Search

This article discusses a study on the assessment of the value of treatment for moderate-to-severe atopic dermatitis (AD) using multi-criteria decision analysis (MCDA). The study aims to determine the most important health outcomes for decision-making from different perspectives. The results show that the value of a new AD treatment is primarily determined by its impact on improving patients' quality of life, controlling the disease, and reducing itching. However, there are differences in how AD patients and experts assess value, emphasizing the importance of considering the patient's opinion. The study acknowledges the limitations of the MCDA methodology and proposes a comprehensive set of criteria for evaluating AD treatments. The report was written by multiple authors and further exploration of the document is necessary to understand the specific topics and perspectives discussed. [Extracted from the article]

In the last two decades, nano-mechanical resonators have risen as highly promising devices for mass sensing due to their ultrahigh sensitivity. They can be used to measure the mass and stiffness of single particles like small pollution particles, viruses, bacteria, or even proteins. These capabilities of the nano-mechanical resonators have allowed the birth of a new type of mass spectrometry with no need of fragmentation or ionization of the sample and therefore ideal to measure big masses, where conventional mass spectrometers have important problems. The shape and modes of vibration of a nano-mechanical resonator can be very different and the advantages and drawbacks of one respect to another is still a hot topic. A unified theoretical framework to describe the effect of particle adsorption on a mechanical resonator is fundamental but still lacks in the literature. In this work, we present such a framework and examine the particular case of a rod-like particle adsorbed on a cantilever beam for flexural and torsional vibrations as well as on a disk resonator for radial breathing vibrations and compare the results with finite element simulations. [ABSTRACT FROM AUTHOR]

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process. [ABSTRACT FROM AUTHOR]

The effects of growth kinetics on crosshatched morphology were studied using real-time in situ laser light scattering.

Objectives: To determine whether nutritional risk is associated with the mortality of elderly patients hospitalized with nonvalvular atrial fibrillation (NVAF). Design: Prospective, multicenter cohort study. Setting: Internal medicine departments in Spain. Participants: Inpatients >75 years with NVAF. Measurements: We measured the thrombotic and hemorrhagic risk at admission using the CHA2DS2-VASc and HAS-BLED scales, respectively, and the nutritional risk with the controlling nutritional status (CONUT) index. We established 4 degrees of nutritional risk: null (CONUT score 0–1 point), low (2–4 points), moderate (5–8 points) and high (9–12 points). We also conducted a 1-year follow-up. Results: We included 449 patients, with a mean age of 85.2(5.2) years. The nutritional risk was null for 70(15.6%) patients, low for 206 45.9%), moderate for 152(33.8%) and high for 21(4.7%). At the end of one year, 177(39.4%) patients had died. The score on the CONUT index was higher for the deceased patients (4.6 vs. 3.6, p<0.001). The CONUT score (HR, 1.076; 95%CI 1.009–1.148; p=0.025), the Charlson index (HR, 1.080; 95%CI 1.017–1.148; p=0.013) and the presence of pressure ulcers (HR, 1.700; 95%CI 1.028–2.810; p=0.039) were independently associated with increased mortality at one year of follow-up. The prescription of oral anticoagulants at discharge was associated with lower mortality (HR, 0.440; 95%CI 0.304–0.638; p<0.001). Conclusions: More than a third of elderly patients hospitalized with NVAF have a moderate to high nutritional risk. These patients have greater mortality at the end of one year. [ABSTRACT FROM AUTHOR]

We present an optical microscopy technique based on the scanning of a laser beam across the surface of a sample and the measurement of the deflection of the reflected laser beam in two dimensions. The technique is intended for characterization of nanomechanical systems. It provides the height of a nanomechanical system with sub-nanometer vertical resolution. In addition, it simultaneously provides a complete map of the resonant properties. We demonstrate the capability of the technique by analyzing the residual stress and vibration mode shape of a system consisting of two elastically coupled nanocantilevers. The technique is simple, allows imaging in air, vacuum and liquids, and it is unique in providing synchronized information of the static and dynamic out-of-plane displacement of nanomechanical systems. [ABSTRACT FROM AUTHOR]

In this study, we have determined the relationship between the nanostructure of the gold film deposited on microcantilevers and the sensitivity and reproducibility of their static response to molecular adsorption. In order to tune the properties of the gold film, gold was deposited at different rates and thicknesses. The cantilever response to molecular adsorption was characterized by exposure of the cantilevers to mercaptohexanol in water. The morphology of the gold surface was characterized by atomic force microscopy, and the residual stress induced in the cantilevers was characterized by a profilometry technique based on the optical beam deflection method. We have found that the discontinuous morphology of the gold film for small thicknesses and low deposition rates gives rise to large values of residual tensile stress due to the formation of grain boundaries at the expense of strain energy. These cantilevers exhibit the highest sensitivity and reproducibility to molecular adsorption. However, larger thicknesses and higher deposition rates produce the coalescence of gold nanoislands via atom diffusion. This is characterized by a large relative decrease (increase) of the tensile (compressive) stress. These cantilevers exhibit small sensitivity and low reproducibility to molecular adsorption. We conclude that the control of the gold coating process is critical for the reliability of the measurements with nanomechanical sensors. [ABSTRACT FROM AUTHOR]

We report the selective excitation of the flexural modes of microcantilevers in aqueous solutions, by applying the photothermal excitation technique. The experiments show that a particular vibration mode can be efficiently excited by focusing the intensity-modulated laser beam on regions of high curvature of the vibration shape. In addition, the resulting resonant peaks in liquid appear distorted by an amplitude component that decreases with the frequency. This distortion produces a shift of the resonance to lower frequencies. A theoretical model based on the transformation of optical energy into mechanical energy via an intermediate thermal stage is proposed to interpret the experimental results. The theory shows that the driven oscillation of the cantilever depends on the curvature of the eigenmode at the excitation position and the heating induced by the excitation laser, which decreases with the frequency. The results reported here set the basis for efficient excitation of high vibration modes in liquids and for optimized design of optically driven microresonators. [ABSTRACT FROM AUTHOR]

The study employs several methodologies to understand and determine the impact of the nanostructure of the gold film deposited on microcantilevers on the nanochemical response of the various commonly used microcantilever sensors. The analysis reveals that the control of the gold coating process is very crucial for a perfect working of the nanomechanical sensors, as the cantilevers exhibit extremely low sensitivity and low reproducibility to molecular adsorption.

The effect of the adsorption of the bacterial Escherichia coli (E. coli) on the resonance frequency of the fundamental flexural mode of a singly clamped microcantilever is studied. The results have shown that the magnitude and sign of resonance frequency shift, both depend critically on the distribution of the adsorbed bacterial cells on the cantilever.

The Asian tiger mosquito, Aedes albopictus (Diptera: Culicidae), is a highly invasive species and a vector of several viruses of serious concern to public health. Investigating the habitat selection of this species at small to medium scales is essential to the planning of effective prevention and control campaigns. The present group considered detailed data for this species' presence/absence collected at 228 sites on Mallorca Island (Spain) in autumn 2015, 3 years after the first detection of the species on the island. Site occupancy models accounting for false negative detections and imperfect monitoring were used to evaluate the relationships between mosquito presence and habitat variables. In the study area, mosquito presence was negatively associated with altitude, probably as a result of greater human presence at low altitudes near the coast. Moreover, the presence of Ae. albopictus was positively associated with swimming pools as a result of associated gardens, plants and sources of fresh water. These two variables were combined to predict the presence of the species across the entire island. Three years after its arrival, the probability of the presence of the mosquito Aedes albopictus (Diptera: Culicidae) in Mallorca was 83% and was highest in coastal and tourist areas.On the island of Mallorca, mosquito presence was negatively associated with altitude, probably as a result of greater human presence at low altitudes near the coast.The presence of Ae. albopictus was positively associated with swimming pools as a result of associated gardens, plants and fresh water sources. [ABSTRACT FROM AUTHOR]

Ultrasensitive physical, chemical and biological sensors have emerged in the last decade based on the measurement of the eigenfrequencies of micro- and nanosized cantilever plates. Surface stress is omnipresent in these devices due to a variety of factors such as the fabrication process, temperature variations and analyte adsorption. How surface stress influences on the eigenfrequencies of cantilever plates has remained as an unsolved question in physics that has raised a long debate since first experiments in 1975. Recent theoretical models have shed light on the role of the net surface stress. Still, there exists a discrepancy between theory and some experimental reports, affecting to the capability for quantification of these sensors. In this Letter, we present a theoretical framework that demonstrates that the cantilever bending due to differential surface stress between opposite faces of the cantilever, a neglected effect in classical beam theory, plays a relevant role in the stiffness and eigenfrequencies of cantilevers. We develop a new theoretical framework that provides analytical equations that accurately describe the effect of surface stress on the first three vibration modes of cantilevers. Our findings provide the final piece of the puzzle for solving this long-standing problem in physics. [ABSTRACT FROM AUTHOR]

Jessica González, 1 Pilar Rivera-Ortega, 1 Macarena Rodríguez-Fraile, 2 Patricia Restituto, 3 Inmaculada Colina, 4 María de los Desamparados Calleja, 5 Ana B Alcaide, 1 Aránzazu Campo, 1 Juan Bertó, 1 Luis Seijo, 6 Maria Teresa Pérez-Warnisher, 6 Javier J Zulueta, 1 Nerea Varo, 3 Juan P de-Torres 7 1Pulmonary Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; 2Nuclear Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain; 3Biochemistry Department, Clínica Universitaria de Navarra, Pamplona, Spain; 4Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain; 5Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain; 6Pulmonary Department, Clínica Universidad de Navarra, Madrid, Spain; 7Respirology Division, Queen’s University, Kingston, ON, CanadaCorrespondence: Jessica GonzálezPulmonary department, Hospital Universitari Arnau de Vilanova, Lleida, SpainEmail jgonzalezgutierrez@gmail.comRationale: Emphysema and osteoporosis are tobacco-related diseases. Many studies have shown that emphysema is a strong and independent predictor of low bone mineral density (BMD) in smokers; however, none of them explored its association with different emphysema subtypes.Objective: To explore the association between the different emphysema subtypes and the presence of low bone mineral density in a population of active or former smokers with and without chronic obstructive pulmonary disease (COPD).Methods: One hundred and fifty-three active and former smokers from a pulmonary clinic completed clinical questionnaires, pulmonary function tests, a low-dose chest computed tomography (LDCT) and a dual-energy absorptiometry (DXA) scans. Subjects were classified as having normal BMD or low BMD (osteopenia or osteoporosis). Emphysema was classified visually for its subtype and severity. Logistic regression analysis explored the relationship between the different emphysema subtypes and the presence of low BMD adjusting for other important factors.Results: Seventy-five percent of the patients had low BMD (78 had osteopenia and 37 had osteoporosis). Emphysema was more frequent (66.1 vs 26.3%, p=< 0.001) and severe in those with low BMD. Multivariable analysis adjusting for other significant cofactors (age, sex, FEV 1, and severity of emphysema) showed that BMI (OR=0.91, 95% CI: 0.76– 0.92) and centrilobular emphysema (OR=26.19, 95% CI: 1.71 to 399.44) were associated with low BMD.Conclusion: Low BMD is highly prevalent in current and former smokers. BMI and centrilobular emphysema are strong and independent predictors of its presence, which suggests that they should be considered when evaluating smokers at risk for low BMD.Keywords: emphysema, COPD, low bone mineral density, osteopenia, osteoporosis; smokers

Blood contains a range of protein biomarkers that could be used in the early detection of disease. To achieve this, however, requires sensors capable of detecting (with high reproducibility) biomarkers at concentrations one million times lower than the concentration of the other blood proteins. Here, we show that a sandwich assay that combines mechanical and optoplasmonic transduction can detect cancer biomarkers in serum at ultralow concentrations. A biomarker is first recognized by a surface-anchored antibody and then by an antibody in solution that identifies a free region of the captured biomarker. This second antibody is tethered to a gold nanoparticle that acts as a mass and plasmonic label; the two signatures are detected by means of a silicon cantilever that serves as a mechanical resonator for 'weighing' the mass of the captured nanoparticles and as an optical cavity that boosts the plasmonic signal from the nanoparticles. The capabilities of the approach are illustrated with two cancer biomarkers: the carcinoembryonic antigen and the prostate specific antigen, which are currently in clinical use for the diagnosis, monitoring and prognosis of colon and prostate cancer, respectively. A detection limit of 1 × 10−16 g ml−1 in serum is achieved with both biomarkers, which is at least seven orders of magnitude lower than that achieved in routine clinical practice. Moreover, the rate of false positives and false negatives at this concentration is extremely low, ∼10−4. [ABSTRACT FROM AUTHOR]