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1.
Acad Radiol ; 31(6): 2405-2411, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38142177

RESUMO

RATIONALE AND OBJECTIVES: Early diagnosis of transplant renal artery stenosis (TRAS) is crucial for salvaging kidney function and improving patient prognosis. The purpose of this study was to evaluate image quality of non-contrast-enhanced MR angiography (NCE-MRA) and the value of NCE-MRA in evaluating TRAS compared to DSA. MATERIALS AND METHODS: In 60 patients with TRAS confirmed by DSA, the degree of TRAS was assessed using balanced triggered angiography non-contrast-enhanced (B-TRANCE) MR angiography and was compared to that of DSA. Image quality for NCE-MRA was assessed independently by two radiologists. The Wilcoxon signed-rank test was used to compare NCE-MRA with DSA in assessing TRAS degree. Specificity, sensitivity, accuracy, positive-predictive value (PPV), and negative-predictive value (NPV) of NCE-MRA for the detection of marked (≥50%) TRAS were calculated. RESULTS: The image quality of NCE-MRA based on the B-TRANCE technology of transplanted renal arteries was sufficient (excellent in 81.67%, good in 8.33%, moderate in 6.67%, and non-diagnostic in 3.33%) and had a high inter-observer reproducibility (Kappa=0.836). DSA helped identify severe, moderate, and mild stenosis in 6, 32, and 22 arteries, respectively. No significant difference in the extent of TRAS between NCE-MRA and DSA were observed (P = 0.317). The specificity, sensitivity, accuracy, PPV, and NPV of NCE-MRA in detecting marked (≥50%) TRAS were 90.91%, 100%, 96.55%, 94.74%, and 100%, respectively. CONCLUSION: NCE-MRA based on B-TRANCE technology has shown promising consistency with DSA in evaluating TRAS and yielding high sensitivity, specificity, and accuracy in assessing the severity of TRAS.


Assuntos
Angiografia Digital , Transplante de Rim , Angiografia por Ressonância Magnética , Obstrução da Artéria Renal , Sensibilidade e Especificidade , Humanos , Obstrução da Artéria Renal/diagnóstico por imagem , Angiografia por Ressonância Magnética/métodos , Masculino , Feminino , Angiografia Digital/métodos , Pessoa de Meia-Idade , Adulto , Reprodutibilidade dos Testes , Idoso , Meios de Contraste
2.
Diabetologia ; 66(9): 1693-1704, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37391625

RESUMO

AIMS/HYPOTHESIS: The aim of this study was to estimate the long-term health and economic consequences of improved risk factor control in German adults with type 2 diabetes. METHODS: We used the UK Prospective Diabetes Study Outcomes Model 2 to project the patient-level health outcomes and healthcare costs of people with type 2 diabetes in Germany over 5, 10 and 30 years. We parameterised the model using the best available data on population characteristics, healthcare costs and health-related quality of life from German studies. The modelled scenarios were: (1) a permanent reduction of HbA1c by 5.5 mmol/mol (0.5%), of systolic BP (SBP) by 10 mmHg, or of LDL-cholesterol by 0.26 mmol/l in all patients, and (2) achievement of guideline care recommendations for HbA1c (≤53 mmol/mol [7%]), SBP (≤140 mmHg) or LDL-cholesterol (≤2.6 mmol/l) in patients who do not meet the recommendations. We calculated nationwide estimates using age- and sex-specific quality-adjusted life year (QALY) and cost estimates, type 2 diabetes prevalence and population size. RESULTS: Over 10 years, a permanent reduction of HbA1c by 5.5 mmol/mol (0.5%), SBP by 10 mmHg or LDL-cholesterol by 0.26 mmol/l led to per-person savings in healthcare expenditures of €121, €238 and €34, and 0.01, 0.02 and 0.015 QALYs gained, respectively. Achieving guideline care recommendations for HbA1c, SBP or LDL-cholesterol could reduce healthcare expenditure by €451, €507 and €327 and gained 0.03, 0.05 and 0.06 additional QALYs in individuals who did not meet the recommendations. Nationally, achieving guideline care recommendations for HbA1c, SBP and LDL-cholesterol could reduce healthcare costs by over €1.9 billion. CONCLUSIONS/INTERPRETATION: Sustained improvements in HbA1c, SBP and LDL-cholesterol control among diabetes patients in Germany can lead to substantial health benefits and reduce healthcare expenditures.


Assuntos
Diabetes Mellitus Tipo 2 , Masculino , Feminino , Humanos , Adulto , Hipoglicemiantes , Pressão Sanguínea , Glucose , Qualidade de Vida , Estudos Prospectivos , Hemoglobinas Glicadas , LDL-Colesterol
3.
BioDrugs ; 37(3): 409-420, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36952213

RESUMO

OBJECTIVE: We aimed to assess whether the introduction of the first infliximab biosimilar was associated with changes in overall infliximab consumption (originator and biosimilars) and price changes to the originator infliximab. METHODS: An interrupted time series analysis using infliximab sales data from 2010 to 2020 from the IQVIA Multinational Integrated Data Analysis System for eight selected regions: Australia, Canada, Hong Kong, Korea, India, Japan, the UK, and the USA. Quarterly measures of infliximab consumption and list prices were respectively defined as the number of standard units (SU)/1000 inhabitants and as 2020 USA dollars (USD)/SU. RESULTS: Following the introduction of infliximab biosimilars, overall infliximab consumption increased in Australia [immediate change: 0.145 SU/1000 inhabitants (P = 0.014); long-term change: 0.022 SU/1000 inhabitants per quarter (P < 0.001)], Canada [immediate change 0.415 (P = 0.008)], the UK [long-term change 0.024 (P < 0.001)], and Hong Kong [immediate change: 0.042 (P < 0.001)]. The list price of originator infliximab also decreased following biosimilar introduction in Australia [immediate change: - 187.84 USD/SU (P < 0.001); long-term change - 6.46 USD/SU per quarter (P = 0.043)], Canada [immediate change: - 145.58 (P < 0.001)], the UK [immediate change: - 34.95 (P = 0.010); long-term change: - 4.77 (P < 0.001)], and Hong Kong [long-term change: - 4.065 (P = 0.046)]. Consumption and price changes were inconsistent in India, Japan, Korea, and the USA. CONCLUSIONS: Introduction of the first infliximab biosimilar was not consistently associated with increased consumption across regions. Additional policy and healthcare system interventions to support biosimilar infliximab adoption are needed.


Assuntos
Medicamentos Biossimilares , Humanos , Infliximab/uso terapêutico , Medicamentos Biossimilares/uso terapêutico , Análise de Séries Temporais Interrompida , Índia
4.
Environ Sci Pollut Res Int ; 30(14): 42192-42213, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36645605

RESUMO

Traditional method of estimating pollution loads may neglect the internal spatial heterogeneity of socio-economic driving factors, which can result in overestimate and underestimate of pollution loads. In this study, the corrected approach to estimating total phosphorus (TP) pollution load was proposed to explore its future variation to develop effective phosphorus pollution control strategies for water environment management. As the first-class tributary of the Yangtze River, the TP out of limits in the Tuojiang River is serious. Thus, based on the presently related basic datasets related to TP pollution load estimation, we firstly adopted the GM (1,1) model to predict their varied trends from 2021 to 2025. We then used the pollution emission coefficient method to calculate the TP pollution load. Moreover, considering the temporal and spatial heterogeneity of the pollutant generation coefficient, we further introduced population and GDP factors to further modify the pollutant generation coefficient to correct TP pollution load. Finally, we employed the exploratory spatial data analysis (ESDA) method to explore spatial distribution characteristics and spatial autocorrelation of TP pollution load from diverse pollution sources in 2025. The results showed that the total TP pollution load from diverse pollution sources will increase from 12,194.92 t in 2021 to 12,461.26 t in 2025, an increase of 2.18%. More concretely, the TP pollution load from rural domestic sewage, rural domestic waste and livestock, and poultry pollution sources will separately decrease by 94.24 t, 77.9 t, and 86.52 t. However, the TP pollution load from agricultural runoff and agricultural solid wastes pollution sources will increase by 74.52 t and 451.49 t, respectively. The contribution of TP pollution load from diverse pollution sources to total TP pollution load will be as follows: livestock and poultry (63.49%) > agricultural solid wastes (16.72%) > agricultural runoff (12.26%) > rural domestic sewage (4.12%) > rural domestic waste (3.41%). The difference in the spatial distribution of TP pollution load from diverse pollution sources in 2025 will be prominent. TP pollution from rural domestic sewage and rural domestic waste pollution sources is more serious in the Xindu and Longquanyi districts, and that from agricultural runoff and agricultural solid wastes pollution sources is more prominent in the midstream and downstream. TP pollution load from livestock and poultry pollution source is higher in the Renshou, Anyue, Rongxian, Luxian counties, and Jiangyang district. Additionally, TP pollution load from rural domestic sewage, rural domestic waste, agricultural runoff, and agricultural solid wastes pollution sources in 2025 will show a clear spatial correlation, but the spatial correlation of TP pollution load from livestock and poultry pollution source will be weak. The study is effective to eliminate the influence of temporal and spatial variation of pollutants generates coefficients on TP pollution load estimation. The method can reflect the actual condition of pollution loads in watersheds more objectively, which can be applied to estimate other pollution loads of similar watersheds with intensive socio-economic activities. The findings in this study can provide a critical reference for the stakeholders to balance water environment conservation and socio-economic development.


Assuntos
Poluentes Químicos da Água , Poluentes Químicos da Água/análise , Monitoramento Ambiental/métodos , Fósforo/análise , Esgotos , Resíduos Sólidos , Nitrogênio/análise , China , Água
5.
Drug Alcohol Depend ; 238: 109542, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35780623

RESUMO

BACKGROUND: Drug use disorders (DUDs) have been a public health crisis which strongly impacted community health and socio-economic development. However, there are few studies based on the latest global data to show changes in the disease burden due to DUDs, specifically investigating associations between the country-level socio-economic factors and the burden of DUDs. METHODS: Data of DUDs were extracted from the Global Burden of Disease Study 2019 database to explore the trends of the disease burden due to DUDs from 1990 to 2019. Univariate linear regression and stepwise multiple linear regression analysis were performed to analyze the correlations between burden due to DUDs and country-level socio-economic factors. RESULTS: Globally, the number of disability-adjusted life-years (DALYs) caused by DUDs approximately increased by 2.6% yearly from 1990 to 2019, though the age-standardized DALY rate has not changed significantly in the past 30 years. The age-standardized DALY rate of opioid use disorders showed an upward trend during the past 30 years and was highest among 5 types of DUDs in 2019. Inequality-adjusted human development index (ß = 15.9, 95% confidence interval [CI]: 12.9-18.9, P < 0.001) was identified as the key risk factor associated with square-root transformed age-standardized DALY rate of DUDs. CONCLUSIONS: Global burden due to DUDs has increased significantly over the past 30 years. More effective targeted public health policies should be formulated to manage the public health challenge of DUDs, especially in developed countries and territories.


Assuntos
Saúde Global , Transtornos Relacionados ao Uso de Substâncias , Adulto , Efeitos Psicossociais da Doença , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
6.
Sci Rep ; 12(1): 12196, 2022 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-35842500

RESUMO

Investigation and assessment of farmland pollution require an efficient method to identify heavy metal (HM) pollutants and their sources. In this study, heavy metals (HMs) in farmland were determined efficiently using high-precision X-ray fluorescence (HDXRF) spectrometer. The potential ecological risk and health risk of HMs in farmland near eight villages of Wushan County in China were quantified using an integrated method of concentration-oriented risk assessment (CORA) and source-oriented risk assessment (SORA). The CORA results showed that Cd in farmland near the villages of Liuping (LP) and Jianping (JP) posed a "very high" potential ecological risk, which is mainly ascribed to soil Cd (single potential ecological risk index ([Formula: see text]) of Cd in villages LP and JP, [Formula: see text] = 2307 and 568 > 320). A "moderate" potential ecological risk was present in other six villages. The overall non-carcinogenic risk (hazard index (HI) = 1.2 > 1) of HMs for children in village LP was unacceptable. The contributions of HMs decrease in the order of Cr > As > Cd > Pb > Ni > Cu > Zn. The total carcinogenic risk (TCR = 2.1 × 10-4 > 1.0 × 10-4) of HMs in village LP was unacceptable, with HMs contributions decreasing in the order of Cr > Ni > Cd > As > Pb. Furthermore, three source profiles were assigned by the positive matrix factorization: F1: agricultural activity; F2: geological anomaly originating from HMs-rich rocks; F3: the natural geological background. According to the results of SORA, F2 was the highest contributor to PER in village LP, up to 64.4%. Meanwhile, the contributions of three factors to HI in village LP were 19.0% (F1), 53.6% (F2), and 27.4% (F3), respectively. It is worth noting that TCR (1.2 × 10-4) from F2 surpassed the threshold of 1.0 × 10-4, with an unacceptable carcinogenic risk level. As mentioned above, the HM pollutants (i.e., Cd and Cr) and their main sources (i.e., F2) in this area should be considered. These results show that an integrated approach combining risk assessments with the determination of HM concentration and identification of HM source is effective in identifying HM pollutants and sources and provides a good methodological reference for effective prevention and control of HM pollution in farmland.


Assuntos
Poluentes Ambientais , Metais Pesados , Poluentes do Solo , Cádmio/análise , Criança , China , Monitoramento Ambiental/métodos , Poluentes Ambientais/análise , Fazendas , Humanos , Chumbo/análise , Metais Pesados/análise , Receptores de Antígenos de Linfócitos T , Medição de Risco , Solo/química , Poluentes do Solo/análise , Espectrometria por Raios X
7.
Lancet Reg Health West Pac ; 22: 100426, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35637863

RESUMO

Background: Few studies investigated the mechanisms of treatment-resistant depression (TRD) leading to the worsened survival outcome, and economic evidence was mostly restricted to short follow-ups. We aimed to examine the association and potential mediators between TRD and all-cause mortality, and estimate a longer-term associated health resource utilisation pattern. Methods: This was a population-based cohort study using territory-wide electronic medical records in Hong Kong. Incident depression patients diagnosed in 2014 were followed up from the first diagnosis to death or December 2019 for TRD identification. We matched the TRD cohort 1:4 to the non-TRD cohort on propensity scores estimated by age, sex, history of physical disorders, and history of psychiatric conditions before depression diagnoses. Findings: 18% of incident patients developed TRD within six years of follow-up. Cox model showed that patients with TRD had 1⋅52-fold (95% CI: 1⋅14-2⋅02) greater risk of all-cause mortality, compared with non-TRD patients. Path analysis suggested that post-TRD psychiatric conditions significantly mediated 41⋅6% of mortality in patients with TRD (p=0.003). TRD was associated with 1⋅8-fold (95%CI: 1⋅63-2⋅00) higher healthcare costs compared to non-TRD patients over six years in negative binomial regression, with higher costs for both psychiatric and non-psychiatric services utilisation in all settings. Interpretation: Identifying patients with TRD and subsequent monitoring for post-TRD psychiatric diagnoses could be a way to reduce premature mortality. Multidisciplinary care involving both psychiatric and general medical professionals is also warranted to relieve the multifaceted impacts on healthcare resources and overall cost. Funding: Unconditional educational grant from Janssen.

8.
Environ Sci Pollut Res Int ; 29(35): 53785-53800, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35288859

RESUMO

Green total factor productivity (GTFP) is an essential indicator to measure economic and environmental efficiency. Moreover, formulating a reasonable environmental regulation system and promoting green technological innovation is a systematic way to improve GTFP. However, previous related studies lack to investigate the impact of environmental regulation on GTFP from the perspective of green technological innovation. For this purpose, this paper aims to examine the specific impact of environmental regulation on GTFP based on the perspective of green technology innovation, so as to provide some policy insights for the formulation of more effective implementation of environmental regulation, improve green technology innovation level, and achieve a win-win situation for both economic growth and environmental protection. Furthermore, epsilon-based measure (EBM), which includes both radial and non-radial distance functions, is used to measure the GTFP. The spatial autoregressive method is also employed to quantify the impact of environmental regulation on GTFP from the perspective of green technological innovation using panel data of 269 prefecture-level cities in China from 2004 to 2018. The main findings indicate that there is a significant spatial autocorrelation between environmental regulation and GTFP. Environmental regulation has a significant positive effect on GTFP. Environmental regulation in the local regions also significantly contributes to GTFP in neighboring regions. Besides, environmental regulation indirectly promotes GTFP by enhancing green technological innovation level. Regional heterogeneity results show that environmental regulation can not only directly promote GTFP but also indirectly significantly promote GTFP through green technological innovation in the eastern and central regions, but insignificant in the western region. Based on the above findings, we conclude that policymakers should not only develop differentiated environmental regulation standards and steadily improving the intensity and rationality of environmental regulation but also add green innovation funds supply, enhance green innovation factor allocation efficiency, and strengthen R&D talents, funds, and policies to green technology innovation, so as to drive GTFP improvement.


Assuntos
Desenvolvimento Econômico , Invenções , China , Cidades , Conservação dos Recursos Naturais , Eficiência
9.
J Glob Health ; 11: 08009, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34737869

RESUMO

BACKGROUND: To evaluate the disease burden of age-related macular degeneration (AMD) in terms of disability-adjusted life years (DALY) in China from 1990 to 2019. METHODS: Prevalence of blindness and vision loss due to AMD and DALY number, rate, and age-standardized rates of AMD were collected from the Global Burden of Disease Study 2019 database. The characters of variables were analyzed between China and its neighboring countries. RESULTS: From 1990 to 2019, the all-age number and rate for AMD prevalence and DALYs increased significantly in China, while the age standardized DALYs rate in 2019 showed a decrease of 3.63% compared with that in 1990. Females were found to have a higher prevalence and DALYs than males. The 65-69 age group had the highest AMD DALYs number, while the DALYs rate showed a positive association with age. In 2019, when compared to neighboring countries, the age standardized prevalence rate of AMD in China was ranked second after Pakistan, while the age standardized DALYs rate ranked second after Pakistan and India. CONCLUSIONS: Despite a small decrease in age standardized DALYs rate in China in the past three decades, the disease burden of AMD is still considerable and much higher compared to neighboring developed countries. Optimizing health services allocation is needed to further reduce this burden.


Assuntos
Carga Global da Doença , Degeneração Macular , China/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Saúde Global , Humanos , Degeneração Macular/epidemiologia , Masculino
10.
Value Health ; 23(12): 1580-1591, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33248513

RESUMO

OBJECTIVES: Three hundred million people living with rare diseases worldwide are disproportionately deprived of in-time diagnosis and treatment compared with other patients. This review provides an overview of global policies that optimize development, licensing, pricing, and reimbursement of orphan drugs. METHODS: Pharmaceutical legislation and policies related to access and regulation of orphan drugs were examined from 194 World Health Organization member countries and 6 areas. Orphan drug policies (ODPs) were identified through internet search, emails to national pharmacovigilance centers, and systematic academic literature search. Texts from selected publications were extracted for content analysis. RESULTS: One hundred seventy-two drug regulation documents and 77 academic publications from 162 countries/areas were included. Ninety-two of 200 countries/areas (46.0%) had documentation on ODPs. Thirty-four subthemes from content analysis were categorized into 6 policy themes, namely, orphan drug designation, marketing authorization, safety and efficacy requirements, price regulation, incentives that encourage market availability, and incentives that encourage research and development. Countries/areas with ODPs were statistically wealthier (gross national income per capita = $10 875 vs $3950, P < .001). Country/area income was also positively correlated with the scope of the respective ODP (correlation coefficient = 0.57, P < .001). CONCLUSIONS: Globally, the number of countries with an ODP has grown rapidly since 2013. Nevertheless, disparities in geographical distribution and income levels affect the establishment of ODPs. Furthermore, identified policy gaps in price regulation, incentives that encourage market availability, and incentives that encourage research and development should be addressed to improve access to available and affordable orphan drugs.


Assuntos
Política de Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Produção de Droga sem Interesse Comercial/estatística & dados numéricos , Desenvolvimento de Medicamentos/métodos , Desenvolvimento de Medicamentos/organização & administração , Saúde Global , Humanos , Formulação de Políticas , Doenças Raras/tratamento farmacológico
11.
Quant Imaging Med Surg ; 10(6): 1286-1297, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32550137

RESUMO

BACKGROUND: Diffusion-weighted imaging (DWI) can noninvasively assess renal allograft pathologic changes that provide useful information for clinical management and prognostication. However, it is still unknown whether the bi-exponential model analysis of DWI signals is superior to that of the mono-exponential model. METHODS: Pathologic and DWI data from a total of 47 allografts were prospectively collected and analyzed. Kidney transplant interstitial fibrosis was quantified digitally. The severity of acute and chronic pathologic changes was semi-quantified by calculating the acute composite scores (ACS) and chronic composite score (CCS). Mono-exponential total apparent diffusion coefficient (ADCT), and the bi-exponential parameters of true diffusion (D) and perfusion fraction (fp) were acquired. The diagnostic performances of both mono-exponential and bi-exponential parameters were assessed and compared by calculating the area under the curve (AUC) from receiver-operating characteristic (ROC) curve analysis. RESULTS: ADCT, D, and fp were all significantly correlated with interstitial fibrosis, ACS, and CCS. Cortical fp discriminated mild from moderate and severe ACS with the largest AUC of 0.89 [95% confidence interval (CI), 0.77-0.96]. Noticeably, only cortical fp could differentiate severe ACS from mild-to-moderate ACS (P<0.001) with an AUC of 0.80 (95% CI, 0.65-0.90) and a sensitivity of 100% (95% CI, 66.4-100%). Strikingly, the joint use of D and fp in either the cortex or the medulla could achieve a sensitivity of 100% for identifying either mild or severe interstitial fibrosis. Meanwhile, the serial use of cortical D and cortical fp showed the largest specificity for identifying both mild [88.9% (95% CI, 70.8-97.6%)] and severe [84.4% (95% CI, 67.2-94.7%)] interstitial fibrosis. For identifying mild CCS, the AUC of medullary ADCT (0.90, 95% CI, 0.78-0.97) was similar to that of cortical D (0.81, 95% CI, 0.67-0.91) and fp (0.86, 95% CI, 0.73-0.94), but statistically larger than that of medullary D (P=0.005) and fp (P=0.01). Furthermore, the parallel use of cortical D and cortical fp could increase the sensitivity to 95.0% (95% CI, 75.1-99.9%), whereas serial use of medullary D and medullary fp could increase the specificity to 100% (95% CI, 87.2-100%). The AUCs for differentiating severe from mild and moderate CCS were statistically insignificant among all parameters in the cortex and medulla (P≥0.15). CONCLUSIONS: Cortical fp was superior to the ADCT for identifying both mild and severe acute pathologic changes. Nevertheless, ADCT was equal to or better than single D or fp for evaluating chronic pathologic changes. Thus, both monoexponential and bi-exponential analysis of DWI images are complementary for evaluating kidney allograft pathologic changes, and the combined use of D and fp can increase the sensitivity and specificity for discriminating allograft pathologic changes severity.

12.
Clin Lung Cancer ; 20(6): e638-e651, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31375452

RESUMO

BACKGROUND: The purpose of the study was to investigate the potential of a radiomic signature developed in a general non-small-cell lung cancer (NSCLC) cohort for predicting the overall survival of anaplastic lymphoma kinase (ALK)-positive (ALK+) patients with different treatment types. MATERIALS AND METHODS: After test-retest in the Reference Image Database to Evaluate Therapy Response data set, 132 features (intraclass correlation coefficient > 0.9) were selected in the least absolute shrinkage and selection operator Cox regression model with a leave-one-out cross-validation. The NSCLC radiomics collection from The Cancer Imaging Archive was randomly divided into a training set (n = 254) and a validation set (n = 63) to develop a general radiomic signature for NSCLC. In our ALK+ set, 35 patients received targeted therapy and 19 patients received nontargeted therapy. The developed signature was tested later in this ALK+ set. Performance of the signature was evaluated with the concordance index (C-index) and stratification analysis. RESULTS: The general signature had good performance (C-index > 0.6; log rank P < .05) in the NSCLC radiomics collection. It includes 5 features: Geom_va_ratio, W_GLCM_Std, W_GLCM_DV, W_GLCM_IM2, and W_his_mean. Its accuracy of predicting overall survival in the ALK+ set achieved 0.649 (95% confidence interval [CI], 0.640-0.658). Nonetheless, impaired performance was observed in the targeted therapy group (C-index = 0.573; 95% CI, 0.556-0.589) whereas significantly improved performance was observed in the nontargeted therapy group (C-index = 0.832; 95% CI, 0.832-0.852). Stratification analysis also showed that the general signature could only identify high- and low-risk patients in the nontargeted therapy group (log rank P = .00028). CONCLUSION: This preliminary study suggests that the applicability of a general signature to ALK+ patients is limited. The general radiomic signature seems to be only applicable to ALK+ patients who had received nontargeted therapy, which indicates that developing special radiomics signatures for patients treated with tyrosine kinase inhibitors might be necessary.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Diagnóstico por Imagem/métodos , Neoplasias Pulmonares/diagnóstico , Pulmão/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Quinase do Linfoma Anaplásico/metabolismo , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/terapia , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Adulto Jovem
13.
Magn Reson Imaging ; 60: 157-163, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31071470

RESUMO

OBJECTIVE: To characterize capillary perfusion and tissue diffusion changes in transplant renal artery stenosis (TRAS) with diffusion-weighted imaging (DWI). MATERIALS & METHODS: We retrospectively identified 30 patients with non-contrast enhanced magnetic resonance angiography-proven TRAS. Another 20 kidney transplant recipients without TRAS were prospectively recruited to serve as control group. DWI parameters were compared among various groups with one-way analysis of variance and post hoc Tukey test. Additionally, DWI parameters were compared in 7 severe TRAS patients before and after successful angioplasty using paired Student t-test. Receiver-operating characteristic (ROC) curves were generated to evaluate the diagnostic performance of various DWI parameters. RESULTS: All DWI parameters of renal cortex and medulla were not statistically different between normal allografts and allografts with mild TRAS. Nonetheless, cortical total apparent diffusion coefficient (ADCT) of allografts with moderate TRAS was significantly decreased compared with normal allografts. All cortical and medullary DWI parameters were significantly reduced in severe TRAS compared with normal allografts. ROC curve analysis indicated ADCT could identify severe TRAS with 93.8% sensitivity, 82.4% specificity and an area under the curve of 0.930. ADCT increased significantly after successful angioplasty while it showed no significant change in a patient with unsuccessful angioplasty. CONCLUSION: DWI is a robust technique that revealed no tissue diffusion and perfusion impairment in mild TRAS. ADCT has good sensitivity and specificity for identifying patients with severe TRAS. DWI is potentially an alternative radiologic biomarker for assessing microstructural and perfusion alterations in TRAS. DWI is useful in detecting renal functional recovery following successful angioplasty.


Assuntos
Imagem de Difusão por Ressonância Magnética , Transplante de Rim/efeitos adversos , Rim/diagnóstico por imagem , Obstrução da Artéria Renal/diagnóstico , Adulto , Idoso , Angiografia , Angioplastia com Balão , Capilares/diagnóstico por imagem , Meios de Contraste , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Perfusão , Complicações Pós-Operatórias , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
14.
Exp Brain Res ; 237(5): 1347-1359, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30877343

RESUMO

Although gender differences in empathy have been well established through measuring subjective outcomes, some studies of the neural mechanisms of pain empathy have not found gender differences. This inconsistent evidence may be caused by different research methods or different paradigms. The present study adopted a different approach from the pain empathy paradigm to examine gender differences in empathic responses to others' economic payoffs using event-related potentials. The results showed that the N2 amplitudes in female participants were more negative than those in male participants, indicating a greater female than male susceptibility to facial expressions at the early stage of empathy. The LPP amplitudes for male participants were found to be more positive in the observation condition (involving no self-interest) than in the participation condition (involving self-interest), but there was no significant difference in the LPP amplitudes for the female participants between the two conditions. The results suggest that females' empathic responses are more likely to be elicited automatically by the perception of others' emotional states. In contrast, males' empathic responses are more likely to be mediated by self-interest, which subsequently reduces their empathic responses.


Assuntos
Córtex Cerebral/fisiologia , Empatia/fisiologia , Potenciais Evocados/fisiologia , Expressão Facial , Caracteres Sexuais , Percepção Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Fatores Sexuais , Adulto Jovem
15.
Sci Rep ; 9(1): 464, 2019 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-30679548

RESUMO

Asymptomatic brain abnormalities are common incidental findings on brain MRI in the elderly population and can be regarded as imaging markers of early stroke and dementia. We initiated the Taizhou Imaging Study (TIS) to examine the prevalence and correlates of incidental findings using brain MRI among an elderly population residing in a rural area of China. A total of 562 individuals, at the age of 55 to 65 years, participated in the TIS study with a response rate of 90%. The prevalence of lacunes, white matter hyperintensity (WMH), cerebral microbleeds (CMB), perivascular space, and intracranial arterial stenosis was 26.69%, 10.68%, 18.51%, 27.76%, and 12.81%, respectively. Age and hypertension were the major correlates of these incidental findings. Per each year increase in age, the risks of WMH and CMB increased by 15% and 14%. Compared to individuals with normal blood pressure, individuals with hypertension had an increased risk of all incidental findings, with the adjusted odds ratios of 2.28 to 5.45. Correlations of age, gender and body mass index with brain gray matter fraction were also observed. The high prevalence of these findings indicates a need of preventative strategy to help prevent future stroke and dementia in this population.


Assuntos
Encéfalo/diagnóstico por imagem , Achados Incidentais , Imageamento por Ressonância Magnética , Idoso , Encéfalo/patologia , Comorbidade , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Razão de Chances , Exame Físico , Vigilância em Saúde Pública , Inquéritos e Questionários
16.
Abdom Radiol (NY) ; 44(1): 218-226, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30054685

RESUMO

PURPOSE: This study aimed to explore the feasibility of susceptibility-weighted imaging (SWI) for evaluating delayed graft function (DGF) during the early posttransplantation period. METHODS: Sixty-nine recipients who accepted allograft renal transplantation underwent SWI during the second posttransplantation week. Renal allograft function was estimated via the glomerular filtration rate. Recipients with and without DGF were identified. For each transplanted kidney, the presence of abnormal signal intensity lesions (ASILs), excluding benign lesions, on SWI was assessed. Renal allograft function was compared between the recipients with and without ASILs. The correlation between ASILs and renal allograft function was tested by Spearman's rank correlation analysis. RESULTS: Thirty-four recipients were diagnosed with DGF, while 35 recipients showed no DGF. In the DGF group, 16 recipients had low-intensity ASILs, primarily at the corticomedullary junction of transplanted kidneys on SWI, and no ASILs were found in 18 recipients. In the non-DGF group, none of the recipients showed ASILs on SWI. In the DGF group, the renal allograft function among the 16 recipients with low-intensity ASILs was significantly lower than that among the other 18 recipients (8.5 ± 4.2 vs. 19.7 ± 9.7 mL/min, P < 0.001). The presence of low-intensity ASILs on SWI showed a moderate negative correlation with renal allograft function in recipients with DGF (r = - 0.553, P = 0.001). CONCLUSION: SWI can be used to evaluate DGF in the early post-kidney transplantation period.


Assuntos
Função Retardada do Enxerto/diagnóstico por imagem , Transplante de Rim , Imageamento por Ressonância Magnética/métodos , Complicações Cognitivas Pós-Operatórias/diagnóstico por imagem , Adulto , Função Retardada do Enxerto/fisiopatologia , Estudos de Viabilidade , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/diagnóstico por imagem , Rim/fisiopatologia , Masculino , Complicações Cognitivas Pós-Operatórias/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
17.
Sci Rep ; 8(1): 4776, 2018 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-29555982

RESUMO

Fast and nondestructive approaches of measuring plant species diversity have been a subject of excessive scientific curiosity and disquiet to environmentalists and field ecologists worldwide. In this study, we measured the hyperspectral reflectances and plant species diversity indices at a fine scale (0.8 meter) in central Hunshandak Sandland of Inner Mongolia, China. The first-order derivative value (FD) at each waveband and 37 hyperspectral indices were used to assess plant species diversity. Results demonstrated that the stepwise linear regression of FD can accurately estimate the Simpson (R2 = 0.83), Pielou (R2 = 0.87) and Shannon-Wiener index (R2 = 0.88). Stepwise linear regression of FD (R2 = 0.81, R2 = 0.82) and spectral vegetation indices (R2 = 0.51, R2 = 0.58) significantly predicted the Margalef and Gleason index. It was proposed that the Simpson, Pielou and Shannon-Wiener indices, which are widely used as plant species diversity indicators, can be precisely estimated through hyperspectral indices at a fine scale. This research promotes the development of methods for assessment of plant diversity using hyperspectral data.


Assuntos
Biodiversidade , Plantas , Estatística como Assunto
18.
Sci Total Environ ; 599-600: 451-463, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28482303

RESUMO

Land use and climate changes affect on the economy and environment with different patterns and magnitudes in the watershed. This study used risk analysis model stochastic efficiency with respect to a function (SERF) to evaluate economic and environmental risks caused by four climate change scenarios (baseline, small-, mid- and large changes) and three land uses (paddy dominated, paddy-farmland mixture and farmland dominated for agriculture) in Teshio watershed in northern Hokkaido, Japan. Under the baseline climate conditions, the lower ranking of economic income of crop yield and higher ranking of pollutant load from agricultural land were both predicted in paddy dominated for agriculture, suggesting that the paddy dominated system caused higher risks of economic and environmental variables compared to other two land uses. Increase of temperature and precipitation increased crop yields under all three climate changes which resulted in increase of the ranking of economic income, indicating that those climate changes could reduce economic risk. The increased temperature and precipitation also accelerated mineralization of organic nutrient and nutrient leaching to river course of Teshio which resulted in increase of the ranking of pollutant load, suggesting that those climate changes could lead to more environmental risk. The rankings of economic income in mid- and large changes of climate were lower than that in small change of climate under paddy-farmland mixture and farmland dominated systems due to decrease of crop yield, suggesting that climate change led to more economic risk. In summary, the results suggested that increase in temperature and precipitation caused higher risks of both economic and environmental perspectives, and the impacts was higher than those of land use changes in the studied watershed. Those findings would help producers and watershed managers to measure the tradeoffs between environmental protection and agricultural economic development for making decision under land use and climate changes.

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