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3.
Mayo Clin Proc ; 96(3): 708-719, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33673922

RESUMO

Multiple system atrophy (MSA) is a neurodegenerative disorder primarily characterized by autonomic failure plus parkinsonism or cerebellar ataxia. The diagnosis may be challenging and is usually made at a tertiary care center. The long-term management issues are equally challenging and frequently require collaboration with the patient's local care providers. Whereas there is currently no cure for MSA, treatment focuses on the most problematic symptoms experienced by the patient. Autonomic symptoms may include severe orthostatic hypotension with syncope, urinary symptoms culminating in incontinence, constipation, anhidrosis, and erectile dysfunction. Motor symptoms include parkinsonism, cerebellar ataxia, and falls. Although certain motor symptoms may respond partially to medications, some of these medications may exacerbate autonomic problems. In this manuscript, we seek to bridge the gap between tertiary care providers and the patient's local care providers to provide multidisciplinary care to the MSA patient. Patients are often best served by management of their chronic and evolving complex problems with a team approach involving their primary care providers and subspecialists. Treatment guidelines typically list myriad therapeutic options without clarifying the most efficacious and simplest treatment strategies. Herein, we provide a guideline based on what has worked in our MSA clinic, a clinic designed to provide care throughout the disease course with subspecialty integration with the goal of empowering a partnership with the patient's home primary care providers.


Assuntos
Pesquisa Interdisciplinar , Atrofia de Múltiplos Sistemas/diagnóstico , Atrofia de Múltiplos Sistemas/tratamento farmacológico , Guias de Prática Clínica como Assunto , Sistema Nervoso Autônomo/fisiopatologia , Progressão da Doença , Humanos , Índice de Gravidade de Doença , Vasodilatadores/uso terapêutico
4.
PLoS Comput Biol ; 17(2): e1008685, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33534793

RESUMO

The SARS-CoV-2 pandemic of 2020 has mobilised scientists around the globe to research all aspects of the coronavirus virus and its infection. For fruitful and rapid investigation of viral pathomechanisms, a collaborative and interdisciplinary approach is required. Therefore, we have developed ViralLink: a systems biology workflow which reconstructs and analyses networks representing the effect of viruses on intracellular signalling. These networks trace the flow of signal from intracellular viral proteins through their human binding proteins and downstream signalling pathways, ending with transcription factors regulating genes differentially expressed upon viral exposure. In this way, the workflow provides a mechanistic insight from previously identified knowledge of virally infected cells. By default, the workflow is set up to analyse the intracellular effects of SARS-CoV-2, requiring only transcriptomics counts data as input from the user: thus, encouraging and enabling rapid multidisciplinary research. However, the wide-ranging applicability and modularity of the workflow facilitates customisation of viral context, a priori interactions and analysis methods. Through a case study of SARS-CoV-2 infected bronchial/tracheal epithelial cells, we evidence the functionality of the workflow and its ability to identify key pathways and proteins in the cellular response to infection. The application of ViralLink to different viral infections in a context specific manner using different available transcriptomics datasets will uncover key mechanisms in viral pathogenesis.


Assuntos
/metabolismo , Biologia Computacional/métodos , Regulação Viral da Expressão Gênica , Transdução de Sinais , Algoritmos , Brônquios/virologia , Análise por Conglomerados , Perfilação da Expressão Gênica , Interações Hospedeiro-Patógeno , Humanos , Pesquisa Interdisciplinar , Pulmão/virologia , Modelos Estatísticos , Biologia de Sistemas , Transcriptoma , Fluxo de Trabalho
5.
Lancet Psychiatry ; 8(2): 87, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33485416
6.
Methods Mol Biol ; 2194: 187-221, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32926368

RESUMO

Highly collaborative scientists are often called on to extend their expertise to different types of projects and to expand the scope and scale of projects well beyond their previous experience. For a large-scale project involving "big data" to be successful, several different aspects of the research plan need to be developed and tested, which include but are not limited to the experimental design, sample collection, sample preparation, metadata recording, technical capability, data acquisition, approaches for data analysis, methods for integration of different data types, recruitment of additional expertise as needed to guide the project, and strategies for clear communication throughout the project. To capture this process, we describe an example project in proteogenomics that built on our collective expertise and experience. Key steps included definition of hypotheses, identification of an appropriate clinical cohort, pilot projects to assess feasibility, refinement of experimental designs, and extensive discussions involving the research team throughout the process. The goal of this chapter is to provide the reader with a set of guidelines to support development of other large-scale multiomics projects.


Assuntos
Bioestatística/métodos , Pesquisa Interdisciplinar/métodos , Proteogenômica/métodos , Big Data , Estudos de Coortes , Expressão Gênica , Genômica/métodos , Humanos , Projetos Piloto , Proteômica/métodos , Projetos de Pesquisa
8.
JAMA Netw Open ; 3(12): e2029917, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315114

RESUMO

Importance: Patients with autoimmune disease and lung cancer pose a multidisciplinary treatment challenge, particularly with the advent of immunotherapy. However, the association between autoimmune disease and lung cancer survival is largely unknown. Objective: To determine the association between autoimmune disease and lung cancer survival. Design, Setting, and Participants: Retrospective cohort study between 2003 and 2019 at a single academic medical center (Northwestern University). A query of the Northwestern Medicine Enterprise Data Warehouse identified 349 patients with lung cancer and several autoimmune diseases. Types of lung cancers included small cell, adenocarcinoma, squamous cell carcinoma, non-small cell not otherwise specified, and large cell carcinoma. Autoimmune diseases included rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, mixed connective tissue disease, myositis, and Sjögren syndrome. Inclusion criteria were biopsy-confirmed lung cancer, autoimmune diagnosis confirmed by a rheumatologist, and death or an encounter listed in the electronic medical record within 2 years of study end. A control group of patients with biopsy-proven lung cancer but without autoimmune disease was identified. Data analysis was conducted from March to July 2020. Exposure: Presence of autoimmune disease. Main Outcomes and Measures: Overall survival and progression-free survival in patients with autoimmune disease. The hypothesis was that patients with autoimmune disease would have worse progression-free survival and overall survival compared with patients in the control group. Results: Of the original 349 patients, 177 met inclusion criteria. Mean (SD) age at lung cancer diagnosis was 67.0 (10.0) years and 136 (76.8%) were women. Most common autoimmune diseases were rheumatoid arthritis (97 [54.8%]), systemic sclerosis (43 [24.3%]), and systemic lupus erythematous (15 [8.5%]). Most common lung cancers were adenocarcinoma (99 [55.9%]), squamous cell carcinoma (29 [16.4%]), and small cell lung cancer (17 [9.6%]). A total of 219 patients (mean [SD] age at diagnosis, 65.9 [4.1] years; 173 [79.0%]) were identified as having lung cancer without autoimmune disease and included in the control cohort. Compared with patients in the control group, patients with autoimmune disease experienced no difference in overall survival (log-rank P = .69). A total of 126 patients (69.5%) with autoimmune disease received standard of care vs 213 patients (97.3%) in the control group (P < .001). No individual autoimmune disease was associated with worse prognosis, even among patients with underlying interstitial lung disease. Conclusions and Relevance: Compared with institutional controls, patients with autoimmune disease experienced no difference in survival despite the fact that fewer patients in this group received standard-of-care treatment. No individual autoimmune disease was associated with worse prognosis. Future multicenter prospective trials are needed to further evaluate autoimmune disease and lung cancer survival.


Assuntos
Neoplasias Pulmonares , Pulmão/patologia , Idoso , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/terapia , Autoimunidade , Biópsia/métodos , Biópsia/estatística & dados numéricos , Comorbidade , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Pesquisa Interdisciplinar , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Estadiamento de Neoplasias , Noroeste dos Estados Unidos/epidemiologia , Prognóstico , Estudos Retrospectivos , Escleroderma Sistêmico/epidemiologia , Escleroderma Sistêmico/fisiopatologia , Escleroderma Sistêmico/terapia , Padrão de Cuidado/organização & administração , Padrão de Cuidado/estatística & dados numéricos , Análise de Sobrevida
10.
PLoS One ; 15(12): e0243827, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326464

RESUMO

Game-based learning and self-regulated learning have long been valued as effective approaches to language education. However, little research has been conducted to investigate their integration, namely, game-based self-regulated language learning (GBSRLL). This study aims to conceptualise GBSRLL based on the combination of theoretical analysis, thematic evolution analysis, and social network analysis on the research articles in the fields of game-based language learning and self-regulated language learning. The results show that GBSRLL is a new interdisciplinary field emerging since the period from 2018 to 2019. Self-regulated learning strategies that can be performed in GBSRLL, the effects of GBSRLL on learners' affective states, and the features in GBSRLL were the prominent research topics in this field. Its theoretical foundation centres on the positive correlations between learner motivation, self-efficacy, and autonomy and the implementation of game-based learning and self-regulated learning. It is feasible to conduct GBSRLL due to the strong supportiveness of game mechanics for various phases and strategies of self-regulated learning. More contributions to this new interdisciplinary field are called for, especially from the aspects of the long-term effects of GBSRLL on academic performance and the useful tools and technologies for implementing GBSRLL.


Assuntos
Bibliometria , Teoria do Jogo , Idioma , Aprendizagem , Modelos Teóricos , Autoeficácia , Humanos , Pesquisa Interdisciplinar , Motivação
11.
An Real Acad Farm ; 86(4): 281-286, oct.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-199662

RESUMO

La relación entre la Real Academia Nacional de Farmacia y la Sociedad Española de Bioquímica y Biología Molecular ha sido, desde la fundación de la Sociedad, un claro exponente del compromiso mantenido entre un número elevado de personas al pertenecer simultáneamente a ambas, en algunos casos además desempeñando cargos de relevancia y responsabilidad. Como muestra se citan algunas de las personas más representativas. La relación entre ambas instituciones se ha visto recientemente reforzada y consolidada con la firma el 17 de noviembre de 2020 de un Convenio de Colaboración entre ambas. Este hecho debe estimular a investigadoras e investigadores jóvenes y de gran valía -ya miembros de las dos instituciones- a intervenir en las actividades promovidas por ambas. Estrechar lazos en iniciativas e intereses comunes será sin duda enormemente beneficioso para las dos instituciones


The relationship between the Royal National Academy of Pharmacy and the Spanish Society of Biochemistry and Molecular Biology has been, since the foundation of the Society, a clear exponent of the commitment that is maintained among a large number of people for simultaneously belonging to both, in some cases also occupying positions of relevance and responsibility. Some of the most representative people are cited. This relationship has recently been strengthened and consolidated with the signing on November 17, 2020 of a Collaboration Agreement between both institutions. This fact should stimulate young and valuable researchers - and members of the two institutions - to participate in the activities promoted by both. Undoubtedly, closing ties in initiatives and common interests will be enormously beneficial for the two institutions


Assuntos
História do Século XVIII , História do Século XX , História do Século XXI , Academias e Institutos/história , Sociedades/história , Bioquímica/história , Biologia Molecular/história , Pesquisa Biomédica/história , Comunicação Interdisciplinar , Pesquisa Interdisciplinar/história
12.
Artigo em Inglês | MEDLINE | ID: mdl-33121161

RESUMO

Although the first coronavirus disease 2019 (COVID-19) wave has peaked with the second wave underway, the world is still struggling to manage potential systemic risks and unpredictability of the pandemic. A particular challenge is the "superspreading" of the virus, which starts abruptly, is difficult to predict, and can quickly escalate into medical and socio-economic emergencies that contribute to long-lasting crises challenging our current ways of life. In these uncertain times, organizations and societies worldwide are faced with the need to develop appropriate strategies and intervention portfolios that require fast understanding of the complex interdependencies in our world and rapid, flexible action to contain the spread of the virus as quickly as possible, thus preventing further disastrous consequences of the pandemic. We integrate perspectives from systems sciences, epidemiology, biology, social networks, and organizational research in the context of the superspreading phenomenon to understand the complex system of COVID-19 pandemic and develop suggestions for interventions aimed at rapid responses.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Incerteza , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Pesquisa Interdisciplinar , Relações Interprofissionais , Equipe de Assistência ao Paciente , Pneumonia Viral/prevenção & controle
15.
Jpn J Clin Oncol ; 50(11): 1282-1289, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-32761084

RESUMO

BACKGROUND: the proportion of adolescent and young adult cancer patients is relatively small, but they require age-specific support. We conducted a survey on the present status of support for adolescent and young adult cancer patients in the Japanese Association of Clinical Cancer Centers. METHODS: in December 2018, the primary questionnaires were sent to 32 hospitals of Japanese Association of Clinical Cancer Centers regarding support for adolescent and young adult cancer patients. Secondary questionnaires were sent to doctors, nurses and medical social workers in 24 hospitals for the implementation rates of information provision and consultation on 17 unmet needs identified in the study by the Ministry of Health, Labour and Welfare, Japan. RESULTS: there were marked differences in support for adolescent and young adult cancer patients among hospitals. Only one hospital facilitated an adolescent and young adult department and ward. Thirteen hospitals cooperated with the paediatric cancer designated hospitals. A learning support for high school-aged patients was provided in 15 hospitals. Adolescent and young adult support teams were active in seven hospitals and staff training sessions were held in eight hospitals. Many hospitals had referrals for fertility preservation. The rates of information provision and consultation for more than 70% of adolescent and young adult patients showed statistically significant differences among the medical professions in most of the 17 items. CONCLUSIONS: support systems and activities for adolescent and young adult cancer patients vary extremely across hospitals. Information provision and consultation for unmet needs are still insufficient. Therefore, sharing information and experiences is required to enhance the support for adolescent and young adult cancer patients.


Assuntos
Hospitais , Neoplasias/psicologia , Apoio Social , Adolescente , Criança , Feminino , Preservação da Fertilidade , Humanos , Pesquisa Interdisciplinar , Japão , Masculino , Inquéritos e Questionários , Adulto Jovem
18.
BMC Int Health Hum Rights ; 20(1): 22, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859194

RESUMO

Notwithstanding COVID-19, non-communicable diseases (NCDs) will be the leading cause of death in every region in the world by 2030. This contribution, which forms an introduction to our collection of articles in this journal, identifies elements for a transdisciplinary research agenda between law, public health, health economics and international relations aimed at designing concrete interventions to curb the NCD pandemic, both globally and domestically.


Assuntos
Pesquisa Interdisciplinar/organização & administração , Doenças não Transmissíveis/prevenção & controle , Pandemias/prevenção & controle , Causas de Morte/tendências , Saúde Global/estatística & dados numéricos , Humanos , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/mortalidade
19.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47689

RESUMO

Portal da Rede Sirius, Rede de Bibliotecas UERJ. Apresenta uma lista de referências bibliográficas reunidas pela Rede Sirius - Rede de Bibliotecas UERJ - para dar visibilidade à produção científica institucional sobre o novo coronavírus (COVID-19). A lista está subdividida por áreas, tendo em vista que o tema é abordado por vários campos disciplinares: Biomédica, Ciências Sociais, Educação e Humanidades, Tecnologia e Ciências, e vídeos ao final. Trata-se de um produto oriundo do projeto "Visibilidade da produção científica da UERJ sobre coronavírus (COVID-19)”.


Assuntos
Comunicação e Divulgação Científica , Publicações Científicas e Técnicas , Betacoronavirus , Infecções por Coronavirus , Pesquisa Interdisciplinar , Pandemias
20.
PLoS One ; 15(7): e0236419, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32716982

RESUMO

CONTEXT: Opioid related deaths are at epidemic levels in many developed nations globally. Concerns about the contribution of prescribed opioids, and particularly high-dose opioids, continue to mount as do initiatives to reduce prescribing. Evidence around opioid tapering, which can be challenging and potentially hazardous, is not well developed. A recent national guideline has recognized this and recommended referral to multidisciplinary care for challenging cases of opioid tapering. However, multidisciplinary care for opioid tapering is not well understood or defined. OBJECTIVE: Identify the existing literature on any multidisciplinary care programs that evaluate impact on opioid use, synthesize how these programs work and clarify whom they benefit. STUDY DESIGN: Systematic rapid realist review. DATASET: Bibliographic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library), grey literature, reference hand search and formal expert consultation. RESULTS: 95 studies were identified. 75% of the programs were from the United States and the majority (n = 62) were published after 2000. A minority (n = 23) of programs reported on >12 month opioid use outcomes. There were three necessary but insufficient mechanisms common to all programs: pain relief, behavior change and active medication management. Programs that did not include a combination of all three mechanisms did not result in opioid dose reductions. A concerning 20-40% of subjects resumed opioid use within one year of program completion. CONCLUSIONS: Providing alternative analgesia is insufficient for reducing opioid doses. Even high quality primary care multidisciplinary care programs do not reduce prescribed opioid use unless there is active medication management accomplished by changing the primary opioid prescriber. Rates of return to use of opioids from these programs are very concerning in the current context of a highly potent and lethal street drug supply. This contextual factor may be powerful enough to undermine the modest benefits of opioid dose reduction via multidisciplinary care.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor Crônica/tratamento farmacológico , Pesquisa Interdisciplinar , Assistência ao Paciente , Comportamento , Relação Dose-Resposta a Droga , Humanos , Avaliação de Resultados em Cuidados de Saúde , Manejo da Dor , Atenção Primária à Saúde , Atenção Terciária à Saúde , Fatores de Tempo
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