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Photo-catalysts based on BiVO4 (BV) and Eco-graphene (EG) were synthesized and obtained in a single step with high-quality properties. These nanostructures (NEs) were obtained through a green chemistry route and by adding 2, 3, and 5 wt% of a homemade EG. The BV/X EG NEs (where X = corresponds to the weight % of EG) demonstrated high photocatalytic activity, obtaining Sulfamethoxazole degradation percentages of 40, 45, 52, and 57 for BV, BV/2 EG, BV/3 EG, and BV/5 EG respectively, using a blue LED light. In addition, it was observed that the presence of EG slightly affected the surface area and porosity of BV. Moreover, it was observed that the presence of EG stabilized the scheelite monoclinic phase (m-s), and decreased the crystal size and band-gap values of BV-based samples. It was detected that EG contents increased the BV reduction, creating oxygen vacancies and V4+ states, which favored electron transfer, enhanced the photo-catalytic activity, and decreased the recombination rate. The adsorption influence of the BV/EG system was also studied. Finally, the stability tests of these materials after four cycles of reuse allowed keeping practically the full degradation capacity, demonstrating that these NEs represent a promising material driven by visible light that can be used for wastewater decontamination in the presence of drugs.
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Grafite , Nanoestruturas , Grafite/química , Sulfametoxazol , Adsorção , LuzRESUMO
With a levitodynamics experiment in the strong and coherent quantum optomechanical coupling regime, we demonstrate that the oscillator acts as a broadband quantum spectrum analyzer. The asymmetry between positive and negative frequency branches in the displacement spectrum traces out the spectral features of the quantum fluctuations in the cavity field, which are thus explored over a wide spectral range. Moreover, in our two-dimensional mechanical system the quantum backaction, generated by such vacuum fluctuations, is strongly suppressed in a narrow spectral region due to a destructive interference in the overall susceptibility.
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Cadiz Bay is a shallow mesotidal lagoon with extensive populations of the seagrass Cymodocea nodosa at intertidal and shallow subtidal elevations. This work aims to understand the mechanisms behind the resilience of this species to gradual sea level rise by studying its acclimation capacity to depth along the shallow littoral, and therefore, to gradual variations in the light environment. To address this objective, these populations have been monitored seasonally over a 10 year period, representing the longest seasonal database available in the literature for this species. The monitoring included populations at 0.4, -0.08 and -0.5 m LAT. The results show that C. nodosa has a strong seasonality for demographic and shoot dynamic properties - with longer shoots and larger growth in summer (high temperature) than in winter (low temperature), but also some losses. Moreover, shoots have different leaf morphometry depending on depth, with small and dense shoots in the intertidal areas (0.4 m) and sparse large shoots in the subtidal ones (-0.08 and 0.5 m). These differences in morphometry and shoot dynamic properties, combined with the differences in shoot density, explain the lack of differences in meadow production balance (i.e. meadow growth - meadow losses) between the intertidal (0.4 m) and the deepest population (-0.5 m), supporting the long term resilience of Cymodocea nodosa in Cadiz Bay. This study contributes to the understanding of the mechanisms behind seagrass stability and resilience, which is particularly important towards predicting the effects of climate change on these key coastal ecosystems, and also highlights the value of continuous long-term monitoring efforts to evaluate seagrass trajectories.
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Alismatales , Ecossistema , Aclimatação , Mudança Climática , Folhas de PlantaRESUMO
Objective: To measure metabolic and physiological demand, subjective fatigue, and enjoyment during a signature 30-minute immersive virtual reality (IVR) adaptive cable resistance exergaming session. Methods: Fourteen healthy college-aged individuals (seven females) were initially acquainted with the IVR equipment and gameplay dynamics. Participants then underwent a 30-minute IVR exergaming session performing six different cable resistance exercises. A portable metabolic gas exchange analyzer concurrently assessed energy expenditure (EE) through indirect calorimetry while a chest-worn monitor captured heart rate (HR). Participants subsequently completed questionnaires, including the Borg scale for rating of perceived exertion (RPE), Physical Activity Enjoyment Scale (PACES), and Simulator Sickness Questionnaire (SSQ). Results: The mean EE, mean metabolic equivalent, and average total calories expended during the 30-minute session were 14.7 (standard deviation [SD] 2.8) kcal/minute, 12.9 (SD 0.5), and 440 (SD 84) kcals respectively. The mean HR was 176 (SD 3.1) beats per minute (bpm) with a mean max HR of 188 SD (SD 2.9) bpm. The combined training volume among all participants was 16,102 kg (SD 4137). Participants classified the IVR training session to be "somewhat hard-to-hard" with a RPE score of 14 (SD 1) while indicating the session to be "enjoyable" with a PACES score of 4.31 (SD 0.36). The participants did not report any cybersickness symptoms, demonstrating an average total SSQ score of 24.04 (SD 24.13). Conclusions: IVR exergaming incorporating cable resistance training elicits high EE and physiological demand with high enjoyment scores while attenuating perceived fatigue. The potential for IVR to elicit these acute training effects over long-term training periods warrants further investigation into its contribution to fitness and health.
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Jogos de Vídeo , Realidade Virtual , Calorimetria Indireta , Exercício Físico , Feminino , Humanos , Esforço Físico , Adulto JovemRESUMO
OBJECTIVES: Diabetes mellitus (DM) and frailty are common in older patients with acute coronary syndromes (ACS). No data exists about its prognostic impact on long-term outcomes and their possible interaction in this setting. DESIGN: Observational prospective study. SETTING: Multicenter registry conducted in 44 hospitals in Spain. PARTICIPANTS: Consecutive patients with ACS aged 80≥years. MEASUREMENTS: A comprehensive geriatric evaluation was performed during hospitalization, including frailty assessment by the FRAIL score. The impact of DM and frailty on the incidence of mortality/readmission at 24 months was analysed by a Cox regression model. RESULTS: A total of 498 patients were included (mean age 84.3 years). Prevalence of previous DM was 199/498 (40.0%). The rate of frail patients was 135/498 (27.1%). The incidence of mortality/readmission was higher frail patients (HR 2.49) (both p<0.001). In contrast, DM was not significantly associated to a higher rate of outcomes (HR 1.23, p=0.060) in the whole cohort. Among non-frail patients, patients with DM had a similar incidence of mortality or readmission (p=0.959). In contrast, among frail patients, DM was significantly associated with a higher incidence of events (HR 1.51, p=0.034). CONCLUSIONS: Unlike frailty status, DM was not associated to poorer long-term outcome in elderly patients with ACS. Among frail patients the presence of DM seems to provide additional prognostic information.
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Síndrome Coronariana Aguda/complicações , Diabetes Mellitus/etiologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/complicações , Síndrome Coronariana Aguda/mortalidade , Idoso de 80 Anos ou mais , Diabetes Mellitus/mortalidade , Feminino , Humanos , Masculino , Prevalência , Prognóstico , Estudos ProspectivosRESUMO
FRAX® calculates the 10-year probability of major osteoporotic fractures (MOF), which are considered to have a greater clinical impact than other fractures. Our results suggest that, in postmenopausal women with severe osteoporosis, those treated with teriparatide had a 60% lower risk of FRAX®-defined MOF compared with those treated with risedronate. INTRODUCTION: The VERO trial was an active-controlled fracture endpoint clinical trial that enrolled postmenopausal women with severe osteoporosis. After 24 months, a 52% reduction in the hazard ratio (HR) of clinical fractures was reported in patients randomized to teriparatide compared with risedronate. We examined fracture results restricted to FRAX®-defined major osteoporotic fractures (MOF), which include clinical vertebral, hip, humerus, and forearm fractures. METHODS: In total, 1360 postmenopausal women (mean age 72.1 years) were randomized to receive subcutaneous daily teriparatide (20 µg) or oral weekly risedronate (35 mg). Patient cumulative incidence of ≥ 1 FRAX®-defined MOF and of all clinical fractures were estimated by Kaplan-Meier analyses, and the comparison between treatments was based on the stratified log-rank test. Additionally, an extended Cox model was used to estimate HRs at different time points. Incidence fracture rates were estimated at each 6-month interval. RESULTS: After 24 months, 16 (2.6%) patients in the teriparatide group had ≥ 1 low trauma FRAX®-defined MOF compared with 40 patients (6.4%) in the risedronate group (HR 0.40; 95% CI 0.23-0.68; p = 0.001). Clinical vertebral and radius fractures were the most frequent FRAX®-defined MOF sites. The largest difference in incidence rates of both FRAX®-defined MOF and all clinical fractures between treatments occurred during the 6- to 12-month period. There was a statistically significant reduction in fractures between groups as early as 7 months for both categories of clinical fractures analyzed. CONCLUSION: In postmenopausal women with severe osteoporosis, treatment with teriparatide was more efficacious than risedronate, with a 60% lower risk of FRAX®-defined MOF during the 24-month treatment period. Fracture risk was statistically significantly reduced at 7 months of treatment. CLINICAL TRIAL INFORMATION: ClinicalTrials.gov Identifier: NCT01709110 EudraCT Number: 2012-000123-41.
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Conservadores da Densidade Óssea , Osteoporose Pós-Menopausa , Fraturas por Osteoporose , Idoso , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Osteoporose Pós-Menopausa/tratamento farmacológico , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/prevenção & controle , Ácido Risedrônico/uso terapêutico , Teriparatida/uso terapêuticoRESUMO
Myelofibrosis (MF) occurs as part of the natural history of polycythemia vera (PV) and essential thrombocythemia (ET), and remarkably shortens survival. Although JAK2V617F and CALR allele burden are the main transformation risk factors, inflammation plays a critical role by driving clonal expansion toward end-stage disease. NF-κB is a key mediator of inflammation-induced carcinogenesis. Here, we explored the involvement of miR-146a, a brake in NF-κB signaling, in MPN susceptibility and progression. rs2910164 and rs2431697, that affect miR-146a expression, were analyzed in 967 MPN (320 PV/333 ET/314 MF) patients and 600 controls. We found that rs2431697 TT genotype was associated with MF, particularly with post-PV/ET MF (HR = 1.5; p < 0.05). Among 232 PV/ET patients (follow-up time=8.5 years), 18 (7.8%) progressed to MF, being MF-free-survival shorter for rs2431697 TT than CC + CT patients (p = 0.01). Multivariate analysis identified TT genotype as independent predictor of MF progression. In addition, TT (vs. CC + CT) patients showed increased plasma inflammatory cytokines. Finally, miR-146a-/- mice showed significantly higher Stat3 activity with aging, parallel to the development of the MF-like phenotype. In conclusion, we demonstrated that rs2431697 TT genotype is an early predictor of MF progression independent of the JAK2V617F allele burden. Low levels of miR-146a contribute to the MF phenotype by increasing Stat3 signaling.
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MicroRNAs/genética , Transtornos Mieloproliferativos/genética , Mielofibrose Primária/genética , Idoso , Alelos , Animais , Citocinas/genética , Progressão da Doença , Feminino , Genótipo , Humanos , Inflamação/genética , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Mutação/genética , Transtornos Mieloproliferativos/patologia , NF-kappa B/genética , Policitemia Vera/genética , Policitemia Vera/patologia , Transdução de Sinais/genética , Trombocitemia Essencial/genética , Trombocitemia Essencial/patologiaRESUMO
Recent optomechanical experiments have observed nonclassical properties in macroscopic mechanical oscillators. A key indicator of such properties is the asymmetry in the strength of the motional sidebands produced in the probe electromagnetic field, which is originated by the noncommutativity between the oscillator ladder operators. Here we extend the analysis to a squeezed state of an oscillator embedded in an optical cavity, produced by the parametric effect originated by a suitable combination of optical fields. The motional sidebands assume a peculiar shape, related to the modified system dynamics, with asymmetric features revealing and quantifying the quantum component of the squeezed oscillator motion.
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PURPOSE: Surgical treatment of moderate hallux valgus (HV) onwards by Chevron osteotomy and all variants described to date including the recent extended distal Chevron osteotomy (EDCO), yields improvable outcome but with recurrence rate. A new modification of this technique is needed to achieve better results. METHODS: 34 consecutive female patients suffering from moderate HV underwent a new minimally extended distal Chevron osteotomy (MEDCO) with percutaneous soft tissue release (PSTR). Outcome was assessed using pre-post operative VAS-Pain, AOFAS Hallux Score and radiological measurements. Mean age was 53.7 years, follow-up 2.7 years and satisfaction score 8. RESULTS: VAS improved from 7 to 1 (p < 0.001) and AOFAS score from 64 to 90.7 (p < 0.001). Comparing postoperative HV and intermetatarsal (IM) angles of previous studies (either employing a Chevron osteotomy alone or a double Chevron-Akin) with our results, an improvement from 15.6/14.8 to 9.1 and 8.2 /8.8 to 5.6 respectively (p < 0.05) was achieved. Complication and recurrence rates were both 5.8%, lower than the documented rates of other techniques. CONCLUSION: The modified technique in the present study was found to be a more effective and reliable method of correcting hallux valgus when compared to other previous procedures. It provides a higher level of satisfaction and excellent outcomes with low complication and recurrence rates. Furthermore, the percutaneous lateral incision improved the cosmetic results by avoiding formation of a dorsal first web space scar. Medial incision is also shorter than the one used for EDCO. LEVEL OF EVIDENCE: Level IV, case series.
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Hallux Valgus/cirurgia , Osteotomia/métodos , Feminino , Hallux Valgus/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Medição da Dor , Satisfação do Paciente , Complicações Pós-Operatórias/prevenção & controle , Recidiva , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The clinical effect of peri-operative bridging therapy in atrial fibrillation (AF) patients remains unclear given that it may increase bleeding risk without providing significant benefits. We aimed to investigate peri-procedural events in relation to peri-operative use of bridging therapy in AF patients under Vitamin K Antagonists (VKAs). METHODS: We included AF patients stable the previous 6 months on VKAs. During a median follow-up of 6.5 years (IQR 4.3-7.9), we recorded all invasive procedures and the peri-operative clinical management. All peri-procedural events (ischaemic stroke/transient ischaemic attack/systemic embolism, clinically relevant non-major bleeding and major bleeding) and severe peri-procedural events (ischaemic stroke/transient ischaemic attack/systemic embolism and major bleeding) suffered until the 30-days post-intervention period were recorded. RESULTS: We included 1361 patients (48.7% male, median age 76 [IQR 71-81] years). There were 1100 (70.9%) procedures performed using bridging therapy. The rate of any (4.5% vs. 0.7%, P < 0.001) and severe (2.3% vs. 0.0%, P = 0.002) peri-procedural events were higher in patients receiving bridging therapy. Adjusted logistic regressions demonstrated that the bleeding risk of the procedure was related with higher risk of severe peri-procedural events (OR 3.51, 95% CI 1.54-8.01) and peri-procedural events (OR 2.77, 95% CI 1.56-4.91). Importantly, the use of bridging therapy was also independently associated with higher risk of any peri-procedural events (OR 4.32, 95% CI 1.28-14.51). CONCLUSIONS: In this study including AF patients under VKA therapy, the use of bridging therapy as part of the clinical management during an invasive procedure was independently associated with higher risk of any peri-procedural event.
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Fibrilação Atrial/terapia , Heparina de Baixo Peso Molecular/efeitos adversos , Assistência Perioperatória , Vitamina K/antagonistas & inibidores , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Feminino , Hemorragia/epidemiologia , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Espanha/epidemiologia , Acidente Vascular Cerebral/prevenção & controle , Tromboembolia/epidemiologia , Tromboembolia/prevenção & controleRESUMO
BACKGROUND: This retrospective single center study aimed to describe circulating tumor DNA (ctDNA) comprehensive genomic profiling (CGP) utilization in a community practice for patients with advanced solid tumors. METHODS: All patients were included who were seen at the Scripps Hillcrest Oncology Clinic (San Diego, CA, USA) between September 2016 to March 2018 who had ctDNA assay testing performed. In this cohort, all ctDNA testing was performed to aid therapeutic decision making with wide variety in both the type of advanced solid tumor, as well as the line of therapy. RESULTS: Of the assays performed in the 41 patients included in this review, 42% of therapeutic actions following ctDNA assay results were influenced by the ctDNA result, including initiation of the corresponding Federal Drug Administration (FDA) approved therapy, placement on clinical trial, and initiation of off label-targeted options. In addition, CGP results guided clinicians away from futile or harmful treatments, such as EGFR inhibition in colorectal cancer patients with discovered KRAS mutations. No additional prognostic or therapeutic information was gathered in one quarter of patients for which ctDNA was drawn. Furthermore, discovered genomic alterations by ctDNA testing did not influence therapeutic action in 58% of cases. CONCLUSIONS: These results highlight the conundrum that having additional information regarding an individual's tumor biology does not yet translate into meaningful targeted therapy in the majority of cases. Further studies are needed regarding ctDNA utilization to help guide community oncologists who will continue to face the choice between targeted therapy, immunotherapy, and cytotoxic chemotherapy as science advances.
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Mathematical models simulating different and representative engineering problem, atomic dry friction, the moving front problems and elastic and solid mechanics are presented in the form of a set of non-linear, coupled or not coupled differential equations. For different parameters values that influence the solution, the problem is numerically solved by the network method, which provides all the variables of the problems. Although the model is extremely sensitive to the above parameters, no assumptions are considered as regards the linearization of the variables. The design of the models, which are run on standard electrical circuit simulation software, is explained in detail. The network model results are compared with common numerical methods or experimental data, published in the scientific literature, to show the reliability of the model.
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Simulação por Computador , Engenharia , Modelos Teóricos , Corrosão , Elasticidade , Fricção , Microscopia de Força Atômica/instrumentação , Oxirredução , Oxigênio/química , Software , Temperatura , Titânio/química , TriterpenosRESUMO
The extraordinary sensitivity of the output field of an optical cavity to small quantum-scale displacements has led to breakthroughs such as the first detection of gravitational waves and of the motions of quantum ground-state cooled mechanical oscillators. While heterodyne detection of the output optical field of an optomechanical system exhibits asymmetries which provide a key signature that the mechanical oscillator has attained the quantum regime, important quantum correlations are lost. In turn, homodyning can detect quantum squeezing in an optical quadrature but loses the important sideband asymmetries. Here we introduce and experimentally demonstrate a new technique, subjecting the autocorrelators of the output current to filter functions, which restores the lost heterodyne correlations (whether classical or quantum), drastically augmenting the useful information accessible. The filtering even adjusts for moderate errors in the locking phase of the local oscillator. Hence we demonstrate the single-shot measurement of hundreds of different field quadratures allowing the rapid imaging of detailed features from a simple heterodyne trace. We also obtain a spectrum of hybrid homodyne-heterodyne character, with motional sidebands of combined amplitudes comparable to homodyne. Although investigated here in a thermal regime, the method's robustness and generality represents a promising new approach to sensing of quantum-scale displacements.
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Several clinical trials have produced conflicting results regarding the benefit of antioxidants in cancer therapy thus questioning the incorporation of these substances in standard treatment regimens. Vitamins E and C, selenium, carotenoids, lycopene, soy products, and green tea extract are a few substances with antioxidant properties that have been studied in detail. This article reviews the results generated over the last 20 years through in vitro and in vivo studies in various types of cancers and stages of cancer treatment. Despite the commercial popularity and the multitude of studies examining antioxidant therapy, the true role of antioxidants is yet to be determined, requiring further investigation into its propagative, causal, or protective nature.
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Antioxidantes/farmacologia , Neoplasias/tratamento farmacológico , Animais , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Interações Medicamentosas , Humanos , Neoplasias/radioterapia , Radioterapia , Espécies Reativas de Oxigênio/metabolismoRESUMO
PURPOSE: To report the mid-term outcomes of percutaneous cryoablation (PCA) performed as second-line therapeutic option of venous malformations (VM). MATERIAL AND METHODS: From 2011 to 2015, PCA was offered in 24 patients (mean age: 31 years, range: 12-64) as second-line treatment for recurrence of symptoms after sclerotherapy and when resection was not possible (due to lesion location or previous failure) or refused by the patient. Adverse effects were recorded, disease-free survival (DFS) and local tissue control (LTC) rates were calculated based on symptoms and volume evolution. RESULTS: Mean follow-up was 18.7 months (6-48). Nine (37.5%, 9/24) adverse effects occurred and three (12.5%, 3/24) were severe. Mean pain assessed by visual analog scale (VAS) was 41.7 mm (0-80) before treatment and 20.3 mm (0-80) (p=0.01) after. Mean volume decreased significantly after treatment from 22.4 cm3 (0.9-146) to 8.35 cm3 (0-81.3) (p<0.001). Pain recurred in nine patients and size of one lesion increased. The DFS and LTC rates were 54% [95%CI: 22.94-77.27] and 93.33% [61.26-99.03] at 24 months, respectively. Only VM volume >10 cm3 was associated with a higher risk of local recurrence (p=0.05). CONCLUSION: PCA as second-line treatment appears to be safe and effective for local control of VM according to mid-term results. KEY POINTS: ⢠Percutaneous cryoablation of venous malformations appeared well tolerated. ⢠Size of venous malformations decreased significantly after percutaneous cryoablation (p<0.001). ⢠Pain decreased significantly after percutaneous cryoablation of venous malformations (p=0.01).