RESUMEN
Epistaxis is common, impacting more than half the population, and can require procedural intervention in approximately 10% of cases. With an aging population and increasing use of antiplatelets and anticoagulants, severe epistaxis is likely to increase in frequency significantly over the next two decades. Sphenopalatine artery embolization is rapidly becoming the most common type of procedural intervention. The efficacy of endovascular embolization is dependent on a refined understanding of the anatomy and collateral physiology of this circulation as well as the impact of temporizing measures such as nasal packing and inflation of a nasal balloon. Likewise, safety is dependent on a detailed appreciation of collateralization with the internal carotid artery and ophthalmic artery. Cone beam CT imaging has the resolution to enable a clear visualization of the anatomy and collateral circulation associated with the arterial supply to the nasal cavity, in addition to assisting with hemorrhage localization. We present a review of epistaxis treatment, a detailed description of anatomic and physiologic considerations informed by cone beam CT imaging, and a proposed protocol for sphenopalatine embolization for which there is currently no standard.
Asunto(s)
Embolización Terapéutica , Epistaxis , Humanos , Anciano , Epistaxis/diagnóstico por imagen , Epistaxis/terapia , Resultado del Tratamiento , Embolización Terapéutica/métodos , Arterias , Tomografía Computarizada de Haz CónicoRESUMEN
The utilization of microalgae to treat carbon dioxide (CO2)-rich industrial off-gas has been suggested as both beneficial for emissions reduction and economically favorable for the production of microalgal products. Common sources of off-gases include coal combustion (2-15% CO2), cement production (8-15% CO2), coke production (18-23% CO2), and ore smelting (6-7% CO2). However, industrial off-gas also commonly contains other acid gas components [typically nitrogen oxides (NOX) and sulfur dioxide (SO2)] and metals that could inhibit microalgae growth and productivity. To utilize industrial off-gas effectively in microalgae cultivation systems, a number of solutions have been proposed to overcome potential inhibitions. These include bioprospecting to identify suitable strains, genetic modification to improve specific cellular characteristics, chemical additions, and bioreactor designs and operating procedures.In this review, results from microalgae experiments related to utilizing off-gas are presented, and the outcomes of different conditions discussed along with potential solutions to resolve limitations associated with the application of off-gas.
RESUMEN
BACKGROUND: Cerebral aneurysm rupture is associated with high rates of morbidity and mortality. Detecting aneurysms at high risk of rupture is critical in management decision making. Rupture risk has traditionally been associated with size-measured as a maximum dimension. However, aneurysms are morphologically dynamic, a characteristic ignored by large prospective aneurysm risk studies. Manual measurement is challenging and fraught with error. We used an artificial intelligence (AI) measurement tool to study aneurysms that ruptured during conservative management to detect changes in size not appreciated by manual linear measurement. METHODS: A single practice database with >5000 aneurysms was queried. Patients followed conservatively for an unruptured aneurysm were identified using appropriate diagnosis codes. This cohort was screened for subsequent rupture using procedure codes. Only patients with two vascular imaging studies before rupture were included. RESULTS: Five patients met the criteria. All patients had aneurysm enlargement, two of which were not detected from manual linear measurements, including adjudication and analysis, during a multidisciplinary neurovascular conference in a high volume practice. Maximum dimension increased at a minimum of 1.8% (range 1.8-63.3%) from the first scan to the last, and aneurysm volume increased at a minimum of 5.9% (5.9-385.5%), highlighting the importance of volumetric measurement. CONCLUSIONS: AI-enabled volumetric measurements are more sensitive to changes in size and detected enlargement in all aneurysms that ruptured during conservative management. This finding has major implications for clinical practice and methods used for interval aneurysm measurement in patients being conservatively followed.
Asunto(s)
Aneurisma Falso , Aneurisma Roto , Aneurisma Intracraneal , Humanos , Estudios Prospectivos , Inteligencia Artificial , Tratamiento Conservador , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/terapia , Aneurisma Roto/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Aneurisma Intracraneal/complicaciones , Factores de RiesgoRESUMEN
Nanoscale fabrication and characterization techniques critically underpin a vast range of fields, including nanoelectronics and nanobiotechnology. Focused ion beam (FIB) techniques are appealing due to their high spatial resolution and widespread use for processing of nanostructured materials. Here, we introduce FIB-induced fluorescence spectroscopy (FIB-FS) as a nanoscale technique for spectroscopic detection of atoms sputtered by an ion beam. We use semiconductor heterostructures to demonstrate nanoscale lateral and depth resolution and show that it is limited by ion-induced intermixing of nanostructured materials. Sensitivity is demonstrated qualitatively by depth profiling of 3.5, 5, and 8 nm quantum wells and quantitatively by detection of trace-level impurities present at parts-per-million levels. The utility of the FIB-FS technique is demonstrated by characterization of quantum wells and Li-ion batteries. Our work introduces FIB-FS as a high-resolution, high-sensitivity, 3D analysis and tomography technique that combines the versatility of FIB nanofabrication techniques with the power of diffraction-unlimited fluorescence spectroscopy.
Asunto(s)
Nanoestructuras , Microscopía Electrónica de Rastreo , Espectrometría de Fluorescencia , Iones , TomografíaRESUMEN
The cost of microalgae cultivation is one of the largest limitations to achieving sustainable, large-scale microalgae production of commercially desirable lipids. Utilizing CO2 as a 'free' carbon source from waste industrial flue gas emissions can offer wide-ranging cost savings. However, these gas streams typically create acidic environments, in which most microalgae cannot survive due to the concentration of CO2 and the presence of other acidic gasses such as NO2 and SO2. To address this situation, we investigated growth of a mixed acid-tolerant green microalgal culture (91% dominated by a single Coccomyxa sp. taxon) bioprospected at pH 2.8 from an acid mine drainage impacted water body. The culture was grown at pH 2.5 and fed with a simulated flue gas containing 6% CO2 and 94% N2. On reaching the end of the exponential growth phase, the culture was exposed to either continued light-dark cycle conditions or continual dark conditions. After three days in the dark, the biomass consisted of 28% of lipids, which was 42% higher than at the end of the exponential phase and 55% higher than the maximum lipid content achieved under light/dark conditions. The stress caused by being continually in the dark also favoured the production of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs; 19.47% and 21.04%, respectively, after 7 days) compared to 7-days of light-dark treatment (1.94% and 9.53%, respectively) and showed an increase in nitrogen content (C:N ratio of 6.4) compared to light-dark treatment (C:N ratio of 11.9). The results of the research indicate that use of acid tolerant microalgae overcomes issues using flue gasses that will create an acidic environment and that applying dark stress is a low-cost stressor stimulates production of desirable dietary lipids.
Asunto(s)
Microalgas , Biocombustibles , Biomasa , Dióxido de Carbono/química , Gases/química , LípidosRESUMEN
Conditional power (CP) is widely used in clinical trial monitoring to quantify the evidence for futility stopping or sample size adaptation during the trial. When planning an interim analysis in vaccine trials for seasonal infectious diseases, CPs calculated under the hypothesized or currently estimated effect sizes may not truly reflect future data due to seasonal variations in disease incidence and/or vaccine efficacy (VE). Relying on these estimates alone could lead to erroneous decisions. Therefore, we carried out simulation studies to investigate the use of seven different choices for the drift parameter in computing CP or predictive power (PP) in end-of-season interim analysis. Our simulations showed that, when used to inform futility stopping, CP under the hypothesized effect and a weighted PP under a normal prior distribution appear to outperform others in terms of the overall type II error rate. All CPs and PPs considered in this study resulted in comparable powers and expected sample sizes when used to inform sample size adaptation. The performance of either CP or PP largely depends on the extent to which the chosen drift parameter or the prior distribution of the drift parameter matches the remainder of the trial. Weighted CP/PP tends to be less sensitive to settings where observed data and emerging data in future seasons differ substantially as they incorporate both current estimate and future variations. Therefore, weighted strategies deserve further exploration and perhaps increased usage in guiding trial operations because they are more robust to inaccuracies in prediction. In summary, for vaccine trials with seasonal variations, a decision on trial operations should be guided by a careful consideration of plausible CPs and PPs calculated under reasonable assumptions leveraging the data, prior hypotheses, and new evidence on clinical relevance.
Asunto(s)
Proyectos de Investigación , Vacunas , Humanos , Inutilidad Médica , Tamaño de la Muestra , Estaciones del Año , Vacunas/uso terapéuticoRESUMEN
Prompt, effective treatment is necessary following aneurysmal subarachnoid hemorrhage to prevent recurrent rupture, which is thought to double mortality. Atypical ruptured aneurysms, such as blister or dissecting pseudoaneurysms, or those that are unusually distal in the middle cerebral artery (MCA) are challenging to treat with either open or endovascular options, though the pipeline embolization device (PED) has shown promise in multiple case series. We present a case of a ruptured dissecting pseudoaneurysm in the distal MCA (distal M3/proximal M4) prefrontal division in an healthy young patient (<60 years) successfully treated with a PED. The PED was chosen both as the only vessel sparing option in the young patient as well as for its potential as a vessel sacrifice tool if the pseudoaneurysm was felt to be incompletely treated, which in this case was not necessary-though would have leveraged the thrombogenicity of the device as a therapeutic advantage.
RESUMEN
The outcome of transarterial chemoembolization for unresectable hepatocellular carcinoma (HCC) relies on the appropriate identification of tumor supplying arteries. HCC derives 90% of the blood supply from the hepatic arteries. However, depending on the tumor's size and location, the extrahepatic collateral artery (EHC) can develop and predominantly supply the tumor. The supraduodenal artery (SDA) arises from the gastroduodenal artery (GDA). On the other hand, the cystic artery (CA) mostly originates from the right hepatic artery. However, a common trunk of the SDA and CA originating from the GDA and feeding the HCC as an EHC has not been reported. We herein present a 76-year-old man with HCC in segment 6, supplied by an EHC from a common trunk of the SDA and CA originating from the GDA. Selective arteriography confirmed the EHC, which was successfully embolized with drug-eluting beads without complications.
RESUMEN
Adaptive designs (ADs) allow pre-planned changes to an ongoing trial without compromising the validity of conclusions and it is essential to distinguish pre-planned from unplanned changes that may also occur. The reporting of ADs in randomised trials is inconsistent and needs improving. Incompletely reported AD randomised trials are difficult to reproduce and are hard to interpret and synthesise. This consequently hampers their ability to inform practice as well as future research and contributes to research waste. Better transparency and adequate reporting will enable the potential benefits of ADs to be realised.This extension to the Consolidated Standards Of Reporting Trials (CONSORT) 2010 statement was developed to enhance the reporting of randomised AD clinical trials. We developed an Adaptive designs CONSORT Extension (ACE) guideline through a two-stage Delphi process with input from multidisciplinary key stakeholders in clinical trials research in the public and private sectors from 21 countries, followed by a consensus meeting. Members of the CONSORT Group were involved during the development process.The paper presents the ACE checklists for AD randomised trial reports and abstracts, as well as an explanation with examples to aid the application of the guideline. The ACE checklist comprises seven new items, nine modified items, six unchanged items for which additional explanatory text clarifies further considerations for ADs, and 20 unchanged items not requiring further explanatory text. The ACE abstract checklist has one new item, one modified item, one unchanged item with additional explanatory text for ADs, and 15 unchanged items not requiring further explanatory text.The intention is to enhance transparency and improve reporting of AD randomised trials to improve the interpretability of their results and reproducibility of their methods, results and inference. We also hope indirectly to facilitate the much-needed knowledge transfer of innovative trial designs to maximise their potential benefits. In order to encourage its wide dissemination this article is freely accessible on the BMJ and Trials journal websites."To maximise the benefit to society, you need to not just do research but do it well" Douglas G Altman.
Asunto(s)
Lista de Verificación/normas , Consenso , Edición/normas , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Proyectos de Investigación/normas , Técnica Delphi , Guías como Asunto , Humanos , Publicaciones Periódicas como Asunto , Control de Calidad , Reproducibilidad de los ResultadosRESUMEN
Adaptive designs (ADs) allow pre-planned changes to an ongoing trial without compromising the validity of conclusions and it is essential to distinguish pre-planned from unplanned changes that may also occur. The reporting of ADs in randomised trials is inconsistent and needs improving. Incompletely reported AD randomised trials are difficult to reproduce and are hard to interpret and synthesise. This consequently hampers their ability to inform practice as well as future research and contributes to research waste. Better transparency and adequate reporting will enable the potential benefits of ADs to be realised.This extension to the Consolidated Standards Of Reporting Trials (CONSORT) 2010 statement was developed to enhance the reporting of randomised AD clinical trials. We developed an Adaptive designs CONSORT Extension (ACE) guideline through a two-stage Delphi process with input from multidisciplinary key stakeholders in clinical trials research in the public and private sectors from 21 countries, followed by a consensus meeting. Members of the CONSORT Group were involved during the development process.The paper presents the ACE checklists for AD randomised trial reports and abstracts, as well as an explanation with examples to aid the application of the guideline. The ACE checklist comprises seven new items, nine modified items, six unchanged items for which additional explanatory text clarifies further considerations for ADs, and 20 unchanged items not requiring further explanatory text. The ACE abstract checklist has one new item, one modified item, one unchanged item with additional explanatory text for ADs, and 15 unchanged items not requiring further explanatory text.The intention is to enhance transparency and improve reporting of AD randomised trials to improve the interpretability of their results and reproducibility of their methods, results and inference. We also hope indirectly to facilitate the much-needed knowledge transfer of innovative trial designs to maximise their potential benefits.
Asunto(s)
Lista de Verificación , Consenso , Edición/normas , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Proyectos de Investigación/normas , Lista de Verificación/normas , Técnica Delphi , Guías como Asunto , Humanos , Publicaciones Periódicas como Asunto , Control de Calidad , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: Aneurysm recurrence after coiling has been associated with aneurysm growth, (re)hemorrhage, and a greater need for follow-up. The second-generation HydroCoil Embolic System (HES; MicroVention, Inc) consists of a platinum core with integrated hydrogel and was developed to reduce recurrence through enhancing packing density and healing within the aneurysm. OBJECTIVE: To compare recurrence between the second-generation HES and bare platinum coil (BPC) in the new-generation Hydrogel Endovascular Aneurysm Treatment Trial (HEAT). METHODS: HEAT is a randomized, controlled trial that enrolled subjects with ruptured or unruptured 3- to 14-mm intracranial aneurysms amenable to coiling. The primary endpoint was aneurysm recurrence using the Raymond-Roy scale. Secondary endpoints included minor and major recurrence, packing density, adverse events related to the procedure and/or device, mortality, initial complete occlusion, aneurysm retreatment, hemorrhage from target aneurysm during follow-up, aneurysm occlusion stability, and clinical outcome at final follow-up. RESULTS: A total of 600 patients were randomized (HES, n = 297 and BPC, n = 303), including 28% with ruptured aneurysms. Recurrence occurred in 11 (4.4%) subjects in the HES arm and 44 (15.4%) subjects in the BPC arm (P = .002). While the initial occlusion rate was higher with BPC, the packing density and both major and minor recurrence rates were in favor of HES. Secondary endpoints including adverse events, retreatment, hemorrhage, mortality, and clinical outcome did not differ between arms. CONCLUSION: Coiling of small-to-medium aneurysms with second-generation HES resulted in less recurrence when compared to BPC, without increased harm. These data further support the use of the second-generation HES for the embolization of intracranial aneurysms.
Asunto(s)
Prótesis Vascular , Embolización Terapéutica/instrumentación , Procedimientos Endovasculares/instrumentación , Hidrogeles , Aneurisma Intracraneal/terapia , Adulto , Anciano , Aneurisma Roto/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Platino (Metal) , Complicaciones Posoperatorias/epidemiología , Recurrencia , Retratamiento , Resultado del TratamientoRESUMEN
BACKGROUND: Adequate reporting of adaptive designs (ADs) maximises their potential benefits in the conduct of clinical trials. Transparent reporting can help address some obstacles and concerns relating to the use of ADs. Currently, there are deficiencies in the reporting of AD trials. To overcome this, we have developed a consensus-driven extension to the CONSORT statement for randomised trials using an AD. This paper describes the processes and methods used to develop this extension rather than detailed explanation of the guideline. METHODS: We developed the guideline in seven overlapping stages: 1) Building on prior research to inform the need for a guideline; 2) A scoping literature review to inform future stages; 3) Drafting the first checklist version involving an External Expert Panel; 4) A two-round Delphi process involving international, multidisciplinary, and cross-sector key stakeholders; 5) A consensus meeting to advise which reporting items to retain through voting, and to discuss the structure of what to include in the supporting explanation and elaboration (E&E) document; 6) Refining and finalising the checklist; and 7) Writing-up and dissemination of the E&E document. The CONSORT Executive Group oversaw the entire development process. RESULTS: Delphi survey response rates were 94/143 (66%), 114/156 (73%), and 79/143 (55%) in rounds 1, 2, and across both rounds, respectively. Twenty-seven delegates from Europe, the USA, and Asia attended the consensus meeting. The main checklist has seven new and nine modified items and six unchanged items with expanded E&E text to clarify further considerations for ADs. The abstract checklist has one new and one modified item together with an unchanged item with expanded E&E text. The E&E document will describe the scope of the guideline, the definition of an AD, and some types of ADs and trial adaptations and explain each reporting item in detail including case studies. CONCLUSIONS: We hope that making the development processes, methods, and all supporting information that aided decision-making transparent will enhance the acceptability and quick uptake of the guideline. This will also help other groups when developing similar CONSORT extensions. The guideline is applicable to all randomised trials with an AD and contains minimum reporting requirements.
Asunto(s)
Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Proyectos de Investigación/normas , Asia , Lista de Verificación , Consenso , Técnicas de Apoyo para la Decisión , Europa (Continente) , HumanosRESUMEN
Synthesis of Co9S8, Ni3S2, Co and Ni nanowires by solventless thermolysis of a mixture of metal(ii) acetate and cysteine in vacuum is reported. The simple precursor system enables the nanowire phase to be tuned from pure metal (Co or Ni) to metal sulfide (Co9S8, Ni3S2) by varying the relative concentration of the metal(ii) acetate. The growth environment facilitates new insights through in situ characterization using field-emission scanning electron microscopy (FESEM) and thermogravimetric analysis with gas chromatography-mass spectrometry (TGA-GC-MS). Direct observation by FESEM shows the temperature at which nanowire growth occurs and suggests adatoms are incorporated into the base of the growing nanowire. TGA-GC-MS reveals the rates of precursor decomposition and identity of the volatilized ligand fragments during heat-up and at the nanowire growth temperature. Our results constitute a new approach for the selective fabrication of high quality Co9S8 and Ni3S2 nanowires and more importantly provides new understanding of precursor decomposition reactions that support symmetry-breaking growth in nanocrystals by heat-up synthesis.
RESUMEN
Bottom-up fabrication of nanowire-based devices is highly attractive for oxide photonic devices because of high light extraction efficiency; however, unsatisfactory electrical injection into ZnO and poor carrier transport properties of nanowires severely limit their practical applications. Here, we demonstrate that ZnO nanorods doped with Ga donors by in situ dopant incorporation during vapour-solid growth exhibit superior optoelectronic properties that exceed those currently synthesised by chemical vapour deposition, and accordingly can be electrically integrated into Si-based photonic devices. Significantly, the doping method was found to improve the nanorod quality by decreasing the concentration of point defects. Light-emitting diodes (LEDs) fabricated from the Ga-doped ZnO nanorod/p-Si heterojunction display bright and colour-tunable electroluminescence (EL). These nanorod LEDs possess a dramatically enhanced performance and an order of magnitude higher EL compared with equivalent devices fabricated with undoped nanorods. These results point to an effective route for large-scale fabrication of conductive, single-crystalline ZnO nanorods for photonic and optoelectronic applications.
RESUMEN
PbS submicron crystals were formed by thermolysis of two different lead dithiocarbamate complexes. These precursors were readily synthesized and fully characterized, and in situ synchrotron powder diffraction experiments were performed to characterize their decomposition. The structure and purity of resultant PbS was examined using scanning electron and transmission electron microscopies, powder X-ray diffraction, and infrared spectroscopy. Submicron crystalline PbS was used to create a new PbS thermistor with excellent sensitivity and an ultrarapid thermal response time.
RESUMEN
Nerve growth factor (NGF), a member of the neurotrophin family, is known to regulate the development and survival of a select population of neurons through the binding and activation of the TrkA receptor. Elevated levels of NGF have been associated with painful pathologies such as diabetic neuropathy and fibromyalgia. However, completely inhibiting the NGF signal could hold significant side effects, such as those observed in a genetic condition called congenital insensitivity to pain and anhidrosis (CIPA). Previous methods of screening for NGF-inhibitors used labeling techniques which have the potential to alter molecular interactions. SPR spectroscopy and NGF-dependent cellular assays were utilized to identify a novel NGF-inhibitor, BVNP-0197 (IC50 = 90 nmol/L), the first NGF-inhibitor described with a high nanomolar NGF inhibition efficiency. The present study utilizes molecular modeling flexible docking to identify a novel binding domain in the loop II/IV cleft of NGF.
Asunto(s)
Naftalimidas/síntesis química , Naftalimidas/farmacología , Factor de Crecimiento Nervioso/química , Receptor trkA/metabolismo , Animales , Sitios de Unión , Diferenciación Celular/efectos de los fármacos , Línea Celular , Sistema Libre de Células , Ratones , Modelos Moleculares , Simulación del Acoplamiento Molecular , Estructura Molecular , Naftalimidas/química , Factor de Crecimiento Nervioso/antagonistas & inhibidores , Fosforilación , RatasRESUMEN
Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15.1years; range: 15-65years) harbored a total of 43 aneurysms, 25 of which were dorsal wall blister aneurysms of the ICA. Eleven (61.1%) patients presented with aneurysmal subarachnoid hemorrhage (aSAH), and 10 (55.6%) patients had multiple aneurysms at admission. Twelve patients had 18 aneurysms that were treated microsurgically. Five (41.7%) of these patients had a single recurrence that was retreated with subsequent repeat clip ligation. Six patients had 7 blister aneurysms that were treated with endovascularly. One (16.7%) of these patients had a single recurrence that was retreated with subsequent coil embolization. Postoperative vasospasm occurred in 8 (44.4%) patients, one of whom suffered from a stroke. This is one of the largest single-institution dICA blister aneurysm studies to date. There was no detected significant difference between microsurgical clip ligation and endovascular coil embolization in terms of surgical outcome. These blister aneurysms demonstrate a propensity to be associated with multiple cerebral aneurysms. Strict clinical and angiographic long-term follow-up may be warranted. STATEMENT OF SIGNIFICANCE: Blister aneurysms are focal wall defects covered by a thin layer of fibrous tissue and adventitia, lacking the usual collagenous layer. Due to their pathologically thin vessel wall, blister aneurysms are prone to rupture. The management of these rare and fragile aneurysms presents a number of challenges. Here, we address the long-term outcome of patients treated for blister aneurysms at non-branching sites of the dICA. The presented data and analysis is imperative to determine the necessary strict long-term clinical and angiographic follow-up.
Asunto(s)
Enfermedades de las Arterias Carótidas/cirugía , Arteria Carótida Interna/cirugía , Embolización Terapéutica/métodos , Procedimientos Endovasculares/métodos , Aneurisma Intracraneal/cirugía , Instrumentos Quirúrgicos , Adolescente , Adulto , Anciano , Vesícula/diagnóstico por imagen , Vesícula/cirugía , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Arteria Carótida Interna/diagnóstico por imagen , Embolización Terapéutica/instrumentación , Procedimientos Endovasculares/instrumentación , Femenino , Estudios de Seguimiento , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Ligadura , Masculino , Persona de Mediana Edad , Recurrencia , Retratamiento/métodos , Estudios Retrospectivos , Instrumentos Quirúrgicos/estadística & datos numéricos , Adulto JovenRESUMEN
A common question in clinical studies is how to use historical data from earlier studies, leveraging relevant information into the design and analysis of a new study. Bayesian approaches are particularly well-suited to this task, with their natural ability to borrow strength across data sources. In this paper, we propose an eMAP approach for incorporating historical data into the analysis of clinical studies, and we discuss an application of this method to the analysis of observational safety studies for a class of products for patients with hemophilia A. The eMAP prior approach is flexible and robust to prior-data conflict. We conducted simulations to compare the frequentist operating characteristics of three approaches under different prior-data conflict assumptions and sample size scenarios.
Asunto(s)
Teorema de Bayes , Ensayos Clínicos como Asunto , Metaanálisis como Asunto , Investigación Biomédica , Humanos , Estudios Observacionales como Asunto , Tamaño de la MuestraRESUMEN
Metal and metal alloy nanowires have applications ranging from spintronics to drug delivery, but high quality, high density single crystalline materials have been surprisingly difficult to fabricate. Here we report a versatile, template-free, self-assembly method for fabrication of single crystalline metal and metal alloy nanowires (Co, Ni, NiCo, CoFe, and NiFe) by reduction of metal nitride precursors formed in situ by reaction of metal salts with a nitrogen source. Thiol reduction of the metal nitrides to the metallic phase at 550-600 °C results in nanowire growth. In this process, sulfur acts as a uniaxial structure-directing agent, passivating the surface of the growing nanowires and preventing radial growth. The versatility of the method is demonstrated by achieving nanowire growth from gas-phase, solution-phase or a combination of gas- and solution-phase precursors. The fabrication method is suited to large-area CVD on a wide range of solid substrates.
RESUMEN
Small-molecule inhibitors have been previously investigated to identify possible therapeutics for the treatment of chronic pain. In the present study, known nerve growth factor (NGF) inhibitors identified by (125)I-NGF binding were characterized using affinity and binding evaluations by surface plasmon resonance (SPR) spectroscopy. A novel strategy for characterizing NGF inhibitors was used to determine the binding affinity (KD) and saturation ability of each compound with immobilized NGF. Seventy-four percent of compounds screened demonstrated a positive binding event to NGF. A KD less than 10 µM and a percent saturation greater than 50% were used as thresholds to identify inhibitors that would warrant further investigation. This study details for the first time a methodology that can be used to directly characterize the binding event between small-molecule inhibitors and NGF.