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1.
Materials (Basel) ; 17(3)2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38591549

RESUMO

This research focuses on analysing the 18Ni300 maraging steel produced through laser powder bed fusion. Specifically, it aims to examine the phase components using X-ray diffraction, the microstructure through scanning electron microscopy, and the hardness of the different structures present in the manufactured material. The primary goal is to meticulously analyse the material and its microstructures. By doing so, a correlation between the hardness and each structure type, be it cellular or columnar, can be established. This will allow us to pinpoint any defects in the material before any surface chemical treatment is carried out and facilitate a thorough examination of its microstructure. A consistent pattern emerges across the samples through systematic measurement of microhardness distribution in various locations and detailed examination of the structure. The findings of the study reveal that the hardness of cellular and columnar structures exhibits a significant variation based on the location of the measurement about cell boundaries. The hardness value is notably higher in the combination of cellular and multiple layers, as the data indicate.

2.
Sensors (Basel) ; 24(7)2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38610443

RESUMO

The present work proposes a comprehensive metaheuristic methodology for the development of a medical robot for the upper limb rehabilitation, which includes the topological optimization of the device, kinematic models (5 DOF), human-robot interface, control and experimental tests. This methodology applies two cutting-edge triads: (1) the three points of view in engineering design (client, designer and community) and (2) the triad formed by three pillars of Industry 4.0 (autonomous machines and systems, additive manufacturing and simulation of virtual environments). By applying the proposed procedure, a robotic mechanism was obtained with a reduction of more than 40% of its initial weight and a human-robot interface with three modes of operation and a biomechanically viable kinematic model for humans. The digital twin instance and its evaluation through therapeutic routines with and without disturbances was assessed; the average RMSEs obtained were 0.08 rad and 0.11 rad, respectively. The proposed methodology is applicable to any medical robot, providing a versatile and effective solution for optimizing the design and development of healthcare devices. It adopts an innovative and scalable approach to enhance their processes.


Assuntos
Exoesqueleto Energizado , Robótica , Humanos , Comércio , Simulação por Computador , Engenharia
3.
ACS Appl Polym Mater ; 6(7): 4244-4255, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38633815

RESUMO

A tetrazole-naphthalene linker was used to prepare a nickel MOF (metal-organic framework) (NiNDTz) with interesting properties: a specific surface area SBET of 320 m2g-1 (SLangmuir 436 m2g-1), high thermal stability (Tdonset = 300 °C), and CO2 uptake of 1.85 mmolg-1, attributed to the tetrazole groups to be used as fillers in gas separation membranes. The role of these groups was crucial in the mechanical properties of mixed membranes prepared using polycarbonate as a polymer matrix, providing a very homogeneous filler distribution and also in the gas separation properties since a simultaneous increase in permeability and selectivity was achieved, especially in the hybrid membrane containing 20% filler (PC@NiNDTz-20%). This membrane exhibited an excellent balance between permeability (P) and selectivity (α) with an increase in the permeability of CO2 and H2, 177 and 185%, respectively, and improvements in the selectivity of these gases against greenhouse gases such as methane and ethylene (between 15 and 28% improvement). These results make this membrane competitive to deal with separations in which these gases are involved, and are of special interest for the H2/CH4 separation since it clearly improves the performance of pure PC and no better PC-based membranes have been reported in the literature for this separation.

4.
bioRxiv ; 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38659744

RESUMO

The gut microbiome (GMB) has been associated with outcomes of immune checkpoint blockade therapy in melanoma, but there is limited consensus on the specific taxa involved, particularly across different geographic regions. We analyzed pre-treatment stool samples from 674 melanoma patients participating in a phase-III trial of adjuvant nivolumab plus ipilimumab versus nivolumab, across three continents and five regions. Longitudinal analysis revealed that GMB was largely unchanged following treatment, offering promise for lasting GMB-based interventions. In region-specific and cross-region meta-analyses, we identified pre-treatment taxonomic markers associated with recurrence, including Eubacterium, Ruminococcus, Firmicutes , and Clostridium . Recurrence prediction by these markers was best achieved across regions by matching participants on GMB compositional similarity between the intra-regional discovery and external validation sets. AUCs for prediction ranged from 0.83-0.94 (depending on the initial discovery region) for patients closely matched on GMB composition (e.g., JSD ≤0.11). This evidence indicates that taxonomic markers for prediction of recurrence are generalizable across regions, for individuals of similar GMB composition. Highlights: Overall gut microbiome (GMB) composition is largely unchanged during ICB treatment.GMB composition varies by geographic regionWe identified gut bacterial markers associated with recurrence in region-specific analyses.Region-identified markers are generalizable if GMB composition is taken into account by matching.

5.
RSC Adv ; 14(13): 9114-9121, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38500617

RESUMO

Creatinine is an important biomarker for the diagnosis of chronic kidney disease (CKD). Recently, it has been reported that the concentration of salivary creatinine correlates well with the concentration of serum creatinine, which makes the former useful for the development of non-invasive and point-of-care (POC) detection for CKD diagnosis. However, there exists a technical challenge in the rapid detection of salivary creatinine at low concentrations of 3-18 µM when using the current kidney function test strips as well as the traditional methods employed in hospitals. Herein, we demonstrate a simple, sensitive colorimetric assay for the detection of creatinine with a limit-of-detection (LOD) down to the nanomolar level. Our approach utilises the dual binding affinity of creatinine for citrate-capped silver nanoparticles (Ag NPs) and Ag(i) ions, which can trigger the aggregation of Ag NPs and thus lead to the colour change of a sample. The quantitative detection of creatinine was achieved using UV-Vis spectroscopy with a LOD of 6.9 nM in artificial saliva and a linear dynamic range of 0.01-0.06 µM. This method holds promise to be further developed into a POC platform for the CKD diagnosis.

6.
Sci Total Environ ; 926: 171858, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38522529

RESUMO

Forest ecosystems worldwide currently face worrying episodes of forest decline, which have boosted weakening and mortality of the trees. In the Mediterranean region, especially in the southeast Iberian Peninsula, Pinus sylvestris forests are severely affected by this phenomenon, and it has been commonly attributed to drought events. Remarkably, the role of root microbiota on pine decline has been overlooked and remains unclear. We therefore used metabarcoding to identify the belowground microbial communities of decline-affected and unaffected pine trees. Taxonomic composition of bacterial and fungal rhizosphere communities, and fungal populations dwelling in root endosphere showed different profiles depending on the health status of the trees. The root endosphere of asymptomatic trees was as strongly dominated by 'Candidatus Phytoplasma pini' as the root of decline-affected pines, accounting for >99 % of the total bacterial sequences in some samples. Notwithstanding, the titer of this phytopathogen was four-fold higher in symptomatic trees than in symptomless ones. Furthermore, the microbiota inhabiting the root endosphere of decline-affected trees assembled into a less complex and more modularized network. Thus, the observed changes in the microbial communities could be a cause or a consequence of forest decline phenomenon. Moreover, 'Ca. Phytoplasma pini' is positively correlated to Pinus sylvestris decline events, either as the primary cause of pine decline or as an opportunistic pathogen exacerbating the process once the tree has been weaken by other factors.


Assuntos
Microbiota , Pinus sylvestris , Pinus , Mudança Climática , Florestas , Árvores
7.
Environ Microbiome ; 19(1): 17, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491515

RESUMO

BACKGROUND: The complex and co-evolved interplay between plants and their microbiota is crucial for the health and fitness of the plant holobiont. However, the microbiota of the seeds is still relatively unexplored and no studies have been conducted with olive trees so far. In this study, we aimed to characterize the bacterial, fungal and archaeal communities present in seeds of ten olive genotypes growing in the same orchard through amplicon sequencing to test whether the olive genotype is a major driver in shaping the seed microbial community, and to identify the origin of the latter. Therefore, we have developed a methodology for obtaining samples from the olive seed's endosphere under sterile conditions. RESULTS: A diverse microbiota was uncovered in olive seeds, the plant genotype being an important factor influencing the structure and composition of the microbial communities. The most abundant bacterial phylum was Actinobacteria, accounting for an average relative abundance of 41%. At genus level, Streptomyces stood out because of its potential influence on community structure. Within the fungal community, Basidiomycota and Ascomycota were the most abundant phyla, including the genera Malassezia, Cladosporium, and Mycosphaerella. The shared microbiome was composed of four bacterial (Stenotrophomonas, Streptomyces, Promicromonospora and Acidipropionibacterium) and three fungal (Malassezia, Cladosporium and Mycosphaerella) genera. Furthermore, a comparison between findings obtained here and earlier results from the root endosphere of the same trees indicated that genera such as Streptomyces and Malassezia were present in both olive compartments. CONCLUSIONS: This study provides the first insights into the composition of the olive seed microbiota. The highly abundant fungal genus Malassezia and the bacterial genus Streptomyces reflect a unique signature of the olive seed microbiota. The genotype clearly shaped the composition of the seed's microbial community, although a shared microbiome was found. We identified genera that may translocate from the roots to the seeds, as they were present in both organs of the same trees. These findings set the stage for future research into potential vertical transmission of olive endophytes and the role of specific microbial taxa in seed germination, development, and seedling survival.

8.
Sci Rep ; 14(1): 6095, 2024 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-38480804

RESUMO

In this study, we aimed to understand the potential role of the gut microbiome in the development of Alzheimer's disease (AD). We took a multi-faceted approach to investigate this relationship. Urine metabolomics were examined in individuals with AD and controls, revealing decreased formate and fumarate concentrations in AD. Additionally, we utilised whole-genome sequencing (WGS) data obtained from a separate group of individuals with AD and controls. This information allowed us to create and investigate host-microbiome personalised whole-body metabolic models. Notably, AD individuals displayed diminished formate microbial secretion in these models. Additionally, we identified specific reactions responsible for the production of formate in the host, and interestingly, these reactions were linked to genes that have correlations with AD. This study suggests formate as a possible early AD marker and highlights genetic and microbiome contributions to its production. The reduced formate secretion and its genetic associations point to a complex connection between gut microbiota and AD. This holistic understanding might pave the way for novel diagnostic and therapeutic avenues in AD management.


Assuntos
Doença de Alzheimer , Microbioma Gastrointestinal , Microbiota , Humanos , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Microbiota/genética , Microbioma Gastrointestinal/genética , Genômica , Formiatos
9.
Front Immunol ; 15: 1333995, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38420123

RESUMO

Introduction: RA patients are at higher risk of cardiovascular disease, influenced by therapies. Studying their cardiovascular and cardiometabolic proteome can unveil biomarkers and insights into related biological pathways. Methods: This study included two cohorts of RA patients: newly diagnosed individuals (n=25) and those with established RA (disease duration >25 years, n=25). Both cohorts were age and sex-matched with a control group (n=25). Additionally, a longitudinal investigation was conducted on a cohort of 25 RA patients treated with methotrexate and another cohort of 25 RA patients treated with tofacitinib for 6 months. Clinical and analytical variables were recorded, and serum profiling of 184 proteins was performed using the Olink technology platform. Results: RA patients exhibited elevated levels of 75 proteins that might be associated with cardiovascular disease. In addition, 24 proteins were increased in RA patients with established disease. Twenty proteins were commonly altered in both cohorts of RA patients. Among these, elevated levels of CTSL1, SORT1, SAA4, TNFRSF10A, ST6GAL1 and CCL18 discriminated RA patients and HDs with high specificity and sensitivity. Methotrexate treatment significantly reduced the levels of 13 proteins, while tofacitinib therapy modulated the expression of 10 proteins. These reductions were associated with a decrease in DAS28. Baseline levels of SAA4 and high levels of BNP were associated to the non-response to methotrexate. Changes in IL6 levels were specifically linked to the response to methotrexate. Regarding tofacitinib, differences in baseline levels of LOX1 and CNDP1 were noted between non-responder and responder RA patients. In addition, response to tofacitinib correlated with changes in SAA4 and TIMD4 levels. Conclusion: In summary, this study pinpoints molecular changes linked to cardiovascular disease in RA and proposes candidate protein biomarkers for distinguishing RA patients from healthy individuals. It also highlights how methotrexate and tofacitinib impact these proteins, with distinct alterations corresponding to each drug's response, identifying potential candidates, as SAA4, for the response to these therapies.


Assuntos
Antirreumáticos , Artrite Reumatoide , Doenças Cardiovasculares , Humanos , Metotrexato , Antirreumáticos/uso terapêutico , Proteoma , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/tratamento farmacológico , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/induzido quimicamente
10.
Children (Basel) ; 11(2)2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38397294

RESUMO

(1) Introduction. An analysis was made of posterior crossbites in deciduous dentition and their relation to the type of feeding received by the child, with the objective of determining the influence of the way in which the child is fed in the early stages of life on the development of posterior crossbites. (2) Material and methods. A total of 1401 preschool children between 3 and 6 years of age from Seville (Spain) were included in the study. An intraoral exploration was carried out to assess the presence of crossbites (uni- or bilateral, and functional or not). The study was completed with a parent or legal guardian questionnaire exploring the type of feeding received by the child in the first stages of life, as well as the presence of bad oral habits and their duration. (3) Results. A total of 276 children (19.7%) presented posterior crossbite in occlusion. Uponn centering the midlines, 197 were maintained, indicating that 79 were due to premature contacts (functional crossbites). There were no significant differences in crossbites among the children who had received breastfeeding, though bottle-feeding was seen to favor crossbite. (4) Conclusions. No statistically significant relationship was found between posterior crossbites and breastfeeding, though an association between posterior crossbites and bottle-feeding was observed, with the number of crossbites increasing with the duration of bottle-feeding.

11.
Materials (Basel) ; 17(4)2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38399141

RESUMO

The presence of defects in additive manufactured maraging steel is a widespread problem as its dependence on processing parameters significantly influences it. Using X-ray computed tomography, along with optical microscope data limited to 2D images, quantifies the internal porosity present on a compact tension sample typically employed in fatigue testing. The primary goal of this research is to analyse the pores obtained after the fabrication of a compact tension sample and their main definition parameters, such as sphericity, aspect ratio, surface, and volume, and obtain validation of which method is valid for each of the parameters analysed. The current study aims to enhance the understanding of defects in maraging steel samples through non-destructive 3D analysis. Conventional 2D analyses are limited to surface measurements, providing incomplete information. The proposed method will provide a comprehensive understanding of the defects inside the maraging steel sample, thereby improving the reliability of this material for further applications. This study will contribute to academic and industrial communities by providing a novel approach to analysing maraging steel samples and, ultimately, developing improved materials for various applications. The study's findings reveal that most pores are produced by gases that are trapped in the fabrication process, and keyhole pores only appear near the surface.

12.
Int Emerg Nurs ; 73: 101422, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38401479

RESUMO

BACKGROUND: Peripheral intravenous cannulation is a common procedure in the emergency department. Nevertheless, failure rates during the first attempt are as high as 40% in adults and 65% in children. Evidence suggests that physician performed ultrasound-guided peripheral intravenous cannulation (USG-PIVC) is an effective alternative to the traditional method; however, there is insufficient data on the efficacy of the technique performed by nurses. OBJECTIVE: To examine the efficacy of the USG-PIVC technique performed by emergency department nurses. METHODS: A literature review with meta-analysis was performed. The databases used were PubMed, Scopus and CINAHL. The search was conducted in March 2023. Two meta-analysis one of clinical trials about the effectiveness and one about the succession rate were performed. RESULTS: 20 studies were selected and analysed. The studies showed that USGPIVC performed by emergency nurses increased the probability of both the overall success and a successful first attempt compared to the standard technique. In addition, patients showed high satisfaction and lower complication rates. However, the procedure had no significant effect on the time or number of attempts required. A lower probability of success was obtained as regards peripheral intravenous cannulation when the standard technique was used, OR = 0.42 (95 %CI 0.25-0.70p < 0,05). CONCLUSIONS: Ultrasound-guided peripheral intravenous cannulation performed by emergency nurses is a safe and effective technique.


Assuntos
Cateterismo Periférico , Enfermagem em Emergência , Ultrassonografia de Intervenção , Humanos , Cateterismo Periférico/métodos , Serviço Hospitalar de Emergência , Ultrassonografia de Intervenção/métodos
13.
Clin. transl. oncol. (Print) ; 26(1): 239-244, jan. 2024.
Artigo em Inglês | IBECS | ID: ibc-229162

RESUMO

Purpose To estimate the cost-effectiveness of adding a CDK4/6 inhibitor to standard endocrine therapy in the first-line setting for advanced HR+/HER2− breast cancer in postmenopausal and premenopausal women, from the perspective of the Mexican public healthcare system. Methods We used a partitioned survival model to simulate relevant health outcomes in a synthetic cohort of patients with breast cancer derived from the PALOMA-2, MONALEESA-2, MONARCH-3 trials for postmenopausal patients, and from the MONALEESA-7 study for premenopausal patients. Effectiveness was measured in life years gained. Cost-effectiveness is reported through incremental cost-effectiveness ratios (ICER). Results In postmenopausal patients, palbociclib led to an increase of 1.51 life years, ribociclib of 1.58 years, and abemaciclib of 1.75 years, compared to letrozole alone. The ICER was 36,648 USD, 32,422 USD, and 26,888 USD, respectively. In premenopausal patients, ribociclib led to an increase of 1.82 life years when added to goserelin and endocrine therapy, with an ICER of 44,579 USD. In the cost minimization analysis, for postmenopausal patients, ribociclib was the treatment with the highest costs due to follow-up requirements. Conclusion Palbociclib, ribociclib, and abemaciclib demonstrated a significant increase in effectiveness in postmenopausal patients, and ribociclib in premenopausal patients, when added to standard endocrine therapy for patients with advanced HR+/HER2− breast cancer. At the national stablished willingness to pay, only the addition of abemaciclib to standard endocrine therapy in postmenopausal women would be considered cost-effective. However, differences on results between therapies for postmenopausal patients were not statistically significant (AU)


Assuntos
Humanos , Feminino , 4-Aminopiridina/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Neoplasias da Mama/tratamento farmacológico , Proteínas Inibidoras de Quinase Dependente de Ciclina/administração & dosagem , México
14.
Int J Med Sci ; 21(2): 332-340, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38169578

RESUMO

The aim of this study was to investigate the efficacy of physical exercise in chronic kidney disease, describing its impact on the Klotho-FGF23 axis. PubMed, Web of Science and Scopus databases, updated to January 2023, were searched. The present study employed mean difference and a 95% confidence interval (CI) to examine the efficacy of the intervention. Heterogeneity was assessed through inconsistency statistics (I2). Out of the 299 studies identified, a total of 4 randomized controlled trials (RCTs), comprising 272 participants, met the eligibility criteria. Compared with the control group, physical exercise significantly decreased the concentrations of FGF23 (MD: -102.07 Pg/mL, 95% CI: -176.23.47, -27.91 I2= 97%, p = 0.001), and a significantly increased the concentrations of Klotho protein: (MD: 158.82 Pg/mL, 95% CI: 123.33, -194.31, I2 = 0%, p = 0.001). The results of our study indicated that the exercise has a direct relationship with Klotho-FGF23 axis. We can conclude that physical exercise in patients with CKD produces beneficial effects on the pathophysiological components related to this disease, including cardiorespiratory fitness and vascular functions. As observed, both endurance and aerobic physical exercise increase Klotho production and decrease FGF23 levels. Evidence indicates that exercise attenuates the progression of CKD, improves uremic parameters and down-regulates inflammation-related markers.


Assuntos
Glucuronidase , Insuficiência Renal Crônica , Humanos , Exercício Físico , Fatores de Crescimento de Fibroblastos , Rim , Insuficiência Renal Crônica/terapia
15.
Biomolecules ; 14(1)2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38254726

RESUMO

(1) Background: Eosinophilia has traditionally been linked to eosinophilic asthma, for which it is the gold-standard prognostic biomarker. However, the association between eosinophilia and the presence of other diseases and comorbidities is yet unclear. (2) Methods: For this retrospective study, we reviewed the electronic medical records of 49,909 subjects with blood eosinophilia to gather data on the presence of asthma, COPD, sleep apnea, tuberculosis, dyslipidemia, hypertension, and other cardiovascular diseases and severe CRSwNP among these subjects. Demographic features including age, sex, and smoking habits were collected, as well as the number of hospitalizations and emergency department visits. T-tests, ANOVA, Fisher test, and logistic regression models were used. (3) Results: For all age groups studied, eosinophilia was significantly more prevalent among asthmatic subjects than nonasthmatics, especially in patients also presenting CRSwNP, hypertension, and dyslipidemia. The likelihood of developing asthma, COPD, and CRSwNP, and hospitalization, was increased when BEC was above 600 eosinophils/µL. The association between asthma, CRSwNP, and BEC was corroborated by multiple logistic regressions models. (4) Conclusions: We demonstrated the association of having over 600 blood eosinophils/µL with a higher number of hospitalizations and comorbidities (CRSwNP and COPD), which proves that BEC is a highly useful parameter to consider in subjects who present blood eosinophilia.


Assuntos
Asma , Dislipidemias , Hipertensão , Mustelidae , Doença Pulmonar Obstrutiva Crônica , Eosinofilia Pulmonar , Humanos , Animais , Estudos Retrospectivos , Asma/complicações , Asma/epidemiologia , Hospitalização , Dislipidemias/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia
16.
Materials (Basel) ; 17(2)2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38255600

RESUMO

In order to improve understanding of the fatigue behaviour in additive manufactured samples, this research delves into the challenging interplay between building parameters, particularly fabrication angles, and the presence of pores. The primary objective is to explore the characterisation of these pores and unravel their relationship with the fatigue properties of the material under investigation. Through a systematic analysis of porosity distribution in various fabrication orientations, supplemented by a detailed examination of the elemental dispersion around specific porous structures using energy-dispersive X-ray spectroscopy, a consistent behavioural pattern emerges across the samples. In assessing fatigue behaviour, an examination of the variables reveals that only area and aspect ratio significantly influence the behaviour of the samples. Such studies can contribute substantially to academic research in the field of material science and engineering.

17.
Clin Transl Oncol ; 26(1): 239-244, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37329428

RESUMO

PURPOSE: To estimate the cost-effectiveness of adding a CDK4/6 inhibitor to standard endocrine therapy in the first-line setting for advanced HR+/HER2- breast cancer in postmenopausal and premenopausal women, from the perspective of the Mexican public healthcare system. METHODS: We used a partitioned survival model to simulate relevant health outcomes in a synthetic cohort of patients with breast cancer derived from the PALOMA-2, MONALEESA-2, MONARCH-3 trials for postmenopausal patients, and from the MONALEESA-7 study for premenopausal patients. Effectiveness was measured in life years gained. Cost-effectiveness is reported through incremental cost-effectiveness ratios (ICER). RESULTS: In postmenopausal patients, palbociclib led to an increase of 1.51 life years, ribociclib of 1.58 years, and abemaciclib of 1.75 years, compared to letrozole alone. The ICER was 36,648 USD, 32,422 USD, and 26,888 USD, respectively. In premenopausal patients, ribociclib led to an increase of 1.82 life years when added to goserelin and endocrine therapy, with an ICER of 44,579 USD. In the cost minimization analysis, for postmenopausal patients, ribociclib was the treatment with the highest costs due to follow-up requirements. CONCLUSION: Palbociclib, ribociclib, and abemaciclib demonstrated a significant increase in effectiveness in postmenopausal patients, and ribociclib in premenopausal patients, when added to standard endocrine therapy for patients with advanced HR+/HER2- breast cancer. At the national stablished willingness to pay, only the addition of abemaciclib to standard endocrine therapy in postmenopausal women would be considered cost-effective. However, differences on results between therapies for postmenopausal patients were not statistically significant.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Análise Custo-Benefício , México , Aminopiridinas/uso terapêutico , Proteínas Inibidoras de Quinase Dependente de Ciclina/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , Receptor ErbB-2 , Quinase 4 Dependente de Ciclina
18.
IEEE Trans Med Imaging ; 43(3): 940-953, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37856267

RESUMO

In cardiac cine magnetic resonance imaging (MRI), the heart is repeatedly imaged at numerous time points during the cardiac cycle. Frequently, the temporal evolution of a certain region of interest such as the ventricles or the atria is highly relevant for clinical diagnosis. In this paper, we devise a novel approach that allows for an automatized propagation of an arbitrary region of interest (ROI) along the cardiac cycle from respective annotated ROIs provided by medical experts at two different points in time, most frequently at the end-systolic (ES) and the end-diastolic (ED) cardiac phases. At its core, a 3D TV- L1 -based optical flow algorithm computes the apparent motion of consecutive MRI images in forward and backward directions. Subsequently, the given terminal annotated masks are propagated by this bidirectional optical flow in 3D, which results, however, in improper initial estimates of the segmentation masks due to numerical inaccuracies. These initially propagated segmentation masks are then refined by a 3D U-Net-based convolutional neural network (CNN), which was trained to enforce consistency with the forward and backward warped masks using a novel loss function. Moreover, a penalization term in the loss function controls large deviations from the initial segmentation masks. This method is benchmarked both on a new dataset with annotated single ventricles containing patients with severe heart diseases and on a publicly available dataset with different annotated ROIs. We emphasize that our novel loss function enables fine-tuning the CNN on a single patient, thereby yielding state-of-the-art results along the complete cardiac cycle.


Assuntos
Imagem Cinética por Ressonância Magnética , Fluxo Óptico , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Processamento de Imagem Assistida por Computador/métodos , Coração/diagnóstico por imagem , Ventrículos do Coração , Imageamento por Ressonância Magnética/métodos , Átrios do Coração
19.
Farm. hosp ; 47(6): 254-260, Noviembre - Diciembre 2023. tab, graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-227537

RESUMO

Objetivos el seguimiento farmacoterapéutico (SFT) realizado por el farmacéutico clínico puede enmarcarse dentro de 3 actividades: la identificación, la resolución y la prevención de eventos adversos a medicamentos. Estas deben ajustarse a los requerimientos y los recursos de cada institución, generando la necesidad de desarrollar procedimientos que aumenten la eficiencia del SFT y garanticen la seguridad del paciente. Los farmacéuticos clínicos de la Red de Salud UC-CHRISTUS Chile desarrollamos un Proceso Estandarizado de Evaluación Farmacoterapéutica (PEEF). El objetivo principal del estudio fue evaluar el impacto de esta herramienta en términos del número de evaluaciones e intervenciones de los farmacéuticos clínicos y secundariamente determinar el ahorro de costos potenciales y directos asociados a las intervenciones en la Unidad de Cuidados Intensivos (UCI). Método estudio cuasi-experimental que evaluó la frecuencia y tipo de evaluaciones e intervenciones realizadas por los farmacéuticos clínicos en unidades de pacientes adultos de la Red UC-CHRISTUS, previo y posterior a la utilización del PEEF. La distribución de variables se evaluó mediante el test Shapiro–Wilk, la asociación entre el uso del PEEF y el número de evaluaciones e intervenciones fue realizada mediante el test Chi cuadrado. La evaluación de costos asociados a las intervenciones del farmacéutico clínico en UCI se realizó utilizando la metodología propuesta por Hammond et al.10. Resultados el total de pacientes evaluados pre- y pos-PEEF fue de 1.781 y 2.129, respectivamente. Las evaluaciones e intervenciones en el periodo pre-PEEF fueron 5.209 y 2.246, en el periodo pos-PEEF fueron 6.105 y 2.641, respectivamente. El aumento de las evaluaciones como de las intervenciones fue significativo solo en las unidades de mayor complejidad. La reducción potencial de costos estimados en el periodo pos-PEEF en UCI fue de 492.805 dólares americanos. ... (AU)


Objectives The Pharmacotherapeutic follow-up program (PFU) carried out by the clinical pharmacist can be categorized within 3 fundamental activities; identification, resolution and prevention of adverse drug events. These must be adjusted to the requirements and resources of each institution, developing procedures to increase PFU efficiency and to guarantee patient safety. The clinical pharmacists of UC-CHRISTUS Healthcare Network developed a Standardized Pharmacotherapeutic Evaluation Process (SPEP). The main goal of our study is to evaluate the impact of this tool through the pharmacist evaluation number and pharmacist interventions number. Secondarily to determine the potential and direct cost savings associated with the pharmacist interventions in an Intensive care unit (ICU). Methods A quasi-experimental study evaluated the frequency and type of pharmacist evaluation and pharmacist interventions performed by clinical pharmacists in adult patients units of UC-CHRISTUS Healthcare Network, before and after the implementation of SPEP. The distribution of variables was evaluated using the Shapiro–Wilk test and the association between the use of SPEP and the pharmacist evaluation and pharmacist interventions number was performed using the Chi-square test. The cost evaluation associated with pharmacist interventions in the ICU was carried out using methodology proposed by Hammond et al. Results A total number of 1,781 patients was evaluated before and 2,129 after the SPEP. The pharmacist evaluation and pharmacist interventions number in the before-SPEP period were 5,209 and 2,246. In the after-SPEP period were 6,105 and 2,641, respectively. The increase in both the pharmacist evaluation and pharmacist interventions number was significant only in critical care patients. The potential cost saving in after-SPEP period in the ICU was USD 492,805.... (AU)


Assuntos
Humanos , Farmacêuticos/normas , Tratamento Farmacológico/normas , Tratamento Farmacológico/tendências , Monitoramento de Medicamentos , Assistência Farmacêutica , Serviços Comunitários de Farmácia
20.
PeerJ ; 11: e16649, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38107559

RESUMO

Background: Soccer is the world's most popular sport for both men and women. Tests of athletic and functional performance are commonly used to assess physical ability and set performance goals. The Functional Movement Screen (FMS™) is a widely used seven-test battery developed by practitioners to provide interpretable measure of movement quality. The main objective of the present study was twofold, to analyze the relationship between FMS™ results from male and female soccer players and to compare their physical performance in different tests. Methods: A total of twenty-eight semi-professional soccer players: fourteen male (age: 21.29 ± 1.64 years; weight: 70.66 ± 5.29 kg; height: 171.86 ± 5.35 cm; BMI: 20.90 ± 2.22 kg/m2) and fourteen females (age: 20.64 ± 1.98 years; weight: 63.44 ± 5.83 kg; height: 166.21 ± 12.18 cm; BMI: 23.02 ± 2.50 kg/m2) were recruited for this study. A paired sample t-test was used for determining differences as a repeated measures analysis. All the participants conducted the following tests: The Functional Movement Test (FMS™), 10-m linear sprint, 5-0-5 COD Test and Yo-Yo Intermittent Recovery Test-Level 1 (YYIRT Level 1). Results: A t-test with data from 505 COD (change of direction) test showed significant differences between groups, p = 0.001, d = 1.11, revealing faster times in male soccer players (2.50 ± 0.19) in respect with female soccer players (2.70 ± 0.17). Crucially, a t-test with data from FMS did not reveal significant differences between groups. Multiple regression for V02max revealed significant effects (r = 0.55, r2 = 0.30, adjusted r2 = 0.24, F = 5.21, p = 0.04 and standard error = 2.20). On the other hand, multiple regression for 10-m sprint showed significant effects (r = 0.58, r2 = 0.33, adjusted r2 = 0.28, F = 5.98, p = 0.03). The impact of these factors on the correlation between FMS™ scores and physical performance measures can vary among individuals. Discussion/Conclusion: This study demonstrates the necessity of utilizing and applying multiple field-based tests to evaluate the movement and capabilities of physical performance in sports. Crucially, consider individual variations and factors such as training background, fitness level, and sport-specific demands when interpreting the relationship between the FMS™ and physical performance in both sexes.


Assuntos
Desempenho Atlético , Corrida , Futebol , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Adolescente , Teste de Esforço/métodos , Aptidão Física
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