To contribute to the understanding of the coronavirus disease (COVID-19) pandemic, this study evaluated the correlations of the frequencies of COVID-19 cases, hospitalisations due to COVID-19, and ...deaths due to COVID-19 with social isolation indices and outpatient prescriptions of hydroxychloroquine and chloroquine in the state of Santa Catarina, southern Brazil.
This was an analytical, observational, retrospective study based on secondary data that were obtained from public Brazilian databases and covered the period from March 1, 2020 to October 31, 2020 (epidemiological weeks 10–44). Data on weekly COVID-19 cases, hospitalisations and deaths due COVID-19, sales of chloroquine and hydroxychloroquine, and social isolation indices were obtained. Associations between the variables were tested using multiple linear regression analysis.
In all regions of Santa Catarina, there were almost simultaneous peaks of COVID-19 pandemic in weeks 28–31, followed by a sudden decrease. Social isolation indices were not associated with the outcomes; sales of chloroquine and hydroxychloroquine were significant predictors of all outcomes (p < 0.001). COVID-19 prevalence was significantly different across the state regions when COVID-19 cases started to decline (p < 0.001).
Collective immunity and social isolation may not have been the only causes for the reduction of the COVID-19 pandemic observed in Santa Catarina. The results of this study were compatible with the hypothesis that early treatment of COVID-19 cases with chloroquine or hydroxychloroquine may contribute to reducing the transmissibility of COVID-19 in the population. This hypothesis needs to be further tested in future studies.
Pembrolizumab plus pemetrexed‐platinum significantly improved overall survival (OS) and progression‐free survival (PFS) with manageable safety compared with placebo plus pemetrexed‐platinum in ...patients with previously untreated metastatic nonsquamous non–small‐cell lung cancer (NSCLC) without EGFR/ALK alterations in the global, randomized, double‐blind, phase 3 KEYNOTE‐189 study. We present results of Japanese patients enrolled in the KEYNOTE‐189 global and Japan extension studies. Patients were randomized 2:1 to intravenous pembrolizumab 200 mg or placebo every 3 weeks (Q3W) for up to 35 cycles. All patients received pemetrexed 500 mg/m2 plus the investigator’s choice of cisplatin or carboplatin Q3W for four cycles, followed by maintenance pemetrexed 500 mg/m2 Q3W (all intravenous). Co–primary endpoints were OS and PFS. Forty Japanese patients enrolled (pembrolizumab, n = 25; placebo, n = 15). At data cutoff (20 May 2019; median time from randomization to data cutoff, 18.5 range, 14.7‒38.2 months), the median OS was not reached in the pembrolizumab plus pemetrexed‐platinum arm; the median OS was 25.9 (95% confidence interval CI, 11.9‒29.0) months in the placebo plus pemetrexed‐platinum arm (hazard ratio HR .29; 95% CI, .07‒1.15). The median (95% CI) PFS was 16.5 (8.8‒21.1) compared with 7.1 (4.7‒21.4) months (HR, .62; 95% CI, .27‒1.42), respectively. There were no grade 5 adverse events (AE). Grade 3/4 AE occurred in 72% vs 60% of patients in the pembrolizumab vs placebo arms; 40% vs 20% had immune‐mediated AE, and 4% vs 0% had infusion reactions. Efficacy and safety outcomes were similar to those from the global study and support first‐line therapy with pembrolizumab plus pemetrexed‐platinum in Japanese patients with nonsquamous NSCLC without EGFR/ALK alterations.
In conclusion, consistent with the global KEYNOTE‐189 study, pembrolizumab in combination with pemetrexed and platinum improved OS, PFS, ORR, and PFS2 compared with placebo plus pemetrexed‐platinum and demonstrated a manageable safety profile in Japanese patients with previously untreated metastatic nonsquamous NSCLC. The results from this study confirm the role of pembrolizumab plus pemetrexed‐platinum as a first‐line standard‐of‐care therapy for Japanese patients with metastatic nonsquamous NSCLC.
Summary Background There is no standard of care for adjuvant therapy for patients with hepatocellular carcinoma. This trial was designed to assess the efficacy and safety of sorafenib versus placebo ...as adjuvant therapy in patients with hepatocellular carcinoma after surgical resection or local ablation. Methods We undertook this phase 3, double-blind, placebo-controlled study of patients with hepatocellular carcinoma with a complete radiological response after surgical resection (n=900) or local ablation (n=214) in 202 sites (hospitals and research centres) in 28 countries. Patients were randomly assigned (1:1) to receive 400 mg oral sorafenib or placebo twice a day, for a maximum of 4 years, according to a block randomisation scheme (block size of four) using an interactive voice-response system. Patients were stratified by curative treatment, geography, Child-Pugh status, and recurrence risk. The primary outcome was recurrence-free survival assessed after database cut-off on Nov 29, 2013. We analysed efficacy in the intention-to-treat population and safety in randomly assigned patients receiving at least one study dose. The final analysis is reported. This study is registered with ClinicalTrials.gov , number NCT00692770. Findings We screened 1602 patients between Aug 15, 2008, and Nov 17, 2010, and randomly assigned 1114 patients. Of 556 patients in the sorafenib group, 553 (>99%) received the study treatment and 471 (85%) terminated treatment. Of 558 patients in the placebo group, 554 (99%) received the study treatment and 447 (80%) terminated treatment. Median duration of treatment and mean daily dose were 12·5 months (IQR 2·6–35·8) and 577 mg per day (SD 212·8) for sorafenib, compared with 22·2 months (8·1–38·8) and 778·0 mg per day (79·8) for placebo. Dose modification was reported for 497 (89%) of 559 patients in the sorafenib group and 206 (38%) of 548 patients in the placebo group. At final analysis, 464 recurrence-free survival events had occurred (270 in the placebo group and 194 in the sorafenib group). Median follow-up for recurrence-free survival was 8·5 months (IQR 2·9–19·5) in the sorafenib group and 8·4 months (2·9–19·8) in the placebo group. We noted no difference in median recurrence-free survival between the two groups (33·3 months in the sorafenib group vs 33·7 months in the placebo group; hazard ratio HR 0·940; 95% CI 0·780–1·134; one-sided p=0·26). The most common grade 3 or 4 adverse events were hand-foot skin reaction (154 28% of 559 patients in the sorafenib group vs four <1% of 548 patients in the placebo group) and diarrhoea (36 6% vs five <1% in the placebo group). Sorafenib-related serious adverse events included hand-foot skin reaction (ten 2%), abnormal hepatic function (four <1%), and fatigue (three <1%). There were four (<1%) drug-related deaths in the sorafenib group and two (<1%) in the placebo group. Interpretation Our data indicate that sorafenib is not an effective intervention in the adjuvant setting for hepatocellular carcinoma following resection or ablation. Funding Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals.
Psychiatric disorders in burning mouth syndrome de Souza, Fabrício T.A; Teixeira, Antônio L; Amaral, Tânia M.P ...
Journal of psychosomatic research,
02/2012, Letnik:
72, Številka:
2
Journal Article
Recenzirano
Abstract Background Prevalence of psychiatric disorders in burning mouth syndrome (BMS) is high, but their role in the pathogenesis of BMS remains unclear. Objective The authors aimed to assess the ...frequency of psychiatric disorders and the severity of psychopathology in BMS. Methods Thirty BMS patients and thirty-one controls underwent a psychiatric evaluation which included a structured interview (MINI-Plus) and five psychometric scales. A Visual Analogue Scale (VAS) was used to measure the intensity of burning sensation. Results Patients with BMS showed a higher frequency of current major depressive disorder, past major depressive disorder, generalized anxiety disorder, hypochondria and cancerophobia (p < 0.05). In BMS patients, generalized anxiety disorder was significantly associated with current major depression and social phobia (p < 0.05). As expected, cancerophobia was significantly associated with hypochondria (p < 0.05). Patients with BMS had higher scores in Hamilton Rating Scale for Depression (HRSD), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Dutch Fatigue Scale (DUFS) (p < 0.05). Conclusion BMS patients may have a particular psychological and/or psychiatric profile. Psychometric scales might be useful in screening psychiatric disorders, as well as for assessment of treatment outcomes. In the presence of clinical relevant psychiatric symptoms, patients must be treated appropriately.
Wireless heterogeneous networks (HetNets) are a cost- and energy-efficient alternative to provide high capacity to end users in the future 5G communication systems. However, the transport segment of ...a RAN poses a big challenge in terms of cost and energy consumption. In fact, if not planned properly, its resulting high cost might limit the benefits of using small cells and impact the revenues of mobile network operators. Therefore, it is essential to be able to properly assess the economic viability of different transport technologies as well as their impact on the cost and profitability of a HetNet deployment (i.e., RAN plus transport). This article first presents a general and comprehensive techno-economic framework able to assess not only the TCO but also the business viability of a HetNet deployment. The framework is then applied to the specific case study of a backhaul-based transport segment. In the evaluation work two technology options for the transport network are considered (i.e., microwave and fiber) assuming both a homogeneous (i.e., macrocells only) and a HetNet deployment. Our results demonstrate the importance of selecting the right technology and deployment strategy in order not to impact the economic benefits of a HetNet deployment. Moreover, the results also reveal that a deployment solution with the lowest TCO does not always lead to the highest profit.
Huanglongbing (HLB) is a disease of worldwide incidence that affects orange trees, among other commercial varieties, implicating in great losses to the citrus industry. The disease is transmitted ...through Diaphorina citri vector, which inoculates Candidatus Liberibacter spp. in the plant sap. HLB disease lead to blotchy mottle and fruit deformation, among other characteristic symptoms, which induce fruit drop and affect negatively the juice quality. Nowadays, the disease is controlled by eradication of sick, symptomatic plants, coupled with psyllid control. Polymerase chain reaction (PCR) is the technique most used to diagnose the disease; however, this methodology involves high cost and extensive sample preparation. Mass spectrometry imaging (MSI) technique is a fast and easily handled sample analysis that, in the case of Huanglongbing allows the detection of increased concentration of metabolites associated to the disease, including quinic acid, phenylalanine, nobiletin and sucrose. The metabolites abieta-8,11,13-trien-18-oic acid, suggested by global natural product social molecular networking (GNPS) analysis, and 4-acetyl-1-methylcyclohexene showed a higher distribution in symptomatic leaves and have been directly associated to HLB disease. Desorption electrospray ionization coupled to mass spectrometry imaging (DESI-MSI) allows the rapid and efficient detection of biomarkers in sweet oranges infected with Candidatus Liberibacter asiaticus and can be developed into a real-time, fast-diagnostic technique.
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•This study presents a new approach for automatic segmentation of lung CT scans.•An original method for image processing using CNNs as kernels.•It comprehends a new model based on ...deep learning using Mask R-CNN combined with supervised and unsupervised machine learning methods.•Our model achieved high quality segmentation results that are better than the results generated by using the standard Mask R-CNN itself.
Computer vision systems have numerous tools to assist in various medical fields, notably in image diagnosis. Computed tomography (CT) is the principal imaging method used to assist in the diagnosis of diseases such as bone fractures, lung cancer, heart disease, and emphysema, among others. Lung cancer is one of the four main causes of death in the world. The lung regions in the CT images are marked manually by a specialist as this initial step is a significant challenge for computer vision techniques. Once defined, the lung regions are segmented for clinical diagnoses. This work proposes an automatic segmentation of the lungs in CT images, using the Convolutional Neural Network (CNN) Mask R-CNN, to specialize the model for lung region mapping, combined with supervised and unsupervised machine learning methods (Bayes, Support Vectors Machine (SVM), K-means and Gaussian Mixture Models (GMMs)). Our approach using Mask R-CNN with the K-means kernel produced the best results for lung segmentation reaching an accuracy of 97.68 ± 3.42% and an average runtime of 11.2 s. We compared our results against other works for validation purposes, and our approach had the highest accuracy and was faster than some state-of-the-art methods.
Alternative sources of fuel have been a concern in the last few decades. The growth of urbanization and industrialization will lead to the exhaustion of fossil fuels, attracting studies on ...alternative routes. The main aim of this study was to produce biodiesel from waste cooking oil (WCO) by methyl transesterification using sodium hydroxide as a catalyst. For this, the physicochemical parameters of biodiesel were studied in triplicate (density, acidity, saponification, viscosity, corrosiveness to copper, visual appearance, and cloud point). An analysis by thin layer chromatography and infrared spectrometry was also performed. The increase in yield (83.3%) was directly proportional to the increase in the catalyst (0.22 g of NaOH). The infrared absorption spectra of WCO and biodiesel showed the presence of common and singular bands of each material. Furthermore, a simple and low-cost mechanism was proposed for purifying glycerol. The spectra of glycerol versus purified glycerin showed that the glycerin produced was pure, being used in the formulation of bioplastic. The product was checked for biodegradation and photodegradation, with incredible soil-degradation times of 180 days and photodegradation of only 60 days. In this way, biodiesel production from WCO showed environmentally friendly proposals and applicability. As the next steps, it is necessary to test the biodiesel produced in combustion engines and improve the bioplastic production, including a spectroscopic characterization and extensive biodegradation testing.
The Special Issue “Emerging Viruses: Surveillance, Prevention, Evolution and Control” has been published annually by Viruses, since 2019, highlighting the increasing effort of the scientific ...community for the surveillance and further research of new emerging or re-emerging viruses ...
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