The peripersonal space (PPS) is a multisensory representation of the near-body region of space where objects appear at hand. It also represents a buffer zone protecting the body from external threats ...and as such it contributes to the organization of social interactions. However, how the combination of embodied objects processing and constraints inherent to social interactions contributes to PPS representation remains an open issue. By using a cooperative task where two male (
N
= 22) or female (
N
= 18) participants, sharing the same action space, were requested to select a number of stimuli on a touch-screen table, we investigated the effect of non-uniform distribution of reward-yielding stimuli on selection strategy and perceptual judgments of reachability, used as a proxy of PPS representation. The probability to select a reward-yielding stimulus (50% of the stimuli) was 75% in the proximal space of one of the two confederates. Results showed that participants initially prioritized stimuli in their proximal space and were progressively influenced by the spatial distribution of reward-yielding stimuli, thus invading their confederate’s action space when associated with higher probability of reward. The distribution of reward-yielding stimuli led to an increase of reachability threshold, but only when biased towards the participants’ distal space. Although the invasion of others’ PPS was more pronounced in male participants, the biased distribution of reward-yielding stimuli altered the reachability threshold similarly in males and females. As a whole, the data revealed that reward expectations in relation to motor actions influence both PPS exploration and representation in social context, but differently in males and females.
SARS-CoV-2 infection ranges from mild to severe presentations, according to the intensity of the aberrant inflammatory response. Purinergic receptors dually control the inflammatory response: while ...adenosine A2A receptors (A2ARs) are anti-inflammatory, ATP P2X7 receptors (P2X7Rs) exert pro-inflammatory effects. The aim of this study was to assess if there were differences in allelic and genotypic frequencies of a loss-of-function SNP of ADORA2A (rs2298383) and a gain-of-function single nucleotide polymorphism (SNP) of P2RX7 (rs208294) in the severity of SARS-CoV-2-associated infection. Fifty-five individuals were enrolled and categorized according to the severity of the infection. Endpoint genotyping was performed in blood cells to screen for both SNPs. The TT genotype (vs. CT + CC) and the T allele (vs. C allele) of P2RX7 SNP were found to be associated with more severe forms of COVID-19, whereas the association between ADORA2A SNP and the severity of infection was not significantly different. The T allele of P2RX7 SNP was more frequent in people with more than one comorbidity and with cardiovascular conditions and was associated with colorectal cancer. Our findings suggest a more prominent role of P2X7R rather than of A2AR polymorphisms in SARS-CoV-2 infection, although larger population-based studies should be performed to validate our conclusions.
Urinary tract infections are defined as the presence of microorganisms in any part of the urinary system, with the exception of the distal urethra. A majority of them are uncomplicated infections ...that are resolved on an outpatient basis, with empirical therapy. The objectives of this work were to study the sociodemographic characteristics of patients, analyze associated strains and examine the response of the main microorganisms to antibiotics. A retrospective observational study of all positive urine cultures between 2018 and 2022 was carried out at an institution (8340 samples). Sociodemographic data were also collected. In total, 61.3% were women, with an average age of 63.4 years, and 43.2% were from the Emergency Department. A total of 13.5% were fitted, 56% of whom were women. Also, 95.9% were not taking any antibiotics, and among the individuals who were taking antibiotics, 50% were injected. Escherichia coli (53.5%) and Klebsiella pneumoniae (13.8%) are identified as the most prevalent strains. In the time periods analyzed, Escherichia coli decreased its resistance to 11 antibiotics and increased to 5 antibiotics, while Klebsiella pneumoniae decreased to 7 and increased to 7, with emphasis on the presence of 3 antibiotics with a resistance rate of 100% to all Klebsiella pneumoniae strains identified in 2022.
The proposed scoping review aims to explore and map wheelchair outcome measurement instruments for children in the literature.
The proposed scoping review will be conducted in accordance with the ...Joanna Briggs Institute (JBI) methodology. The review question and eligibility criteria were developed using the PCC (population, concept, context) mnemonic as follows: (P) children manual or motorised wheelchair users (aged ≤ 18 years), (C) wheelchair outcome measurement instruments, (C) primary sources of literature. The search will be conducted in nine relevant electronic databases. including grey literature from Academic Google. Study screening, selection, and data extraction will be performed independently by two authors. A third reviewer will resolve discrepancies between the authors. General characteristics, population, feasibility, interpretability data will be extracted in accordance with the COSMIN methodology (Consensus-based Standards for the selection of health Measurement Instruments). This will encompass data pertaining to the measurement properties of the domains of reliability, validity and responsiveness. A descriptive analysis will be carried out, and the results will be classified into categories and presented in tables accompanied by a descriptive summary.
The results can inform future research directions, clinical practice and the development of wheelchair outcome measurement instruments. Furthermore, it will help professionals in rehabilitation and wheelchair services to find the wheelchair outcome measurement instruments according to the target population and cultural context.
The study aims to characterize and discuss the processes of patient and public involvement (PPI) in the Brazilian Health Regulatory Agency (Anvisa), the National Committee for Health Technology ...Incorporation (Conitec), and the National Agency for Supplementary Health (ANS) in Brazil.
This is an exploratory, descriptive, and comparative study, conducted by analyzing the public documents and regulation of the three institutions.
The mechanisms for PPI included public consultations, public hearings, participation in advisory committees, and health technology evaluation requests. Anvisa conducted 187 public consultations between 1999 and 2018, gathering 10,699 contributions. In total, 76 (41%) public consultations did not present information about the contributions received. Conitec carried out 234 public consultations and received 53,174 contributions between 2011 and 2018. It was identified that 70 (23%) recommendations from Conitec did not go through public consultation, and 26 (8%) recommendations changed after public consultation. Recommendation changes seemed to have occurred especially in cases with a greater number of contributions in the public consultation process. ANS conducted eight public consultations regarding the list of health procedures and events covered by health insurances between 2000 and 2018, and it received 31,498 contributions. For three public consultations, there was no information about the number of contributions received.
There are regulatory advances and institutional activity supporting PPI in highly technical decision-making processes in Brazil, although heterogeneously among the analyzed institutions. The power of PPI to influence health technology deliberative processes still requires in-depth studies, including the characterization of stakeholders and the legitimacy of decisions.
Clinical criteria/Family history-based BRCA testing misses a large proportion of BRCA carriers who can benefit from screening/prevention. We estimate the cost-effectiveness of population-based BRCA ...testing in general population women across different countries/health systems. A Markov model comparing the lifetime costs and effects of BRCA1/BRCA2 testing all general population women ≥30 years compared with clinical criteria/FH-based testing. Separate analyses are undertaken for the UK/USA/Netherlands (high-income countries/HIC), China/Brazil (upper–middle income countries/UMIC) and India (low–middle income countries/LMIC) using both health system/payer and societal perspectives. BRCA carriers undergo appropriate screening/prevention interventions to reduce breast cancer (BC) and ovarian cancer (OC) risk. Outcomes include OC, BC, and additional heart disease deaths and incremental cost-effectiveness ratio (ICER)/quality-adjusted life year (QALY). Probabilistic/one-way sensitivity analyses evaluate model uncertainty. For the base case, from a societal perspective, we found that population-based BRCA testing is cost-saving in HIC (UK-ICER = $−5639/QALY; USA-ICER = $−4018/QALY; Netherlands-ICER = $−11,433/QALY), and it appears cost-effective in UMIC (China-ICER = $18,066/QALY; Brazil-ICER = $13,579/QALY), but it is not cost-effective in LMIC (India-ICER = $23,031/QALY). From a payer perspective, population-based BRCA testing is highly cost-effective in HIC (UK-ICER = $21,191/QALY, USA-ICER = $16,552/QALY, Netherlands-ICER = $25,215/QALY), and it is cost-effective in UMIC (China-ICER = $23,485/QALY, Brazil−ICER = $20,995/QALY), but it is not cost-effective in LMIC (India-ICER = $32,217/QALY). BRCA testing costs below $172/test (ICER = $19,685/QALY), which makes it cost-effective (from a societal perspective) for LMIC/India. Population-based BRCA testing can prevent an additional 2319 to 2666 BC and 327 to 449 OC cases per million women than the current clinical strategy. Findings suggest that population-based BRCA testing for countries evaluated is extremely cost-effective across HIC/UMIC health systems, is cost-saving for HIC health systems from a societal perspective, and can prevent tens of thousands more BC/OC cases.
ObjectivesTo map the available methodological guidelines and documents for conducting and reporting benefit–risk assessment (BRA) during health technologies’ life cycle; and to identify ...methodological guidelines for BRA that could serve as the basis for the development of a BRA guideline for the context of health technology assessment (HTA) in Brazil.DesignScoping review.MethodsSearches were conducted in three main sources up to March 2023: (1) electronic databases; (2) grey literature (48 HTA and regulatory organisations) and (3) manual search and contacting experts. We included methodological guidelines or publications presenting methods for conducting or reporting BRA of any type of health technologies in any context of the technology’s life cycle. Selection process and data charting were conducted by independent reviewers. We provided a structured narrative synthesis of the findings.ResultsFrom the 83 eligible documents, six were produced in the HTA context, 30 in the regulatory and 35 involved guidance for BRA throughout the technology’s life cycle. We identified 129 methodological approaches for BRA in the documents. The most commonly referred to descriptive frameworks were the Problem, Objectives, Alternatives, Consequences, Trade-offs, Uncertainty, Risk and Linked decisions and the Benefit–Risk Action Team. Multicriteria decision analysis was the most commonly cited quantitative framework. We also identified the most cited metric indices, estimation and utility survey techniques that could be used for BRA.ConclusionsMethods for BRA in HTA are less established. The findings of this review, however, will support and inform the elaboration of the Brazilian methodological guideline on BRA for HTA.Trial registration numberhttps://doi.org/10.17605/OSF.IO/69T3V.
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