Barriers to medication adherence by caregivers of children with leukemia: an observational study / Barreiras de adesão medicamentosa por cuidadores de crianças com leucemia: um estudo observacional

ABSTRACT Objective: To identify barriers to adherence to home oral maintenance chemotherapy in children with leukemia treated at a specialized cancer center. Methods: We used the Brief Medication Questionnaire (BMQ) as a tool for screening barriers to adherence. The level of adherence was calculated considering at least one positive response in each BMQ domain, defined as Regimen Screen, Belief Screen, and Recall Screen. A positive screening for belief barriers (PSB) indicates that the caregiver reports not understanding the medication's mechanism of action and adverse effects. Results: Three important barriers to adherence were identified: beliefs, number of children of the caregiver, and age of the caregiver. The primary caregivers included 32 mothers (80%), four fathers (10%), three grandmothers (7.5%), and one unrelated caregiver (2.5 %). Most caregivers with a PSB were mothers. A PSB indicates that the caregiver reports not understanding the medication's mechanism of action and adverse effects. Caregivers with two or more children (median, three) had more barriers to adherence. Caregivers with potential non-adherence tended to be older than those with potential adherence, although without statistical significance (p=0.079, Mann-Whitney U test). Conclusions: The main barriers to adherence to home oral maintenance chemotherapy in children with leukemia identified through interviews with their caregivers, most often mothers, were lack of understanding of the treatment regimen, a greater number of children, and older age.

RESUMO Objetivo: Identificar barreiras de adesão ao tratamento de manutenção da quimioterapia via oral domiciliar, em uma amostra de crianças diagnosticadas com leucemia atendidas em um serviço especializado em oncologia. Métodos: O Brief Medication Questionnaire (BMQ) foi utilizado como instrumento de coleta para a identificação de barreiras de adesão. O nível de adesão foi calculado considerando-se pelo menos uma resposta positiva no domínio do BMQ, definido como regime, crença e recordação. Uma crença positiva mostra que o cuidador reporta não entender o mecanismo de ação e os efeitos adversos. Resultados: Três importantes barreiras de adesão foram identificadas, incluindo crença, o número de filhos do casal e a idade dos cuidadores. A mãe como principal responsável pelo tratamento da criança apresentou frequência maior entre as pessoas com rastreamento positivo para barreiras de crenças (BPC). Crença positiva significa que o cuidador relata não entender o mecanismo de ação dos medicamentos e os efeitos adversos. Quanto ao número de filhos, o estudo mostrou que quanto mais filhos (dois filhos ou mais, mediana=três) maior a barreira de adesão. Houve tendência de responsáveis com potencial não adesão serem mais velhos que os responsáveis com potencial adesão, embora sem significância estatística ao nível de significância de 5% (p=0,079, teste U de Mann-Whitney). Conclusões: As principais barreiras de adesão dos cuidadores de crianças com leucemia ao tratamento medicamentoso de manutenção foram dificuldades relatadas pelos cuidadores, na maioria das vezes as mães, que não entenderam como o medicamento funcionava, o número de filhos — quanto mais filhos menor a adesão — e a idade dos cuidadores. Cuidadores mais velhos aderiram menos ao tratamento prescrito.

Perspectivas teóricas para un enfoque dialógico de la acreditación de posgrado en México

Los procesos de acreditación se ubican en el marco de las megatendencias globales que colocan en el centro del debate las nociones excelencia y evaluación de la calidad en las instituciones de educación superior contemporáneas. El estudio se realiza en la Benemérita Universidad Autónoma de Puebla, parte de un enfoque cualitativo en el que el método análisis de contenidos ocupó el centro de las acciones para develar desde las epistemologías globales y regionales, las regularidades que se manifiestan en la dinámica de los procesos de acreditación con énfasis en las instituciones de educación mexicana. La unidad de análisis se ubica en los documentos normativos, foros e informes de buenas prácticas en el quehacer de la acreditación. Como resultado, se proponen las bases conceptuales que favorecen una dialógica en el proceso de evaluación aplicada a los programas de posgrado mexicano, el cual, con las adecuaciones necesarias podría aplicarse a otras universidades.

Accreditation processes are located within the framework of global megatrends that place the notions of excellence and quality assessment in contemporary higher education institutions at the center of the debate. The study presented here was carried out at the Benemérita Universidad Autónoma de Puebla, based on a qualitative approach in which the content analysis method was at the center of the actions to unveil from the global and regional epistemologies regularities that are manifested in the dynamics of accreditation processes with emphasis on Mexican educational institutions. The unit of analysis is located in the normative documents, forums and reports of good practices in accreditation. As a result, conceptual bases are proposed that can favor a dialogic in the evaluation process applied to Mexican graduate programs, which, with the necessary adaptations could be applied to con universities.

Identifying childhood leukemia with an excess of hematological malignancies in first-degree relatives in Brazil.

Background: Familial aggregation in childhood leukemia is associated with epidemiological and genomic factors. Albeit epidemiological studies on the familial history of hematological malignancies (FHHMs) are scarce, genome-wide studies have identified inherited gene variants associated with leukemia risk. We revisited a dataset of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients to explore the familial aggregation of malignancies among their relatives. Methods: A series of 5,878 childhood leukemia (≤21 years of age) from the EMiLI study (2000-2019) were assessed. Lack of well-documented familial history of cancer (FHC) and 670 cases associated with genetic phenotypic syndromes were excluded. Leukemia subtypes were established according to World Health Organization recommendations. Logistic regression-derived odds ratios (ORs) and 95% confidence intervals (CIs) were performed and adjusted by age as a continuous variable, where ALL was the reference group for AML and conversely. The pedigree of 18 families with excess hematological malignancy was constructed. Results: FHC was identified in 472 of 3,618 eligible cases (13%). Ninety-six of the 472 patients (20.3%) had an occurrence of FHHMs among relatives. Overall, FHC was significantly associated with AML (OR, 1.36; 95% CI, 1.01-1.82; p = 0.040). Regarding the first-degree relatives, the OR, 2.92 95% CI,1.57-5.42 and the adjOR, 1.16 (1.03-1.30; p0.001) were found for FHC and FHHM, respectively. Conclusion: Our findings confirmed that AML subtypes presented a significant association with hematological malignancies in first-degree relatives. Genomic studies are needed to identify germline mutations that significantly increase the risk of developing myeloid malignancies in Brazil.

Alternative medicine therapies in neurological disorders: Prevalence, reasons and associated factors. A systematic review.

OBJECTIVE: This systematic review aimed to identify the prevalence of CAM use in patients with neurological disorders, and also to know most frequent types of CAM used. METHODS: Five databases: PubMed, Science Direct, EBSCO, Latindex and Scielo (in English and Spanish) were searched from January 2010 to May 2021. Only original cross-sectional, retrospective and cohort studies were included, whose primary objective was to describe the frequency of CAM use in neurological disorders and/or the related factors to its use in adults. Based on the data, a descriptive analysis was performed, covering the characteristics of studies, measuring methods, prevalence, types and related factors. To control the risk of bias, a quality assessment of each study was performed using STROBE checklist. RESULTS: For the final analysis, 40 studies were included. Most common pathologies observed in the studies were multiple sclerosis, headache, stroke, Parkinson and epilepsy. The STROBE score of studies ranged from 13 to 22 points, with an average of 18.2. Prevalence of CAM use was highly variable from one study to another (16% in stroke patients, to 100% in amyotrophic lateral sclerosis or spinal cord injury patients). Biological therapies (dietary supplements and herbal medicine) were the most commonly CAM types used. The associated factors identified were female sex, an age between 40 and 50 years, and higher socioeconomic level. Not all studies investigated about the results of CAMs but these ranged from 35% to more than 80% of reporting positive effects. CONCLUSIONS: The prevalence of CAM use in neurological diseases is highly variable (16%-100%); the most used type of CAM was biological therapies and the associated factors were female sex, age between 40 and 50 years old and high socioeconomic level.

A sensitive and inexpensive high-resolution melting-based testing algorithm for diagnosis of transient abnormal myelopoiesis and myeloid leukemia of Down syndrome.

Patients with Down syndrome (DS) are commonly affected by a pre-leukemic disorder known as transient abnormal myelopoiesis (TAM). This condition usually undergoes spontaneous remission within the first 2 months after birth; however, in children under 5, 20%-30% of cases evolve to myeloid leukemia of Down syndrome (ML-DS). TAM and ML-DS are caused by co-operation between trisomy 21 and acquired mutations in the GATA1 gene. Currently, only next-generation sequencing (NGS)-based methodologies are sufficiently sensitive for diagnosis in samples with small GATA1 mutant clones (≤10% blasts). Alternatively, this study presents research on a new, fast, sensitive, and inexpensive high-resolution melting (HRM)-based diagnostic approach that allows the detection of most cases of GATA1 mutations, including silent TAM. The algorithm first uses flow cytometry for blast count, followed by HRM and Sanger sequencing to search for mutations on exons 2 and 3 of GATA1. We analyzed 138 samples of DS patients: 110 of asymptomatic neonates, 10 suspected of having TAM, and 18 suspected of having ML-DS. Our algorithm enabled the identification of 33 mutant samples, among them five cases of silent TAM (5/110) and seven cases of ML-DS (7/18) with blast count ≤10%, in which GATA1 alterations were easily detected by HRM. Depending on the type of genetic variation and its location, our methodology reached sensitivity similar to that obtained by NGS (0.3%) at a considerably reduced time and cost, thus making it accessible worldwide.

Blockchain Mechanism and Symmetric Encryption in A Wireless Sensor Network.

The Internet of Things (IoT) paradigm allows the connection and exchange of information between millions of smart devices. This paradigm grows and develops exponentially as do the risks and attacks on IoT infrastructures. Security, privacy, reliability, and autonomy are the most important requirements in IoT Systems. If these issues are not guaranteed, the IoT system could be susceptible to malicious users and malicious use. In centralized IoT systems, attacks and risks are greater, especially when data is transmitted between devices and shared with other organizations. To avoid these types of situations, this work presents a decentralized system that guarantees the autonomy and security of an IoT system. The proposed methodology helps to protect data integrity and availability based on the security advantages provided by blockchain and the use of cryptographic tools. The accuracy of the proposed methodology was measured on a temperature and humidity sensing IoT-based Wireless Sensor Network (WSN). The obtained results prove that the proposal fulfils the main requirements of an IoT system. It is autonomous, secure to share and send information between devices and users, has privacy, it is reliable, and the information is available in the infrastructure. Furthermore, this research demonstrates that the proposal is less susceptible to the most frequent attacks against IoT systems, such as linking attack, man in the middle, and Distributed Denial of Service (DDoS) attack.

Partição de Comprimidos Antineoplásicos Utilizados no Tratamento de Leucemias Agudas em Crianças e Adolescentes / Splitting of Antineoplastic Tablets Used in Acute Leukemias Treatment in Children and Adolescents / Partición de Comprimidos Antineoplásicos Empleados en el Tratamiento de Leucemias Agudas en Niños y Adolescentes

Introdução: A manipulação de antineoplásicos para ajuste de dose, como partição de comprimidos, é comum no tratamento de leucemias agudas de crianças e adolescentes. Objetivo: Identificar a frequência e descrever a prática da partição domiciliar de comprimidos antineoplásicos utilizados no tratamento oral de crianças e adolescentes com leucemias agudas na fase de manutenção. Método: Trata-se de um estudo transversal descritivo, realizado em um hospital pertencente à rede de saúde pública do Distrito Federal com assistência especializada em pediatria. Foram incluídos no estudo crianças e adolescentes entre 1 e 18 anos, diagnosticados com leucemias agudas e em fase de manutenção do tratamento no período de estudo. Foi aplicado um questionário semiestruturado ao responsável principal pela administração dos medicamentos quimioterápicos via oral, podendo ser o cuidador ou a própria criança/adolescente. Foram coletadas variáveis sociodemográficas dos pacientes e cuidadores e variáveis sobre a prática de partição de medicamentos antineoplásicos no domicílio. Resultados: Todos os 48 entrevistados no período do estudo relataram ter partido comprimidos antineoplásicos ao longo do tratamento de leucemias agudas, sendo estes mercaptopurina (n=45 [93,75%]) e tioguanina (n=3 [6,25%]). Conclusão: A partição de comprimidos antineoplásicos foi uma prática unânime em virtude da necessidade referida de ajuste de dose individual para o tratamento de leucemias agudas de crianças e adolescentes, considerando a indisponibilidade de formulações adequadas. Os resultados reforçam a necessidade de a partição ser uniformizada e realizada de maneira a minimizar os riscos e a garantir a segurança para as crianças e adolescentes e seus cuidadores.

Introduction: Antineoplastic drug manipulation for dose adjustment, such as tablet splitting, is standard in acute leukemia treatment for children and adolescents. Objective: To identify the frequency and describe the practice of household splitting of antineoplastic tablet for oral treatment of children and adolescents with acute leukemias in the maintenance phase. Method: Cross-sectional descriptive study performed in a public health system hospital from Distrito Federal (Brazil) with specialized pediatric assistance. Children and teenagers between 1 and 18 years old, diagnosed with acute leukemia and in treatment maintenance phase during the study period were included. A semi-structured questionnaire was applied to the main responsible for administering oral chemotherapy drugs, which could be the caregiver or the child/adolescent themselves. Sociodemographic variables of patients and caregivers and variables on the practice of splitting antineoplastic drugs at home were collected. Results: All 48 interviewees in the study period reported having split antineoplastic tablets during the treatment for acute leukemias, such as mercaptopurine (n = 45 [93.75%]) and thioguanine (n = 3 [6.25%]). Conclusion: The splitting of antineoplastic tablets was a unanimous practice due to the reported need to adjust the individual dose for acute leukemia treatment in children and adolescents, considering the unavailability of adequate formulations. The results reinforce the need for splitting to be standardized and performed in a way that minimizes risks and ensures safety for patients and their caregivers

Introducción: La manipulación de fármacos antineoplásicos para el ajuste de dosis, como las particiones de comprimidos, es frecuente en el tratamiento de las leucemias agudas en niños y jóvenes. Objetivo: Identificar la frecuencia y describir la práctica de la división domiciliaria de medicamentos antineoplásicos utilizados en el tratamiento oral de niños y adolescentes con leucemias agudas en la fase de mantenimiento. Método: Se trata de un estudio transversal descriptivo realizado en un hospital de la red de salud pública del Distrito Federal (Brasil) con asistencia especializada en pediatría. El estudio incluyó a niños y jóvenes de entre 1 y 18 años de edad diagnosticados con leucemia aguda y en fase de mantenimiento del tratamiento en el período del estudio. Se aplicó un cuestionario semiestructurado a la persona principal responsable de la administración de fármacos quimioterapéuticos por vía oral, que puede ser el cuidador o el propio niño/joven. Fueron colectadas variables sociodemográficas de los pacientes y cuidadores y variables sobre la práctica de la división de los medicamentos antineoplásicos en domicílios. Resultados: Los 48 entrevistados en el período de estudio informaron haber roto las pastillas antineoplásicas durante el tratamiento de la leucemia aguda, siendo éstas mercaptopurina (n=45 [93,75%]) y tioguanina (n=3 [6,25%]). Conclusión: La partición de comprimidos antineoplásicos fue una práctica unánime debido a la necesidad mencionada de ajustar la dosis individual para el tratamiento de las leucemias agudas de niños y adolescentes, considerando la falta de formulaciones apropiadas. Los resultados refuerzan la necesidad de estandarizar y realizar la partición para minimizar los riesgos y garantizar la seguridad de los niños, jóvenes y sus cuidadores.

Symbolic Recurrence Analysis of RR Interval to Detect Atrial Fibrillation.

Atrial fibrillation (AF) is a sustained cardiac arrhythmia associated with stroke, heart failure, and related health conditions. Though easily diagnosed upon presentation in a clinical setting, the transient and/or intermittent emergence of AF episodes present diagnostic and clinical monitoring challenges that would ideally be met with automated ambulatory monitoring and detection. Current approaches to address these needs, commonly available both in smartphone applications and dedicated technologies, combine electrocardiogram (ECG) sensors with predictive algorithms to detect AF. These methods typically require extensive preprocessing, preliminary signal analysis, and the integration of a wide and complex array of features for the detection of AF events, and are consequently vulnerable to over-fitting. In this paper, we introduce the application of symbolic recurrence quantification analysis (SRQA) for the study of ECG signals and detection of AF events, which requires minimal pre-processing and allows the construction of highly accurate predictive algorithms from relatively few features. In addition, this approach is robust against commonly-encountered signal processing challenges that are expected in ambulatory monitoring contexts, including noisy and non-stationary data. We demonstrate the application of this method to yield a highly accurate predictive algorithm, which at optimal threshold values is 97.9% sensitive, 97.6% specific, and 97.7% accurate in classifying AF signals. To confirm the robust generalizability of this approach, we further evaluated its performance in the implementation of a 10-fold cross-validation paradigm, yielding 97.4% accuracy. In sum, these findings emphasize the robust utility of SRQA for the analysis of ECG signals and detection of AF. To the best of our knowledge, the proposed model is the first to incorporate symbolic analysis for AF beat detection.

Synthesis and structural characterization of homochiral coordination polymers with imidazole-based monocarboxylate ligands.

Chiral Na[(S)-LR] (R = Me, 1a; iPr, 1b; CH2iPr, 1c, and (S)-secBu, 1d) and Na[(R)-LR] (R = Me, 1a') compounds were synthesised following standard procedures. New compounds 1d and 1a' were analytically and spectroscopically characterised. 1a and 1c were structurally identified by single-crystal X-ray diffraction methods as homochiral 2D coordination polymers, {Na(H2O)[(S)-LMe]}n and {Na[(S)-LCH2iPr]}n, respectively. Both (S)-2alkyl,2-(1H-imidazol-1-yl)acetate anions displayed unprecedented coordination modes in these coordination polymers: µ3κ2OκO' for 1a and µ4κ2Oκ2O' for 1c. Enantiomeric species 1a', {Na(H2O)[(R)-LMe]}n, showed the same X-ray powder diffractogram (XRPD) as 1a, in agreement with a similar crystal structure. DFT calculations on the [LR]- anions confirmed their coordination capabilities as ditopic linkers. In fact, the reaction of Na[LR] with several metal salts yielded the following coordination polymers: {Ag[(S)-LMe]}n, 2a, {Ag[(R)-LMe]}n, 2a', {Cu[(S)-LR]2}n (R = Me, 3a; iPr, 3b), {Cu[(R)-LMe]}n, 3a', {Zn[(S)-LR]2}n (R = Me, 4a; iPr, 4b; (S)-secBu, 4d) and {Zn[(R)-LMe]2}n, 4a'. For the known compounds 3a and 4a, this procedure is a new synthetic route that avoided high temperature reaction conditions. New complexes 2, 3a', b, and 4a', b, d were characterised by elemental analysis, infrared and XRPD methods and complex 2a by single-crystal X-ray diffraction. This complex is also a two-dimensional coordination polymer in which the [(S)-LMe]- anion acts as a µ4κN,κ2O,κ2O' bridging ligand. Compounds 1-4a' are the first examples of homochiral coordination polymers with imidazole-monocarboxylate ligands based on non-natural amino acids. Preliminary studies on the metal-catalysed preparation of chiral α-aminophosphonates were carried out but, unfortunately, no enantioselectivity was observed.

Tailoring the Band Gap in the ZnS/ZnSe System: Solid Solutions by a Mechanically Induced Self-Sustaining Reaction.

The complete ZnS xSe1- x solid solution was successfully obtained by the mechanochemical process denoted as a mechanically induced self-sustaining reaction. Excellent control of the chemical stoichiometry of the solid solution was possible by adjusting the atomic ratio of the starting Zn/S/Se elemental mixture subjected to milling. A mixture of both wurtzite-2H (hexagonal) and zinc blende (cubic) structures was always obtained, although for a similar milling time the proportion of the zinc blende structure increased with the Se content in the solid solution. However, wurtzite was the major phase for S-rich compositions when milling was stopped just after ignition. It was demonstrated that milling induces the wurtzite-to-zinc blende phase transition. The 8H hexagonal polytype was also observed in samples subjected to long milling times. Variation of the lattice parameters for both structures with the x value in the solid solution presented an excellent linearity, confirming the validity of Vegard's law. However, variation of the band-gap energy ( Eg) with x was not perfectly linear, and a small bowing parameter of 0.34 was obtained. It was possible to tune the Eg value between those of the end members of the solid solution in a continuous manner by adjusting the stoichiometry of the solid solution. The morphology and crystalline domain size can also be controlled by adjusting, in this case, the postignition milling time of the mechanochemical process.

Muscle Activation During Power-Oriented Resistance Training: Continuous vs. Cluster Set Configurations.

Morales-Artacho, AJ, García-Ramos, A, Pérez-Castilla, A, Padial, P, Gomez, AM, Peinado, AM, Pérez-Córdoba, JL, and Feriche, B. Muscle activation during power-oriented resistance training: continuous vs. cluster set configurations. J Strength Cond Res 33(7S): S95-S102, 2019-This study examined performance and electromyography (EMG) changes during a power training protocol comprising continuous or clustered set configurations. Eighteen active males completed 6 sets of 6 repetitions during the loaded (20% 1 repetition maximum) countermovement jump (CMJ) exercise, continuously (n = 9) or with a 30-second pause every 2 repetitions (cluster; n = 9). Power output, vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) EMG were recorded during all CMJs. Relative changes from the first repetition were assessed on the EMG root mean square (RMS), median frequency (Fmed), and a low- to high-frequency ratio index of fatigue (FInsmk). Greater power output decrements were observed during the continuous set configuration (p = 0.001, (Equation is included in full-text article.)< 0.01). Greater RMS increments in VL (6.8 ± 11.3 vs. -1.7 ± 5.8%) and RF (9.3 ± 14.2 vs. 1.9 ± 6.9%), but not VM (2.0 ± 4.7 vs. 2.6 ± 7.3%), were also observed in the continuous compared with the cluster sets (p = 0.033, (Equation is included in full-text article.)= 0.06). Progressive decrements in Fmed and increments in FInsmk were observed across repetitions in both set configurations. In conclusion, although clustering sets between repetitions clearly maintained power output, mixed responses were observed on the examined EMG parameters.

Influencia de la protocolización del tratamiento inicial con corticoides en la estancia y costo de las neumonías adquiridas en la comunidad. Estudio prospectivo 2015 / Influence of initial protocolized treatment with steroids in length of stay and costs of community acquired pneumonia

Objetivos. Valorar el impacto que la inclusión inicial de corticoides en el protocolo de tratamiento de un paciente con neumonía de la comunidad (NAC) puede tener en la estancia y costo de los procesos en enfermos ingresados con este diagnóstico en un hospital clínico universitario. Pacientes y métodos. Estudio prospectivo de los pacientes ingresados con el diagnóstico de NAC en los Servicios de Medicina Interna e Infecciosas durante los meses de enero a marzo de 2015; los pacientes se clasificaron en Grupo I, en caso de haber recibido esteroides desde el diagnóstico del proceso neumónico y hasta la finalización del tratamiento antibiótico y en Grupo II, si no habían recibido esteroides; la administración o no de esteroides fue realizada según la práctica clínica de cada médico responsable del paciente. Se valoró el costo según el GRD de NAC. Resultados. La edad < de 65 años es más frecuente en el grupo I que en el II, siendo el único factor diferencial entre ambas cohortes con significación estadística (p<0,05). En el análisis bivariado, las estancias medias del grupo I (5,37 vs 8,88 días) fueron significativamente menores (p<0,0005) y también lo fueron los costes (2.361 euros vs 3.907 euros) (p<0,0005). En el estudio multivariado se asociaron de forma independiente los costes altos (>3.520 euros) a los pacientes con EPOC (OR=2,602; IC95% 1,074-6,305) y al grupo II (pacientes que no habían recibido esteroides) (OR=6,2; p=0,007). Conclusiones. El no utilizar corticoides en el tratamiento de los pacientes con neumonías comunitarias se asoció, junto con el ser EPOC a un mayor coste del ingreso, valorado por el GRD/estancia diaria (AU)

Objective. The aim of the study was to analyze the impact of steroid treatment in patients with community acquired pneumonia (CAP), both in length of stay and economical cost of admission at a clinical university hospital. Patients and methods. Prospective study of admitted patients with the diagnosis of CAP, both in Internal Medicine and Infectious diseases department. The study was conducted from January to march 2015; patients receiving steroids from diagnosis to end of antibiotic treatment were classified as group I; otherwise, they were considered in group II. Administration of steroids was done according to the criteria of the responsible. Cost was stablished according to CAP Diagnostic Related Group (DRG). Results. Prevalence of patients younger than 65 year old was higher in group I (p<0.05). In bivariate analyses, mean admission time was lower in group I (5.37 vs 8.88 days) (p<0.0005) and also economical cost (2,361 euros vs 3,907 euros) (p<0.0005). In multivariate analysis, factors independently associated to higher cost (>3,520 euros) were COPD (OR=2.602; 95% CI 1.074-6.305) and group II (patients with no steroids) (OR=6.2; p=0,007). Conclusions. No administration of steroids in patients with CAP was associated, together with COPD, with higher economical cost (evaluated by DRG/length of stay) (AU)

Photocatalytic Properties of TiO2 Thin Films Modified with Ag and Pt Nanoparticles Deposited by Gas Flow Sputtering.

In this work, a gas flow sputtering (GFS) process which allows the production and deposition of metal nanoparticles (NPs) in a vacuum environment is described. Aim of the study is to prove the potential of this technology for the fabrication of new TiO2 films with enhanced photocatalytic properties. For this purpose, Ag and Pt NPs have been produced and deposited on photocatalytic float glass coated with TiO2 thin films by magnetron sputtering. The influence of the process parameters and of the metal amount on the final properties of the particles (quantity, size, size distribution, oxidation state etc.,) was widely investigated. Moreover, the effect of the NPs on the photocatalytic activity of the resulting materials was evaluated for the case of the decomposition of stearic acid (SA) during UV-A irradiation. The reduction of the water contact angle (WCA) during the irradiation period was measured in order to test the photo-induced super-hydrophilicity (PSH).

A new signal characterization and signal-based Chou's PseAAC representation of protein sequences.

Most of the algorithms used for information extraction and for processing the amino acid chains that make up proteins treat them as symbolic chains. Fewer algorithms exploit signal processing techniques that require a numerical representation of amino acid chains. However, these algorithms are very powerful for extracting regularities that cannot be detected when working with a symbolic chain, which may be important for understanding the biological meaning of a sequence or in classification tasks. In this study, a new mathematical representation of amino acid chains is proposed, which is derived using a similarity measure based on the PAM250 amino acid substitution matrix and that generates 20 signals for each protein sequence. Using this representation 20 consensus spectra for a protein family are determined and the relevance of the frequency peaks is established, obtaining a group of significant frequency peaks that manifest common periodicities of the amino acid sequences that belong to a protein family. We also show that the proposed representation in 20 signals can be integrated into Chou's pseudo amino acid composition (PseAAC) and constitute a useful alternative to amino acid physicochemical properties in Chou's PseAAC.

Percutaneous Balloon Compression for Trigeminal Neuralgia: Imaging and Technical Aspects.

Trigeminal neuralgia attacks are among the most painful conditions known. Trigeminal neuralgias are hypothesized to be caused by neurovascular conflict at the trigeminal root entry zone in the prepontine cistern. A range of therapeutic options is available including open surgical microvascular decompression and several percutaneous ablative techniques (eg, radiofrequency rhizotomy and glycerol gangliolysis). Percutaneous balloon compression of the Gasserian retroganglionic rootlets has been reported to have results comparable to those of other minimally invasive techniques. This operative approach has proven popular with neurosurgeons as it is considered to be technically easier to perform than other methods. Nevertheless, pain physicians might regard this technique as challenging, relatively risky, and requiring special expertise. Accordingly, in this imaging article, we describe our percutaneous balloon compression procedure, paying particular attention to the technical and radiological details.

NQO1 rs1800566 (C609T), PON1 rs662 (Q192R), and PON1 rs854560 (L55M) polymorphisms segregate the risk of childhood acute leukemias according to age range distribution.

PURPOSE: The risk of developing childhood leukemia has been associated with gene polymorphisms that decrease the activity of detoxifying metabolic enzymes and enzymes involved in systemic oxidative stress. We investigated the NQO1 and PON1 polymorphisms for associations with susceptibility to childhood leukemia. METHODS: Samples from 1,027 Brazilian children (519 acute lymphoblastic leukemia, ALL; 107 acute myeloid leukemia, AML; 401 controls) were analyzed. TaqMAN real-time assays were used to determine the NQO1 rs1800566 (C609T), PON1 rs662 (Q192R), and PON1 rs854560 (L55M) frequencies. Logistic regression was used to evaluate the association of polymorphisms with cases and controls, with age and somatic fusion genes (MLL-r and ETV6-RUNX1) as covariables. RESULTS: Children with at least one NQO1 variant allele were at lower risk for developing infant AML (odds ratio (OR) 0.26, 95 % confidence interval (CI) 0.10-0.68); no association was detected for ALL. PON1 rs854560 (L55M) was associated with an increased risk of developing childhood leukemia (LM + MM, OR 1.93, 95 % CI 1.32-2.81). The PON1 rs662 R192R genotype had a statistically significant decreased frequency in ALL (OR 0.64, 95 % CI 0.43-0.93). Infant ALL cases were more likely to harbor homozygous PON1 rs854560 alleles than controls (OR 1.72, 95 % CI 1.03-2.89); at least one M allele was associated with an increased risk of ALL in children older than 1 year (OR 1.99, 95 % CI 1.17-3.3). CONCLUSIONS: The NQO1 rs1800566 (C609T), PON1 rs854560 (L55M), and PON1 rs662 (Q192R) polymorphisms modified risk depending on leukemia subtype (decreased in AML, increased and decreased in ALL, respectively), age strata, and variant genotype combinations.

Recruitment of occipital cortex during sensory substitution training linked to subjective experience of seeing in people with blindness.

Over three months of intensive training with a tactile stimulation device, 18 blind and 10 blindfolded seeing subjects improved in their ability to identify geometric figures by touch. Seven blind subjects spontaneously reported 'visual qualia', the subjective sensation of seeing flashes of light congruent with tactile stimuli. In the latter subjects tactile stimulation evoked activation of occipital cortex on electroencephalography (EEG). None of the blind subjects who failed to experience visual qualia, despite identical tactile stimulation training, showed EEG recruitment of occipital cortex. None of the blindfolded seeing humans reported visual-like sensations during tactile stimulation. These findings support the notion that the conscious experience of seeing is linked to the activation of occipital brain regions in people with blindness. Moreover, the findings indicate that provision of visual information can be achieved through non-visual sensory modalities which may help to minimize the disability of blind individuals, affording them some degree of object recognition and navigation aid.

Rapid synthesis of SBA-15 rods with variable lengths, widths, and tunable large pores.

Dispersed SBA-15 rods have been synthesized with varying lengths, widths, and pore sizes in a low-temperature synthesis in the presence of heptane and NH(4)F. The pore size of the material can systematically be varied between 11 and 17 nm using different hydrothermal treatment times and/or temperatures. The particle length (400-600 nm) and width (100-400 nm) were tuned by varying the HCl concentration. All the synthesized materials possess a large surface area of 400-600 m(2)/g and a pore volume of 1.05-1.30 cm(3). A mechanism for the effect of the HCl concentration on the particle morphology is suggested. Furthermore, it is shown that the reaction time can be decreased to 1 h, with well-retained pore size and morphology. This work has resulted in SBA-15 rods with the largest pore size reported for this morphology.