680 research outputs found

    Global Challenges for Cancer Imaging

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    Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19

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    Objective: This study aimed to synthesize the existing evidence on biomarkers related to coronavirus disease 2019 (COVID-19) patients who presented neurological events. Methods: A systematic review of observational studies (any design) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Collaboration recommendations was performed (PROSPERO: CRD42021266995). Searches were conducted in PubMed and Scopus (updated April 2023). The methodological quality of nonrandomized studies was assessed using the Newcastle‒Ottawa Scale (NOS). An evidence gap map was built considering the reported biomarkers and NOS results. Results: Nine specific markers of glial activation and neuronal injury were mapped from 35 studies published between 2020 and 2023. A total of 2,237 adult patients were evaluated in the included studies, especially during the acute phase of COVID-19. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) biomarkers were the most frequently assessed (n = 27 studies, 77%, and n = 14 studies, 40%, respectively). Although these biomarkers were found to be correlated with disease severity and worse outcomes in the acute phase in several studies (p < 0.05), they were not necessarily associated with neurological events. Overall, 12 studies (34%) were judged as having low methodological quality, 9 (26%) had moderate quality, and 9 (26%) had high quality. Conclusions: Different neurological biomarkers in neurosymptomatic COVID-19 patients were identified in observational studies. Although the evidence is still scarce and conflicting for some biomarkers, well-designed longitudinal studies should further explore the pathophysiological role of NfL, GFAP, and tau protein and their potential use for COVID-19 diagnosis and management.info:eu-repo/semantics/publishedVersio

    Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol

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    © 2018 The Author(s). Background: In Brazilian private hospitals, caesarean section (CS) is almost universal (88%) and is integrated into the model of birth care. A quality improvement intervention, “Adequate Birth” (PPA), based on four driving components (governance, participation of women and families, reorganisation of care, and monitoring), has been implemented to help 23 hospitals reduce their CS rate. This is a protocol designed to evaluate the implementation of PPA and its effectiveness at reducing CS as a primary outcome of birth care. Methods: Case study of PPA intervention conducted in 2017/2018. We integrated quantitative and qualitative methods into data collection and analysis. For the quantitative stage, we selected a convenient sample of twelve hospitals. In each of these hospitals, we included 400 women. This resulted in a total sample of 4800 women. We used this sample to detect a 2.5% reduction in CS rate. We interviewed managers and puerperal women, and extracted data from hospital records. In the qualitative stage, we evaluated a subsample of eight hospitals by means of systematic observation and semi-structured interviews with managers, health professionals and women. We used specific forms for each of the four PPA driving components. Forms for managers and professionals addressed the decision-making process, implemented strategies, participatory process in strategy design, and healthcare practice. Forms for women and neonatal care addressed socio-economic, demographic and health condition; prenatal and birth care; tour of the hospital before delivery; labour expectation vs. real experience; and satisfaction with care received. We will estimate the degree of implementation of PPA strategies related to two of the four driving components: “participation of women and families” and “reorganisation of care”. We will then assess its effect on CS rate and secondary outcomes for each of the twelve selected hospitals, and for the total sample. To allow for clinical, socio-demographic and obstetric characteristics in women, we will conduct multivariate analysis. Additionally, we will evaluate the influence of internal context variables (the PPA driving components “governance” and “monitoring”) on the degree of implementation of the components “participation of women and families” and “reorganisation of care”, by means of thematic content analysis. This analysis will include both quantitative and qualitative data. Discussion: The effectiveness of quality improvement interventions that reduce CS rates requires examination. This study will identify strategies that could promote healthier births

    Photoelectrochemical, photophysical and morphological studies of electrostatic layer-by-layer thin films based on poly(p-phenylenevinylene) and single-walled carbon nanotubes

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    The preparation of multilayer films based on poly(p-phenylenevinylene) (PPV) and carboxylic-functionalized single-walled carbon nanotubes (SWNT-COOH) by electrostatic interaction using the layer-by-layer (LbL) deposition method is reported herein. The multilayer build-up, monitored by UV-Vis and photoluminescence (PL) spectroscopies, displayed a linear behavior with the number of PPV and SWNT-COOH layers deposited that undergo deviation and spectral changes for thicker films. Film morphology was evaluated by AFM and epifluorescence microscopies showing remarkable changes after incorporation of SWNT-COOH layers. Films without SWNT show roughness and present dispersed grains; films with SWNT-COOH layers are flatter and some carbon nanotube bundles can be visualized. The photoinduced charge transfer from the conducting polymer to SWNT-COOH was analyzed by PL quenching either by the decrease of the emission intensity or by the presence of dark domains in the epifluorescence micrographs. Photoelectrochemical characterization was performed under white light and the films containing SWNT-COOH displayed photocurrent values between 2.0 μA cm-2 and 7.5 μA cm-2, as the amount of these materials increases in the film. No photocurrent was observed for the film without carbon nanotubes. Photocurrent generation was enhanced and became more stable when an intermediate layer of PEDOT:PSS was interposed between the active layer and the ITO electrode, indicating an improvement in hole transfer to the contacts. Our results indicate that these multilayer films are promising candidates as active layers for organic photovoltaic cells.FAPESP (08/530594-; 08/54017-3)CNPqINCT-INE

    Diabetes Mellitus and arterial hypertension control with educational and therapeutic groups in outpatient follow-up in a "Unidade Básica de Saúde" (Basic Health Unit)

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    Health education is important to increase adherence to treatment and the control of patients with hypertension or diabetes, associated to the self-control of blood pressure or glycemia levels, physical activity and diet. The better understanding of the diseases is related to an improvement in quality of life, decrease in the number of decompensations, fewer hospital admissions, and better acceptance of the disease. An intervention in a population of diabetic and hypertensive patients, through the establishment of groups to promote educative measures, regular follow-up, drug supply, periodic control and treatment of medical intercurrences was proposed at a Basic Health Unit. Monthly meetings took place during the first three months, followed by periodic medical evaluations, disease control and drug supply for additional 27 months. A series of 191 patients was included for a follow-up. Comparing the initial results and those seen post-intervention, we observed a relative decrease of 42% and an absolute one of 26% in the number of patients with moderate and severe hypertension. Regarding the diabetic patients, there was an absolute decrease of 22% in those with glycemia levels above 200mg/dl and an increase of 33% for those with levels below 125mg/dl. For patients who depend on the public health system and drug supply by the government, mostly elderly patients with low schooling, the intervention proved to be effective, although the control of the diseases and all adherence determinants was not achieved. We suggest the implementation of this intervention.A educação em saúde, associada ao autocontrole dos níveis de pressão e/ou glicemia, à atividade física e à dieta alimentar, é importante instrumento para aumentar a procura por tratamento e controlar os índices de pacientes hipertensos e/ou diabéticos,. O conhecimento das doenças está relacionado à melhora da qualidade de vida, à redução do número de descompensações, ao menor número de internações hospitalares e à maior aceitação da doença. Na Unidade Básica de Saúde Vila Romana, São Paulo, foi proposta intervenção em uma população de pacientes diabéticos e hipertensos por meio de formação de grupos para ação educativa, seguimento regular, fornecimento de medicação, controles periódicos e atendimento de intercorrências. Nos primeiros 3 meses, ocorreram encontros mensais, seguidos de consultas periódicas, controle das doenças e dispensação da medicação por mais 27 meses. Com os 191 pacientes, foram formados grupos de hipertensos e grupos de diabéticos hipertensos. Comparando-se os resultados iniciais com os pós-intervenção, observou-se redução relativa de 42% e absoluta de 26% no número de pacientes com pressão moderada e grave. Para os diabéticos, a redução absoluta foi de 22%, para aqueles com glicemia superior a 200mg/dl, e aumento de 33%, para aqueles com níveis inferiores a 125mg/dl. Para pacientes dependentes do sistema oficial de saúde e do fornecimento da medicação, em grande parte idosos e pessoas com baixa escolaridade, embora não se tenha obtido no estudo o controle de todos os determinantes de adesão e o controle das doenças, a intervenção se mostrou eficiente. Sugere-se que seja institucionalizada

    Integrated proteomics identified up-regulated focal adhesion-mediated proteins in human squamous cell carcinoma in an orthotopic murine model

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    Understanding the molecular mechanisms of oral carcinogenesis will yield important advances in diagnostics, prognostics, effective treatment, and outcome of oral cancer. Hence, in this study we have investigated the proteomic and peptidomic profiles by combining an orthotopic murine model of oral squamous cell carcinoma (OSCC), mass spectrometry-based proteomics and biological network analysis. Our results indicated the up-regulation of proteins involved in actin cytoskeleton organization and cell-cell junction assembly events and their expression was validated in human OSCC tissues. In addition, the functional relevance of talin-1 in OSCC adhesion, migration and invasion was demonstrated. Taken together, this study identified specific processes deregulated in oral cancer and provided novel refined OSCC-targeting molecules.Understanding the molecular mechanisms of oral carcinogenesis will yield important advances in diagnostics, prognostics, effective treatment, and outcome of oral cancer. Hence, in this study we have investigated the proteomic and peptidomic profiles by co95e98208FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO2009/54067-3; 2010/19278-0; 2011/22421-2; 2009/53839-2; 2011/02267-9470567/2009-0; 470549/2011-4; 301702/2011-0; 470268/2013-1; 505413/2013-

    A tetravalent dengue nanoparticle stimulates antibody production in mice

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    <p>Abstract</p> <p>Background</p> <p>Dengue is a major public health problem worldwide, especially in the tropical and subtropical regions of the world. Infection with a single <it>Dengue virus </it>(DENV) serotype causes a mild, self-limiting febrile illness called dengue fever. However, a subset of patients experiencing secondary infection with a different serotype progresses to the severe form of the disease, dengue hemorrhagic fever/dengue shock syndrome. Currently, there are no licensed vaccines or antiviral drugs to prevent or treat dengue infections. Biodegradable nanoparticles coated with proteins represent a promising method for in vivo delivery of vaccines.</p> <p>Findings</p> <p>Here, we used a murine model to evaluate the IgG production after administration of inactivated DENV corresponding to all four serotypes adsorbed to bovine serum albumin nanoparticles. This formulation induced a production of anti-DENV IgG antibodies (p < 0.001). However, plaque reduction neutralization assays with the four DENV serotypes revealed that these antibodies have no neutralizing activity in the dilutions tested.</p> <p>Conclusions</p> <p>Our results show that while the nanoparticle system induces humoral responses against DENV, further investigation with different DENV antigens will be required to improve immunogenicity, epitope specicity, and functional activity to make this platform a viable option for DENV vaccines.</p

    Photo- and electroluminescence in a series of PPV type terpolymers containing fluorene, thiophene and phenylene units

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    The emissive properties of terpolymers with fluorene, thiophene and phenylene groups, forming alternating PPV type structures, are discussed in terms of their composition, photo- and electroluminescence properties. The fluorene groups were inserted in each phenylene-vinylene and thiophene-vinylene units, and their concentration did not vary, representing 50% of the molar composition. The ratio of thiophene-vinylene/phenylene-vinylene varied in the range 25,50 and 75%. Photo- and electroluminescence properties were strongly dependent on the thiophene-vinylene content and were compared with the fluorene-vinylene-thiophene and fluorene-vinylene-phenylene parent copolymers. (C) 2012 Elsevier B.V. All rights reserved
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