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1.
Bone Joint J ; 101-B(10): 1218-1229, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564157

RESUMO

AIMS: Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. PATIENTS AND METHODS: A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. RESULTS: We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. CONCLUSION: In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218-1229.


Assuntos
Artroscopia/métodos , Impacto Femoroacetabular/cirurgia , Imagem Tridimensional , Metatarso Valgo/diagnóstico por imagem , Metatarso Varo/diagnóstico por imagem , Osteotomia/efeitos adversos , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Fêmur/fisiopatologia , Seguimentos , Humanos , Modelos Lineares , Imagem por Ressonância Magnética/métodos , Masculino , Metatarso Valgo/epidemiologia , Metatarso Varo/epidemiologia , Pessoa de Meia-Idade , Osteotomia/métodos , Prevalência , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Anormalidade Torcional/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
2.
Medicine (Baltimore) ; 98(36): e16812, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490367

RESUMO

Chronic kidney disease (CKD)-associated pruritus is one of the most common symptoms found in patients who undergo dialysis for CKD, leading to a compromised quality of life. This study aimed to investigate the association between CKD-associated pruritus and the quality of life in patients undergoing hemodialysis in Pakistan.A cross-sectional multicenter study was carried out from July 2016 to April 2017 in 2 tertiary care hospitals in Pakistan. Patients aged 18 years and above of both genders, undergoing hemodialysis, understood the Urdu language, and were willing to participate; were included.Of 354 recruited patients with a response rate of 100%, majority (66.1%) of the patients were males. The median (intra-quartile range [IQR]) age of patients was 42.0 [34.0-50.0] years. The prevalence of pruritus was 74%. The median [IQR] score for pruritus was 10.0 (out of possible 25) [8.0-12.0]. Multivariate linear regression revealed a statistically significant association between CKD-associated pruritus with age of patients (ß = 0.031; 95% confidence interval [CI] = 0.002-0.061; P = .038), duration of CKD (ß = -0.013; 95% CI = -0.023 --0.003; P = .014) and quality of life (ß= -0.949; 95% CI = -1.450; -0.449). The median [IQR] score for health-related quality of life was 52.00 [43.00-58.00].Prevalence of CKD-associated pruritus was reported to be 74% and it negatively affected the patient's quality of life. Patients with moderate to severe CKD-associated pruritus have poor quality of life. With an increase in intensity of pruritus, the QOL score decreased among the patients undergoing hemodialysis.


Assuntos
Prurido/epidemiologia , Prurido/etiologia , Qualidade de Vida , Insuficiência Renal Crônica/complicações , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Prevalência , Diálise Renal/métodos , Insuficiência Renal Crônica/terapia , Índice de Gravidade de Doença , Fatores Socioeconômicos
3.
Pan Afr Med J ; 33: 148, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558945

RESUMO

Introduction: This study aimed to determine the factors that predict the incidence of burnout in nurses who work at the Public Hospital of Tangerang Regency in Banten, Indonesia. Methods: A cross-sectional design was used in this study. Participants were selected from eight inpatient wards at the Public Hospital of Tangerang Regency (hereinafter termed the hospital) by using a proportionate stratified random sampling method. A total of 133 nurses working in the inpatient wards were recruited. Data were collected using a questionnaire on nursing work schedule setting policy, daily log questionnaire for workload, competency scale and the Maslach Burnout Inventory scale for nurse burnout. Stepwise multiple linear regression was used to analyze the data. Results: For most respondents (54.1%), the nursing work scheduling policy was appropriate, whereas the average score of nurse workload was 80.42 with SD ± 0.49, and the competency of most nurses was appropriate (64.7%). The average score of nurse burnout was 17.48 with an SD ± 0.50. Work schedule policy and workload were significant burnout predictors, accounting for 87.2% of the variance (Adjusted R2=0.872) in burnout among nurses who worked in the hospital's inpatient wards. Conclusion: Nursing work schedule setting policy and workload were the main factors that led to burnout in nurses working in the inpatient wards. This issue can be overcome by regulating the workload in a balanced manner and applying appropriate policy in the nurse work schedule.


Assuntos
Esgotamento Profissional/epidemiologia , Competência Clínica , Recursos Humanos de Enfermagem no Hospital/psicologia , Carga de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Incidência , Indonésia , Modelos Lineares , Masculino , Inquéritos e Questionários , Tolerância ao Trabalho Programado/psicologia
4.
Tumour Biol ; 41(9): 1010428319878536, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31552812

RESUMO

Histone H2AX undergoes phosphorylation as an answer to DNA double-strand breaks, which in turn are part of the oncogenic procedure. The detection of gamma-H2AX can potentially serve as a biomarker for transformation of normal tissue to premalignant and consequently to malignant tissues. The aim of this study was to evaluate the clinical significance of gamma-H2AX expression in breast cancer. Gamma-H2AX expression in tissues from 110 breast cancer patients was analyzed by immunohistochemistry and correlated with clinicopathological variables. Greater tumor size, higher grade, and the number of affected lymph nodes are significantly associated with greater values of gamma-H2AX. In addition, gamma-H2AX differs significantly among patients' International Federation of Gynecology and Obstetrics stage. Higher values of estrogen receptor and progesterone receptor are significantly associated with lower gamma-H2AX values. In conclusion, a positive association between gamma-H2AX expression and infaust histopathological parameters was observed.


Assuntos
Biomarcadores Tumorais/biossíntese , Neoplasias da Mama Masculina/metabolismo , Neoplasias da Mama/metabolismo , Histonas/biossíntese , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/cirurgia , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Fosforilação , Receptores Estrogênicos , Receptores de Progesterona
5.
Vet Parasitol ; 273: 112-121, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31476666

RESUMO

Toxoplasma gondii is the parasite responsible for toxoplasmosis, a highly prevalent zoonosis that affects humans and warm-blooded animals. Faeces of infected cats can contain millions of T. gondii oocysts, which remain infectious in the environment for months. Sites repeatedly used by cats for defecation ('latrines') are recognised as hotspots of T. gondii soil contamination, but this contamination varies from one latrine to another. To understand this spatial heterogeneity, camera traps were deployed in 39 cat latrines on three dairy farms with high-density cat populations and programmed to record visits during sixteen 10-day sessions, rotating between three farms over a period of a year. Generalized Linear Mixed Models were used to test the effects of cat sexual maturity, latrine location and season on the number of cat faeces deposited and on the number of cats defecating per latrine, as determined from the analysis of 41,282 video recordings. Sexually immature cats defecated 6.60-fold (95% CI = [2.87-15.25]) more often in latrines located close to a feeding site than in other latrines. This pattern was also observed for mature males (odds ratio [OR] = 9.42, 95% CI = [3.29-26.91]), especially during winter, but not for mature females (OR = 1.77, 95% CI = [0.80-3.94]). The number of defecating cats was also 2.67-fold (95% CI = [1.66-4.30], P < 0.001) higher in latrines located close to a feeding point than in those located far from it, regardless of cat category and season. Visits by intermediate T. gondii hosts (micromammals, birds and others) were also recorded. Out of the 39 latrines, 30 (76.92%) were visited by at least one intermediate host during the study period, and some latrines were highly frequented (up to 8.74 visits/day on average). These results provide evidence that the location of food resources in dairy farms influences the latrine use pattern by cats. Highly frequented latrines can be of high risk of T. gondii infection for definitive and intermediate hosts.


Assuntos
Comportamento Animal/fisiologia , Doenças do Gato/transmissão , Solo/parasitologia , Toxoplasmose Animal/transmissão , Animais , Gatos , Indústria de Laticínios , Feminino , Interações Hospedeiro-Parasita , Modelos Lineares , Densidade Demográfica
6.
Medicine (Baltimore) ; 98(37): e17100, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517839

RESUMO

BACKGROUND: Tongue squamous cell carcinoma (TSCC) is one of the most common malignant tumors in head and neck, but its molecular mechanism is not clear. METHODS: Weighted gene co-expression network analysis (WGCNA) combining with gene differential expression analysis, survival analysis to screen key modules and hub genes related to the progress of TSCC. Gene Set Enrichment Analysis (GSEA) was used to identify biological pathways that might be involved. RESULTS: Weighted gene co-expression network was constructed based on dataset GSE34105. The blue module and turquoise module most related to the progress of TSCC were identified by the network. Gene Ontology (GO) enrichment analysis showed that 2 key modules were significantly enriched in apoptosis and immunity related biological processes and pathway. Network topology analysis, gene difference analysis and survival analysis were used to screen 9 hub genes (NOC2L, AIMP2, ANXA2, DIABLO, H2AFZ, MANBAL, PRDX6, SNX14, TIMM23). The expression of hub genes was significantly correlated with the prognosis of TSCC. GSEA showed that the high expression group of hub genes was mainly enriched in olfactory transduction, neuroactive ligand receptor interaction, nicotinate and nicotinamide metabolism, and the low expression group was mainly enriched in base excision repair, cysteine and methionine metabolism, oxidative phosphorylation. CONCLUSION: Two key modules and 9 hub genes screened by WGCNA were closely related to the occurrence and prognosis of TSCC. Hub genes can be used as biomarkers and potential therapeutic targets for the accurate diagnosis and treatment of TSCC in the future.


Assuntos
Perfilação da Expressão Gênica/métodos , Redes Reguladoras de Genes , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Neoplasias da Língua/genética , Perfilação da Expressão Gênica/estatística & dados numéricos , Humanos , Modelos Lineares , Prognóstico , Neoplasias da Língua/classificação
7.
J Appl Oral Sci ; 27: e20180722, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411266

RESUMO

OBJECTIVES: Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. METHODOLOGY: A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. RESULTS: The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans). CONCLUSION: The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population.


Assuntos
Determinação da Idade pelos Dentes/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Polpa Dentária/anatomia & histologia , Polpa Dentária/diagnóstico por imagem , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , Dente Canino/anatomia & histologia , Dente Canino/diagnóstico por imagem , Feminino , Humanos , Imagem Tridimensional , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto Jovem
8.
Stud Health Technol Inform ; 264: 1538-1539, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438220

RESUMO

In hospital management, health technology assessment techniques are being increasingly developed. This paper presents a comparison of the results obtained using two models for replacement priority value calculation applied to the Galliera hospital in Genoa (Italy). One the models was developed at the Galliera Hospital along the lines of the model by Fennigkoh and addresses four primary replacement issues: equipment service and support, equipment function, cost benefits and clinical efficacy, by a "yes-no" scheme. This model is compared with a model based on fuzzy logic. The comparison between the two models shows a conservative behaviour by the Galliera model, according to which 77.4% of the analysed instrumentation is maintained, whereas the classification by the fuzzy model allows for a better discrimination among the devices.


Assuntos
Lógica Fuzzy , Modelos Lineares , Equipamentos e Provisões , Itália
9.
Bone Joint J ; 101-B(8): 984-994, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31362557

RESUMO

AIMS: The aim of the Scaphoid Magnetic Resonance Imaging in Trauma (SMaRT) trial was to evaluate the clinical and cost implications of using immediate MRI in the acute management of patients with a suspected fracture of the scaphoid with negative radiographs. PATIENTS AND METHODS: Patients who presented to the emergency department (ED) with a suspected fracture of the scaphoid and negative radiographs were randomized to a control group, who did not undergo further imaging in the ED, or an intervention group, who had an MRI of the wrist as an additional test during the initial ED attendance. Most participants were male (52% control, 61% intervention), with a mean age of 36.2 years (18 to 73) in the control group and 38.2 years (20 to 71) in the intervention group. The primary outcome was total cost impact at three months post-recruitment. Secondary outcomes included total costs at six months, the assessment of clinical findings, diagnostic accuracy, and the participants' self-reported level of satisfaction. Differences in cost were estimated using generalized linear models with gamma errors. RESULTS: The mean cost up to three months post-recruitment per participant was £542.40 (sd £855.20, n = 65) for the control group and £368.40 (sd £338.60, n = 67) for the intervention group, leading to an estimated cost difference of £174 (95% confidence interval (CI) -£30 to £378; p = 0.094). The cost difference per participant increased to £266 (95% CI £3.30 to £528; p = 0.047) at six months. Overall, 6.2% of participants (4/65, control group) and 10.4% of participants (7/67, intervention group) had sustained a fracture of the scaphoid (p = 0.37). In addition, 7.7% of participants (5/65, control group) and 22.4% of participants (15/67, intervention group) had other fractures diagnosed (p = 0.019). The use of MRI was associated with higher diagnostic accuracy both in the diagnosis of a fracture of the scaphoid (100.0% vs 93.8%) and of any other fracture (98.5% vs 84.6%). CONCLUSION: The use of immediate MRI in the management of participants with a suspected fracture of the scaphoid and negative radiographs led to cost savings while improving the pathway's diagnostic accuracy and patient satisfaction. Cite this article: Bone Joint J 2019;101-B:984-994.


Assuntos
Análise Custo-Benefício , Fraturas Ósseas/diagnóstico por imagem , Custos de Cuidados de Saúde/estatística & dados numéricos , Imagem por Ressonância Magnética/economia , Osso Escafoide/lesões , Traumatismos do Punho/diagnóstico por imagem , Adolescente , Adulto , Idoso , Redução de Custos/estatística & dados numéricos , Serviço Hospitalar de Emergência , Feminino , Seguimentos , Fraturas Ósseas/economia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Estudos Prospectivos , Radiografia , Osso Escafoide/diagnóstico por imagem , Reino Unido , Traumatismos do Punho/economia , Adulto Jovem
10.
Rev Saude Publica ; 53: 61, 2019 Aug 01.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31390430

RESUMO

OBJECTIVE: To analyze the temporal trend of leprosy indicators in a hyperendemic state of Brazil, from 2001-2015. METHODS: This is a time-series study of leprosy indicators in the state of Maranhão, Northeastern region of Brazil. The study used data from the Brazilian National System of Reportable Diseases, for the period between 2001 and 2015. The following indicators were evaluated: (i) detection coefficient in the general population; (ii) detection coefficient in people under 15 years old; (iii) rate of cases with grade 2 physical disability in the diagnosis; (iv) rate of examined contacts, and (v) proportion of healing . The Prais-Winsten regression model was used for trend analysis. Analyses were performed for the state and by each health region. RESULTS: 77,697 leprosy cases were analyzed in the general population and 7,599 in individuals under 15 years old. The detection coefficient in the general population ranged from 80.7/100 thousand inhabitants in 2001 to 51.2/100 thousand inhabitants in 2015. The coefficient in the general population presented a downward trend (annual percentage variation [APV] = -2.98; 95%CI -4.15- -1.79). For the population under 15 years old, the rate was 24.9/100 thousand inhabitants in 2001, and 19.9/100 thousand inhabitants in 2015, with downward trend (APV = -3.07; 95%CI -4.95- -1.15). It was observed upward trend in rate of contacts examined (APV = 2.35; 95%CI 0.58-4.15) and rate of cases with grade 2 disability (APV = 2.19; 95%CI 0.23-4.19). Stationary trend was observed in the proportion of healing (APV = -0.10; 95%CI -0.50-0.30). Regional differences were found in the performance of the indicators. CONCLUSIONS: A downward trend for the detection coefficients in the general population and in individuals under 15 years old was found in Maranhão. Despite this result, the rates are still very high, demanding efforts from all spheres of public administration and health professionals to reduce the burden of the disease in the state.


Assuntos
Doenças Endêmicas/estatística & dados numéricos , Indicadores Básicos de Saúde , Hanseníase/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Feminino , Geografia , Humanos , Hanseníase/diagnóstico , Hanseníase/prevenção & controle , Hanseníase/transmissão , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Tempo , Adulto Jovem
11.
BMC Bioinformatics ; 20(1): 411, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31362713

RESUMO

BACKGROUND: Linear mixed-effects models (LMM) are a leading method in conducting genome-wide association studies (GWAS) but require residual maximum likelihood (REML) estimation of variance components, which is computationally demanding. Previous work has reduced the computational burden of variance component estimation by replacing direct matrix operations with iterative and stochastic methods and by employing loose tolerances to limit the number of iterations in the REML optimization procedure. Here, we introduce two novel algorithms, stochastic Lanczos derivative-free REML (SLDF_REML) and Lanczos first-order Monte Carlo REML (L_FOMC_REML), that exploit problem structure via the principle of Krylov subspace shift-invariance to speed computation beyond existing methods. Both novel algorithms only require a single round of computation involving iterative matrix operations, after which their respective objectives can be repeatedly evaluated using vector operations. Further, in contrast to existing stochastic methods, SLDF_REML can exploit precomputed genomic relatedness matrices (GRMs), when available, to further speed computation. RESULTS: Results of numerical experiments are congruent with theory and demonstrate that interpreted-language implementations of both algorithms match or exceed existing compiled-language software packages in speed, accuracy, and flexibility. CONCLUSIONS: Both the SLDF_REML and L_FOMC_REML algorithms outperform existing methods for REML estimation of variance components for LMM and are suitable for incorporation into existing GWAS LMM software implementations.


Assuntos
Algoritmos , Genômica , Funções Verossimilhança , Modelos Lineares , Método de Monte Carlo , Software , Processos Estocásticos , Fatores de Tempo
12.
BMC Bioinformatics ; 20(1): 410, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31362714

RESUMO

BACKGROUND: Antiretroviral drugs are a very effective therapy against HIV infection. However, the high mutation rate of HIV permits the emergence of variants that can be resistant to the drug treatment. Predicting drug resistance to previously unobserved variants is therefore very important for an optimum medical treatment. In this paper, we propose the use of weighted categorical kernel functions to predict drug resistance from virus sequence data. These kernel functions are very simple to implement and are able to take into account HIV data particularities, such as allele mixtures, and to weigh the different importance of each protein residue, as it is known that not all positions contribute equally to the resistance. RESULTS: We analyzed 21 drugs of four classes: protease inhibitors (PI), integrase inhibitors (INI), nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI). We compared two categorical kernel functions, Overlap and Jaccard, against two well-known noncategorical kernel functions (Linear and RBF) and Random Forest (RF). Weighted versions of these kernels were also considered, where the weights were obtained from the RF decrease in node impurity. The Jaccard kernel was the best method, either in its weighted or unweighted form, for 20 out of the 21 drugs. CONCLUSIONS: Results show that kernels that take into account both the categorical nature of the data and the presence of mixtures consistently result in the best prediction model. The advantage of including weights depended on the protein targeted by the drug. In the case of reverse transcriptase, weights based in the relative importance of each position clearly increased the prediction performance, while the improvement in the protease was much smaller. This seems to be related to the distribution of weights, as measured by the Gini index. All methods described, together with documentation and examples, are freely available at https://bitbucket.org/elies_ramon/catkern.


Assuntos
Algoritmos , Biologia Computacional/métodos , Farmacorresistência Viral/genética , HIV-1/genética , Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral/efeitos dos fármacos , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , HIV-1/isolamento & purificação , Humanos , Modelos Lineares , Análise de Componente Principal
13.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(4): 619-626, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31441263

RESUMO

Aiming at the problem of the influence of preloading force on its mechanical response in soft tissue compression experiments, an elimination method of preloading force based on linear loading region is proposed. Unconfined compression experiments under a variety of different preloading forces are performed. The influence of the preloading force on the parameters of constitutive model is analyzed. In the preload phase, the mechanical response of the soft tissue is taken as a linear model. The preloading force is eliminated by taking the preloading phase into account throughout the response process. According to five different preloading forces of the unconfined compression experiments, the elimination method is validated with two different constitutive models of soft tissue, and the error between the models obtained by the preloading force elimination method and the traditional method with the experimental results is compared. The results show that the error obtained by preloading force elimination method is significantly smaller than the traditional method. The preloading force elimination method can eliminate the influence of preloading force on mechanical response to a certain extent, and constitutive model parameters which are closer to the true properties of soft tissue can be obtained.


Assuntos
Modelos Biológicos , Pressão , Elasticidade , Modelos Lineares , Estresse Mecânico
14.
Rev Bras Epidemiol ; 22: e190046, 2019 Aug 26.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31460625

RESUMO

OBJECTIVE: To investigate the food consumption according to the degree of processing and associations with sociodemographic characteristics. METHODS: A cross-sectional study of the Estudo Pró-Saúde (Pro-Health Study), with 520 civil servants of university campuses, Rio de Janeiro, 2012-13. A food frequency questionnaire was used to classify food consumption: 1) in natura, minimally processed, food preparations based on these foods; 2) processed foods; 3) ultra-processed foods. The relative energy contribution of each group was determined, and a seemingly unrelated equations regression (SUR) regression model was used to estimate associations with sociodemographic characteristics. RESULTS: The in natura food group (1) contributed with 59% of the energy consumption and was directly associated with age [45-49 years (ß = 1.8 confidence interval of 95% - 95%CI -1.2; 4.8); 50-54 (ß = 1.5 95%CI -1.5; 4.5); 55-59 (ß = 2.9 95%CI -0.4; 6.3) and ≥ 60 (ß = 4.6 95%CI 1.1; 8.2)], compared to age ≤ 44. In contrast, the group of ultra-processed foods contributed 27% and were inversely associated with age [45-49 (ß = -1.7 95%CI -4.3; 0.9); 50-54 (ß = -1.8 95%CI -4.3; 0.9); 55-59 (ß = -4.9 95%CI -8.0; -2.0); ≥ 60 (ß = -4.5 95%CI -7.6; -1.5)]. Gender, income and schooling were not associated with food consumption. CONCLUSION: Younger adults had higher consumption of ultra-processed foods, indicating the need for interventions mainly in this age group. The absence of association with other sociodemographic characteristics may be due to the influence of contextual factors.


Assuntos
Inquéritos sobre Dietas/estatística & dados numéricos , Ingestão de Energia , Comportamento Alimentar , Manipulação de Alimentos/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Escolaridade , Feminino , Humanos , Renda , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Valores de Referência
15.
Medicine (Baltimore) ; 98(35): e16866, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464915

RESUMO

This study evaluated whether the interval from the first clinic visit until the start of antiretroviral treatment (ART) was correlated with common parameters of immunological recovery among patients with early HIV infection (EHI).We reviewed the medical records of patients with EHI who started ART using integrase strand-transfer inhibitors (ISTIs) within the first 6 months after diagnosis. Simple linear regression analyses were performed to determine whether the interval from the first visit to the start of ART was correlated with 1-year changes in CD4+ cell count, CD8+ cell count, CD4+ percentage, and CD4+/CD8+ ratio.Fifty-three patients with probable or definite EHI started ART using ISTIs between April 2014 and August 2016. Forty-nine patients completed 1 year of follow-up, including 48 men. The routes of HIV transmission were 1 case of needle sharing, 5 cases of heterosexual activity, and 43 cases of men who had sex with men. None of the immunological recovery parameters were correlated with time to the start of ART (CD4+ cell count: R = .12, P = .42; CD8+ cell count: R = .107, P = .5; CD4+ percentage: R = .14, P = .34; CD4+/CD8+ ratio: R = .23, P = .14). Furthermore, subgroup sensitivity analyses failed to detect significant correlations based on definite or probable diagnoses, treatment using elvitegravir or dolutegravir, or the time from HIV diagnosis to ART initiation.This series of EHI cases indicate that using ART with ISTI-based regimens is efficacious and well-tolerated. However, earlier initiation of treatment was not significantly correlated with common parameters of immunological recovery.


Assuntos
Infecções por HIV/tratamento farmacológico , Inibidores de Integrase de HIV/uso terapêutico , Adulto , Contagem de Linfócito CD4 , Relação CD4-CD8 , Feminino , Infecções por HIV/imunologia , Humanos , Modelos Lineares , Contagem de Linfócitos , Masculino , Fatores de Tempo , Resultado do Tratamento
16.
J Sports Med Phys Fitness ; 59(8): 1311-1318, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31373189

RESUMO

BACKGROUND: The purpose of this study was to examine the relationship between select physiological variables and sprint triathlon performance. METHODS: Moderately trained male triathletes (N.=15) performed two graded maximal exercise tests, on a cycle ergometer and a treadmill. Anaerobic capacity was evaluated, on a cycle ergometer and a treadmill. Within two weeks before or after the testing, all triathletes participated in a sprint triathlon race (750 m sea swim, 20 km cycle, 5 km run). RESULTS: The results showed that significant correlations exist between VO2max during cycling (r=-0.811, P<0.05) or running (r=-0.757, P<0.05) and overall triathlon performance. Stepwise multiple linear regression analysis, with triathlon performance as the dependent variable and the physiological measures during running as the independent variables, showed that VO2max (mL.min-1.kg-1), Time_CF, CHO_rate @ VT and % body fat yielded the best prediction of performance (R2=0,912). When only the physiological variables from cycling were included into the model, the results showed that VO2max (mL.min-1), VO2max (mL.min-1.kg-1) and PFmax (rpm) explained 88% of the variation in sprint triathlon performance. CONCLUSIONS: Our data indicate that overall race time for moderately trained triathletes, competing over the sprint distance can be accurately predicted from maximal laboratory tests.


Assuntos
Ciclismo/fisiologia , Corrida/fisiologia , Natação/fisiologia , Tecido Adiposo/fisiologia , Adulto , Desempenho Atlético/fisiologia , Teste de Esforço/métodos , Humanos , Modelos Lineares , Masculino , Consumo de Oxigênio/fisiologia , Fatores de Tempo
18.
Environ Monit Assess ; 191(7): 472, 2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31256242

RESUMO

To improve accuracy and efficiency of monitoring remediated sites, the current study proposed the use of bivariate linear mixed modelling and subsequent hypothesis testing to determine significant change in contaminant concentrations over time. The modelling method integrated soil heavy metal (arsenic-As, lead-Pb and zinc-Zn) concentrations obtained from Bicentennial Park, Sydney, Australia, in the years 1990 (n = 144) and 2015 (n = 60), alongside potential influencing factors as predictor variables. Following variable selection, significant predictors included As (1990)-plan curvature, land cover change; As (2015)-multi-resolution ridge top flatness (MRRTF); Pb (1990)-elevation, MRRTF, type of nearest road; Pb (2015)-land cover change; Zn (1990)-distance to the nearest road and road type; and for Zn (2015)-aspect and land cover change. Model quality statistics (standardised squared prediction error; SSPE) indicated relatively good estimates of the prediction variance (mean ~ 1.0 for all metals, median = 0.512 for As (1990), 0.420 for As (2015), 0.417 for Pb (1990), 0.388 for Pb (2015), 0.342 for Zn (1990) and 0.263 for Zn (2015)), however Lin's concordance correlation coefficient indicated poor prediction of point estimates (LCCC = 0.263 for As (1990), 0.414 for As (2015), 0.250 for Pb (1990), 0.166 for Pb (2015), 0.233 for Zn (1990) and 0.408 for Zn (2015)). Pb in 1990 exceeded the Australian guide value of 600 mg kg-1 in small, isolated areas of the park, and by 2015, these 'hotspots' had significantly diminished (P < 0.05). Concentrations of As were low in both 1990 and 2015, not exceeding the 300 mg kg-1 guide; yet, in 2015, As had significantly increased in the south of the study area (P < 0.2). Zn concentrations in 1990 were elevated but did not exceed the guide value of 30,000 mg kg-1. Overall, the models exhibited good estimation of prediction variance and therefore are suitable for hypothesis testing; however, they exhibited poor prediction quality at times. Despite this, bivariate linear mixed modelling is worth exploring as it provides an advantage over modelling single time points and can assist with tracking potential contaminant sources before they cause harm.


Assuntos
Monitoramento Ambiental/métodos , Modelos Lineares , Metais Pesados/análise , Poluentes do Solo/análise , Arsênico/análise , Austrália , Chumbo , Análise Espacial , Instalações de Eliminação de Resíduos , Zinco/análise
19.
Rev Bras Enferm ; 72(3): 600-608, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269122

RESUMO

OBJECTIVE: To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room. METHOD: Randomized and parallel trial study, with 120 patients randomized patients in an experimental group - menthol measurements (n=59) and control group - measures without menthol (n = 61). RESULTS: There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package. CONCLUSION: There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.


Assuntos
Mentol/farmacologia , Sede/efeitos dos fármacos , Adulto , Antipruriginosos/farmacologia , Antipruriginosos/uso terapêutico , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Brasil , Feminino , Humanos , Modelos Lineares , Masculino , Mentol/uso terapêutico , Pessoa de Meia-Idade , Obesidade/cirurgia , Estatísticas não Paramétricas
20.
Health Qual Life Outcomes ; 17(1): 115, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266501

RESUMO

BACKGROUND: Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. METHODS: Two cross-sectional studies were conducted in 2009-2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. RESULTS: Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not (P <  0.001). HL survivors showed increasing fatigue level with age while in NHL survivors mean fatigue level remained constant until age 70 and increased beyond. HL survivors showed fatigue changes with age higher than those of the general population with health disorders while NHL survivors were in between those of the general population with and without health disorders. CONCLUSIONS: Among lymphoma survivors progressive increase of fatigue level with time since treatment completion is a distinctive feature of HL. Our data suggest that changes in fatigue level are unlikely to only depend on treatment complications and health disorders. Investigations should be undertaken to identify which factors including biologic mechanisms could explain why a substantial proportion of survivors develop high level of fatigue.


Assuntos
Sobreviventes de Câncer , Fadiga/etiologia , Doença de Hodgkin/complicações , Linfoma não Hodgkin/complicações , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Doença de Hodgkin/psicologia , Humanos , Modelos Lineares , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
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