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1.
Comput Math Methods Med ; 2020: 9017157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029196

RESUMO

This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of the susceptible-exposed-infectious-removed model. Initially, a model verification is carried out calibrating system parameters with data from China, Italy, Iran, and Brazil. Results show the model capability to predict infectious evolution. Afterward, numerical simulations are performed in order to analyze different scenarios of COVID-19 in Brazil. Results show the importance of the governmental and individual actions to control the number and the period of the critical situations related to the pandemic.


Assuntos
Simulação por Computador , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Algoritmos , Betacoronavirus , Brasil/epidemiologia , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Itália/epidemiologia , Modelos Teóricos , Pandemias , Informática em Saúde Pública , Reprodutibilidade dos Testes
3.
Nat Commun ; 11(1): 4947, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009392

RESUMO

Pseudomonas syringae is a Gram-negative and model pathogenic bacterium that causes plant diseases worldwide. Here, we set out to identify binding motifs for all 301 annotated transcription factors (TFs) of P. syringae using HT-SELEX. We successfully identify binding motifs for 100 TFs. We map functional interactions between the TFs and their targets in virulence-associated pathways, and validate many of these interactions and functions using additional methods such as ChIP-seq, electrophoretic mobility shift assay (EMSA), RT-qPCR, and reporter assays. Our work identifies 25 virulence-associated master regulators, 14 of which had not been characterized as TFs before.


Assuntos
Proteínas de Bactérias/metabolismo , DNA Bacteriano/metabolismo , Pseudomonas syringae/metabolismo , Fatores de Transcrição/metabolismo , Sistemas de Secreção Bacterianos , Sítios de Ligação , Matrizes de Pontuação de Posição Específica , Ligação Proteica , Multimerização Proteica , Pseudomonas syringae/patogenicidade , Reprodutibilidade dos Testes , Técnica de Seleção de Aptâmeros , Virulência
4.
Nat Commun ; 11(1): 4946, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009409

RESUMO

Immune-related adverse events (irAEs), caused by anti-PD-1/PD-L1 antibodies, can lead to fulminant and even fatal consequences and thus require early detection and aggressive management. However, a comprehensive approach to identify biomarkers of irAE is lacking. Here, we utilize a strategy that combines pharmacovigilance data and omics data, and evaluate associations between multi-omics factors and irAE reporting odds ratio across different cancer types. We identify a bivariate regression model of LCP1 and ADPGK that can accurately predict irAE. We further validate LCP1 and ADPGK as biomarkers in an independent patient-level cohort. Our approach provides a method for identifying potential biomarkers of irAE in cancer immunotherapy using both pharmacovigilance data and multi-omics data.


Assuntos
Genômica , Imunoterapia/efeitos adversos , Neoplasias/imunologia , Neoplasias/terapia , Biomarcadores Tumorais/metabolismo , Estudos de Coortes , Análise Fatorial , Humanos , Proteínas dos Microfilamentos/metabolismo , Reprodutibilidade dos Testes
5.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026198

RESUMO

We report the brief experience of the Nephrology Center located in a "no-COVID" Hospital in Massa Marittima. We describe the actions taken to prevent the transmission of the virus SARS-CoV-2 among hemodialysis patients and healthcare workers and the methods for diagnosing COVID-19, with particular attention to serological tests and nasopharyngeal swabs in asymptomatic subjects. The detection of IgM and IgG antibodies through the serological test performed on 34 patients, all negative for nasopharyngeal swabs, showed positivity in 41,18% of cases. These have been classified as false positives following repeated negative nasopharyngeal swabs, the evaluation of clinical and epidemiological history and of clinical manifestations and, finally, a second serological test performed after 18 days, which resulted negative for all patients. Interpreting serological tests is not easy; the strategies for diagnosis should include clinical and epidemiological history and clinical manifestations, as well as the results of confirmation tests and the evaluation over a precise observation period. Otherwise, there is a risk of considering as protected by antibodies subjects that are in fact false positives.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Pandemias , Pneumonia Viral/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Betacoronavirus/isolamento & purificação , Reações Falso-Positivas , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Itália , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
6.
Prog Orthod ; 21(1): 38, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33043408

RESUMO

BACKGROUND AND AIM: Determination of skeletal maturity and bone age from cervical vertebrae has been well documented. Most methods described use subjective evaluation of morphological characteristics of cervical vertebrae and may be prone to variability and error. A few objective methods have also been developed, specific for certain populations and genders. The aim of this study was to establish and validate an objective method to determine cervical vertebral bone age from lateral cephalometric radiographs, for Asian South Indian patients of both genders. METHODS: Ninety boys and 90 girls between 9 and 15 years of age were recruited, and their lateral cephalograms were taken. Using measurements made from the third and fourth cervical vertebrae, a formula to determine cervical vertebral bone age was derived using stepwise regression analysis. To validate the formula, a separate sample of 30 boys and 30 girls was chosen, and hand-wrist radiographs and lateral cephalograms were obtained. Cervical vertebral bone age (CVBA) was determined by applying the formula derived. Bone age was also calculated using the Tanner-Whitehouse 3 method. The bone ages determined by both methods were compared to each other and chronological age, using one-way ANOVA, Tukey's post hoc analysis, and Pearson's correlation coefficient. RESULTS: The formulae derived in the current study to determine CVBA differed for both genders. No statistically significant difference was found between CVBA, bone age derived by the Tanner-Whitehouse 3 method, and chronological age for both boys (p value = 0.425) and girls (p value = 0.995). A moderate to strong positive correlation was found between CVBA, bone age, and chronological age. CONCLUSION: The formulae derived in this study were validated and are reliable for objectively determining cervical vertebral bone age and skeletal maturation from lateral cephalograms for Asian South Indian patients of both genders.


Assuntos
Determinação da Idade pelo Esqueleto , Vértebras Cervicais , Adolescente , Cefalometria , Vértebras Cervicais/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Análise de Regressão , Reprodutibilidade dos Testes
7.
Einstein (Sao Paulo) ; 18: eAO5539, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053019

RESUMO

OBJECTIVE: To translate and make cross-cultural adaptation of NECPAL CCOMS-ICO© tool to Portuguese, and to analyze its semantic validity. METHODS: A methodological research about NECPAL CCOMS-ICO© tool cross-cultural adaptation, translated from Spanish into Portuguese and measurement of semantic validity. The cross-cultural adaptation process was conducted according to Beaton recommendations, including translation, translation synthesis, back-translation, and analysis of semantic, idiomatic, conceptual, and cultural equivalence of translated and back-translated tool versions, resulting in a pre-final version, which was submitted to a pre-test (n=35). Contend Validity Index was calculated to analyze semantic validity. RESULTS: Cross-cultural adaptation process allowed us to prepare the final version of this tool, which was named NECPAL-BR. Collected data from pre-testing step enabled the analysis of semantic validity. The Content Validity Index observed at this step was 0.94. CONCLUSION: The semantic validity of the tool in its Portuguese version was confirmed; therefore, it may assist in screening chronic progressive disease patients, aiming to provide early palliative care. It may also be used to develop clinical and team performance indicators, and be employed as a care management tool designed to optimize resources.


Assuntos
Comparação Transcultural , Cuidados Paliativos/normas , Semântica , Inquéritos e Questionários/normas , Humanos , Portugal , Reprodutibilidade dos Testes , Traduções
8.
Rev Bras Epidemiol ; 23: e200100, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053093

RESUMO

OBJECTIVE: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. METHODS: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. RESULTS: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. CONCLUSION: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.


Assuntos
Comparação Transcultural , Inovação Organizacional , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/normas , Brasil , Estudos Transversais , Humanos , Portugal , Reprodutibilidade dos Testes
9.
J Environ Qual ; 49(5): 1073-1080, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33016437

RESUMO

Non-steady-state (NSS) chamber techniques have been used for decades to measure nitrous oxide (N2 O) fluxes from agricultural soils. These techniques are widely used because they are relatively inexpensive, easy to adopt, versatile, and adaptable to varying conditions. Much of our current understanding of the drivers of N2 O emissions is based on studies using NSS chambers. These chamber techniques require decisions regarding multiple methodological aspects (e.g., chamber materials and geometry, deployment, sample analysis, and data and statistical analysis), each of which may significantly affect the results. Variation in methodological details can lead to challenges in comparing results between studies and assessment of reliability and uncertainty. Therefore, the New Zealand Government, in support of the objectives of the Livestock Research Group of the Global Research Alliance on Agricultural Greenhouse Gases (GRA), funded two international projects to, first, develop standardized guidelines on the use of NSS chamber techniques and, second, refine them based on the most up to date knowledge and methods. This introductory paper summarizes a collection of papers that represent the revised guidelines. Each article summarizes existing knowledge and provides guidance and minimum requirements on chamber design, deployment, sample collection, storage and analysis, automated chambers, flux calculations, statistical analysis, emission factor estimation and data reporting, modeling, and "gap-filling" approaches. The minimum requirements are not meant to be highly prescriptive but instead provide researchers with clear direction on best practices and factors that need to be considered. Health and safety considerations of NSS chamber techniques are also provided with this introductory paper.


Assuntos
Óxido Nitroso/análise , Projetos de Pesquisa , Nova Zelândia , Reprodutibilidade dos Testes , Solo
10.
J Environ Qual ; 49(5): 1156-1167, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33016448

RESUMO

Static chambers are often used for measuring nitrous oxide (N2 O) fluxes from soils, but statistical analysis of chamber data is challenged by the inherently heterogeneous nature of N2 O fluxes. Because N2 O chamber measurements are commonly used to assess N2 O mitigation strategies or to determine country-specific emission factors (EFs) for calculating national greenhouse gas inventories, it is important that statistical analysis of the data is sound and that EFs are robustly estimated. This paper is one of a series of articles that provide guidance on different aspects of N2 O chamber methodologies. Here, we discuss the challenges associated with statistical analysis of heterogeneous data, by summarizing statistical approaches used in recent publications and providing guidance on assessing normality and options for transforming data that follow a non-normal distribution. We also recommend minimum requirements for reporting of experimental and metadata of N2 O studies to ensure that the robustness of the results can be reliably evaluated. This includes detailed information on the experimental site, methodology and measurement procedures, gas analysis, data and statistical analyses, and approaches to generate EFs, as well as results of ancillary measurements. The reliability, robustness, and comparability of soil N2 O emissions data will be improved through (a) application, and reporting, of more rigorous methodological standards by researchers and (b) greater vigilance by reviewers and scientific editors to ensure that all necessary information is reported in scientific publications.


Assuntos
Gases de Efeito Estufa , Projetos de Pesquisa , Óxido Nitroso/análise , Reprodutibilidade dos Testes , Solo
11.
Artigo em Inglês | MEDLINE | ID: mdl-33008102

RESUMO

Assessing healthy diet literacy and eating behaviors is critical for identifying appropriate public health responses to the COVID-19 pandemic. We examined the psychometric properties of digital healthy diet literacy (DDL) and its association with eating behavior changes during the COVID-19 pandemic among nursing and medical students. We conducted a cross-sectional study from 7 April to 31 May 2020 at 10 public universities in Vietnam, in which 7616 undergraduate students aged 19-27 completed an online survey to assess socio-demographics, clinical parameters, health literacy (HL), DDL, and health-related behaviors. Four items of the DDL scale loaded on one component explained 71.32%, 67.12%, and 72.47% of the scale variances for the overall sample, nursing, and medical students, respectively. The DDL scale was found to have satisfactory item-scale convergent validity and criterion validity, high internal consistency reliability, and no floor or ceiling effect. Of all, 42.8% of students reported healthier eating behavior during the pandemic. A 10-index score increment of DDL was associated with 18%, 23%, and 17% increased likelihood of healthier eating behavior during the pandemic for the overall sample (OR, 1.18; 95%CI, 1.13, 1.24; p < 0.001), nursing students (OR, 1.23; 95%CI, 1.10, 1.35; p < 0.001), and medical students (OR, 1.17; 95%CI, 1.11, 1.24; p < 0.001), respectively. The DDL scale is a valid and reliable tool for the quick assessment of digital healthy diet literacy. Students with higher DDL scores had a higher likelihood of healthier eating behavior during the pandemic.


Assuntos
Infecções por Coronavirus , Dieta Saudável , Comportamento Alimentar , Pandemias , Pneumonia Viral , Estudantes de Medicina , Estudantes de Enfermagem , Adulto , Betacoronavirus , Estudos Transversais , Bacharelado em Enfermagem , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Vietnã , Adulto Jovem
12.
J Contemp Dent Pract ; 21(7): 765-768, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020360

RESUMO

AIM: The present study was conducted to evaluate the reliability of cone-beam computed tomography (CBCT) in dental asymmetry with skeletal midline deviation. MATERIALS AND METHODS: This study was conducted on 124 patients (males 52, females 72) who underwent orthodontic treatment. The CBCT scan was obtained with the Planmica machine. Three maxillofacial radiologists evaluated 10 landmarks and 12 distances on maxillary and mandibular arches on CBCT images in all patients. RESULTS: Interobserver mean difference at point 1 was 0.33; point 2, 0.34; point 3, 0.32; point 4, 0.58; point 5, 0.56; point 6, 0.44; point 7, 0.28; point 8, 0.22; point 9, 0.54; point 10, 0.21; point 11, 0.34; and point 12, 0.36. The discrepancy between intra- and interobserver was not considerable (p > 0.05). CONCLUSION: Cone-beam computed tomography is useful for diagnosis of skeletal asymmetry. CLINICAL SIGNIFICANCE: Cone-beam computed tomography is a reliable and reproducible tool for diagnosis of skeletal asymmetry for successful orthodontic treatment.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Mandíbula/diagnóstico por imagem , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Reprodutibilidade dos Testes
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3819-3822, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018833

RESUMO

Different neural signal blocking technologies provide potential therapy for various diseases caused by pathological or involuntary neural activities. In this paper, a novel neural signal blocking concept based on spike-trapping principle is introduced. The blocking system was designed and implemented. In the system, a compound action potential was induced by a proximal stimulus, and a blocking signal was generated after a neural signal was detected, which was applied to the distal end of the nerve to block the nerve conduction. The reliability of the system was verified on bullfrog sciatic nerve gastrocnemius muscle specimens. The optimal blocking signal parameters, the relationship between nerve diameter and blocking threshold voltage, and the nerve safety of blocking signals were explored. The experimental results show that the system is possible to block a pathological or involuntary neural signal automatically. The average voltage of block threshold and the minimum pulse width are -1.66 V and 120 ms, respectively. The blocking threshold decreases as the diameter of the nerve increases. The blocking signals at the threshold level are safe for the stimulated nerve.


Assuntos
Bloqueio Nervoso , Nervo Isquiático , Potenciais de Ação , Animais , Condução Nervosa , Reprodutibilidade dos Testes
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3839-3843, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018838

RESUMO

Muscular spasticity represents one of the most common motor disorder associated to lesions of the Central Nervous System, such as Stroke, and affects joint mobility up to the complete prevention of skeletal muscle voluntary control. Its clinical evaluation is hence of fundamental relevance for an effective rehabilitation of the affected subjects. Standard assessment protocols are usually manually performed by humans, and hence their reliability strongly depends on the capabilities of the clinical operator performing the procedures. To overcome this limitation, one solution is the usage of mechatronic devices based on the estimation of the Tonic Stretch Reflex Threshold, which allows for a quite reliable and operator-independent evaluation. In this work, we present the design and characterization of a novel mechatronic device that targets the estimation of the Tonic Stretch Reflex Threshold at the elbow level, and, at the same time, it can potentially act as a rehabilitative system. Our device can deliver controllable torque/velocity stimulation and record functional parameters of the musculo-skeletal system (joint position, torque, and multi-channel ElectroMyoGraphyc patterns), with the ultimate goals of: i) providing significant information for the diagnosis and the classification of muscular spasticity, ii) enhancing the recovery evaluation of patients undergoing through therapeutic rehabilitation procedures and iii) enabling a future active usage of this device also as therapeutic tool.Clinical relevance- The contribution presented in this work proposes a technological advancement for a device-based evaluation of motion impairment related to spasticity, with a major potential impact on both the clinical appraisal and the rehabilitation procedures.


Assuntos
Cotovelo , Reflexo de Estiramento , Eletromiografia , Humanos , Espasticidade Muscular/diagnóstico , Reprodutibilidade dos Testes
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3953-3956, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018865

RESUMO

Intestinal motility is coordinated by myogenic, neuronal and hormonal factors. Myogenic control of motility via bioelectric slow waves (SW) has been investigated using low-resolution and high-resolution (HR) electrical mapping techniques. Due to the highly conformable and irregular surface of the gut, suboptimal coverage of HR recordings may occur. In this study we designed and developed an inflatable cuff as a platform to apply even pressure across the intestinal surface to achieve consistent and reliable recordings. The inflatable cuff and a HR electrode array were applied in vivo to demonstrate the reliability of SW signal acquisition over a range of inflatable pressures (0 - 5 mm Hg). The frequency, amplitude, percentage of viable signals and signal to noise ratio metrics of the SW signals were computed and compared. Overall, with an increase in inflatable pressure from 0 to 5 mm Hg, the frequency did not change, but the amplitude of the SWs decreased from 0.10 to 0.07 mV. The noise levels were consistent across the range of inflatable pressure levels and the percentage of viable SW recordings improved significantly from 57% to 74% after application of 1 mm Hg of pressure. The inflatable and conformable cuff presented in this study provides a reliable platform for HR mapping of bioelectrical events in the intestines and other conformable organs.Clinical Relevance- This framework improves the quality and reliability of bioelectrical high-resolution recordings obtained from the small intestine. In the future, these recordings will improve our understanding of the pathophysiological mechanisms governing intestinal motility disorders and may provide clinicians with new strategies for diagnosis and treatment.


Assuntos
Motilidade Gastrointestinal , Intestino Delgado , Fenômenos Eletrofisiológicos , Reprodutibilidade dos Testes , Razão Sinal-Ruído
16.
Nat Commun ; 11(1): 4982, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020474

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is associated with obesity but also found in non-obese individuals. Gut microbiome profiles of 171 Asians with biopsy-proven NAFLD and 31 non-NAFLD controls are analyzed using 16S rRNA sequencing; an independent Western cohort is used for external validation. Subjects are classified into three subgroups according to histological spectra of NAFLD or fibrosis severity. Significant alterations in microbiome diversity are observed according to fibrosis severity in non-obese, but not obese, subjects. Ruminococcaceae and Veillonellaceae are the main microbiota associated with fibrosis severity in non-obese subjects. Furthermore, stool bile acids and propionate are elevated, especially in non-obese subjects with significant fibrosis. Fibrosis-related Ruminococcaceae and Veillonellaceae species undergo metagenome sequencing, and four representative species are administered in three mouse NAFLD models to evaluate their effects on liver damage. This study provides the evidence for the role of the microbiome in the liver fibrosis pathogenesis, especially in non-obese subjects.


Assuntos
Bactérias/isolamento & purificação , Microbioma Gastrointestinal/fisiologia , Hepatopatia Gordurosa não Alcoólica/microbiologia , Hepatopatia Gordurosa não Alcoólica/patologia , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/metabolismo , Ácidos e Sais Biliares/análise , Ácidos e Sais Biliares/metabolismo , Biomarcadores , Fezes/química , Fezes/microbiologia , Fibrose , Microbioma Gastrointestinal/genética , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/metabolismo , Cirrose Hepática/microbiologia , Cirrose Hepática/patologia , Camundongos , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade/metabolismo , Obesidade/microbiologia , Obesidade/patologia , Propionatos/análise , Propionatos/metabolismo , RNA Ribossômico 16S/genética , Reprodutibilidade dos Testes
17.
Eur J Med Res ; 25(1): 49, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046116

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has brought a global disaster. Quantitative lesions may provide the radiological evidence of the severity of pneumonia and further to assess the effect of comorbidity on patients with COVID-19. METHODS: 294 patients with COVID-19 were enrolled from February, 24, 2020 to June, 1, 2020 from six centers. Multi-task Unet network was used to segment the whole lung and lesions from chest CT images. This deep learning method was pre-trained in 650 CT images (550 in primary dataset and 100 in test dataset) with COVID-19 or community-acquired pneumonia and Dice coefficients in test dataset were calculated. 50 CT scans of 50 patients (15 with comorbidity and 35 without comorbidity) were random selected to mark lesions manually. The results will be compared with the automatic segmentation model. Eight quantitative parameters were calculated based on the segmentation results to evaluate the effect of comorbidity on patients with COVID-19. RESULTS: Quantitative segmentation model was proved to be effective and accurate with all Dice coefficients more than 0.85 and all accuracies more than 0.95. Of the 294 patients, 52 (17.7%) patients were reported having at least one comorbidity; 14 (4.8%) having more than one comorbidity. Patients with any comorbidity were older (P < 0.001), had longer incubation period (P < 0.001), were more likely to have abnormal laboratory findings (P < 0.05), and be in severity status (P < 0.001). More lesions (including larger volume of lesion, consolidation, and ground-glass opacity) were shown in patients with any comorbidity than patients without comorbidity (all P < 0.001). More lesions were found on CT images in patients with more comorbidities. The median volumes of lesion, consolidation, and ground-glass opacity in diabetes mellitus group were largest among the groups with single comorbidity that had the incidence rate of top three. CONCLUSIONS: Multi-task Unet network can make quantitative CT analysis of lesions to assess the effect of comorbidity on patients with COVID-19, further to provide the radiological evidence of the severity of pneumonia. More lesions (including GGO and consolidation) were found in CT images of cases with comorbidity. The more comorbidities patients have, the more lesions CT images show.


Assuntos
Algoritmos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Processamento de Imagem Assistida por Computador/métodos , Pulmão/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Comorbidade , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia/epidemiologia , Pneumonia Viral/diagnóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos
18.
Biochem Med (Zagreb) ; 30(3): 030901, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33071558

RESUMO

Introduction: The 2019 Coronavirus disease (COVID-19) has been characterized as a pandemic, representing a serious global public health emergency. Serological tests have been proposed as reliable tools for detecting Coronavirus SARS-CoV-2 antibodies in infected patients, especially for surveillance or epidemiological purposes. The aim of this study is to evaluate the agreement between the IgM/IgG rapid assays, based on lateral flow immunochromatographic assay, and the fully automated 2019-nCoV IgM and IgG, based on chemiluminescence immunoassay. Materials and methods: SARS-CoV-2 antibodies were measured with the BIOSYNEX COVID-19 BSS IgM/IgG test (BIOSYNEX, Illkirch-Graffenstaden, France) and the MAGLUMI CLIA (IgM and IgG) (SNIBE - Shenzhen New Industries Biomedical Engineering, Shenzhen, China) in 70 serum samples from patients with PCR-confirmed diagnosis. The strength of the agreement of the two methods was calculated by using the Cohen Kappa index. Results: The results showed a good grade of concordance between the two immunoassays with a Cohen's kappa coefficient of 0.71 (95%CI: 0.54-0.87) for IgG SARS-CoV-2 antibodies and 0.70 (95%CI: 0.53-0.87) for IgM SARS-CoV-2 antibodies. In addition, the rapid assays BIOSYNEX COVID-19 BSS for detecting SARS-CoV-2 antibodies showed a positive likelihood ratio (LR) of 10.63 (95%CI: 2.79-40.57) for IgG and a LR of 6.79 (95%CI: 2.93-15.69) for IgM. Conclusion: Our results suggest that the immunochromatographic rapid IgM/IgG test and the chemiluminescence IgM and IgG immunoassay have a good degree of concordance, suggesting that both could be considered as useful tools for epidemiologic surveillance.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pandemias , Pneumonia Viral/diagnóstico , Idoso , Feminino , Humanos , Imunoensaio , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Vigilância da População , Reprodutibilidade dos Testes
19.
J Med Internet Res ; 22(10): e21299, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33001828

RESUMO

BACKGROUND: A large number of web-based COVID-19 symptom checkers and chatbots have been developed; however, anecdotal evidence suggests that their conclusions are highly variable. To our knowledge, no study has evaluated the accuracy of COVID-19 symptom checkers in a statistically rigorous manner. OBJECTIVE: The aim of this study is to evaluate and compare the diagnostic accuracies of web-based COVID-19 symptom checkers. METHODS: We identified 10 web-based COVID-19 symptom checkers, all of which were included in the study. We evaluated the COVID-19 symptom checkers by assessing 50 COVID-19 case reports alongside 410 non-COVID-19 control cases. A bootstrapping method was used to counter the unbalanced sample sizes and obtain confidence intervals (CIs). Results are reported as sensitivity, specificity, F1 score, and Matthews correlation coefficient (MCC). RESULTS: The classification task between COVID-19-positive and COVID-19-negative for "high risk" cases among the 460 test cases yielded (sorted by F1 score): Symptoma (F1=0.92, MCC=0.85), Infermedica (F1=0.80, MCC=0.61), US Centers for Disease Control and Prevention (CDC) (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Cleveland Clinic (F1=0.40, MCC=0.07), Providence (F1=0.40, MCC=0.05), Apple (F1=0.29, MCC=-0.10), Docyet (F1=0.27, MCC=0.29), Ada (F1=0.24, MCC=0.27) and Your.MD (F1=0.24, MCC=0.27). For "high risk" and "medium risk" combined the performance was: Symptoma (F1=0.91, MCC=0.83) Infermedica (F1=0.80, MCC=0.61), Cleveland Clinic (F1=0.76, MCC=0.47), Providence (F1=0.75, MCC=0.45), Your.MD (F1=0.72, MCC=0.33), CDC (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Apple (F1=0.70, MCC=0.25), Ada (F1=0.42, MCC=0.03), and Docyet (F1=0.27, MCC=0.29). CONCLUSIONS: We found that the number of correctly assessed COVID-19 and control cases varies considerably between symptom checkers, with different symptom checkers showing different strengths with respect to sensitivity and specificity. A good balance between sensitivity and specificity was only achieved by two symptom checkers.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Autoavaliação Diagnóstica , Internet , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Avaliação de Sintomas/instrumentação , Adolescente , Adulto , Algoritmos , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Técnicas de Laboratório Clínico , Coleta de Dados , Humanos , Pessoa de Meia-Idade , Pandemias , Valor Preditivo dos Testes , Informática em Saúde Pública , Reprodutibilidade dos Testes , Autorrelato , Sensibilidade e Especificidade , Estados Unidos , Adulto Jovem
20.
Nat Commun ; 11(1): 5084, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33033253

RESUMO

Identifying factors underlying resistance to immune checkpoint therapy (ICT) is still challenging. Most cancer patients do not respond to ICT and the availability of the predictive biomarkers is limited. Here, we re-analyze a publicly available single-cell RNA sequencing (scRNA-seq) dataset of melanoma samples of patients subjected to ICT and identify a subset of macrophages overexpressing TREM2 and a subset of gammadelta T cells that are both overrepresented in the non-responding tumors. In addition, the percentage of a B cell subset is significantly lower in the non-responders. The presence of these immune cell subtypes is corroborated in other publicly available scRNA-seq datasets. The analyses of bulk RNA-seq datasets of the melanoma samples identify and validate a signature - ImmuneCells.Sig - enriched with the genes characteristic of the above immune cell subsets to predict response to immunotherapy. ImmuneCells.Sig could represent a valuable tool for clinical decision making in patients receiving immunotherapy.


Assuntos
Perfilação da Expressão Gênica , Imunoterapia , Macrófagos/metabolismo , Glicoproteínas de Membrana/metabolismo , Receptores de Antígenos de Linfócitos T gama-delta/metabolismo , Receptores Imunológicos/metabolismo , Linfócitos T/metabolismo , Área Sob a Curva , Linfócitos B/metabolismo , Biomarcadores Tumorais/metabolismo , Humanos , Macrófagos/patologia , Melanoma/genética , Melanoma/patologia , Reprodutibilidade dos Testes
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