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1.
Artigo em Inglês | MEDLINE | ID: mdl-33611565

RESUMO

BACKGROUND: To determine if dried blood spot specimens (DBS) can reliably detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, we compared the SARS-CoV-2 IgG antibody response in paired serum and eluates from DBS specimens. METHODS: A total of 95 paired DBS and serum samples were collected from 74 participants (aged 1-63 years) as part of a household cohort study in Melbourne, Australia. SARS-CoV-2 IgG antibodies specific for the receptor-binding domain (RBD) and S1 proteins between serum and eluates from DBS specimens were compared using an FDA-approved ELISA method. RESULTS: Among the 74 participants, 42% (31/74) were children and the rest were adults. A total of 16 children and 13 adults were SARS-CoV-2 positive by polymerase chain reaction. The IgG seropositivity rate was similar between serum and DBS specimens (18.9% (18/95) versus 16.8% (16/95)), respectively. Similar RBD and S1-specific IgG levels were detected between serum and DBS specimens. Serum IgG levels strongly correlated with DBS IgG levels (r = 0.99, P < 0.0001) for both SARS-CoV-2 proteins. Furthermore, antibodies remained stable in DBS specimens for >3 months. CONCLUSIONS: DBS specimens can be reliably used as an alternative to serum samples for SARS-CoV-2 antibody measurement. The use of DBS specimens would facilitate serosurveillance efforts particularly in hard-to-reach populations and inform public health responses including COVID-19 vaccination strategies.

2.
Talanta ; 224: 121817, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33379042

RESUMO

The potential of a portable Near Infrared spectrophotometer compared with that of NIR benchtop equipment is assessed to determine the13C/12C relationship of stable isotopes and the fatty acid content. 105 samples of subcutaneous fat of Iberian pigs collected at the time of their slaughter have been analyzed. The analysis of stable isotopes and gas chromatography were the methods of reference used. The samples were analyzed without prior handling (portable and benchtop NIR) and after extracting the fat (benchtop NIR). The results show that with the portable equipment it is possible to determine δ13C (‰), 12 fatty acids, and 5 summations of fatty acids (SFA, MUFA, PUFA, w3, and w6), while with the benchtop NIR equipment it is possible to measure δ13C (‰), 16 fatty acids, and the 5 summationsof fatty acids. The correlation coefficients of the portable equipment were slightly lower than those of the NIR benchtop equipment.

3.
Sensors (Basel) ; 20(23)2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33276571

RESUMO

For Protected Geographical Indication (PGI)-labeled products, such as the dry-cured beef meat "cecina de León", a sensory analysis is compulsory. However, this is a complex and time-consuming process. This study explores the viability of using near infrared spectroscopy (NIRS) together with artificial neural networks (ANN) for predicting sensory attributes. Spectra of 50 samples of cecina were recorded and 451 reflectance data were obtained. A feedforward multilayer perceptron ANN with 451 neurons in the input layer, a number of neurons varying between 1 and 30 in the hidden layer, and a single neuron in the output layer were optimized for each sensory parameter. The regression coefficient R squared (RSQ > 0.8 except for odor intensity) and mean squared error of prediction (MSEP) values obtained when comparing predicted and reference values showed that it is possible to predict accurately 23 out of 24 sensory parameters. Although only 3 sensory parameters showed significant differences between PGI and non-PGI samples, the optimized ANN architecture applied to NIR spectra achieved the correct classification of the 100% of the samples while the residual mean squares method (RMS-X) allowed 100% of non-PGI samples to be distinguished.

4.
Front Oncol ; 10: 586679, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33224884

RESUMO

Object: Low-field intraoperative magnetic resonance (LF-iMR) has demonstrated a slight increase in the extent of resection of intra-axial tumors while preserving patient`s neurological outcomes. However, whether this improvement is cost-effective or not is still matter of controversy. In this clinical investigation we sought to evaluate the cost-effectiveness of the implementation of a LF-iMR in glioma surgery. Methods: Patients undergoing LF-iMR guided glioma surgery with gross total resection (GTR) intention were prospectively collected and compared to an historical cohort operated without this technology. Socio-demographic and clinical variables (pre and postoperative KPS; histopathological classification; Extent of resection; postoperative complications; need of re-intervention within the first year and 1-year postoperative survival) were collected and analyzed. Effectiveness variables were assessed in both groups: Postoperative Karnofsky performance status scale (pKPS); overall survival (OS); Progression-free survival (PFS); and a variable accounting for the number of patients with a greater than subtotal resection and same or higher postoperative KPS (R-KPS). All preoperative, procedural and postoperative costs linked to the treatment were considered for the cost-effectiveness analysis (diagnostic procedures, prosthesis, operating time, hospitalization, consumables, LF-iMR device, etc). Deterministic and probabilistic simulations were conducted to evaluate the consistency of our analysis. Results: 50 patients were operated with LF-iMR assistance, while 146 belonged to the control group. GTR rate, pKPS, R-KPS, PFS, and 1-year OS were respectively 13,8% (not significative), 7 points (p < 0.05), 17% (p < 0.05), 38 days (p < 0.05), and 3.7% (not significative) higher in the intervention group. Cost-effectiveness analysis showed a mean incremental cost per patient of 789 € in the intervention group. Incremental cost-effectiveness ratios were 111 € per additional point of pKPS, 21 € per additional day free of progression, and 46 € per additional percentage point of R-KPS. Conclusion: Glioma patients operated under LF-iMR guidance experience a better functional outcome, higher resection rates, less complications, better PFS rates but similar life expectancy compared to conventional techniques. In terms of efficiency, LF-iMR is very close to be a dominant technology in terms of R-KPS, PFS and pKPS.

5.
Sensors (Basel) ; 20(19)2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33019622

RESUMO

Dry-cured ham is a high-quality product owing to its organoleptic characteristics. Sensory analysis is an essential part of assessing its quality. However, sensory assessment is a laborious process which implies the availability of a trained tasting panel. The aim of this study was the prediction of dry-ham sensory characteristics by means of an instrumental technique. To do so, an artificial neural network (ANN) model for the prediction of sensory parameters of dry-cured hams based on NIR spectral information was developed and optimized. The NIR spectra were obtained with a fiber-optic probe applied directly to the ham sample. In order to achieve this objective, the neural network was designed using 28 sensory parameters analyzed by a trained panel for sensory profile analysis as output data. A total of 91 samples of dry-cured ham matured for 24 months were analyzed. The hams corresponded to two different breeds (Iberian and Iberian x Duroc) and two different feeding systems (feeding outdoors with acorns or feeding with concentrates). The training algorithm and ANN architecture (the number of neurons in the hidden layer) used for the training were optimized. The parameters of ANN architecture analyzed have been shown to have an effect on the prediction capacity of the network. The Levenberg-Marquardt training algorithm has been shown to be the most suitable for the application of an ANN to sensory parameters.

6.
J Dent ; 100: 103429, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32673637

RESUMO

OBJECTIVES: The present study investigated the effects of in vitro and in-vivo radiotherapy on endogenous enzymatic activity in dentin using gelatin zymography and in-situ zymography. METHODS: Gelatin zymographic assays were performed on protein extracts obtained from dentin powder of sound non-irradiated (NRT), in vitro irradiated (VTRT) and in vivo irradiated (VIRT) human teeth. Their proteolytic activities were quantified using band densitometric evaluation. For in-situ zymography, dentin specimens from NRT, VIRT and VTRT were covered with fluorescein-conjugated gelatin and examined with confocal laser-scanning microscopy. Fluorescence intensity emitted by the hydrolyzed fluorescein-conjugated gelatin was quantified and statistically analyzed. In-situ zymography data were statistically analyzed using Kruskal-Wallis ANOVA and Dunn's multiple comparison procedures (α = 0.05). RESULTS: No difference between in vitro and in vivo radiotherapy treatment was found. Both VTRT and VIRT groups showed increase in MMP-9 expression when compared to NRT group. Significant increases (p < 0.05) in gelatinolytic activity (26 % for VTRT; 55 % for VIRT) were observed when compared to the NRT group. CONCLUSION: Radiotherapy increase endogenous enzymatic activity in non-restored dentin.

7.
Animals (Basel) ; 10(6)2020 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-32486472

RESUMO

Animal training is meant to teach specific behavioral responses to specific cues. Clicker training (CT) is a popular training method based on the use of a device that emits a sound of double-click to be associated as a first-order conditioned stimulus in contingency with positive reinforcements. After some repetitions, the clicker sound gains some incentive value and can be paired with the desired behavior. Animal trainers believed that CT can decrease training time compared to other types of training. Herein, we used two-month old miniature piglets to evaluate whether CT decreased the number of repetitions required to learn complex behaviors as compared with animals trained with voice instead of the clicker. In addition, we compared the number of correct choices of animals from both groups when exposed to object discriminative tests. Results indicated that CT decreased the number of repetitions required for pigs to learn to fetch an object but reduced the ability of animals to make correct choices during the discriminate trials. This suggests that CT is more efficient than voice to teach complex behaviors but reduces the ability of animals to use cognitive processes required to discriminate and select objects associated with reward.

8.
Ophthalmic Epidemiol ; 27(4): 310-324, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32363970

RESUMO

Epidemiological information is expected to be used to develop key aspects of eye care such as to control and minimise the impact of diseases, to allocate resources, to monitor public health actions, to determine the best treatment options and to forecast the consequence of diseases in populations. Epidemiological studies are expected to provide information about the prevalence and/or incidence of eye diseases or conditions. To determine prevalence is necessary to perform a cross-sectional screening of the population at risk to ascertain the number of cases. The aim of this review is to describe and evaluate capture-recapture methods (or models) to ascertaining the number of individuals with a disease (e.g. diabetic retinopathy) or condition (e.g. vision impairment) in the population. The review covers the fundamental aspects of capture-recapture methods that would enable non-experts in epidemiology to use it in ophthalmic studies. The review provides information about theoretical aspects of the method with examples of studies in ophthalmology in which it has been used. We also provide a problem/solution approach for limitations arising from the lists obtained from registers or other reliable sources. We concluded that capture-recapture models can be considered reliable to estimate the total number of cases with eye conditions using incomplete information from registers. Accordingly, the method may be used to maintain updated epidemiological information about eye conditions helping to tackle the lack of surveillance information in many regions of the globe.

9.
J Clin Lab Anal ; 34(7): e23282, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32198796

RESUMO

BACKGROUND: LDL-C lowering is the main measure in cardiovascular disease prevention but a residual risk of ischemic events still remains. Alterations of lipoproteins, specially, increase in small dense LDL (sdLDL) particles are related to this risk. OBJECTIVE: To investigate the potential use of sdLDL cholesterol concentration (sdLDL-C) isolated by an easy precipitation method and to assess the impact of a set of clinical and biochemical variables determined by NMR on sdLDL concentration. METHODS: sdLDL-C and NMR lipid profile were performed in 85 men samples. Association among them was evaluated using Pearson coefficients (rxy ). A multivariate regression was performed to identify the influence of NMR variables on sdLDL-C. RESULTS: A strong association between sdLDL-C and LDLLDL-P (rxy  = 0.687) and with LDL-Z (rxy  = -0.603) was found. The multivariate regression explained a 56.8% in sdLDL-C variation (P = 8.77.10-12). BMI, ApoB, triglycerides, FFA, and LDL-Z showed a significant contribution. The most important ones were ApoB and LDL-Z; a 1nm increase (LDL-Z) leads to decrease 126 nmol/L in sdLDL-C. CONCLUSION: The association between sdLDL-C, LDL-Z, and LDL-P is clear. From a large number of variables, especially LDL-Z and apoB influence on sdLDL-C. Results show that the smaller the LDL size, the higher their cholesterol concentration. Therefore, sdLDL-C determination by using this easy method would be useful to risk stratification and to uncover cardiovascular residual risk.

10.
Value Health Reg Issues ; 23: 25-29, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32199171

RESUMO

OBJECTIVES: As health systems start to discuss alternative payment models for fostering value in healthcare, there is increased interest in understanding how physicians will cope with different remuneration schemes. We conducted a survey of physicians practicing at Hospital Israelita Albert Einstein, a nonprofit private healthcare provider in Brazil, aimed at capturing their awareness of value-based healthcare (VBHC). METHODS: Our study uses data from a survey administered to doctors practicing at Einstein between September and November 2018. Descriptive statistics and adjusted multivariate logistic regression analyses were used to describe physicians' characteristics associated with their views on VBHC. RESULTS: A total of 1000 physicians completed the survey (response rate: 13%). Although only 25% knew the value equation, 67% defined value in health according to Porter's-the outcomes that matter to patients in relation to the costs of offering such outcomes. Most participants identified increased healthcare costs as the main reason for the discussions over new financing models. Only 27% of physicians rated their awareness of VBHC as high or very high. In the multivariate analysis, awareness of VBHC was associated with holding a management position, scoring high in the hospital's physician segmentation program, being familiar with the value equation, and attributing high importance to developing new VBHC financing models for health system transformation. CONCLUSIONS: Physician awareness of key VBHC concepts is still heterogeneous in our clinical setting. Promoting opportunities for involving physicians in the discussion of VBHC is key for a successful value-driven transformation of healthcare.

11.
Asian-Australas J Anim Sci ; 33(10): 1656-1665, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32054158

RESUMO

OBJECTIVE: This study aimed to determine the effects of stress during slaughter of beef cattle on physiological parameters, carcass, and meat quality at a Federal Inspection Type slaughterhouse located in the southeast of Mexico. METHODS: A total of 448 carcasses of male Zebu×European steers with an average age of 36 months were included. Carcass assessment of presence of bruises and bruise characteristics was carried out on each half-carcass. Blood variable indicators of stress (packed cell volume, neutrophil to lymphocyte ratio, glucose, cortisol concentration) and meat quality parameters (pH, color, shear force, drip loss) were evaluated. RESULTS: Of the 448 carcasses evaluated, 81% of the carcasses showed at least one bruise; one bruise was detected in 36.6% and two bruises in 27.0% of animals. Of the 775 bruises found, 69.2% of the bruises were grade 1 in region 3. Of the 448 carcasses studied, 69.6% showed hyperglycemia (6.91 mmol/L); 44.3% and 22.7% showed high (74.7 ng/mL) and extremely high (108.8 ng/mL) cortisol levels, respectively, indicative of inadequate handling of animals during preslaughter and slaughter. Of the carcasses evaluated, 90.4% had a pH ≥5.8 with an average of pH 6.3. In both pH groups, meat samples showed L* values >37.0 (81.6%) and a shear force >54.3 N; meat pH≥5.8 group showed a drip loss of 2.5%. These findings were indicative of dark, firm, and dry (DFD) meat. According to principal component analysis, grades 1 and 2 bruises in region 3 and grade 1 bruises in region 5 were highly associated with cortisol, drip loss, and color parameters b* and h* and were negatively associated with L*, a*, and C*. CONCLUSION: The bruises probably caused by stress-inducing situations triggered DFD meat. Appropriate changes in handling routines in operating conditions should be made to minimize stress to animals during the slaughter process to improve animal welfare and meat quality.

12.
Transgenic Res ; 29(2): 171-186, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31919795

RESUMO

The expression of recombinant proteins in plants is a valuable alternative to bioreactors using mammalian cell systems. Ease of scaling, and their inability to host human pathogens, enhance the use of plants to generate complex therapeutic products such as monoclonal antibodies. However, stably transformed plants expressing antibodies normally have a poor accumulation of these proteins that probably arise from the negative positional effects of their flanking chromatin. The induction of boundaries between the transgenes and the surrounding DNA using matrix attachment regions (MAR) and insulator elements may minimize these effects. With the PHB-01 antibody as a model, we demonstrated that the insertion of DNA elements, the TM2 (MAR) and M4 insulator, flanking the transcriptional cassettes that encode the light and heavy chains of the PHB-01 antibody, increased the protein accumulation that remained stable in the first plant progeny. The M4 insulator had a stronger effect than the TM2, with over a twofold increase compared to the standard construction. This effect was probably associated with an enhancer-promoter interference. Moreover, transgenic plants harboring two transcriptional units encoding for the PHB-01 heavy chain combined with both TM2 and M4 elements enhanced the accumulation of the antibody. In summary, the M4 combined with a double transcriptional unit of the heavy chain may be a suitable strategy for potentiating PHB-01 production in tobacco plants.

13.
Blood Adv ; 4(2): 274-286, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31968078

RESUMO

The immunologic microenvironment in various solid tumors is aberrant and correlates with clinical survival. Here, we present a comprehensive analysis of the immune environment of acute myeloid leukemia (AML) bone marrow (BM) at diagnosis. We compared the immunologic landscape of formalin-fixed paraffin-embedded BM trephine samples from AML (n = 69), chronic myeloid leukemia (CML; n = 56), and B-cell acute lymphoblastic leukemia (B-ALL) patients (n = 52) at diagnosis to controls (n = 12) with 30 immunophenotype markers using multiplex immunohistochemistry and computerized image analysis. We identified distinct immunologic profiles specific for leukemia subtypes and controls enabling accurate classification of AML (area under the curve [AUC] = 1.0), CML (AUC = 0.99), B-ALL (AUC = 0.96), and control subjects (AUC = 1.0). Interestingly, 2 major immunologic AML clusters differing in age, T-cell receptor clonality, and survival were discovered. A low proportion of regulatory T cells and pSTAT1+cMAF- monocytes were identified as novel biomarkers of superior event-free survival in intensively treated AML patients. Moreover, we demonstrated that AML BM and peripheral blood samples are dissimilar in terms of immune cell phenotypes. To conclude, our study shows that the immunologic landscape considerably varies by leukemia subtype suggesting disease-specific immunoregulation. Furthermore, the association of the AML immune microenvironment with clinical parameters suggests a rationale for including immunologic parameters to improve disease classification or even patient risk stratification.

14.
Ophthalmic Physiol Opt ; 40(3): 350-364, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31989690

RESUMO

PURPOSE: To investigate the cost-effectiveness of a basic vision rehabilitation service (basic-VRS) in Portugal. We designed a parallel group, randomised controlled trial whose aim is to compare the effects and costs of 'usual low vision care' with a 'basic-VRS intervention' on self-reported visual ability and other psychosocial and health-related quality-of-life outcomes. METHODS: The trial will recruit participants that meet the following inclusion criteria: (1) visual acuity between 0.4-1.0 logMAR in the better-seeing eye, (2) cause of vision loss is diabetic retinopathy or age-related macular degeneration, (3) 18 years or older and iv) live in the community (not in nursing homes or other type of institution). Participants will be randomised to one of the study arms consisting of immediate intervention and delayed intervention. The delayed intervention group will receive 'usual care' or no intervention in the first 12 weeks. Visual acuity, contrast sensitivity and retinal structure will be assessed during the study. RESULTS: The primary outcome measure is visual ability, which will be evaluated with the Massof Activity Inventory, we expect that the intervention will raise the overall person measure or visual ability. Reading, health-related quality-of-life, anxiety and depression and social support will be also assessed. The analysis will be undertaken on an intention-to-treat basis. A cost-effectiveness analysis will be performed to provide information about the cost per unit of utility. To evaluate the cost-effectiveness of the intervention we will adopt the perspective of the healthcare system. CONCLUSION: This study will provide additional evidence about the effects of basic-VRS on self-reported visual ability. Findings from this study should also contribute to better planning of low vision provision and, consequently, may contribute to reduce barriers to basic-VRS.

15.
Reprod Domest Anim ; 55(3): 266-273, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31880841

RESUMO

Cow stayability plays a major role on the overall profitability of the beef cattle industry, as it is directly related to reproductive efficiency and cow's longevity. Stayability (STAY63) is usually defined as the ability of the cow to calve at least three times until 76 months of age. This is a late-measured and lowly heritable trait, which consequently constrains genetic progress per time unit. Thus, the use of genomic information associated with novel stayability traits measured earlier in life will likely result in higher prediction accuracy and faster genetic progress for cow longevity. In this study, we aimed to compare pedigree-based and single-step GBLUP (ssGBLUP) methods as well as to estimate genetic correlations between the proposed stayability traits: STAY42, STAY53 and STAY64, which are measured at 52, 64 and 76 months of cow's age, considering at least 2, 3 and 4 calving, respectively. ssGBLUP yielded the highest prediction accuracy for all traits. The heritability estimates for STAY42, STAY53, STAY63 and STAY64 were 0.090, 0.151, 0.152 and 0.143, respectively. The genetic correlations between traits ranged from 0.899 (STAY42 and STAY53) to 0.985 (STAY53 and STAY63). The high genetic correlation between STAY42 and STAY53 suggests that besides being related to cow longevity, STAY53 is also associated with the early-stage reproductive efficiency. Thus, STAY53 is recommended as a suitable selection criterion for reproductive efficiency due to its higher heritability, favourable genetic correlation with other traits, and measured earlier in life, compared with the conventional stayability trait, that is STAY63.


Assuntos
Bovinos/genética , Fertilidade/genética , Reprodução/genética , Envelhecimento/genética , Envelhecimento/fisiologia , Animais , Cruzamento , Bovinos/fisiologia , Feminino , Fertilidade/fisiologia , Genoma , Longevidade/genética , Linhagem , Reprodução/fisiologia
16.
Pharmacogenomics J ; 20(3): 494-504, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31806882

RESUMO

Statin therapy response is highly variable. Variants of lipid metabolism genes and statin pharmacokinetic modulators could play a role, however, the impact of most of these variants remains unconfirmed. A prospective and multicenter study included 252 patients was carried out in order to assess, according to achievement of LDL-C or non-HDL-C therapeutic targets and quantitative changes in lipid profiles, the impact of CETP, ABCA1, CYP2D6, and CYP2C9 gene candidate variants on the simvastatin, atorvastatin, and rosuvastatin response. Patients carrier ABCA1 rs2230806 and CYP2D6*3 variants are less likely to achieve therapeutic lipid targets (p = 0.020, OR = 0.59 [0.37, 0.93]; p = 0.040, OR = 0.23 [0.05, 0.93], respectively). Among CETP variants, rs708272 was linked to a 10.56% smaller reduction in LDL-C with rosuvastatin (95% CI = [1.27, 19.86] %; p = 0.028). In contrast, carriers of rs5882 had a 13.33% greater reduction in LDL-C (95% CI = [25.38, 1.28]; p = 0.032). If these findings are confirmed, ABCA1, CYP2D6, and CETP genotyping could be used to help predict which statin and dosage is appropriate in order to improve personalized medicine.

17.
An Acad Bras Cienc ; 91(3): e20190002, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31432908

RESUMO

In this paper, we revisit the Wilson-Hilferty distribution and presented its mathematical properties such as the r-th moments and reliability properties. The parameters estimators are discussed using objective reference Bayesian analysis for both complete and censored data where the resulting marginal posterior intervals have accurate frequentist coverage. A simulation study is presented to compare the performance of the proposed estimators with the frequentist approach where it is observed a clear advantage for the Bayesian method. Finally, the proposed methodology is illustrated on three real datasets.

18.
PLoS One ; 14(8): e0221332, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31469851

RESUMO

In this paper, from the practical point of view, we focus on modeling traumatic brain injury data considering different stages of hospitalization, related to patients' survival rates following traumatic brain injury caused by traffic accidents. From the statistical point of view, the primary objective is related to overcoming the limited number of traumatic brain injury patients available for studying by considering different estimation methods to obtain improved estimators of the model parameters, which can be recommended to be used in the presence of small samples. To have a general methodology, at least in principle, we consider the very flexible Generalized Gamma distribution. We compare various estimation methods using extensive numerical simulations. The results reveal that the penalized maximum likelihood estimators have the smallest mean square errors and biases, proving to be the most efficient method among the investigated ones, mainly to be used in the presence of small samples. The Simulated Annealing technique is used to avoid numerical problems during the optimization process, as well as the need for good initial values. Overall, we considered an amount of three real data sets related to traumatic brain injury caused by traffic accidents to demonstrate that the Generalized Gamma distribution is a simple alternative to be used in this type of applications for different occurrence rates and risks, and in the presence of small samples.


Assuntos
Lesões Encefálicas Traumáticas/epidemiologia , Modelos Estatísticos , Distribuições Estatísticas , Acidentes de Trânsito , Algoritmos , Lesões Encefálicas Traumáticas/fisiopatologia , Simulação por Computador , Hospitalização , Humanos , Funções Verossimilhança , Distribuição Normal
19.
Stereotact Funct Neurosurg ; 97(2): 101-105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31280257

RESUMO

BACKGROUND/AIMS: Internal pulse generator (IPG) replacement is considered a relatively minor surgery but exposes the deep brain stimulation system to the risk of infectious and mechanical adverse events. We retrospectively reviewed complications associated with IPG replacement surgery in our center and reviewed the most relevant publications on the issue. METHODS: A retrospective analysis of all the IPG replacements performed in our center from January 2003 until March 2018 was performed. A logistic regression model was used to analyze the risk factors associated with IPG infections at our center. RESULTS: A total of 171 IPG replacements in 93 patients were analyzed. The overall rate of replacement complications was 8.8%, whereas the rate of infection was 5.8%. IPG removal was required in 8 out of 10 infected cases. An increased risk of infection was found in patients with subcutaneous thoracic placement of the IPG (OR 5.3, p = 0.016). The most commonly isolated germ was Staphylococcus coagulase negative (60%). We found a non-significant trend towards increased risk of infection in patients with more than 3 replacements (p = 0.07). CONCLUSIONS: Infection is the most frequent complication related to IPG replacement. Staphylococcus coagulase negative is the most commonly isolated bacteria causing the infection. According to our results, the subcutaneous thoracic placement represents a greater risk of infection compared to subcutaneous abdominal placement.


Assuntos
Estimulação Encefálica Profunda/efeitos adversos , Estimulação Encefálica Profunda/instrumentação , Eletrodos Implantados/efeitos adversos , Neuroestimuladores Implantáveis/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Estimulação Encefálica Profunda/métodos , Tremor Essencial/diagnóstico , Tremor Essencial/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Doença de Parkinson/cirurgia , Estudos Retrospectivos , Fatores de Risco
20.
Ophthalmic Epidemiol ; 26(6): 378-392, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31280630

RESUMO

Purpose: To estimate productivity losses amongst people with impaired vision in Portugal and to investigate explanatory factors associated with non-participation in the labour market.Methods: A total of 546 visually impaired individuals participated in face-to-face interviews. Participants were asked about their workforce participation to determine productivity (employment status questionnaire), their health-related quality of life - HRQoL (EQ-5D) and their visual acuity and visual ability (Activity Inventory). Productivity losses included absenteeism and reduction in workforce participation. Logistic regression was used to determine independent factors associated with participation in the labour market.Results: From the 546 participants, 50% were retired, 47% were of working age and 3% were students. The employment rate was 28%, and the unemployment rate was 21% for the working age sample. For those of working age, productivity losses were estimated at €1.51 million per year, mean of €5496 per participant. The largest contributor to productivity losses was reduced workforce participation, estimated from 159 early retired or unemployed participants. After controlling for visual acuity and ability, younger individuals, with more years of education, without comorbidities and high HRQoL had a higher probability of being employed.Conclusions: Our findings show a high unemployment rate and high productivity losses amongst people with impaired vision. The probability of being employed was associated with education, HRQoL and comorbidities. We speculate that promoting education and health through effective visual rehabilitation programs may help to increase participation in the labour market. These findings can inform decisions to intervene to reduce the burden of vision loss.


Assuntos
Emprego/estatística & dados numéricos , Pessoas com Deficiência Visual/estatística & dados numéricos , Absenteísmo , Adolescente , Adulto , Efeitos Psicossociais da Doença , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Portugal , Qualidade de Vida , Inquéritos e Questionários , Acuidade Visual , Adulto Jovem
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