RESUMO
Introduction: Hypothyroidism is conventionally treated with replacement therapy through levothyroxine (LT4). Despite the improvement in symptoms, cold intolerance persists in some patients. The present study aims to determine whether there is a difference in temperature perception and skin temperature between patients with primary controlled hypothyroidism (PCH) and a group of healthy controls matched for body mass index and age. Secondarily we aimed to determine difference in quality of life. Methodology: Skin temperature measurements were performed in both groups, both in the central and peripheral regions of the body. In addition, subjects were asked about their perception of temperature in a temperature-controlled room; anthropometric measurements were taken, their quality of life was assessed using the ThyPRO-39, and a thyroid hormone profile was performed. Results: Eleven patients in the PCH group and 30 patients in the control group were studied. It was found that the group with PCH presented a significantly lower palmar temperature than the control group [mean (SD) of 32.05 (1.79) vs 33.10 (1.30) oC, P = .046]. A mediation model showed a direct effect. Temperature perception was equal between groups. The median (interquartile range) of ThyPRO was 8 (5.2) points in the control group vs 21.8 (13.5) in the group of controlled hypothyroidism, P < .001. Discussion: These results suggest that, despite LT4 treatment, patients continue to present abnormalities in thermogenesis-related thermogenesis, and this may be due to a lack of hormonal adaptation to environmental changes and physiological demands, leading to lower body temperatures and increased sensitivity to cold.
RESUMO
Background: There are no validation studies on patient satisfaction surveys in Spanish that can evaluate a hospital pharmacy drive-thru service. Objective: To develop and apply a pharmacy drive-thru satisfaction survey in Spanish during the COVID-19 pandemic with an analysis of the instrument validation. Methods: This was a qualitative study for developing, validating, and measuring patient satisfaction who used the drive-thru pharmacy during the COVID-19 pandemic. Content validity was obtained by a two-round Delphi and patient interview for apparent validity. The questionnaire was administered to 110 patients. The researchers made an item reduction by inter-item and item-total correlation analysis, stability validation by a test-retest, a test of reliability by Cronbach's alpha, and extraction of factors by an exploratory factorial analysis. Likewise, confirmatory factor analysis was developed to obtain a structural equation model based on generating an instrument of two sub-models of latent factors (service and place) with ten observed variables (items). Results: A questionnaire was developed that relates six observable variables to the latent factor service and four observable variables to the latent factor place which are ten items based on a Likert scale from 1 to 5, obtaining a Cronbach's alpha = 0.901. The mean population satisfaction score was 4.523. The model presented a Root Mean Square Error of Approximation (RMSEA) of 0.026 (0.000-0.098), and standardized beta values greater than 0.2 according to the confirmatory factor analysis. Therefore, the goodness-of-fit of our model is consistent and the instrument of patient satisfaction with the use of drive-thru has been validated. Patient satisfaction had a mean of 4.9 points. Conclusions: This study developed and validated a reliable scale that evaluates satisfaction in a hospital pharmacy drive-thru service during COVID-19 pandemic that can be applied in other Spanish speaking countries. A great percentage of the patients that were evaluated had good satisfaction.
RESUMO
Cancer is the second cause of mortality worldwide. Early diagnosis of this multifactorial disease is challenging, especially in populations with limited access to healthcare services. A vast repertoire of cancer biomarkers has been studied to facilitate early diagnosis; particularly, the use of antibodies against these biomarkers has been of interest to detect them through biorecognition. However, there are certain limitations to this approach. Emerging biorecognition engineering technologies are alternative methods to generate molecules and molecule-based scaffolds with similar properties to those presented by antibodies. Molecularly imprinted polymers, recombinant antibodies, and antibody mimetic molecules are three novel technologies commonly used in scientific studies. This review aimed to present the fundamentals of these technologies and address questions about how they are implemented for cancer detection in recent scientific studies. A systematic analysis of the scientific peer-reviewed literature regarding the use of these technologies on cancer detection was carried out starting from the year 2000 up to 2021 to answer these questions. In total, 131 scientific articles indexed in the Web of Science from the last three years were included in this analysis. The results showed that antibody mimetic molecules technology was the biorecognition technology with the highest number of reports. The most studied cancer types were: multiple, breast, leukemia, colorectal, and lung. Electrochemical and optical detection methods were the most frequently used. Finally, the most analyzed biomarkers and cancer entities in the studies were carcinoembryonic antigen, MCF-7 cells, and exosomes. These technologies are emerging tools with adequate performance for developing biosensors useful in cancer detection, which can be used to improve cancer diagnosis in developing countries.
RESUMO
Purpose: Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables. Methods: A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS. Results: Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory. Conclusion: The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.
RESUMO
CMOS microelectronics design has evolved tremendously during the last two decades. The evolution of CMOS devices to short channel designs where the feature size is below 1000 nm brings a great deal of uncertainty in the way the microelectronics design cycle is completed. After the conceptual idea, developing a thinking model to understand the operation of the device requires a good "ballpark" evaluation of transistor sizes, decision making, and assumptions to fulfill the specifications. This design process has iterations to meet specifications that exceed in number of the available degrees of freedom to maneuver the design. Once the thinking model is developed, the simulation validation follows to test if the design has a good possibility of delivering a successful prototype. If the simulation provides a good match between specifications and results, then the layout is developed. This paper shows a useful open science strategy, using the Excel software, to develop CMOS microelectronics hand calculations to verify a design, before performing the computer simulation and layout of CMOS analog integrated circuits. The full methodology is described to develop designs of passive components, as well as CMOS amplifiers. The methods are used in teaching CMOS microelectronics to students of electronic engineering with industrial partner participation. This paper describes an exhaustive example of a low-voltage operational transconductance amplifier (OTA) design which is used to design an instrumentation amplifier. Finally, a test is performed using this instrumentation amplifier to implement a front-end signal conditioning device for CMOS-MEMS biomedical applications.
Assuntos
Amplificadores Eletrônicos , Semicondutores , Simulação por Computador , Desenho de Equipamento , Humanos , ÓxidosRESUMO
Worldwide, people's quality of health has been decreasing due to bad eating habits that have generated an increase in diseases such as diabetes, hypertension, overweight, as well as an increase in hours of the daily workday and stress. This situation can generate sudden illness and work accidents where the need to have knowledge in emergency first response (EFR) is necessary for all. Unfortunately, workshops and courses to certify EFR individuals are usually taught only to healthcare professionals. Therefore, to address this need a EFR project has been developed at the Tecnológico de Monterrey (TEC) which consists of a multidisciplinary challenge to train, certify, and evaluate students' competency as "emergency first responders" in medical emergencies and healthcare awareness. This EFR project has been performed for one week, every year since 2015, and constitutes a joint venture among academic departments, faculty, and industrial/government institutions, which work together in multidisciplinary projects, providing a source of innovative proposals. The EFR project at TEC has provided instruction and certification for 966 students between 2015 to 2019 and this study has analyzed results considering a sample size of 197 participants. The combination of exam evaluation, medical emergency skills verification, and project proposal results indicate that most students reach skill levels between 2 and 3 in EFR competency after successfully completing the program, regardless of their year of study or the undergraduate program they are enrolled on. This evaluation emphasizes the compromise of the institution and its students in preparation for new living under sanitary conditions for pandemic conditions such as COVID-19.
Assuntos
COVID-19 , Educação Médica , Saúde Ocupacional , Estudantes de Medicina , Currículo , Emergências , Humanos , SARS-CoV-2 , EstudantesRESUMO
Copper indium gallium selenium (CIGS) films are attractive for photovoltaic applications due to their high optical absorption coefficient. The generation of CIGS films by electrodeposition is particularly appealing due to the relatively low capital cost and high throughput. Numerous publications address the electrodeposition of CIGS; however, very few recognize the critical significance of transport in affecting the composition and properties of the compound. This study introduces a new electrolyte composition, which is far more dilute than systems that had been previously described, which yields much improved CIGS films. The electrodeposition experiments were carried out on a rotating disk electrode, which provides quantitative control of the transport rates. Experiments with the conventional electrolyte, ten times more concentrated than the new electrolyte proposed here, yielded powdery and non-adherent deposit. By contrast, the new, low concentration electrolyte produced in the preferred potential interval of -0.64 ≤ E ≤ -0.76 V vs. NHE, a smooth and adherent uniform deposit with the desired composition across a broad range of rotation speeds. The effects of mass transport on the deposit are discussed. Sample polarization curves at different electrode rotation rates, obtained in deposition experiments from the high and the low concentration electrolytes, are critically compared. Characterization of the overall efficiency, quantum efficiency, open circuit voltage, short circuit current, dark current, band gap, and the fill factor are reported.
RESUMO
Pharmaceuticals enhance our quality of life; consequently, their consumption is growing as a result of the need to treat ageing-related and chronic diseases and changes in the clinical practice. The market revenues also show an historic growth worldwide motivated by the increase on the drug demand. However, this positivism on the market is fogged because the discharge of pharmaceuticals and their metabolites into the environment, including water, also increases due to their inappropriate management, treatment and disposal; now, worldwide, this fact is recognized as an environmental concern and human health risk. Intriguingly, researchers have studied the most effective methods for pharmaceutical removal in wastewater; however, the types of pharmaceuticals investigated in most of these studies do not reflect the most produced and consumed pharmaceuticals on the market. Hence, an attempt was done to analyze the pharmaceutical market, drugs consumption trends and the pharmaceutical research interests worldwide. Notwithstanding, the intensive research work done in different pharmaceutical research fronts such as disposal and fate, environmental impacts and concerns, human health risks, removal, degradation and development of treatment technologies, found that such research is not totally aligned with the market trends and consumption patterns. There are other drivers and interests that promote the pharmaceutical research. Thus, this review is an important contribution to those that are interested not only on the pharmaceutical market and drugs consumption, but also on the links, the drivers and interests that motivate and determine the research work on certain groups of pharmaceuticals on water and wastewater.