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1.
Clin Kidney J ; 17(6): sfae140, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38835512

RESUMO

Background: Albuminuria could potentially emerge as a novel marker of congestion in acute heart failure. However, the current evidence linking albuminuria and congestion in patients with congestive heart failure (CHF) remains somewhat scarce. This study aimed to evaluate the prevalence of albuminuria in a cohort of patients with CHF, identify the independent factors associated with albuminuria and analyse the correlation with different congestion parameters. Methods: This is a subanalysis of the Spanish Cardiorenal Registry, in which we enrolled 864 outpatients with heart failure and a value of urinary albumin:creatinine ratio (UACR) at the first visit. Results: The median age was 74 years, 549 (63.5%) were male and 438 (50.7%) had a reduced left ventricular ejection fraction. A total of 350 patients (40.5%) had albuminuria. Among these patients, 386 (33.1%) had a UACR of 30-300 mg/g and 64 (7.4%) had a UACR >300 mg/g. In order of importance, the independent variables associated with higher UACR were estimated glomerular filtration rate determined by the Chronic Kidney Disease Epidemiology Collaboration equation (R2 = 57.6%), systolic blood pressure (R2 = 21.1%), previous furosemide equivalent dose (FED; R2 = 7.5%), antigen carbohydrate 125 (CA125; R2 = 6.1%), diabetes mellitus (R2 = 5.6%) and oedema (R2 = 1.9%). The combined influence of oedema, elevated CA125 levels and the FED accounted for 15.5% of the model's variability. Conclusions: In patients with chronic stable heart failure, the prevalence of albuminuria is high. The risk factors of albuminuria in this population are chronic kidney disease and hypertension. Congestion parameters are also associated with increased albuminuria.

2.
Actas Esp Psiquiatr ; 52(3): 192-203, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38863054

RESUMO

BACKGROUND: Treatment of Substance Use Disorder (SUD) is complex and therefore including patients in the therapeutic process is needed. Patient-Centered Care (PCC) and Shared Decision-Making (SDM) have been associated with greater satisfaction, self-control, and less substance use. However, correlates of SDM have not been investigated in this population. METHOD: A cross-sectional analysis was carried out in 214 SUD patients to identify sociodemographic, clinical and psychological correlates of preferences and perceptions about participation in SDM and degree of activation. The Control Preference Scale (CPS), the Shared Decision-Making Questionnaire (SDM-9-Q) and the Patient Activation Measure (PAM) were used to assess the PCC elements. Multinomial logistic regression was used to analyze the correlates of the CPS variables (preferred role, perceived role, and role matching). For SDM-9-Q and PAM, multilevel linear regression was used. RESULTS: Preferring an active role, compared to a shared one, was significantly associated with higher educational level, lower neuroticism, absence of affective and alcohol use disorders, and higher quality of life. Perceiving greater participation was significantly associated with not being a new patient, having fewer legal problems, higher severity of alcohol consumption, not presenting polydrug use and main substance use different than opioids or sedatives. Activation was associated with higher scores in the personality trait activity, a preference for an active role and greater perception of being involved in the decision process. CONCLUSIONS: Patients with milder clinical profiles prefer an active role compared to a shared one. Patients who prefer or perceive a shared or passive role did not show relevant differences. Greater activation was related to preference for an active role and the perception of having been involved in decisions.


Assuntos
Participação do Paciente , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estudos Transversais , Masculino , Transtornos Relacionados ao Uso de Substâncias/psicologia , Feminino , Participação do Paciente/psicologia , Adulto , Pessoa de Meia-Idade , Preferência do Paciente/psicologia , Tomada de Decisão Compartilhada , Assistência Centrada no Paciente , Tomada de Decisões , Inquéritos e Questionários
3.
J Biotechnol ; 391: 72-80, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-38876311

RESUMO

The lipase from Prunus dulcis almonds was inactivated under different conditions. At pH 5 and 9, enzyme stability remained similar under the different studied buffers. However, when the inactivation was performed at pH 7, there were some clear differences on enzyme stability depending on the buffer used. The enzyme was more stable in Gly than when Tris was employed for inactivation. Then, the enzyme was immobilized on methacrylate beads coated with octadecyl groups at pH 7 in the presence of Gly, Tris, phosphate and HEPES. Its activity was assayed versus triacetin and S-methyl mandelate. The biocatalyst prepared in phosphate was more active versus S-methyl mandelate, while the other ones were more active versus triacetin. The immobilized enzyme stability at pH 7 depends on the buffer used for enzyme immobilization. The buffer used in the inactivation and the substrate used determined the activity. For example, glycine was the buffer that promoted the lowest or the highest stabilities depending on the substrate used to quantify the activities.


Assuntos
Estabilidade Enzimática , Enzimas Imobilizadas , Lipase , Prunus dulcis , Enzimas Imobilizadas/química , Enzimas Imobilizadas/metabolismo , Lipase/química , Lipase/metabolismo , Prunus dulcis/química , Prunus dulcis/enzimologia , Soluções Tampão , Concentração de Íons de Hidrogênio , Triacetina/química , Triacetina/metabolismo , Glicina/química , Glicina/metabolismo , Trometamina/química , Biocatálise , Especificidade por Substrato , Fosfatos/química , Fosfatos/metabolismo , HEPES/química
4.
Int J Biol Macromol ; 273(Pt 2): 133089, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38878936

RESUMO

This review shows the endeavors performed to prepare immobilized formulations of bromelain extract, usually from pineapple, and their use in diverse applications. This extract has a potent proteolytic component that is based on thiol proteases, which differ depending on the location on the fruit. Stem and fruit are the areas where higher activity is found. The edible origin of this enzyme is one of the features that determines the applications of the immobilized bromelain to a more significant degree. The enzyme has been immobilized on a wide diversity of supports via different strategies (covalent bonds, ion exchange), and also forming ex novo solids (nanoflowers, CLEAs, trapping in alginate beads, etc.). The use of preexisting nanoparticles as immobilization supports is relevant, as this facilitates one of the main applications of the immobilized enzyme, in therapeutic applications (as wound dressing and healing components, antibacterial or anticancer, mucus mobility control, etc.). A curiosity is the immobilization of this enzyme on spores of probiotic microorganisms via adsorption, in order to have a perfect in vivo compatibility. Other outstanding applications of the immobilized enzyme are in the stabilization of wine versus haze during storage, mainly when immobilized on chitosan. Curiously, the immobilized bromelain has been scarcely applied in the production of bioactive peptides.


Assuntos
Bromelaínas , Enzimas Imobilizadas , Bromelaínas/química , Bromelaínas/metabolismo , Enzimas Imobilizadas/química , Enzimas Imobilizadas/metabolismo , Ananas/enzimologia , Ananas/química , Nanopartículas/química
5.
Bioengineering (Basel) ; 11(5)2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38790366

RESUMO

This study aimed to evaluate the inter-examiner reliability of shear wave elastography (SWE) for measuring cervical multifidus (CM) muscle stiffness in asymptomatic controls and patients with chronic neck pain. A longitudinal observational study was conducted to assess the diagnostic accuracy of a procedure. SWE images, following a detailed procedure previously tested, were acquired by two examiners (one novice and one experienced) to calculate the shear wave speed (SWS) and Young's modulus. The painful side was examined for the experimental cases while the side examined in the control group was selected randomly. Data analyses calculated the intra-class correlation coefficients (ICCs), absolute errors between examiners, standard errors of measurement, and minimal detectable changes. A total of 125 participants were analyzed (n = 54 controls and n = 71 cases). The Young's modulus and SWS measurements obtained by both examiners were comparable within the asymptomatic group (both, p > 0.05) and the chronic neck pain group (both, p > 0.05). Nonetheless, a notable distinction was observed in the absolute error between examiners for shear wave speed measurements among patients with neck pain, where a significant difference was registered (p = 0.045), pointing to a sensitivity in measurement consistency affected by the presence of chronic neck pain. ICCs demonstrated moderate-to-good reliability across both groups, with ICC values for asymptomatic individuals reported as >0.8. Among the chronic neck pain patients, ICC values were slightly lower (>0.780). The study revealed moderate-to-good consistency, highlighting the practicality and generalizability of SWE.

6.
Front Public Health ; 12: 1320159, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38633230

RESUMO

Aim: To assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders. Methods: An open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interventions. The intervention for psychiatrists (PsI) included an educational program based on a patient-centered care model. The intervention for patients and relatives (PtI) included a collaborative care program plus a reminder system that works using an already available medication reminder application. The primary outcome was patient adherence to antidepressant treatment assessed through the Sidorkiewicz Adherence Instrument. Secondary measures were depression severity, comorbid anxiety and health-related quality of life. Mixed regression models with repeated measures were used for data analysis. Results: Ten psychiatrists and 150 patients diagnosed with depressive disorder from eight Community Mental Health Units in the Canary Islands (Spain) were included. Compared with usual care, no differences in long-term adherence were observed in either group PsI or PtI. The PsI group had significantly improved depression symptoms (B = -0.39; 95%CI: -0.65, -0.12; p = 0.004) during the follow-up period. The PtI group presented improved depression symptoms (B = -0.63; 95%CI: -0.96, -0.30; p < 0.001) and mental quality of life (B = 0.08; 95%CI: 0.004, 0.15; p = 0.039) during the follow-up period. Conclusion: The assessed interventions to improve adherence in patients with depressive disorder were effective for depression symptoms and mental quality of life, even over the long term. However, no effect on antidepressant adherence was observed.


Assuntos
Transtorno Depressivo , Qualidade de Vida , Humanos , Antidepressivos/uso terapêutico , Adesão à Medicação , Terapia Comportamental
7.
Rev. crim ; 66(1): 47-58, 20240412. Tab, Ilus
Artigo em Espanhol | LILACS | ID: biblio-1553810

RESUMO

El presente estudio tuvo como propósito principal determinar la relación entre la ansiedad y las estrategias de afrontamiento empleadas por personas privadas de la libertad (PPL) en el EPMSC Establecimiento de Reclusión Especial Barranquilla-Cárcel del Bosque. Para ello se siguió una ruta de investigación cuantitativa, de diseño no experimental, transversal y de alcance correlacional. La muestra estuvo conformada por 98 PPL, en edades entre 19 y 73 años, a quienes se aplicaron los instrumentos Escala de Valoración de la Ansiedad de Hamilton y Escala de Estrategias de Afrontamiento de Coping Modificada. Los resultados señalan niveles moderados de ansiedad, siendo los PPL más jóvenes (19-27 años) los que presentan mayor ansiedad psíquica; las personas mayores de 50 años tienden más a buscar solución a los problemas. Se concluye que a mayores niveles de ansiedad mayor relación con la estrategia de afrontamiento reacción agresiva.


The main purpose of this study was to determine the relationship between anxiety and the coping strategies employed by persons deprived of liberty (PPL) in the EPMSC Establecimiento de Reclusión Especial Barranquilla-Cárcel del Bosque. For this purpose, a quantitative, non-experimental, cross-sectional and correlational research route was followed. The sample consisted of 98 PPL, aged between 19 and 73 years, who were administered the Hamilton Anxiety Rating Scale and the Modified Coping Strategies Scale of Coping Modified. The results indicate moderate levels of anxiety, with younger PPL (19-27 years old) showing higher levels of psychological anxiety; people over 50 years old tend more to seek solutions to problems. It is concluded that the higher the level of anxiety, the greater the relationship with the coping strategy aggressive reaction.


O principal objetivo deste estudo foi determinar a relação entre ansiedade e estratégias de enfrentamento usadas por pessoas privadas de liberdade (PPL) no EPMSC Establecimiento de Reclusión Especial Barranquilla-Cárcel del Bosque. Para isso, foi seguido um roteiro de pesquisa quantitativo, não experimental, transversal e correlacional. A amostra consistiu em 98 PPL, com idades entre 19 e 73 anos, que receberam a Escala de Avaliação de Ansiedade de Hamilton e a Escala de Estratégias de Enfrentamento Modificada de Enfrentamento Modificada. Os resultados indicam níveis moderados de ansiedade, sendo que as PPL mais jovens (19 a 27 anos) apresentam níveis mais altos de ansiedade psicológica; as pessoas com mais de 50 anos tendem a buscar mais soluções para os problemas. Conclui-se que quanto maior o nível de ansiedade, maior a relação com a estratégia de enfrentamento reação agressiva.


Assuntos
Humanos
10.
Transpl Infect Dis ; 26(2): e14250, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38375958

RESUMO

BACKGROUND AND METHODS: Heart transplant recipients (HTr) have a higher probability of suffer from severe coronavirus disease-2019 (COVID-19) in comparison to general population, but their risk has changed over the course of the pandemic in relation to various factors. We conducted a prospective study including all HTr at risk of COVID-19 in a tertiary center between February 2020 and October 2022. The aim was to analyze how the prognosis (incidence of pneumonia and mortality) of COVID-19 in HTr has evolved over time, contextualizing variants, vaccination, and other treatments. RESULTS: Of 308 HTr included, 124 got the infection (39.2%). COVID and non-COVID HTr had similar baseline characteristics. COVID-19 patients with pneumonia had a poorer prognosis than those with less severe presentations, with a higher rate of hospitalization (93.3 vs. 14.1%, p < .001) and death (41.0 vs. 1.2%, p < .001). Multivariate analysis identified age ≥60 years (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.16-11.49, p = .027), and chronic kidney disease ≥3a (OR 4.95, 95% CI 1.39-17.54, p = .014) as predictors of pneumonia. Two-dose vaccination (OR 0.20, CI 95% 0.05-0.72, p = .02) and early remdesivir administration (OR 0.17, CI 0.03-0.90, p = .037) were protective factors. Over the course of the pandemic considering three periods in the follow-up (prevaccination February-December 2020, postvaccination January-December 2021, and post early remdesivir indication January-October 2022), we observed a reduction in pneumonia incidence from 62% to 19% (p < .001); and mortality (from 23% to 4%, p < .001). CONCLUSIONS: The prognosis of COVID-19 in HTr has improved over time, likely due to vaccination and early administration of remdesivir.


Assuntos
COVID-19 , Transplante de Coração , Humanos , Pessoa de Meia-Idade , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias , SARS-CoV-2 , Estudos Prospectivos , Transplante de Coração/efeitos adversos , Transplantados
11.
JAMA Netw Open ; 7(1): e2352377, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38261321

RESUMO

Importance: Out-of-hospital cardiac arrest (OHCA) health care provision may be a good indicator of the recovery of the health care system involved in OHCA care following the COVID-19 pandemic. There is a lack of data regarding outcomes capable of verifying this recovery. Objective: To determine whether return to spontaneous circulation, overall survival, and survival with good neurological outcome increased in patients with OHCA since the COVID-19 pandemic was brought under control in 2022 compared with prepandemic and pandemic levels. Design, Setting, and Participants: This observational cohort study was conducted to examine health care response and survival with good neurological outcome at hospital discharge in patients treated following OHCA. A 3-month period, including the first wave of the pandemic (February 1 to April 30, 2020), was compared with 2 periods before (April 1, 2017, to March 31, 2018) and after (January 1 to December 31, 2022) the pandemic. Data analysis was performed in July 2023. Emergency medical services (EMS) serving a population of more than 28 million inhabitants across 10 Spanish regions participated. Patients with OHCA were included if participating EMS initiated resuscitation or continued resuscitation initiated by a first responder. Exposure: The pandemic was considered to be under control following the official declaration that infection with SARS-CoV-2 was to be considered another acute respiratory infection. Main Outcome and Measures: The main outcomes were return of spontaneous circulation, overall survival, and survival at hospital discharge with good neurological outcome, expressed as unimpaired or minimally impaired cerebral performance. Results: A total of 14 732 patients (mean [SD] age, 64.2 [17.2] years; 10 451 [71.2%] male) were included, with 6372 OHCAs occurring during the prepandemic period, 1409 OHCAs during the pandemic period, and 6951 OHCAs during the postpandemic period. There was a higher incidence of OHCAs with a resuscitation attempt in the postpandemic period compared with the pandemic period (rate ratio, 4.93; 95% CI, 4.66-5.22; P < .001), with lower incidence of futile resuscitation for OHCAs (2.1 per 100 000 person-years vs 1.3 per 100 000 person-years; rate ratio, 0.81; 95% CI, 0.71-0.92; P < .001). Recovery of spontaneous circulation at hospital admission increased from 20.5% in the pandemic period to 30.5% in the postpandemic period (relative risk [RR], 1.08; 95% CI, 1.06-1.10; P < .001). In the same way, overall survival at discharge increased from 7.6% to 11.2% (RR, 1.45; 95% CI, 1.21-1.75; P < .001), with 6.6% of patients being discharged with good neurological status (Cerebral Performance Category Scale categories 1-2) in the pandemic period compared with 9.6% of patients in the postpandemic period (RR, 1.07; 95% CI, 1.04-1.10; P < .001). Conclusions and Relevance: In this cohort study, survival with good neurological outcome at hospital discharge following OHCA increased significantly after the COVID-19 pandemic.


Assuntos
COVID-19 , Parada Cardíaca Extra-Hospitalar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Coortes , COVID-19/epidemiologia , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/terapia , Pandemias , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais
12.
Rev Esp Cardiol (Engl Ed) ; 77(1): 50-59, 2024 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37217135

RESUMO

INTRODUCTION AND OBJECTIVES: Patients with combined heart failure (HF) and chronic kidney disease (CKD) have been underrepresented in clinical trials. The prevalence of CKD in these patients and their clinical profile require constant evaluation. This study aimed to analyze the prevalence of CKD, its clinical profile, and patterns of use of evidence-based medical therapies in HF across CKD stages in a contemporary cohort of ambulatory patients with HF. METHODS: From October 2021 to February 2022, the CARDIOREN registry included 1107 ambulatory HF patients from 13 HF clinics in Spain. RESULTS: The median age was 75 years, 63% were male, and 48% had heart failure with reduced left ventricular ejection fraction (HFrEF). A total of 654 (59.1%) had an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and 122 (11%) patients with eGFR ≥ 60 mL/min/1.73 m2 had a urine albumin-creatinin ratio ≥ 30 mg/g. The most important variables associated with lower eGFR were age (R2=61%) and furosemide dose (R2=21%). The proportion of patients receiving an angiotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blockers (ARB), an angiotensin receptor-neprilysin inhibitor (ARNi), a sodium-glucose cotransporter 2 inhibitor (SGLT2i), or a mineralocorticoid receptor antagonist (MRA) progressively decreased with lower eGFR categories. Notably, 32% of the patients with HFrEF and an eGFR <30 mL/min/1.73 m2 received the combination of ACEI/ARB/ARNi+beta-blockers+MRA+SGLT2i. CONCLUSIONS: In this contemporary HF registry, 70% of patients had kidney disease. Although this population is less likely to receive evidence-based therapies, structured and specialized follow-up approaches within HF clinics may facilitate the adoption of these life-saving drugs.


Assuntos
Insuficiência Cardíaca , Insuficiência Renal Crônica , Humanos , Masculino , Idoso , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Volume Sistólico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Prevalência , Função Ventricular Esquerda , Doença Crônica , Antagonistas de Receptores de Mineralocorticoides/uso terapêutico , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Sistema de Registros
13.
Angew Chem Int Ed Engl ; 63(8): e202314773, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38055325

RESUMO

Molecular Dynamics (MD) simulations constitute a powerful tool that provides a 3D perspective of the dynamical behavior of chemical systems. Herein the first MD study of the dynamics of a catalytic organometallic system, in micellar media, is presented. The challenging methane catalytic functionalization into ethyl propionate through a silver-catalyzed process has been targeted as the case study. The intimate nature of the micelles formed with the surfactants sodium dodecylsulfate (SDS) and potassium perfluorooctane sulfonate (PFOS) has been ascertained, as well as the relative distribution of the main actors in this transformation, namely methane, the diazo reagent and the silver catalyst, the latter in two different forms: the initial compound and a silver-carbene intermediate. Catalyst deactivation occurs with halide containing surfactants dodecyltrimethylammonium chloride (DTAC) and Triton X-100. Computed simulations allow explaining the experimental results, indicating that micelles behave differently regarding the degree of accumulation and the local distribution of the reactants and their effect in the molecular collisions leading to net reaction.

14.
Biotechnol Prog ; 40(1): e3394, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37828788

RESUMO

In this article, we have analyzed the interactions between enzyme crowding on a given support and its chemical modification (ethylenediamine modification via the carbodiimide route and picryl sulfonic (TNBS) modification of the primary amino groups) on the enzyme activity and stability. Lipase from Thermomyces lanuginosus (TLL) and lipase B from Candida antarctica (CALB) were immobilized on octyl-agarose beads at two very different enzyme loadings, one of them exceeding the capacity of the support, one well under this capacity. Chemical modifications of the highly loaded and lowly loaded biocatalysts gave very different results in terms of activity and stability, which could increase or decrease enzyme activity depending on the enzyme support loading. For example, both lowly loaded biocatalysts increased their activity after modification while the effect was the opposite for the highly loaded biocatalysts. Additionally, the modification with TNBS of highly loaded CALB biocatalyst increased its stability while decrease the activity.


Assuntos
Enzimas Imobilizadas , Lipase , Lipase/metabolismo , Enzimas Imobilizadas/metabolismo , Proteínas Fúngicas/metabolismo , Sefarose , Estabilidade Enzimática
15.
Chemistry ; 30(14): e202303939, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38116945

RESUMO

Performing transition metal-catalyzed reactions in cells and living systems has equipped scientists with a toolbox to study biological processes and release drugs on demand. Thus far, an impressive scope of reactions has been performed in these settings, but many are yet to be introduced. Nitrene transfer presents a rather unexplored new-to-nature reaction. The reaction products are frequently encountered motifs in pharmaceuticals, presenting opportunities for the controlled, intracellular synthesis of drugs. Hence, we explored the transition metal-catalyzed sulfimidation reaction in water for future in vivo application. Two Cu(I) complexes containing trispyrazolylborate ligands (Tpx ) were selected, and the catalytic system was evaluated with the aid of three fitness factors. The excellent nitrene transfer reactivity and high chemoselectivity of the catalysts, coupled with good biomolecule compatibility, successfully enabled the sulfimidation of thioethers in aqueous media. We envision that this copper-catalyzed sulfimidation reaction could be an interesting starting point to unlock the potential of nitrene transfer catalysis in vivo.

16.
Toxics ; 11(10)2023 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-37888671

RESUMO

The contexts where there are mining and agriculture activities are potential sources of risk to human health due to contamination by chemical mixtures. These contexts are frequent in several Colombian regions. This study explored the potential association between the frequency of micronuclei and pesticides and elements in regions with ferronickel (Montelibano, Córdoba) and gold (Nechí, Antioquia) mining, and a closed native mercury mine (Aranzazu, Caldas), with an emphasis in the potential effect of selenium as a potential chelator. A cross-sectional study was carried out with 247 individuals. Sociodemographic, occupational, and toxicological variables were ascertained. Blood and urine samples were taken for pesticide analysis (5 organophosphates, 4 organochlorines, and 3 carbamates), 68 elements were quantified in hair, and micronuclei were quantified in lymphocytes. The mixtures of elements were grouped through principal component analysis. Prevalence ratios were estimated with robust variance Poisson regressions to explore associations. Interactions of selenium with toxic elements were explored. The highest concentrations of elements were in the active mines. The potentially most toxic chemical mixture was observed in the ferronickel mine. Pesticides were detected in a low proportion of participants (<2.5%), except paraoxon-methyl in blood (27.55%) in Montelibano and paraoxon-ethyl in blood (18.81%) in Aranzazu. The frequency of micronuclei was similar in the three mining contexts, with means between 4 to 7 (p = 0.1298). There was great heterogeneity in the exposure to pesticides and elements. The "hormetic effect" of selenium was described, in which, at low doses, it acts as a chelator in Montelibano and Aranzazu, and at high doses, it can enhance the toxic effects of other elements, maybe as in Nechí. Selenium can serve as a protective agent, but it requires adaptation to the available concentrations in each region to avoid its toxic effects.

17.
Front Cardiovasc Med ; 10: 1255503, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37859684

RESUMO

There is a growing interest in the evaluation of tricuspid regurgitation due to its increasing prevalence and detrimental impact on clinical outcomes. Historically, it has been coined the "forgotten" defect in the field of valvular heart disease due to the lack of effective treatments to improve prognosis. However, the development of percutaneous treatment techniques has led to a new era in its management, with promising results and diminished complication risk. In spite of these advances, a comprehensive exploration of the pathophysiological mechanisms is essential to establish clear indications and optimal timing for medical and percutaneous intervention. This review will address the most important aspects related to the diagnosis, pathophysiology and treatment of tricuspid regurgitation from a cardiorenal perspective, with a special emphasis on the interaction between right ventricular dysfunction and the development of hepatorenal congestion.

18.
Psychiatry Res ; 329: 115540, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37857131

RESUMO

Patient-centered care in therapeutic processes has been associated with better clinical outcomes, however, it remains a poorly studied aspect in Substance Use Disorder (SUD). The study aimed to evaluate patient's preferences, perceived participation in treatment decisions and activation level; and how they predict retention, pharmacological adherence and substance use during one-year follow-up. Logistic regression models were used to analyze the association between independent variables, along with a wide number of sociodemographic and clinical covariates, and outcomes. Most patients prefer a shared or passive role when making decisions about their treatment, and showed concordance between their preferred and perceived roles. In the univariate models, perceiving more involvement than desired showed a higher likelihood of treatment discontinuation at 12 months, and substance use at 6 and 12 months. No significant associations were found between the remaining decisional variables or the degree of activation with the assessed outcomes. A majority of SUD patients prefer and perceive to be involved in the decision-making process about their treatment. Patients perceiving more involvement than desired might experience an excess of responsibility that could negatively influence treatment continuation and substance use. Limitations of the study preclude any definitive conclusion, and more research is needed to confirm these results.


Assuntos
Tomada de Decisão Compartilhada , Transtornos Relacionados ao Uso de Substâncias , Humanos , Seguimentos , Tomada de Decisões , Participação do Paciente , Transtornos Relacionados ao Uso de Substâncias/terapia , Relações Médico-Paciente
19.
IEEE Trans Vis Comput Graph ; 29(11): 4350-4360, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37782595

RESUMO

Understanding human visual behavior within virtual reality environments is crucial to fully leverage their potential. While previous research has provided rich visual data from human observers, existing gaze datasets often suffer from the absence of multimodal stimuli. Moreover, no dataset has yet gathered eye gaze trajectories (i.e., scanpaths) for dynamic content with directional ambisonic sound, which is a critical aspect of sound perception by humans. To address this gap, we introduce D-SAV360, a dataset of 4,609 head and eye scanpaths for 360° videos with first-order ambisonics. This dataset enables a more comprehensive study of multimodal interaction on visual behavior in virtual reality environments. We analyze our collected scanpaths from a total of 87 participants viewing 85 different videos and show that various factors such as viewing mode, content type, and gender significantly impact eye movement statistics. We demonstrate the potential of D-SAV360 as a benchmarking resource for state-of-the-art attention prediction models and discuss its possible applications in further research. By providing a comprehensive dataset of eye movement data for dynamic, multimodal virtual environments, our work can facilitate future investigations of visual behavior and attention in virtual reality.


Assuntos
Gráficos por Computador , Realidade Virtual , Humanos , Fixação Ocular , Movimentos Oculares , Atenção
20.
ACS Catal ; 13(1): 706-713, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-37808365

RESUMO

In the context of copper-catalyzed nitrene transfer to olefins, many systems operate upon mixing a CuX salt (X = halide, OTf) and a polydentate N-based ligand, assuming that the X ligand is displaced from the coordination sphere toward a counterion position. Herein, we demonstrated that such general assumption should be in doubt since studies carried out with the well-defined copper(I) complexes (TTM)CuCl and [(TTM)Cu(NCMe)]PF6 (TTM = tris(triazolyl)methane ligand) demonstrate a dual behavior from a catalytic and mechanistic point of view that exclusively depends on the presence or absence of the chloride ligand bonded to the metal center. When coordinated, the turnover-limiting step corresponds to the formation of the carbon-nitrene bond, whereas in its absence, the highest barrier corresponds to the formation of the copper-nitrene intermediate.

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