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1.
Biomed Pharmacother ; 174: 116569, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38603886

RESUMO

Alpha-alpha diaspirin-crosslinked human hemoglobin (DCLHb or ααHb) was a promising early generation red blood cell (RBC) substitute. The DCLHb was developed through a collaborative effort between the United States Army and Baxter Healthcare. The core design feature underlying its development was chemical stabilization of the tetrameric structure of hemoglobin (Hb) to prevent Hb intravascular dimerization and extravasation. DCLHb was developed to resuscitate warfighters on the battlefield, who suffered from life-threatening blood loss. However, extensive research revealed toxic side effects associated with the use of DCLHb that contributed to high mortality rates in clinical trials. This study explores whether scavenging Hb and heme via the apohemoglobin-haptoglobin (apoHb-Hp) complex can reduce DCLHb associated toxicity. Awake Golden Syrian hamsters were equipped with a window chamber model to characterize the microcirculation. Each group was first infused with either Lactated Ringer's or apoHb-Hp followed by a hypovolemic infusion of 10% of the animal's blood volume of DCLHb. Our results indicated that animals pretreated with apoHb-Hb exhibited improved microhemodynamics vs the group pretreated with Lactated Ringer's. While systemic acute inflammation was observed regardless of the treatment group, apoHb-Hp pretreatment lessened those effects with a marked reduction in IL-6 levels in the heart and kidneys compared to the control group. Taken together, this study demonstrated that utilizing a Hb and heme scavenger protein complex significantly reduces the microvasculature effects of ααHb, paving the way for improved HBOC formulations. Future apoHb-Hp dose optimization studies may identify a dose that can completely neutralize DCLHb toxicity.

2.
Comput Biol Med ; 174: 108406, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38603898

RESUMO

This study aims to extend earlier Krogh Cylinder Models of an oxygen profile by considering axial diffusion and analytically solving Fick's Law Partial Differential Equation with novel boundary conditions via the separation of variables. We next prospectively collected a total of 20 animals, which were randomly assigned to receive either fresh or two-week-old stored red blood cell (RBC) transfusions and PQM oxygen data were measured acutely (90 min) or chronically (24 h). Transfusion effects were evaluated in vivo using intravital microscopy of the dorsal skinfold window chamber in Golden Syrian Hamsters. Hamsters were initially hemorrhaged by 50% of total blood volume and resuscitated 1-h post hemorrhage. PQM data were subsequently collected and fit the derived 2D Krogh cylinder model. Systemic hemodynamics (mean arterial pressure, heart rate) were similar in both pre and post-transfusion with either stored or fresh cells. Transfusion with stored cells was found to impair axial and radial oxygen gradients as quantified by our model and consistent with previous studies. Specifically, we observed a statistically significant decrease in the arteriolar tissue radial oxygen gradient after transfusion with stored RBCs at 24 h compared with fresh RBCs (0.33 ± 0.17 mmHg µ m-1 vs, 0.14 ± 0.12 mmHg µ m-1; p = 0.0280). We also observed a deficit in the arteriolar tissue oxygen gradient (0.03 ± 0.01 mmHg µ m-1 fresh vs. 0.018 ± 0.007 mmHg µ m-1 stored; p = 0.0185). We successfully derived and validated an analytical 2D Krogh cylinder model in an animal model of microhemodynamic oxygen diffusion aberration secondary to storage lesions.

3.
Antibiotics (Basel) ; 13(3)2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38534648

RESUMO

Antibiotic overuse and the resulting antimicrobial resistance pose significant global public health challenges, providing an avenue for opportunistic pathogens like Acinetobacter baumannii to thrive. This study will report the trends of Acinetobacter baumannii antimicrobial resistance patterns at the Hospital Teodoro Maldonado Carbo, Ecuador. An observational, analytical, longitudinal, and prospective study was conducted involving patients diagnosed with hospital-acquired infections. Antimicrobial susceptibility testing was performed, followed by molecular analysis of carbapenemase genes in Acinetobacter baumannii isolates. We included 180 patients aged from 16 to 93 years. The hospital mortality rate was 63/180 (35%). Invasive mechanical ventilation (IMV) was indicated in 91/180 patients (50.4%). The overall survival (OS) rate in patients on IMV was 49.5% (45/91), with a median survival of 65 days. The OS rate in patients not on IMV was 80.9% (72/89), with a median survival of 106 days (HR 2.094; 95% CI 1.174-3.737; p = 0.012). From multivariate analysis, we conclude that ventilator-associated pneumonia is the most related factor to OS.

4.
J Fungi (Basel) ; 10(3)2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38535195

RESUMO

Kodamaea ohmeri is an environmental yeast considered a rare emerging pathogen. In clinical settings, the correct identification of this yeast is relevant because some isolates are associated with resistance to antifungals. There is a lack of available data regarding the geographical distribution, virulence, and drug resistance profile of K. ohmeri. To contribute to the knowledge of this yeast, this study aimed to describe in depth three isolates of K. ohmeri associated with fungemia in Honduras. The identification of the isolates was carried out by sequencing the ribosomal ITS region. In addition, the susceptibility profile to antifungals was determined, and some properties associated with virulence were evaluated (exoenzyme production, biofilm formation, cell adhesion, and invasion). The isolates showed strong protease, phospholipase, and hemolysin activity, in addition to being biofilm producers. Adherence and invasion capacity were evident in the HeLa and Raw 264.7 cell lines, respectively. This study expands the understanding of the underlying biological traits associated with virulence in K. ohmeri, and it is the first report of the detection and identification of K. ohmeri in Honduras as a cause of human infection.

5.
Phys Rev Lett ; 132(5): 056704, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38364117

RESUMO

Here, we report the observation of strong coupling between magnons and surface acoustic wave (SAW) phonons in a thin CoFeB film constructed in an on-chip SAW resonator by analyzing SAW phonon dispersion anticrossings. We employ a nanostructured SAW resonator design that, in contrast to conventional SAW resonators, allows us to enhance shear-horizontal strain. Crucially, this type of strain couples strongly to magnons. Our device design provides the tunability of the film thickness with a fixed phonon wavelength, which is a departure from the conventional approach in strong magnon-phonon coupling research. We detect a monotonic increase in the coupling strength by expanding the film thickness, which agrees with our theoretical model. Our work offers a significant way to advance fundamental research and the development of devices based on magnon-phonon hybrid quasiparticles.

6.
Br J Pharmacol ; 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38359818

RESUMO

BACKGROUND AND PURPOSE: The post-acute sequelae of SARS-CoV-2 infection pose a significant global challenge, with nearly 50% of critical COVID-19 survivors manifesting persistent lung abnormalities. The lack of understanding about the molecular mechanisms and effective treatments hampers their management. Here, we employed microRNA (miRNA) profiling to decipher the systemic molecular underpinnings of the persistent pulmonary complications. EXPERIMENTAL APPROACH: We conducted a longitudinal investigation including 119 critical COVID-19 survivors. A comprehensive pulmonary evaluation was performed in the short-term (median = 94.0 days after hospital discharge) and long-term (median = 358 days after hospital discharge). Plasma miRNAs were quantified at the short-term evaluation using the gold-standard technique, RT-qPCR. The analyses combined machine learning feature selection techniques with bioinformatic investigations. Two additional datasets were incorporated for validation. KEY RESULTS: In the short-term, 84% of the survivors exhibited impaired lung diffusion (DLCO  < 80% of predicted). One year post-discharge, 54.4% of this patient subgroup still presented abnormal DLCO . Four feature selection methods identified two specific miRNAs, miR-9-5p and miR-486-5p, linked to persistent lung dysfunction. The downstream experimentally validated targetome included 1473 genes, with heterogeneous enriched pathways associated with inflammation, angiogenesis and cell senescence. Validation studies using RNA-sequencing and proteomic datasets emphasized the pivotal roles of cell migration and tissue repair in persistent lung dysfunction. The repositioning potential of the miRNA targets was limited. CONCLUSION AND IMPLICATIONS: Our study reveals early mechanistic pathways contributing to persistent lung dysfunction in critical COVID-19 survivors, offering a promising approach for the development of targeted disease-modifying agents.

7.
Med Phys ; 51(1): 522-532, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37712869

RESUMO

BACKGROUND: Radiopharmaceutical therapy (RPT) is an increasingly adopted modality for treating cancer. There is evidence that the optimization of the treatment based on dosimetry can improve outcomes. However, standardization of the clinical dosimetry workflow still represents a major effort. Among the many sources of variability, the impact of using different Dose Voxel Kernels (DVKs) to generate absorbed dose (AD) maps by convolution with the time-integrated activity (TIA) distribution has not been systematically investigated. PURPOSE: This study aims to compare DVKs and assess the differences in the ADs when convolving the same TIA map with different DVKs. METHODS: DVKs of 3 × 3 × 3 mm3 sampling-nine for 177 Lu, nine for 90 Y-were selected from those most used in commercial/free software or presented in prior publications. For each voxel within a 11 × 11 × 11 matrix, the coefficient of variation (CoV) and the percentage difference between maximum and minimum values (% maximum difference) were calculated. The total absorbed dose per decay (SUM), calculated as the sum of all the voxel values in each kernel, was also compared. Publicly available quantitative SPECT images for two patients treated with 177 Lu-DOTATATE and PET images for two patients treated with 90 Y-microspheres were used, including organs at risk (177 Lu: kidneys; 90 Y: liver and healthy liver) and tumors' segmentations. For each patient, the mean AD to the volumes of interest (VOIs) was calculated using the different DVKs, the same TIA map and the same software tool for dose convolution, thereby focusing on the DVK impact. For each VOI, the % maximum difference of the mean AD between maximum and minimum values was computed. RESULTS: The CoV (% maximum difference) in voxels of normalized coordinates [0,0,0], [0,1,0], and [0,1,1] were 5%(21%), 9%(35%), and 10%(46%) for the 177 Lu DVKs. For the case of 90 Y, these values were 2%(9%), 4%(14%), and 4%(16%). The CoV (% maximum difference) for SUM was 9%(33%) for 177 Lu, and 4%(15%) for 90 Y. The variability of the mean tumor and organ AD was up to 19% and 15% in 177 Lu-DOTATATE and 90 Y-microspheres patients, respectively. CONCLUSIONS: This study showed a considerable AD variability due exclusively to the use of different DVKs. A concerted effort by the scientific community would contribute to decrease these discrepancies, strengthening the consistency of AD calculation in RPT.


Assuntos
Radiometria , Compostos Radiofarmacêuticos , Humanos , Fígado , Radiometria/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Software
8.
Trends Neurosci Educ ; 33: 100216, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38049295

RESUMO

INTRODUCTION: This research intends to increase the knowledge about the use of board games in the classroom to train executive functions and academic skills. 99 children from rural schools were assessed in executive functions and academic skills. METHODS: Through a randomized controlled trial, they were assigned to a playing group (n = 51) and an active control group (regular classes without games, n = 48). Play program consisted of 12 sessions for 6 weeks with eight commercial board games. RESULTS: In flexibility, the playing group was significantly faster after the program (p= = .01, d = 0.76), but not the control group (p = .23; d = 0.35). Both groups improved in the academic tasks, but the significance in calculus was greater in the playing group (p = .00; d = 2.19) than in the control group (p = .01; d = 0.97). DISCUSION: The use of board games during school hours could be as good or better methodology for cognitive training and learning academic skills than regular classes.


Assuntos
Função Executiva , Instituições Acadêmicas , Criança , Humanos , Aprendizagem , Treino Cognitivo , Matemática
9.
J Chem Phys ; 159(16)2023 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-37877492

RESUMO

X-ray photoelectron spectroscopy (XPS) is generally used for chemical analysis of surfaces and interfaces. This method involves the analysis of changes in binding energies and peak shapes of elements under consideration. It is also possible to use XPS to study the effect of x-ray radiation on the electrical properties of thin films. We measured the Si 2p peak using x-ray powers of 300 and 150 W on ∼135 nm silicon dioxide (SiO2) thin films grown on both n- and p-type substrates while applying DC or AC external biases. Using the shifts in the binding energy of the Si 2p peak, we calculated the resistances and the capacitances of the SiO2 thin film. The way that the binding energies of the Si 2p peak and the capacitance of the thin film change as a function of the type of Si substrate and the power of the x-ray are explained using band bending.

10.
Phys Rev Lett ; 131(14): 143602, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37862662

RESUMO

Recently gained insights into equilibrium squeezing and entanglement harbored by magnets point toward exciting opportunities for quantum science and technology, while concrete protocols for exploiting these are needed. Here, we theoretically demonstrate that a direct dispersive coupling between a qubit and a noneigenmode magnon enables detecting the magnonic number states' quantum superposition that forms the ground state of the actual eigenmode-squeezed magnon-via qubit excitation spectroscopy. Furthermore, this unique coupling is found to enable control over the equilibrium magnon squeezing and a deterministic generation of squeezed even Fock states via the qubit state and its excitation. Our work demonstrates direct dispersive coupling to noneigenmodes, realizable in spin systems, as a general pathway to exploiting the equilibrium squeezing and related quantum properties thereby motivating a search for similar realizations in other platforms.

11.
J Clin Med ; 12(17)2023 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-37685553

RESUMO

BACKGROUND: Acute appendicitis is a frequently encountered surgical emergency. Despite several scoring systems, the possibility of delayed diagnosis persists. In addition, a delayed diagnosis leads to an increased risk of complicated appendicitis. Hence, there is a need to identify biological markers to help clinicians rapidly and accurately diagnose and prognosticate acute appendicitis with a high sensitivity and specificity. Although several markers have been evaluated, the pressing concern is still the low specificity of these markers. One such marker is serum ischemia-modified albumin (IMA), which can be a novel biomarker for accurately diagnosing and prognosticating acute appendicitis. METHODS: The authors conducted a systematic search of the PubMed, EMBASE, Web of Science, and Scopus databases through February 2023 as per the PRISMA guidelines. The difference in the levels of IMA between patients with acute appendicitis vs. healthy controls, and the difference in the levels of IMA between patients with complicated vs. non-complicated acute appendicitis were taken as the outcome measures. Statistical analysis was performed using a random effects model and mean difference (MD) was calculated. The methodological quality of the studies was assessed by utilizing the Newcastle-Ottawa scale. RESULTS: A total of six prospective comparative studies were included in the meta-analysis. The analysis revealed that the mean level of serum IMA was significantly raised in the acute appendicitis group (MD 0.21, 95% CI 0.05 to 0.37, p = 0.01). Similarly, the mean serum IMA levels were also raised in the complicated appendicitis group compared to the non-complicated appendicitis group (MD 0.05, 95% CI 0.01 to 0.10, p = 0.02). Three of the studies included were, however, of poor methodological quality. CONCLUSIONS: Serum IMA is a viable potential marker for diagnosing and prognosticating acute appendicitis. However, due to the limited methodological quality of available studies, further prospectively designed and adequately powered studies are needed.

12.
Kidney Med ; 5(10): 100704, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37745646

RESUMO

Rationale & Objective: In FIDELITY, finerenone improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes. This analysis explores the efficacy and safety of finerenone in Hispanic patients. Study Design: Post hoc analysis of the FIDELITY prespecified pooled analysis of the FIDELIO-DKD and FIGARO-DKD randomized control trials. Setting & Participants: Patients with type 2 diabetes and CKD (urinary albumin-to-creatinine ratio [UACR] of ≥30 to <300 mg/g and estimated glomerular filtration rate [eGFR] of ≥25-≤90 mL/min/1.73 m2, or UACR of ≥300 to ≤5,000 and eGFR of ≥25 mL/min/1.73 m2) on optimized renin-angiotensin system blockade. Intervention: Finerenone or placebo. Outcomes: Cardiovascular composite (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure); kidney composite (kidney failure, sustained ≥57% eGFR decline, or renal death); change in UACR. Results: Of 13,026 patients, 2,099 (16.1%) self-identified as Hispanic. Median follow-up was 3.0 years. The cardiovascular composite outcome occurred in 10.0% of Hispanic patients receiving Finerenone and in 12.3% of Hispanic patients receiving placebo (HR, 0.80; 95% CI, 0.62-1.04). This was consistent with non-Hispanic patients (HR, 0.87; 95% CI, 0.79-0.97; Pinteraction= 0.59). The kidney composite outcome occurred in 6.5% and 6.6% of Hispanic patients with finerenone and placebo, respectively (HR, 0.94; 95% CI, 0.67-1.33). The risk reduction was consistent with that observed in non-Hispanic patients (HR, 0.75; 95% CI, 0.64-0.87; Pinteraction= 0.22). Finerenone reduced UACR by 32% at month 4 in both Hispanic and non-Hispanic patients versus placebo (P < 0.001 for both patient groups). The safety profile of finerenone and incidence of hyperkalemia was similar between Hispanic and non-Hispanic patient groups. Limitations: Small sample size, short follow-up time, and lower treatment adherence in the Hispanic population. Conclusions: Overall, the efficacy and safety of finerenone were similar in Hispanic and non-Hispanic patients with CKD and type 2 diabetes. Funding: Bayer AG. Trial Registration: ClinicalTrials.gov identifier: NCT02540993, NCT02545049. Plain-Language Summary: Chronic kidney disease (CKD) in patients with type 2 diabetes occurs more frequently in Hispanic patients than in non-Hispanic patients, with a more rapid progression to kidney failure. Treatment with finerenone reduces the risk of having a kidney or heart event (such as starting dialysis or having a heart attack) in patients with CKD and type 2 diabetes. Because clinical trials that investigate treatments for CKD and type 2 diabetes have not included enough Hispanic patients, the benefits of treatments particularly for Hispanic patients are frequently unknown. This study explores the benefits of finerenone in Hispanic patients. Overall, the study shows that finerenone can provide kidney and heart benefits in Hispanic patients with CKD and type 2 diabetes, as it does in non-Hispanic patients.

13.
Infect Dis Rep ; 15(5): 535-548, 2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37737000

RESUMO

The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs) presents global heterogeneity, and their relative effect on pediatric severity is still limited. In this study, we associate VOCs with pediatric clinical severity outcomes in Mexico. Bioinformatics methods were used to characterize VOCs and single amino acid (aa) mutations in 75,348 SARS-CoV-2 genetic sequences from February 2020 to October 2022. High-predominance VOCs groups were calculated and subsequently associated with 372,989 COVID-19 clinical pediatric outcomes. We identified 21 high-frequency mutations related to Omicron lineages with an increased prevalence in pediatric sequences compared to adults. Alpha and the other lineages had a significant increase in case fatality rate (CFR), intensive critical unit (ICU) admission, and automated mechanical ventilation (AMV). Furthermore, a logistic model with age-adjusted variables estimated an increased risk of hospitalization, ICU/AMV, and death in Gamma and Alpha, in contrast to the other lineages. We found that, regardless of the VOCs lineage, infant patients presented the worst severity prognoses. Our findings improve the understanding of the impact of VOCs on pediatric patients across time, regions, and clinical outcomes. Enhanced understanding of the pediatric severity for VOCs would enable the development and improvement of public health strategies worldwide.

14.
Am J Audiol ; 32(4): 812-822, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-37616190

RESUMO

PURPOSE: The purpose of the study was twofold: (a) to explore hearing aid management experiences of Spanish-speaking parents who have young children using hearing aids and (b) to explore parents' access to the Internet and perceptions about remote audiology services. METHOD: The study used a mixed methods design. Data were collected through a phone interview. RESULTS: Eleven mothers of children aged 14-60 months participated. Most of the children (9/11) had a bilateral hearing loss, and two had an additional disability. Three themes emerged for hearing aid management experiences: audiology services, routines, and emotional challenges/supports. Parents had variable levels of confidence in their skills ranging from no confidence to complete confidence, with the greatest variability for three items: (a) using the listening tube to make sure that the sound quality of the hearing aid is good, (b) removing moisture from the earmold tubing, and (c) troubleshooting problems when your child's hearing aids are not working. All participants reported having consistent Internet access and had positive perceptions about the possibility of remote audiology services. CONCLUSIONS: This study provided insights into hearing aid management experiences and perceptions of Spanish-speaking parents. Parents described variability for audiology services, routines for hearing aid use and care, and access to other parents of children with hearing loss. Spanish-speaking parents present additional elements in the hearing care process that need to be incorporated in planning. Remote services may be an opportunity to enhance access to support that could improve effectiveness of hearing aid management.


Assuntos
Surdez , Auxiliares de Audição , Perda Auditiva , Feminino , Criança , Humanos , Pré-Escolar , Audição , Perda Auditiva/reabilitação , Pais/psicologia
15.
Rev Med Inst Mex Seguro Soc ; 61(4): 409-411, 2023 Jul 31.
Artigo em Espanhol | MEDLINE | ID: mdl-37535955

RESUMO

We thank the group headed by Jorge Valencia Alonso for taking the time to review in detail and prepare the letter about our article entitled: " Bibliometric analysis of scientific publications on COVID-19 elaborated by staff of the Instituto Mexicano del Seguro Social", which has recently been published in the Medical Journal of the Mexican Social Security Institute. Based on your observations and comments, we allow ourselves to make the following clarifications following the same sequence of your letter to the Editor.


Agradecemos al grupo encabezado por Jorge Valencia Alonso por tomarse el tiempo para revisar con detalle y elaborar la carta sobre nuestro artículo titulado: "Análisis bibliométrico de las publicaciones científicas sobre COVID-19 por personal del IMSS", que recientemente se ha publicado en la Revista Médica del Instituto Mexicano del Seguro Social. De acuerdo con sus observaciones y comentarios, nos permitimos realizar las siguientes aclaraciones siguiendo la misma secuencia de su carta al Editor.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , México , Previdência Social , Academias e Institutos , Bibliometria
16.
J Neurosurg Case Lessons ; 5(26)2023 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-37399139

RESUMO

BACKGROUND: The occurrence of both an intracranial aneurysm and epilepsy, especially drug-resistant epilepsy (DRE), is rare. Although the overall incidence of aneurysms associated with DRE is unclear, it is thought to be particularly infrequent in the pediatric population. Surgical ligation of the offending aneurysm has been reported in conjunction with resolving seizure activity, although few cases have cited a combined approach of aneurysm ligation and resection of an epileptogenic focus. OBSERVATIONS: We present the case of a 14-year-old female patient with drug-resistant temporal lobe epilepsy and an ipsilateral supraclinoid internal carotid artery aneurysm. Seizure semiology, electroencephalography monitoring, and magnetic resonance imaging all indicated a left temporal epileptogenic focus, in addition to an incidental aneurysm. The authors recommended a combined surgery involving resection of the temporal lesion and surgical clip ligation of the aneurysm. Near-total resection and successful ligation were achieved, and the patient has remained seizure free since surgery at 1 year postoperatively. LESSONS: In patients with focal DRE and an adjacent intracranial aneurysm, a combined surgical approach involving both resection and surgical ligation can be used. Several surgical timing and neuroanesthetic considerations should be made to ensure the overall safety and efficacy of this procedure.

17.
Open Respir Arch ; 5(1): 100213, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37497256

RESUMO

Introduction: In February 2022, the Emerging Thoracic Surgery Group of the Spanish Society of Pneumology and Thoracic Surgery initiated a multicenter study on the surgical management of primary spontaneous pneumothorax (PSP). As a preliminary step, this survey was developed with the aim of finding out the current situation in our country to specify and direct this project. Method: A descriptive study was carried out based on the results of this survey launched through the Google Docs® platform. The survey was sent to all active national thoracic surgeons, a total of 319. It consisted of 20 questions including demographic, surgical and follow-up data. Results: We obtained 124 responses (39% of all specialists and doctors in training in the national territory). The most consistent indications were: homolateral recurrence for 124 (100%), lack of resolution of the episode for 120 (96.7%), risk professions for 104 (84%) and bilateral pneumothorax for 93 (75%). The approach of choice for 100% of respondents was videothoracoscopy. Of these, 96 contemplated pulmonary resection of obvious lesions (77%). Regarding the pleurodesis technique, pleural abrasion was the technique most used by 70 respondents (56.7%) while 49 (40%) performed chemical pleurodesis with talc either alone or in combination with mechanical pleurodesis. Conclusions: While there is some consistency in some aspects of surgical management of PSP, this survey makes evident the variability in pleurodesis techniques applied among surgeons in our country.

18.
Sensors (Basel) ; 23(14)2023 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-37514583

RESUMO

Microgrids represent a promising energy technology, because of the inclusion in them of clean and smart energy technologies. They also represent research challenges, including controllability, stability, and implementation. This article presents a dSPACE-control-platform-based implementation of a fixed-switching-frequency modulated model predictive control (M2PC) strategy, as an inner controller of a two-level, three-phase voltage source inverter (VSI) working in an islanded AC microgrid. The developed controller is hierarchical, as it includes a primary controller to share the load equally with the other power converter with its own local modulated predictive-based controller. All details of the implementation are given for establishing the dSPACE-based implementation of the control on a dSPACE ds1103 control platform, using MATLAB/Simulink for the controller design, I/O implementation and configuration with the embedded dSPACE's real-time interface in Simulink, and then using the ControlDesk software for monitoring and testing of the real plant. The latter consists of the VSI operating with LCL filters, and sharing an RL load with a paralleled VSI with exactly the same controller. Finally, the obtained experimental waveforms are shown, with our respective conclusions representing this work, which is a very valuable tool for helping microgrid researchers implement dSPACE-based real-time simulations.

19.
Phys Rev Lett ; 130(20): 203604, 2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37267533

RESUMO

Multiphoton absorption is of vital importance in many spectroscopic, microscopic, or lithographic applications. However, given that it is an inherently weak process, the detection of multiphoton absorption signals typically requires large field intensities, hindering its applicability in many practical situations. In this Letter, we show that placing a multiphoton absorbent inside an imbalanced nonlinear interferometer can enhance the precision of multiphoton cross section estimation with respect to strategies based on photon-number measurements using coherent or even squeezed light directly transmitted through the medium. In particular, the power scaling of the sensitivity with photon flux can be increased by 1 order compared with transmission measurements of the sample with coherent light, such that the measurement precision at any given intensity can be greatly enhanced. Furthermore, we show that this enhanced measurement precision is robust against experimental imperfections leading to photon losses, which usually tend to degrade the detection sensitivity. We trace the origin of this enhancement to an optimal degree of squeezing which has to be generated in a nonlinear SU(1,1) interferometer.

20.
Viruses ; 15(6)2023 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-37376694

RESUMO

Twenty years have passed since the emergence of hantavirus zoonosis in Panama at the beginning of this millennium. We provide an overview of epidemiological surveillance of hantavirus disease (hantavirus pulmonary syndrome and hantavirus fever) during the period 1999-2019 by including all reported and confirmed cases according to the case definition established by the health authority. Our findings reveal that hantavirus disease is a low-frequency disease, affecting primarily young people, with a relatively low case-fatality rate compared to other hantaviruses in the Americas (e.g., ANDV and SNV). It presents an annual variation with peaks every 4-5 years and an interannual variation influenced by agricultural activities. Hantavirus disease is endemic in about 27% of Panama, which corresponds to agroecological conditions that favor the population dynamics of the rodent host, Oligoryzomys costaricensis and the virus (Choclo orthohantavirus) responsible for hantavirus disease. However, this does not rule out the existence of other endemic areas to be characterized. Undoubtedly, decentralization of the laboratory test and dissemination of evidence-based surveillance guidelines and regulations have standardized and improved diagnosis, notification at the level of the primary care system, and management in intensive care units nationwide.


Assuntos
Doenças Transmissíveis , Infecções por Hantavirus , Síndrome Pulmonar por Hantavirus , Febre Hemorrágica com Síndrome Renal , Orthohantavírus , Animais , Infecções por Hantavirus/epidemiologia , Síndrome Pulmonar por Hantavirus/epidemiologia , Panamá/epidemiologia , Roedores , Sigmodontinae
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