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1.
RSC Adv ; 12(10): 5990-5996, 2022 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-35424587

RESUMO

Two-dimensional molybdenum disulfide (MoS2) has attracted increasing attention due to its promise for next-generation electronics. To realize MoS2-based electronics, however, a synthesis method is required that produces a uniform single-layer material and that is compatible with existing semiconductor fabrication techniques. Here, we demonstrate that uniform films of single-layer MoS2 can be directly produced on Si/SiO2 at wafer-scale without the use of catalysts or promoters. Control of the precursor transport through oxygen dosing yielded complete coverage and increased connectivity between crystalline MoS2 domains. Spectroscopic characterization and carrier transport measurements furthermore revealed a reduced density of defects compared to conventional chemical vapor deposition growth that increased the quantum yield over ten-fold. To demonstrate the impact of enhanced scale and optoelectronic performance, centimeter-scale arrays of MoS2 photosensors were produced that demonstrate unprecedentedly high and uniform responsivity. Our approach improves the prospect of MoS2 for future applications.

2.
ACS Nano ; 2022 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-35377604

RESUMO

The clean production of hydrogen from water using sunlight has emerged as a sustainable alternative toward large-scale energy generation and storage. However, designing photoactive semiconductors that are suitable for both light harvesting and water splitting is a pivotal challenge. Atomically thin transition metal dichalcogenides (TMD) are considered as promising photocatalysts because of their wide range of available electronic properties and compositional variability. However, trade-offs between carrier transport efficiency, light absorption, and electrochemical reactivity have limited their prospects. We here combine two approaches that synergistically enhance the efficiency of photocarrier generation and electrocatalytic efficiency of two-dimensional (2D) TMDs. The arrangement of monolayer WS2 and MoS2 into a heterojunction and subsequent nanostructuring into a nanoscroll (NS) yields significant modifications of fundamental properties from its constituents. Spectroscopic characterization and ab initio simulation demonstrate the beneficial effects of straining and wall interactions on the band structure of such a heterojunction-NS that enhance the electrochemical reaction rate by an order of magnitude compared to planar heterojunctions. Phototrapping in this NS further increases the light-matter interaction and yields superior photocatalytic performance compared to previously reported 2D material catalysts and is comparable to noble-metal catalyst systems in the photoelectrochemical hydrogen evolution reaction (PEC-HER) process. Our approach highlights the potential of morphologically varied TMD-based catalysts for PEC-HER.

3.
Chemosphere ; 297: 134112, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35227752

RESUMO

There has been a growing interest in the scientific world in the production of biochar from natural organic wastes as potential sustainable precursors for bioremediation. Potato peel biochar was produced by slow pyrolysis method under oxygen-limited conditions and used as bio adsorbent in bioremediation of commercial pesticide having Chlorpyrifos as an active component. Chlorpyrifos is an organophosphate pesticide, highly neurotoxic, and primarily targets the central nervous system of pests and insects. The excess residues of chlorpyrifos are hazardous to environmental flora and fauna. Chlorpyrifos was treated against biochar at varying physical parameters and further optimized by using response surface methodology through Box-Behnken design (BBD). 72.06% of pesticide removal was observed post 24 h of treatment against a pesticide concentration of 1346.85 µg/ml with a biochar concentration of 1.04 mg/ml under room temperature at pH 5.04. Biochar was characterized by proximate and ultimate analysis, FTIR, and SEM-EDX. Characterization by SEM-EDX showed the surface morphology and minerals on the peel and biochar. Microgram of potato peel shows pores of larger size than biochar having many cavities with different dimensions. In the plant system, growth morphology, nutritional status, polyphenols, total antioxidant content, and free radical scavenging activity were assessed. Enhancement in presence of biochar was recorded in growth morphology and plant biomolecules including photosynthetic pigments. Better translocation of the nutrient is recorded in biochar treated plants, as evidenced by the low amount of carbohydrate and protein in treated leaves. Biocompatibility assessment of chlorpyriphos in fish erythrocytes showed 43.26% hemolysis by pesticide-treated biochar. The practical use of this approach can also be best utilized if applied to those geographical regions where the soil pH is acidic. Biochar is a marketable bio-product, which can have a positive impact in agriculture, industries, and the energy sector creating a bio-based economy with reduced environmental pollution.


Assuntos
Clorpirifos , Inseticidas , Praguicidas , Solanum tuberosum , Adsorção , Animais , Carvão Vegetal/química , Clorpirifos/química , Inseticidas/química
4.
Aliment Pharmacol Ther ; 55(11): 1431-1440, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35229906

RESUMO

BACKGROUND: Anti-tumor necrosis factor (anti-TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to an increased risk of tuberculosis (TB) reactivation despite latent tuberculosis (LTB) screening, especially in TB endemic regions. AIM: We evaluated the effect of stringent screening strategy and LTB prophylaxis on TB reactivation. METHODS: We performed an ambispective comparison between patients who received anti-TNF therapy after January 2019 (late cohort) and between Jan 2005 and Jan 2019 (early cohort). Late cohort patients were subjected to stringent screening criteria which included all: history of past TB/recent contact with active TB, chest X-ray, CT (computed tomography) chest, IGRA (interferon-gamma release assay), TST (tuberculin skin test), and if any positive were given chemoprophylaxis. A cohort comparison was done to evaluate for risk reduction of TB following the stringent screening strategy. RESULTS: One hundred seventy-one patients (63: ulcerative colitis/108: Crohn's disease, mean age diagnosis: 28.5 ± 13.4 years, 60% males, median follow-up duration after anti-TNF: 33 months [interquartile range: 23-57 months]) were included. Among the 112 in the early cohort, 29 (26%) underwent complete TB screening, 22 (19.6%) had LTB, 10 (9%) received chemoprophylaxis, and 19 (17%) developed TB. In comparison, in the late cohort, 100% of patients underwent complete TB screening, 26 (44%) had LTB, 23 (39%) received chemoprophylaxis, and only 1(1.7%) developed TB (p < 0.01). On survival analysis, patients in early cohort had a higher probability of TB reactivation compared with the late cohort (HR: 14.52 (95% CI: 1.90-110.61 [p = 0.01]) after adjusting for gender, age at anti-TNF initiation, concomitant immunosuppression, anti-TNF doses, and therapy escalation. CONCLUSION: The high risk of TB reactivation with anti-TNF therapy in TB endemic regions can be significantly mitigated with stringent LTB screening and chemoprophylaxis.


Assuntos
Doenças Inflamatórias Intestinais , Tuberculose Latente , Tuberculose , Adolescente , Adulto , Feminino , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/tratamento farmacológico , Testes de Liberação de Interferon-gama , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Tuberculose Latente/epidemiologia , Masculino , Programas de Rastreamento/métodos , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/prevenção & controle , Inibidores do Fator de Necrose Tumoral , Fator de Necrose Tumoral alfa/uso terapêutico , Adulto Jovem
6.
Adv Healthc Mater ; : e2102640, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35038229

RESUMO

Tuberculosis (TB), including extrapulmonary TB, is responsible for more than one million deaths in a year worldwide. Existing methods of mycobacteria detection have poor sensitivity, selectivity, and specificity, especially in human tissues. Herein, the synthesis of a cholic acid-derived fluorescent probe (P4) that can specifically stain the mycobacterium species is presented. It is shown that P4 probe specifically binds with mycobacterial lipids, trehalose monomycolate, and phosphatidylinositol mannoside 6. P4 probe can detect mycobacteria in polymicrobial planktonic cultures and biofilms with high specificity, selectivity, and sensitivity. Moreover, it can detect a single mycobacterium in the presence of 10 000 other bacilli. Unlike the probes that depend on active mycobacterial enzymes, the membrane-specific P4 probe can detect mycobacteria even in formalin-fixed paraffin-embedded mice and human tissue sections. Therefore, the ability of the P4 probe to detect mycobacteria in different biological milieu makes it a potential candidate for diagnostic and prognostic applications in clinical settings.

7.
JAMA Netw Open ; 5(1): e2142210, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34994793

RESUMO

Importance: A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021. Objective: To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the inactivated whole virion vaccine BBV152 against reinfection. Design, Setting, and Participants: This was a retrospective cohort study among HCWs working at a tertiary care center in New Delhi, India. Exposures: Vaccination with 0, 1, or 2 doses of BBV152. Main Outcomes and Measures: The HCWs were categorized as fully vaccinated (with 2 doses and ≥15 days after the second dose), partially vaccinated (with 1 dose or 2 doses with <15 days after the second dose), or unvaccinated. The incidence density of COVID-19 reinfection per 100 person-years was computed, and events from March 3, 2020, to June 18, 2021, were included for analysis. Unadjusted and adjusted hazard ratios (HRs) were estimated using a Cox proportional hazards model. Estimated vaccine effectiveness (1 - adjusted HR) was reported. Results: Among 15 244 HCWs who participated in the study, 4978 (32.7%) were diagnosed with COVID-19. The mean (SD) age was 36.6 (10.3) years, and 55.0% were male. The reinfection incidence density was 7.26 (95% CI: 6.09-8.66) per 100 person-years (124 HCWs [2.5%], total person follow-up period of 1696 person-years as time at risk). Fully vaccinated HCWs had lower risk of reinfection (HR, 0.14 [95% CI, 0.08-0.23]), symptomatic reinfection (HR, 0.13 [95% CI, 0.07-0.24]), and asymptomatic reinfection (HR, 0.16 [95% CI, 0.05-0.53]) compared with unvaccinated HCWs. Accordingly, among the 3 vaccine categories, reinfection was observed in 60 of 472 (12.7%) of unvaccinated (incidence density, 18.05 per 100 person-years; 95% CI, 14.02-23.25), 39 of 356 (11.0%) of partially vaccinated (incidence density 15.62 per 100 person-years; 95% CI, 11.42-21.38), and 17 of 1089 (1.6%) fully vaccinated (incidence density 2.18 per 100 person-years; 95% CI, 1.35-3.51) HCWs. The estimated effectiveness of BBV152 against reinfection was 86% (95% CI, 77%-92%); symptomatic reinfection, 87% (95% CI, 76%-93%); and asymptomatic reinfection, 84% (95% CI, 47%-95%) among fully vaccinated HCWs. Partial vaccination was not associated with reduced risk of reinfection. Conclusions and Relevance: These findings suggest that BBV152 was associated with protection against both symptomatic and asymptomatic reinfection in HCWs after a complete vaccination schedule, when the predominant circulating variant was B.1.617.2.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde , Reinfecção , SARS-CoV-2 , Adulto , COVID-19/etiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Estudos de Coortes , Feminino , Humanos , Imunogenicidade da Vacina , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Centros de Atenção Terciária , Vacinas de Produtos Inativados/administração & dosagem , Vírion/imunologia , Adulto Jovem
8.
Inorg Chem ; 60(24): 18698-18705, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34823356

RESUMO

The recent years have witnessed the glory development for the construction of high-performance mononuclear single molecule magnets (SMMs) within a specific coordination geometry, which, however, is not well applied in cluster-based SMMs due to the synthetic challenges. Given that the monocobalt(II) complexes within a trigonal-prismatic (TPR) coordination geometry have been classified as excellent SMMs with huge axial anisotropy (D ≈ -100 cm-1), here we designed and synthesized a new dual-capping tetrazine ligand, 3,6-bis(6-(di(1H-pyrazol-1-yl)methyl)pyridin-2-yl)-1,2,4,5-tetrazine (bpptz), and prepared a novel dicobalt(II) complex, [Cp2CoIII][{(hfac)CoII}2(bpptz•-)][hfac]2·2Et2O (1, hfac = hexafluoroacetylacetonate). In the structure of 1, the bpptz•- radical ligand enwraps two Co(II) centers within quasi-TPR geometries, which are further bridged by the tetrazine radical in the trans mode. The magnetic study revealed that the interaction between the Co centers and the tetrazine radical is strongly antiferromagnetic with a coupling constant (J) of -65.8 cm-1 (in the -2J formalism). Remarkably, 1 exhibited the typical SMM behavior with an effective energy barrier of 69 cm-1 under a 1.5 kOe dc field, among the largest for polynuclear transition metal SMMs. In addition, DFT and ab initio calculations suggested that the presence of a strong Co(II)-radical magnetic interaction effectively quenches the QTM effect and enhances the barrier height for the magnetization reversal.

9.
Chem Sci ; 12(34): 11506-11514, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34667554

RESUMO

Lanthanide based single molecular magnets (SMMs), particularly dysprocenium based SIMs, are well known for their high energy barrier for spin reversal (U eff) and blocking temperatures (T B). Enhancing these two parameters and at the same time obtaining ambient stability is key to realising end-user applications such as compact storage or as qubits in quantum computing. In this work, by employing an array of theoretical tools (DFT, ab initio CASSCF and molecular dynamics), we have modelled six complexes [(η5-corannulene)Dy(Cp)] (1), [(η5-corannulene)Dy(C6H6)] (2), [(η6-corannulene)Dy(Cp)] (3), [(η6-corannulene)Dy(C6H6)] (4), [(exo-η5-corannulene)Dy(endo-η5-corannulene)] (5), and [(endo-η5-corannulene)Dy(endo-η5-corannulene)] (6) containing corannulene as a capping ligand to stabilise Dy(iii) half-sandwich complexes. Our calculations predict a strong axiality exerted by the Dy-C interactions in all complexes. Ab initio calculations predict a very large barrier height for all six molecules in the order 1 (919 cm-1) ≈ 3 (913 cm-1) > 2 (847 cm-1) > 4 (608 cm-1) ≈ 5 (603 cm-1) ≈ 6 (599 cm-1), suggesting larger barrier heights for Cp ring systems, followed by six-membered arene systems and then corannulene. DFT based molecular dynamics calculations were performed on complexes 3, 5 and 6. For complexes 3 and 5, the geometries that are dynamically accessible are far fewer. The range of U eff computed for molecular dynamics snapshots is high, indicating a possibility of translating the large U eff obtained into attractive blocking temperatures in these complexes, but the converse is found for 6. Furthermore, an in-depth C-H bond vibrational analysis performed on complex 3 suggests that the vibration responsible for reducing the blocking temperature in dysprocenium SIMs is absent here as the C-H bonds are stronger and corannulene steric strain prevents the C(Cp)-Dy-C(Cor) bending. As [(η6-corannulene)TM(X)]+ (TM = Ru, Zr, Os, Rh, Ir and X = C5Me5, C6Me6) are known, the predictions made here have a higher prospect of yielding stability under ambient conditions, a very large U eff value and a high blocking temperature - a life-giving combination to new generation SMMs.

10.
Chem Commun (Camb) ; 57(71): 8925-8928, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34396373

RESUMO

The combination of two different FeIII salts in a solvothermal reaction with triethanolamine results in the formation of a high symmetry [FeIII15] cluster whose structure conforms to a centred, tetrakis hexahedron.

11.
PLoS One ; 16(8): e0256098, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34407136

RESUMO

BACKGROUND AND OBJECTIVES: Crohn's disease (CD) and Intestinal tuberculosis (ITB) are chronic inflammatory ulcero-constrictive intestinal diseases with similar phenotype. Although both are disease models of chronic inflammation and their clinical presentations, imaging, histological and endoscopic findings are very similar, yet their etiologies are diverse. Hence, we aimed to look at differences in the prevalence of pathobionts like adherent-invasive Escherichia coli (AIEC), Listeria monocytogenes, Campylobacter jejuni and Yersinia enterocolitica in CD and ITB as well as their associations with host-associated genetic polymorphisms in genes majorly involved in pathways of microbial handling and immune responses. METHODS: The study cohort included 142 subjects (69 patients with CD, 32 with ITB and 41 controls). RT- PCR amplification was used to detect the presence of AIEC, L. monocytogenes, C. jejuni, and Y. enterocolitica DNA in colonic mucosal biopsies. Additionally, we tested three SNPs in IRGM (rs13361189, rs10065172, and rs4958847), one SNP in ATG16L1 (rs2241880) and one SNP in TNFRSF1A (rs4149570) by real-time PCR with SYBR green from peripheral blood samples in this cohort. RESULTS: In patients with CD, AIEC was most frequently present (16/ 69, 23.19%) followed by L. monocytogenes (14/69, 20.29%), C. jejuni (9/69, 13.04%), and Y. enterocolitica (7/69, 10.14%). Among them, L. monocytogenes and Y. enterocolitica were significantly associated with CD (p = 0.02). In addition, we identified all the three SNPs in IRGM (rs13361189, rs10065172, and rs4958847), one SNP in ATG16L1 (rs2241880) and TNFRSF1A (rs4149570) with a significant difference in frequency in patients with CD compared with ITB and controls (p<0.05). CONCLUSION: Higher prevalence of host gene polymorphisms, as well as the presence of pathobionts, was seen in the colonic mucosa of patients with CD as compared to ITB, although both are disease models of chronic inflammation.


Assuntos
Bactérias/patogenicidade , Doença de Crohn/genética , Doenças Inflamatórias Intestinais/patologia , Mucosa Intestinal/microbiologia , Tuberculose Gastrointestinal/genética , Adulto , Bactérias/genética , Bactérias/isolamento & purificação , Estudos de Casos e Controles , Estudos de Coortes , Doença de Crohn/microbiologia , Doença de Crohn/patologia , Feminino , Humanos , Doenças Inflamatórias Intestinais/genética , Doenças Inflamatórias Intestinais/microbiologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Masculino , Polimorfismo de Nucleotídeo Único , Prevalência , Tuberculose Gastrointestinal/microbiologia , Tuberculose Gastrointestinal/patologia
13.
Dalton Trans ; 50(15): 5318-5326, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33881042

RESUMO

We report the synthesis and characterization of four new tetranuclear Ni(ii) complexes, C1-C4, all of which exhibit defective dicubane cores. C1-C4 are derived from the same salicylaldoxime derived ligand, H2L1. Complexes C1 and C4 have isostructural cores, differing in structure only by solvate molecules. Magnetic and computational analyses have revealed that complexes C1, C2, and C4 exhibit competing ferro- and antiferromagnetic interactions, however the different solvated species in C1 and C4 leads to notably different magnitudes in their magnetic coupling constants. Theoretical magneto-structural studies show that the pairwise magnetic exchange interaction is highly dependent on the Ni-X-Ni angle, as revealed by orbital overlap calculations.

15.
Chem Commun (Camb) ; 57(34): 4122-4125, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33908462

RESUMO

A [Mn18] wheel of wheels is obtained from the reaction of MnBr2·4H2O and LH3 in MeOH. The metallic skeleton reveals two asymmetric [MnIII6MnII2] square wheels connected into a larger wheel via two MnII ions. Magnetic susceptibility and magnetisation data reveal competing exchange interactions, supported by computational studies.

16.
Trop Doct ; 51(3): 361-365, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33586633

RESUMO

Vitamin D deficiency is a common disorder that is associated with morbidity and mortality in the general population. We conducted a cross-sectional study of 384 children admitted to paediatric intensive care to determine its prevalence and association with severity of illness and outcome in critically ill children. The severity of illness was evaluated using the paediatric risk of mortality score (PRISM III), on admission, at 24 and 48 h. Vitamin D deficiency was observed in 175 children (45.6%) and was associated with higher severity of illness, need for mechanical ventilation and increased mortality.


Assuntos
Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adolescente , Criança , Pré-Escolar , Estado Terminal , Estudos Transversais , Humanos , Índia/epidemiologia , Lactente , Índice de Gravidade de Doença , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico
17.
Folia Microbiol (Praha) ; 66(2): 255-271, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33411249

RESUMO

Microbial biofilm indicates a cluster of microorganisms having the capability to display drug resistance property, thereby increasing its proficiency in spreading diseases. In the present study, the antibiofilm potential of thymoquinone, a black seed-producing natural molecule, was contemplated against the biofilm formation by Pseudomonas aeruginosa. Substantial antimicrobial activity was exhibited by thymoquinone against the test organism wherein the minimum inhibitory concentration of the compound was found to be 20 µg/mL. Thereafter, an array of experiments (crystal violet staining, protein count, and microscopic observation, etc.) were carried out by considering the sub-MIC doses of thymoquinone (5 and 10 µg/mL), each of which confirmed the biofilm attenuating capacity of thymoquinone. However, these concentrations did not show any antimicrobial activity. Further explorations on understanding the underlying mechanism of the same revealed that thymoquinone accumulated reactive oxygen species (ROS) and also inhibited the expression of the quorum sensing gene (lasI) in Pseudomonas aeruginosa. Furthermore, by taking up a combinatorial approach with two other reported antibiofilm agents (tetrazine-capped silver nanoparticles and tryptophan), the antibiofilm efficiency of thymoquinone was expanded. In this regard, the highest antibiofilm activity was observed when thymoquinone, tryptophan, and tetrazine-capped silver nanoparticles were applied together against Pseudomonas aeruginosa. These combinatorial applications of antibiofilm molecules were found to accumulate ROS in cells that resulted in the inhibition of biofilm formation. Thus, the combinatorial study of these antibiofilm molecules could be applied to control biofilm threats as the tested antibiofilm molecules alone or in combinations showed negligible or very little cytotoxicity.


Assuntos
Nanopartículas Metálicas , Pseudomonas aeruginosa , Antibacterianos/farmacologia , Benzoquinonas , Biofilmes , Testes de Sensibilidade Microbiana , Prata/farmacologia , Triptofano
18.
J Med Econ ; 24(1): 131-139, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33397178

RESUMO

AIMS: To estimate the budget impact of adding capmatinib, the first FDA approved MET inhibitor, to a US commercial or Medicare health plan for patients with metastatic non-small cell lung cancer (mNSCLC) whose tumors have a mutation that leads to MET exon 14 (METex14) skipping. METHODS: Target population size was estimated using published epidemiology data. Clinical data were obtained from the GEOMETRY mono-1 capmatinib trial and published trials. Treatments in the market mix included crizotinib, pembrolizumab, ramucirumab, and chemotherapy. Uptake of capmatinib and testing rates were based on market research. All costs (drug acquisition and administration, pre-progression, progression, terminal care, adverse event, and testing) were estimated based on public sources (2020 USD). RESULTS: The number of patients eligible for capmatinib in the first three years was estimated to be 2-3 in a hypothetical 1 million member commercial plan and 34-44 in a hypothetical 1 million member Medicare plan each year. The estimated total budget impact ranged from $9,695 to $67,725 for a commercial plan and $141,350 to $985,695 for Medicare. With capmatinib included, a marginal per member per month budget impact was estimated (commercial: $0.0008 to $0.0056; Medicare: $0.0118 to $0.0821). Capmatinib inclusion resulted in lower medical costs (commercial: -$0.0003 to -$0.0007; Medicare: -$0.0037 to -$0.0106), partially offsetting increased drug costs ($0.0011 to $0.0064; $0.0154 to $0.0928, respectively), and were primarily driven by reductions in progression and terminal care costs (-$0.0003 to -$0.0009; -$0.0037 to -$0.0125, respectively). The results were most sensitive to capmatinib market share, capmatinib price, and treatment duration. LIMITATIONS: Certain assumptions were applied to the model to account for inputs with limited evidence. CONCLUSIONS: The estimated budget impact of including capmatinib for mNSCLC with a METex14 skipping mutation is minimal, and the increased drug costs were partially offset by savings in AEs, and progression-related and terminal care costs.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adulto , Idoso , Benzamidas , Orçamentos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Éxons , Humanos , Imidazóis , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Medicare , Mutação , Triazinas , Estados Unidos
19.
Aliment Pharmacol Ther ; 53(5): 568-576, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33440046

RESUMO

BACKGROUND: Intravenous corticosteroids are the mainstay of therapy for acute severe ulcerative colitis (ASUC), but 30%-40% of patients fail to respond. AIM: To investigate the effectiveness of exclusive enteral nutrition (EEN) as adjunctive therapy to intravenous corticosteroids in patients with ASUC. METHODS: This was an open-label randomised controlled trial, in which patients who were admitted with ASUC between August 2018 and May 2020 were randomised 1:1 to EEN or standard of care (SOC). Patients on EEN received a semi-elemental formula for 7 days along with SOC. The primary outcome was corticosteroid failure, defined by the need for salvage medical therapy or colectomy. Faecal microbial analysis was performed on day 1 and day 7 by 16s ribosomal RNA sequencing in some patients. RESULTS: Of 62 patients (mean age 35.3 ± 12.1 years, 40% male), 32 were randomised to EEN and 30 to SOC. Corticosteroid failure was lower on EEN compared to SOC (intention-to-treat analysis 25% vs 43%, P = 0.051; per protocol analysis 19% vs 43%, P = 0.04), without any difference in colectomy rate (9% vs 13%; P = 0.41). Patients on EEN had a shorter hospital stay [median (range) 10 (8-17) vs 13 (8-24) days; P = 0.04], higher day 7 albumin level (34 ± 4 vs 29 ± 3 g/L, P < 0.01), greater reduction in serum C-reactive protein and faecal calprotectin levels (both P = 0.04) and a lower composite outcome of colectomy/hospitalisation at 6 months (16% vs 39%; P = 0.045) compared to SOC. Patients on EEN showed increased abundance of Erysipelotrichaceae on day 7, with reduced Bifidobacterium and Veillonellaceae compared to SOC. CONCLUSIONS: EEN for 7 days may augment corticosteroid responsiveness in patients with ASUC. (REF/2018/05/019844; CTRI/2020/06/025989).


Assuntos
Colite Ulcerativa , Adulto , Colite Ulcerativa/tratamento farmacológico , Nutrição Enteral , Fezes , Feminino , Humanos , Complexo Antígeno L1 Leucocitário , Masculino , Pessoa de Meia-Idade , Padrão de Cuidado , Resultado do Tratamento , Adulto Jovem
20.
J Trop Pediatr ; 67(3)2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32929468

RESUMO

BACKGROUND: Fatalities in children left unattended in parked motor vehicles are being reported frequently in the last decade but little research has been done analysing the circumstances leading to such preventable deaths in India. OBJECTIVES: To analyse circumstances leading to fatalities in children left unattended in parked motor vehicles in India. METHODS: This study was a descriptive analysis conducted on the basis of an Internet search of published news in major Indian newspapers/channels using different combination of keywords. We extracted data from the published news using a pre-determined tool. RESULTS: Between 2011 and 2020, there were 23 incidents that resulted in 40 fatalities across India mostly in summer months. Majority of children were 4-6 years of age (26/40). Ninety percent of children gained access to unattended vehicles for playing and getting locked accidentally (36/40) while remaining cases involved being forgotten (3/40) or intentionally left behind (1/40). CONCLUSION: Majority of hyperthermia-related deaths occurred while children gained access to unattended vehicles for playing and getting locked accidentally.


Assuntos
Febre , Veículos Automotores , Criança , Humanos , Hipertermia , Índia/epidemiologia , Estações do Ano
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