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1.
Appl Opt ; 63(7): B49-B58, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38437255

RESUMO

Among modern optical microscopy techniques, digital lensless holographic microscopy (DLHM) is one of the simplest label-free coherent imaging approaches. However, the hardware simplicity provided by the lensless configuration is often offset by the demanding computational postprocessing required to match the retrieved sample information to the user's expectations. A promising avenue to simplify this stage is the integration of artificial intelligence and machine learning (ML) solutions into the DLHM workflow. The biggest challenge to do so is the preparation of an extensive and high-quality experimental dataset of curated DLHM recordings to train ML models. In this work, a diverse, open-access dataset of DLHM recordings is presented as support for future research, contributing to the data needs of the applied research community. The database comprises 11,760 experimental DLHM holograms of bio and non-bio samples with diversity on the main recording parameters of the DLHM architecture. The database is divided into two datasets of 10 independent imaged samples. The first group, named multi-wavelength dataset, includes 8160 holograms and was recorded using laser diodes emitting at 654 nm, 510 nm, and 405 nm; the second group, named single-wavelength dataset, is composed of 3600 recordings and was acquired using a 633 nm He-Ne laser. All the experimental parameters related to the dataset acquisition, preparation, and calibration are described in this paper. The advantages of this large dataset are validated by re-training an existing autofocusing model for DLHM and as the training set for a simpler architecture that achieves comparable performance, proving its feasibility for improving existing ML-based models and the development of new ones.

2.
Chest ; 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38395297

RESUMO

BACKGROUND: Exacerbation frequency strongly influences treatment choices in patients with severe asthma. RESEARCH QUESTION: What is the extent of the variability of exacerbations rate across countries and its implications in disease management? STUDY DESIGN AND METHODS: We retrieved data from the International Severe Asthma Registry, an international observational cohort of patients with a clinical diagnosis of severe asthma. We identified patients ≥ 18 years of age who did not initiate any biologics prior to baseline visit. A severe exacerbation was defined as the use of oral corticosteroids for ≥ 3 days or asthma-related hospitalization/ED visit. A series of negative binomial models were applied to estimate country-specific severe exacerbation rates during 365 days of follow-up, starting from a naïve model with country as the only variable to an adjusted model with country as a random-effect term and patient and disease characteristics as independent variables. RESULTS: The final sample included 7,510 patients from 17 countries (56% from the United States), contributing to 1,939 severe exacerbations (0.27/person-year). There was large between-country variation in observed severe exacerbation rate (minimum, 0.04 [Argentina]; maximum, 0.88 [Saudi Arabia]; interquartile range, 0.13-0.54), which remained substantial after adjusting for patient characteristics and sampling variability (interquartile range, 0.16-0.39). INTERPRETATION: Individuals with similar patient characteristics but coming from different jurisdictions have varied severe exacerbation risks, even after controlling for patient and disease characteristics. This suggests unknown patient factors or system-level variations at play. Disease management guidelines should recognize such between-country variability. Risk prediction models that are calibrated for each jurisdiction will be needed to optimize treatment strategies.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38179428

RESUMO

Introduction: There is a need to better understand the etiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoke (TS-COPD). Wood smoke COPD (WS-COPD) is characterized by greater airway compromise, milder emphysema, and slower rate of lung function decline than TS-COPD. However, it is unclear if these two etiotypes of COPD have differences in sputum biomarker concentrations. Objective was to compare sputum levels of selected sputum biomarkers between WS-COPD and TS-COPD, and healthy controls. Methods: Eighty-eight women (69±12 years) were recruited and classified into: WS-COPD (n=31), TS-COPD (n=29) and controls (n=28). Using ELISA, we determined induced sputum levels of metalloproteinase 9 (MMP-9), chemokine ligand 5 (CCL5), interleukin-8 (IL-8), chemokine ligand 16 (CCL16/HCC-4) and vascular endothelial growth factor (VEGF-1). Differences were analyzed by Kruskal-Wallis and Mann-Whitney-U tests and correlation between airflow limitation and biomarkers by Spearman's test. Results: At similar degree of airflow obstruction, anthropometrics and medications use, the level of sputum CCL5 was higher in TS-COPD than WS-COPD (p=0.03) without differences in MMP-9, IL-8, CCL16/HCC-4, and VEGF-1. Women with WS-COPD and TS-COPD showed significantly higher sputum levels of MMP-9, IL-8 and CCL5 compared with controls (p<0.001). FEV1% predicted correlated negatively with levels of MMP-9 (rho:-0.26; P=0.016), CCL5 (rho:-0.37; P=0.001), IL-8 (rho:-0.42; P<0.001) and VEGF (rho:-0.22; P=0.04). Conclusion: While sputum concentrations of MMP-9, IL-8, and CCL5 were higher in COPD women compared with controls, women with TS-COPD had higher levels of CCL5 compared with those with WS-COPD. Whether this finding relates to differences in pathobiological pathways remains to be determined.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Doença Pulmonar Obstrutiva Crônica , Poluição por Fumaça de Tabaco , Humanos , Feminino , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/etiologia , Doença Pulmonar Obstrutiva Crônica/metabolismo , Interleucina-8/metabolismo , Escarro/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Madeira , Metaloproteinase 9 da Matriz/metabolismo , Carcinoma Hepatocelular/metabolismo , Ligantes , Neoplasias Hepáticas/metabolismo , Fumaça/efeitos adversos , Biomarcadores/metabolismo , Quimiocinas/metabolismo , Produtos do Tabaco
4.
Expert Rev Pharmacoecon Outcomes Res ; 24(3): 361-374, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37994432

RESUMO

BACKGROUND: Cost-effectiveness studies evaluate health technologies and help choose treatments. The current study compared dupilumab to omalizumab, mepolizumab, and benralizumab in Colombian adults with severe uncontrolled type 2 asthma. METHODS: Over a 5-year period, a Markov model was utilized to assess the costs of biological treatments and management of exacerbations, comparing various doses of exacerbations, comparing various doses of dupilumab, omalizumab, mepolizumab, and benralizumab as add-on treatments. It included a 5% annual discount rate per local HTA, and set willingness-to-pay at three times GDP per capita per quality-adjusted life year (QALY) in Colombia. RESULTS: Dupilumab (200 mg) exhibited greater QALYs and reduced overall costs compared to mepolizumab (100 mg), benralizumab (30 mg), and omalizumab (450 mg and 600 mg), with the incremental cost-effectiveness ratio (ICER) per QALYgained being -$5.429, -$6.269, -$196.567 and -$991.007, respectively. Dupilumab had greater QALYs and costs versus omalizumab 300 mg (ICERof $200.653 per QALY, above the willingness-to-pay threshold of 3 × GDP per capita). Sensitivity analyses were consistent with base case results. CONCLUSIONS: Dupilumab 200 mg was strongly dominant versus omalizumab 450 mg and 600 mg, mepolizumab 100 mg, and benralizumab 30 mg; however, cost-effectiveness was not demonstrated versus omalizumab 300 mg. These results could assist healthcare professionals in choosing an appropriate biologic for treating severe type 2 asthma.


Assuntos
Antiasmáticos , Anticorpos Monoclonais Humanizados , Asma , Adulto , Humanos , Omalizumab/uso terapêutico , Colômbia , Análise de Custo-Efetividade , Padrão de Cuidado , Asma/tratamento farmacológico
5.
Am J Respir Crit Care Med ; 209(3): 262-272, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38016003

RESUMO

Rationale: Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. Objectives: To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV1% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Measurements and Main Results: Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; P < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; P < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV1% predicted improvement of 3.2% (95% CI, 1.0-5.3; P = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.


Assuntos
Asma , Produtos Biológicos , Pólipos Nasais , Rinite Alérgica , Rinite , Sinusite , Adulto , Humanos , Rinite/complicações , Rinite/tratamento farmacológico , Rinite/epidemiologia , Estudos de Coortes , Asma/complicações , Asma/tratamento farmacológico , Asma/epidemiologia , Comorbidade , Doença Crônica , Sinusite/tratamento farmacológico , Sinusite/epidemiologia , Produtos Biológicos/uso terapêutico , Rinite Alérgica/complicações , Rinite Alérgica/tratamento farmacológico , Rinite Alérgica/epidemiologia , Pólipos Nasais/complicações , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/epidemiologia
6.
Ann Allergy Asthma Immunol ; 132(1): 42-53, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37640263

RESUMO

BACKGROUND: Investigation for the presence of asthma comorbidities is recommended by the Global Initiative for Asthma because their presence can complicate asthma management. OBJECTIVE: To understand the prevalence and pattern of comorbidities and multimorbidity in adults with severe asthma and their association with asthma-related outcomes. METHODS: This was a cross-sectional study using data from the International Severe Asthma Registry from 22 countries. A total of 30 comorbidities were identified and categorized a priori as any of the following: (1) potentially type 2-related comorbidities, (2) potentially oral corticosteroid (OCS)-related comorbidities, or (3) comorbidities mimicking or aggravating asthma. The association between comorbidities and asthma-related outcomes was investigated using multivariable models adjusted for country, age at enrollment, and sex (ie male or female). RESULTS: Of the 11,821 patients, 69%, 67%, and 55% had at least 1 potentially type 2-related, potentially OCS-related, or mimicking or aggravating comorbidities, respectively; 57% had 3 or more comorbidities, and 33% had comorbidities in all 3 categories. Patients with allergic rhinitis, nasal polyposis, and chronic rhinosinusitis experienced 1.12 (P = .003), 1.16 (P < .001), and 1.29 times (P < .001) more exacerbations per year, respectively, than those without. Patients with nasal polyposis and chronic rhinosinusitis were 40% and 46% more likely (P < .001), respectively, to have received long-term (LT) OCS. All assessed potential OCS-related comorbidities (except obesity) were associated with a greater likelihood of LTOCS use (odds ratios [ORs]: 1.23-2.77) and, except for dyslipidemia, with a greater likelihood of uncontrolled asthma (ORs: 1.29-1.68). All mimicking or aggravating comorbidities assessed were associated with more exacerbations (1.24-1.68 times more), all (except bronchiectasis) with increased likelihood of uncontrolled asthma (ORs: 1.57-1.81), and all (except chronic obstructive pulmonary disease) with increased likelihood of LTOCS use (ORs: 1.37-1.57). A greater number of comorbidities was associated with worse outcomes. CONCLUSION: In a global study, comorbidity or multimorbidity is reported in most adults with severe asthma and is associated with poorer asthma-related outcomes. CLINICAL TRIAL REGISTRATION: The International Severe Asthma Registry database has ethical approval from the Anonymous Data Ethics Protocols and Transparency (ADEPT) committee (ADEPT0218) and is registered with the European Union Electronic Register of Post-Authorization Studies (European Network Centres for Pharmacoepidemiology and Pharmacovigilance [ENCEPP]/DSPP/23720). The study was designed, implemented, and reported in compliance with the European Network Centres for Pharmacoepidemiology and Pharmacovigilance (ENCEPP) Code of Conduct (EMA 2014; EUPAS44024) and with all applicable local and international laws and regulations, and registered with ENCEPP (https://www.encepp.eu/encepp/viewResource.htm?id=48848). Governance was provided by ADEPT (registration number: ADEPT1121).


Assuntos
Asma , Sinusite , Adulto , Humanos , Masculino , Feminino , Multimorbidade , Estudos Transversais , Asma/epidemiologia , Comorbidade , Sinusite/epidemiologia , Doença Crônica , Sistema de Registros
7.
J Asthma ; 61(3): 222-231, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37801283

RESUMO

BACKGROUND: There is a lack of information on house dust mite (HDM) sensitization and phenotype distribution in patients with severe asthma (SA) living permanently at high-altitude (HA) in tropical regions, which may be different. OBJECTIVE: The aim of this study was to characterize adults with SA in a tropical high altitude city (2,640 m): Bogotá, Colombia. MATERIAL AND METHODS: This observational cross-sectional study included severe asthmatic outpatients (n = 129) referred to the ASMAIRE program of the Fundación Neumológica Colombiana in Bogotá (2,640 m). Clinical history, spirometry, total IgE, blood eosinophils, and skin prick test (SPT), including HDM allergens, were performed. Phenotype definitions: Allergic/atopic (AA): IgE ≥100 IU/mL and/or at least one positive SPT; eosinophilic (EOS): blood eosinophils ≥300 cells/µL; type 2-high: AA and/or EOS phenotype; type 2-low: non-AA/non-EOS phenotype (IgE <100 IU/mL, negative SPT, and blood eosinophils <300 cells/µL). RESULTS: A total of 129 adults with SA were included, 79.8% female. Phenotype distribution: AA: 61.2%; EOS: 37.2%; type 2-high: 72.1%; type 2-low: 27.9%. Among AA patients, HDM sensitization was present in 87% and 34.9% were non-eosinophilic. There was a significant overlap between the phenotypes. CONCLUSIONS: In contrast to non-tropical high-altitude regions, we found a high frequency of HDM sensitization in patients with AA phenotype living in a tropical high-altitude city. We also found a discrete lower frequency of EOS phenotype with no other significant differences in the phenotypic distribution compared to that described at low altitudes. We propose that tropical location may modify the effect of high altitude on HDM concentrations and allergenicity.


Assuntos
Asma , Hipersensibilidade , Humanos , Adulto , Animais , Feminino , Masculino , Asma/epidemiologia , Pyroglyphidae , Altitude , Imunoglobulina E , Dermatophagoides pteronyssinus , Alérgenos , Testes Cutâneos , Antígenos de Dermatophagoides , Poeira
8.
Pulm Ther ; 10(1): 69-84, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38112909

RESUMO

INTRODUCTION: The objective of this Delphi study was to understand and assess the level of consensus among respiratory experts on the clinical application of GOLD 2023 recommendations in management of patients with chronic obstructive pulmonary disease (COPD). METHODS: The study comprised two online surveys and a participant meeting with 34 respiratory experts from 16 countries. Responses of 73 questions were recorded using a Likert scale ranging from 0 (disagreement) to 9 (agreement). The consensus threshold was 75%. RESULTS: Survey 1 and survey 2 had 34 and 32 participants, respectively; and 25 attended the participant meeting. Consensus was reached on survey 1: 28/42; survey 2: 18/30 close-ended questions. A consensus was reached on the clinical relevance of most updates in definitions and diagnosis of COPD. Mixed results for the treatment recommendations by GOLD were noted: 74% agreed with the recommendation to initiate treatment with dual bronchodilators for group E patients; 63% agreed for including inhaled corticosteroids (ICS)/long-acting ß2 agonist(LABA)/ Long-acting muscarinic receptor antagonists (LAMA) as a treatment option for GOLD B patients. Also, consensus lacked on removing ICS + LABA as an initial therapeutic option, in countries with challenges in access to other treatment option;. 88% agreed that they use GOLD recommendations in their daily clinical practice. CONCLUSIONS: This Delphi study demonstrated a high level of consensus regarding key concepts of GOLD 2023 report, with most participants favoring recent updates in definitions, diagnosis, management, and prevention of COPD. More evidence on the etiotype based management and treatment options for group B and E are required which could further strengthen clinical application of the GOLD report.


The goal of this Delphi study was to understand and assess the level of alignment among the respiratory experts on the application of key changes and recommendations proposed by the GOLD 2023 report in their routine clinical practice for the management of patients with chronic obstructive pulmonary disease (COPD). There were two online surveys in this study, and experts from 16 countries (primarily focused on developing countries) were invited to participate. Using the Delphi method, expert representatives shared their insights with the aim of optimizing patient care. The alignment was assessed in six well-defined themes: 1) Overall view on GOLD/other recommendations; 2) Assessing patients with COPD; 3) Initial pharmacological treatment in patients with COPD; 4) Vaccination for patients with COPD; 5) Follow-up pharmacological treatment in patients with COPD; and 6) Survival evidence in patients with COPD. Participants expressed a high level of agreement regarding key concepts of the GOLD 2023 report, with most of them agreeing with recent updates in definitions, diagnosis, management, and prevention of COPD. The results also highlighted the need to publish GOLD reports in multiple languages and in a shorter, pocket-sized format to increase awareness and adaptation among healthcare providers.

9.
Artigo em Inglês | MEDLINE | ID: mdl-38059147

RESUMO

Background: Even though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring have been described to confirm not only the integrity but-most importantly-the function of the recurrent laryngeal nerve, in parotid gland surgery, a formal guideline to follow while dissecting the facial nerve has yet to be described. Methods: A five-year retrospective study was done reviewing the intraoperative records of patients who underwent parotid gland surgery under neural monitoring. The operative findings regarding the neuromonitoring process, particularly in regard to the amplitude of two main branches, were revised. A literature search was done to search for guidelines to follow when a facial nerve loss of signal is encountered. Results: Fifty-five patients were operated on using the Nim 3 Nerve Monitoring System (Medtronic); 31 were female patients, and 47 patients had benign lesions. Minimum changes were observed in the amplitude records after a comparison was made between the first and the last stimulation. There were only three articles discussing the term loss of signal during parotid gland surgery. Conclusion: Today, no sufficient attention has been given to the facial nerve monitoring process during parotidectomy. This study proposes a formal guideline to follow during this procedure as well as an instruction to consider when a loss of signal is observed to develop a uniform technique of facial nerve stimulation.

10.
Artigo em Inglês | MEDLINE | ID: mdl-38151100

RESUMO

BACKGROUND: There is little agreement on clinically useful criteria for identifying real-world responders to biologic treatments for asthma. OBJECTIVE: To investigate the impact of pre-biologic impairment on meeting domain-specific biologic responder definitions in adults with severe asthma. METHODS: This was a longitudinal, cohort study across 22 countries participating in the International Severe Asthma Registry (https://isaregistries.org/) between May 2017 and January 2023. Change in 4 asthma domains (exacerbation rate, asthma control, long-term oral corticosteroid [LTOCS] dose, and lung function) was assessed from biologic initiation to 1 year post-treatment (minimum 24 weeks). Pre- to post-biologic changes for responders and nonresponders were described along a categorical gradient for each domain derived from pre-biologic distributions (exacerbation rate: 0 to 6+/y; asthma control: well controlled to uncontrolled; LTOCS: 0 to >30 mg/d; percent-predicted forced expiratory volume in 1 second [ppFEV1]: <50% to ≥80%). RESULTS: Percentage of biologic responders (ie, those with a category improvement pre- to post-biologic) varied by domain and increased with greater pre-biologic impairment, increasing from 70.2% to 90.0% for exacerbation rate, 46.3% to 52.3% for asthma control, 31.1% to 58.5% for LTOCS daily dose, and 35.8% to 50.6% for ppFEV1. The proportion of patients having improvement post-biologic tended to be greater for anti-IL-5/5R compared with for anti-IgE for exacerbation, asthma control, and ppFEV1 domains, irrespective of pre-biologic impairment. CONCLUSION: Our results provide realistic outcome-specific post-biologic expectations for both physicians and patients, will be foundational to inform future work on a multidimensional approach to define and assess biologic responders and response, and may enhance appropriate patient selection for biologic therapies. TRIAL REGISTRATION: The ISAR database has ethical approval from the Anonymous Data Ethics Protocols and Transparency (ADEPT) committee (ADEPT0218) and is registered with the European Union Electronic Register of Post-Authorization studies (ENCEPP/DSPP/23720). The study was designed, implemented, and reported in compliance with the European Network Centres for Pharmacoepidemiology and Pharmacovigilance (ENCEPP) Code of Conduct (EUPAS38288) and with all applicable local and international laws and regulation, and registered with ENCEPP (https://www.encepp.eu/encepp/viewResource.htm?id=38289). Governance was provided by ADEPT (registration number: ADEPT1220).

11.
Opt Lett ; 48(21): 5807-5810, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37910764

RESUMO

Several methods have been proposed to reduce the detrimental effects of coherent noise in holographic imaging. Among them, the use of spatial-frequency masking or resampling has been widely applied because of its low implementation complexity and well-studied trade-off between denoising effectiveness and spatial resolution. While the digital application of this method has been successfully demonstrated for intensity images, its application to phase maps fails. This work shows that the phase applicability of these methods depends on the use of resampling masks that strictly keep the zero-order spatial frequencies. Alternative masks are proposed that demonstrate effective single-shot noise reduction in experimental phase maps from digital holographic microscopy. The resulting method is potentially extendable to any other complex-valued-field retrieval technique.

12.
Int J Chron Obstruct Pulmon Dis ; 18: 2257-2265, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37854316

RESUMO

Purpose: To compare the level of knowledge in vaccination against influenza and pneumococcus of patients with chronic obstructive pulmonary disease (COPD) who are managed in an Integrated Care Program (ICP) with those who receive usual care (UC). Methods: A telephone survey of patients diagnosed with COPD registered in public care networks or private institutions was done. A descriptive and comparative analysis of the characteristics of the ICP and UC groups was carried out. The relationship between belonging to an ICP and the level of knowledge about vaccination was evaluated using Propensity Score Matching (PSM) and multivariate logistic and ordinal regression models. Results: Of 674 study participants, 27.2% were from the ICP group. ICP patients were older, more frequently men, from a higher socioeconomic stratum and a higher educational level (p<0.05). 75.5% of the patients in the ICP group had a high level of vaccination knowledge compared to 42.7% in the UC group (p<0.001). In the multivariate analysis, adjusting for sociodemographic variables, years of COPD diagnosis, and comorbidities, belonging to the ICP was associated with a higher probability of answering questions about vaccination correctly and having a high level of knowledge (OR 3.397, IC 95% 2.058-5.608, p<0.001). Conclusion: Patients with COPD managed in an ICP have a higher level of knowledge in vaccination against influenza and pneumococcus, compared to patients in usual care.


Assuntos
Prestação Integrada de Cuidados de Saúde , Vacinas contra Influenza , Influenza Humana , Doença Pulmonar Obstrutiva Crônica , Masculino , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia , Streptococcus pneumoniae , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinação
13.
Pragmat Obs Res ; 14: 127-147, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37881411

RESUMO

Aim: The International Severe Asthma Registry (ISAR; http://isaregistries.org/) uses standardised variables to enable multi-country and adequately powered research in severe asthma. This study aims to look at the data countries within ISAR and non-ISAR countries reported collecting that enable global research that support individual country interests. Methods: Registries were identified by online searches and approaching severe asthma experts. Participating registries provided data collection specifications or confirmed variables collected. Core variables (results from ISAR's Delphi study), steroid-related comorbidity variables, biologic safety variables (serious infection, anaphylaxis, and cancer), COVID-19 variables and additional variables (not belonging to the aforementioned categories) that registries reported collecting were summarised. Results: Of the 37 registries identified, 26 were ISAR affiliates and 11 non-ISAR affiliates. Twenty-five ISAR-registries and 4 non-ISAR registries reported collecting >90% of the 65 core variables. Twenty-three registries reported collecting all optional steroid-related comorbidity variables. Twenty-nine registries reported collecting all optional safety variables. Ten registries reported collecting COVID-19 variables. Twenty-four registries reported collecting additional variables including data from asthma questionnaires (10 Asthma Control Questionnaire, 20 Asthma Control Test, 11 Asthma Quality of Life Questionnaire, and 4 EuroQol 5-dimension 5-level Questionnaire). Eight registries are linked to databases such as electronic medical records and national claims or disease databases. Conclusion: Standardised data collection has enabled individual severe asthma registries to collect unified data and increase statistical power for severe asthma research irrespective of ISAR affiliations.

14.
Cureus ; 15(5): e39643, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37388619

RESUMO

This systematic review aims to provide a comprehensive understanding of the role of human papillomavirus (HPV) in head and neck cancer of unknown primary (HNCUP). HNCUP is a rare type of cancer with an unknown primary site, which makes it difficult to diagnose and treat. The review includes articles published between 2013 and 2023 that investigated the prevalence of HPV in HNCUP, its association with clinical outcomes, and its potential implications for diagnosis and treatment. The search was conducted in 11 electronic databases, and the gray literature: Cochrane, Cumed, IBECS, JAMA Network, LILACS, MEDLINE Ovid, MEDLINE-EBSCO, PubMed, Scopus, SciELO, and Taylor & Francis Online; a total of 23 studies met the inclusion criteria. The review found that HPV is present in a significant proportion of HNCUP cases, ranging from 15.5% to 100%. HNCUP incidence is increasing, and the presence of HPV was associated with improved clinical outcomes in some studies, such as overall survival and disease-free survival; but was found to have no association with outcomes in others. This may have implications for diagnostic and treatment strategies. The findings of this review suggest that further research is needed to better understand the role of HPV in HNCUP and to develop targeted therapies for this disease.

15.
Appl Opt ; 62(10): D39-D47, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37132768

RESUMO

The adaptation of an off-the-shelf Blu-ray optical pickup unit (OPU) into a highly versatile point source for digital lensless holographic microscopy (DLHM) is presented. DLHM performance is mostly determined by the optical properties of the point source of spherical waves used for free-space magnification of the sample's diffraction pattern; in particular, its wavelength and numerical aperture define the achievable resolution, and its distance to the recording medium sets the magnification. Through a set of straightforward modifications, a commercial Blu-ray OPU can be transformed into a DLHM point source with three selectable wavelengths, a numerical aperture of up to 0.85, and integrated micro-displacements in both axial and transversal directions. The functionality of the OPU-based point source is then experimentally validated in the observation of micrometer-sized calibrated samples and biological specimens of common interest, showing the feasibility of obtaining sub-micrometer resolution and offering a versatile option for the development of new cost-effective and portable microscopy devices.

16.
Nanomaterials (Basel) ; 13(10)2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37242112

RESUMO

The optical emission of cone-shell quantum structures (CSQS) under vertical electric (F) and magnetic (B) fields is studied by means of simulations. A CSQS has a unique shape, where an electric field induces the transformation of the hole probability density from a disk into a quantum-ring with a tunable radius. The present study addresses the influence of an additional magnetic field. A common description for the influence of a B-field on charge carriers confined in a quantum dot is the Fock-Darwin model, which introduces the angular momentum quantum number l to describe the splitting of the energy levels. For a CSQS with the hole in the quantum ring state, the present simulations demonstrate a B-dependence of the hole energy which substantially deviates from the prediction of the Fock-Darwin model. In particular, the energy of exited states with a hole lh> 0 can become lower than the ground state energy with lh= 0. Because for the lowest-energy state the electron le is always zero, states with lh> 0 are optically dark due to selection rules. This allows switching from a bright state (lh= 0) to a dark state (lh> 0) or vice versa by changing the strength of the F or B field. This effect can be very interesting for trapping photoexcited charge carriers for a desired time. Furthermore, the influence of the CSQS shape on the fields required for the bright to dark state transition is investigated.

17.
Nanomaterials (Basel) ; 13(8)2023 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-37110945

RESUMO

In this paper, we investigate the electronic and optical properties of an electron in both symmetric and asymmetric double quantum wells that consist of a harmonic potential with an internal Gaussian barrier under a nonresonant intense laser field. The electronic structure was obtained by using the two-dimensional diagonalization method. To calculate the linear and nonlinear absorption, and refractive index coefficients, a combination of the standard density matrix formalism and the perturbation expansion method was used. The obtained results show that the electronic and thereby optical properties of the considered parabolic-Gaussian double quantum wells could be adjusted to obtain a suitable response to specific aims with parameter alterations such as well and barrier width, well depth, barrier height, and interwell coupling, in addition to the applied nonresonant intense laser field.

18.
Nanomaterials (Basel) ; 13(5)2023 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-36903737

RESUMO

Strain-free GaAs cone-shell quantum structures (CSQS) with widely tunable wave functions (WF) are fabricated using local droplet etching (LDE) during molecular beam epitaxy (MBE). During MBE, Al droplets are deposited on an AlGaAs surface, which then drill low-density (about 1 × 107 cm-2) nanoholes with adjustable shape and size. Subsequently, the holes are filled with GaAs to form CSQS, where the size can be adjusted by the amount of GaAs deposited for hole filling. An electric field is applied in growth direction to tune the WF in a CSQS. The resulting highly asymmetric exciton Stark shift is measured using micro-photoluminescence. Here, the unique shape of the CSQS allows a large charge-carrier separation and, thus, a strong Stark shift of up to more than 16 meV at a moderate field of 65 kV/cm. This corresponds to a very large polarizability of 8.6 × 10-6 eVkV -2 cm2. In combination with simulations of the exciton energy, the Stark shift data allow the determination of the CSQS size and shape. Simulations of the exciton-recombination lifetime predict an elongation up to factor of 69 for the present CSQSs, tunable by the electric field. In addition, the simulations indicate the field-induced transformation of the hole WF from a disk into a quantum ring with a tunable radius from about 10 nm up to 22.5 nm.

19.
Nanomaterials (Basel) ; 13(5)2023 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-36903770

RESUMO

In this study, we considered the linear and non-linear optical properties of an electron in both symmetrical and asymmetrical double quantum wells, which consist of the sum of an internal Gaussian barrier and a harmonic potential under an applied magnetic field. Calculations are in the effective mass and parabolic band approximations. We have used the diagonalization method to find eigenvalues and eigenfunctions of the electron confined within the symmetric and asymmetric double well formed by the sum of a parabolic and Gaussian potential. A two-level approach is used in the density matrix expansion to calculate the linear and third-order non-linear optical absorption and refractive index coefficients. The potential model proposed in this study is useful for simulating and manipulating the optical and electronic properties of symmetric and asymmetric double quantum heterostructures, such as double quantum wells and double quantum dots, with controllable coupling and subjected to externally applied magnetic fields.

20.
Nanomaterials (Basel) ; 13(5)2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36903791

RESUMO

In this work, the characterization and analysis of the physics of a GaAs quantum well with AlGaAs barriers were carried out, according to an interior doped layer. An analysis of the probability density, the energy spectrum, and the electronic density was performed using the self-consistent method to solve the Schrödinger, Poisson, and charge-neutrality equations. Based on the characterizations, the system response to geometric changes in the well width and to non-geometric changes, such as the position and with of the doped layer as well as the donor density, were reviewed. All second-order differential equations were solved using the finite difference method. Finally, with the obtained wave functions and energies, the optical absorption coefficient and the electromagnetically induced transparency between the first three confined states were calculated. The results showed the possibility of tuning the optical absorption coefficient and the electromagnetically induced transparency via changes to the system geometry and the doped-layer characteristics.

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