Clinically available medications face several hurdles that limit their therapeutic activity, including restricted access to the target tissues due to biological barriers, low bioavailability, and ...poor pharmacokinetic properties. Drug delivery systems (DDS), such as nanoparticles (NPs) and hydrogels, have been widely employed to address these issues. Furthermore, the DDS improves drugs' therapeutic efficacy while reducing undesired side effects caused by the unspecific distribution over the different tissues. The integration of NPs into hydrogels has emerged to improve their performance when compared with each DDS individually. The combination of both DDS enhances the ability to deliver drugs in a localized and targeted manner, paired with a controlled and sustained drug release, resulting in increased drug therapeutic effectiveness. With the incorporation of the NPs into hydrogels, it is possible to apply the DDS locally and then provide a sustained release of the NPs in the site of action, allowing the drug uptake in the required location. Additionally, most of the materials used to produce the hydrogels and NPs present low toxicity. This article provides a systematic review of the polymeric NPs-loaded hydrogels developed for various biomedical applications, focusing on studies that present in vivo data.
We aim to understand the relationship between people’s declared bioclimatic comfort, their personal characteristics (age, origin, clothing, activity and motivation, etc.) and the atmospheric ...conditions. To attain this goal, questionnaire surveys were made concurrently with weather measurements (air temperature, relative humidity, solar and long-wave radiation and wind speed) in two open leisure areas of Lisbon (Portugal), during the years 2006 and 2007. We analysed the desire expressed by the interviewees to decrease, maintain or increase the values of air temperature and wind speed, in order to improve their level of comfort. Multiple logistic regression was used to analyse the quantitative relation between preference votes and environmental and personal parameters. The preference for a different temperature depends on the season and is strongly associated with wind speed. Furthermore, a general decrease of discomfort with increasing age was also found. Most people declared a preference for lower wind speed in all seasons; the perception of wind shows significant differences depending on gender, with women declaring a lower level of comfort with higher wind speed. It was also found that the tolerance of warmer conditions is higher than of cooler conditions, and that adaptive strategies are undertaken by people to improve their level of comfort outdoors.
Rainfall intensity, duration, frequency and magnitude influence both runoff generation and sediment yield. In this study, 176 rainfall events over a five-year period were classified into four regimes ...based on rainfall depth, duration and 30-minute maximum intensity, using hierarchical cluster analysis in the semiarid region of Brazil. Rainfall Regimes were grouped from higher to lower rainfall depth, longer to shorter duration, and higher to lower I30. Rainfall regime impact on surface runoff and sediment yield was studied in three watersheds under different land use - native tropical dry forest, thinned tropical dry forest, and slash and burn followed by grass cultivation. Thinning of native dry tropical forest reduced surface runoff and sediment yield due to the protective effect of the well-developed herbaceous layer. Runoff generation in the three watersheds showed strong dependence on antecedent soil moisture and the type of rain. Rainfall depth was the major factor for highest sediment yields.
Vitamin D may be implicated in the pathophysiology of several ocular diseases, but its role in age-related macular degeneration (AMD) remains uncertain. We sought to review systematically the ...existing evidence to evaluate the association between serum 25-hydroxyvitamin D 25(OH)D levels and AMD. A four-database search (PubMed, ISI Web of Science, Cochrane, and Scopus) was performed from inception to May 2020 using the MeSH terms: (“Macular Degeneration” OR “Age-related macular degeneration” OR “Retinal degeneration” OR “Macula lutea”) AND (“Vitamin D” OR “Ergocalciferols” OR “Cholecalciferol” OR “25-Hydroxyvitamin D”). Random-effects meta-analyses were performed to compute 1) the standard mean difference in 25(OH)D concentration between AMD and non-AMD patients and 2) the AMD risk according to serum 25(OH)D levels. Eighteen observational studies enrolling 75,294 patients after a selection process among 375 original abstracts were selected. No significant differences were found, but there appears to exist a trend for late AMD among subjects with a serum 25(OH)D level below 50 nmol/L (odds ratio, 1.8; 95% confidence interval: 1.00–3.24, P = 0.05). There is no clear evidence of a definitive association between serum 25(OH)D and AMD risk, mainly due to heterogeneity in study procedures and lack of longitudinal designs.
Coffee may protect against non-alcoholic fatty liver disease (NAFLD), but the roles of the caffeine and non-caffeine components are unclear. Coffee intake by 156 overweight subjects (87% with ...Type-2-Diabetes, T2D) was assessed via a questionnaire, with 98 subjects (all T2D) also providing a 24 h urine sample for quantification of coffee metabolites by LC-MS/MS. NAFLD was characterized by the fatty liver index (FLI) and by Fibroscan
assessment of fibrosis. No associations were found between self-reported coffee intake and NAFLD parameters; however, total urine caffeine metabolites, defined as Σ
(caffeine + paraxanthine + theophylline), and adjusted for fat-free body mass, were significantly higher for subjects with no liver fibrosis than for those with fibrosis. Total non-caffeine metabolites, defined as Σ
(trigonelline + caffeic acid +
-coumaric acid), showed a significant negative association with the FLI. Multiple regression analyses for overweight/obese T2D subjects (n = 89) showed that both Σ
and Σ
were negatively associated with the FLI, after adjusting for age, sex, Hb
, ethanol intake and glomerular filtration rate. The theophylline fraction of Σ
was significantly increased with both fibrosis and the FLI, possibly reflecting elevated CYP2E1 activity-a hallmark of NAFLD worsening. Thus, for overweight/obese T2D patients, higher intake of both caffeine and non-caffeine coffee components is associated with less severe NAFLD. Caffeine metabolites represent novel markers of NAFLD progression.
The role of capsule endoscopy and enteroscopy in managing various small-bowel pathologies is well-established. However, their broader application has been hampered mainly by their lengthy reading ...times. As a result, there is a growing interest in employing artificial intelligence (AI) in these diagnostic and therapeutic procedures, driven by the prospect of overcoming some major limitations and enhancing healthcare efficiency, while maintaining high accuracy levels. In the past two decades, the applicability of AI to gastroenterology has been increasing, mainly because of the strong imaging component. Nowadays, there are a multitude of studies using AI, specifically using convolutional neural networks, that prove the potential applications of AI to these endoscopic techniques, achieving remarkable results. These findings suggest that there is ample opportunity for AI to expand its presence in the management of gastroenterology diseases and, in the future, catalyze a game-changing transformation in clinical activities. This review provides an overview of the current state-of-the-art of AI in the scope of small-bowel study, with a particular focus on capsule endoscopy and enteroscopy.
Alzheimer's Disease (AD) is a neurodegenerative disorder related with the increase of age and it is the main cause of dementia in the world. AD affects cognitive functions, such as memory, with an ...intensity that leads to several functional losses. The continuous increase of AD incidence demands for an urgent development of effective therapeutic strategies. Despite the extensive research on this disease, only a few drugs able to delay the progression of the disease are currently available. In the last years, several compounds with pharmacological activities isolated from plants, animals and microorganisms, revealed to have beneficial effects for the treatment of AD, targeting different pathological mechanisms. Thus, a wide range of natural compounds may play a relevant role in the prevention of AD and have proven to be efficient in different preclinical and clinical studies. This work aims to review the natural compounds that until this date were described as having significant benefits for this neurological disease, focusing on studies that present clinical trials.
•First study to quantify QALY loss due to varicella in hospitalised children.•First study to describe QALY loss in the carers of children with varicella.•High QALY loss in the family units of ...children admitted to hospital with varicella.•Significant impact on HRQoL of varicella infection in family units.
Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection.
Children with varicella in the community and admitted to hospitals in Portugal were included over 18 months from January 2019. Children's and carers’ HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs.
Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0 days (95 % CI 1.9–2.2, n = 101) (mean 5.4 QALYs/1000 children (95 % CI 5.3–6.1) and 1.3 days/primary carer (95 % CI 1.2–1.6, n = 103) (mean 3.6 QALYs /1000 carers (95 % CI 3.4–4.4).
Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8 days (95 % CI 9.4–10.6, n = 114) (mean 26.8 QALYs /1000 children (95 % CI 25.8–29.0) and 8.5 days/primary carer (95 % CI 7.4–9.6, n = 114) (mean 23.4 QALYs/1000 carers (95 % CI 20.3–26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections 67.5 (95 % CI 43.9–97.6).
Estimates for children’s QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower.
The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.
Systemic lupus erythematosus (SLE) is a chronic, systemic, autoimmune connective tissue disease that affects several vascular territories. We sought to assess the role of optical coherence tomography ...angiography in detecting subclinical microvascular alterations in SLE patients. PubMed, Scopus, and Web of Science databases were systematically searched until January 21, 2023. Studies using optical coherence tomography angiography as a primary diagnostic method to evaluate the macular microvasculature of SLE patients versus healthy controls were included. Primary outcomes were macular vessel density and foveal zone parameters. A meta-analysis was performed using a random-effects model. Of 301 screened abstracts, 15 were found eligible, enrolling 1,246 eyes from 1,013 patients. SLE patients presented a reduction of macular vessel density at both plexuses in all zones (whole scan, fovea, parafovea, and perifovea), and of foveal density compared with healthy controls. No differences were found at foveal avascular zone parameters. SLE patients presented a reduction of macular vessel density without signs or symptoms of SLE ocular involvement. Optical coherence tomography angiography application for the assessment of subclinical microvascular changes needs to be elucidated with longitudinal studies.
•Retinal microvascular changes were found in SLE patients using OCT-Angiography.•SLE leads to a reduction of macular vessel density.•OCT-Angiography may be used to detect subclinical microvascular changes.
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