Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 662
Filtrar
1.
J Orthop ; 56: 87-91, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38800591

RESUMO

Background: Limited evidence is available comparing the modified transtibial (MTT) and transportal (TP) techniques in anterior cruciate ligament (ACL) reconstruction and their impact on returning to sports participation. The objective was to analyze the outcomes after arthroscopic reconstruction of the ACL in recreational athletes with a 2-year postoperative follow-up, comparing the MTT and TP techniques, based on the method used to drill the femoral tunnel. Hypotesis: The rate of return to sport would be comparable regardless of the surgical technique used. Material and methods: A retrospective study was conducted with 66 patients who underwent arthroscopic monofascicular ACL reconstruction between September 2016 and March 2020. Patients aged between 16 and 50 years old, recreational athletes at Tegner levels 6 and 7, with a 2-year follow-up were included. Groups were established for comparative analysis (MTT vs TP) based on the method for drilling the femoral tunnel. The main outcome variable was the return to sport at the same level. Secondary variables included patient satisfaction evaluated with a visual analogue scale (VAS) and knee function according to the Lysholm scale. Results: At 2 years of postoperative follow-up, the return to sport rate was 30.3 % in the MTT group and 33.3 % in the TP group (p = 0.791). There were no significant differences between both groups in patient satisfaction (p = 0.664) and knee function (p = 0.113). Conclusion: Drilling the femoral tunnel with the MTT and TP techniques did not influence the rate of return to sport, patient satisfaction, and knee function in recreational athletes with 2 years of postoperative follow-up. Level of evidence: III.

2.
ACS Pharmacol Transl Sci ; 7(5): 1310-1319, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38751643

RESUMO

The value of connected devices and health apps with features such as adherence trackers, dosing reminders, and remote communication tools for users and healthcare providers has been assessed to support home-based subcutaneous administration. A comprehensive survey was conducted with 605 participants, including users and caregivers, from eight countries. Medical conditions encompassed ankylosing spondylitis, asthma, cerebral palsy, cluster headaches, Crohn's disease, hemophilia, lupus, migraine, multiple sclerosis, Parkinson's disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, spasticity, spondyloarthritis, and ulcerative colitis. Utilizing a maximum difference scaling methodology, the survey gauged participant preferences regarding specific attributes and features of connected drug delivery devices. Irrespective of demographic factors like age, gender, nationality, or the specific medical condition, the device's ability to verify a successful injection stood out as universally valued. The second and third most valued attributes pertained to temperature-related indicators or warnings. These features do not necessitate the use of a connected device and can be integrated into existing autoinjector platforms. The survey findings support the development of a universal adherence tool for at-home subcutaneous dosing, independent of a specific medical condition. This tool may be gradually improved with disease-specific features. Once established as a platform, manufacturers can launch any subcutaneous medication and later integrate real-world evidence for enhanced educational, treatment, and diagnostic capabilities. This approach is crucial for advancing connected adherence tools in decentralized healthcare, aligning with user and healthcare system needs while translating scientific innovation into practical solutions.

3.
Orthop Traumatol Surg Res ; : 103876, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38582225

RESUMO

BACKGROUND: The influence of smoking on the risk of periprosthetic joint infection (PJI) remains unclear. The objective was to explore the impact of smoking on PJI after primary total knee (TKA) and hip (THA) arthroplasty. HYPOTHESIS: Current smoking patients should have an increased risk of PIJ compared with nonsmoking patients. PATIENTS AND METHODS: A prospective registry-based observational cohort study was performed. A total of 4591 patients who underwent primary TKA (3076 patients) or THA (1515) were included. According to the smoking status at the time of arthroplasty, patients were classified as nonsmokers (3031 patients), ex-smokers (688), and smokers (872). Multivariate analysis included smoking status, age, gender, education level, body mass index, American Society of Anesthesiologists class, diagnosis (osteoarthritis, rheumatism), diabetes, chronic obstructive pulmonary disease, perioperative blood transfusion, site of arthroplasty (knee, hip), length of operation, and length of stay. RESULTS: There were PJI after 59 (1.9%) TKA and 27 (1.8%) THA (p=0.840). There were PJI in 47 (1.6%) nonsmokers, 12 (1.7%) ex-smokers, and 17 (1.9%) smokers (p=0.413). There were wound complications (delayed wound healing and superficial wound infection) in 34 (0.7%) nonsmokers, 9 (1.3%) in ex-smokers, and 17 (1.9%) in smokers (p=0.045). In multivariate analysis, only the female gender was a significant predictor of PJI (OR 1.3, 95% CI 1.1-2.4 [p=0.039]). Specifically, the categories of ex-smokers (OR 0.8, 95% CI 0.2-1.7 [p=0.241]) and smokers (OR 1.1, 95% CI 0.6-1.5 [p=0.052]) were not significant predictors. The 4-year arthroplasty survival with PJI as the endpoint was 99.1% (95% CI: 99.0-99.7) for nonsmokers, 99.0% (95% CI: 98.8-99.2) for ex-smokers, and 98.7% (95% CI: 98.2-99.0) for smokers was not significantly different between smoking status groups (p=0.318). DISCUSSION: Smoking was not identified as a significant predictor for PJI following primary TKA or THA. LEVEL OF EVIDENCE: III, prospective cohort study.

4.
J Clin Med ; 13(5)2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38592707

RESUMO

Background: Previous research has established good test-retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed "poor" to "excellent" values for maximum peak torque in knee extension and "moderate" to "excellent" values for average. "Poor" to "excellent" reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from "moderate" to "excellent" for maximum and average values, and in knee flexion, it ranged from "poor" to "excellent" for maximum value and from "moderate" to "excellent" for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.

5.
Rev Esp Enferm Dig ; 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38685904

RESUMO

The complication rate for Pancreaticoduodenectomy (PD) is 40-50% in most published series and mortality can raise up to 4-5% even in high-volume centers. Severe portal hypertension secondary to liver disease is associated to high perioperative mortality and therefore is considered a contraindication for PD. No standardized management exists for surgically resectable patients with periampullary cancer and severe portal hypertension. The aim of this case study is to analyse the treatment alternatives in patients with periampullary cancer and severe portal hypertension and focus into the surgical treatment of these patients. We present the case of a 67 year-old patient case with a resectable ampullary cancer and portal hypertension managed with Preoperative Transjugular Intrahepatic Portosystemic Shunt (TIPS) to allow a PD. We present a literature review on the use of preoperative TIPS in patients who are candidates to PD. Neoadjuvant TIPS can be safely used in selected patients with severe portal hypertension who need a PD.

6.
Dalton Trans ; 53(18): 8041-8049, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38652019

RESUMO

Octahedrally coordinated spin crossover (SCO) FeII complexes represent an important class of switchable molecular materials. This study presents the synthesis and characterisation of a novel complex, [FeII(ppt-2Fph)2]0·2MeOH, where ppt-2Fph is a new asymmetric ionogenic tridentate planar ligand 2-(5-(2-fluorophenyl)-4H-1,2,4-triazol-3-yl)-6-(1H-pyrazol-1-yl)pyridine. The complex exhibits a hysteretic thermally induced SCO transition at 285 K on cooling and at 293 K on heating, as well as light induced excited spin state trapping (LIESST) at lower temperatures with a relaxation T(LIESST) temperature of 73 K. Single crystal analysis in both spin states shows that the compound undergoes an unusual partial (25%) reversible order-disorder of the asymmetrically substituted phenyl group coupled to the thermal SCO. The highly cooperative SCO transition, analysed by structural energy framework analysis at the B3LYP/6-31G(d,p) theory level, revealed the co-existence of stabilising and destabilising energy variations in the lattice. The observed antagonism of intermolecular interactions and synchronous rotational disorder, which contributes to the overall entropy change, is suggested to be at the origin of the cooperative SCO transition.

7.
Plant Physiol Biochem ; 209: 108520, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38522131

RESUMO

In Arabidopsis, the plastidial isoform of phosphoglucose isomerase, PGI1, mediates growth and photosynthesis, likely due to its involvement in the vascular production of cytokinins (CK). To examine this hypothesis, we characterized pgi1-2 knockout plants impaired in PGI1 and pgi1-2 plants specifically expressing PGI1 in root tips and vascular tissues. Moreover, to investigate whether the phenotype of pgi1-2 plants is due to impairments in the plastidial oxidative pentose phosphate pathway (OPPP) or the glycolytic pathway, we characterized pgl3-1 plants with reduced OPPP and pfk4pfk5 knockout plants impaired in plastidial glycolysis. Compared with wild-type (WT) leaves, pgi1-2 leaves exhibited weaker expression of photosynthesis- and 2-C-methyl-D-erythritol 4-P (MEP) pathway-related proteins, and stronger expression of oxidative stress protection-related enzymes. Consistently, pgi1-2 leaves accumulated lower levels of chlorophyll, and higher levels of tocopherols, flavonols and anthocyanins than the WT. Vascular- and root tip-specific PGI1 expression countered the reduced photosynthesis, low MEP pathway-derived CK content, dwarf phenotype and the metabolic characteristics of pgi1-2 plants, reverting them to WT-like levels. Moreover, pgl3-1, but not pfk4pfk5 plants phenocopied pgi1-2. Histochemical analyses of plants expressing GUS under the control of promoter regions of genes encoding plastidial OPPP enzymes exhibited strong GUS activity in root tips and vascular tissues. Overall, our findings show that root tip and vascular PGI1-mediated plastidial OPPP activity affects photosynthesis and growth through mechanisms involving long-distance modulation of the leaf proteome by MEP pathway-derived CKs.


Assuntos
Arabidopsis , Via de Pentose Fosfato , Antocianinas/metabolismo , Fotossíntese , Arabidopsis/metabolismo , Citocininas/metabolismo
8.
Proc Natl Acad Sci U S A ; 121(14): e2316101121, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38547068

RESUMO

Though YB6 and LaB6 share the same crystal structure, atomic valence electron configuration, and phonon modes, they exhibit drastically different phonon-mediated superconductivity. YB6 superconducts below 8.4 K, giving it the second-highest critical temperature of known borides, second only to MgB2. LaB6 does not superconduct until near-absolute zero temperatures (below 0.45 K), however. Though previous studies have quantified the canonical superconductivity descriptors of YB6's greater Fermi-level (Ef) density of states and higher electron-phonon coupling (EPC), the root of this difference has not been assessed with full detail of the electronic structure. Through chemical bonding, we determine low-lying, unoccupied 4f atomic orbitals in lanthanum to be the key difference between these superconductors. These orbitals, which are not accessible in YB6, hybridize with π B-B bonds and bring this π-system lower in energy than the σ B-B bonds otherwise at Ef. This inversion of bands is crucial: the optical phonon modes we show responsible for superconductivity cause the σ-orbitals of YB6 to change drastically in overlap, but couple weakly to the π-orbitals of LaB6. These phonons in YB6 even access a crossing of electronic states, indicating strong EPC. No such crossing in LaB6 is observed. Finally, a supercell (the M k-point) is shown to undergo Peierls-like effects in YB6, introducing additional EPC from both softened acoustic phonons and the same electron-coupled optical modes as in the unit cell. Overall, we find that LaB6 and YB6 have fundamentally different mechanisms of superconductivity, despite their otherwise near-identity.

9.
PLoS One ; 19(3): e0295368, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38507347

RESUMO

The World Health Organization has recommended a range of social and health measures to mitigate the spread of coronavirus disease 2019 (COVID-19), including strategies such as quarantines, border closures, social distancing, and mask usage, among others. Specifically, the Chilean authorities implemented the "step-by-step" plan, built on the concept of dynamic quarantine. Numerous studies have examined the effectiveness of these quarantines in Chile during the pandemic, utilizing data published by the Chilean Ministry of Health. This study's primary aim was to enhance our understanding of quarantine effectiveness in Chile during the pandemic. We accomplished this by analyzing the distributional behavior of the time until the COVID-19 pandemic was deemed under control or not. In our study, we defined an event with two potential outcomes related to the instantaneous reproductive number (Rt), which signifies the time until a change in the event outcome occurs. Importantly, we did not predefine a specific temporal observation unit. These findings allowed us to complement the concept of effective quarantine by considering the dynamics generated by the protocols, such as phase 1 of the quarantine, in achieving natural herd immunity in response to the number of COVID-19 cases and Rt. We assessed the behavior of the mean and median residual lifetime until the initiation of controlled/uncontrolled episodes of the COVID-19 pandemic based on Rt in all regions of Chile. Despite variations in the distribution of residual times for controlled/uncontrolled episodes in different regions, there was a similar observation during the period considered (between March 2020 and March 2021): the mitigation measures did not produce a clear positive effect for controlling the epidemic. The residual times of episodes with Rr,t > 1 were not different from those episodes with Rr,t ≤ 1.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Quarentena , Pandemias/prevenção & controle , Chile/epidemiologia , SARS-CoV-2
10.
Biomedicines ; 12(1)2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38255270

RESUMO

This research studies the dose-plasma level (PL) relationship of second-generation antipsychotics, together with the treatment outcomes achieved, in seriously ill people with schizophrenia. An observational, prospective, one-year follow-up study was carried out with patients (N = 68) with severe schizophrenia treated with paliperidone three-month (PP3M) or aripiprazole one-month (ARIM). Participants were divided into standard-dose or high-dose groups. PLs were divided into "standard PL" and "high PL" (above the therapeutic reference range, TRR) groups. The dose/PL relationship, and severity, hospitalizations, tolerability, compliance, and their relationship with doses and PLs were evaluated. There was no clear linear relationship between ARIM or PP3M doses and the PLs achieved. In half of the subjects, standard doses reached PLs above the TRR. The improvements in clinical outcomes (decrease in clinical severity and relapses) were related to high PLs, without worse treatment tolerability or adherence. All participants remained in the study, regardless of dose or PL. Clinical severity and hospitalizations decreased significantly more in those patients with high PLs. Considering the non-linear dose-PL relationship of ARIM and PP3M in people with severe schizophrenia, PLs above the TRR are linked to better treatment outcomes, without worse tolerability. The need in a notable number of cases for high doses to reach those effective PLs is highlighted.

11.
J Cogn Neurosci ; 36(3): 460-474, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38165746

RESUMO

Although it is well established that self-related information can rapidly capture our attention and bias cognitive functioning, whether this self-bias can affect language processing remains largely unknown. In addition, there is an ongoing debate as to the functional independence of language processes, notably regarding the syntactic domain. Hence, this study investigated the influence of self-related content on syntactic speech processing. Participants listened to sentences that could contain morphosyntactic anomalies while the masked face identity (self, friend, or unknown faces) was presented for 16 msec preceding the critical word. The language-related ERP components (left anterior negativity [LAN] and P600) appeared for all identity conditions. However, the largest LAN effect followed by a reduced P600 effect was observed for self-faces, whereas a larger LAN with no reduction of the P600 was found for friend faces compared with unknown faces. These data suggest that both early and late syntactic processes can be modulated by self-related content. In addition, alpha power was more suppressed over the left inferior frontal gyrus only when self-faces appeared before the critical word. This may reflect higher semantic demands concomitant to early syntactic operations (around 150-550 msec). Our data also provide further evidence of self-specific response, as reflected by the N250 component. Collectively, our results suggest that identity-related information is rapidly decoded from facial stimuli and may impact core linguistic processes, supporting an interactive view of syntactic processing. This study provides evidence that the self-reference effect can be extended to syntactic processing.


Assuntos
Potenciais Evocados , Percepção da Fala , Humanos , Potenciais Evocados/fisiologia , Idioma , Semântica , Linguística , Eletroencefalografia , Percepção da Fala/fisiologia
12.
RSC Adv ; 14(3): 2070-2079, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38196901

RESUMO

Our present study focuses on examining the thermal, structural and luminescent characteristics of sodium barium metaphosphate glasses doped with Sm3+. Glass samples with molar compositions (100 - y)[(50P2O5)-(50-xNa2O)-(xBaO)]-ySm2O3, where x = 20, 25, 30, 35, 40 and y = 0.3 and 1% were first synthesized by conventional melt quenching and later dehydroxylated under a constant N2 flow to ensure final glasses with a very high degree of chemical and optical homogeneity and free of water. Upon the addition of BaO and Sm2O3, refractive index, molar mass, density, glass transition temperature and dilatometric softening temperature exhibited an increase, whereas the coefficient of thermal expansion showed a decrease. The FTIR spectra analysis reveals a network depolymerization that intensifies with rising BaO concentration, ultimately transitioning from a modifier oxide to a glass-forming element, at higher BaO concentrations. All doped samples exhibited prominent absorption bands in the visible (VIS) and near-infrared (NIR) regions, as revealed by the optical absorption spectra. The Na2O modifier demonstrated greater influence on Sm3+ emission compared to BaO, a phenomenon that can explained by the moderation of the local ligand field strength resulting from this substitution. With an increase in Sm2O3 concentration from 0.3 to 1 mol%, the experimental lifetimes of the 4G5/2 level decrease, primarily attributed to the presence of energy transfer mechanisms. A discussion of Judd-Ofelt parameter analysis and glass radiation properties will be presented.

13.
Mol Biol Evol ; 41(2)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38285634

RESUMO

Rainforest hunter-gatherers from Southeast Asia are characterized by specific morphological features including a particularly dark skin color (D), short stature (S), woolly hair (W), and the presence of steatopygia (S)-fat accumulation localized in the hips (DSWS phenotype). Based on previous evidence in the Andamanese population, we first characterized signatures of adaptive natural selection around the calcium-sensing receptor gene in Southeast Asian rainforest groups presenting the DSWS phenotype and identified the R990G substitution (rs1042636) as a putative adaptive variant for experimental follow-up. Although the calcium-sensing receptor has a critical role in calcium homeostasis by directly regulating the parathyroid hormone secretion, it is expressed in different tissues and has been described to be involved in many biological functions. Previous works have also characterized the R990G substitution as an activating polymorphism of the calcium-sensing receptor associated with hypocalcemia. Therefore, we generated a knock-in mouse for this substitution and investigated organismal phenotypes that could have become adaptive in rainforest hunter-gatherers from Southeast Asia. Interestingly, we found that mouse homozygous for the derived allele show not only lower serum calcium concentration but also greater body weight and fat accumulation, probably because of enhanced preadipocyte differentiation and lipolysis impairment resulting from the calcium-sensing receptor activation mediated by R990G. We speculate that such differential features in humans could have facilitated the survival of hunter-gatherer groups during periods of nutritional stress in the challenging conditions of the Southeast Asian tropical rainforests.


Assuntos
Polimorfismo Genético , Receptores de Detecção de Cálcio , Animais , Humanos , Camundongos , Cálcio , Fenótipo , Receptores de Detecção de Cálcio/genética , Seleção Genética
14.
J Proteome Res ; 23(2): 560-573, 2024 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-38252700

RESUMO

One of the primary goals of systems medicine is the detection of putative proteins and pathways involved in disease progression and pathological phenotypes. Vascular cognitive impairment (VCI) is a heterogeneous condition manifesting as cognitive impairment resulting from vascular factors. The precise mechanisms underlying this relationship remain unclear, which poses challenges for experimental research. Here, we applied computational approaches like systems biology to unveil and select relevant proteins and pathways related to VCI by studying the crosstalk between cardiovascular and cognitive diseases. In addition, we specifically included signals related to oxidative stress, a common etiologic factor tightly linked to aging, a major determinant of VCI. Our results show that pathways associated with oxidative stress are quite relevant, as most of the prioritized vascular cognitive genes and proteins were enriched in these pathways. Our analysis provided a short list of proteins that could be contributing to VCI: DOLK, TSC1, ATP1A1, MAPK14, YWHAZ, CREB3, HSPB1, PRDX6, and LMNA. Moreover, our experimental results suggest a high implication of glycative stress, generating oxidative processes and post-translational protein modifications through advanced glycation end-products (AGEs). We propose that these products interact with their specific receptors (RAGE) and Notch signaling to contribute to the etiology of VCI.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Demência Vascular , Humanos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/genética , Estresse Oxidativo , Cognição , Demência Vascular/genética , Demência Vascular/diagnóstico
15.
J Arthroplasty ; 39(2): 374-378, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37598778

RESUMO

BACKGROUND: To assess any clinically important difference in functional outcome over 10 years after primary total knee arthroplasty (TKA). METHODS: A prospective registry-based observational cohort study including 309 patients older than 60 years who underwent primary TKA. Patients were assessed at 1, 3, 5, 7 and 10 postoperative years with the Knee Society scores (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Clinically important improvement was defined according to the minimal clinically important difference (MCID). Patients were also categorized as type A (unilateral knee osteoarthritis), type B (bilateral knee osteoarthritis) or type C (various sites of osteoarthritis). RESULTS: The mean age at the TKA surgery was 69.2 (SD 7.3) years, 197 (63.7%) were women.Maximum postoperative improvements in functional scores occurred at 3 postoperative years, remained relatively stable up to 5-year. There were significant decreases in all KSS and WOMAC scores at 7-year follow-up (P = .001), remained stable up to 10-year. At 10-year, functional scores were significantly higher than preoperatively (P = .001). Differences between maximum scores at 3-year and those at 10-year were significantly lesser than MCID in all scores (P = .001). In multivariate analysis, type-C patient at TKA surgery was the only significant predictor of unsuccessful KSS score and dissatisfaction at 10-year follow-up. CONCLUSION: Primary TKA provides clinically important improvements in functional and quality of life outcomes over 10-year follow-up compared to preoperatively. Although there were statistically significant declines in KSS and WOMAC scores from 3 to 10 years, the differences were lesser than the MCID.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Humanos , Feminino , Idoso , Masculino , Osteoartrite do Joelho/cirurgia , Qualidade de Vida , Estudos Longitudinais , Resultado do Tratamento , Articulação do Joelho/cirurgia
16.
Alzheimers Dement ; 20(1): 538-548, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37727082

RESUMO

INTRODUCTION: This study examined the relationship between blood-brain-barrier permeability (BBBp), measured by cerebrospinal fluid/serum albumin ratio (QAlb), and cognitive decline progression in a clinical cohort. METHODS: This prospective observational study included 334 participants from the BIODEGMAR cohort. Cognitive decline progression was defined as an increase in Global Deterioration Scale and/or Clinical Dementia Rating scores. Associations between BBBp, demographics, and clinical factors were explored. RESULTS: Male sex, diabetes mellitus, and cerebrovascular burden were associated with increased log-QAlb. Vascular cognitive impairment patients had the highest log-QAlb levels. Among the 273 participants with valid follow-up data, 154 (56.4%) showed cognitive decline progression. An 8% increase in the hazard of clinical worsening was observed for each 10% increase in log-QAlb. DISCUSSION: These results suggest that increased BBBp in individuals with cognitive decline may contribute to clinical worsening, pointing to potential targeted therapies. QAlb could be a useful biomarker for identifying patients with a worse prognosis.


Assuntos
Barreira Hematoencefálica , Disfunção Cognitiva , Humanos , Masculino , Estudos Longitudinais , Encéfalo , Permeabilidade
17.
Genet Med ; 26(1): 100991, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37791544

RESUMO

PURPOSE: We conducted qualitative interviews with patients with cancer and providers to identify gaps in clinical care and highlight care delivery solutions for the return of secondary germline findings. METHODS: Twelve patients and 19 cancer providers from the United States were interviewed between January 2019 and May 2021. Interviews elicited feedback about patient information needs, emotional responses to secondary findings, and recommendations for improving pre-test education. RESULTS: Patients' responses ranged from gratitude to regret, depending on how much pre-test counseling they received before tumor testing. Providers cited insufficient clinic time as a major barrier to pretest education, favoring online support tools and standardized pre-test education models. Providers had differing perspectives on how pre-test education should be integrated into clinical workflows but agreed that it should include the differences between somatic and germline testing, the likelihood of medically actionable findings, and the possibility of being referred to a genetics provider. CONCLUSION: The spectrum of participants' responses to their secondary findings underscores the importance of adequate pre-test discussions before somatic sequencing. Although educational interventions could address patients' information needs and augment traditional pre-test counseling, health care systems, labs, and genetic providers may be called on to play greater roles in pre-test education.


Assuntos
Neoplasias , Humanos , Estados Unidos , Neoplasias/genética , Neoplasias/terapia , Atenção à Saúde
18.
Chem Mater ; 35(22): 9591-9602, 2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38047182

RESUMO

Materials based on spin crossover (SCO) molecules have centered the attention in molecular magnetism for more than 40 years as they provide unique examples of multifunctional and stimuli-responsive materials, which can be then integrated into electronic devices to exploit their molecular bistability. This process often requires the preparation of thermally stable SCO molecules that can sublime and remain intact in contact with surfaces. However, the number of robust sublimable SCO molecules is still very scarce. Here, we report a novel example of this kind. It is based on a neutral iron(II) coordination complex formulated as [Fe(neoim)2], where neoimH is the ionogenic ligand 2-(1H-imidazol-2-yl)-9-methyl-1,10-phenanthroline. In the first part, a comprehensive study, which covers the synthesis and magnetostructural characterization of the [Fe(neoim)2] complex as a bulk microcrystalline material, is reported. Then, in the second part, we investigate the suitability of this material to form thin films through high-vacuum sublimation. Finally, the retainment of all present SCO capabilities in the bulk when the material is processed is thoroughly studied by means of X-ray absorption spectroscopy. In particular, a very efficient and fast light-induced spin transition (LIESST effect) has been observed, even for ultrathin films of 15 nm.

19.
Cienc. act. fís. (Talca, En línea) ; 24(2): 1-18, dic. 2023. tab
Artigo em Espanhol | LILACS | ID: biblio-1528266

RESUMO

La aplicación de las políticas públicas deportivas locales (PPDL) de la comuna de Linares se han visualizado gracias a la aplicación del Plan de Desarrollo Comunal de Actividad Física y Deportes (PDC AFyD) en el período 2018 - 2022 en la comunidad y las organizaciones deportivas locales (OODD), así como de funcionarios del propio municipio. Para conocer la percepción sobre la aplicación de PPDL se aplica una entrevista semiestructurada y confeccionada para tales efectos, a 28 dirigentes deportivos y 18 funcionarios municipales, de un universo muestral total de 127 posibles. Los individuos indican que, pese a ver cambios favorables en el período desconocen el proceso y, por ende, el mecanismo aplicado para el cambio, lo que despotencia la comprensión de la PPDL y el desarrollo de ésta por medio de las propias OODD y el municipio. La aplicación de las PPDL por medio de sus distintas herramientas e instrumentos requiere que se desarrolle bajo un proceso de consulta, pertinencia y complementación entre municipio, OODD, mundo educativo y vecinos beneficiarios; todo dentro de un marco de comunicación e información concreta y permanente que logre involucrar a todos los actores, brindando con ello una cuota de responsabilidad en su ejecución, control y evaluación.


The application of local public policies on sports (LPSP) of the commune of Linares has been visualized thanks to the application of the Communal Development Plan for Physical Activity and Sports (CDP PA&S) in the period 2018 - 2022 in the community and local sports organizations (LSO), as well as officials of the municipality itself. To know the perception of the implementation of LPSP, a semi-structured interview was applied to 28 sports leaders and 18 municipal officials out of a total sample universe of 127 possible. The individuals indicate that, despite seeing favorable changes in the period, they are unaware of the process and, therefore, the mechanism applied for change, which undermines the understanding of the LPSP and its development through the LSOO and the municipality. The application of the LPSP through its different tools and instruments requires that it be developed under a process of consultation, relevance, and complementarity between the municipality, LSOO, the educational world and beneficiary neighbors; all under a framework of communication and concrete and permanent information that manages to involve all the actors, thus providing a share of responsibility in its execution, control, and evaluation.


A implementação das políticas esportivas públicas locais (PEPL) na comuna de Linares foi visualizada graças à implementação do Plano de Desenvolvimento Comunitário para Atividade Física e Esporte (PDC AFyE) no período 2018 - 2022 na comunidade e organizações esportivas locais (OOEE), bem como funcionários do próprio município. Foi realizada uma entrevista semi-estruturada com 28 líderes esportivos e 18 funcionários municipais de um universo de amostra total de 127. Os indivíduos indicam que, apesar de verem mudanças favoráveis no período, não conhecem o processo e, portanto, o mecanismo aplicado para a mudança, o que prejudica a compreensão do PEPL e seu desenvolvimento através do OOEE e do próprio município. A implementação do PEPL através de suas diferentes ferramentas e instrumentos requer um processo de consulta, relevância e complementaridade entre o município, o OOEE, o mundo educacional e os vizinhos beneficiários; tudo isso dentro de uma estrutura de comunicação e informação concreta e permanente que envolva todos os atores, proporcionando assim uma parcela de responsabilidade em sua implementação, controle e avaliação.


Assuntos
Humanos , Masculino , Feminino , Política Pública , Exercício Físico , Categorias de Trabalhadores/legislação & jurisprudência , Planejamento Social , Esportes , Características de Residência , Epidemiologia Descritiva , Crescimento e Desenvolvimento
20.
Ther Adv Psychopharmacol ; 13: 20451253231220907, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38152569

RESUMO

Background: Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. Objectives: To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. Methods: The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). Results: At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. Conclusion: Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA