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Validity of scoring system for palliative care in oncology: CODETM – “Care of the dying evaluation”. Is it important in assessing the end-of-life process?
Get PDFBackground: Patients with advanced cancer experience a range of distressing symptoms. Palliative care (PC) emerges as an essential area to be implemented by health systems in the care of patients with irreversible diseases and beyond therapeutic possibilities.
Aims: To compare the perception of caregivers of patients in palliative care offered by two public hospitals using the CODETM questionnaire; to determine the score obtained by the questionnaire and its usefulness in the evaluation of the palliative care offered.
Methods: The post-death questionnaire “Care of the Dying Evaluation” (CODETM) was applied to the family members who accompanied the patients in the last days, assessing the perception of the quality of care provided to the patient and the level of support to the family.
Results: No statistical difference in demographics. Participants who received palliative care had higher scores in the score, as well as in the ward and ICU unit compared to the emergency unit. The predictive cut-off value for adequate palliative care practice was 97 points, corresponding to 78.6% of the score.
Conclusions: There was no statistical difference between the caregivers’ perception of the care offered to patients between the two hospitals, being worse in the emergency unit. The cut-off value was 78.6% and was considered adequate and the CODETM questionnaire was a useful tool in the evaluation of palliative care offered by hospitals to patients and can be applied to propose improvements in palliative care. Therefore, there is a need for an instrument that can constantly classify and qualify the care provided to patients and their families in order to offer dignified, comprehensive and humanized care, as proposed by the CODETM questionnair
A landscape assessment of key evidence needs in study design and statistical methodologies for HTA submissions
Get PDFHealth Technology Assessment (HTA) evaluations play a crucial role in informing decisions related to the adoption, reimbursement, and utilization of healthcare technologies. To ensure robust and reliable outcomes, HTA requires a diverse range of evidence, which may vary depending on the specific technology under evaluation, the questions to be answered, and the available data sources. It is imperative to design and conduct studies that generate high-quality and pertinent evidence to facilitate effective HTA evaluations. Furthermore, sophisticated and appropriate statistical methodologies are often necessary to analyze and interpret the collected data in HTA assessments. Recognizing the lack of discussion and best practice recommendations to fulfill the HTA needs, the American Statistical Association (ASA) Biopharmaceutical Section (BIOP) Health Technology Assessment (HTA) Scientific Working Group (SWG) has undertaken an initiative to assess the HTA landscape in major global markets. We aim to offer strategic considerations for evidence planning related to HTA, alongside specific statistical methodologies commonly used in delivering clinical evidence and demonstrating value. Our targeted audience includes statisticians working in clinical development who may not be familiar with the intricacies and specific needs of HTA. This paper focuses specifically on study designs and statistical methods. This paper sheds light on the challenges that persist in study design and analytic approaches concerning HTA evidence requirements and discusses potential opportunities and mitigations. By bridging the knowledge gap in HTA needs and offering practical guidance on study designs and statistical methods, this research advances the field of statistics within HTA
Tribological Studies of Braided Packings with Natural and Expanded Graphite under Dry and Water-Lubricated Condition
Get PDFThe aim of this study was to evaluate the tribological properties of braided packings impregnated with natural graphite (NG) and expanded graphite (EG), operating against AISI 4130 alloy steel under dry and water-lubricated conditions. Tests were performed using an Amsler A135 tester in the “block–ring” configuration at a load of 350 N, speed of 200 rpm, and a duration of 30 minutes. The coefficient of friction, operating temperature, and mass wear were determined, and SEM/EDS analyses were carried out to characterize transfer layers. The results demonstrated a significant influence of graphite type and operating environment on friction behavior. Under dry conditions, EG-based packings exhibited a lower coefficient of friction (0.11 vs. 0.24 for NG), reduced operating temperature (by ~30%), and markedly lower mass wear. In water-lubricated conditions, COF values remained more favorable for EG; however, its mass wear increased by 367%, while for NG the increase was only 15%. SEM and EDS analyses revealed that expanded graphite formed more uniform and adhesive transfer layers under dry conditions, which promoted friction stabilization. In the presence of water, these films became less homogeneous. Natural graphite in the water-lubricated environment exhibited weak adhesion to the substrate and discontinuous coverage of the steel surface
Invited commentary on the importance of endothelial TRPV4 ion channel in myocardial ischemia-reperfusion
No full textTransient receptor potential vallinoid subfamily 4 (TRPV₄) channels are increasingly recognised as critical regulators in cardiovascular diseases. A recent article published by Zhang et al. in CJC identifies TRPV₄ as a key determinant of endothelial integrity during Ischemia-reperfusion, consolidating its potential as a therapeutic target
Predicting rigidity and connectivity percolation in disordered particulate networks using graph neural networks
Get PDFGraph neural networks can accurately predict the chemical properties of many molecular systems, but their suitability for large, macromolecular assemblies such as gels is unknown. Here, graph neural networks were trained and optimized for two large-scale classification problems: the rigidity of a molecular network, and the connectivity percolation status, which is nontrivial to determine for systems with periodic boundaries. Models trained on lattice systems were found to achieve accuracies >95% for rigidity classification, with slightly lower scores for connectivity percolation due to the inherent class imbalance in the data. Dynamically generated off-lattice networks achieved consistently lower accuracies overall due to the correlated nature of the network geometry that was absent in the lattices. An open source tool is provided allowing usage of the highest-scoring trained models, and directions for future improved tools to surmount the challenges limiting accuracy in certain situations are discussed
Streamlined Work-Up for High-Throughput Experimentation Using Automated Filtration
Get PDFAutomated pipetting is a valuable tool for the preparation of high-throughput experimentation screens; however, automation in postreaction processing (work-up) steps is often overlooked. Opentrons has created an affordable commercial pipetting robot that unlocks automated liquid dispensing and transferring for even the early-career researcher. This article demonstrates the utility of this affordable automated pipetting solution for postreaction processing through four case studies, selectively sampling biphasic mixtures when applicable. Work-up procedures appropriate for high-throughput screening of academic and industrially relevant reactions, including Suzuki–Miyaura coupling, Buchwald–Hartwig coupling and Miyaura borylation, are described. An additional protocol is designed for determining the appropriate aqueous wash to reduce protodeboronation for both an aryl boronic acid and aryl boronic pinacol ester
CO180 Pillcam COLON 2 for investigation of the COLON through direct visualization: a systematic review
No full textCrystal Morphology and Associated Face-Specific Growth Kinetics of Tolfenamic Acid as a Function of Its Solution Crystallization Environment
Get PDFThe crystal morphology and face-specific growth kinetics of tolfenamic acid (TFA) forms I and II are investigated through an integrated molecular modeling and experimental approach. Morphology predictions based on attachment energy calculations are consistent with experimental observations, with needle-like habits for both forms, although with some subtle differences in the capping faces formed, which can be attributed to the variations in intermolecular packing and surface chemistry. The solvent polarity is found to significantly influence the crystal growth of both forms: for instance, polar solvents, such as ethanol, promote higher aspect ratios by disrupting hydrogen bonding at prismatic faces, while nonpolar solvents, such as toluene, are found to hinder elongation of the crystal habit by providing strong solute/solvent aromatic stacking interactions at the capping faces. Examination of the measured growth rates for form I in ethanolic solutions reveals markedly slower growth rates (0-0.02 μm/s) on the prismatic faces (e.g., {0 1 1}) when compared to the capping faces e.g., {1 0 0} (0.044-0.555 μm/s), consistent with the lower surface intermolecular unsaturation and limited solute binding on the former faces. Examination shows that the facet crystal growth rates of form II (at a supersaturation of 0.3) are higher than that for form I for both capping and prismatic faces, consistent with the ease of crystallization of form II in ethanolic solutions. Analysis of the growth rate data for form I as a function of supersaturation reveals a good fit using a BCF model, with the surface integration at the crystal/solution interface rather than solute mass transfer in the bulk solution being identified as the rate-limiting step for the prismatic faces. This is in contrast to the capping faces, which is found to be less well-defined with mass transfer and surface integration being more balanced depending on the degree of solution supersaturation. The interplay between solvent-dependent surface interactions and intermolecular packing with the crystal face-specific growth kinetics is highlighted, contributing well toward the development of a predictive framework for the design and control of the solid-form properties of organic materials
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