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1.
Molecules ; 29(11)2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38893451

RESUMO

Chronic kidney disease (CKD) presents a formidable global health concern, affecting one in six adults over 25. This review explores the potential of phenolic compounds in managing CKD and its complications. By examining the existing research, we highlight their diverse biological activities and potential to combat CKD-related issues. We analyze the nutritional benefits, bioavailability, and safety profile of these compounds. While the clinical evidence is promising, preclinical studies offer valuable insights into underlying mechanisms, optimal dosages, and potential side effects. Further research is crucial to validate the therapeutic efficacy of phenolic compounds for CKD. We advocate for continued exploration of their innovative applications in food, pharmaceuticals, and nutraceuticals. This review aims to catalyze the scientific community's efforts to leverage phenolic compounds against CKD-related challenges.


Assuntos
Fenóis , Insuficiência Renal Crônica , Humanos , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/metabolismo , Fenóis/química , Fenóis/uso terapêutico , Fenóis/farmacologia , Animais , Suplementos Nutricionais , Disponibilidade Biológica
2.
Nutr Metab Cardiovasc Dis ; 33(7): 1377-1388, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37236898

RESUMO

BACKGROUND AND AIMS: Ambulatory blood pressure monitoring (ABPM) allows the assessment of cardiovascular risk markers that cannot be obtained by casual measurements; however, the evidence on the association between food consumption and blood pressure (BP) assessed by ABPM is scarce. We aimed to evaluate the association between food consumption by degree of processing and ambulatory BP. METHODS AND RESULTS: Cross-sectional analysis (2012-2014) of data from a subsample (n = 815) of ELSA-Brasil cohort participants who performed 24-h ABPM was conducted. Systolic (SBP) and diastolic (DBP) BP means and variability during the 24 h and subperiods (sleep and wake), nocturnal dipping, and morning surge were evaluated. Food consumption was classified according to NOVA. Associations were tested by generalized linear models. The consumption of unprocessed, minimally processed foods, and culinary ingredients (U/MPF&CI) was 63.1% of daily caloric intake, 10.8% of processed (PF), and 24.8% of ultraprocessed (UPF). A negative association was found between U/MPF&CI consumption and extreme dipping (T2: odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.55-0.58; T3: OR = 0.55; 95% CI = 0.54-0.57); and between UPF consumption and nondipping (T2: OR = 0.68, 95% CI = 0.55-0.85) and extreme dipping (T2: OR = 0.63, 95% CI = 0.61-0.65; T3: OR = 0.95, 95% CI = 0.91-0.99). There was a positive association between PF consumption and extreme dipping (T2: OR = 1.22, 95% CI = 1.18-1.27; T3: OR = 1.34, 95% CI = 1.29-1.39) and sleep SBP variability (T3: Coef = 0.56, 95% CI = 0.03-1.10). CONCLUSIONS: The high consumption of PF was associated with greater BP variability and extreme dipping, while the U/MPF&CI and UPF consumption were negatively associated with alterations in nocturnal dipping.


Assuntos
Hipertensão , Humanos , Pressão Sanguínea/fisiologia , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/complicações , Monitorização Ambulatorial da Pressão Arterial/métodos , Estudos Transversais , Fatores de Risco , Ritmo Circadiano/fisiologia
3.
Sensors (Basel) ; 24(1)2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38202894

RESUMO

Terahertz (THz) band will play an important role in enabling sixth generation (6G) envisioned applications. Compared with lower frequency signals, THz waves are severely attenuated by the atmosphere temperature, pressure, and humidity. Thus, designing a THz communication system must take into account how to circumvent or diminish those issues to achieve a sufficient quality of service. Different solutions are being analyzed: intelligent communication environments, ubiquitous artificial intelligence, extensive network automation, and dynamic spectrum access, among others. This survey focuses on the benefits of integrating intelligent surfaces (ISs) and THz communication systems by providing an overview of IS in wireless communications with the scanning of the recent developments, a description of the architecture, and an explanation of the operation. The survey also covers THz channel models, differentiating them based on deterministic and statistical channel modeling. The IS-aided THz channels are elucidated at the end of the survey. Finally, discussions and research directions are given to help enrich the IS field of research and guide the reader through open issues.

4.
Cell Mol Neurobiol ; 41(6): 1227-1244, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32504326

RESUMO

Glioblastoma (GBM) is the most common adult primary tumor of the CNS characterized by rapid growth and diffuse invasiveness into the brain parenchyma. The GBM resistance to chemotherapeutic drugs may be due to the presence of cancer stem cells (CSCs). The CSCs activate the same molecular pathways as healthy stem cells such as WNT, Sonic hedgehog (SHH), and Notch. Mutations or deregulations of those pathways play a key role in the proliferation and differentiation of their surrounding environment, leading to tumorigenesis. Here we investigated the effect of SHH signaling pathway inhibition in human GBM cells by using GANT-61, considering stem cell phenotype, cell proliferation, and cell death. Our results demonstrated that GANT-61 induces apoptosis and autophagy in GBM cells, by increasing the expression of LC3 II and cleaved caspase 3 and 9. Moreover, we observed that SHH signaling plays a crucial role in CSC phenotype maintenance, being also involved in the epithelial-mesenchymal transition (EMT) phenotype. We also noted that SHH pathway modulation can regulate cell proliferation as revealed through the analysis of Ki-67 and c-MYC expressions. We concluded that SHH signaling pathway inhibition may be a promising therapeutic approach to treat patients suffering from GBM refractory to traditional treatments.


Assuntos
Apoptose/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Neoplasias Encefálicas/metabolismo , Glioblastoma/metabolismo , Piridinas/farmacologia , Pirimidinas/farmacologia , Apoptose/fisiologia , Autofagia/fisiologia , Neoplasias Encefálicas/patologia , Carcinogênese/efeitos dos fármacos , Carcinogênese/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/fisiologia , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Transição Epitelial-Mesenquimal/fisiologia , Glioblastoma/patologia , Proteínas Hedgehog/metabolismo , Humanos , Células-Tronco Neoplásicas/efeitos dos fármacos , Células-Tronco Neoplásicas/metabolismo
5.
Mol Psychiatry ; 25(10): 2422-2430, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-30610202

RESUMO

Suicide accounts for nearly 800,000 deaths per year worldwide with rates of both deaths and attempts rising. Family studies have estimated substantial heritability of suicidal behavior; however, collecting the sample sizes necessary for successful genetic studies has remained a challenge. We utilized two different approaches in independent datasets to characterize the contribution of common genetic variation to suicide attempt. The first is a patient reported suicide attempt phenotype asked as part of an online mental health survey taken by a subset of participants (n = 157,366) in the UK Biobank. After quality control, we leveraged a genotyped set of unrelated, white British ancestry participants including 2433 cases and 334,766 controls that included those that did not participate in the survey or were not explicitly asked about attempting suicide. The second leveraged electronic health record (EHR) data from the Vanderbilt University Medical Center (VUMC, 2.8 million patients, 3250 cases) and machine learning to derive probabilities of attempting suicide in 24,546 genotyped patients. We identified significant and comparable heritability estimates of suicide attempt from both the patient reported phenotype in the UK Biobank (h2SNP = 0.035, p = 7.12 × 10-4) and the clinically predicted phenotype from VUMC (h2SNP = 0.046, p = 1.51 × 10-2). A significant genetic overlap was demonstrated between the two measures of suicide attempt in these independent samples through polygenic risk score analysis (t = 4.02, p = 5.75 × 10-5) and genetic correlation (rg = 1.073, SE = 0.36, p = 0.003). Finally, we show significant but incomplete genetic correlation of suicide attempt with insomnia (rg = 0.34-0.81) as well as several psychiatric disorders (rg = 0.26-0.79). This work demonstrates the contribution of common genetic variation to suicide attempt. It points to a genetic underpinning to clinically predicted risk of attempting suicide that is similar to the genetic profile from a patient reported outcome. Lastly, it presents an approach for using EHR data and clinical prediction to generate quantitative measures from binary phenotypes that can improve power for genetic studies.


Assuntos
Estudo de Associação Genômica Ampla , Aprendizado de Máquina , Probabilidade , Tentativa de Suicídio/estatística & dados numéricos , Bancos de Espécimes Biológicos , Registros Eletrônicos de Saúde , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Fenótipo , Fatores de Risco , Ideação Suicida , Tennessee , Reino Unido , População Branca/genética
6.
J Dairy Res ; 88(1): 95-97, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33726885

RESUMO

Artisanal unripened cheeses produced in northwestern Paraná, Brazil, were studied for microbiological quality and sensory quality. The cheeses analyzed showed high counts of aerobic mesophilic microorganisms and S. aureus. However, even with the results showing poor microbiological quality, from a sensory point of view, consumers considered cheeses acceptable (high acceptance index). The results may indicate that there is still a lack of training and knowledge of production procedures to reduce microbiological contamination of artisanal cheese produced in northwestern Paraná.


Assuntos
Queijo/análise , Queijo/microbiologia , Microbiologia de Alimentos , Qualidade dos Alimentos , Brasil , Comportamento do Consumidor , Sensação , Staphylococcus aureus/isolamento & purificação
7.
Sensors (Basel) ; 21(23)2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34884014

RESUMO

We demonstrate a concept for a large enhancement of the directivity and gain of readily available cm- and mm-wave antennas, i.e., without altering any property of the antenna design. Our concept exploits the high reflectivity of a Bragg reflector composed of three bilayers made of transparent materials. The cavity has a triangular aperture in order to resemble the idea of a horn-like, highly directive antenna. Importantly, we report gain enhancements of more than 400% in relation to the gain of the antenna without the Bragg structure, accompanied by a highly directive radiation pattern. The proposed structure is cost-effective and easy to fabricate with 3D-printing. Our results are presented for frequencies within the conventional WiFi frequencies, based on IEEE 802.11 standards, thus, enabling easily implementation by non-experts and needing only to be placed around the antenna to improve the directivity and gain of the signal.

8.
Conserv Biol ; 34(2): 438-448, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31538670

RESUMO

The switch from hunting wild meat for home consumption to supplying more lucrative city markets in Amazonia can adversely affect some game species. Despite this, information on the amounts of wild meat eaten in Amazonian cities is still limited. We estimated wild meat consumption rates in 5 cities in the State of Amazonas in Brazil through 1046 door-to-door household interviews conducted from 2004 to 2012. With these data, we modeled the relationship between wild meat use and a selection of socioeconomic indices. We then scaled up our model to determine the amounts of wild meat likely to be consumed annually in the 62 urban centers in central Amazonia. A total of 80.3% of all interviewees reported consuming wild meat during an average of 29.3 (CI 11.6) days per year. Most wild meat was reported as bought in local markets (80.1%) or hunted by a family member (14.9%). Twenty-one taxa were cited as consumed, mostly mammals (71.6%), followed by reptiles (23.2%) and then birds (5.2%). The declared frequency of wild meat consumption was positively correlated with the proportion of rural population as well as with the per capita gross domestic product of the municipality (administrative divisions) where the cities were seated. We estimated that as much as 10,691 t of wild meat might be consumed annually in the 62 urban centers within central Amazonia, the equivalent of 6.49 kg per person per year. In monetary terms, this amounts to US$21.72 per person per year or US$35.1 million overall, the latter figure is comparable to fish and timber production in the region. Given this magnitude of wild meat trade in central Amazonia, it is fundamental to integrate this activity into the formal economy and actively develop policies that allow the trade of more resilient taxa and restrict trade in species sensitive to hunting.


Mercado y Consumo Urbano de Carne Silvestre en la Amazonia Central Resumen El cambio de la caza de animales silvestres para consumo del hogar a caza para surtir mercados urbanos más lucrativos en la Amazonia puede afectar negativamente a algunas especies de caza. A pesar de esto, la información sobre la cantidad de carne silvestre que se consume en las ciudades de la Amazonia todavía es limitada. Estimamos las tasas de consumo de carne silvestre en cinco ciudades del Estado de Amazonas, Brasil, por medio de 1046 entrevistas presenciales a hogares realizadas entre 2004 y 2012. Con estos datos modelamos la relación entre el uso de la carne silvestre y una selección de índices socioeconómicos. Después aumentamos nuestro modelo para determinar la cantidad de carne silvestre que tal vez se consume anualmente en los 62 centros urbanos de la Amazonia central. Un total de 80.3% de todos los entrevistados reportaron el consumo de carne silvestre durante un promedio de 29.3 (CI 11.6) días por año. La mayoría de la carne silvestre fue reportada como comprada en mercados locales (80.1%) o cazada por algún integrante de la familia (14.9%). Se citaron 21 taxones como parte del consumo, principalmente mamíferos (71.6%), seguidos por reptiles (23.2%) y aves (5.2%). La frecuencia declarada de consumo de carne silvestre estuvo correlacionada positivamente con la proporción de población rural, así como con el producto doméstico bruto per cápita de la municipalidad (divisiones administrativas) en donde se encuentran las ciudades. Estimamos que un máximo de 10,691 toneladas de carne silvestre podrían ser consumidas anualmente en los 62 centros urbanos de la Amazonia central, el equivalente a 6.49 kg/persona/año. En términos monetarios, esto equivale a US$21.72/persona/año o US$35.1 millones en general. Esta última cifra es comparable con la producción de madera y de peces en la región. Dada esta magnitud del mercado de carne silvestre en la Amazonia central, es fundamental la integración de esta actividad en la economía formal y el desarrollo activo de políticas que permitan el mercado de taxones más resilientes y que restrinjan el mercado para las especies sensibles a la caza.


Assuntos
Animais Selvagens , Conservação dos Recursos Naturais , Animais , Brasil , Cidades , Humanos , Carne
9.
Int J Eat Disord ; 53(11): 1801-1808, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32856752

RESUMO

OBJECTIVE: Amidst restrictions to reduce the spread of COVID-19, jokes have surfaced regarding weight gain during the pandemic. The current study documents perceived changes since COVID-19 and compares these to observed longitudinal changes in reported weight, BMI, and how college students described their weight from January to April 2020. METHOD: Undergraduates (N = 90; 88% female) completed on-line assessments before and after students were required to leave campus due to COVID-19. Time 1 and Time 2 surveys collected demographic information, height, weight, and a Likert-scale rating to describe perceived weight, ranging from 1 = very underweight to 5 = very overweight (weight description). Time 2 surveys added questions for perceived changes since COVID-19 in body weight, eating, physical activity, various forms of screen time, and concerns about weight, shape, and eating. RESULTS: Time 2 surveys indicated perceived increases in body weight, eating, and screen time, and decreases in physical activity along with increased concerns about weight, shape and eating since COVID-19. Longitudinal data indicated no significant change in weight, body mass index (BMI), or BMI category, but how participants described their weight changed significantly from January to April 2020. Compared to longitudinal changes in BMI category, students' weight description was significantly more likely to fall into a higher category from Time 1 to Time 2. DISCUSSION: Shifts in how body weight is experienced in the wake of COVID-19 that do not align with observed changes in reported weight may reflect cognitive distortions that could increase risk for disordered eating in some individuals.


Assuntos
Imagem Corporal/psicologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Estudantes/psicologia , Aumento de Peso , Adolescente , Adulto , COVID-19 , Exercício Físico/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Comportamento Sedentário , Adulto Jovem
10.
Support Care Cancer ; 27(2): 407-421, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30370471

RESUMO

PURPOSE: The aim of this systematic review was to identify the interventions used to treat obstructive events, whether thrombotic or non-thrombotic, in long-term central venous catheters (LT-CVC) in cancer patients. METHODS: This review included clinical trials and observational studies reporting the drugs used to treat obstructive catheter events in cancer patients. The authors developed specific search strategies for CINAHL, Cochrane CENTRAL, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest. The authors evaluated methodological quality of included studies using criteria from Cochrane's Collaboration Tool and the Methodological Index for non-randomized studies (MINORS). The quality of evidence was analyzed by using GRADE's software. RESULTS: More than 9000 articles were found across the databases. After duplicates removed, the studies were selected in 2 phases. After that, only 15 studies were included. The drugs used to restoration of catheter function were urokinase (53.3%), alteplase (20%), tenecteplase (13.3%), reteplase (6.7%), recombinant urokinase (6.7%), and staphylokinase (6.7%). The results of meta-analysis of 14 studies showed an overall restoration rate of ~ 84%. The drug type meta-analysis demonstrates a success rate of ~ 84%, ~ 92%, and ~ 84% for urokinase, alteplase, and tenecteplase groups, respectively. The main methodological problem in included articles concerns the sample. The quality of evidence ranged from very low to high. CONCLUSION: The most common interventions used to treat thrombotic catheter occlusion in cancer patients were urokinase and alteplase. No evidence was found about the treatment for non-thrombotic occlusion, thus elucidating an important gap to be investigated.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Neoplasias/terapia , Humanos , Neoplasias/patologia
11.
Int J Neurosci ; 129(6): 523-533, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29914282

RESUMO

AIM OF THE STUDY: Previous studies have shown that several cortical regions are involved in temporal tasks in multiple timescales. However, the hemispheric predominance of the dorsolateral prefrontal cortex (DLPFC) during time reproduction after repetitive low-frequency transcranial magnetic stimulation (rTMS) is relatively unexplored. Here, we study the effects of 1 Hz rTMS and sham stimulation applied medially over the superior parietal cortex (SPC) on the DLPFC alpha and beta band asymmetry and on time reproduction. MATERIALS AND METHODS: For this purpose, we have combined rTMS with electroencephalography in 20 healthy subjects who performed the time reproduction task in two conditions (sham and 1 Hz). RESULTS: The worst performance was observed in sham and 1Hz conditions for longer time intervals (p < .05), with the 1Hz condition subjects sub-reproducing the time interval, closer to the target interval (p < .05). The right DLPFC hemispheric predominance was found in both conditions, but after low-frequency rTMS, the right hemisphere predominance increased in the 1Hz condition (p < .05). CONCLUSIONS: Results of this study suggest that rTMS applied over the SPC influences time interval interpretation and the DLPFC functions. Future studies would explore the effects of the rTMS application to other cortical areas, and study how it influences time interval interpretation.


Assuntos
Dominância Cerebral , Lobo Parietal/fisiologia , Córtex Pré-Frontal/fisiologia , Percepção do Tempo/fisiologia , Estimulação Magnética Transcraniana/métodos , Adulto , Ritmo alfa/fisiologia , Ritmo beta/fisiologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Adulto Jovem
12.
Behav Sci Law ; 37(3): 214-222, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30609102

RESUMO

For decades, our ability to predict suicide has remained at near-chance levels. Machine learning has recently emerged as a promising tool for advancing suicide science, particularly in the domain of suicide prediction. The present review provides an introduction to machine learning and its potential application to open questions in suicide research. Although only a few studies have implemented machine learning for suicide prediction, results to date indicate considerable improvement in accuracy and positive predictive value. Potential barriers to algorithm integration into clinical practice are discussed, as well as attendant ethical issues. Overall, machine learning approaches hold promise for accurate, scalable, and effective suicide risk detection; however, many critical questions and issues remain unexplored.


Assuntos
Ética Médica , Aprendizado de Máquina/legislação & jurisprudência , Suicídio/ética , Suicídio/legislação & jurisprudência , Algoritmos , Análise por Conglomerados , Técnicas de Apoio para a Decisão , Humanos , Estudos Longitudinais , Aprendizado de Máquina/ética , Probabilidade , Pesquisa , Medição de Risco/legislação & jurisprudência , Aprendizado de Máquina não Supervisionado/ética , Aprendizado de Máquina não Supervisionado/legislação & jurisprudência , Aprendizado de Máquina não Supervisionado/estatística & dados numéricos , Prevenção do Suicídio
13.
Br J Psychiatry ; 212(5): 279-286, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29587888

RESUMO

BACKGROUND: Many studies have documented robust relationships between depression and hopelessness and subsequent suicidal thoughts and behaviours; however, much weaker and non-significant effects have also been reported. These inconsistencies raise questions about whether and to what degree these factors confer risk for suicidal thoughts and behaviours.AimsThis study aimed to evaluate the magnitude and clinical utility of depression and hopelessness as risk factors for suicide ideation, attempts and death. METHOD: We conducted a meta-analysis of published studies from 1971 to 31 December 2014 that included at least one longitudinal analysis predicting suicide ideation, attempt or death using any depression or hopelessness variable. RESULTS: Overall prediction was weaker than anticipated, with weighted mean odds ratios of 1.96 (1.81-2.13) for ideation, 1.63 (1.55-1.72) for attempt and 1.33 (1.18-1.49) for death. Adjusting for publication bias further reduced estimates. Effects generally persisted regardless of sample severity, sample age or follow-up length. CONCLUSIONS: Several methodological constraints were prominent across studies; addressing these issues would likely be fruitful moving forward.Declaration of interestNone.


Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Esperança , Suicídio/estatística & dados numéricos , Humanos , Estudos Longitudinais , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos
14.
J Biomed Sci ; 25(1): 26, 2018 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-29554962

RESUMO

BACKGROUND: Parkinson's disease is described as resulting from dopaminergic cells progressive degeneration, specifically in the substantia nigra pars compacta that influence the voluntary movements control, decision making and time perception. AIM: This review had a goal to update the relation between time perception and Parkinson's Disease. METHODOLOGY: We used the PRISMA methodology for this investigation built guided for subjects dopaminergic dysfunction in the time judgment, pharmacological models with levodopa and new studies on the time perception in Parkinson's Disease. We researched on databases Scielo, Pubmed / Medline and ISI Web of Knowledge on August 2017 and repeated in September 2017 and February 2018 using terms and associations relevant for obtaining articles in English about the aspects neurobiology incorporated in time perception. No publication status or restriction of publication date was imposed, but we used as exclusion criteria: dissertations, book reviews, conferences or editorial work. RESULTS/DISCUSSION: We have demonstrated that the time cognitive processes are underlying to performance in cognitive tasks and that many are the brain areas and functions involved and the modulators in the time perception performance. CONCLUSIONS: The influence of dopaminergic on Parkinson's Disease is an important research tool in Neuroscience while allowing for the search for clarifications regarding behavioral phenotypes of Parkinson's disease patients and to study the areas of the brain that are involved in the dopaminergic circuit and their integration with the time perception mechanisms.


Assuntos
Gânglios da Base/fisiopatologia , Doença de Parkinson/fisiopatologia , Parte Compacta da Substância Negra/fisiopatologia , Percepção do Tempo , Gânglios da Base/química , Parte Compacta da Substância Negra/química , Transmissão Sináptica/fisiologia
15.
J Child Psychol Psychiatry ; 59(12): 1261-1270, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29709069

RESUMO

BACKGROUND: Adolescents have high rates of nonfatal suicide attempts, but clinically practical risk prediction remains a challenge. Screening can be time consuming to implement at scale, if it is done at all. Computational algorithms may predict suicide risk using only routinely collected clinical data. We used a machine learning approach validated on longitudinal clinical data in adults to address this challenge in adolescents. METHODS: This is a retrospective, longitudinal cohort study. Data were collected from the Vanderbilt Synthetic Derivative from January 1998 to December 2015 and included 974 adolescents with nonfatal suicide attempts and multiple control comparisons: 496 adolescents with other self-injury (OSI), 7,059 adolescents with depressive symptoms, and 25,081 adolescent general hospital controls. Candidate predictors included diagnostic, demographic, medication, and socioeconomic factors. Outcome was determined by multiexpert review of electronic health records. Random forests were validated with optimism adjustment at multiple time points (from 1 week to 2 years). Recalibration was done via isotonic regression. Evaluation metrics included discrimination (AUC, sensitivity/specificity, precision/recall) and calibration (calibration plots, slope/intercept, Brier score). RESULTS: Computational models performed well and did not require face-to-face screening. Performance improved as suicide attempts became more imminent. Discrimination was good in comparison with OSI controls (AUC = 0.83 [0.82-0.84] at 720 days; AUC = 0.85 [0.84-0.87] at 7 days) and depressed controls (AUC = 0.87 [95% CI 0.85-0.90] at 720 days; 0.90 [0.85-0.94] at 7 days) and best in comparison with general hospital controls (AUC 0.94 [0.92-0.96] at 720 days; 0.97 [0.95-0.98] at 7 days). Random forests significantly outperformed logistic regression in every comparison. Recalibration improved performance as much as ninefold - clinical recommendations with poorly calibrated predictions can lead to decision errors. CONCLUSIONS: Machine learning on longitudinal clinical data may provide a scalable approach to broaden screening for risk of nonfatal suicide attempts in adolescents.


Assuntos
Aprendizado de Máquina , Tentativa de Suicídio/prevenção & controle , Adolescente , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Retrospectivos , Medição de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos
16.
Int J Eat Disord ; 51(4): 343-351, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29469933

RESUMO

OBJECTIVE: The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. METHOD: Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. RESULTS: Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. DISCUSSION: Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors.


Assuntos
Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adulto , Atitude , Feminino , Humanos , Masculino , Autorrelato , Inquéritos e Questionários
17.
Neurol Sci ; 39(3): 527-532, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29330626

RESUMO

Spatial working memory has been extensively investigated with different tasks, treatments, and analysis tools. Several studies suggest that low frequency of the repetitive transcranial magnetic stimulation (rTMS) applied to the parietal cortex may influence spatial working memory (SWM). However, it is not yet known if after low-frequency rTMS applied to the superior parietal cortex, according to Pz electroencephalography (EEG) electrode, would change the orientation interpretation about the vertical and horizontal axes coordinates in an SWM task. The current study aims at filling this gap and obtains a better understanding of the low-frequency rTMS effect in SWM. In this crossover study, we select 20 healthy subjects in two conditions (control and 1-Hz rTMS). The subjects performed an SWM task with two random coordinates. Our results presented that low-frequency rTMS applied over the superior parietal cortex may influence the SWM to lead to a larger distance of axes interception point (p < 0.05). We conclude that low-frequency rTMS over the superior parietal cortex (SPC) changes the SWM performance, and it has more predominance in horizontal axis.


Assuntos
Memória de Curto Prazo/fisiologia , Lobo Parietal/fisiologia , Memória Espacial/fisiologia , Estimulação Magnética Transcraniana , Adulto , Análise de Variância , Estudos Cross-Over , Eletroencefalografia , Humanos , Modelos Logísticos , Testes Neuropsicológicos , Estimulação Magnética Transcraniana/efeitos adversos , Estimulação Magnética Transcraniana/métodos , Adulto Jovem
18.
Int J Neurosci ; 128(3): 262-282, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28950734

RESUMO

Dopaminergic system plays a key role in perception, which is an important executive function of the brain. Modulation in dopaminergic system forms an important biochemical underpinning of neural mechanisms of time perception in a very wide range, from milliseconds to seconds to longer daily rhythms. Distinct types of temporal experience are poorly understood, and the relationship between processing of different intervals by the brain has received little attention. A comprehensive understanding of interval timing functions should be sought within a wider context of temporal processing, involving genetic aspects, pharmacological models, cognitive aspects, motor control and the neurological diseases with impaired dopaminergic system. Particularly, an unexplored question is whether the role of dopamine in interval timing can be integrated with the role of dopamine in non-interval timing temporal components. In this review, we explore a wider perspective of dopaminergic system, involving genetic polymorphisms, pharmacological models, executive functions and neurological diseases on the time perception. We conclude that the dopaminergic system has great participation in impact on time perception and neurobiological basis of the executive functions and neurological diseases.


Assuntos
Transtornos Cognitivos/etiologia , Dopamina/metabolismo , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/metabolismo , Transdução de Sinais/fisiologia , Percepção do Tempo/fisiologia , Dopamina/genética , Humanos
19.
J Clin Psychol ; 74(9): 1607-1625, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29687442

RESUMO

OBJECTIVE: Our primary objective was to determine the potency of externalizing psychopathology as a risk factor for suicidal thoughts and behaviors (STBs). METHOD: We conducted a random effects meta-analysis of 174 prospective studies (839 unique statistical tests) examining externalizing psychopathology and suicidal thoughts and behaviors (STBs) published prior to December 8, 2017. The weighted mean odds ratios for the overall relationship between externalizing psychopathology and STBs were below 2.00 in magnitude, and all risk factor subcategories were also fairly modest predictors of STBs. Taking publication bias into account reduced the magnitude of these associations, particularly for death. Although externalizing psychopathology modestly predicts STBs, this may be due to design limitations of existing studies. Future research should employ shorter follow-up periods, consider risk factors in combination, and focus on forms of externalizing psychopathology that have not been studied extensively. RESULTS: The weighted mean odds ratios for the overall relationship between externalizing psychopathology and STBs were below 2.00 in magnitude, and all risk factor subcategories were also fairly modest predictors of STBs. Taking publication bias into account reduced the magnitude of these associations, particularly for death. Additionally, our results were mostly consistent regardless of sample age, sample severity, follow-up length, and predictor scale. CONCLUSIONS: Although externalizing psychopathology modestly predicts STBs, this may be due to design limitations of existing studies. Future research should employ shorter follow-up periods, consider risk factors in combination, and focus on forms of externalizing psychopathology that have not been studied extensively.


Assuntos
Controle Interno-Externo , Psicopatologia , Ideação Suicida , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco , Tentativa de Suicídio
20.
Int J Paediatr Dent ; 2018 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-29984557

RESUMO

BACKGROUND: Limited data is available on variables influencing the survival of composite restorations in primary teeth. AIM: This retrospective university-based study assessed the survival and risk factors associated with failures of resin composite restorations performed in primary teeth. DESIGN: The sample was composed of 961 restorations from records of 337 patients (178 girls and 159 boys) attended in a university dental clinic. The restorations' longevity up to 48 months of follow-up was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P < 0.05). RESULTS: Mean survival time was 41.5 months (95% CI: 39.7-43.3), with 70.6% of the restorations surviving after 48 months of evaluation. The overall annual failure rate up to 48 months follow-up was 8.3%. Restorations placed in lower arch had lower survival rate than those in upper arch (HR: 1.82, 95% CI: 1.02-3.28). Restorations involving two or more surfaces had more risk of failure than restorations placed in cavities involving only one surface (HR: 2.55 95% CI: 1.34- 4.83). Girls had less risk of failure in their restorations (HR: 0.43, 95% CI: 0.19-0.96). CONCLUSION: Individual and dental variables such as gender, arch type and number of restored surfaces were associated with failure of composite restorations performed in children under daily life clinical environment.

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