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1.
Sci Data ; 11(1): 884, 2024 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-39143096

RESUMO

AI image classification algorithms have shown promising results when applied to skin cancer detection. Most public skin cancer image datasets are comprised of dermoscopic photos and are limited by selection bias, lack of standardization, and lend themselves to development of algorithms that can only be used by skilled clinicians. The SLICE-3D ("Skin Lesion Image Crops Extracted from 3D TBP") dataset described here addresses those concerns and contains images of over 400,000 distinct skin lesions from seven dermatologic centers from around the world. De-identified images were systematically extracted from sensitive 3D Total Body Photographs and are comparable in optical resolution to smartphone images. Algorithms trained on lower quality images could improve clinical workflows and detect skin cancers earlier if deployed in primary care or non-clinical settings, where photos are captured by non-expert physicians or patients. Such a tool could prompt individuals to visit a specialized dermatologist. This dataset circumvents many inherent limitations of prior datasets and may be used to build upon previous applications of skin imaging for cancer detection.


Assuntos
Neoplasias Cutâneas , Neoplasias Cutâneas/diagnóstico por imagem , Humanos , Algoritmos , Imageamento Tridimensional , Pele/diagnóstico por imagem
2.
JMIR Mhealth Uhealth ; 12: e55421, 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39052330

RESUMO

BACKGROUND: Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format. OBJECTIVE: This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome. METHODS: A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability. RESULTS: The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P<.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [<2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P<.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P<.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P<.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P<.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points). CONCLUSIONS: With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, knowledge level, systolic blood pressure, heart rate, and blood sugar level. Furthermore, participants reported high app satisfaction and rated its usability as excellent. Thus, this innovative tool is very promising. TRIAL REGISTRATION: ClinicalTrials.gov NCT05247606; https://clinicaltrials.gov/study/NCT05247606.


Assuntos
Reabilitação Cardíaca , Doença da Artéria Coronariana , Aplicativos Móveis , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doença da Artéria Coronariana/psicologia , Doença da Artéria Coronariana/reabilitação , Idoso , Reabilitação Cardíaca/métodos , Reabilitação Cardíaca/normas , Reabilitação Cardíaca/estatística & dados numéricos , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos
3.
Front Med (Lausanne) ; 11: 1380984, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38654834

RESUMO

Introduction: Artificial Intelligence (AI) has proven effective in classifying skin cancers using dermoscopy images. In experimental settings, algorithms have outperformed expert dermatologists in classifying melanoma and keratinocyte cancers. However, clinical application is limited when algorithms are presented with 'untrained' or out-of-distribution lesion categories, often misclassifying benign lesions as malignant, or misclassifying malignant lesions as benign. Another limitation often raised is the lack of clinical context (e.g., medical history) used as input for the AI decision process. The increasing use of Total Body Photography (TBP) in clinical examinations presents new opportunities for AI to perform holistic analysis of the whole patient, rather than a single lesion. Currently there is a lack of existing literature or standards for image annotation of TBP, or on preserving patient privacy during the machine learning process. Methods: This protocol describes the methods for the acquisition of patient data, including TBP, medical history, and genetic risk factors, to create a comprehensive dataset for machine learning. 500 patients of various risk profiles will be recruited from two clinical sites (Australia and Spain), to undergo temporal total body imaging, complete surveys on sun behaviors and medical history, and provide a DNA sample. This patient-level metadata is applied to image datasets using DICOM labels. Anonymization and masking methods are applied to preserve patient privacy. A two-step annotation process is followed to label skin images for lesion detection and classification using deep learning models. Skin phenotype characteristics are extracted from images, including innate and facultative skin color, nevi distribution, and UV damage. Several algorithms will be developed relating to skin lesion detection, segmentation and classification, 3D mapping, change detection, and risk profiling. Simultaneously, explainable AI (XAI) methods will be incorporated to foster clinician and patient trust. Additionally, a publicly released dataset of anonymized annotated TBP images will be released for an international challenge to advance the development of new algorithms using this type of data. Conclusion: The anticipated results from this protocol are validated AI-based tools to provide holistic risk assessment for individual lesions, and risk stratification of patients to assist clinicians in monitoring for skin cancer.

4.
JMIR Mhealth Uhealth ; 12: e48756, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38648103

RESUMO

BACKGROUND: Coronary heart disease is one of the leading causes of mortality worldwide. Secondary prevention is essential, as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve lifestyles. OBJECTIVE: This study aimed to evaluate the effect of an mHealth intervention on people with coronary heart disease who received percutaneous coronary intervention. Improvements in lifestyle regarding diet, physical activity, and smoking; level of knowledge of a healthy lifestyle and the control of cardiovascular risk factors (CVRFs); and therapeutic adherence and quality of life were analyzed. METHODS: This was a randomized controlled trial with a parallel group design assigned 1:1 to either an intervention involving a smartphone app (mHealth group) or to standard health care (control group). The app was used for setting aims, the self-monitoring of lifestyle and CVRFs using measurements and records, educating people with access to information on their screens about healthy lifestyles and adhering to treatment, and giving motivation through feedback about achievements and aspects to improve. Both groups were assessed after 9 months. The primary outcome variables were adherence to the Mediterranean diet, frequency of food consumed, patient-reported physical activity, smoking, knowledge of healthy lifestyles and the control of CVRFs, adherence to treatment, quality of life, well-being, and satisfaction. RESULTS: The study analyzed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (92/128, 71.9%), with a mean age of 59.49 (SD 8.97) years. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (mean 11.83, SD 1.74 points vs mean 10.14, SD 2.02 points; P<.001), frequency of food consumption, patient-reported physical activity (mean 619.14, SD 318.21 min/week vs mean 471.70, SD 261.43 min/week; P=.007), giving up smoking (25/67, 75% vs 11/61, 42%; P=.01), level of knowledge of healthy lifestyles and the control of CVRFs (mean 118.70, SD 2.65 points vs mean 111.25, SD 9.05 points; P<.001), and the physical component of the quality of life 12-item Short Form survey (SF-12; mean 45.80, SD 10.79 points vs mean 41.40, SD 10.78 points; P=.02). Overall satisfaction was higher in the mHealth group (mean 48.22, SD 3.89 vs mean 46.00, SD 4.82 points; P=.002) and app satisfaction and usability were high (mean 44.38, SD 6.18 out of 50 points and mean 95.22, SD 7.37 out of 100). CONCLUSIONS: The EVITE app was effective in improving the lifestyle of patients in terms of adherence to the Mediterranean diet, frequency of healthy food consumption, physical activity, giving up smoking, knowledge of healthy lifestyles and controlling CVRFs, quality of life, and overall satisfaction. The app satisfaction and usability were excellent. TRIAL REGISTRATION: Clinicaltrials.gov NCT04118504; https://clinicaltrials.gov/study/NCT04118504.


Assuntos
Aplicativos Móveis , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Idoso , Qualidade de Vida/psicologia , Doença das Coronárias/psicologia , Doença das Coronárias/prevenção & controle , Estilo de Vida , Telemedicina/métodos , Telemedicina/normas , Telemedicina/estatística & dados numéricos
5.
Digit Health ; 10: 20552076241234474, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38510574

RESUMO

Background: Coronary disease is the main cause of death around the world. mHealth technology is considered attractive and promising to promote behavioural changes aimed at healthy lifestyle habits among coronary patients. The purpose of this study is to evaluate the efficacy of an mHealth intervention regarding improved results in secondary prevention in patients after an acute myocardial infarction (AMI) or angina in terms of lifestyle, clinical variables and therapeutic compliance. Methods: Randomised clinical trial with 300 patients who underwent a percutaneous coronary intervention (PCI) with stent implant. They will be assigned to either the mHealth group, subject to a self-monitored educational intervention involving an internet application installed on their mobile phone or tablet, or to a control group receiving standard healthcare (150 patients in each arm). The primary outcome variables will be adherence to the Mediterranean diet, physical activity, smoking, therapeutic compliance, knowledge acquired, user-friendliness and satisfaction with the application. Measurements of blood pressure, heart rate, body weight, waist circumference (WC) and the 6-min walk test will be taken. Furthermore, the blood lipid profile, glucose and HbA1c will be evaluated. Clinical interview will be conducted, and validated questionnaires completed. The primary quantitative results will be compared using an analysis of covariance adjusted for age and sex. A multivariate analysis will be performed to examine the association of the intervention with lifestyle habits, the control of cardiovascular risk factors (CDRFs) and the results after the hospital discharge (major adverse events, treatment compliance and lifestyle). Conclusions: The study will provide evidence about the effectiveness of an mHealth intervention at improving the lifestyle of the participants and could be offered to patients with coronary disease to complement existing services. Trial registration: NCT05247606. [https://ClinicalTrials.gov]. 21/02/2022.

6.
Sci Rep ; 14(1): 5646, 2024 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454017

RESUMO

Brain tumour microstructure is potentially predictive of changes following treatment to cognitive functions subserved by the functional networks in which they are embedded. To test this hypothesis, intra-tumoural microstructure was quantified from diffusion-weighted MRI to identify which tumour subregions (if any) had a greater impact on participants' cognitive recovery after surgical resection. Additionally, we studied the role of tumour microstructure in the functional interaction between the tumour and the rest of the brain. Sixteen patients (22-56 years, 7 females) with brain tumours located in or near speech-eloquent areas of the brain were included in the analyses. Two different approaches were adopted for tumour segmentation from a multishell diffusion MRI acquisition: the first used a two-dimensional four group partition of feature space, whilst the second used data-driven clustering with Gaussian mixture modelling. For each approach, we assessed the capability of tumour microstructure to predict participants' cognitive outcomes after surgery and the strength of association between the BOLD signal of individual tumour subregions and the global BOLD signal. With both methodologies, the volumes of partially overlapped subregions within the tumour significantly predicted cognitive decline in verbal skills after surgery. We also found that these particular subregions were among those that showed greater functional interaction with the unaffected cortex. Our results indicate that tumour microstructure measured by MRI multishell diffusion is associated with cognitive recovery after surgery.


Assuntos
Neoplasias Encefálicas , Disfunção Cognitiva , Feminino , Humanos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/patologia , Cognição , Imagem de Difusão por Ressonância Magnética/métodos , Córtex Cerebral/patologia , Encéfalo/patologia
7.
Cortex ; 173: 1-15, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38354669

RESUMO

The extent to which tumour-infiltrated brain tissue contributes to cognitive function remains unclear. We tested the hypothesis that cortical tissue infiltrated by diffuse gliomas participates in large-scale cognitive circuits using a unique combination of intracranial electrocorticography (ECoG) and resting-state functional magnetic resonance (fMRI) imaging in four patients. We also assessed the relationship between functional connectivity with tumour-infiltrated tissue and long-term cognitive outcomes in a larger, overlapping cohort of 17 patients. We observed significant task-related high gamma (70-250 Hz) power modulations in tumour-infiltrated cortex in response to increased cognitive effort (i.e., switch counting compared to simple counting), implying preserved functionality of neoplastic tissue for complex tasks probing executive function. We found that tumour locations corresponding to task-responsive electrodes exhibited functional connectivity patterns that significantly co-localised with canonical brain networks implicated in executive function. Specifically, we discovered that tumour-infiltrated cortex with larger task-related high gamma power modulations tended to be more functionally connected to the dorsal attention network (DAN). Finally, we demonstrated that tumour-DAN connectivity is evident across a larger cohort of patients with gliomas and that it relates to long-term postsurgical outcomes in goal-directed attention. Overall, this study contributes convergent fMRI-ECoG evidence that tumour-infiltrated cortex participates in large-scale neurocognitive circuits that support executive function in health. These findings underscore the potential clinical utility of mapping large-scale connectivity of tumour-infiltrated tissue in the care of patients with diffuse gliomas.


Assuntos
Encéfalo , Glioma , Humanos , Encéfalo/fisiologia , Função Executiva/fisiologia , Cognição/fisiologia , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Glioma/diagnóstico por imagem , Vias Neurais/fisiologia
8.
Motrivivência (Florianópolis) ; 36(67): 1-24, 2024.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1532980

RESUMO

Objetivou-se levantar a produção científica na literatura sobre violência nas aulas de EF escolar nos últimos 5 anos. Desenvolveu-se uma revisão sistemática sobre a temática de violência nas áreas da Educação e EF através do método PRISMA. As bases consultadas foram Scielo, Lilacs, Scopus e Google Acadêmico, durante setembro/2022- outubro/2022. Foram encontrados 1028 estudos e, após aplicados os filtros de seleção, chegou-se a 14 trabalhos. Percebeu- se uma ascendência de pesquisas relacionadas à violência escolar e EF de cunho qualitativo e predominantes nas regiões Sudeste e Sul do Brasil. Os dados mostram que os cursos de formação de professores de EF ainda carecem de informações sobre o fenômeno da violência escolar, questão que afeta a vivência pedagógica dos docentes, uma vez que a postura do professor pode gerar e/ou intensificar atos de violência ao corpo docente e discente, tendo a escola, muitas vezes, um papel omisso frente à problemática.


The objective was to survey the scientific production in the literature on violence in PE classes at school in the last 5 years. A systematic review was developed on the theme of violence in the areas of Education and PE using the PRISMA method. The databases consulted were Scielo, Lilacs, Scopus and Google Scholar, during September/2022-October/2022. 1028 studies were found and, after applying the selection filters, 14 works were reached. An ascendance of research related to school violence and PE of a qualitative nature and predominant in the Southeast and South regions of Brazil was noticed. The data show that the training courses for PE teachers still lack information about the phenomenon of school violence, an issue that affects the pedagogical experience of teachers, since their attitude can generate and/or intensify acts of violence against teachers and students, with the school often having a silent role in the face of the problem.


El objetivo fue relevar la producción científica en la literatura sobre la violencia en las clases de EF en la escuela en los últimos 5 años. Se desarrolló una revisión sistemática sobre el tema de la violencia en las áreas de Educación y EF utilizando el método PRISMA. Las bases de datos consultadas fueron Scielo, Lilacs, Scopus y Google Scholar, durante septiembre/2022-octubre/2022. Se encontraron 1028 estudios y, después de aplicar los filtros de selección, se llegó a 14 trabajos. Se notó un ascenso de investigaciones relacionadas con la violencia escolar y la EF de carácter cualitativo y predominantes en las regiones Sureste y Sur de Brasil. Los datos muestran que los cursos de formación de docentes de EF aún carecen de información sobre el fenómeno de la violencia escolar, tema que afecta la experiencia pedagógica de los docentes, ya que la actitud del profesor puede generar y/o intensificar actos de violencia contra docentes y alumnos, teniendo la escuela muchas veces un papel silencioso frente al problema.

9.
Salud colect ; 20: 4648-4648, 2024.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1560483

RESUMO

RESUMEN Las mujeres consumidoras de drogas se enfrentan a grandes desafíos en el acceso y la adherencia al tratamiento ambulatorio. Sin embargo, esta cuestión ha sido poco estudiada. El objetivo del estudio es comprender las experiencias de un grupo de mujeres en tratamiento por consumo de drogas. Entre marzo y diciembre de 2021, se realizó un estudio cualitativo fenomenológico interpretativo mediante entrevistas semiestructuradas a 16 mujeres usuarias de un centro de atención a las drogodependencias de Cataluña (España). Los datos se procesaron mediante el análisis de contenido. Los resultados indican que las mujeres, pese a percibir un impacto positivo del tratamiento, viven realidades de vulnerabilidad relacionadas con la estigmatización, la falta de apoyo social y una baja cobertura de necesidades específicas con implicaciones en el seguimiento terapéutico. Los hallazgos enfatizan la necesidad de mejorar los recursos para una atención especializada y promover una red de apoyo social donde participen activamente las mujeres consumidoras de drogas.


ABSTRACT Women drug-users face significant challenges in accessing and adhering to outpatient treatment. However, this issue has been underexplored. The study aims to understand the experiences of a group of women undergoing drug use treatment. Between March and December 2021, a qualitative phenomenological interpretative study was carried out through semi-structured interviews with 16 women attending a drug-dependence care center in Catalonia, Spain. Data were processed through content analysis. The results indicate that, despite perceiving a positive impact of the treatment, women experience vulnerabilities related to stigmatization, lack of social support, and insufficient coverage of specific needs, impacting therapeutic follow-up. The findings emphasize the need to enhance resources for specialized care and promote a social support network where women drug-users actively participate.

10.
Life (Basel) ; 13(11)2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-38004263

RESUMO

Skin cancer has become increasingly common over the past decade, with melanoma being the most aggressive type. Hence, early detection of skin cancer and melanoma is essential in dermatology. Computational methods can be a valuable tool for assisting dermatologists in identifying skin cancer. Most research in machine learning for skin cancer detection has focused on dermoscopy images due to the existence of larger image datasets. However, general practitioners typically do not have access to a dermoscope and must rely on naked-eye examinations or standard clinical images. By using standard, off-the-shelf cameras to detect high-risk moles, machine learning has also proven to be an effective tool. The objective of this paper is to provide a comprehensive review of image-processing techniques for skin cancer detection using clinical images. In this study, we evaluate 51 state-of-the-art articles that have used machine learning methods to detect skin cancer over the past decade, focusing on clinical datasets. Even though several studies have been conducted in this field, there are still few publicly available clinical datasets with sufficient data that can be used as a benchmark, especially when compared to the existing dermoscopy databases. In addition, we observed that the available artifact removal approaches are not quite adequate in some cases and may also have a negative impact on the models. Moreover, the majority of the reviewed articles are working with single-lesion images and do not consider typical mole patterns and temporal changes in the lesions of each patient.

11.
Front Surg ; 10: 1245851, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37671031

RESUMO

Background: Augmented reality (AR) is increasingly being explored in neurosurgical practice. By visualizing patient-specific, three-dimensional (3D) models in real time, surgeons can improve their spatial understanding of complex anatomy and pathology, thereby optimizing intra-operative navigation, localization, and resection. Here, we aimed to capture applications of AR in glioma surgery, their current status and future potential. Methods: A systematic review of the literature was conducted. This adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, Embase, and Scopus electronic databases were queried from inception to October 10, 2022. Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis. Data regarding AR workflow, surgical application, and associated outcomes were then extracted. The quality of evidence was additionally examined, using hierarchical classes of evidence in neurosurgery. Results: The search returned 77 articles. Forty were subject to title and abstract screening, while 25 proceeded to full text screening. Of these, 22 articles met eligibility criteria and were included in the final review. During abstraction, studies were classified as "development" or "intervention" based on primary aims. Overall, AR was qualitatively advantageous, due to enhanced visualization of gliomas and critical structures, frequently aiding in maximal safe resection. Non-rigid applications were also useful in disclosing and compensating for intra-operative brain shift. Irrespective, there was high variance in registration methods and measurements, which considerably impacted projection accuracy. Most studies were of low-level evidence, yielding heterogeneous results. Conclusions: AR has increasing potential for glioma surgery, with capacity to positively influence the onco-functional balance. However, technical and design limitations are readily apparent. The field must consider the importance of consistency and replicability, as well as the level of evidence, to effectively converge on standard approaches that maximize patient benefit.

12.
Artigo em Inglês | MEDLINE | ID: mdl-37562582

RESUMO

In fishes, the availability of taurine is regulated during ontogenetic development, where its endogenous synthesis capacity is species dependent. Thus, different pathways and involved enzymes have been described: pathway I (cysteine sulfinate-dependent pathway), cysteine dioxygenase type 1 (cdo1) and cysteine sulfinic acid decarboxylase (csad); pathway II (cysteic acid pathway), cdo1 and glutamic acid decarboxylase (gad); and pathway III (cysteamine pathway), 2-aminoethanethiol dioxygenase (ado); whereas taurine transporter (taut) is responsible for taurine entry into cells on the cell membrane and the mitochondria. This study determined if the tropical gar (Atractosteus tropicus), an ancient holostean fish model, has the molecular mechanism to synthesize taurine through the identification and analysis expression of transcripts coding for proteins involved in its biosynthesis and transportation, at different embryo-larvae stages and in different organs of juveniles (31 dah). We observed a fluctuating expression of all transcripts involved in the three pathways at all analyzed stages. All transcripts are expressed during the beginning of larval development; however, ado and taut show a peak expression at 9 dah, and all transcripts but csad decreased at 23 dah, when the organism ended the larval period. Furthermore, at 31 dah, we observed taut expression in all examined organs. The transcripts involved in pathways I and III are expressed differently across all organs, whereas pathway II was only observed in the brain, eye, and skin. The results suggested that taurine biosynthesis in tropical gar is regulated during its early development before first feeding, and the pathway might also be organ-type dependent.


Assuntos
Carboxiliases , Peixes , Animais , Peixes/metabolismo , Larva/genética , Larva/metabolismo , Taurina/metabolismo , Carboxiliases/genética , Carboxiliases/metabolismo
13.
BMJ Open ; 13(8): e065222, 2023 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-37620277

RESUMO

INTRODUCTION: Volunteer support for patients and families at the end of life provides many benefits for the beneficiaries. New technologies could be a necessary resource in the accompaniment although, if there is little literature on palliative care volunteering in general, specifically on volunteering and new technologies, we find little information on the subject.Therefore, the aim of this study is to implement and evaluate a training program for palliative care volunteers using new technologies in order to begin accompanying patients and families in hospital or at home. METHODS AND ANALYSIS: A mixed-method study design will be conducted. We will recruit 20 volunteers and 70 patients in two years. INTERVENTION: training of volunteers in new technologies and volunteer accompaniment of patients/relatives using technologies. The control group will accompany patients as usual. ETHICS AND DISSEMINATION: Ethics approval for the ITV-Pal Programme project was granted by the Malaga Regional Research Ethics Committee. As new knowledge is gained from this project, findings will be disseminated through publications, presentations and feedback to clinicians who are participating in this study. TRIAL REGISTRATION NUMBER: NCT04900103.


Assuntos
Morte , Cuidados Paliativos , Humanos , Grupos Controle , Comitês de Ética em Pesquisa , Voluntários
14.
Medisan ; 27(2)abr. 2023. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1440579

RESUMO

Introducción: El dolor es el síntoma más común luego de la primera activación de la aparatología ortodóncica. El tratamiento analgésico más utilizado es el paracetamol; sin embargo, su uso inhibe la actividad de la ciclooxigenasa y la síntesis de prostaglandinas, lo que puede afectar el mecanismo del movimiento dental y el remodelado óseo. Objetivo: Evaluar la efectividad del láser de baja potencia para el alivio del dolor en pacientes con tratamiento ortodóntico. Métodos: Se realizó un estudio cuasiexperimental de intervención terapéutica, desde enero hasta diciembre de 2020, en 40 pacientes atendidos en la consulta de ortodoncia del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, en quienes se aplicaría fuerza ortodóncica por primera vez. Estos fueron distribuidos de forma aleatoria en 2 grupos de 20 integrantes cada uno: el de estudio, tratado con láser de baja potencia, y el de control, que recibió medicación convencional (paracetamol). Para la validación estadística de la información se emplearon el porcentaje y la prueba de la t de Student para muestras independientes, con 95 % de confiabilidad. Resultados: Luego de tres sesiones terapéuticas, 90,0 % del grupo de estudio refirió no presentar dolor o sentirlo de forma leve, mientras que del grupo de control solo 10,0 % de los pacientes fue ubicado en cualquiera de las dos categorías anteriores. Existió diferencia significativa entre ambos grupos (p=0,00). Conclusiones: Se demostró que el láser, como terapia alternativa, fue más efectivo que el paracetamol.


Introduction: Pain is the most common symptom after the first activation of orthodontic appliance. The most widely used analgesic treatment is paracetamol; however, its use inhibits cyclooxygenase activity and prostaglandin synthesis, which can affect the mechanism of tooth movement and bone remodeling. Objective: To evaluate the effectiveness of low power laser for pain relief in patients with orthodontic treatment. Methods: A quasi-experimental study of therapeutic intervention was carried out, from January to December 2020, in 40 patients treated at the orthodontic clinic of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, in whom orthodontic force was applied for the first time. These were randomly distributed into 2 groups of 20 members each: the study group, treated with low-power laser, and the control group, that received conventional medication (paracetamol). For statistical validation of data, the percentage and the Student's t test for independent samples were used, with 95 % confidence interval. Results: After three therapeutic sessions, 90.0% of the study group reported not presenting pain or feeling it slightly, while only 10.0% of patients in control group were put in any of the two previous categories. There was a significant difference between both groups (p=0.00). Conclusions: Laser, as an alternative therapy, was shown to be more effective than paracetamol.


Assuntos
Terapia com Luz de Baixa Intensidade , Dor Processual , Aparelhos Ortodônticos , Técnicas de Movimentação Dentária , Analgesia
15.
J Inorg Biochem ; 242: 112149, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36780772

RESUMO

We report the synthesis and characterization of new tri-cationic corrole derivatives, containing Pt(II) or Pd(II) complexes attached at the peripheral position of thienyl moieties. Corrole derivatives were characterized through microanalysis, electrochemical, spectrometry and spectroscopy analysis. Singlet and triplet excited-states are investigated by photophysical/theoretical calculation methods and photobiological parameters were also evaluated spectroscopic techniques (UV-Vis and EPR). Also, the binding capacity of each corrole derivative with nucleic acids (DNA) and human serum albumin (HSA) was determined by UV-Vis, steady-state, and time-resolved fluorescence spectroscopy, combined with molecular docking analysis. Moreover, the new corroles containing peripheral complexes improve their interactions with biomacromolecules, generate reactive oxygen species under light source irradiation studied and has potential for application in photodynamic therapeutic processes.


Assuntos
Porfirinas , Humanos , Simulação de Acoplamento Molecular , Porfirinas/química , Espectrometria de Fluorescência
16.
Cortex ; 159: 286-298, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36645968

RESUMO

Though the lateral frontal cortex is broadly implicated in cognitive control, functional MRI (fMRI) studies suggest fine-grained distinctions within this region. To examine this question electrophysiologically, we placed electrodes on the lateral frontal cortex in patients undergoing awake craniotomy for tumor resection. Patients performed verbal tasks with a manipulation of attentional switching, a canonical control demand. Power in the high gamma range (70-250 Hz) distinguished electrodes based on their location within a high-resolution fMRI network parcellation of the frontal lobe. Electrodes within the canonical fronto-parietal control network showed increased power in the switching condition, a result absent in electrodes within default mode, language and somato-motor networks. High gamma results contrasted with spatially distributed power decreases in the beta range (12-30 Hz). These results confirm the importance of fine-scale functional distinctions within the human frontal lobe, and pave the way for increased precision of functional mapping in tumor surgeries.


Assuntos
Mapeamento Encefálico , Neoplasias , Humanos , Mapeamento Encefálico/métodos , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/fisiologia , Vigília , Imageamento por Ressonância Magnética , Cognição/fisiologia
17.
Brain ; 146(3): 1200-1211, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36256589

RESUMO

Unravelling the complex events driving grade-specific spatial distribution of brain tumour occurrence requires rich datasets from both healthy individuals and patients. Here, we combined open-access data from The Cancer Genome Atlas, the UK Biobank and the Allen Brain Human Atlas to disentangle how the different spatial occurrences of glioblastoma multiforme and low-grade gliomas are linked to brain network features and the normative transcriptional profiles of brain regions. From MRI of brain tumour patients, we first constructed a grade-related frequency map of the regional occurrence of low-grade gliomas and the more aggressive glioblastoma multiforme. Using associated mRNA transcription data, we derived a set of differential gene expressions from glioblastoma multiforme and low-grade gliomas tissues of the same patients. By combining the resulting values with normative gene expressions from post-mortem brain tissue, we constructed a grade-related expression map indicating which brain regions express genes dysregulated in aggressive gliomas. Additionally, we derived an expression map of genes previously associated with tumour subtypes in a genome-wide association study (tumour-related genes). There were significant associations between grade-related frequency, grade-related expression and tumour-related expression maps, as well as functional brain network features (specifically, nodal strength and participation coefficient) that are implicated in neurological and psychiatric disorders. These findings identify brain network dynamics and transcriptomic signatures as key factors in regional vulnerability for glioblastoma multiforme and low-grade glioma occurrence, placing primary brain tumours within a well established framework of neurological and psychiatric cortical alterations.


Assuntos
Neoplasias Encefálicas , Conectoma , Glioblastoma , Glioma , Humanos , Glioblastoma/genética , Transcriptoma , Estudo de Associação Genômica Ampla , Glioma/genética , Neoplasias Encefálicas/metabolismo
18.
Ginecol. obstet. Méx ; 91(3): 197-209, ene. 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448333

RESUMO

Resumen ANTECEDENTES: El síndrome de Hamman se caracteriza por la coexistencia de aire libre en el mediastino sin una causa identificable; también puede ser secundario a traumatismos, infecciones intratorácicas, procedimientos médicos como la esofagoscopia y broncoscopia. Su incidencia se estima entre 1 en 2000 y 1 en 100,000 embarazos. CASO CLÍNICO: Paciente de 18 años, con 65 kg de peso, 1.56 m de talla e IMC 26.74, correspondiente a sobrepeso, primigesta, sin antecedentes patológicos ni heredofamiliares relevantes, con evolución normal del embarazo. A las 39 semanas acudió a urgencias ginecológicas debido a contractilidad uterina y salida de líquido por la vagina. La finalización del embarazo fue por parto, con recién nacido vivo. En el puerperio mediato (30 horas después del parto) súbitamente tuvo disnea, ortopnea y dolor en la región infraclavicular, sensación de "burbujeo" en la parte anterior del tórax. La radiografía simple de tórax mostró aire libre en el mediastino y enfisema subcutáneo. La TAC de tórax evidenció múltiples burbujas de aire, con extensión del espacio perivertebral de predominio derecho. La conclusión diagnóstica fue: enfisema extenso subcutáneo en los espacios del cuello, con alcance al mediastino anterior, con extenso neumomediastino y cardiomegalia global. CONCLUSIONES: El síndrome de Hamman prevalece en primigestas jóvenes y tiene un curso benigno. El tratamiento debe ser conservador, con oxígeno y analgésicos.


Abstract BACKGROUND: Hamman's syndrome is characterized by the coexistence of free air in the mediastinum without an identifiable cause; it may also be secondary to trauma, intrathoracic infections, medical procedures such as oesophagoscopy and bronchoscopy. Its incidence is estimated to be between 1 in 2000 and 1 in 100,000 pregnancies. CLINICAL CASE: 18-year-old female patient, weight 65 kg, height 1.56 m and BMI 26.74, corresponding to overweight, primigravida, with no relevant pathological or heredofamilial history, with normal evolution of pregnancy. At 39 weeks, she attended the gynaecological emergency department due to uterine contractility and leakage of fluid from the vagina. The pregnancy was terminated by delivery, with a live newborn. In the immediate postpartum period (30 hours after delivery) she suddenly experienced dyspnoea, orthopnoea and pain in the infraclavicular region, with a sensation of "bubbling" in the anterior chest. Plain chest X-ray showed free air in the mediastinum and subcutaneous emphysema. Chest CT showed multiple air bubbles, with extension of the perivertebral space predominantly on the right. The diagnostic conclusion was: extensive subcutaneous emphysema in the neck spaces extending into the anterior mediastinum, with extensive pneumomediastinum and global cardiomegaly. CONCLUSIONS: Hamman syndrome is prevalent in young primigravidae and has a benign course. Treatment should be conservative, with oxygen and analgesics.

19.
Movimento (Porto Alegre) ; 29: e29045, 2023. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1529032

RESUMO

Resumo Hoje em dia, o cenário esportivo, sobretudo retratado pelas mídias, vem apresentando novas perspectivas em relação às práticas atlético-esportivas LGBTI+. O objetivo desta pesquisa foi analisar a cobertura televisiva sobre a participação de atletas trans no esporte, com base no programa Esporte Espetacular. Metodologicamente, a pesquisa caracteriza-se como qualitativa e exploratória, utilizando a etnografia de tela como ferramenta de produção dos dados. Foram analisadas 4 reportagens produzidas de 2017 a 2019, totalizando aproximadamente 35 minutos. Os achados permitem inferir que todas as narrativas televisivas apresentam equívocos conceituais e uma abordagem que tende ao sensacionalismo, além de enfocarem um tipo específico de identidade transgênero, no discurso biomédico da vantagem e da testosterona e de episódios de negação, constrangimento e não-reconhecimento do corpo trans no Esporte.


Resumen En la actualidad, el escenario deportivo, el escenario deportivo, tal como es retratado por los medios de comunicación, presenta nuevas perspectivas con respecto a las prácticas atlético-deportivas LGBTI+. El objetivo de esta investigación fue analizar la cobertura televisiva sobre la participación de atletas trans en el deporte, basándose en el programa "Esporte Espetacular". La metodología empleada en esta investigación se caracteriza como cualitativa y exploratoria, y utiliza la Etnografía de Pantalla como herramienta para la producción de datos.. Se analizaron 4 reportajes, producidos desde 2017 hasta 2019, con una duración total de aproximadamente 35 minutos. Los hallazgos sugieren que todas las narrativas televisivas analizadas presentan errores conceptuales y muestran un enfoque que tiende hacia el sensacionalismo, centrándose en un tipo particular de identidad transgénero, en el discurso biomédico de la ventaja y la testosterona, así como en episodios de negación, vergüenza y no reconocimiento del cuerpo trans en el deporte.


Abstract Nowadays, the sports scenario, particularly portrayed by the media, is presenting new perspectives regarding LGBTI+ athletic-sport practices. The objective of this research was to analyze television coverage of the participation of transgender athletes in sports, based on the program "Esporte Espetacular". Methodologically, the research is characterized as qualitative and exploratory, using screen ethnography as a data production tool. Four reports produced from 2017 to 2019 were analyzed, totaling approximately 35 minutes. The findings allow us to infer that all episodes' narratives present conceptual mistakes and an approach that tends towards sensationalism, focusing on a particular type of transgender identity, on the biomedical discourse of advantage and testosterone, as well as instances of denial, embarrassment, and non-recognition of the transgender body in sports.

20.
Saúde Soc ; 32(4): e220352pt, 2023. tab
Artigo em Português | LILACS | ID: biblio-1530420

RESUMO

Resumo À luz das práticas de lazer, objetivamos analisar os sentidos do consumo de drogas por homens homossexuais em uma casa noturna da cidade do Rio de Janeiro, RJ. Realizamos o processo de observação participante em 36 episódios de festas eletrônicas em uma boate, entre janeiro de 2018 e setembro de 2019. Detectamos que os usos de substâncias estabelecem um sentimento de pertencimento social entre os sujeitos, funcionando como rede de apoio coesa e cerimonial. Concluímos que, para os interlocutores, as drogas assumem diferentes sentidos para um "bem-viver" coletivo, em que a droga simboliza a união e o apoio socioemocional que conecta os homossexuais consumidores em um espaço plural às diversidades, a princípio sem julgamentos morais. O consumo das drogas em cada festa fortaleceu a coesão grupal, além de refletir sentimentos de fraternidade, companheirismo e irmandade, edificando e retroalimentando uma espécie de "grupo terapêutico" atrelado a essa vivência do lazer, uma prática acionada para "suportar e sobreviver" às demandas sociais, por vezes preconceituosas e discriminatórias.


Abstract In light of leisure practices, we aim to analyze the meanings of drug consumption by homosexual men in a nightclub in the city of Rio de Janeiro, RJ. We carried out the participant observation process in 36 episodes of electronic parties in a nightclub, between January 2018 and September 2019. We detected that substance use establishes a sense of social belonging among the subjects, functioning as a cohesive and ceremonial support network. We conclude that, for those interlocutors, drugs take on different meanings for a collective "good living," in which the drug symbolizes the union and socio-emotional support that connects homosexual consumers in a plural space to diversities, at first without moral judgments. The consumption of drugs at each party strengthened group cohesion, in addition to reflecting feelings of fraternity, companionship, and brotherhood, building and feeding back a kind of "therapeutic group" linked to this experience of leisure, a practice activated to "endure and survive" the social demands, sometimes prejudiced and discriminatory.


Assuntos
Drogas Ilícitas , Homossexualidade Masculina , Pesquisa Qualitativa , Políticas Públicas Antidiscriminatórias
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