Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 395
Filtrar
1.
Heliyon ; 10(17): e36159, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39263052

RESUMO

The demand for increasingly fine detail in optical lithography for semiconductors necessitates the use of lower-wavelength lithographic light. This drives the need for lenses in optical lithography steppers made of vacuum ultraviolet-transparent (VUV-transparent) materials. In this work, the density functional theory (DFT) study of potassium magnesium fluoride KMgF3 is presented. Total energy was calculated with correlation functional generalized gradient approximation (GGA). The ground state quantities such as bulk modulus and lattice parameters have been evaluated. The material's cubic structure is scrutinized under various stress levels (0-100 GPa), revealing that KMgF3 starts to deform at 128 GPa. The C11, C12, and C44 independent elastic constants were used to analyze the structural stability of the KMgF3. The densities of states and electronic band structures have also been computed. According to electronic calculations, when stress is applied to KMgF3, the band gap increases for all values of stress (0-100 GPa). Mechanical parameters, including elastic constants and ratios, indicate the material's remarkable ductility and stability. Phonon density of states and thermal characteristics exhibit shifts and variations with increasing stress, providing insights into the material's behaviour below its melting point. The thermodynamic properties of KMgF3, such as enthalpy, free energy, entropy, heat capacity, and Debye temperatures at various temperatures ranging from 0 K to 1000 K, have also been examined to explore their basic properties. These findings contribute to a comprehensive understanding of KMgF3, opening avenues for its application in advanced technologies, particularly in the realms of semiconductors and optoelectronics.

2.
Ann Neurosci ; 31(3): 166-175, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39156621

RESUMO

Background: Indian females have been objectified since time immemorial. The ancient Indian texts and architecture have numerous instances of sexual objectification of females. In the present time, self-objectification in girls is evident from the increasing popularity of apps like Photoshop, the rise in the makeup industry, plastic and cosmetic surgeries, and so on. This is especially relevant for females across the globe and leads to huge negative effects on women's identities. Purpose: The aim of the present study is to assess and compare the levels of body surveillance (self-objectification), body shaming, and control beliefs in adolescent girls from co-educational schools and all-girls schools. Methods: Four hundred adolescent girls from Convent schools in different cities in Uttar Pradesh were included in the study using purposive (homogeneous) sampling based on the inclusion criteria. The Objectified Body Consciousness Scale (OBCS) was used to assess body surveillance (self-objectification), body shaming, and control beliefs. Results: The results of the study revealed that the level of body surveillance (self-objectification) was significantly high among Indian adolescent girls. It was found that all-girls schools had a higher level of body surveillance (self-objectification), body shaming, and control beliefs as compared to adolescent girls from co-educational schools. Conclusion: It can be concluded that the phenomenon of self-objectification has numerous implications for the physical and mental well-being of girls, particularly during their formative years. Healthy behaviors and positive thoughts are the best ways to respect and honor one's body. The research suggests the need for meditation, awareness workshops, and school-level counseling for adolescent girls, especially in all-girls schools.

3.
IJTLD Open ; 1(2): 63-68, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38966691

RESUMO

BACKGROUND: Existing models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage. OBJECTIVE: To evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability. METHODS: Purpose-built centres were established within the private sector that integrated TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged through community workers to generate screening referrals. RESULTS: Overall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203. CONCLUSION: The SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.


CONTEXTE: Les modèles existants visant à augmenter les notifications de cas de TB par le secteur privé au Pakistan ne sont pas viables financièrement et n'ont obtenu qu'un succès modeste en raison d'une couverture limitée. OBJECTIF: Évaluer l'impact d'un modèle déntreprise sociale (SEM, pour l'anglais « social entreprise model ¼) sur la détection des cas de TB à Karachi, au Pakistan, et évaluer sa viabilité financière. MÉTHODES: Des centres spécialisés ont été créés dans le secteur privé. Ils intègrent le dépistage, le diagnostic et le traitement de la TB et fonctionnent 12 heures par jour dans des lieux adaptés afin dén faciliter l'accès. Les services de lutte contre la TB étaient gratuits et les recettes provenaient des frais d'utilisation des autres diagnostics. Des prestataires privés, axés sur le secteur informel, ont été engagés par l'intermédiaire d'agents communautaires pour orienter les patients vers les services de dépistage. RÉSULTATS: Au total, 171 488 personnes ont été dépistées et 18 683 cas ont été notifiés, dont 197 personnes atteintes de TB résistante aux médicaments. Les notifications annuelles de TB à Karachi sont passées de 18 105 en 2014 à un maximum de 25 840 (augmentation de 40%). La proportion de cas à Karachi notifiés par les centres est passée à 27% en 2020. Les recettes commerciales ont atteint 288 065 USD et ont permis un recouvrement des coûts déxploitation de 15%. Le coût moyen par cas de TB notifié était de 203 USD. CONCLUSION: L'intervention SEM a contribué à une grande proportion de notifications à Karachi et a permis un modeste recouvrement des coûts.

4.
J Mol Model ; 30(8): 247, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38960900

RESUMO

BACKGROUND: Cubic perovskite titanium stannous oxide (TiSnO3) is a promising material for various applications due to its functional properties. However, understanding how these properties change under external stress is crucial for its development and optimization. METHOD: This study employed density functional theory calculations to investigate the structural, electronic, optical, thermal, and mechanical properties of TiSnO3 under varying degrees of external static isotropic stress (0-120 GPa). RESULTS: The study reveals a significant decrease in the bandgap of TiSnO3 with increasing stress due to lattice modifications and the formation of delocalized electrons. Partial density of states analysis indicates that Sn and O states play a key role in shaping the electronic band structure. TiSnO3 exhibits increased light absorption with stress, accompanied by a blue shift in absorption peaks, whereas, both polarizability and refractive index decrease with increasing stress. Mechanically, all elastic moduli (bulk, shear, and Young's) show an increase under stress, signifying a stiffening response of the material under stress. Similarly, the Pugh ratio suggests a transition from ductile to brittle behaviour at elevated stress levels. Phonon dispersion calculations indicate the instability of the cubic phase at 0 K. However, a phonon gap emerges at 30 GPa and widens with increasing stress. X-ray diffraction further supports these findings by demonstrating a shift in diffraction peaks towards higher angles with increasing stress, consistent with the applied stress. CONCLUSION: In conclusion, this computational study offers a thorough understanding of how external stress influences the properties of TiSnO3, providing valuable insights for potential applications in various fields.

5.
Int J Tuberc Lung Dis ; 28(8): 381-386, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39049167

RESUMO

BACKGROUNDIn recent years, there has been increasing recognition of the public health significance of the spectrum of TB disease presentation, and the existing classification systems of asymptomatic infection and symptomatic TB have been limited in terms of explanatory power. Accordingly, in 2022-2023, a new International Consensus framework for Early TB (ICE-TB) was developed, categorising the spectrum of TB infection and disease into five states based on the presence or absence of macroscopic pathology, host infectiousness, and symptoms and signs.METHODSWe used the ICE-TB framework to re-analyse existing notification data for 2022 within a low-incidence setting to explore the potential utility and future challenges for its public health application.RESULTSExisting notification data were sufficient to allow substantial reclassification of currently recognised active disease states, but did not systematically capture Mycobacterium tuberculosis infection or subclinical TB. Fifty percent of existing TB notifications would be classified as 'Clinical, infectious', with the potential need to consider further subclassification.CONCLUSIONOur exploration highlighted limitations in existing classification systems and diagnostic approaches and should encourage researchers and programmatic implementers to emphasise person-centred and programmatic needs in the development of new tools for TB management..


Assuntos
Consenso , Saúde Pública , Tuberculose , Humanos , Incidência , Tuberculose/epidemiologia , Tuberculose/diagnóstico , Mycobacterium tuberculosis/isolamento & purificação , Notificação de Doenças
6.
Ann Neurosci ; 31(2): 95-104, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38694715

RESUMO

Background: Professional world nowadays is very competitive, and surviving the cutthroat competition while sustaining work-related stress and pressure is an important task for employees. Professionals are required to meet daily and monthly objectives and may encounter work-related stressors. Purpose: The study aims to explore occupational stress among middle-aged professionals in the age range of 45-60 years from the marketing, banking, and teaching sectors. Methods: A total sample of 180 consented middle-aged professionals in the age range of 45-60 years from the banking, teaching, and marketing sectors were included in the study using a purposive and snowball sampling technique. Professionals having serious medical or psychiatric conditions and undergoing treatment for the same were excluded. The Occupational Stress Index was administered to assess different types of occupational stressors. The statistical analysis was done using the Statistical Package for Social Sciences version 20 software. A descriptive analysis and a one-way analysis of variance (ANOVA) were used to get meaningful results. Results: Results revealed that 40% of the middle-aged professionals reported experiencing minimal levels of occupational stress, followed by 32.2% experiencing moderate levels and 27.8% experiencing high levels of occupational stress. Additionally, it was found that a significantly higher percentage (91.6%) of banking professionals reported low levels of occupational stress compared to their counterparts. Eighty percent of marketing professionals reported experiencing high levels of occupational stress, whereas a majority (73.3%) of teaching professionals reported moderate levels of occupational stress. Conclusion: Occupational stress with different severity levels is found to be common among middle-aged professionals, which is a risk factor to develop mental health problems and affects well-being. Large-scale primary and secondary interventions are required to manage stress and facilitate professional growth and development in India.

7.
Comp Immunol Microbiol Infect Dis ; 106: 102126, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38325127

RESUMO

Aiming at identifying the reservoir and contamination sources of Coxiella burnetii in Northern Algeria, we investigated the molecular presence of the bacterium in 599 samples (blood, placenta, liver, spleen, and uterus) collected from cattle, sheep, dogs and cats. Our qPCR results showed that 15/344 (4.36%) blood samples and six/255 (2.35%) organ specimens were positive for C. burnetii. In cattle, three (4%) blood and liver samples were positive. In sheep, one blood (1.19%) and 3 (8.57%) placenta samples were positive. At the Algiers dog pound, 8 (10%) and 3 (5%) blood samples were qPCR positivein dogs and cats, respectively. In addition, MST genotyping showed that MST 33 was present in cattle and sheep, MST 20 in cattle,andMST 21 in dogs and cats.


Assuntos
Doenças do Gato , Doenças dos Bovinos , Coxiella burnetii , Doenças do Cão , Doenças das Cabras , Febre Q , Doenças dos Ovinos , Gravidez , Feminino , Animais , Cães , Gatos , Bovinos , Ovinos , Coxiella burnetii/genética , Febre Q/epidemiologia , Febre Q/veterinária , Febre Q/microbiologia , Genótipo , Argélia/epidemiologia , Doenças do Gato/microbiologia , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Doenças dos Bovinos/microbiologia , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/microbiologia , Ruminantes , Cabras , Doenças das Cabras/microbiologia
8.
Neuropsychopharmacology ; 49(6): 993-1006, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38233571

RESUMO

The medial prefrontal cortex (mPFC) is critical to cognitive and emotional function and underlies many neuropsychiatric disorders, including mood, fear and anxiety disorders. In rodents, disruption of mPFC activity affects anxiety- and depression-like behavior, with specialized contributions from its subdivisions. The rodent mPFC is divided into the dorsomedial prefrontal cortex (dmPFC), spanning the anterior cingulate cortex (ACC) and dorsal prelimbic cortex (PL), and the ventromedial prefrontal cortex (vmPFC), which includes the ventral PL, infralimbic cortex (IL), and in some studies the dorsal peduncular cortex (DP) and dorsal tenia tecta (DTT). The DP/DTT have recently been implicated in the regulation of stress-induced sympathetic responses via projections to the hypothalamus. While many studies implicate the PL and IL in anxiety-, depression-like and fear behavior, the contribution of the DP/DTT to affective and emotional behavior remains unknown. Here, we used chemogenetics and optogenetics to bidirectionally modulate DP/DTT activity and examine its effects on affective behaviors, fear and stress responses in C57BL/6J mice. Acute chemogenetic activation of DP/DTT significantly increased anxiety-like behavior in the open field and elevated plus maze tests, as well as passive coping in the tail suspension test. DP/DTT activation also led to an increase in serum corticosterone levels and facilitated auditory fear extinction learning and retrieval. Activation of DP/DTT projections to the dorsomedial hypothalamus (DMH) acutely decreased freezing at baseline and during extinction learning, but did not alter affective behavior. These findings point to the DP/DTT as a new regulator of affective behavior and fear extinction in mice.


Assuntos
Afeto , Comportamento Animal , Extinção Psicológica , Medo , Córtex Pré-Frontal , Feminino , Masculino , Camundongos , Afeto/fisiologia , Ansiedade/fisiopatologia , Comportamento Animal/fisiologia , Capacidades de Enfrentamento , Corticosterona/sangue , Extinção Psicológica/fisiologia , Medo/fisiologia , Medo/psicologia , Reação de Congelamento Cataléptica , Elevação dos Membros Posteriores , Aprendizagem em Labirinto , Camundongos Endogâmicos C57BL , Vias Neurais , Córtex Pré-Frontal/citologia , Córtex Pré-Frontal/fisiologia , Som , Natação , Teto do Mesencéfalo/citologia , Teto do Mesencéfalo/fisiologia , Animais
9.
J Vasc Surg Cases Innov Tech ; 9(4): 101347, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38089553

RESUMO

Introduction: An extracranial carotid artery aneurysm (ECAA) is a rare pathology comprising <1% of all arterial aneurysms. The etiology includes trauma, previous surgery, radiation, and infection. Treatment of ECAAs has evolved from open repair to endovascular repair with stenting. Reports of endovascular repair describe the transfemoral approach; however, little more than case reports are available describing the transcarotid approach for ECAAs. In this study, we describe a cohort of patients who safely underwent transcarotid repair of ECAAs. Methods: We performed a retrospective medical record review of all cases of transcarotid stenting using covered stents for a carotid aneurysm within 11 different hospitals within the Memorial Hermann Health System from December 2019 through December 2022. Technical success is defined as coverage of the aneurysm with no endoleak. We report the patient demographics, clinical presentation, intraoperative metrics, and outcomes. Results: Seven patients underwent transcarotid covered stent placement using flow reversal for neurologic protection. Their average age was 65 years, and four of the seven patients were men. Three patients presented with pain, two with transient ischemic attack, one with stroke, and one with a pulsatile mass. Technical success was 100%. All the patients were treated with transcarotid stenting, and the average aneurysm size was 13 mm. The average operative time was 69 minutes, and the flow reversal time was 9 minutes. No postoperative stroke, myocardial infarction, or death occurred. The average length of hospital stay was 2.7 days. Conclusions: A transcarotid approach for endovascular treatment of ECAAs was safe for this cohort of patients, with no postoperative death, stroke, or myocardial infarction. Also, the technical success was 100%.

10.
Ann Neurosci ; 30(2): 100-108, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37706098

RESUMO

Background: The worldwide spread of COVID-19 infection and its preventive measures has resulted in global disruption of overall functioning of the individuals. In the post-COVID period, several stressors associated with the pandemic have exacerbated adjustment problems in students and impacted their mental health. Purpose: The study aims to assess the Academic Stress and Emotional Adjustment of male and female secondary school students in Uttar Pradesh, post-COVID-19 pandemic lockdown. Methods: A sample of 500 students from various schools in Uttar Pradesh pursuing high school were included in the study. A purposive sampling technique was employed for data collection based on inclusion and exclusion criteria. The Scale for Assessing Academic Stress and the Adolescents Emotional Adjustment Inventory were used to assess the academic stress and emotional adjustment of secondary school students post-COVID-19 pandemic lockdown. Results: The results of the study revealed that there was a significant difference in academic stress and emotional adjustment between male and female secondary school students. A significant positive relationship between academic stress and emotional adjustment was found, which indicates a high level of academic stress perpetuates emotional maladjustment. Furthermore, it was found that the level of academic stress and emotional adjustment were higher among females as compared to males. Conclusion: It can be concluded that the extended impact of COVID-19 has led to a surfeited level of distress propounding that females are more predisposed to academic stress and tend to have poor emotional adjustment than their male counterparts.

12.
Ann Neurosci ; 30(1): 54-69, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37313338

RESUMO

Background: The existing structural framework of defining gender and sexuality based on heteronormative ideology led to the succession of the notions of stigma, prejudice, and hate towards the sexual and gender minority population. The presence of strong scientific evidence for the negative consequences of discriminatory and violent events has directed the association with mental and emotional distress. This study aims to comprehend the role of minority stress in emotional regulation and suppression among the sexual minority population globally using systematic review of literature through elaborate Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Summary: The analyses of the sorted literature premised on the PRISMA guidelines revealed that minority stress mediates the emotion regulation processes among the individuals who witness continuous episodes of discrimination and violence leading to emotional dysregulation and emotion suppression. Studies also reported the dominance of various health-risk behaviors such as alcohol addiction, drug abuse, and other forms of intoxication among sexual minority individuals. Increased instances of anxiety, stress, depression, and suicidal ideations were prominent in the findings of the empirical research suggesting an intricate role of minority stress in advancing the faulty emotion suppression and mental health concerns among the sexual and gender minority population. Key message: Minority stressors among sexual and gender minority individuals mediate emotion suppression and mental distress.

13.
Pediatr Cardiol ; 2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37204486

RESUMO

Despite recent advances, hypoplastic left heart syndrome (HLHS) patients subsequent to the Fontan still have significant morbidity and mortality. Some require heart transplant due to systemic ventricular dysfunction. Limited data exist on timing for transplant referral. This study aims to correlate systemic ventricular strain by echocardiography to transplant-free survival. HLHS patients who had Fontan palliation at our institution were included. Patients were divided into: 1) Required transplant or experienced mortality (composite end point); 2) Did not require transplant or survived. For those who experienced the composite endpoint, the last echocardiogram prior to the composite outcome was used, while for those who did not experience the composite endpoint the last echocardiogram obtained was used. Several qualitative and quantitative parameters were analyzed with focus on strain parameters. Ninety-five patients with HLHS Fontan palliation were identified. Sixty-six had adequate images and eight (12%) experienced transplant or mortality. These patients had greater myocardial performance index by flow Doppler (0.72 versus 0.53, p = 0.01), higher systolic/diastolic duration ratio (1.51 versus 1.13, p = 0.02), lower fractional area change (17.65 versus 33.99, p < 0.01), lower global longitudinal strain (GLS) (-8.63 versus - 17.99, p < 0.01), lower global longitudinal strain rate (GLSR) (- 0.51 versus - 0.93, p < 0.01), lower global circumferential strain (GCS) (-6.68 versus -18.25, p < 0.01), and lower (GCSR) global circumferential strain rate (-0.45 versus -1.01, p < 0.01). ROC analysis demonstrated predictive value for GLS - 7.6 (71% sensitive, 97% specific, AUC 81%), GLSR -0.58 (71% sensitive, 88% specific, AUC 82%), GCS - 10.0 (86% sensitive, 91% specific, AUC 82%), and GCSR -0.85 (100% sensitive, 71% specific, AUC 90%). GLS and GCS can help predict transplant-free survival in patients with hypoplastic left heart syndrome having undergone Fontan palliation. Higher strain values (closer to zero) may be a helpful tool in determining when transplant evaluation is warranted in these patients.

14.
Oncoimmunology ; 11(1): 2066050, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35558159

RESUMO

Systemic relapse after radiotherapy and surgery is the major cause of disease-related mortality in sarcoma patients. Combining radiotherapy and immunotherapy is under investigation as a means to improve response rates. However, the immune contexture of sarcoma is understudied. Here, we use a retrospective cohort of sarcoma patients, treated with neoadjuvant radiotherapy, and TCGA data. We explore therapeutic targets of relevance to sarcoma, using genomics and multispectral immunohistochemistry to provide insights into the tumor immune microenvironment across sarcoma subtypes. Differential gene expression between radioresponsive myxoid liposarcoma (MLPS) and more radioresistant undifferentiated pleomorphic sarcoma (UPS) indicated UPS contained higher transcript levels of a number of immunotherapy targets (CD73/NT5E, CD39/ENTPD1, CD25/IL2RA, and 4-1BB/TNFRSF9). We focused on 4-1BB/TNFRSF9 and other costimulatory molecules. In TCGA data, 4-1BB correlated to an inflamed and exhausted phenotype. OX40/TNFRSF4 and 4-1BB/TNFRSF9 were highly expressed in sarcoma subtypes versus other cancers. Despite OX40 and 4-1BB being described as Treg markers, we identified that they delineate distinct tumor immune profiles. This was true for sarcoma and other cancers. While only a limited number of samples could be analyzed, spatial analysis of OX40 expression identified two diverse phenotypes of OX40+ Tregs, one associated with and one independent of tertiary lymphoid structures (TLSs). Patient stratification is of intense interest for immunotherapies. We provide data supporting the viewpoint that a cohort of sarcoma patients, appropriately selected, are promising candidates for immunotherapies. Spatial profiling of OX40+ Tregs, in relation to TLSs, could be an additional metric to improve future patient stratification.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Adulto , Humanos , Recidiva Local de Neoplasia , Estudos Retrospectivos , Sarcoma/genética , Sarcoma/terapia , Linfócitos T Reguladores , Microambiente Tumoral
16.
ESMO Open ; 6(5): 100258, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34509803

RESUMO

INTRODUCTION: Palliative chemotherapy is the principal treatment of patients with advanced soft tissue sarcomas (STS); however prognosis is limited (median overall survival 12-19 months). In this setting, patient values and priorities are central to personalised treatment decisions. PATIENTS AND METHODS: The prospective HOLISTIC study was conducted in the UK and the Netherlands assessing health-related quality of life in STS patients receiving palliative chemotherapy. Participants completed a questionnaire before starting chemotherapy, including attitudes towards quality of life (QoL) versus length of life (LoL), decisional control preferences, and decisional conflict. Chi-square and Fisher's exact tests were used to evaluate associations between patient characteristics and preferences. RESULTS: One hundred and thirty-seven patients with advanced STS participated (UK: n = 72, the Netherlands: n = 65). Median age was 62 (27-79) years. Preference for extended LoL (n = 66, 48%) was slightly more common than preference for QoL (n = 56, 41%); 12 patients (9%) valued LoL and QoL equally (missing: n = 3). Younger patients (age <40 years) prioritised LoL, whereas two-thirds of older patients (aged ≥65 years) felt that QoL was equally or more important than LoL (P = 0.020). Decisional conflict was most common in patients who prioritised QoL (P = 0.024). Most patients preferred an active (n = 45, 33%) or collaborative (n = 59, 44%) role in treatment decisions. Gender, performance status, and country were significantly associated with preferred role. Concordance between preferred and actual role in chemotherapy decision was high (n = 104, 76%). CONCLUSIONS: Heterogeneous priorities and preferences among advanced STS patients support personalised decisions about palliative treatment. Considering individual differences during treatment discussions may enhance communication and optimise patient-centred care.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Adulto , Humanos , Pessoa de Meia-Idade , Cuidados Paliativos , Estudos Prospectivos , Qualidade de Vida , Sarcoma/tratamento farmacológico
17.
Biomed Res Int ; 2021: 9968602, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34285920

RESUMO

BACKGROUND: Chemotherapeutic drugs cause severe toxicities if administered unprotected, without proper targeting, and controlled release. In this study, we developed topotecan- (TPT-) loaded solid lipid nanoparticles (SLNs) for their chemotherapeutic effect against colorectal cancer. The TPT-SLNs were further incorporated into a thermoresponsive hydrogel system (TRHS) (TPT-SLNs-TRHS) to ensure control release and reduce toxicity of the drug. Microemulsion technique and cold method were, respectively, used to develop TPT-SLNs and TPT-SLNs-TRHS. Particle size, polydispersive index (PDI), and incorporation efficiency (IE) of the TPT-SLNs were determined. Similarly, gelation time, gel strength, and bioadhesive force studies of the TPT-SLNs-TRHS were performed. Additionally, in vitro release and pharmacokinetic and antitumour evaluations of the formulation were done. RESULTS: TPT-SLNs have uniformly distributed particles with mean size in nanorange (174 nm) and IE of ~90%. TPT-SLNs-TRHS demonstrated suitable gelation properties upon administration into the rat's rectum. Moreover, drug release was exhibited in a control manner over an extended period of time for the incorporated TPT. Pharmacokinetic studies showed enhanced bioavailability of the TPT with improved plasma concentration and AUC. Further, it showed significantly enhanced antitumour effect in tumour-bearing mice as compared to the test formulations. CONCLUSION: It can be concluded that SLNs incorporated in TRHS could be a potential source of the antitumour drug delivery with better control of the drug release and no toxicity.


Assuntos
Neoplasias Colorretais/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Hidrogéis/química , Lipídeos/química , Substâncias Macromoleculares/química , Nanopartículas/química , Temperatura , Topotecan/uso terapêutico , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Feminino , Humanos , Masculino , Camundongos Nus , Mucosa/efeitos dos fármacos , Mucosa/patologia , Nanopartículas/ultraestrutura , Tamanho da Partícula , Ratos Sprague-Dawley , Reto/efeitos dos fármacos , Reto/patologia , Topotecan/sangue , Topotecan/farmacocinética , Topotecan/farmacologia
20.
Pediatr Cardiol ; 42(4): 768-773, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33517466

RESUMO

Multiple studies have shown that quantitative evaluation of right ventricular (RV) systolic function in children with hypoplastic left heart syndrome (HLHS) is associated with outcomes. However, the most widely used method is qualitative, or subjective echocardiographic evaluation. Tricuspid annular displacement (TMAD) is a quantitative method and has been shown to be associated with transplant/death in a cohort of pediatric patients with HLHS. In this study, the same echocardiograms used in the quantitative TMAD study were qualitatively evaluated to see if the assessment correlated with midterm outcomes. We hypothesized that TMAD measures would outperform qualitative measurements. A previously published retrospective study of patients with systemic right ventricle demonstrated that TMAD measurements of function prior to the Glenn procedure were associated with midterm mortality/transplant (mean TMAD 12.4% for survivors and 10.0% for non-survivors/transplant, p = 0.03). Echocardiographic images used in that study were re-evaluated using qualitative assessment of function. A score between severely depressed (0) and supra-normal (7) was assigned independently by three cardiologists. A chart review included short-term clinical outcome measures in addition to midterm mortality/transplant. Spearman correlations and logistic regression were used to estimate the associations between function scores and clinical outcomes. Function scores were measured with acceptable inter- and intra-rater reliabilities in 47 patients who had echocardiograms used in the prior analysis before their bidirectional Glenn. The mean functional score was 5.3 ± 1.32 in survivors and 5.0 ± 1.02 in non-survivors/transplant. Subjective echocardiographic scores of function were not predictive of mortality (p = 0.23). Scores were correlated with length of cardiac intensive care unit stay (Spearman's rho = - 0.31, p = 0.04), but not post-Glenn total length of hospital stay (p = 0.4). A sub-analysis was performed for each individual operator. Only one of three operators produced scores with a significant association with mortality/transplant (p = 0.01, p = 0.25, p = 0.22, respectively). Averaged subjective measurement of function by three pediatric cardiologists in children with single right ventricle prior to the Glenn procedure was not associated with midterm outcomes. Previous work based on the same echocardiograms showed that quantitative analysis was associated with midterm outcomes. This suggests quantitative analysis may be more useful in prognostication. Future studies could confirm these results and identify which quantitative methods are most helpful.


Assuntos
Ecocardiografia/métodos , Síndrome do Coração Esquerdo Hipoplásico/fisiopatologia , Função Ventricular Direita , Feminino , Técnica de Fontan/métodos , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Síndrome do Coração Esquerdo Hipoplásico/diagnóstico por imagem , Síndrome do Coração Esquerdo Hipoplásico/mortalidade , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Lactente , Tempo de Internação , Modelos Logísticos , Masculino , Pesquisa Qualitativa , Estudos Retrospectivos , Estatísticas não Paramétricas , Sístole
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA