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Introduction: High-grade gliomas are the most common primary brain tumors in adults, and they usually have a quick fatal course. Average survival is 18 months, mainly, because of tumor resistance to Stupp protocol. Objective: To determine high-grade glioma patient survival and the effect of persuasion variables on survival. Materials and methods: We conducted a longitudinal descriptive study in which 80 untreated recently diagnosed high-grade glioma patients participated. A survey was conducted regarding their exposure to some risk factors, degree of genetic instability in peripheral blood using micronucleus quantification on binuclear lymphocytes, micronuclei in reticulocytes and sister-chromatid exchanges in lymphocytes. In the statistical analysis, this study constructed life tables, used the Kaplan-Meier, and the log-rank test, and in the multivariate analysis, a Cox proportional hazards model was constructed. Results: Eighty patients' clinical, demographic and lifestyle characteristics were analyzed, as well as their survival rates and the average survival time is 784 days (interquartile range: 928). Factors like age, exposure at work to polycyclic hydrocarbons and the number of sister-chromatid exchanges in lymphocytes in the first sampling was significantly survivalrelated in the multivariate analysis. Conclusion: We determined that only three of the analyzed variables have an important effect on survival time when it comes to high-grade glioma patients.
Introducción. Los gliomas de alto grado son los tumores cerebrales primarios más comunes en adultos y, por lo general, tienen un curso mortal rápido. La supervivencia media es de 18 meses, principalmente, como consecuencia de la resistencia del tumor al protocolo Stupp. Objetivo. Determinar la supervivencia de los pacientes con glioma de alto grado y el efecto de las variables de persuasión en la supervivencia. Materiales y métodos. Se llevó a cabo un estudio descriptivo longitudinal en el que participaron 80 pacientes con diagnóstico reciente de glioma de alto grado no tratados. Se hizo una encuesta sobre su exposición a algunos factores de riesgo, grado de inestabilidad genética en sangre periférica mediante cuantificación de micronúcleos en linfocitos binucleares, micronúcleos en reticulocitos e intercambios de cromátidas hermanas en linfocitos. En el análisis estadístico, se construyeron tablas de vida, se utilizó Kaplan-Meier y la prueba de rangos logarítmicos, y en el análisis multivariado, se construyó un modelo de riesgos proporcionales de Cox. Resultados. Se analizaron las características clínicas, demográficas y de estilo de vida de 80 pacientes, así como sus tasas de supervivencia y el tiempo medio de supervivencia fue de 784 días (rango intercuartílico: 928). Factores como la edad, la exposición laboral a hidrocarburos policíclicos y el número de intercambios de cromátidas hermanas en linfocitos en el primer muestreo se relacionaron significativamente con la supervivencia en el análisis multivariante. Conclusión. Según los resultados, el estudio determinó que solo tres de las variables analizadas tienen un efecto importante en el tiempo de supervivencia cuando se trata de pacientes con glioma de alto grado.
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Neoplasias Encefálicas , Glioma , Humanos , Glioma/mortalidade , Glioma/patologia , Glioma/genética , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Longitudinais , Análise de Sobrevida , Fatores de Risco , Troca de Cromátide Irmã , Exposição Ocupacional/efeitos adversos , Idoso , Estimativa de Kaplan-Meier , Gradação de TumoresRESUMO
This work addresses the challenge of classifying multiclass visual EEG signals into 40 classes for brain-computer interface applications using deep learning architectures. The visual multiclass classification approach offers BCI applications a significant advantage since it allows the supervision of more than one BCI interaction, considering that each class label supervises a BCI task. However, because of the nonlinearity and nonstationarity of EEG signals, using multiclass classification based on EEG features remains a significant challenge for BCI systems. In the present work, mutual information-based discriminant channel selection and minimum-norm estimate algorithms were implemented to select discriminant channels and enhance the EEG data. Hence, deep EEGNet and convolutional recurrent neural networks were separately implemented to classify the EEG data for image visualization into 40 labels. Using the k-fold cross-validation approach, average classification accuracies of 94.8% and 89.8% were obtained by implementing the aforementioned network architectures. The satisfactory results obtained with this method offer a new implementation opportunity for multitask embedded BCI applications utilizing a reduced number of both channels (<50%) and network parameters (<110 K).
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Algoritmos , Interfaces Cérebro-Computador , Aprendizado Profundo , Eletroencefalografia , Redes Neurais de Computação , Eletroencefalografia/métodos , Humanos , Processamento de Sinais Assistido por ComputadorRESUMO
ABSTRACT Introduction. High-grade gliomas are the most common primary brain tumors in adults, and they usually have a quick fatal course. Average survival is 18 months, mainly, because of tumor resistance to Stupp protocol. Objective. To determine high-grade glioma patient survival and the effect of persuasion variables on survival. Materials and methods. We conducted a longitudinal descriptive study in which 80 untreated recently diagnosed high-grade glioma patients participated. A survey was conducted regarding their exposure to some risk factors, degree of genetic instability in peripheral blood using micronucleus quantification on binuclear lymphocytes, micronuclei in reticulocytes and sister-chromatid exchanges in lymphocytes. In the statistical analysis, this study constructed life tables, used the Kaplan-Meier, and the log-rank test, and in the multivariate analysis, a Cox proportional hazards model was constructed. Results. Eighty patients' clinical, demographic and lifestyle characteristics were analyzed, as well as their survival rates and the average survival time is 784 days (interquartile range: 928). Factors like age, exposure at work to polycyclic hydrocarbons and the number of sister-chromatid exchanges in lymphocytes in the first sampling was significantly survival-related in the multivariate analysis. Conclusion. We determined that only three of the analyzed variables have an important effect on survival time when it comes to high-grade glioma patients.
RESUMEN Introducción. Los gliomas de alto grado son los tumores cerebrales primarios más comunes en adultos y, por lo general, tienen un curso mortal rápido. La supervivencia media es de 18 meses, principalmente, como consecuencia de la resistencia del tumor al protocolo Stupp. Objetivo. Determinar la supervivencia de los pacientes con glioma de alto grado y el efecto de las variables de persuasión en la supervivencia. Materiales y métodos. Se llevó a cabo un estudio descriptivo longitudinal en el que participaron 80 pacientes con diagnóstico reciente de glioma de alto grado no tratados. Se hizo una encuesta sobre su exposición a algunos factores de riesgo, grado de inestabilidad genética en sangre periférica mediante cuantificación de micronúcleos en linfocitos binucleares, micronúcleos en reticulocitos e intercambios de cromátidas hermanas en linfocitos. En el análisis estadístico, se construyeron tablas de vida, se utilizó Kaplan-Meier y la prueba de rangos logarítmicos, y en el análisis multivariado, se construyó un modelo de riesgos proporcionales de Cox. Resultados. Se analizaron las características clínicas, demográficas y de estilo de vida de 80 pacientes, así como sus tasas de supervivencia y el tiempo medio de supervivencia fue de 784 días (rango intercuartílico: 928). Factores como la edad, la exposición laboral a hidrocarburos policíclicos y el número de intercambios de cromátidas hermanas en linfocitos en el primer muestreo se relacionaron significativamente con la supervivencia en el análisis multivariante. Conclusión. Según los resultados, el estudio determinó que solo tres de las variables analizadas tienen un efecto importante en el tiempo de supervivencia cuando se trata de pacientes con glioma de alto grado.
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Introduction. The currently available dosimetry techniques in computed tomography can be inaccurate which overestimate the absorbed dose. Therefore, we aimed to provide an automated and fast methodology to more accurately calculate the SSDE usingDwobtained by using CNN from thorax and abdominal CT study images.Methods. The SSDE was determined from the 200 records files. For that purpose, patients' size was measured in two ways: (a) by developing an algorithm following the AAPM Report No. 204 methodology; and (b) using a CNN according to AAPM Report No. 220.Results. The patient's size measured by the in-house software in the region of thorax and abdomen was 27.63 ± 3.23 cm and 28.66 ± 3.37 cm, while CNN was 18.90 ± 2.6 cm and 21.77 ± 2.45 cm. The SSDE in thorax according to 204 and 220 reports were 17.26 ± 2.81 mGy and 23.70 ± 2.96 mGy for women and 17.08 ± 2.09 mGy and 23.47 ± 2.34 mGy for men. In abdomen was 18.54 ± 2.25 mGy and 23.40 ± 1.88 mGy in women and 18.37 ± 2.31 mGy and 23.84 ± 2.36 mGy in men.Conclusions. Implementing CNN-based automated methodologies can contribute to fast and accurate dose calculations, thereby improving patient-specific radiation safety in clinical practice.
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Algoritmos , Doses de Radiação , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Masculino , Feminino , Tamanho Corporal , Redes Neurais de Computação , Software , Automação , Tórax/diagnóstico por imagem , Adulto , Abdome/diagnóstico por imagem , Radiometria/métodos , Radiografia Torácica/métodos , Pessoa de Meia-Idade , Processamento de Imagem Assistida por Computador/métodos , Radiografia Abdominal/métodos , IdosoRESUMO
Brazil is the fourth largest cement consumer in the world and the largest producer in Latin America, around 1.3% of global production. The main inputs in the manufacture of cement are limestone and clay. Few studies have been carried out in the country on the risk of these materials used in civil construction. Therefore, the objective of this present work is to evaluate the radiological danger that they can present to society. Gamma spectrometry analysis on 16 samples of different brands of cement used as construction material in Rio de Janeiro (Brazil) was performed in this study, using an HPGe detector and the Genie 2000 data acquisition software. Samples were set to count for an accumulation time of 14,400 s (4 h) and all measurements were corrected to eliminate background and backscattering. Activity concentrations are determined for 226Ra was from (41.2 ± 1.6 to 174.9 ± 3.9) Bq kg-1, 232Th was from (15.7 ± 0.5 to 43.1 ± 0.7) Bq kg-1 and 40K was from (82.6 ± 7.2 to 254 ± 17) Bq kg-1. To assess radiological health risks: mean values of Radium Activity Equivalent 150.0 ± 3.4 Bq kg-1, Annual Gonadal Dose Equivalent 468 ± 11 µSv year-1 and Lifetime Excess Cancer Risk (ELCR) 2.42 ± 0.06 were calculated. Total Absorbed Dose Rates ranged from 72.2 ± 1.7 to 225.1 ± 5.2 nGy h-1. The damage to collective health was also estimated from the annual effective dose rates with an estimated total cost of damage to health of US$ 130 million. Values are generally within global limits reported by UNSCEAR.
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Monitoramento de Radiação , Radioatividade , Rádio (Elemento) , Poluentes Radioativos do Solo , Radioisótopos de Potássio/análise , Tório/análise , Monitoramento de Radiação/métodos , Brasil , Materiais de Construção/análise , Rádio (Elemento)/análise , Poluentes Radioativos do Solo/análise , Espectrometria gamaRESUMO
The regulatory EMA's reference scaled average bioequivalence (RSABE) approach for highly variable drugs suffers from some type I error control problems at the neighborhood of the 30% coefficient of variation (CV), where the bioequivalence (BE) limits change from constant to linearly scaled. This paper analyses BE inference methods based on the "Leveling-off" (LO) soft sigmoid expanding BE limits that were proposed as an appealing surrogate for the EMA's limits and compares both approaches, on the replicated and partially replicated crossover designs. The initially proposed version of the LO method also has type I error inflation problems, albeit attenuated. But given its more mathematically regular character, it is more suitable for analytical corrections. Here we introduce two improvements over LO, one based on the application of Howe's method and the other based on correcting the estimation error. They further reduce the type I error inflation, although it does not disappear completely. Finally, the effect of heteroscedasticity on the above results is studied. It leads to inflation or deflation of the type I error, depending on the design and the type of heteroscedasticity (variability of the test product greater than that of the reference product or the opposite). The replicated design is much more stable against these effects than the partially replicated design and maintains these improvements much better.
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Equivalência Terapêutica , Humanos , Estudos Cross-Over , Tamanho da AmostraRESUMO
In the present work, a study was carried out on the dosage of wastes from the chemical industry (tannery sludge) and civil construction (concrete and plaster) in mixtures used in concrete blocks' production. The objective was the application of these blocks in paving. The characterization of the materials used was performed employing X-ray diffractometry (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The effect of the different residues on the blocks' properties was evaluated through compressive strength, flexion-traction, water absorption, abrasion resistance, and leaching tests. The results indicated that the concrete paving blocks produced with the addition of residues did not obtain gains in the values of mechanical resistance to compression and traction in bending compared to blocks made with standard raw material. However, the blocks produced with construction waste presented satisfactory results for application in street paving after 7 days of concrete curing, reaching values between 36.54 and 44.6 MPa for the mentioned properties. These values also increased to 21.4% within 28 days of curing. The blocks produced with plaster showed values between 37.03 and 39.85 MPa after 28 days of curing, allowing their use for street paving. On the other hand, the blocks containing residues from the chemical industry had lower strengths, reaching a maximum of 29.36 MPa after 28 days of curing. In addition, it was also noted that the blocks produced with recycled concrete showed an improvement in performance for a composition of 50% recycled material.
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Materiais de Construção , Resíduos Industriais , Resíduos Industriais/análise , Indústria Química , Reciclagem/métodos , Força CompressivaRESUMO
OBJECTIVE: To assess the association between language proficiency and absolute dominance on language versus visual-perceptual formatted and executive versus delayed memory neuropsychological measures in bilingual adults. METHODS: Data from 55 bilingual, conversationally fluent, neurologically intact, Mexican American, consecutive, adults tested in separate sessions in Spanish and English in a counterbalanced order were analyzed. Age, years of education, self-reported language proficiency, Woodcock-Muñoz Language Survey-Revised (WMLS-R) picture vocabulary measures of language proficiency, and dominance (absolute Spanish-English WMLS-R difference scores) were correlated with 11 measures from La Batería Neuropsicólogica en Español and its original English language tests. RESULTS: Self-reported and WMLS-R measures of language proficiency were significantly correlated in each language. Absolute language dominance was not significantly associated with any Spanish or English neuropsychological raw score. The WMLS-R language proficiency, but not age or years of education, was significantly correlated with language-formatted neuropsychological measures of California Verbal Learning Test delayed free recall number of words (both languages), letter fluency (both languages), delayed story memory (in English), and Stroop interference (Spanish). Linear regression models using age, years of education, and WMLS-R picture vocabulary scores as predictors were significant for all these measures excepting the last. The WMLS-R language proficiency was not significantly associated with raw scores on any visual-perceptual formatted measure. CONCLUSIONS: Monolingual neuropsychological test norms for language-formatted tests likely overestimate bilingual Mexican Americans' performance.
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The objective of this study is to assess the performance of an innovative AI-powered tool for sex determination using panoramic radiographs (PR) and to explore factors affecting the performance of the convolutional neural network (CNN). The study involved 207,946 panoramic dental X-rays and their corresponding reports from 15 clinical centers in São Paulo, Brazil. The PRs were acquired with four different devices, and 58% of the patients were female. Data preprocessing included anonymizing the exams, extracting pertinent information from the reports, such as sex, age, type of dentition, and number of missing teeth, and organizing the data into a PostgreSQL database. Two neural network architectures, a standard CNN and a ResNet, were utilized for sex classification, with both undergoing hyperparameter tuning and cross-validation to ensure optimal performance. The CNN model achieved 95.02% accuracy in sex estimation, with image resolution being a significant influencing factor. The ResNet model attained over 86% accuracy in subjects older than 6 years and over 96% in those over 16 years. The algorithm performed better on female images, and the area under the curve (AUC) exceeded 96% for most age groups, except the youngest. Accuracy values were also assessed for different dentition types (deciduous, mixed, and permanent) and missing teeth. This study demonstrates the effectiveness of an AI-driven tool for sex determination using PR and emphasizes the role of image resolution, age, and sex in determining the algorithm's performance.
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Aprendizado Profundo , Humanos , Feminino , Masculino , Radiografia Panorâmica , Brasil , Redes Neurais de Computação , AlgoritmosRESUMO
Introducción: La pandemia de COVID-19 evidenció la importancia de los trabajadores esen-ciales de la salud. Objetivo: Estimar la ocurrencia de la infección por el virus Sars_CoV2 en funcionarios de un hospital, antes y después de implementación del programa de vacunación institucional y la fracción preventiva atribuible a la vacunación. Material y métodos: Estudio de cohorte histórica, teniendo como punto de inicio la fecha del primer funcionario diagnosticado con la Covid19 en el Hospital. Alrededor de mil traba-jadores fueron examinados, durante el periodo de estudio comprendido entre junio de 2020 y octubre 2021. Se utilizó el estadístico de Kaplan-Meier, para comparar la velocidad de infección y la fracción preventiva atribuible al programa de vacunación. Resultados. Hubo diferencias estadísticamente significativas en la reducción de casos según tipo de trabajo, los trabajadores asistenciales experimentaron una reducción del 58,1%, de 124 a 52 y la diferencia en la mediana de la velocidad de infección, antes y después, Log Rank = 127,4 gl = 1 p = 0,000; los administrativos 51,7% de 29 a 14, mediana log Rank = 34,4 gl = 1 p = 0,000, y los operativos 45,5% de 11 a 6, mediana Log Rank = 13,5 gl = 1 p = 0,000. La fracción atribuible preventiva entre los asistenciales fue 47,5% (37,454,9); 85,2% (77,788,9) en administrativos y una reducción no significativa de 43,6% (-20,7, 63,2) en operativos. Conclusiones: Los trabajadores asistenciales tienen un riesgo alto de contraer la infección por Sars_CoV2. Fue una acertada decisión vacunar a todos los trabajadores del hospital, el impacto es demostrable.
Introduction: The COVID-19 pandemic highlighted the importance of essential health care workers.Objective: To estimate the occurrence of Sars_CoV2 virus infection in hospital staff before and after implementation of the institutional vaccination program and the preventive fraction attributable to vaccination. Material and methods: Historical cohort study, having as starting point the date of the first employee diagnosed with Covid19 in the Hospital. About one thousand workers were exa-mined, during the study period from June 2020 to October 2021. The Kaplan-Meier statistic was used to compare the infection, rate and the preventive fraction attributable to the vac-cination program. Results: There were statistically significant differences in the reduction of cases according to type of work, with the assistential workers experiencing a reduction of 58.1%, from 124 to 52 and the difference in median infection rate, before and after, Log Rank = 127.4 gl = 1 p = 0.000; the administrative 51.7% from 29 to 14, median Log Rank = 34.4 gl = 1 p = 0.000, and the operatives 45.5% from 11 to 6, median Log Rank = 13.5 gl = 1 p = 0.000. The preventive attributable fraction among assistants was 47.5% (37.4-54.9); 85.2% (77.7-88.9) in adminis-trative and a non-significant reduction of 43.6% (-20.7, 63.2) in operatives.Conclusions: Healthcare workers are at high risk of contracting Sars_CoV2 infection. It was a wise decision to vaccinate all hospital workers, the impact is demonstrable.
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Humanos , Adulto , Pessoa de Meia-Idade , Pessoal de Saúde , Vacinas contra COVID-19 , COVID-19 , Vacinas , Programas de Imunização , COVID-19/prevenção & controleRESUMO
Radiotherapy is the main treatment for cervical cancer. It is usually applied alone or in combination with surgery and/or chemotherapy. To explore the association between immune microenvironment of cervical cancer and radiotherapy response, we collected 20 paired cervical cancer tumor samples before and after radiotherapy and partial clinical information. With paired-end RNA-seq, we quantified the immune infiltration and tumor purity of these samples, and obtained 6350 differentially expressed genes before and after radiotherapy. With the help of R language, the function enrichment analysis and 22 immune cells infiltration analysis were carried out. Moreover, we built a random forest model based on the immune microenvironment to predict the short-term efficacy of radiotherapy. We found that the effect of radiotherapy on the immune microenvironment of stage III and IV cervical cancer patients was weaker than that of stage I and II cervical cancer patients. Radiotherapy can significantly reduce the tumor purity and increase immune infiltration. The proportions of the immune infiltrating cells are predictive of the radiotherapy efficacy. In addition, the local mucositis caused by radiotherapy can improve the curative effect of radiotherapy.
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Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/patologia , Radioterapia Adjuvante , Microambiente Tumoral , PrognósticoRESUMO
The quality of life of animals can have a direct impact on the health of the community where they live, therefore, knowledge of the number of animals and the conditions in which they are found is fundamental to the development of actions focused on Unique Health. Aiming to carry out a population estimate of dogs and cats, domiciled and semi-domiciled, in the urban area of Barra-BA and to analyze the population's knowledge about the themes "responsible guarding" and "animal welfare", it was carried out, in the period of August to November 2019, the application of a questionnaire in 365 residences. The results showed that for each inhabitant there were about 0.152 dogs and 0.108 cats, thus, it is estimated about 6,341 domesticated and semi-domesticated animals, being 3,707 dogs and 2,634 cats. The analysis of notions of animal welfare and responsible guarding showed that most tutors do not satisfactorily practice responsible guarding, especially for cats that, when compared to dogs, had lower rates of deworming and vaccination, as well as average age below that of the canine population. The number of animals with free access to the street was higher for felines. In terms of reproductive control, between the two species, only 3.6% were spayed. At the end of the work, it can be concluded that the cat: inhabitant proportion in the studied region is consistent with the national proportion. In contrast, the dog: inhabitant relationship was shown to be inferior when compared to national values. Furthermore, there was a need for educational actions within the scope of responsible custody.(AU)
A qualidade de vida dos animais pode ter impacto direto na saúde da comunidade onde vivem. Portanto, o conhecimento do número de animais e das condições em que se encontram é fundamental para o desenvolvimento de ações voltadas para a abordagem Saúde Única. Com o objetivo de realizar uma estimativa populacional de cães e gatos domiciliados e semidomiciliados na área urbana de Barra-BA, e analisar o conhecimento da população local sobre os temas "guarda responsável" e "bem-estar animal" foi realizado um questionário em 365 residências no período de agosto a novembro de 2019. Os resultados mostraram que para cada habitante havia cerca de 0,152 cães e 0,108 gatos. Assim, estima-se que existam cerca de 6.341 animais domesticados e semi-domesticados, sendo 3.707 cães e 2.634 gatos. A análise do conhecimento sobre bem-estar animal e guarda responsável mostrou que a maioria dos tutores não pratica a guarda responsável de forma satisfatória, principalmente para gatos. Quando comparados aos cães, os gatos apresentaram menores índices de vermifugação e vacinação e apresentaram idade média abaixo da população canina. O número de animais com livre acesso à rua foi maior para os felinos. Em termos de controle reprodutivo, entre as duas espécies, apenas 3,6% foram esterilizadas. Ao final do trabalho, pode-se concluir que a proporção gato por habitante na região estudada é condizente com a proporção nacional. Em contrapartida, a relação cão por habitante mostrou-se inferior aos valores nacionais.(AU)
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Animais , Bem-Estar do Animal/estatística & dados numéricos , Gatos , Cães , Brasil , Controle da População/estatística & dados numéricos , Crescimento DemográficoRESUMO
BACKGROUND: Clinical trials and individual-level observational data in Israel demonstrated approximately 95% effectiveness of mRNA-based vaccines against symptomatic SARS-CoV-2 infection. Individual-level data are not available in many countries, particularly low- and middle- income countries. Using a novel Poisson regression model, we analyzed ecologic data in Costa Rica to estimate vaccine effectiveness and assess the usefulness of this approach. METHODS: We used national data from December 1, 2020 to May 13, 2021 to ascertain incidence, hospitalizations and deaths within ecologic units defined by 14 age groups, gender, 105 geographic areas, and day of the epidemic. Within each unit we used the proportions of the population with one and with two vaccinations, primarily tozinameran. Using a non-standard Poisson regression model that included an ecologic-unit-specific rate factor to describe rates without vaccination and a factor that depended on vaccine effectiveness parameters and proportions vaccinated, we estimated vaccine effectiveness. RESULTS: In 3.621 million persons aged 20 or older, there were 125,031 incident cases, 7716 hospitalizations, and 1929 deaths following SARS-CoV-2 diagnosis; 73% of those aged ≥ 75 years received two doses. For one dose, estimated effectiveness was 59% (95% confidence interval 53% to 64%) for SARS-CoV-2 incidence, 76% (68% to 85%) for hospitalizations, and 63% (47% to 80%) for deaths. For two doses, the respective estimates of effectiveness were 93% (90% to 96%), 100% (97% to 100%), and 100% (97% to 100%). CONCLUSIONS: These effectiveness estimates agree well with findings from clinical trials and individual-level observational studies and indicate high effectiveness in the general population of Costa Rica. This novel statistical approach is promising for countries where ecologic, but not individual-level, data are available. The method could also be adapted to monitor vaccine effectiveness over calendar time.
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COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19 , Vacinas contra COVID-19 , Costa Rica/epidemiologia , Hospitalização , Humanos , SARS-CoV-2/genética , Eficácia de VacinasRESUMO
In sequential testing with binary data, sample size and time to detect a signal are the key performance measures to optimize. While the former should be optimized in Phase III clinical trials, minimizing the latter is of major importance in post-market drug and vaccine safety surveillance of adverse events. The precision of the relative risk estimator on termination of the analysis is a meaningful design criterion as well. This paper presents a linear programming framework to find the optimal alpha spending that minimizes expected time to signal, or expected sample size as needed. The solution enables (a) to bound the width of the confidence interval following the end of the analysis, (b) designs with outer signaling thresholds and inner non-signaling thresholds, and (c) sequential designs with variable Bernoulli probabilities. To illustrate, we use real data on the monitoring of adverse events following the H1N1 vaccination. The numerical results are obtained using the R Sequential package.
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Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Vacinas , Intervalos de Confiança , Probabilidade , Tamanho da Amostra , Vacinas/efeitos adversos , Ensaios Clínicos Fase III como Assunto , Vacinas contra Influenza/efeitos adversosRESUMO
A estimativa de idade representa um tipo de perícia com a finalidade de auxiliar na estimativa do perfil biológico de indivíduos vivos e mortos. O presente trabalho teve como objetivo verificar a aplicabilidade do método Cameriere (2004) de estimativa de idade pelos dentes, em indivíduos adultos, a partir do emprego de radiografias panorâmicas, caracterizando a amostra segundo sexo e idade e verificando a relação entre idade real e idade estimada pelo método. Para isso, foram utilizados caninos hígidos para cálculo da área do dente e da polpa, com o Programa Adobe Photoshop, em 50 radiografias panorâmicas. Os valores em pixels foram inseridos em fórmulas propostas pelo método, obtendo-se, assim, a idade estimada. A concordância intraexaminador evidenciou um coeficiente de correlação intraclasse quase perfeito, com valor de p igual a 0,9998. Para a amostra estudada, quando comparadas às médias das idades estimadas e reais para cada indivíduo, observou-se uma tendência de subestimação da idade com o método de Cameriere (2004), em todas as formas de análises, apresentando resultados de médias mais discrepantes, quando utilizado os caninos inferiores. Conclui-se que o método de Cameriere (2004) não se mostrou aplicável considerando a amostra, a faixa etária e a população analisada, com tendência de subestimação das idades quando comparadas com as idades reais
Age estimation represents a type of expertise with the purpose of helping to estimate the biological profile of living and dead individuals. This study aimed to verify the applicability of the Cameriere (2004) method of age estimating by teeth, in adult individuals, from panoramic radiographs use, characterizing the sample according to sex and age and verifying the relationship between actual age and age estimated by the method. For this, we used healthy canine teeth to calculate the area of the tooth and the pulp, with the Adobe Photoshop Program, in 50 panoramic radiographs, using the healthy canine teeth as a reference for analysis. The pixel values were inserted into formulas proposed by the method, thus obtaining the estimated age. The intra-examiner agreement showed an almost perfect correlation coefficient, with p-value equal to 0.9998. For the sample studied, when comparing the averages of the estimated and actual ages for each individual, there was a tendency to underestimate age with the Cameriere (2004) method, in all forms of analysis, with more discrepant average results when using the lower canines It is concluded that the method of Cameriere (2004) was not applicable considering the sample, the age group and the population analyzed, with a tendency of underestimation of the ages when compared with the real ages
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BACKGROUND: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in predicting eGFR. The aim of the study was to compare 24-h CrCl with eGFR derived from these formulae and to identify which could be the best alternative. METHOD: A prospective study was conducted involving 140 CKD patients. Creatinine and cystatin C concentrations were determined using the cobas 6000 analyzer. The eGFR was calculated using the CG formula, 4-variable MDRD and CKD-EPI equations, and Bland-Alman plots bias was determined. RESULTS: The CG and MDRD formulas had mean eGFR values similar to CrCl and correlation coefficients (r) were highest for CG (0.906) and lowest for MDRD (0.799). The CG equation was in agreement with 24-h CrCl in all but stage V CKD while the MDRD equation compared well in all except Stage IV CKD. The CG equation was positively biased (0.9857) while the MDRD had a negative bias (-0.05). CONCLUSION: The Cockcroft-Gault formula provides a more accurate assessment of GFR than 24-h CrCl and would be recommended as a substitute to provide the best estimate of GFR in our population.
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Hereditary fructose intolerance (HFI) is an inborn error of fructose metabolism of autosomal recessive inheritance caused by pathogenic variants in the ALDOB gene that lead to aldolase B deficiency in the liver, kidneys, and intestine. Patients manifest symptoms, such as ketotic hypoglycemia, vomiting, nausea, in addition to hepatomegaly and other liver and kidney dysfunctions. The treatment consists of a fructose-restricted diet, which results in a good prognosis. To analyze the distribution of ALDOB variants described in patients and to estimate the prevalence of HFI based on carrier frequency in the gnomAD database, a systematic review was conducted to assess ALDOB gene variants among patients with HFI. The prevalence of HFI was estimated from the carrier frequency of variants described in patients, as well as rare variants predicted as pathogenic by in silico tools. The p.(Ala150Pro) and p.(Ala175Asp) variants are the most frequent and are distributed worldwide. However, these variants have particular distribution patterns in Europe. The analysis of the prevalence of HFI showed that the inclusion of rare alleles predicted as pathogenic is a more informative approach for populations with few patients. The data show that HFI has a wide distribution and an estimated prevalence of ~1:10,000.
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Intolerância à Frutose , Alelos , Intolerância à Frutose/diagnóstico , Intolerância à Frutose/epidemiologia , Intolerância à Frutose/genética , Frutose-Bifosfato Aldolase/genética , Humanos , Fígado/patologia , MutaçãoRESUMO
Crustaceans of the subclass Copepoda are an important component of the invertebrate aquatic fauna. They occur in all aquatic environments and include some representatives that are free-living organisms and others that have a parasitic lifestyle. The genus Therodamas comprises marine and freshwater copepods whose females are parasites of fish in their adult phase, with only seven species described so far. During a field survey of fish parasites in the Jari River, a large tributary of the Amazon River system, in Brazil, we found a new species of the genus Therodamas infecting Leporinus fasciatus. Therodamas longicollum n. sp. is the second strictly freshwater species known. Phylogenetic analysis showed that the new species is grouped in the family Ergasilidae, and divergence estimates showed that T. longicollum n. sp. diverged from its ancestor at around 66.34 Ma, in the late Upper Cretaceous. Therodamas longicollum n. sp. differs from its congeneric in that it does not have lobes and/or expansion of the anterior neck region. Besides describing a new Therodamas species, thereby increasing the diversity of the genus to eight species, this study points out the existence of a lineage of these copepods that has adapted to the freshwater environment of the Amazon. This study also corroborates the genus Therodamas as part of the family Ergasilidae.
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Caraciformes , Copépodes , Doenças dos Peixes , Animais , Brasil , Caraciformes/parasitologia , Copépodes/classificação , Feminino , Doenças dos Peixes/parasitologia , Água Doce , Filogenia , RiosRESUMO
Background: The impact of donor quality on post-kidney transplant survival may vary by candidate condition. Objective: Analyzing the combined use of the Kidney Donor Profile Index (KDPI) and the estimated post-transplant survival (EPTS) scale and their correlation with the estimated glomerular filtration rate (eGFR) decline in deceased-donor kidney recipients (DDKR). Methods: This was a retrospective, observational cohort study. We included DDKRs between 2015 and 2017 at a national third-level hospital. Results: We analyzed 68 DDKR. The mean age at transplant was 41 ± 14 years, 47 (69%) had sensitization events, 18 (26%) had delayed graft function, and 16 (23%) acute rejection. The graft survival at 12 and 36 months was 98.1% (95% CI 94-100) and 83.7% (95% CI 65-100), respectively. The Pearson correlation coefficient between the percentage reduction in the annual eGFR and the sum of EPTS and KDPI scales was r = 0.61, p < 0.001. The correlation coefficient between the percentage reduction in the annual eGFR and the EPTS and KDPI scales separately was r = 0.55, p < 0.001, and r = 0.53, p < 0.001, respectively. Conclusions: The sum of EPTS and KDPI scales can provide a better donor-recipient relationship and has a moderately positive correlation with the decrease in eGFR in DDKR.
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Humanos , Adulto , Pessoa de Meia-Idade , Doadores de Tecidos , Transplante de Rim , Sobrevivência de Enxerto , Análise de Sobrevida , Estudos Retrospectivos , Transplantados , Taxa de Filtração Glomerular , RimRESUMO
Digital image analysis is a practical, non-invasive, and relatively low-cost tool that may assist in the evaluation of body traits in Nile tilapia, being particularly useful for assessing difficult-to-measure variables, such as body areas. In this study, we aimed to estimate variance components and genetic parameters for body areas of Nile tilapia obtained by digital images. The data set comprised body weight (BW) records of 1,917 pond-reared fish at 366 days of age. Of this total, 656 animals were photographed and subjected to image analysis of trunk area (TA), head area (HA), caudal fin area (CFA) and fillet area (FA). Heritabilities and genetic correlations were estimated through multiple-trait models based on Bayesian inference. Heritability estimates for BW, TA, HA, CFA and FA were 0.25, 0.23, 0.26, 0.21 and 0.25, respectively. Genetic correlations between the traits were high and positive, ranging from 0.70 to 0.98. We highlight the genetic correlation between BW and TA (rG = 0.98) and FA (rG = 0.97). In view of the observed results, it can be concluded that trunk and fillet areas obtained by digital image analysis can lead to indirect genetic gains in weight and other body areas. In addition, the areas studied have potential as a selection criterion and may assist in studies on changes in the body shape in Nile tilapia.