 10-year time horizon in a cohort of 1,000 patients. The baseline transition probabilities between New York Heart Association (NYHA), mortality rate, and hospitalization rate were extracted from the literature. The effect of ivabradine on mortality, hospitalization, and NYHA improvement or worsening were retrieved from the SHIFT study. The effectiveness was measured as quality-adjusted life-years (QALYs) using the utility values derived from Iranian Heart Failure Quality of Life study. Direct medical costs were obtained from hospital records and national tariffs. Deterministic and probabilistic sensitivity analyses were conducted to show the robustness of the model. RESULTS: Ivabradine therapy was associated with an incremental cost per QALY of USD $5,437 (incremental cost of USD $2,207 and QALYs gained 0.41) versus SoC. The probabilistic sensitivity analysis showed that ivabradine is expected to have a 60 percent chance of being cost-effective accepting a threshold of USD $6,550 per QALY. Furthermore, deterministic sensitivity analysis indicated that the model is sensitive to the ivabradine drug acquisition cost. CONCLUSIONS: The cost-effectiveness model suggested that the addition of ivabradine to SoC therapy was associated with improved clinical outcomes along with increased costs. The analysis indicates that the clinical benefit of ivabradine can be achieved at a reasonable cost in eligible heart failure patients with sinus rhythm and a baseline heart rate ≥ 75 beats per minute (bpm).

20.
Data Brief ; 19: 1287-1290, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30225287

RESUMO

Data on the chemical, physical and biological of effluent from wastewater treatment are provided in table format in the current article. Samples were taken in Peak Flows at effluent Treatment Plants. Sampling and tests were conducted according to the standards methods. The collected data were analyzed by SPSS software and excel program. Nickel metal showed higher amounts than the standards required for irrigation agricultural land. Data could be useful from environmental and agricultural sciences to those concerned about heavy metals, Alkalinity, EC, COD, BOD5 and Microbial concentrations threats.

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