773 research outputs found

    Angiogenesis genotyping in the selection of first-line treatment with either sunitinib or pazopanib for advanced renal cell carcinoma

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    Recent data from the COMPARZ study seem to suggest a noninferiority of pazopanib confronted with sunitinib in PFS and OS. We previously reported how VEGF and VEGFR polymorphisms might have a predictive role in patients treated with first-line sunitinib. Aim of our study was to investigate whether tumour angiogenesis genotyping could influence clinical outcome in RCC patients treated with either sunitinib or pazopanib, in order to help clinicians select the appropriate treatment for each patient. Results: 19 patients were treated with pazopanib while 78 received sunitinib. VEGF A rs833061 resulted significant in PFS in sunitinib vs pazopanib patients (CC+CT > TT in sunitinib, TT > CC+CT in pazopanib; p CC in sunitinib, CC > GG+CG in pazopanib; p CC in sunitinib, CC > AA+AC in pazopanib; p < 0,0001). OS showed no statistically significant difference. Conclusions: In our analysis patients with opposite polymorphisms of rs833061, rs2010963, rs699947 of VEGF A seems to have a better PFS if treated with either sunitinib or pazopanib. Our data seem to suggest that biology could have a role choosing first line treatment for mRCC patients. Methods: A retrospective analysis on 97 histologic samples of mRCC patients was conducted for VEGF-A, VEGF-C and VEGFR-1,2,3 single nucleotide polymorphisms (SNPs

    Visceral leishmaniasis in the State of Maranhão, Brazil: evolution of an epidemic

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    The authors provide a brief report on the historical evolution of visceral leishmaniasis in the State of Maranhão, Brazil, evaluating possible factors for growth of the disease in the State and control measures by the Brazilian Ministry of Health to integrate health services finto the maintenance of control programs.Os autores fazem um breve relato da evolução histórica da leishmaniose visceral no Estado do Maranhão, Brasil, avaliando as possíveis causas da expansão da referida doença no Estado, assim como as medidas de controle adotadas pelo Ministério da Saúde objetivando a diminuição da incidência da mesma.Universidade Federal do Maranhão Faculdade de Medicina Departamento de PatologiaEscola Paulista de MedicinaUNIFESP, EPMSciEL

    Magnitude and frequency variations of vector-borne infection outbreaks using the Ross–Macdonald model : explaining and predicting outbreaks of dengue fever

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    The classical Ross–Macdonald model is often utilized to model vector-borne infections; however, this model fails on several fronts. First, using measured (or estimated) parameters, which values are accepted from the literature, the model predicts a much greater number of cases than what is usually observed. Second, the model predicts a single large outbreak that is followed by decades of much smaller outbreaks, which is not consistent with what is observed. Usually towns or cities report a number of recurrences for many years, even when environmental changes cannot explain the disappearance of the infection between the peaks. In this paper, we continue to examine the pitfalls in modelling this class of infections, and explain that, if properly used, the Ross–Macdonald model works and can be used to understand the patterns of epidemics and even, to some extent, be used to make predictions.We model several outbreaks of dengue fever and show that the variable pattern of yearly recurrence (or its absence) can be understood and explained by a simple Ross–Macdonald model modified to take into account human movement across a range of neighbourhoods within a city. In addition, we analyse the effect of seasonal variations in the parameters that determine the number, longevity and biting behaviour of mosquitoes. Based on the size of the first outbreak, we show that it is possible to estimate the proportion of the remaining susceptible individuals and to predict the likelihood and magnitude of the eventual subsequent outbreaks. This approach is described based on actual dengue outbreaks with different recurrence patterns from some Brazilian regions

    Modelisation of transition and noble metal vicinal surfaces: energetics, vibrations and stability

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    The energetics of transition and noble metal (Rh, Pd, Cu) vicinal surfaces, i.e., surface energy, step energy, kink energy and electronic interactions between steps, is studied at 0K from electronic structure calculations in the tight-binding approximation using a {\it s, p} and {\it d} valence orbital basis set. Then, the surface phonon spectra of copper are investigated in the harmonic approximation with the help of a semi-empirical inter-atomic potential. This allows to derive the contribution of phonons at finite temperatures to the step free energy and to the interactions between steps. The last part is devoted to the stability of vicinal surfaces relative to faceting with special attention to the domain of orientations (100)-(111). Semi-empirical potentials are shown to be not realistic enough to give a reliable answer to this problem. The results derived from electronic structure calculations predict a variety of behaviors and, in particular, a possible faceting into two other vicinal orientations. Finally, temperature effects are discussed. Comparisons are made with other theoretical works and available experiments

    Supramolecular thermoplastics and thermoplastic elastomer materials with self-healing ability based on oligomeric charged triblock copolymers

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    Supramolecular polymeric materials constitute a unique class of materials held together by non-covalent interactions. These dynamic supramolecular interactions can provide unique properties such as a strong decrease in viscosity upon relatively mild heating, as well as self-healing ability. In this study we demonstrate the unique mechanical properties of phase-separated electrostatic supramolecular materials based on mixing of low molar mass, oligomeric, ABA-triblock copolyacrylates with oppositely charged outer blocks. In case of well-chosen mixtures and block lengths, the charged blocks are phase separated from the uncharged matrix in a hexagonally packed nanomorphology as observed by transmission electron microscopy. Thermal and mechanical analysis of the material shows that the charged sections have a T-g closely beyond room temperature, whereas the material shows an elastic response at temperatures far above this T-g ascribed to the electrostatic supramolecular interactions. A broad set of materials having systematic variations in triblock copolymer structures was used to provide insights in the mechanical properties and and self-healing ability in correlation with the nanomorphology of the materials

    A Computer-Aided Screening Solution for the Identification of Diabetic Neuropathy from Standing Balance by Leveraging Multi-Domain Features

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    The early diagnosis of diabetic neuropathy (DN) is fundamental in order to enact timely therapeutic strategies for limiting disease progression. In this work, we explored the suitability of standing balance task for identifying the presence of DN. Further, we proposed two diagnosis pathways in order to succeed in distinguishing between different stages of the disease. We considered a cohort of non-neuropathic (NN), asymptomatic neuropathic (AN), and symptomatic neuropathic (SN) diabetic patients. From the center of pressure (COP), a series of features belonging to different description domains were extracted. In order to exploit the whole information retrievable from COP, a majority voting ensemble was applied to the output of classifiers trained separately on different COP components. The ensemble of kNN classifiers provided over 86% accuracy for the first diagnosis pathway, made by a 3-class classification task for distinguishing between NN, AN, and SN patients. The second pathway offered higher performances, with over 97% accuracy in identifying patients with symptomatic and asymptomatic neuropathy. Notably, in the last case, no asymptomatic patient went undetected. This work showed that properly leveraging all the information that can be mined from COP trajectory recorded during standing balance is effective for achieving reliable DN identification. This work is a step toward a clinical tool for neuropathy diagnosis, also in the early stages of the disease

    Estimation of Tidal Volume during Exercise Stress Test from Wearable-Device Measures of Heart Rate and Breathing Rate

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    Tidal volume (TV), defined as the amount of air that moves in or out of the lungs with each respiratory cycle, is important in evaluating the respiratory function. Although TV can be reliably measured in laboratory settings, this information is hardly obtainable under everyday living conditions. Under such conditions, wearable devices could provide valuable support to monitor vital signs, such as heart rate (HR) and breathing rate (BR). The aim of this study was to develop a model to estimate TV from wearable-device measures of HR and BR during exercise. HR and BR were acquired through the Zephyr Bioharness 3.0 wearable device in nine subjects performing incremental cycling tests. For each subject, TV during exercise was obtained with a metabolic cart (Cosmed). A stepwise regression algorithm was used to create the model using as possible predictors HR, BR, age, and body mass index; the model was then validated using a leave-one-subject-out cross-validation procedure. The performance of the model was evaluated using the explained variance (R-2), obtaining values ranging from 0.65 to 0.72. The proposed model is a valid method for TV estimation with wearable devices and can be considered not subject-specific and not instrumentation-specific
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