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1.
AMIA Jt Summits Transl Sci Proc ; 2024: 662-669, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827094

RESUMO

Obstructive sleep apnea is a sleep disorder that is linked with many health complications and severe form of apnea can even be lethal. Overnight polysomnography is the gold standard for diagnosing apnea, which is expensive, time-consuming, and requires manual analysis by a sleep expert. Recently, there have been numerous studies demonstrating the application of artificial intelligence to detect apnea in real time. But the majority of these studies apply data pre-processing and feature extraction techniques resulting in a longer inference time that makes the real-time detection system inefficient. This study proposes a single convolutional neural network architecture that can automatically extract spatial features and detect apnea from both electrocardiogram (ECG) and blood-oxygen saturation (SpO2) signals. Using segments of 10s, the network classified apnea with an accuracy of 94.2% and 96% for ECG and SpO2 respectively. Moreover, the overall performance of both models was consistent with an AUC score of 0.99.

2.
Cureus ; 16(4): e58479, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38765399

RESUMO

Monkeypox is a zoonotic disease caused by an enveloped single-stranded DNA virus that belongs to the Poxviridae family. It was first identified in humans in the 1970s. In 2022, a monkeypox outbreak spread extensively outside of endemic countries. Monkeypox infection begins with the prodromal symptoms of fever, myalgia, and lethargy, followed by the development of a characteristic maculopapular rash. In most cases, the illness is self-limiting. However, severe cases can lead to devastating neurological complications, such as encephalitis. Here, we present the case of a 31-year-old male patient with monkeypox who developed encephalomyelitis and exhibited complete neurological recovery upon treatment with pulse steroid and intravenous immunoglobulin.

3.
Cell Death Dis ; 15(4): 247, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575576

RESUMO

The primary site of metastasis for epithelial ovarian cancer (EOC) is the peritoneum, and it occurs through a multistep process that begins with adhesive contacts between cancer cells and mesothelial cells. Despite evidence that Notch signaling has a role in ovarian cancer, it is unclear how exactly it contributes to ovarian cancer omental metastasis, as well as the cellular dynamics and intrinsic pathways that drive this tropism. Here we show that tumor cells produced the Notch ligand Jagged2 is a clinically and functionally critical mediator of ovarian cancer omental metastasis by activating the Notch signaling in single-layered omental mesothelial cells. In turn, Jagged2 promotes tumor growth and therapeutic resistance by stimulating IL-6 release from mesothelial cells. Additionally, Jagged2 is a potent downstream mediator of the omental metastasis cytokine TGF-ß that is released during omental destruction. Importantly, therapeutic inhibition of Jagged2-mediated omental metastasis was significantly improved by directly disrupting the Notch pathway in omental mesothelial cells. These findings highlight the key role of Jagged2 to the functional interplay between the TGF-ß and the Notch signaling pathways during the metastatic process of ovarian cancer cells to the omentum and identify the Notch signaling molecule as a precision therapeutic target for ovarian cancer metastasis.


Assuntos
Neoplasias Ovarianas , Neoplasias Peritoneais , Neoplasias Retroperitoneais , Feminino , Humanos , Carcinoma Epitelial do Ovário , Linhagem Celular Tumoral , Metástase Neoplásica , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/secundário , Transdução de Sinais , Fator de Crescimento Transformador beta/metabolismo
4.
Lancet Reg Health Southeast Asia ; 24: 100398, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38665890

RESUMO

Background: Upazila Health Complexes (UHCs) and District Hospitals (DHs) play a crucial role in the healthcare delivery system of Bangladesh. But very few research has been conducted to find out the prevailing challenges of the medical officers working in these tiers. The objective of the study was to identify the challenges faced by medical officers in providing healthcare services at UHCs and DHs. Methods: In-depth interviews of 51 medical officers from 17 UHCs and nine DHs were done between March and April 2021. All participants were purposively sampled. Data were transcribed verbatim and analysed using thematic analysis. Findings: Inadequate service rooms, unavailability of proper medical equipment, poor housing conditions, lack of public amenities, shortage of health workforce, lack of laboratory services, and excessive workload were the common challenges mentioned by the medical officers in providing healthcare services in UHCs and DHs. Lack of workplace safety, security, and undue pressure from local political leaders and journalists made the work environment fearful. The absence of proper implementation of policy related to higher education, posting, transfer, and promotion was also stated as challenge for the medical officers. Interpretation: Infrastructural improvements along with increased safety and security of the doctors at their workplace and transparent implementation of reformed policies are essential to reduce the workplace challenges of medical officers in UHCs and DHs of Bangladesh. Funding: The study was funded by Hospital Services Management, Directorate General Of Health Services (DGHS), Mohakhali, Dhaka, and Bangabandhu Sheikh Mujib Medical University.

5.
Arch Osteoporos ; 19(1): 24, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38565791

RESUMO

A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific. PURPOSE: Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies. The current incidence of hip and other fragility fractures across the Asia Pacific region is enormous and set to escalate rapidly in the coming decades. This publication describes findings of a survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association (APOA) conducted in 2022. METHODS: The survey was developed as a collaboration between the Asia Pacific Osteoporosis and Fragility Fracture Society and the Asia Pacific Fragility Fracture Alliance, and included questions relating to aspects of care upon presentation, during surgery and mobilisation, secondary fracture prevention, and access to specific services. RESULTS: In total, 521 APOA members completed the survey and marked variation in delivery of care was evident. Notable findings included: Fifty-nine percent of respondents indicated that analgesia was routinely initiated in transit (by paramedics) or within 30 minutes of arrival in the Emergency Department. One-quarter of respondents stated that more than 80% of their patients underwent surgery within 48 hours of admission. One-third of respondents considered non-hip, non-vertebral fractures to merit assessment of future fracture risk. One-third of respondents reported the presence of an Orthogeriatric Service in their hospital, and less than a quarter reported the presence of a Fracture Liaison Service. CONCLUSION: A Call to Action for all National Orthopaedic Associations affiliated with APOA is proposed to improve the care of fragility fracture patients across the region.


Assuntos
Ortopedia , Fraturas por Osteoporose , Humanos , Idoso , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Ásia/epidemiologia , Inquéritos e Questionários , Apolipoproteínas A
6.
Infect Dis Rep ; 16(2): 181-188, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38525761

RESUMO

Chronic infection of Helicobacter pylori represents a key factor in the etiology of gastrointestinal diseases, with high endemicity in South Asia. The present study aimed to determine the prevalence of H. pylori among dyspeptic patients in north-central Bangladesh (Mymensingh) and analyze risk factors of infection and antimicrobial resistance (AMR) determinants in the pathogen. Endoscopic gastrointestinal biopsy samples were collected from dyspeptic patients for a one-year period from March 2022 and were checked for the presence of H. pylori via the rapid urease test and PCR and further analyzed for the status of virulence factors vacA/cagA and genetic determinants related to AMR via PCR with direct sequencing or RFLP. Among a total of 221 samples collected, 80 (36%) were positive for H. pylori, with the vacA+/cagA+ genotype being detected in almost half of them. H. pylori was most prevalent in the age group of 41-50-year-olds, with it being more common in males and rural residents with a lower economic status and using nonfiltered water, though the rates of these factors were not significantly different from those of the H. pylori-negative group. Relatively higher frequency was noted for the A2147G mutation in 23S rRNA, related to clarithromycin resistance (18%, 7/39). Amino acid substitutions in PBP-1A (T556S) and GyrA (N87K and D91N) and a 200 bp deletion in rdxA were detected in samples from some patients with recurrence after treatment with amoxicillin, levofloxacin, and metronidazole, respectively. The present study describes the epidemiological features of H. pylori infection in the area outside the capital in Bangladesh, revealing the spread of AMR-associated mutations.

7.
Cell Death Discov ; 10(1): 61, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38296962

RESUMO

Breast cancer (BC) patient who receives chemotherapy for an extended length of time may experience profound repercussions in terms of metastases and clinical outcomes due to the involvement of the epithelial-to-mesenchymal transition (EMT) mechanism and enriched cancer stem cells (CSCs). BC cells that express high levels of lncRNA deleted in lymphocytic leukemia-2 (lncRNA DLEU2) and type I tyrosine kinase-like orphan receptor ROR1 (ROR1) may play roles in the enhanced ability of the activation EMT and CSC induction. Here we find that lncRNA DLEU2 and ROR1 are specifically upregulated in tumor tissues compared to their normal counterparts in TCGA, PubMed GEO datasets, and samples from archived breast cancer tumor tissues. Following chemotherapy, lncRNA DLEU2 and ROR1 were enhanced in BC tumor cells, coupled with the expression of CSCs, EMT-related genes, and BMI1. Mechanistically, ROR1 and lncRNA DLEU2 overexpression led to enhanced tumor cell proliferation, inhibition of apoptosis, cell-cycle dysregulation, chemoresistance, as well as BC cell's abilities to invade, migrate, develop spheroids. These findings imply that the role of lncRNA DLEU2 and ROR1 in BC therapeutic failure is largely attributed to EMT, which is intricately linked to enriched CSCs. In conclusion, our findings indicate that a lncRNA DLEU2 and ROR1-based regulatory loop governs EMT and CSC self-renewal, implying that targeting this regulatory pathway may improve patients' responses to chemotherapy and survival.

8.
Microvasc Res ; 152: 104646, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38092222

RESUMO

Blood flow in the gingiva, comprising the interdental papilla as well as attached and marginal gingiva, is important for maintaining of gingival function and is modulated by risk factors such as stress that may lead to periodontal disease. Marked blood flow changes mediated by the autonomic (parasympathetic and sympathetic) nervous system may be essential for gingival hemodynamics. However, differences in autonomic vasomotor responses and their functional significance in different parts of the gingiva are unclear. We examined the differences in autonomic vasomotor responses and their interactions in the gingiva of anesthetized rats. Parasympathetic vasodilation evoked by the trigeminal (lingual nerve)-mediated reflex elicited frequency-dependent blood flow increases in gingivae, with the increases being greatest in the interdental papilla. Parasympathetic blood flow increases were significantly reduced by intravenous administration of the atropine and VIP antagonist. The blood flow increase evoked by acetylcholine administration was higher in the interdental papilla than in the attached gingiva, whereas that evoked by VIP agonist administration was greater in the attached gingiva than in the interdental papilla. Activation of the cervical sympathetic nerves decreased gingival blood flow and inhibited parasympathetically induced blood flow increases. Our results suggest that trigeminal-parasympathetic reflex vasodilation 1) is more involved in the regulation of blood flow in the interdental papilla than in the other parts of the gingiva, 2) is mediated by cholinergic (interdental papilla) and VIPergic systems (attached gingiva), and 3) is inhibited by excess sympathetic activity. These results suggest a role in the etiology of periodontal diseases during mental stress.


Assuntos
Gengiva , Sistema Nervoso Simpático , Ratos , Animais , Gengiva/irrigação sanguínea , Vasodilatação , Atropina/farmacologia
9.
Environ Pollut ; 341: 122886, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-37952923

RESUMO

Heavy metal (HM) contamination has emerged as one of the most damaging abiotic stress factors due to their prominent release into the environment through industrialization and urbanization worldwide. The increase in HMs concentration in soil and the environment has invited attention of researchers/environmentalists to minimize its' impact by practicing different techniques such as application of phytohormones, gaseous molecules, metalloids, and essential nutrients etc. Silicon (Si) although not considered as the essential nutrient, has received more attention in the last few decades due to its involvement in the amelioration of wide range of abiotic stress factors. Silicon is the second most abundant element after oxygen on earth, but is relatively lesser available for plants as it is taken up in the form of mono-silicic acid, Si(OH)4. The scattered information on the influence of Si on plant development and abiotic stress adaptation has been published. Moreover, the use of nanoparticles for maintenance of plant functions under limited environmental conditions has gained momentum. The current review, therefore, summarizes the updated information on Si nanoparticles (SiNPs) synthesis, characterization, uptake and transport mechanism, and their effect on plant growth and development, physiological and biochemical processes and molecular mechanisms. The regulatory connect between SiNPs and phytohormones signaling in counteracting the negative impacts of HMs stress has also been discussed.


Assuntos
Metaloides , Metais Pesados , Poluentes do Solo , Silício/farmacologia , Reguladores de Crescimento de Plantas , Metais Pesados/toxicidade , Plantas/química , Poluentes do Solo/química
10.
ACS Omega ; 8(49): 46523-46527, 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38107933

RESUMO

This study investigated a novel membrane solvent extraction (MSX) process for the recovery and separation of lithium (Li) from clay minerals using a cation exchange organic extractant [di-(2-ethylhexyl)phosphoric acid] (DEHPA). The Li is selectively extracted from clay mineral leachate solution using highly efficient aluminum hydroxide sorbents to form lithium aluminum double hydroxide sulfate (LDH sulfate) as the precipitate. Several delithiation methods have been explored to separate Li from aluminum (Al). LDH sulfate is dissolved in dilute H2SO4 and used as the feed solution, and DEHPA is used to selectively separate Li and Al from the feed solution. The MSX process immobilizes DEHPA in the microporous membrane pores and continuously removes Al from the feed solution to obtain pure Li. The efficiency of DEHPA for the selective separation of Li from Al is determined by measuring its distribution coefficient. This study used the optimum feed solution pH of 3, strip solution concentration of 2 mol/L H2SO4, and an organic phase composition of 30% v/v DEHPA in Isopar-L. The MSX process achieved a Li yield of about 92% and a purity of ⩾ 94%. The results suggest that the innovative MSX technology is a time- and energy-efficient approach for the recovery and separation of high-purity Li for application in Li-ion batteries and other clean energy technologies.

11.
J Phys Chem B ; 127(41): 8888-8899, 2023 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-37800993

RESUMO

Deep eutectic solvents such as reline are an emerging class of low-cost, environmentally friendly solvents with tunable properties that are potentially applicable for the capture and separation of CO2. Experimental measurements showed that a reline-based membrane contactor can capture and separate CO2 via physisorption through a dissolution process with 96.7% purity from a mixed gas containing CO2 and N2 (50:50% molar ratio). We examine the nature of the interaction of CO2 and N2 with reline employing quantum chemical methods. We focus on explaining the mechanism by which CO2 and N2 bind to reline and the reason for the high selectivity for absorption of CO2 compared to N2. We analyze the dynamics, energetics, and binding motifs for CO2 and N2 in reline employing density functional theory, density functional tight binding, and ab initio molecular dynamics. We also investigate the effect of reline on the vibrational spectra of CO2 and reline. Our simulations indicate that the selective capture of CO2 from the mixture of CO2 and N2 is due to the interplay between attractive electrostatic and charge polarization forces with opposing entropic effects, which shift the energetic balance and make the N2 absorption unfavorable in reline.

12.
Cancers (Basel) ; 15(20)2023 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-37894373

RESUMO

Mutations in Keap1/Nrf2 in head and neck cancer result in abnormal cell growth. Progenitor cells, bulk tumor cells, and head and neck cancer stem cells (HN-CSCs) may all harbor these mutations. Nevertheless, whether Keap1/Nrf2 mutations in HN-CSCs have an impact on clinical outcomes is unknown. Cancerous HN-CSCs and benign stem cells were obtained from freshly resected head and neck cancer patients (n = 50) via flow cytometry cell sorting and tested for Keap1/Nrf2 mutations. The existence of Keap1/Nrf2 mutations in HN-CSCs, as well as their correlations with tumor mutations, pathologic tumor stage, tumor histologic grades, lung metastasis, treatment outcomes, and the patient's age and conditions, are assessed at the last follow-up visit. Thirteen tumors were found to have Keap1/Nrf2 mutations in their HN-CSCs. More than half of the lung metastases and disease progression occurred in HN-CSCs with mutations. Patients whose tumors carried Keap1/Nrf2 mutations in their HN-CSCs had significantly shorter progression-free survival, overall survival, and time of treatment failure than their non-HN-CSC counterparts. These associations were partly driven by HN-CSCs, in which Keap1/Nrf2 mutations were overrepresented in fast progressors and associated with an increased risk of disease progression. Our findings suggest that molecular genotyping of HN-CSCs may facilitate personalized treatment strategies and assist in identifying patients who are likely to benefit from chemotherapy.

13.
Sensors (Basel) ; 23(17)2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37687805

RESUMO

Volatile organic compounds (VOCs) have recently received considerable attention for the analysis and monitoring of different biochemical processes in biological systems such as humans, plants, and microorganisms. The advantage of using VOCs to gather information about a specific process is that they can be extracted using different types of samples, even at low concentrations. Therefore, VOC levels represent the fingerprints of specific biochemical processes. The aim of this work was to develop a sensor based on a photoionization detector (PID) and a zeolite layer, used as an alternative analytic separation technique for the analysis of VOCs. The identification of VOCs occurred through the evaluation of the emissive profile during the thermal desorption phase, using a stainless-steel chamber for analysis. Emission profiles were evaluated using a double exponential mathematical model, which fit well if compared with the physical system, describing both the evaporation and diffusion processes. The results showed that the zeolite layer was selective for propionic acid molecules if compared to succinic acid molecules, showing linear behavior even at low concentrations. The process to define the optimal adsorption time between the propionic acid molecules was performed in the range of 5 to 60 min, followed by a thermal desorption process at 100 °C. An investigation of the relationship between the evaporation and diffusion rates showed that the maximum concentration of detected propionic acid molecules occurred in 15 min. Other analyses were performed to study how the concentration of VOCs depended on the desorption temperature and the volume of the analysis chamber. For this purpose, tests were performed using three analysis chambers with volumes of 25 × 10-6, 50 × 10-6, and 150 × 10-6 m3 at three different desorption temperatures of 20 °C, 50 °C, and 100 °C, respectively. The results demonstrated that the evaporation rate of the VOCs increased rapidly with an increasing temperature, while the diffusion rate remained almost constant and was characterized by a slow decay time. The diffusion ratio increased when using a chamber with a larger volume. These results highlight the capabilities of this alternative technique for VOC analysis, even for samples with low concentrations. The coupling of a zeolite layer and a PID improves the detection selectivity in portable devices, demonstrating the feasibility of extending its use to a wide range of new applications.

14.
Int J Biol Macromol ; 253(Pt 1): 126469, 2023 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-37625743

RESUMO

Epidemiological studies have shown an inverse correlation between dietary intake of prebiotics and the risk of chronic diseases. Pearl millet is a potential economic source to develop a new class of prebiotics in the form of its polysaccharide. In the present study, the chemical structure of a water insoluble homopolysaccharide (PMG), and its prebiotic properties were investigated. The structure of PMG was elucidated on the basis of total hydrolysis, methylation analysis, and 1D/2D NMR (1H, 13C, DEPT-135, HSQC, DQF-COSY, NOESY and ROESY) experiments. The results indicated that PMG was a glucan with an average molecular weight ~ 361 kDa having a backbone of (1 â†’ 3) α-d-glucopyranosyl residues. Hydrolysis of PMG by salivary and pancreatic α amylase was 1.75 % ± 0.34 and 1.99 % ± 0.18 respectively. A positive prebiotic score of PMG with both L. acidophilus and L. brevis (0.446 ± 0.031 & 0.427 ± 0.016) hints towards its prebiotic potential. These observations suggest that PMG might be used as a potential prebiotic component in the food and pharmaceutical applications.


Assuntos
Pennisetum , Sequência de Carboidratos , Água , Polissacarídeos/farmacologia , Polissacarídeos/química , Glucanos/química
16.
RSC Adv ; 13(32): 22088-22100, 2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37492517

RESUMO

In this study, DFT based first principles calculations are used for measuring the structural, elastic, mechanical, electronic, optical and thermodynamic features of topological semimetal TaM2 (M = As, Sb) under various pressures. We conducted the first investigation into the physical properties of the topological semimetal TaM2 (M = As, Sb) under pressure. Formation energy and Born stability criteria justify the compound's thermodynamic and mechanical stability. We used elastic constants, elastic moduli, Kleinman parameter, machinability index, and Vickers hardness to investigate the mechanical properties of topological semimetal TaM2. Poisson's and Pugh's ratios reveal that both compounds change from brittle to ductile in response to pressure. The increasing nature of elastic moduli suggests that TaM2 becomes stiffer under stress. The pressure has a significant effect on the anisotropy factor for both materials. Band structure analysis shows that both compounds are Weyl semi-metals and the d orbital contributes significantly to the formation of the Fermi level, as shown by the density of states (DOS) analysis. Investigation of electronic characteristics provides important support for dissecting optical performance. Both the reflectivity and absorption spectra shift upwards in energy when pressure is increased. The refractive index value decreases and becomes flat in the higher energy region. Based on their refractive indices, both of these materials demonstrate as a high-density optical data storage medium when exposed to the right light source. The thermodynamic properties including sound velocity, and Debye temperature all exhibit an increasing nature with applied pressure. Due to their high Debye temperatures, the components under study have a rather high melting point.

17.
PLoS One ; 18(7): e0288838, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37498957

RESUMO

INTRODUCTION: Human Immunodeficiency Virus infection continue to represent a global health concern influenced by various social, economic, and cultural factors. The MENA are among the top regions in the world with the fastest-growing HIV epidemic. Thus, adequate knowledge and a positive attitude of people toward HIV/AIDS are of utmost importance to prevent the spreading of the disease. Accordingly, this study aims to evaluate the knowledge and attitude of the public and healthcare population toward HIV/AIDs. METHODS: A cross-sectional analysis was conducted among residents within our population from October 2018 until August 2019. An anonymous online questionnaire was used to investigate the population's demographic characteristics, HIV/AIDS-related knowledge, and attitudes toward HIV-infected patients. Participants completed a 40-item questionnaire designed to measure their knowledge and attitude toward HIV/AIDS. The data was collected via surveys, administered through electronic tablets to the participants at public places (n = 5,757) and through an online version of the questionnaire on Google Forms (n = 2500), which was sent through social media platforms. Descriptive statistics were used to analyse the data using the R-statistical software program. RESULTS: A total of 8,257 participants were included in our analysis. Saudi Arabian citizens represented 79% of the participants, while participants from the MENA countries represented 11.7% and 3% from the other Gulf Cooperation Council countries. Fifty-nine (59%) knew that HIV is a contagious infection, and 13.8% were unaware that HIV could be transmitted sexually. A few healthcare professionals reported negative attitudes toward HIV infected patients. Many risk factors, including age, gender, nationality, and education, significantly affected the knowledge and attitude scores. In this survey, we found that social media is the primary source of participants' information. CONCLUSIONS: Overall correct knowledge score of individuals about HIV/AIDS was relatively low. This study showed that the general population was knowledgeable to a certain degree about HIV/AIDS and its modes of transmission. Nevertheless, they lack a detailed understanding of the disease's nature, modes of transmission, and existing treatment. Policymakers in the region should further eliminate social discrimination and stigma in HIV-infected patients.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Humanos , Estudos Transversais , Arábia Saudita , Conhecimentos, Atitudes e Prática em Saúde , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Infecções por HIV/prevenção & controle , Pessoal de Saúde , Inquéritos e Questionários
18.
Heart Lung Circ ; 32(8): 894-904, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37507275

RESUMO

Significant advances have been made in artificial intelligence technology in recent years. Many health care applications have been investigated to assist clinicians and the technology is close to being integrated into routine clinical practice. The high prevalence of cardiac disease in Australia places overwhelming demands on the existing health care system, challenging its capacity to provide quality patient care. Artificial intelligence has emerged as a promising solution. This discussion paper provides an Australian perspective on the current state of artificial intelligence in cardiology, including the benefits and challenges of implementation. This paper highlights some current artificial intelligence applications in cardiology, while also detailing challenges such as data privacy, ethical considerations, and integration within existing health infrastructures. Overall, this paper aims to provide insights into the potential benefits of artificial intelligence in cardiology, while also acknowledging the barriers that need to be addressed to ensure safe and effective implementation into an Australian health system.


Assuntos
Cardiologia , Cardiopatias , Humanos , Inteligência Artificial , Austrália/epidemiologia , Atenção à Saúde
19.
J Infect Public Health ; 16(8): 1209-1219, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37276715

RESUMO

BACKGROUND: This prospective follow-up study aimed to determine the temporal changes in respiratory outcomes over 6 months period in patients with and without cancer hospitalized for severe COVID-19 and to determine the associated risk factors based on admission viral load. METHODS: All adult patients hospitalized with a confirmed diagnosis of severe SARS-CoV-2 infection were investigated using rRT-PCR on nasopharyngeal swab specimens. Patients were divided into three arbitrary groups according to their cycle threshold (CT) values obtained at admission as high (CT<25.0), medium (CT between 25.0 and 30.0), and low (CT>30.0) viral load. Patients had pulmonary function tests, chest high-resolution computed tomography (HRCT), and a 6-minute walking time distance measured at each follow-up visit. RESULTS: This follow-up study had a total of 112 participants, of which 75 were cancer-free and 37 had active cancer. Overall, 29.5% had a low viral load, compared to 48.2% who had a high viral load, and 22.3% had a medium viral load. For patients who did not have cancer, the mean age was 57.3 (SD 15.4) and for those who had cancer, it was 62.3 (SD 18.4). Most patients had overall better temporal changes in pulmonary function and tolerance, as well as exercise capacity, even though severe and chronic respiratory abnormalities persisted in a fraction of the patients. In patients without cancer who had a high viral load, we have seen a substantial reduction in diffusion capacity of the lungs for carbon monoxide (DLCO) predicted value with a median of 65 (IQR 63-70) while in patients with cancer, it was 60 (IQR 56-67) at 2 months. At 4 and 6 months, the predicted DLCO values for patients without cancer were 65 (IQR 61-70), whereas the predicted DLCO values for patients with active cancer were 62 (IQR 60-67) and 67 (59-73). Importantly, radiological abnormalities persisted in 22 (29%) non-cancer patients and 16 (43%) cancer patients. Multivariate regression analysis showed an increased odds ratio of impaired HRCT associated with a high viral load of 3.04 (95% CI:1.68-6.14; p < 0.001) for patients without cancer and 5.07 (95% CI: 4.04-10.8; p < 0.0001) for patients with cancer. The CT pneumonia score at hospitalization was 2.25 (95% CI:1.76-3.08; p = 0.041) and 2.85 (95% CI:1.89-5.14; p = 0.031) for non-cancer and cancer patients respectively. CONCLUSIONS: The evidence of persistent pulmonary abnormalities and radiographic changes was found in both patient groups who had high viral load at hospital admission and suggesting that SARS-CoV-2 viral load might serve as a useful indicator to predict the development of respiratory complications in patients with COVID-19.


Assuntos
COVID-19 , Neoplasias , Adulto , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Seguimentos , Estudos Prospectivos , Carga Viral , Hospitalização , Neoplasias/complicações
20.
PLoS One ; 18(6): e0287342, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37319267

RESUMO

The economic landscape of the United Kingdom has been significantly shaped by the intertwined issues of Brexit, COVID-19, and their interconnected impacts. Despite the country's robust and diverse economy, the disruptions caused by Brexit and the COVID-19 pandemic have created uncertainty and upheaval for both businesses and individuals. Recognizing the magnitude of these challenges, academic literature has directed its attention toward conducting immediate research in this crucial area. This study sets out to investigate key economic factors that have influenced various sectors of the UK economy and have broader economic implications within the context of Brexit and COVID-19. The factors under scrutiny include the unemployment rate, GDP index, earnings, and trade. To accomplish this, a range of data analysis tools and techniques were employed, including the Box-Jenkins method, neural network modeling, Google Trend analysis, and Twitter-sentiment analysis. The analysis encompassed different periods: pre-Brexit (2011-2016), Brexit (2016-2020), the COVID-19 period, and post-Brexit (2020-2021). The findings of the analysis offer intriguing insights spanning the past decade. For instance, the unemployment rate displayed a downward trend until 2020 but experienced a spike in 2021, persisting for a six-month period. Meanwhile, total earnings per week exhibited a gradual increase over time, and the GDP index demonstrated an upward trajectory until 2020 but declined during the COVID-19 period. Notably, trade experienced the most significant decline following both Brexit and the COVID-19 pandemic. Furthermore, the impact of these events exhibited variations across the UK's four regions and twelve industries. Wales and Northern Ireland emerged as the regions most affected by Brexit and COVID-19, with industries such as accommodation, construction, and wholesale trade particularly impacted in terms of earnings and employment levels. Conversely, industries such as finance, science, and health demonstrated an increased contribution to the UK's total GDP in the post-Brexit period, indicating some positive outcomes. It is worth highlighting that the impact of these economic factors was more pronounced on men than on women. Among all the variables analyzed, trade suffered the most severe consequences in the UK. By early 2021, the macroeconomic situation in the country was characterized by a simple dynamic: economic demand rebounded at a faster pace than supply, leading to shortages, bottlenecks, and inflation. The findings of this research carry significant value for the UK government and businesses, empowering them to adapt and innovate based on forecasts to navigate the challenges posed by Brexit and COVID-19. By doing so, they can promote long-term economic growth and effectively address the disruptions caused by these interrelated issues.


Assuntos
COVID-19 , Pandemias , Masculino , Humanos , Feminino , Reino Unido/epidemiologia , União Europeia , COVID-19/epidemiologia , Renda
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