[Perception of insulin therapy in uncontrolled patients with type 2 diabetes mellitus]. / Percepción de la insulinoterapia en pacientes con diabetes mellitus tipo 2 descontrolada.

OBJECTIVE: To determine the perception of insulin therapy by patients with uncontrolled type2 diabetes mellitus, who have been treated with oral hypoglycaemic agents or insulin. DESIGN: Prospective comparative cross-sectional study. SETTING: Family Medicine Unit No. 53 León, Guanajuato of Mexican Institute of Social Security. PARTICIPANTS: Patients between 40 and 80years old with uncontrolled type2 mellitus diabetes, treated with insulin or oral hypoglycaemic agents. MAIN MEASUREMENTS: Perception was assessed using the insulin treatment appraisal scale (ITAS). The rating of the survey is from 20 to 100 points, as such that when score increases the greater is the negative opinion. RESULTS: A sample of 459 diabetes patients were interviewed and split into 2 groups of patients according to their treatment. The OH group were patients treated with oral hypoglycaemic drugs only (56.9%), and the IN group were patients treated with insulin alone or combined with an oral hypoglycaemic (43.1%). Perception score was significantly higher in OH group (56.95±7.78 versus 49.55±8.89 points) than in the IN group (P<.001). CONCLUSIONS: The perception of insulin therapy was worse in patients treated with only oral hypoglycaemic agents than in patients using insulin.

Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis.

Background: We aimed to evaluate overall survival in US patients with amyotrophic lateral sclerosis (ALS) treated with intravenous (IV) edaravone compared with those not treated with IV edaravone in a real-world setting. Methods: This exploratory retrospective comparative effectiveness observational analysis included patients with ALS who were enrolled in an administrative claims database from 8 August 2017 to 31 March 2020. Propensity score matching identified IV edaravone-treated patients (cases) and non-edaravone-treated patients (controls) matched for covariates: age, race, geographic region, sex, pre-index disease duration, insurance, history of cardiovascular disease, riluzole prescription, gastrostomy tube placement, artificial nutrition, noninvasive ventilation, and all-cause hospitalisation. For cases, the index date was the date of the first claim for IV edaravone. For controls, it was the date IV edaravone was available (8 August 2017). The effect of IV edaravone on all-cause mortality was estimated with shared frailty Cox regression analysis. Findings: 318 cases were matched to 318 controls. In both groups, 208 patients (65.4%) had a history of riluzole prescription. As of 31 March 2021, there were 155 deaths (48.7%) among the cases and 196 among the controls (61.6%). Median overall survival time was 29.5 months with edaravone and 23.5 months without, respectively, and the risk of death was 27% lower in cases than in controls (HR, 0.73; 95% CI, 0.59-0.91; p=0.005). Interpretation: In this real-world analysis, IV edaravone treatment in a large predominantly riluzole-treated US cohort was associated with prolonged overall survival compared with not using IV edaravone. Data from adequately powered RCTs are needed to support this finding. Funding: Funded by Mitsubishi Tanabe Pharma America.

Mathematical model of COVID-19 intervention scenarios for São Paulo-Brazil.

With COVID-19 surging across the world, understanding the effectiveness of intervention strategies on transmission dynamics is of primary global health importance. Here, we develop and analyze an epidemiological compartmental model using multi-objective genetic algorithm design optimization to compare scenarios related to strategy type, the extent of social distancing, time window, and personal protection levels on the transmission dynamics of COVID-19 in São Paulo, Brazil. The results indicate that the optimal strategy for São Paulo is to reduce social distancing over time with a stepping-down reduction in the magnitude of social distancing every 80-days. Our results also indicate that the ability to reduce social distancing depends on a 5-10% increase in the current percentage of people strictly following protective guidelines, highlighting the importance of protective behavior in controlling the pandemic. Our framework can be extended to model transmission dynamics for other countries, regions, states, cities, and organizations.

Modeling the effects of intervention strategies on COVID-19 transmission dynamics.

OBJECTIVES: To model the effects of continuous, intermittent, and stepping-down social distancing (SD) strategies and personal protection measures on COVID-19 transmission dynamics. METHODS: Constant, intermittent, and stepping-down SD strategies were modeled at 4 mean magnitudes (5%, 10 %, 15 % and 20 %), 2 time windows (40-days, 80-days), and 2 levels of personal caution (30 % and 50 %). RESULTS: The stepping-down strategy was the best long-term SD strategy to minimize the peak number of active COVID-19 cases and associated deaths. The stepping-down strategy also resulted in a reduction in total time required to SD over a two-year period by 6.5 % compared to an intermittent or constant SD strategy. An 80-day SD time-window was statistically more effective in maintaining control over the COVID-19 pandemic than a 40-day window. However, the results were dependent upon 50 % of people being cautious (engaging in personal protection measures). CONCLUSION: If people exercise caution while in public by protecting themselves (e.g., wearing a facemask, proper hand hygiene and avoid agglomeration) the magnitude and duration of SD necessary to maintain control over the pandemic can be reduced. Our models suggest that the most effective way to reduce SD over a two-year period is a stepping-down approach every 80 days. According to our model, this method would prevent a second peak and the number of intensive care units needed per day would be within the threshold of those currently available.

Experimental realisation of tunable ferroelectric/superconductor [Formula: see text] 1D photonic crystals in the whole visible spectrum.

Emergent technologies that make use of novel materials and quantum properties of light states are at the forefront in the race for the physical implementation, encoding and transmission of information. Photonic crystals (PCs) enter this paradigm with optical materials that allow the control of light propagation and can be used for optical communication, and photonics and electronics integration, making use of materials ranging from semiconductors, to metals, metamaterials, and topological insulators, to mention but a few. Here, we show how designer superconductor materials integrated into PCs fabrication allow for an extraordinary reduction of electromagnetic waves damping, making possible their optimal propagation and tuning through the structure, below critical superconductor temperature. We experimentally demonstrate, for the first time, a successful integration of ferroelectric and superconductor materials into a one-dimensional (1D) PC composed of [Formula: see text] bilayers that work in the whole visible spectrum, and below (and above) critical superconductor temperature [Formula: see text]. Theoretical calculations support, for different number of bilayers N, the effectiveness of the produced 1D PCs and may pave the way for novel optoelectronics integration and information processing in the visible spectrum, while preserving their electric and optical properties.

Novel enzyme-free immunomagnetic microfluidic device based on Co0.25Zn0.75Fe2O4 for cancer biomarker detection.

Early diagnosis of cancer by biomarker detection has been widely studied since it can lead to an increase in patient survival rates. Magnetic nanoparticles (MNPs) play an important role in this field acting as a valuable tool in the biomarker immunocapture and detection. In this work, Co0.25Zn0.75Fe2O4 (CoZnFeONPs) nanoparticles were synthesized and applied as enzyme mimics of peroxidase-like catalysis in a disposable enzyme-free microfluidic immunoarray device (µID). The catalytic activity of CoZnFeONPs was evaluated by hydrogen peroxide detection using cyclic voltammetry and the apparent Michaelis-Menten constant was estimated by Lineweaver-Burk equation showing good Km values. In µID, the immunosensors were assembled with monoclonal antibody against CYFRA 21-1 covalently immobilized on graphene oxide previously deposited on the screen-printed carbon-based electrodes. Under optimized conditions, the method presented a good linear response for CYFRA 21-1 in the range of 3.9-1000 fg mL-1 achieving an ultralow limit of detection (LOD) of 0.19 fg mL-1. For comparison, Fe3O4 nanoparticles (FeONPs) was also synthetized and presented results slight inferior to that obtained with CoZnFeONPs. The methods developed using both MNPs exhibited countless advantages when compared with the immunosensors developed for CYFRA-21-1, previously reported in the literature. The methods were successful applied for the detection of CYFRA 21-1 in real serum samples of healthy and prostate cancer patients and showed good correlation with results obtained with the enzyme-linked immunosorbent assay (ELISA). The CoZnFeONPs associated with the disposable microfluidic immunoarray device provides a simple and effective method for biomarker detection that could satisfy the need for a low-cost and rapid test for early diagnosis of cancer.

Cáncer infantil en el Área Metropolitana de Bucaramanga, Colombia, 2003-2007 / Childhood cancer on Metropolitan Area of Bucaramanga, Colombia 2003-2007

Introducción: El cáncer infantil es una enfermedad relativamente rara comparado con los el de adultos, siendo la segunda causa de muerte entre los 0-14 años de edad. Los tumores más frecuentes en los niños son los de origen hematopoyético, SNC y tejido mesenquimal. No hay en la región un Registro de Tumores específico de niños, pero el Registro Poblacional de Cáncer del Área Metropolitana de Bucaramanga (RPC-AMB), recopila la información de los casos obtenidos en múltiples fuentes de información. Objetivo: Determinar la incidencia de cáncer en niños menores de 15 años en el Área Metropolitana de Bucaramanga. Metodología: Los datos incluyen tumores malignos de pacientes menores de 15 años del RPC-AMB. Los casos fueron agrupados de acuerdo con la Clasificación Internacional de Cáncer Infantil (ICCC). Las tasas se calcularon usando el software CanReg4 de la IARC. Resultados: 207 casos fueron diagnosticados en niños menores de 15 años de edad. En los niños la TEE fue 159.2 casos por millón de habitantes. En las niñas la TEE fue de 118.6 casos por millón de habitantes. La distribución por tipos de cáncer agrupada según la clasificación de ICCC fue muy similar para el Área Metropolitana de Bucaramanga y otras regiones del mundo. Conclusiones: Los datos epidemiológicos obtenidos son similares con otras regiones como Cali.

Background: Childhood cancer is relatively uncommon disease compared with adults and is the second cause of death among 0-14 years old. The most common cancers in children are leukemia, central nervous system and mesenchyme tumors. There is not a Childhood Cancer Registry in this Geographical region, however The Population Based Cancer of the Metropolitan Area of Bucaramanga (RPC-AMB), collects the information of all cancer cases, obtained from multiple sources of information. Objective: Determine the cancer incidence of children younger than 15 years old in the Metropolitan Area of Bucaramanga. Methodology: The data include all malignant tumors in patients younger than 15 years of RPC-AMB. The cases were grouped according to the International Classification of Childhood Cancer (ICCC). The rates were calculated using the IARC CanReg4 software. Results: 207 cancer cases were diagnosed in children younger than 15 years old. The male average annual age-adjusted cancer incidence rate is 159.2 per million inhabitants. The female average annual age-adjusted cancer incidence rate is 118.6 per million inhabitants. The cancers were grouped according to the ICCC classification is similar to other regions. Conclusions: The data are similar to other regions as Cali. [Uribe CJ, Amado AM, Ramírez G, Alarcón IC. Childhood cancer on Metropolitan Area of Bucaramanga, Colombia, 2003-2007. MedUNAB 2011; 14:86-93].

Resultados de las experiencias clinicas con el metodo EB-140 en pacientes sero positivos para el HIV / Results of the clinical experiences with the methods EB-140 in patients for HIV seropositivity

Se ha escogido al azar 15 pacientes con inmuno deficiencia adquirida (SIDA), quienes fueron tratados con el Método EB-140 el mismo que está compuesto por 4 substancias que actúan sinérgicamente produciendo aumento de la inmunidad y acción en las distintas fase de replicación viral (del retrovirus)