PUK5 Evaluacion Economica Del Manejo Farmacologico Del Paciente Con Hiperplasia Prostatica Benigna En Colombia

Esta evaluación económica busca conocer, dentro de las opciones de tratamiento farmacológico, cuál medicamento (doxazosina, tadalafilo, finasteride, tamsulosina, o terapia combinada de tamsulosina/dutasteride) es más costo-efectivo.Q1A846Pacientes con cancer de próstat

Aggression, Impulsivity and Suicidal Behavior in Depressive Disorders: A Comparison Study between New York City (US), Madrid (Spain) and Florence (Italy)

The association of aggression and impulsivity with suicidal behavior (SB) in depression may vary across countries. This study aimed (i) to compare aggression and impulsivity levels, measured with the Brown-Goodwin Scale (BGS) and the Barratt Impulsivity Scale (BIS), respectively, between New York City (NYC) (US), Madrid (Spain) and Florence (Italy) (ANOVA); and (ii) to investigate between-site differences in the association of aggression and impulsivity with previous SB (binary logistic regression). Aggression scores were higher in NYC, followed by Florence and Madrid. Impulsivity levels were higher in Florence than in Madrid or NYC. Aggression and impulsivity scores were higher in suicide attempters than in non-attempters in NYC and in Madrid. SB was associated with aggression in NYC (OR 1.12, 95% CI 1.07–1.16; p p = 0.032). Impulsivity was linked with SB in NYC (OR 1.01, 95% CI 1.00–1.02; p p < 0.001). The higher suicide rates in NYC, compared to Madrid or Florence, may be, in part, explained by these cross-cultural differences in the contribution of aggression-impulsivity to SB, which should be considered by future research on SB prevention

Quasi-normal modes, area spectra and multi-horizon spacetimes

We suggest an interpretation for the highly damped QNM frequencies of the spherically symmetric multi-horizon spacetimes (Reissner-Nordstrom, Schwarzschild-deSitter, Reissner-Nordstrom-deSitter) following Maggiore's proposal about the link between the asymptotic QNM frequencies and the black hole thermodynamics. We show that the behavior of the asymptotic frequencies is easy to understand if one assumes that all of the horizons have the same equispaced area spectra. The QNM analysis is then consistent with the choice of the area spectra to be the one originally proposed for the black hole's horizon by Bekenstein: A=8\pi n (in Planck units). The interpretation of the highly damped QNM frequencies in the multi-horizon case is based on the similar grounds as in the single horizon (Schwarzschild) case, but it has some new features that are discussed in the paper.Comment: 8 pages, v2: no physics changed, some references added, few sentences added in the discussion part

A Biomathematical Model of Tumor Response to Radioimmunotherapy with PDL1 and CTLA4

There is evidence of synergy between radiotherapy and immunotherapy. Radiotherapy can increase liberation of tumor antigens, causing activation of antitumor T-cells. This effect can be boosted with immunotherapy. Radioimmunotherapy has potential to increase tumor control rates. Biomathematical models of response to radioimmunotherapy may help on understanding of the mechanisms affecting response, and assist clinicians on the design of optimal treatment strategies. In this work we present a biomathematical model of tumor response to radioimmunotherapy. The model uses the linear-quadratic response of tumor cells to radiation (or variation of it), and builds on previous developments to include the radiation-induced immune effect. We have focused this study on the combined effect of radiotherapy and PDL1/CTLA4 therapies. The model can fit preclinical data of volume dynamics and control obtained with different dose fractionations and PDL1/CTLA4. A biomathematical study of optimal combination strategies suggests that a good understanding of the involved biological delays, the biokinetics of the immunotherapy drug, and the interplay between them, may be of paramount importance to design optimal radioimmunotherapy schedules. Biomathematical models like the one we present can help to interpret experimental data on the synergy between radiotherapy and immunotherapy, and to assist in the design of more effective treatments

Evaluation of the Multilook Size in Polarimetric Optimization of Differential SAR Interferograms

The interferometric coherence is a measure of the correlation between two SAR images and constitutes a commonly used estimator of the phase quality. Its estimation requires a spatial average within a 2-D window, usually named as multilook. The multilook processing allows reducing noise at the expenses of a resolution loss. In this letter, we analyze the influence of the multilook size while applying a polarimetric optimization of the coherence. The same optimization algorithm has been carried out with different multilook sizes and also with the nonlocal SAR filter filter, which has the advantage of preserving the original resolution of the interferogram. Our experiments have been carried out with a single pair of quad-polarimetric RADARSAT-2 images mapping the Mount Etna's volcanic eruption of May 2008. Results obtained with this particular data set show that the coherence is increased notably with respect to conventional channels when small multilook sizes are employed, especially over low-vegetated areas. Conversely, very decorrelated areas benefit from larger multilook sizes but do not exhibit an additional improvement with the polarimetric optimization

Survey of Zoonotic Diarrheagenic Protist and Hepatitis E Virus in Wild Boar (Sus scrofa) of Portugal

Simple Summary Enteropathogenic viruses, such as hepatitis E virus, and diarrhoeagenic protists have been frequently reported in swine and can infect a wide range of mammals, including humans. Data on their fecal shedding and circulation pathways are still lacking or incomplete. Hence, the aim of the present study was to characterize the presence of microeukaryotes and HEV in the wild boar of Portugal. Of the 144 samples tested, 2 showed the presence of Cryptosporidium scrofarum, 21 Balantioides coli, 42 Blastocystis ST5, and 4 HEV genotype 3. The present work shows that potentially zoonotic protozoa and HEV are circulating in wild boar populations in Portugal. Enteropathogenic parasites and viruses have been frequently reported in swine and can infect a wide range of mammals, including humans. Among the wide variety of parasites infecting swine, diarrhoeagenic protists are among those that cause significant morbidity. Hepatitis E virus (HEV) has also been reported both in domestic pigs and wild boar and is known to have an important public health significance. These agents share the fecal-oral transmission route, but data on their fecal shedding and circulation pathways are still lacking or incomplete. Hence, the aim of the present study was to characterize the presence of microeukaryotes and HEV in the wild boar of Portugal. Wild boar stool samples (n = 144) were obtained during the official hunting seasons (October to February) in 2018/2019, 2019/2020, and 2021/2022 and tested for Cryptosporidium spp., Balantioides coli, Giardia duodenalis, Blastocystis sp., Enterocytozoon bieneusi and HEV by molecular assays, followed by sequencing and phylogenetic analysis. We have detected Cryptosporidium scrofarum (1.4%, 95% CI: 0.2-4.9), B. coli (14.6%, 95% CI: 9.2-21.4), Blastocystis ST5 (29.2%, 95% CI: 21.9-37.2) and HEV genotype 3 (2.8%, 95% CI: 0.7-6.9; subgenotypes 3e and 3m). Co-infections were observed in thirteen animals where two were positive for both HEV and B. coli, one was positive for both C. scrofarum and Blastocystis ST5, and ten were positive for both B. coli and Blastocystis ST5. Giardia duodenalis and E. bieneusi were not detected in the surveyed wild boar population. As far as we know, this is the first report describing protist infections by Cryptosporidium spp., B. coli, and Blastocystis sp., as well as the first identification of the emerging HEV genotype 3m in wild boar of Portugal. The present work shows that potentially zoonotic protozoa and HEV are circulating in wild boar populations in Portugal. Awareness and epidemic-surveillance network implementation measures targeting wild boar are needed to prevent the spread of these pathogenic agents to humans.This research was funded by Fundacao para Ciencia e Tecnologia (FCT), grant number 2021.09461.BD

Analytical and numerical analyses of the micromechanics of soft fibrous connective tissues

State of the art research and treatment of biological tissues require accurate and efficient methods for describing their mechanical properties. Indeed, micromechanics motivated approaches provide a systematic method for elevating relevant data from the microscopic level to the macroscopic one. In this work the mechanical responses of hyperelastic tissues with one and two families of collagen fibers are analyzed by application of a new variational estimate accounting for their histology and the behaviors of their constituents. The resulting, close form expressions, are used to determine the overall response of the wall of a healthy human coronary artery. To demonstrate the accuracy of the proposed method these predictions are compared with corresponding 3-D finite element simulations of a periodic unit cell of the tissue with two families of fibers. Throughout, the analytical predictions for the highly nonlinear and anisotropic tissue are in agreement with the numerical simulations

Enantiopure and racemic radical-cation salts of B(malate)2−anions with BEDT-TTF

We have synthesized the first examples of radical-cation salts of BEDT-TTF with chiral borate anions, [B(malate)2]−, prepared from either enantiopure or racemic bidentate malate ligands. In the former case only one of two diastereoisomers of the borate anion is incorporated, while for the hydrated racemic salt one racemic pair of borate anions containing a R and a S malate ligand is incorporated. Their conducting and magnetic properties are reported. The tight-binding band calculation indicates that the chiral salt has an effective half-filled flat band, which is likely to be caused by the chiral structural feature

New semiconducting radical-cation salts of chiral bis(2-hydroxylpropylthio)ethylenedithio TTF

Electrocrystallisations of the chiral donor molecule S,S-bis(2-hydroxylpropylthio)ethylenedithiotetrathiafulvalene have produced a series of 1 : 1 semiconducting radical-cation salts with anions bromide, chloride, perchlorate and hexafluorophosphate. The flexibility and hydrogen bonding ability of the donor's chiral side chains lead to three quite different packing arrangements of donor cation pairs. Conductivity is maintained despite significant separations of donor cation pairs in some cases

Physician Clinical Alignment and Integration: A Community Academic Hospital Approach

An overwhelming need for change in the U.S. healthcare delivery system, coupled with the need to improve clinical and financial outcomes, has prompted hospitals to direct renewed efforts toward achieving high quality and cost-effectiveness. Additionally, with the dawn of accountable care organizations and increasing focus on patient expectations, hospitals have begun to seek physician partners through clinical alignment. Contrary to the unsuccessful alignment strategies of the 1990s, today\u27s efforts are more mutually beneficial, driven by the need to achieve better care coordination, increased access to infrastructure, improved quality, and lower costs. In this article, we describe a large, academic, tertiary care hospital\u27s approach to developing and implementing alignment and integration models with its collaboration-ready physicians and physician groups. We developed four models--short of physicians\u27 employment with the organization--tailored to meet the needs of both the physician group and the hospital: (1) medical directorship (group physicians are appointed to serve as medical directors of a clinical area), (2) professional services agreement (specific clinical services, such as overnight admissions help, are contracted), (3) co-management services agreement (one specialty group co-manages all services within the specialty service lines), and (4) lease arrangement (closest in scope to employment, in which the hospital pays all expenses and receives all revenue). Successful hospital-physician alignment requires careful planning and the early engagement of legal counsel to ensure compliance with federal statutes. Establishing an integrated system with mutually identified goals better positions hospitals to deliver cost-effective and high-quality care under the new paradigm of healthcare reform