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1.
Ann Oncol ; 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38950679

RESUMO

BACKGROUND: PD-L1 tumor proportion score (TPS) and tumor mutational burden (TMB) are key predictive biomarkers for immune checkpoint inhibitors (ICI) efficacy in non-small cell lung cancer (NSCLC). Data on their variation across multiple samples are limited. METHODS: Patients with NSCLC and multiple PD-L1 TPS and/or TMB assessments were included. Clinicopathologic and genomic data were analyzed according to PD-L1 and TMB variation. RESULTS: In total, 402 PD-L1 sample pairs and 413 TMB sample pairs were included. Concordance between pairs was moderate for PD-L1 (ρ=0.53, P<0.0001) and high for TMB (ρ=0.80, P<0.0001). Shorter time between biopsies correlated with higher concordance in PD-L1, but not in TMB. Major increases (ΔTPS≥+50%) and decreases (ΔTPS≤-50%) in PD-L1 were observed in 9.7% and 8.0% of cases, respectively. PD-L1, but not TMB, decreased with intervening ICI (P=0.02). Acquired copy number loss of CD274, PDCD1LG2, and JAK2 were associated with major decrease in PD-L1 (q<0.05). Among patients with multiple PD-L1 assessments before ICI, cases where all samples had a PD-L1 ≥1%, compared to cases with at least one sample with PD-L1 <1% and another with PD-L1 ≥1%, achieved improved objective response rate and progression-free survival (PFS). Among patients with at least one PD-L1 <1% and one ≥1% before ICI, cases where the most proximal sample was PD-L1 ≥1% had longer median PFS compared to cases where the most proximal PD-L1 was <1%. Among patients with multiple TMB assessments before ICI, patients with a TMB ≥10 mut/Mb based on the most recent assessment, as compared to those with a TMB <10 mut/Mb, achieved improved PFS and OS to ICI; instead, no differences were observed when patients were categorized using the oldest TMB assessment. CONCLUSION: Despite intrapatient concordance in PD-L1 and TMB, variation in these biomarkers can influence ICI outcomes, warranting consideration for reassessment prior to ICI initiation when feasible.

2.
Phys Rev Lett ; 132(6): 060603, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38394595

RESUMO

A high-spin nucleus coupled to a color center can act as a long-lived memory qudit in a spin-photon interface. The germanium vacancy (GeV) in diamond has attracted recent attention due to its excellent spectral properties and provides access to the ten-dimensional Hilbert space of the I=9/2 ^{73}Ge nucleus. Here, we observe the ^{73}GeV hyperfine structure, perform nuclear spin readout, and optically initialize the ^{73}Ge spin into any eigenstate on a µs timescale and with a fidelity of up to ∼84%. Our results establish ^{73}GeV as an optically addressable high-spin quantum platform for a high-efficiency spin-photon interface as well as for foundational quantum physics and metrology.

3.
Phys Rev Lett ; 132(14): 146902, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38640398

RESUMO

Spin defects in silicon carbide are promising candidates for quantum sensing applications as they exhibit long coherence times even at room temperature. However, spin readout methods that rely on fluorescence detection can be challenging due to poor photon collection efficiency. Here, we demonstrate coherent spin control and all-electrical readout of a small ensemble of spins in a SiC junction diode using pulsed electrically detected magnetic resonance. A lock-in detection scheme based on a three stage modulation cycle is implemented, significantly enhancing the signal-to-noise ratio. This technique enabled observation of coherent spin dynamics, specifically Rabi spin nutation, spin dephasing, and spin decoherence. The use of these protocols for magnetometry applications is evaluated.

4.
Phys Rev Lett ; 132(18): 186402, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38759200

RESUMO

A gallium interstitial defect is thought to be responsible for the spectacular spin-dependent recombination in GaAs_{1-x}N_{x} dilute nitrides. Current understanding associates this defect with at least two in-gap levels corresponding to the (+/0) and (++/+) charge-state transitions. Using a spin-sensitive photoinduced current transient spectroscopy, the in-gap electronic structure of a x=0.021 alloy is revealed. The (+/0) state lies ≈0.27 eV below the conduction band edge, and an anomalous, negative activation energy reveals the presence of not one but two other in-gap states. The observations are consistent with a (++/+) state ≈0.19 eV above the valence band edge, and a (+++/++) state ≈25 meV above the valence band edge.

5.
Artigo em Inglês | MEDLINE | ID: mdl-38308745

RESUMO

PURPOSE OF REVIEW: Cervical spine pain with or without radicular symptoms is a common condition leading to high utilization of the healthcare system with over 10 million medical visits per year. Many patients undergo surgical interventions and unfortunately are still left with neck and upper extremity pain, sometimes referred to as "Failed Neck Surgery Syndrome." When these options fail, cervical spinal cord stimulation can be a useful tool to decrease pain and suffering as well as reduce prescription medication use. RECENT FINDINGS: Spinal cord stimulation is a well-established therapy for chronic back and leg pain and is becoming more popular for neck and upper extremity pain. Recent studies have explored cervical spinal cord stimulation with successful outcomes regarding improved pain scores, functional outcomes, and reduction of prescription medication use. Continued research into cervical spinal cord stimulation is essential for maximizing its therapeutic potential for patients with chronic neck and upper extremity pain. This review highlights the importance of cervical spinal cord stimulation as an option for patients with failed neck surgery syndrome.

6.
Phys Rev Lett ; 131(22): 221801, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38101357

RESUMO

Using an 185-kg NaI[Tl] array, COHERENT has measured the inclusive electron-neutrino charged-current cross section on ^{127}I with pion decay-at-rest neutrinos produced by the Spallation Neutron Source at Oak Ridge National Laboratory. Iodine is one the heaviest targets for which low-energy (≤50 MeV) inelastic neutrino-nucleus processes have been measured, and this is the first measurement of its inclusive cross section. After a five-year detector exposure, COHERENT reports a flux-averaged cross section for electron neutrinos of 9.2_{-1.8}^{+2.1}×10^{-40} cm^{2}. This corresponds to a value that is ∼41% lower than predicted using the MARLEY event generator with a measured Gamow-Teller strength distribution. In addition, the observed visible spectrum from charged-current scattering on ^{127}I has been measured between 10 and 55 MeV, and the exclusive zero-neutron and one-or-more-neutron emission cross sections are measured to be 5.2_{-3.1}^{+3.4}×10^{-40} and 2.2_{-0.5}^{+0.4}×10^{-40} cm^{2}, respectively.

7.
Ultrasound Obstet Gynecol ; 61(1): 74-80, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36099454

RESUMO

OBJECTIVE: To determine if preoperative cervical length in the low-normal range increases the risk of adverse perinatal outcome in patients undergoing fetoscopic spina bifida repair. METHODS: This was a retrospective cohort study of patients who underwent fetal spina bifida repair between September 2014 and May 2022 at a single center. Cervical length was measured on transvaginal ultrasound during the week before surgery. Eligibility for laparotomy-assisted fetoscopic spina bifida repair was as per the criteria of the Management of Myelomeningocele Study, although maternal body mass index (BMI) up to 40 kg/m2 was allowed. Laparotomy-assisted fetoscopic spina bifida repair was performed, with carbon dioxide insufflation via two 12-French ports in the exteriorized uterus. All patients received the same peri- and postoperative tocolysis regimen, including magnesium sulfate, nifedipine and indomethacin. Postoperative follow-up ultrasound scans were performed either weekly (< 32 weeks' gestation) or twice a week (≥ 32 weeks). Perinatal outcome was compared between patients with a preoperative cervical length of 25-30 mm vs those with a cervical length > 30 mm. Logistic regression analyses and generalized linear mixed regression analyses were used to predict delivery at less than 30, 34 and 37 weeks' gestation. RESULTS: The study included 99 patients with a preoperative cervical length > 30 mm and 12 patients with a cervix 25-30 mm in length. One further case which underwent spina bifida repair was excluded because cervical length was measured > 1 week before surgery. No differences in maternal demographics, gestational age (GA) at surgery, duration of surgery or duration of carbon dioxide uterine insufflation were observed between groups. Cases with low-normal cervical length had an earlier GA at delivery (median (range), 35.2 (25.1-39.7) weeks vs 38.2 (26.0-40.9) weeks; P = 0.01), higher rates of delivery at < 34 weeks (41.7% vs 10.2%; P = 0.01) and < 30 weeks (25.0% vs 1.0%; P < 0.01) and a higher rate of preterm prelabor rupture of membranes (PPROM) (58.3% vs 26.3%; P = 0.04) at an earlier GA (mean ± SD, 29.3 ± 4.0 weeks vs 33.0 ± 2.4 weeks; P = 0.05) compared to those with a normal cervical length. Neonates of cases with low-normal cervical length had a longer stay in the neonatal intensive care unit (20 (7-162) days vs 9 (3-253) days; P = 0.02) and higher rates of respiratory distress syndrome (50.0% vs 14.4%; P < 0.01), sepsis (16.7% vs 1.0%; P = 0.03), necrotizing enterocolitis (16.7% vs 0%; P = 0.01) and retinopathy (33.3% vs 1.0%; P < 0.01). There was an association between preoperative cervical length and risk of delivery at < 30 weeks which was significant only for patients with a maternal BMI < 25 kg/m2 (odds ratio, 0.37 (95% CI, 0.07-0.81); P = 0.02). CONCLUSIONS: Low-normal cervical length (25-30 mm) as measured before in-utero laparotomy-assisted fetoscopic spina bifida repair may increase the risk of adverse perinatal outcomes, including PPROM and preterm birth, leading to higher rates of neonatal complications. These data warrant further research and are of critical relevance for clinical teams considering the eligibility of patients for in-utero spina bifida repair. Based on this evidence, patients with a low-normal cervical length should be aware of their increased risk for adverse perinatal outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Nascimento Prematuro , Disrafismo Espinal , Gravidez , Feminino , Recém-Nascido , Humanos , Estudos Retrospectivos , Colo do Útero/diagnóstico por imagem , Colo do Útero/cirurgia , Dióxido de Carbono , Laparotomia , Nascimento Prematuro/etiologia , Nascimento Prematuro/prevenção & controle , Nascimento Prematuro/cirurgia , Fetoscopia/efeitos adversos , Idade Gestacional , Disrafismo Espinal/cirurgia
8.
Artigo em Inglês | MEDLINE | ID: mdl-38112985

RESUMO

PURPOSE OF REVIEW: Persistent spinal pain syndromes are pervasive and lead to functional impairment, increased healthcare utilization, potential disability, and high societal costs. Spinal (cervical, thoracic, lumbar, and sacroiliac joint) pain includes mechanical, degenerative, inflammatory, oncologic, and infectious etiologies. Regenerative medicine is a novel biotechnology targeting mechanical, degenerative, and inflammatory conditions believed to cause pain. Preparations including platelet-rich plasma, mesenchymal stem cells (adipose tissue and bone marrow aspirate concentrates), and growth factors are derived from an autologous donor. The goal of intervention through guided injection of the regenerative media is to reduce inflammation and reverse the degenerative cascade in hopes of restoring normal cellular composition (physiologic homeostasis) and anatomical function to improve pain and function. The authors review limited research supporting the use of platelet-rich plasma injections for facet joint arthropathy and sacroiliac joint pain compared to traditional steroid treatments, as well as the use of platelet rich plasma or mesenchymal stem cells for lumbar discogenic and radicular pain. RECENT FINDINGS: Current evidence to support regenerative medicine for spine-related pain is limited. Although several studies demonstrated a reduction in pain, many of these studies had a small number of participants and were case series or prospective trials. Regenerative medicine treatments lack evidence for the treatment of spine-related pain. Large randomized controlled trials are needed with consistent study protocols to make further recommendations.

9.
Nurs Educ Perspect ; 44(6): 359-364, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37158730

RESUMO

AIM: The purpose of this study was to explore whether grit is a predictor of success in associate degree nursing (ADN) programs. BACKGROUND: A question that challenges admission decision-making in nursing programs is "Who will succeed?" This question is particularly relevant in ADN programs, which often have higher attrition rates than baccalaureate programs. METHOD: This longitudinal, mixed-methods study was conducted with 451 ADN students across nine programs, including interviews with seven unsuccessful students and nine successful students. RESULTS: Short Grit Scale scores were not found to be statistically significant as a predictor of academic success; however, themes that emerged from the interviews do align with the theory of grit. CONCLUSION: Further research is needed to explore whether recognizing the level of grit in students during admission processes would help identify students who are likely to succeed.

10.
Ann Oncol ; 33(8): 836-844, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35715285

RESUMO

BACKGROUND: COVID-19 disproportionately impacted patients with cancer as a result of direct infection, and delays in diagnosis and therapy. Oncological clinical trials are resource-intensive endeavors that could be particularly susceptible to disruption by the pandemic, but few studies have evaluated the impact of the pandemic on clinical trial conduct. PATIENTS AND METHODS: This prospective, multicenter study assesses the impact of the pandemic on therapeutic clinical trials at two large academic centers in the Northeastern United States between December 2019 and June 2021. The primary objective was to assess the enrollment on, accrual to, and activation of oncology therapeutic clinical trials during the pandemic using an institution-wide cohort of (i) new patient accruals to oncological trials, (ii) a manually curated cohort of patients with cancer, and (ii) a dataset of new trial activations. RESULTS: The institution-wide cohort included 4756 new patients enrolled to clinical trials from December 2019 to June 2021. A major decrease in the numbers of new patient accruals (-46%) was seen early in the pandemic, followed by a progressive recovery and return to higher-than-normal levels (+2.6%). A similar pattern (from -23.6% to +30.4%) was observed among 467 newly activated trials from June 2019 to June 2021. A more pronounced decline in new accruals was seen among academically sponsored trials (versus industry sponsored trials) (P < 0.05). In the manually curated cohort, which included 2361 patients with cancer, non-white patients tended to be more likely taken off trial in the early pandemic period (adjusted odds ratio: 2.60; 95% confidence interval 1.00-6.63), and substantial pandemic-related deviations were recorded. CONCLUSIONS: Substantial disruptions in clinical trial activities were observed early during the pandemic, with a gradual recovery during ensuing time periods, both from an enrollment and an activation standpoint. The observed decline was more prominent among academically sponsored trials, and racial disparities were seen among people taken off trial.


Assuntos
COVID-19 , Neoplasias , COVID-19/epidemiologia , Humanos , Oncologia , Neoplasias/epidemiologia , Neoplasias/terapia , Pandemias , Estudos Prospectivos
11.
Nature ; 540(7631): 104-108, 2016 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-27905442

RESUMO

The majority of the Earth's terrestrial carbon is stored in the soil. If anthropogenic warming stimulates the loss of this carbon to the atmosphere, it could drive further planetary warming. Despite evidence that warming enhances carbon fluxes to and from the soil, the net global balance between these responses remains uncertain. Here we present a comprehensive analysis of warming-induced changes in soil carbon stocks by assembling data from 49 field experiments located across North America, Europe and Asia. We find that the effects of warming are contingent on the size of the initial soil carbon stock, with considerable losses occurring in high-latitude areas. By extrapolating this empirical relationship to the global scale, we provide estimates of soil carbon sensitivity to warming that may help to constrain Earth system model projections. Our empirical relationship suggests that global soil carbon stocks in the upper soil horizons will fall by 30 ± 30 petagrams of carbon to 203 ± 161 petagrams of carbon under one degree of warming, depending on the rate at which the effects of warming are realized. Under the conservative assumption that the response of soil carbon to warming occurs within a year, a business-as-usual climate scenario would drive the loss of 55 ± 50 petagrams of carbon from the upper soil horizons by 2050. This value is around 12-17 per cent of the expected anthropogenic emissions over this period. Despite the considerable uncertainty in our estimates, the direction of the global soil carbon response is consistent across all scenarios. This provides strong empirical support for the idea that rising temperatures will stimulate the net loss of soil carbon to the atmosphere, driving a positive land carbon-climate feedback that could accelerate climate change.


Assuntos
Atmosfera/química , Ciclo do Carbono , Carbono/análise , Geografia , Aquecimento Global , Solo/química , Bases de Dados Factuais , Ecossistema , Retroalimentação , Modelos Estatísticos , Reprodutibilidade dos Testes , Temperatura
12.
Platelets ; 33(5): 655-665, 2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34986759

RESUMO

Burn injuries are common and often life-threatening trauma. With this trauma comes an interruption of normal hemostasis, with distinct impacts on platelets. Our interest in the relationships between burn injury and platelet function stems from two key perspectives: platelet function is a vital component of acute responses to injury, and furthermore the incidence of cardiovascular disease (CVD) is higher in burn survivors compared to the general population. This review explores the impact of burn injury on coagulation, platelet function, and the participation of platelets in immunopathology. Potential avenues of further research are explored, and consideration is given to what therapies may be appropriate for mediating post-burn thrombopathology.


Assuntos
Plaquetas , Doenças Cardiovasculares , Coagulação Sanguínea , Plaquetas/fisiologia , Hemostasia , Humanos , Testes de Função Plaquetária
13.
J Helminthol ; 96: e79, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36305615

RESUMO

As part of surveillance of snail-borne trematodiasis in Knowsley Safari (KS), Prescot, United Kingdom, a collection was made in July 2021 of various planorbid (n = 173) and lymnaeid (n = 218) snails. These were taken from 15 purposely selected freshwater habitats. In the laboratory emergent trematode cercariae, often from single snails, were identified by morphology with a sub-set, of those most accessible, later characterized by cytochrome oxidase subunit 1 (cox1) DNA barcoding. Two schistosomatid cercariae were of special note in the context of human cercarial dermatitis (HCD), Bilharziella polonica emergent from Planorbarius corneus and Trichobilharzia spp. emergent from Ampullacaena balthica. The former schistosomatid was last reported in the United Kingdom over 50 years ago. From cox1 analyses, the latter likely consisted of two taxa, Trichobilharzia anseri, a first report in the United Kingdom, and a hitherto unnamed genetic lineage having some affiliation with Trichobilharzia longicauda. The chronobiology of emergent cercariae from P. corneus was assessed, with the vertical swimming rate of B. polonica measured. We provide a brief risk appraisal of HCD for public activities typically undertaken within KS educational and recreational programmes.


Assuntos
Dermatite , Schistosomatidae , Esquistossomose , Dermatopatias Parasitárias , Infecções por Trematódeos , Humanos , Animais , Schistosomatidae/genética , Dermatopatias Parasitárias/epidemiologia , Infecções por Trematódeos/epidemiologia , Cercárias/genética , Dermatite/epidemiologia
14.
Opt Express ; 29(21): 34411-34426, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34809232

RESUMO

A 3-D instrument self-shading correction has been developed for the MOBY upwelling radiance measurements. This correction was tested using the 23 year time series of MOBY measurements, at the Lanai, Hawaii site. The correction is small (less than 2%) except when the sun and collectors are aligned within 20° azimuth on opposite sides of the main MOBY structure. Estimates of the correction uncertainty were made with a Monte-Carlo method and the variation of the model input parameters at this site. The correction uncertainty was generally less than 1%, but increased to 30% of the correction in the strongest shadow region.

15.
Hum Reprod ; 36(9): 2529-2537, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34293108

RESUMO

STUDY QUESTION: Does having a male co-twin, older brothers, or sons lead to an increased probability of persistent male microchimerism in female members of twin pedigrees? SUMMARY ANSWER: The presence of a male co-twin did not increase risk of male microchimerism and the prevalence of male microchimerism was not explained by having male offspring or by having an older brother. WHAT IS KNOWN ALREADY: Microchimerism describes the presence of cells within an organism that originate from another zygote and is commonly described as resulting from pregnancy in placental mammals. It is associated with diseases with a female predilection including autoimmune diseases and pregnancy-related complications. However, microchimerism also occurs in nulliparous women; signifying gaps in the understanding of risk factors contributing to persistent microchimerism and the origin of the minor cell population. STUDY DESIGN, SIZE, DURATION: This cross-sectional study composed of 446 adult female participants of the Netherlands Twin Register (NTR). PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants included in the study were female monozygotic (MZ) twins, female dizygotic same-sex twins and females of dizygotic opposite-sex twin pairs, along with the mothers and sisters of these twins. Peripheral blood samples collected from adult female participants underwent DNA extraction and were biobanked prior to the study. To detect the presence of male-origin microchimerism, DNA samples were tested for the relative quantity of male specific Y chromosome gene DYS14 compared to a common ß-globin gene using a highly sensitive quantitative PCR assay. MAIN RESULTS AND THE ROLE OF CHANCE: We observed a large number of women (26.9%) having detectable male microchimerism in their peripheral blood samples. The presence of a male co-twin did not increase risk of male microchimerism (odds ratio (OR) = 1.23: SE 0.40, P = 0.61) and the prevalence of male microchimerism was not explained by having male offspring (OR 0.90: SE 0.19, P = 0.63) or by having an older brother (OR = 1.46: SE 0.32, P = 0.09). The resemblance (correlation) for the presence of microchimerism was similar (P = 0.66) in MZ pairs (0.27; SE 0.37) and in first-degree relatives (0.091; SE 0.092). However, age had a positive relationship with the presence of male microchimerism (P = 0.02). LIMITATIONS, REASONS FOR CAUTION: After stratifying for variables of interest, some participant groups resulted in a low numbers of subjects. We investigated microchimerism in peripheral blood due to the proposed mechanism of cell acquisition via transplacental blood exchange; however, this does not represent global chimerism in the individual and microchimerism may localize to numerous other tissues. WIDER IMPLICATIONS OF THE FINDINGS: Immune regulation during pregnancy is known to mitigate allosensitization and support tolerance to non-inherited antigens found on donor cells. While unable to identify a specific source that promotes microchimerism prevalence within pedigrees, this study points to the underlying complexities of natural microchimerism in the general population. These findings support previous studies which have identified the presence of male microchimerism among women with no history of pregnancy, suggesting alternative sources of microchimerism. The association of detectable male microchimerism with age is suggestive of additional factors including time, molecular characteristics and environment playing a critical role in the prevalence of persistent microchimerism. The present study necessitates investigation into the molecular underpinnings of natural chimerism to provide insight into women's health, transplant medicine and immunology. STUDY FUNDING/COMPETING INTEREST(S): This work is funded by Royal Netherlands Academy of Science Professor Award (PAH/6635 to D.I.B.); The Netherlands Organisation for Health Research and Development (ZonMw)-Genotype/phenotype database for behavior genetic and genetic epidemiological studies (ZonMw 911-09-032); Biobanking and Biomolecular Research Infrastructure (BBMRI-NL, 184.021.007; 184.033.111); The Netherlands Organisation for Scientific Research (NWO)-Netherlands Twin Registry Repository (NWO-Groot 480-15-001/674); the National Institutes of Health-The Rutgers University Cell and DNA Repository cooperative agreement (NIMH U24 MH068457-06), Grand Opportunity grants Integration of genomics and transcriptomics in normal twins and major depression (NIMH 1RC2 MH089951-01), and Developmental trajectories of psychopathology (NIMH 1RC2 MH089995); and European Research Council-Genetics of Mental Illness (ERC 230374). C.B.L. declares a competing interest as editor-in-chief of Human Reproduction and his department receives unrestricted research grants from Ferring, Merck and Guerbet. All remaining authors have no conflict-of-interest to declare in regards to this work. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Bancos de Espécimes Biológicos , Quimerismo , Estudos Transversais , Feminino , Humanos , Masculino , Linhagem , Placenta , Gravidez , Estados Unidos
16.
Osteoporos Int ; 32(10): 2011-2021, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33772328

RESUMO

This study assessed the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japan, using bone mineral density (BMD) efficacy data. Results show that romosozumab/alendronate produces greater health benefits at a lower cost than teriparatide/alendronate. INTRODUCTION: This study aims to assess the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japanese women previously treated with bisphosphonates. METHODS: A Markov model was used to assess the relative cost effectiveness of 1 year of romosozumab versus 2 years of teriparatide, both sequenced to alendronate for a total treatment duration of 5 years. Outcomes for a cohort of women with a mean age of 78 years, a T-score ≤-2.5 and a previous fragility fracture were simulated over a lifetime horizon. The analysis was conducted from the perspective of the Japanese healthcare system and used a discount rate of 2% per annum. To inform relative fracture incidence, the bone mineral density (BMD) advantage of romosozumab over teriparatide was translated into relative risks of fracture, using relationships provided by a meta-regression of osteoporosis therapy trials. Outcomes were assessed in terms of lifetime costs (2020 US dollars) and quality-adjusted life years (QALYs). RESULTS: Base case results showed that, compared with teriparatide/alendronate, romosozumab/alendronate reduced costs by $5134 per patient and yielded 0.045 additional QALYs. Scenario analyses and probabilistic sensitivity analysis confirmed that results are robust to uncertainty in model assumptions and inputs. CONCLUSION: Results show that romosozumab/alendronate produces greater health benefits at a lower total cost than teriparatide/alendronate.


Assuntos
Conservadores da Densidade Óssea , Osteoporose Pós-Menopausa , Idoso , Alendronato/uso terapêutico , Anticorpos Monoclonais , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Análise Custo-Benefício , Feminino , Humanos , Japão/epidemiologia , Osteoporose Pós-Menopausa/tratamento farmacológico , Teriparatida/uso terapêutico
17.
Appl Opt ; 60(35): 10935-10944, 2021 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-35200856

RESUMO

The long-term temporal stability of a spectrograph is one of the most important characteristics affecting the spectrograph's radiometric performance. For many applications, from monitoring ocean color and lunar irradiance to laboratory irradiance measurement standards, the stability of a spectrograph is a primary factor in the overall measurement uncertainty and therefore is the major criterion for the suitability of the spectrograph as an optical-scale transfer standard. Here we report a facility built for testing the long-term radiometric stability of commercial, fiber-coupled spectrographs. The facility uses tungsten quartz-halogen irradiance standard lamps, type "FEL," of the National Institute of Standards and Technology (NIST) as light sources. To ensure the highest stability of these lamps during spectrograph tests, parameters such as lamp current, lamp voltage, and signals from an independent filter radiometer were continuously recorded to monitor any possible instability caused by such effects as lamp aging. Using this facility, we report the stability study of four spectrographs with spectral coverage from the UV to short-wave infrared over an interval of two months during which the lamp irradiance was stable to better than 0.02%. The tested spectrographs show good stability in general, ranging from 0.02% to 0.1% in the visible over a span of 11 days. For a longer two-month test, the variation in spectrograph responses increases by less than 0.1% with no discernable long-term drifts. In addition, we measured the response variation of two of the test spectrographs before and after they were sent to remote field locations and subjected to adverse environmental conditions. In this case, a larger response variation of up to 1.0% dependence on the wavelength was observed. We discuss the performance of the facility and the implications for using these spectrographs for several of NIST's remote sensing projects as radiometric transfer standards based on these stability measurements.

18.
Appl Opt ; 60(12): 3380-3392, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33983243

RESUMO

The Ocean Color component of the global Aerosol Robotic Network (AERONET-OC) utilizes CE-318 sun photometers modified for above-water radiometry from fixed structures such as oil rigs, lighthouses, and service platforms. Primarily, AERONET-OC measurements allow determination of the water-leaving radiance required for the validation of ocean color satellite data products. One instrument from the AERONET-OC network, identified as AERONET #080, was studied in this work. A laser-illuminated integrating sphere of known radiance enabled determination of the linearity with flux and absolute radiance responsivity at multiple wavelengths within seven of the AERONET #080 filter bands. We compared the results to calibrations from the AERONET facility at the Goddard Space Flight Center of the National Aeronautics and Space Administration and from the Joint Research Centre of the European Commission. These results agree within the estimated mean comparison uncertainty of 1.88 % (k=2). We also assessed these results using calibrated lamp-illuminated integrating spheres and observed a spectral dependence to the comparison results that is unexplained.

19.
Public Health ; 198: 315-323, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34507138

RESUMO

OBJECTIVES: This study aimed to evaluate associations between mental distress and COVID-19-related changes in behavioral outcomes and potential modifiers (age, gender, educational attainment) of such associations. STUDY DESIGN: This was a cross-sectional study. METHODS: An online survey using anonymous network sampling was conducted in China from April to May 2020 using a 74-item questionnaire. A national sample of 10,545 adults in 31 provinces provided data on sociodemographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. RESULTS: After adjusting for covariates, greater mental distress was associated with increased smoking (odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.20-1.68 and OR = 1.54, 95% CI: 1.31-1.82 per one standard deviation [SD] increase in mental distress) and alcohol consumption (OR = 1.67, 95% CI: 1.45-1.92 and OR = 1.47, 95% CI: 1.24-1.75 per one SD increase in mental distress) among current smokers and drinkers and with both increased and decreased physical activity (ORs ranged from 1.32 to 1.56). Underweight adults were more likely to lose body weight (≥1 kg; OR = 1.63, 95% CI: 1.30-2.04), whereas overweight adults were more likely to gain weight (OR = 1.61, 95% CI: 1.46-1.78) by the same amount. Association between mental distress and change in physical activity was stronger in adults aged ≥40 years (ORs ranged from 1.43 to 2.05) and those with high education (ORs ranged from 1.43 to 1.77). Mental distress was associated with increased smoking in males (OR = 1.60, 95% CI: 1.37-1.87) but not females (OR = 1.11, 95% CI: 0.82-1.51). CONCLUSIONS: Greater mental distress was associated with some positive and negative changes in behavioral outcomes during the pandemic. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.


Assuntos
COVID-19 , Pandemias , Adulto , China/epidemiologia , Estudos Transversais , Humanos , Masculino , SARS-CoV-2
20.
Horm Behav ; 122: 104757, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32305342

RESUMO

The traditional focus of physiological and functional genomic research is on molecular processes that play out within a single multicellular organism. In the colonial (eusocial) insects such as ants, bees, and termites, molecular and behavioral responses of interacting nestmates are tightly linked, and key physiological processes are regulated at the scale of the colony. Such colony-level physiological processes regulate nestmate physiology in a distributed fashion, through various social communication mechanisms. As a result of physiological decentralization over evolutionary time, organismal mechanisms, for example related to pheromone detection, hormone signaling, and neural signaling pathways, are deployed in novel contexts to influence nestmate and colony traits. Here we explore how functional genomic, physiological, and behavioral studies can benefit from considering the traits of eusocial insects in this light. We highlight functional genomic work exploring how nestmate-level and colony-level traits arise and are influenced by interactions among physiologically-specialized nestmates of various developmental stages. We also consider similarities and differences between nestmate-level (organismal) and colony-level (superorganismal) physiological processes, and make specific hypotheses regarding the physiology of eusocial taxa. Integrating theoretical models of distributed systems with empirical functional genomics approaches will be useful in addressing fundamental questions related to the evolution of eusociality and collective behavior in natural systems.


Assuntos
Comportamento Animal/fisiologia , Genoma de Inseto/fisiologia , Insetos/genética , Insetos/fisiologia , Comportamento Social , Animais , Formigas/genética , Formigas/fisiologia , Abelhas/genética , Abelhas/fisiologia , Evolução Biológica , Comportamento Cooperativo , Isópteros/genética , Isópteros/fisiologia , Comportamento de Nidação/fisiologia , Fenótipo
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