Добірка наукової літератури з теми "616-78"

Abstract Hereditary hearing loss is a monogenic disease with high genetic heterogeneity. Variants in more than 100 deafness genes underlie the basis of its pathogenesis. The aim of this study was to assess the ratio of SNVs in known deafness genes contributing to the etiology of both sporadic and familial sensorineural hearing loss patients from China. DNA samples from 1127 individuals, including normal hearing controls (n = 616), sporadic SNHL patients (n = 433), and deaf individuals (n = 78) from 30 hearing loss pedigrees were collected. The NGS tests included analysis of sequence alterations in 129 genes. The variants were interpreted according to the ACMG/AMP guidelines for genetic hearing loss combined with NGS data from 616 ethnically matched normal hearing adult controls. We identified a positive molecular diagnosis in 226 patients with sporadic SNHL (52.19%) and in patients from 17 deafness pedigrees (56.67%). Ethnically matched MAF filtering reduced the variants of unknown significance by 8.7%, from 6216 to 5675. Some complexities that may restrict causative variant identification are discussed. This report highlight the clinical utility of NGS panels identifying disease-causing variants for the diagnosis of hearing loss and underlines the importance of a broad data of control and ACMG/AMP standards for accurate clinical delineation of VUS variants.

The area of New South Wales infested with Cassinia aiwuta (sifton bush) increased from 93 000 ha in 1975 to 616 000 ha in 1988, indicating a need to investigate its biology and control. Of 6 samples of seed collected over 3 years from 2 sites, 5 germinated readily, emerged from a soil depth of 15 mm or less, and grew 7-48 times slower than pasture species in 28 days. The remaining sample had an after-ripening period of more than 5 months before full germination was achieved. Lime depressed growth of C. arcuata seedlings whilst superphosphate promoted growth. Preemergence herbicides simazine and atrazine killed seedlings in the cotyledon stage, while post-emergence herbicides glyphosate, triclopyr + picloram and hexazinone killed 40-, 78- and 139-day-old seedlings. Control on arable land could be achieved by burying seeds below 15 mm, followed by cultivation or herbicide application to remove establishing seedlings and addition of lime and spelling to allow sown species to smother late-establishing seedlings. On non-arable land burning to remove mature plants, spraying to kill establishing seedlings and aerial application of seed of improved species and superphosphate will contribute to control on soils that can support sown species without the application of large quantities of lime.

This study evaluates the costs and utilities of different treatment strategies for stable chronic obstructive pulmonary disease (COPD) patients based on Markov model and provides guidance for clinical decision and health policy making. Patients with stable COPD from four subcenters had been investigated. A Markov model with three states, namely, GOLD 1-2, GOLD 3-4, and death, was built using TreeAge Pro 2011 software. Cost-utility ratio (CUR) and incremental cost-utility ratio (ICUR) from forty Markov circles were applied to measuring the economics evaluation of three different treatments. A total of 236 stable COPD patients were randomly assigned into three groups, Western medicine group (79 cases), traditional Chinese medicine (TCM) group (79 cases), and combined group (78 cases). The results of Markov cohort simulation showed that the accumulative quality-adjusted life years (QALYs) of the three above groups per 100 000 people in 40 years were 1 702 773, 1 616 797, and 1 709 668 years, respectively, and the accumulative costs were 13 582 138 466, 1 207 904 113, and 14 656 607 371 Yuan, respectively. The CURs of the three groups were 87 235, 74 602, and 87 223 Yuan/QALY, respectively. ICURs of combined group were 8 707 and 41 705 Yuan as against Western medicine group and TCM group, respectively. Therefore, combined treatment has a lower cost, higher health output, and more socioeconomic benefits in the long run. Markov model is recommended to conduct health economics evaluation of different treatments for COPD.

Mammalian mitochondrial DNA often contains a short DNA displacement loop at the heavy-strand origin of replication. This short nascent DNA molecule has been used to study site-specific termination of mitochondrial DNA synthesis in human and mouse cells. We examined D-loop strand termination in two distantly related artiodactyls, the pig and the cow. Porcine mitochondrial DNA was unique among mammals in that it contained only a single species of D-loop single-stranded DNA. Its 3' end mapped to a site 187 nucleotides from the 5' end of the proline tRNA gene. This site was 21 and 47 nucleotides 5' to two very similar sequences (5' ACATATPyATTAT 3') which are closely related to the human and mouse termination-associated sequences noted by Doda et al. (J. N. Doda, D. T. Wright, and D. A. Clayton, Proc. Nat. Acad. Sci. USA 78:616-6120, 1981). Bovine mitochondrial DNA contained three major D-loop DNA species whose 3' ends mapped to three different sites. These sites were not found in the porcine sequence. However, the bovine termination sites were located 60 to 64 base pairs 5' from sequences which were also very similar to the termination-associated sequences present in pigs and other mammals. These results firmly establish the concept that arrest of heavy-strand DNA synthesis is an event determined, at least in part, by template sequence. They also suggest that arrest is determined by sequences which are a considerable physical distance away from the actual termination site.

Mammalian mitochondrial DNA often contains a short DNA displacement loop at the heavy-strand origin of replication. This short nascent DNA molecule has been used to study site-specific termination of mitochondrial DNA synthesis in human and mouse cells. We examined D-loop strand termination in two distantly related artiodactyls, the pig and the cow. Porcine mitochondrial DNA was unique among mammals in that it contained only a single species of D-loop single-stranded DNA. Its 3' end mapped to a site 187 nucleotides from the 5' end of the proline tRNA gene. This site was 21 and 47 nucleotides 5' to two very similar sequences (5' ACATATPyATTAT 3') which are closely related to the human and mouse termination-associated sequences noted by Doda et al. (J. N. Doda, D. T. Wright, and D. A. Clayton, Proc. Nat. Acad. Sci. USA 78:616-6120, 1981). Bovine mitochondrial DNA contained three major D-loop DNA species whose 3' ends mapped to three different sites. These sites were not found in the porcine sequence. However, the bovine termination sites were located 60 to 64 base pairs 5' from sequences which were also very similar to the termination-associated sequences present in pigs and other mammals. These results firmly establish the concept that arrest of heavy-strand DNA synthesis is an event determined, at least in part, by template sequence. They also suggest that arrest is determined by sequences which are a considerable physical distance away from the actual termination site.

10545 Background: Early identification of survivors at high risk for treatment-induced cardiomyopathy may allow for prevention and/or early intervention. We utilized deep learning methods using COG guideline-recommended baseline electrocardiography (ECG) to improve prediction of future cardiomyopathy. Methods: SJLIFE is a cohort of 5-year clinically assessed childhood cancer survivors including baseline ECG measurements. Development of cardiomyopathy was identified from clinical and echocardiographic measurement using CTCAE criteria (grade 3-4). We applied deep learning approaches to ECG, treatment exposure and demographic data obtained at baseline SJLIFE assessment. We trained a cascaded model combining a 12-layer 1D convolutional neural network to extract features from waveform ECG signals with a 2-layer dense neural network to embed features from other phenotypic data in tabular format to determine if use of deep learning with ECG data could improve prediction of cardiomyopathy. Results: Among 1,218 subjects (median age 31.7 years, range 18.4-66.4) without cardiomyopathy at baseline evaluation, 616 (51%) were male, 1,041 (85%) white, 157 (13%) African American and 792 (65%) were survivors of lymphoma/leukemia. Follow-up averaged 5 (0.5 to 9) years from baseline examination. Mean chest radiation dose was 1350 cGy (range 0 to 6,200 cGy) and mean cumulative anthracycline dose was 191 mg/m2 (range o to 734 mg/m2). A total of 114 (9.4%) survivors developed cardiomyopathy after baseline. A cascaded deep learning model built on a training set (N = 974 participants) classified cardiomyopathy in the test set (N = 244 participants) using both clinical and ECG data with a sensitivity of 70%, specificity of 73%, and AUC of 0.74 (95% CI 0.63-0.85), compared to a model using clinical data alone (sensitivity 61%, specificity 62%, and AUC 0.67, 95% CI 0.56-0.79). In subgroup analyses, models predicting cardiomyopathy within 0-4 years following baseline had a sensitivity, specificity, and AUC of 77%, 78%, and 0.78 (0.65-0.91), respectively. When predicting cardiomyopathy 5-9 years following baseline, model performance dropped to a sensitivity, specificity, and AUC of 70%, 70%, and 0.68 (0.50-0.87), respectively. Conclusions: Deep learning using ECG at baseline evaluation significantly improved prediction of cardiomyopathy in childhood cancer survivors at high risk for cardiomyopathy. Future directions will incorporate deep learning approaches to echocardiography to further improve prediction.

7578 Background: In early-stage NSCLC the neoadjuvant approach is a promising option since relatively low compliance rate with adjuvant therapy and incomplete recovery after surgery are commonly reported. The NATCH trial was therefore designed to address whether neoadjuvant or adjuvant paclitaxel (P)/carboplatin (C) improves disease-free survival compared to surgery alone in early-stage NSCLC. Patients randomized to the neoadjuvant arm have now undergone analyses of toxicity, radiographic response, resectability and surgical mortality. Methods: Consenting patients with clinical stage I (>2 cm), II, T3N1 NSCLC are randomized to surgery alone or 3 cycles of neoadjuvant PC (P: 200 mg/m2/ C:AUC=6 on day 1 every 3wk), or surgery followed by 3 cycles of adjuvant PC at the same schedule. Planned sample size of this prospective, randomized trial is 628 patients. Results: Since 2000, 616 patients have been accrued, 200 in the neoadjuvant arm, 208 in the adjuvant arm, and 208 in the surgery arm. Demographic data is now available for 162 patients in the neoadjuvant arm: 89% male; median age 64 years (range, 37–78); 45% PS 0; 53% squamous cell, 27% adenocarcinoma, 13% large cell; 7% stage IA, 64% IB, 2% IIA, 24% IIB, 2.5% T3N1. Neoadjuvant chemotherapy has been well tolerated with a median number of cycles per patient of 3. No unexpected toxicities have been seen with 12% of patients having grade 3–4 neutropenia and 43% grade 1–2 anemia. Major radiographic response has been observed in 59% of patients and progression during chemotherapy occurred in 6%. No patient characteristics were predictive for clinical response. Resection procedures at thoracotomy: lobectomy or bilobectomy in 70%, pneumonectomy in 26%, and explorative thoracotomy due to unresectable disease in 3% of patients. Post-operative mortality was 4%. Median tumor size was 4.5 cm at baseline CT-scan and 2.5 cm at surgery. At surgery, 9% patients had pathologic complete response, 75% N0–1 disease (with persistent T tumor), and 15% pathologic N2 disease. Conclusion: Neoadjuvant chemotherapy in early NSCLC has proven feasible and safe in this large multicenter sample. Chemotherapy compliance has been high and resectability rates as expected. Our findings are comparable with those of previous studies (BLOT and S9900). Mature survival results of the NATCH trial are expected in 2009. No significant financial relationships to disclose.

Abstract Background: Flow cytometry (FCM) has recently been recognized as an important supplementary tool in the diagnostic work-up of patients with MDS. Within the international MDS-flow working group of the ELN, different and also novel Flow scores have been evaluated and tested in rather small patients series. Aim: Currently available FCM scores have been prospectively compared concerning their potential diagnostic and prognostic impact in patients with proven or suspected MDS. Patients and Methods: Bone marrow (BM) samples from 616 patients (951 measurements) with proven or suspected MDS, 42 MPN patients, 30/18 MDS patients in cytomorphologic/cytogenetic CR, 22 patients with inappropriate BM aspirations as well as 48 age matched controls have been analyzed by FCM. For measurement and analysis a FACS-CantoII cytometer including FACS-DiVa software was used, performing an 8-color panel and measuring 200,000 events per sample. The following FCM scores were compared: FCSS (granulopoiesis / monopoiesis), Ogata-score (blasts), ELN-red score and Mathis score (both erythropoiesis), and the new iFScore (granulo-, mono-, erythropoiesis, and blasts). Overall survival (OS) was estimated with a median follow up of 21 month (range: 3.4-77 month) applying the Log-Rank-Test within SPSS software. Results: The new iFScore, evaluating granulo-, mono-, erythropoiesis and blasts, turned out to be the most comprehensive score with the best balance between sensitivity and specificity (81%; 78%). FCSS indeed showed a comparably high sensitivity (82%) but has a clearly lower specificity (60%). The Ogata-score and the red-scores showed a lower sensitivity (60%, 31%, 40%) but were very specific (92%, 97%, 89%). Interestingly, despite inappropriate bone marrow aspirations (w/o crumbs) in 22 patients the new iFScore accounted for a "MDS conformable" result in 72% of these cases. Next, the prognostic impact of the different FCM scores was evaluated. Of note, patients with MDS conformable FCM-scores showed a significantly shorter OS compared to patients with scores being not MDS conformable, new iFS, Ogata- and Mathis-score: p = 0.001 (ELN-red: p = 0.003; FCSS: p = 0.005). This also held true evaluating only untreated patients, with Ogata-score exhibiting the highest significance (p < 0.001). Remarkably, even when analyzing the subgroup of MDS-SLD/MLD with normal karyotype and without ringsideroblasts plus non-clonal cytopenias only, a high Ogata score predicted for a significantly lower OS (p = 0.035; median OS = 40 month vs. not reached). Thus, the group of patients with MDS conformable FCM showed significantly higher IPSS-R (p = 0.023) and more mutations (p = 0.0357). When evaluating MDS patients in cytomorphologic or even cytogenetic CR, 23% (17%) showed a MDS conformable iFS with significantly shorter OS (p = 0.025; p = 0.026). Finally, 49% or 35% of patients with MPN showed MDS conformable iFS or Ogata scores, respectively. This translated in a shorter OS in those patients (p = 0.048; p = 0.018). Conclusions: Currently available FCM scores have different sensitivity and specificity in diagnosing MDS, with the novel and comprehensive iFScore, capturing granulo-, mono-, erythropoiesis and blasts together, being superior to other FCM-scores. Additionally, iFS and Ogata score comprise significant prognostic information, even in lower risk MDS. Remarkably, FCM might be a tool to refine response evaluation in MDS and reveal significant dyspoietic features in a subset of MPN patients. Disclosures Platzbecker: Celgene: Research Funding.

Магістерська дисертація складається зі вступу та 6 розділів, висновку та списку використаної літератури. Повний обсяг складає 89 сторінок, в тому числі 41 ілюстрація, 26 таблиць та 25 літературних джерел. Актуальність даної теми полягає в тому, що автоматизація виробництва спрощує процес контролю, а також може замінити деякі процеси виробництва. Відомі закордонні роботи-маніпулятори мають значний недолік – високу ціну, а в нашій країні роботи-маніпулятори схожого або такого самого типу не виготовляються. Через це, автоматизація вітчизняного виробництва та подальшого контролю виготовлених виробів є високовартісною та не кожен виробник або компанія можуть собі дозволити використання робота-маніпулятора. Тому пропонується створити модель робота-маніпулятора для підготовки спеціалістів, які в майбутньому програмуватимуть таких роботів-маніпуляторів на роботу. Через високу ціну промислових роботів-маніпуляторів їх наявність у вищих закладах освіти є неможливою, тому пропонується надрукувати спроектовану подібну його модель за допомогою 3D-принтера та використавши в якості джерела рушійної сили сервопривід та крокові двигуни. Мета даного дослідження полягає у розробці робота-маніпулятора для позиціонування датчиків на виробах зі складною геометрією. Створення програми керування є другим етапом проведеного дослідження. Завдання: Аналітичний огляд і патентний пошук; Розробка конструкції робота-маніпулятора; Розробка програми керування; Макетування та експериментальні дослідження. Об'єкт досліджень – процес автоматизації. Предмет досліджень – методи і засоби позиціонування датчиків. За результатами дослідження був створений робот-маніпулятор за допомогою апаратної платформи Arduino, середовища графічної розробки SolidWorks та 3D-принтера. Використання даних технологій значно здешевить процес контролю, зробить його більш доступним та автоматизує. Частина процесу дослідження була опублікована в збірнику тез 11-ї Всеукраїнської науково-практичної конференції студентів та аспірантів «Погляд у майбутнє приладобудування».
The master's dissertation consists of the introduction and 6 sections, the conclusion and the list of used literature. The full volume is 89 pages, including 41 illustrations, 26 tables and 25 literary sources. The urgency of this topic is that automation of production simplifies the control process, and also can replace some processes of production. Known foreign work-manipulators have a significant drawback - a high price, and in our country work manipulators of the same type or the same type are not manufactured. Because of this, the automation of domestic production and further control of manufactured products is high value, and not every manufacturer or company can afford to use a robot-manipulator. Therefore, it is proposed to create a robot-manipulator model for the training of specialists who in the future will program such robot manipulators for work. Due to the high price of industrial robot manipulators, their availability in higher education institutions is impossible, therefore, it is proposed to print a design of this similar model using a 3D printer and using as a source of propulsion power and stepper motors. The purpose of this study is to develop a robot-manipulator for positioning sensors in products with complex geometry. Creating a management program is the second stage of the study. Task: Analytical review and patent search; Development of robot-manipulator design; Development of a management program; Layout and experimental research. Object of research - the process of automation. Subject of research - methods and means of positioning sensors. The robot-manipulator was created by means of the Arduino hardware platform, the SolidWorks graphics development environment, and the 3D printer. Using these technologies will significantly reduce the cost of control, make it more affordable and automate. Part of the research process was published in the collection of theses of the 11th All-Ukrainian Scientific and Practical Conference of Students and Postgraduates "A View to the Future of Instrumentation."

Molts estudis de música i musicoteràpia en l’àmbit de la salut, clínic, hospitalari, assistencial, en demència i en oncologia, mostren resultats rellevants en la seva aplicació, amb gran diversitat en la metodològica, i en la terminologia utilitzada fent referència a l’ús de la música com a teràpia: musicoteràpia, música i salut, música i medicina. L’objectiu d’aquesta tesi doctoral és aportar coneixement sobre els efectes emocionals i cognitius del model d’intervenció en musicoteràpia aplicat en pacients de l’àmbit clínic i de la salut. En la tesi es presenten tres estudis. Dos dels estudis són investigacions pràctiques sobre els efectes de la musicoteràpia en pacients adults afectats, un amb pacients amb demència, i l’altre amb pacients oncològics. La metodologia d’intervenció, amb o sense interacció terapèutica verbal, analitza els punts en comú i les diferències metodològiques per tal de donar llum a les possibles divergències en el tipus d’intervenció dels dos estudis. La investigación amb pacients oncològics és un estudi pilot amb tres pacients on s’aplica el model d’escolta musical en la modalitat telehealth, responent a les necessitats sanitàries plantejades per la crisi del Covid-19. La tesi incorpora un tercer estudi, que es presenta en segon lloc, com introducció a la recerca amb pacients oncològics. És una recerca bibliomètrica en musicoteràpia en l’àmbit clínic i de la salut i la modalitat tele health. S’han identificat 8 estudis amb els criteris d’inclusió proposats i es discuteixen les seves aportacions. S’aporten conclusions sobre les diferents terminologies utilitzades en l’aplicació de música com a eina terapèutica, clarificant el marc de referència en l’ús de la música com a teràpia en àmbits clínic i mèdic, Musicoteràpia, Música i Salut, Música i Medicina, on la metodologia pot variar segons cada tipus d’intervenció i estudi. Els dos estudis pràctics aporten coneixement respecte la metodologia d’intervenció, les activitats i el paper dels professionals implicats. També s’estableixen línies de treball comunes i no comunes en les diferents metodologies d’intervenció. Els condicionants ètics i deontològics d’ambdós estudis s’emmarquen dins l’Informe Belmont (1978). El primer estudi pràctic ha estat aprovat per la Comissió de Recerca del Parc Sanitari St. Joan de Déu i el segon estudi pràctic per la Comissió d’Ètica i Recerca de la FPCEE Blanquerna, URL.
Muchos estudios de música y musicoterapia en el ámbito de la salut, clínico, hospitalario, asistencial, en personas con demencia y tratamiento en oncología, muestran resultados relevantes en su aplicación, con gran diversidad metodológica; también en la terminología utilizada al hacer referencia al uso de la música como terapia: musicoterapia, música y salud, música y medicina. El objetivo de esta tesis doctoral es aportar conocimiento sobre los efectos emocionales y cognitivos del modelo de intervención en musicoterapia aplicado en pacientes del ámbito clínico y de la salud. Se realizan dos investigaciones prácticas, sobre los efectos de la musicoterapia, el primero en pacientes adultos afectados de demencia y el segundo en pacientes oncológicos. En éste se aplica el modelo de escucha musical en la modalidad tele health, dando respuesta a las necesidades sanitarias planteadas por la crisis del Civid-19. La metodología de intervención con o sin interacción terapéutica verbal, analiza los puntos en común y las diferencias metodológicas para hallar las posibles divergencias en los tipos de intervención. La tesis incluye un tercer estudio, que se presenta como introducción a la investigación con pacientes oncológicos. Se trata de una investigación bibliométrica en musicoterapia en el ámbito clínico y de la salud, en la modalidad tele health. Se identifican 8 estudios que cumplen los criterios de inclusión y se discuten sus aportaciones. Se aportan conclusiones sobre las diferentes terminologías utilizadas en la aplicación de música como recurso terapéutico, clarificando el marco de referencia en el uso de la música como terapia en ámbito clínico y médico, Musicoterapia, Música y Salud, Música y Medicina, donde la metodología puede variar según cada tipo de intervención y estudio. Los dos estudios prácticos aportan conocimiento respecto a la metodología de intervención, las actividades y el papel de los profesionales implicados. También se establecen líneas de trabajo comunes y no comunes en las diferentes metodologías de intervención. Los principios éticos y deontológicos de ambos se enmarcan en el Informe Belmont (1978). El primer estudio práctico fue aprobado por la Comissió de Recerca del Parc Sanitari St. Joan de Déu y el segundo estudio práctico por la Comissió d’Ètica i Recerca de la FPCEE Blanquerna, URL.
There are many studies in music and music therapy in the field of health, clinical, hospital, care, dementia and oncology, which show relevant results in their application, with great diversity in the methodology used and activities, as well as in the terminology used to refer to the use of music as therapy: music therapy, music and health, music and medicine. The aim of this doctoral thesis is to provide knowledge of the emotional and cognitive effects of music therapy in patients in the clinical and health fields. To study in adult patients affected by dementia (first study) and in cancer patients (second study) and, in relation to the methodology and activities used, with or without verbal therapeutic intervention, to analyze the common points and methodological differences in order to shed light. to possible divergences in this type of intervention. In the second study, the musical listening model is applied in the tele health modality, responding to the health needs raised by the Civid-19 crisis. The thesis includes a third study, which is presented as an introduction to the study with cancer patients. This research consists in a bibliometric investigation on the state of the art in music therapy in the clinical and health fields, specifically as a musical listening intervention in the tele health modality. Following the inclusion criteria, 8 studies are identified and the results are discussed. The intervention methodology with or without verbal therapeutic interaction, analyses the points in common and the methodological differences to find the possible divergences in the types of intervention of the two studies. A third study, which is presented as an introduction to the study with cancer patients, is a bibliometric investigation on the state of the art in music therapy in the clinical and health fields, specifically as a musical listening intervention in the tele health modality. In the literature review we observe different terms when referring to this use of music as therapy in clinical and medical fields, Music Therapy, Music and Health, Music and Medicine, where the methodology may vary according to each intervention and study. This situation creates or can create confusion in the field of music therapy both in the field of health and the general public. The two practical studies provide knowledge regarding the intervention methodology, the activities and the role of the professionals involved. Common and non-common lines of work are also established in the different intervention methodologies. The ethical and deontological determinants of both studies are framed within the Belmont Report (1978). First study has been approved by the Research Committee of the St. Joan de Déu Health Park. Second study has been approved by the Ethics Committee of Research of FPCEE Blanquerna, Ramon Llull University.

El càncer és una malaltia invasiva, amenaçadora i que genera un nivell alt de distrès en el malalt durant les diferents fases del procés oncològic. Actualment, i paral·lelament als tractaments oncològics convencionals, es recomanen als malalts d’altres opcions terapèutiques, entre les quals es troba la musicoteràpia. En aquest context, aquesta tesi doctoral té com a objectiu avaluar l’efecte d’un tractament de musicoteràpia sobre l’estat anímic i la qualitat de vida de pacients afectats de càncer. Aquesta avaluació s’ha centrat en observar l’efecte d'un programa de musicoteràpia de grup després de vuit sessions de tractament, així com després de cada sessió. També s’ha volgut conèixer la valoració d’aquest programa per part dels pacients participants. En primer lloc, es va dur a terme una revisió de la literatura científica sobre el tema, per tal d’exposar un marco teóric actualitzat sobre alguns aspectes de la musicoteràpia oncològica. A continuació, es va dur a terme un estudi amb una mostra de 22 subjectes amb diagnòstics oncològics heterogenis, i es va analitzar la variable estat anímic a nivell de pre- i post-tractament. A més, es va comparar l’efecte d’aquesta intervenció sobre el nivell d’ansietat i tristor dels pacients abans i després de cada sessió setmanal de 90 minuts. Posteriorment, es va decidir desenvolupar un nou estudi i examinar les variables estat anímic i qualitat de vida a l’anàlisi del pre- i post- tractament. La mostra de subjectes estava configurada per 18 malalts diagnosticats de càncer colorrectal. També es va afegir l’ítem malestar físic per comparar l’efecte del tractament abans i després de cada sessió. Finalment, es va implementar un programa de musicoteràpia adreçat a un altre perfil de pacients amb càncer: vuit dones diagnosticades de càncer de mama, amb els tractaments oncològics actius ja finalitzats, i en fase de supervivència. Aquest tercer estudi presentava el mateix disseny que el programa anterior. L’anàlisi quantitativa dels resultats pre- i post-tractament de la variable estat d’ànim mostra una disminució de les puntuacions a la majoria de subescales, fet que es pot interpretar com una millora del malestar emocional, tot i que no obté significació estadística de la mateixa manera a cadascun dels tres estudis. En el cas de dues subescales, els resultats no són consistents entre aquests estudis, mostrant empitjorament del símptoma en alguns casos i millora en d’altres. Respecte a la variable qualitat de vida, aquesta reflecteix un canvi estadísticament significatiu únicament a la dimensió emocional, i en només un dels dos estudis en què ha estat analitzada. Per altra banda, l’anàlisi de resultats obtinguts en el pre- i post-sessió exposa una total concordança entre els tres estudis, mostrant un canvi i millora estadísticament significativa a totes les variables. Aquest tipus de mesura, recollida a nivell immediat de l’inici i finalització de la sessió, sembla ser més sensible per detectar malestar i millora emocional que els altres tests i tipus de mesures a nivell de pre- i post-tractament. L’anàlisi qualitativa ha aportat informació interessant sobre la percepció i valoració del programa de musicoteràpia per parte dels participants, i ha permès constatar un grau elevat d’utilitat i satisfacció amb el mateix. Aquesta tesi presenta resultats de tres estudis que tenen les seves limitacions: cal considerar-los com a estudis preliminars que permeten apuntar recomanacions de millora per a futures investigacions. Les conclusions generals emfatitzen la necessitat d’incorporar mostres amb subjectes amb un nivell de malestar clínic més elevat, que pugui ser detectat mitjançant instruments de screening de malestar emocional, per tal de poder observar amb més claredat el possible efecte del tractament. D’altres recomanacions serien augmentar la mida de les mostres per poder generalitzar els resultats, així com configurar grups amb mostres més homogènies quant a variables sociodemogràfiques i clíniques, i augmentar la freqüència de la intervenció. Els aspectes abordats en aquesta tesi, així com els resultats analitzas, han portat a reflexionar sobre la importància d’oferir aquest tipus de programes de suport amb una intervenció de musicoteràpia, a les persones diagnosticades de càncer, tant a la fase de tractament com de supervivència.
El cáncer es una enfermedad que resulta invasiva, amenazadora y que genera altos niveles de distrés en el enfermo, en las diferentes fases del proceso de enfermedad. En la actualidad, y paralelamente a los tratamientos oncológicos convencionales, se recomiendan otras opciones terapéuticas entre las que se encuentra la musicoterapia. En este contexto, la presente tesis doctoral ha tenido como objetivo evaluar el efecto de un tratamiento de musicoterapia en el estado anímico y en la calidad de vida de pacientes afectados de cáncer. Esta evaluación se ha centrado en observar el efecto de un programa de musicoterapia en grupo después de ocho sesiones de tratamiento así como después de cada sesión. Además, se ha pretendido conocer la valoración de este programa por parte de los pacientes participantes. En primer lugar, se llevó a cabo una revisión de la literatura científica sobre el tema, a fin de exponer un marco teórico actualizado acerca de algunos aspectos de la musicoterapia oncológica. A continuación, se llevó a cabo un estudio con una muestra de 22 sujetos con diagnósticos oncológicos heterogéneos y se analizó la variable estado anímico a nivel de pre- y post-tratamiento. Además, se comparó el efecto de esta intervención en el nivel de ansiedad y tristeza de los pacientes antes y después de cada sesión semanal de 90 minutos. Posteriormente, se decidió desarrollar un nuevo estudio y analizar las variables estado anímico y calidad de vida en el análisis pre-y post- tratamiento. La muestra de sujetos estaba configurada por 18 enfermos diagnosticados de cáncer colorrectal. También se añadió el ítem malestar físico para comparar el efecto del tratamiento antes y después de cada sesión. Finalmente, se implementó un programa de musicoterapia dirigido a otro perfil de pacientes con cáncer: ocho mujeres diagnosticadas de cáncer de mama, con el tratamiento oncológico activo ya finalizado, y en fase de supervivencia. Este tercer estudio presentaba el mismo diseño de programa que el anterior. El análisis cuantitativo de los resultados pre- y post-tratamiento de la variable estado de ánimo muestran una disminución de las puntuaciones en la mayoría de subescalas, que debe interpretarse como una mejora del malestar emocional, si bien no alcanza significación estadística de igual manera en los tres estudios. En el caso de dos subescalas, los resultados no son consistentes entre estos estudios, de modo que en algunos casos muestran empeoramiento y en otros mejora del síntoma. Respecto a la variable calidad de vida, ésta refleja un cambio estadísticamente significativo únicamente en la dimensión emocional y en solo uno de los dos estudios en los que ha sido analizada. Por otra parte, el análisis de resultados obtenidos en el pre- y post-sesión expone una total concordancia entre los tres estudios, mostrando un cambio y mejora estadísticamente significativos en todas las variables. Este tipo de medida, recogida a nivel inmediato en el momento antes y después de finalizar la sesión, parece ser más sensible para detectar malestar y mejora emocional que los otros tests y mediciones a nivel de pre- y post-tratamiento. El análisis cualitativo ha aportado interesante información sobre la percepción y valoración del programa de musicoterapia por parte de los participantes, y ha revelado un alto grado de utilidad y satisfacción con el mismo. Esta tesis ofrece resultados de tres estudios con limitaciones, que deben considerarse como preliminares y que permiten apuntar recomendaciones de mejora para futuras investigaciones. Las conclusiones generales muestran la necesidad de incorporar muestras con sujetos que presenten un mayor nivel de malestar clínico, a ser posible detectado por instrumentos de screening de malestar emocional, para poder observar con más claridad el efecto del tratamiento. Aumentar el tamaño de las muestras para poder generalizar los resultados, configurar grupos con muestras más homogéneas en cuanto a variables sociodemográficas y clínicas, y aumentar la frecuencia de la intervención serían otras de las recomendaciones. Los aspectos abordados en esta tesis, así como los resultados analizados, han llevado a reflexionar sobre la importancia de ofrecer este tipo programas de apoyo, a través de una intervención de musicoterapia, a las personas diagnosticadas de cáncer, tanto en la fase de tratamiento como de supervivencia.
Cancer is a disease that is invasive, threatening and that generates high levels of distress for the patient in the different stages of the disease’s process. At present, and alongside conventional cancer treatment, other therapeutic options are recommended, including music therapy. In this context, the objective of this doctoral thesis was to evaluate the effect of a music therapy treatment on mood and quality of life of patients suffering from cancer. Evaluation was based on observation of the effect of a group music therapy programme after eight sessions of treatment and after each treatment session. In addition, the study sought to find out how the participants valued this programme. Firstly, a review of scientific literature was undertaken in order to display last findings within a theoretical framework of some issues of oncologic music therapy. Afterwards, a study was carried out with a sample of 22 subjects with heterogeneous cancer diagnoses, and the variable of mood was analysed pre- and post-treatment. The effect of this intervention on patients’ anxiety and sadness was compared before and after each weekly session of 90 minutes. Subsequently, a new study was carried out in which the variables of mood and quality of life were analysed pre- and post-treatment. The sample consisted of 18 patients diagnosed with colorectal cancer. Physical discomfort was also added as an item in order to compare the effect of treatment before and after each session. Finally, a music therapy programme was applied to another profile of cancer patients, which consisted of eight women diagnosed with breast cancer, having completed the active oncological treatment, and in the survival phase. This third study had the same design as the previous programme. Quantitative analysis of the pre- and post-treatment results of the mood variable shows a decline in scores on most subscales, which is interpreted as an improvement in emotional distress, although without statistical significance in the same way in the three studies. For two subscales, the results are not consistent across the studies, showing a worsening of the symptom in some cases and an improvement in others. Regarding the quality of life variable, a statistically significant change only arises in the emotional dimension and in only one of the two studies in which it has been analysed. However, analysis of the results obtained pre- and post-session presents complete concordance between the three studies, showing statistically significant change and improvement in all the variables. This type of measurement, gathered immediately before and after the session, appears to be more sensitive in detecting emotional distress and improvement than other tests and measurements at the pre- and post-treatment level. Qualitative analysis has provided interesting information about the participants’ perception and appreciation of the music therapy programme, revealing that it was found very useful and highly satisfying. This thesis provides results of three studies with limitations. These should be considered as preliminary studies, which allow recommendations to be made for improvements in future research. The overall findings show the need to include samples with subjects who present a higher level of clinical discomfort, possibly detected by instruments for screening for emotional distress, in order to see the effect of treatment more clearly. Other recommendations include increasing in the sample size in order to generalize the results, configuring groups with greater homogeneity in terms of socio-demographic and clinical variables, and increasing intervention frequency. The issues addressed in this thesis, and the results analysed, have led to a reflection on the importance of providing support programmes of this type, through a music therapy intervention, for people diagnosed with cancer, both in the treatment phase and in the survival phase.

У роботі вирішено комплекс задач, що дозволило вирішити важливу науково-прикладну проблему розробки методу побудови і застосування еліпсоїдальних рефлекторів в системах реєстрації та аналізу розсіяного оптичного випромінювання, а також апробації нових конструктивних, функціональних та медико-біологічних рішень. Це дало змогу теоретично та експериментально обґрунтувати метод і апаратні засоби застосування еліпсоїдальних рефлекторів для фотометрії світлорозсіяння біологічними середовищами при виявленні їх оптичних властивостей та ідентифікації фізичного та фізіологічного стану. Запропоновано фундаментальну основу вирішення вказаної проблеми завдяки вперше розробленого механізму рей-трейсингу, що взаємо пов’язує параметри джерела випромінювання, біологічного середовища, еліпсоїдального дзеркала та матричного приймача випромінювання в інформаційно-вимірювальній системі біомедичного фотометру з еліпсоїдальними рефлекторами, і який дозволяє вирішувати пряму та інверсну задачі поширення оптичного випромінювання методом статистичного моделювання Монте-Карло.
The thesis is devoted to the solution of the important scientifically applied problem of development the construction and application method of ellipsoidal reflectors in the registration and analysis systems of scattered optical radiation, as well as approbation of new structural, functional and biomedical solutions. This made it possible to theoretically and experimentally substantiate the method and hardware of the use the ellipsoidal reflectors for photometry of light scattering by biological media in the detection of their optical properties and identification of physical and physiological state. A fundamental basis for solving this problem is the first-time developed mechanism of ray-tracing, which colligate the parameters of the radiation source, biological media, ellipsoidal reflector and matrix photodetector in the information-measuring system of biomedical photometer, which allows to solve the direct and inverse problems of light propagation by the Monte Carlo statistical simulation. The main content of the thesis is outlined in eight chapters, which present and substantiate the goal and results of the work. The first chapter presents the results of analytical review and literary search, which reveal the tasks raised in the doctorate thesis. In particular, the methods of biophotonics that are most commonly used in the study of different biological media are given. The features of optical radiation propagation in biological media are analyzed, as well as the basic principles of the transfer radiative theory, which mathematically and analytically interpret this process. Typical photometric tools used for the study of biological media, boundary conditions of their use, and functional limitations are analyzed. The second chapter is devoted to the development a method of investigation the biological media optical properties. Structural schemes of basic photometers with ellipsoidal reflectors and features of their functioning are presented. The mathematical apparatus for calculating the ray tracing in a reflector with an internal ellipsoidal reflecting surface is presented, and the main types of ray trajectories are considered. The algorithm of the proposed mechanism of ray tracing and the features of its software are presented. The results of aberration analysis of ellipsoidal reflector are shown. The third chapter is devoted to the development of Monte Carlo models of light propagation in the information-measuring system of biomedical photometer with ellipsoidal reflectors. The features of the input data formation and the basic simulation algorithm are substantiated, as well as the boundary conditions of simulation. The analytical models of software adaptation of radiation source parameters, the receiving system, as well as the boundaries and scattering-absorption properties of the biological media that underlie the simulation are presented. The principles of determination the optical coefficients, algorithm and grounds of software implementation of Monte Carlo simulation in the system "radiation source + biological media + measuring tool" are presented. In the fourth chapter proposed the features of designing photometers with ellipsoidal reflectors by improving the standard equipment for microscopy, as well as in the construction of individual prototypes. Schemes of zone analysis at processing of photometric images obtained by photometry by ellipsoidal reflectors are considered. Mathematical and analytical aspects of solving the inverse problem of the radiative transfer theory by methods of Kubelka-Munk and inverse Monte-Carlo in the context the work of biomedical photometers with ellipsoidal reflectors operating in reflected and also in reflected and transmitted light are presented. The interrelation of photometric images and optical properties of the investigated biological media is considered. In the fifth chapter discusses the technological principles of ellipsoidal reflectors production and control. The materials choice of ellipsoid for different methods of shaping the aspherical surface is substantiated. The principles of production of metallic mirror ellipsoids of revolution using vertical-boring technology, as well as 3D printing technology from plastic are formulated. Practical aspects of applying a mirror coating to the inner ellipsoidal surface from plastic are determined. The analytical model and technical stages the shape control of the ellipsoidal surface are presented and photometric comparison of the functioning of reflectors produced by different technologies is made. The sixth chapter is devoted to the analysis of the effects of light scattering in the system "radiation source + biological media + measuring tool" for different profiles of energy distribution in the laser beam and their effect on the relative illuminance distribution of photometric image at zone analysis for different layers of human skin. The influence the parameters of ellipsoidal reflectors on the boundary geometric properties of optical radiation in the forward and backscattered light is considered. The influence the diameter and power of the incident beam at the tasks of Raman spectroscopy by ellipsoidal reflectors is also substantiated. In the seventh chapter features of application the photometry by ellipsoidal reflectors for creation and improvement tools of biological and medical diagnostics and control are shown. The influence of the scattering anisotropy factor on the illuminance of photometric images and the possibility of biomedical goniophotometry were evaluated. A measurement system for angular photometry in backscattered light was developed and investigated. Based on the model experiment, the prospects of using a photometer with ellipsoidal reflectors to control the optical clearing of human skin were evaluated. A prototype optical non-invasive glucometer with ellipsoidal reflectors was created and its functional features were investigated. The eighth chapter discusses the prospects of applying the mirror ellipsoids of revolution method for various problems in optical biomedical diagnostics.
В работе решен комплекс задач, позволивший решить важную научно-прикладную проблему разработки метода построения и применения эллипсоидальных рефлекторов в системах регистрации и анализа рассеянного оптического излучения, а также апробации новых конструктивных, функциональных и медико-биологических решений. Это позволило теоретически и экспериментально обосновать метод и аппаратные средства применения эллипсоидальные рефлекторов для фотометрии светорассеяния биологическими средами при обнаружении их оптических свойств и идентификации физического и физиологического состояния. Предложено фундаментальную основу решения указанной проблемы за счет впервые разработанного механизма рей-трейсинга, что взаимно связывает параметры источника излучения, биологической среды, эллипсоидального зеркала и матричного приемника излучения в информационно-измерительной системе биомедицинского фотометра с эллипсоидальными рефлекторами, и который позволяет решать прямую и инверсную задачи распространения оптического излучения методом статистического моделирования Монте-Карло.