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1.
Int J Environ Health Res ; : 1-11, 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39135441

RESUMEN

This study aimed to determine the effects of indoor environment (IE) and outdoor air pollutants (OAPs) in residential areas on acute exacerbation (AE) in patients with severe asthma. A total of 115 participants were recruited. To characterize IE, we used structured questionnaires and estimated OAP concentrations using a land-use regression model. Participants who were exposed to passive smoking and lived in houses where the kitchen and living room were not separated showed a significantly higher rate of AE (p = 0.014 and 0.0016, respectively). The mean concentration of PM2.5 in residential areas during the last 3 years was significantly higher in participants with AE than that in those without AE (19.8 ± 3.1 vs. 21.0 ± 2.5 µg/m3, p = 0.033). Moreover, the serum level of 8-hydroxy-2'-deoxyguanosine significantly increased in participants with AE compared to those without AE (56.9 ± 30.0 vs. 94.7 ± 44.5 ng/mL, p = 0.0047) suggesting enhanced oxidative stress in those with AE.

2.
Environ Epidemiol ; 8(5): e329, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39170820

RESUMEN

Background: Evidence linking environmental toxicants to sleep quality is growing; however, these associations during pregnancy remain unclear. We examined the associations of repeated measures of urinary phthalates in early and late pregnancy with multiple markers of sleep quality among pregnant women. Methods: The study population included 2324 pregnant women from the Korean Children's Environmental Health Study. We analyzed spot urine samples collected at two time points during pregnancy for exposure biomarkers of eight phthalate metabolites. We investigated associations between four summary phthalates (all phthalates: ∑Phthalates; di-(2-ethylhexyl) phthalate: ∑DEHP; phthalates from plastic sources: ∑Plastic; and antiandrogenic phthalates: ∑AA) and eight individual phthalates and self-reported sleep measures using generalized ordinal logistic regression and generalized estimating equations models that accounted for repeated exposure measurements. The models were adjusted for age, body mass index, education, gestational age, income, physical activity, smoking, occupation, chronic diseases, depression, and urinary cotinine levels. Results: Multiple individual phthalates and summary measures of phthalate mixtures, including ∑Plastic, ∑DEHP, ∑AA, and ∑Phthalates, were associated with lower sleep efficiency. To illustrate, every 1-unit log increase in ∑AA was associated with a reduction of sleep efficiency by 1.37 % (95% confidence interval [CI] = -2.41, -0.32). ∑AA and ∑Phthalates were also associated with shorter sleep duration and longer sleep latency. Associations between summary phthalate measures and sleep efficiency differed by urinary cotinine levels (P for subgroup difference < 0.05). Conclusions: Findings suggest that higher phthalate exposure may be related to lower sleep efficiency, shorter sleep duration, and prolonged sleep latency during pregnancy.

3.
J Virol ; 98(8): e0056024, 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-39087762

RESUMEN

Powassan virus (POWV) is an emergent tick-borne flavivirus that causes fatal encephalitis in the elderly and long-term neurologic sequelae in survivors. How age contributes to severe POWV encephalitis remains an enigma, and no animal models have assessed age-dependent POWV neuropathology. Inoculating C57BL/6 mice with a POWV strain (LI9) currently circulating in Ixodes ticks resulted in age-dependent POWV lethality 10-20 dpi. POWV infection of 50-week-old mice was 82% fatal with lethality sequentially reduced by age to 7.1% in 10-week-old mice. POWV LI9 was neuroinvasive in mice of all ages, causing acute spongiform CNS pathology and reactive gliosis 5-15 dpi that persisted in survivors 30 dpi. High CNS viral loads were found in all mice 10 dpi. However, by 15 dpi, viral loads decreased by 2-4 logs in 10- to 40-week-old mice, while remaining at high levels in 50-week-old mice. Age-dependent differences in CNS viral loads 15 dpi occurred concomitantly with striking changes in CNS cytokine responses. In the CNS of 50-week-old mice, POWV induced Th1-type cytokines (IFNγ, IL-2, IL-12, IL-4, TNFα, IL-6), suggesting a neurodegenerative pro-inflammatory M1 microglial program. By contrast, in 10-week-old mice, POWV-induced Th2-type cytokines (IL-10, TGFß, IL-4) were consistent with a neuroprotective M2 microglial phenotype. These findings correlate age-dependent CNS cytokine responses and viral loads with POWV lethality and suggest potential neuroinflammatory therapeutic targets. Our results establish the age-dependent lethality of POWV in a murine model that mirrors human POWV severity and long-term CNS pathology in the elderly. IMPORTANCE: Powassan virus is an emerging tick-borne flavivirus causing lethal encephalitis in aged individuals. We reveal an age-dependent POWV murine model that mirrors human POWV encephalitis and long-term CNS damage in the elderly. We found that POWV is neuroinvasive and directs reactive gliosis in all age mice, but at acute stages selectively induces pro-inflammatory Th1 cytokine responses in 50-week-old mice and neuroprotective Th2 cytokine responses in 10-week-old mice. Our findings associate CNS viral loads and divergent cytokine responses with age-dependent POWV lethality and survival outcomes. Responses of young mice suggest potential therapeutic targets and approaches for preventing severe POWV encephalitis that may be broadly applicable to other neurodegenerative diseases. Our age-dependent murine POWV model permits analysis of vaccines that prevent POWV lethality, and therapeutics that resolve severe POWV encephalitis.


Asunto(s)
Citocinas , Modelos Animales de Enfermedad , Virus de la Encefalitis Transmitidos por Garrapatas , Encefalitis Transmitida por Garrapatas , Ratones Endogámicos C57BL , Neuroglía , Carga Viral , Animales , Ratones , Virus de la Encefalitis Transmitidos por Garrapatas/inmunología , Encefalitis Transmitida por Garrapatas/inmunología , Encefalitis Transmitida por Garrapatas/virología , Encefalitis Transmitida por Garrapatas/mortalidad , Encefalitis Transmitida por Garrapatas/patología , Citocinas/metabolismo , Citocinas/inmunología , Neuroglía/virología , Neuroglía/inmunología , Neuroglía/patología , Femenino , Factores de Edad , Ixodes/virología , Ixodes/inmunología , Sistema Nervioso Central/virología , Sistema Nervioso Central/inmunología , Sistema Nervioso Central/patología , Encéfalo/virología , Encéfalo/patología , Encéfalo/inmunología
4.
PLoS One ; 19(8): e0308934, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39186723

RESUMEN

The classification of vessel trajectories using Automatic Identification System (AIS) data is crucial for ensuring maritime safety and the efficient navigation of ships. The advent of deep learning has brought about more effective classification methods, utilizing Convolutional Neural Networks (CNN). However, existing CNN-based approaches primarily focus on either sailing or loitering movement patterns and struggle to capture valuable features and subtle differences between these patterns from input images. In response to these limitations, we firstly introduce a novel framework, Dense121-VMC, based on Deep Convolutional Neural Networks (DCNN) with transfer learning for simultaneous extraction and classification of both sailing and loitering trajectories. Our approach efficiently performs in extracting significant features from input images and in identifying subtle differences in each vessel's trajectory. Additionally, transfer learning effectively reduces data requirements and addresses the issue of overfitting. Through extended experiments, we demonstrate the novelty of proposed Dense121-VMC framework, achieving notable contributions for vessel trajectory classification.


Asunto(s)
Aprendizaje Profundo , Redes Neurales de la Computación , Navíos , Procesamiento de Imagen Asistido por Computador/métodos , Humanos , Algoritmos
5.
J Cardiothorac Surg ; 19(1): 416, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961402

RESUMEN

BACKGROUND: The occurrence of type II endoleaks after endovascular repair of aortic aneurysm has gradually gained increasing attention. We present a case of a patient with an expanding aneurysm after thoracic endovascular aortic repair (TEVAR) for a type II endoleak, in which successful direct ligations of the intercostal artery were performed using a sac incision without cardiopulmonary bypass (CPB) or graft replacement. CASE PRESENTATION: A 62-year-old male patient, previously treated with TEVAR for a descending thoracic aortic aneurysm, presented with ongoing chest discomfort. Based on the diagnosis of a growing aneurysm and type II endoleak, the patient was prepared for CPB and aortic cross-clamping, as a precautions against the possibility of a type I endoleak. A longitudinal opening of the thoracic aortic aneurysm sac was performed following left thoracotomy. Visual confirmation identified the T5 level intercostal artery as the source of the endoleak, and after confirming the absence of a type I endoleak, multiple ligations were applied to the intercostal artery. Follow-up computed tomography confirmed the absence of endoleaks or sac growth. CONCLUSION: In a case involving TEVAR for a thoracic aortic aneurysm, open suture ligations were used to treat type II endoleaks without having to resort to CPB, resulting in successful outcomes.


Asunto(s)
Aneurisma de la Aorta Torácica , Endofuga , Procedimientos Endovasculares , Humanos , Masculino , Endofuga/cirugía , Endofuga/etiología , Persona de Mediana Edad , Aneurisma de la Aorta Torácica/cirugía , Procedimientos Endovasculares/métodos , Implantación de Prótesis Vascular/métodos , Implantación de Prótesis Vascular/efectos adversos , Tomografía Computarizada por Rayos X , Aorta Torácica/cirugía , Ligadura , Reparación Endovascular de Aneurismas
6.
Biomater Res ; 28: 0049, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38952716

RESUMEN

One of the bacterial infections caused by tympanic membrane perforation is otitis media (OM). Middle ear inflammation causes continuous pain and can be accompanied by aftereffects such as facial nerve paralysis if repeated chronically. Therefore, it is necessary to develop an artificial tympanic membrane (TM) that can effectively regenerate the eardrum due to the easy implantation and removal of OM inflammation. In this study, we synthesized hydrogel by mixing gelatin and polyacrylamide. Cefuroxime sodium salt was then incorporated into this hydrogel to both regenerate the TM and treat OM. Cytotoxicity experiments confirmed the biocompatibility of hydrogels equipped with antibiotics, and we conducted drug release and antibacterial experiments to examine continuous drug release. Through experiments, we have verified the excellent biocompatibility, drug release ability, and antibacterial effectiveness of hydrogel. It holds the potential to serve as an effective strategy for treating OM and regenerating TM as a drug delivery substance.

7.
Int J Chron Obstruct Pulmon Dis ; 19: 1661-1671, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39050737

RESUMEN

Background: COPD causes substantial economic burden on healthcare. Alternative treatment strategies for COPD can be associated with different costs dependent upon their relative safety and effectiveness. We compared costs and healthcare resource utilization (HCRU) associated with LAMA or LABA/ICS initiation. Methods: Using the Korean National Health Insurance Service database, we enrolled COPD patients initiating treatment with LAMA or LABA/ICS between January 2005 and April 2015. Propensity score matched individuals were compared on all-cause and COPD-related medical costs and HCRU over a three-year follow-up period. Results: A total of 2444 patients were enrolled in each treatment group. LAMA group was associated with significantly lower costs than LABA/ICS group, both in all-cause (403.08 vs 474.50 USD per patient per month [PPPM], cost ratio 1.18, 95% confidence interval [CI]=1.10-1.26, p<0.0001) and COPD-related (216.37 vs 267.32 USD PPPM, cost ratio 1.24, 95% CI=1.13-1.35, p<0.0001) medical costs. All-cause HCRU was not significantly different between groups, while COPD-related HRCU was higher in LAMA group (0.66 vs 0.60 medical visits PPPM, p<0.0001). Conclusion: COPD patients initiating treatment with LAMA were associated with lower all-cause and COPD-related medical costs than those starting with LABA/ICS despite the similar all-cause HCRU and higher COPD-related HCRU. Initiation with LAMA is a cost-efficient option for the treatment of COPD.


Asunto(s)
Agonistas de Receptores Adrenérgicos beta 2 , Broncodilatadores , Bases de Datos Factuales , Costos de los Medicamentos , Enfermedad Pulmonar Obstructiva Crónica , Bromuro de Tiotropio , Humanos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/economía , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , República de Corea/epidemiología , Masculino , Femenino , Anciano , Persona de Mediana Edad , Agonistas de Receptores Adrenérgicos beta 2/economía , Agonistas de Receptores Adrenérgicos beta 2/administración & dosificación , Bromuro de Tiotropio/administración & dosificación , Bromuro de Tiotropio/economía , Resultado del Tratamiento , Broncodilatadores/economía , Broncodilatadores/administración & dosificación , Factores de Tiempo , Administración por Inhalación , Antagonistas Muscarínicos/economía , Antagonistas Muscarínicos/administración & dosificación , Antagonistas Muscarínicos/efectos adversos , Corticoesteroides/administración & dosificación , Corticoesteroides/economía , Combinación de Medicamentos , Análisis Costo-Beneficio , Estudios Retrospectivos , Ahorro de Costo , Recursos en Salud/estadística & datos numéricos , Recursos en Salud/economía , Pulmón/fisiopatología , Pulmón/efectos de los fármacos
8.
Eur Heart J Case Rep ; 8(7): ytae353, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39081400

RESUMEN

Background: Pulmonary thromboembolism and active haemoptysis represent distinct yet critical emergencies necessitating immediate intervention. However, the treatment protocols for these conditions-anticoagulation therapy and haemostatic therapy-often pose a dilemma. Case summary: We present the case of a 25-year-old female who presented to our emergency room with haemoptysis and a concurrent diagnosis of pulmonary thromboembolism. Due to persistent active haemoptysis, we temporarily paused anticoagulation and opted for surgical pulmonary thrombectomy, enabling the safe resumption of anticoagulation therapy. Discussion: Haemoptysis occurring in pulmonary thromboembolism is infrequently reported in the literature, and established treatment guidelines for such cases are lacking. This case could provide guidance on how to handle the intricate treatment challenges posed by concurrent haemoptysis and pulmonary thromboembolism.

9.
Nanoscale ; 16(29): 13874-13884, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-38990512

RESUMEN

Chemically synthesized PEDOT (poly(3,4-ethylenedioxythiophene)) nanomaterials, with various nanostructured morphologies as well as different intrinsic electrical conductivities and crystallinities, were compared as electrocatalysts for Co(III) reduction in dye-sensitized solar cells (DSSCs). Electrochemical parameters, charge transfer resistance toward the electrode/electrolyte interface, catalytic activity for Co(III)-reduction, and diffusion of cobalt redox species greatly depend on the morphology, crystallinity, and intrinsic electrical conductivity of the chemically synthesized PEDOTs and optimization of the fabrication procedure for counter electrodes. The PEDOT counter electrode, fabricated by spin coating a DMSO-dispersed PEDOT solution with an ordered 1D structure and nanosized fibers averaging 70 nm in diameter and an electrical conductivity of ∼16 S cm-1, exhibits the lowest charge transfer resistance, highest diffusion for a cobalt redox mediator and superior electrocatalytic performance compared to a traditional Pt-counter electrode. The photovoltaic performance of the DSSC using chemically synthesized PEDOT exceeds that of a Pt-electrode device because of the enhanced current density, which is directly related to the superior electrocatalytic ability of PEDOT for Co(III)-reduction. This simple spin-coated counter electrode prepared using cheap and scalable chemically synthesized PEDOT can be a potential alternative to the expensive Pt-counter electrode for cobalt and other redox electrolytes in DSSCs and various flexible electronic devices.

10.
Int J Environ Health Res ; : 1-13, 2024 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-38909289

RESUMEN

This study investigated the correlation between the individual chemical constituents of particulate matter 2.5 µm (PM2.5) and respiratory parameters as well as the living environment and daily behaviors in patients with chronic obstructive pulmonary disease (COPD). Data were obtained from prospective COPD panel conducted in South Korea. Following collection via a microPEM, 18 metallic elements were determined using energy-dispersive X-ray fluorescence spectroscopy. All participants completed detailed questionnaires on living environments and lifestyle practices. Eighty-nine stable COPD patients (mean age 68.1 years; 94.4% male) were analyzed. Several constituents (titanium, aluminum, bromine, and silicone) were significantly associated with respiratory outcomes. Copper and manganese concentrations were significantly associated with the living environment. Increased ventilation time and air purifier operation were associated with lower concentrations of copper, silicone, barium, and titanium. These findings suggest varying relationships between PM2.5 constituents and clinical parameters in COPD patients, providing a basis for personalized interventions and future research.

11.
Molecules ; 29(10)2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38792080

RESUMEN

Tumor cells in hypoxic conditions control cancer metabolism and angiogenesis by expressing HIF-1α. Tanshinone is a traditional Chinese medicine that has been shown to possess antitumor properties and exerts a therapeutic impact on angiogenesis. However, the precise molecular mechanism responsible for the antitumor activity of 3-Hydroxytanshinone (3-HT), a type of tanshinone, has not been fully understood. Therefore, our study aimed to investigate the mechanism by which 3-HT regulates the expression of HIF-1α. Our findings demonstrate that 3-HT inhibits HIF-1α activity and expression under hypoxic conditions. Additionally, 3-HT inhibits hypoxia-induced angiogenesis by suppressing the expression of VEGF. Moreover, 3-HT was found to directly bind to α-enolase, an enzyme associated with glycolysis, resulting in the suppression of its activity. This inhibition of α-enolase activity by 3-HT leads to the blockade of the glycolytic pathway and a decrease in glycolysis products, ultimately altering HIF1-α expression. Furthermore, 3-HT negatively regulates the expression of HIF-1α by altering the phosphorylation of AMP-activated protein kinase (AMPK). Our study's findings elucidate the mechanism by which 3-HT regulates HIF-1α through the inhibition of the glycolytic enzyme α-enolase and the phosphorylation of AMPK. These results suggest that 3-HT holds promise as a potential therapeutic agent for hypoxia-related angiogenesis and tumorigenesis.


Asunto(s)
Glucólisis , Subunidad alfa del Factor 1 Inducible por Hipoxia , Fosfopiruvato Hidratasa , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Fosfopiruvato Hidratasa/metabolismo , Fosfopiruvato Hidratasa/genética , Glucólisis/efectos de los fármacos , Humanos , Abietanos/farmacología , Hipoxia de la Célula/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Línea Celular Tumoral , Neovascularización Patológica/tratamiento farmacológico , Neovascularización Patológica/metabolismo
12.
Medicine (Baltimore) ; 103(21): e38344, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38788044

RESUMEN

BACKGROUND: A dysphagia rehabilitation method using kinesiology taping (KT) was recently introduced, and its potential for clinical efficacy was demonstrated by evaluating muscle activity and thickness. However, its effect on the swallowing function in patients with dysphagia remains unclear. This study aimed to investigate the effects of effortful swallowing against KT resistance on the swallowing function in patients with post stroke dysphagia. METHODS: Thirty patients with poststroke dysphagia were recruited and randomly assigned to the experimental and placebo groups. In the experimental group, the KT was attached to the front of the neck (the hyoid bone between the sternum) with a tension of approximately 70% to 80%, and effortful swallowing was performed against the KT tension. In contrast, the placebo group performed effortful swallowing with KT applied at the same location without tension. The intervention was performed 30 times/day, 5 days/week for 6 weeks. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study were used to analyze oropharyngeal swallowing function. RESULTS: The experimental group showed statistically significant improvements in the oral and pharyngeal phases of the VDS (P = .029 and .007, respectively) and PAS (P = .034) compared with the placebo group. Effect sizes were observed for the oral (0.3) and pharyngeal phases (0.5) of the VDS and PAS (1.1). CONCLUSION: This study demonstrated that effortful swallowing against resistance to KT is an effective therapeutic exercise for improving the swallowing function in patients with poststroke dysphagia.


Asunto(s)
Cinta Atlética , Trastornos de Deglución , Deglución , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Trastornos de Deglución/rehabilitación , Trastornos de Deglución/fisiopatología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Rehabilitación de Accidente Cerebrovascular/métodos , Deglución/fisiología , Resultado del Tratamiento
13.
Anal Chem ; 96(21): 8467-8473, 2024 05 28.
Artículo en Inglés | MEDLINE | ID: mdl-38723271

RESUMEN

Lipid droplets (LDs) store energy and supply fatty acids and cholesterol. LDs are a hallmark of chronic nonalcoholic fatty liver disease (NAFLD). Recently, studies have focused on the role of hepatic macrophages in NAFLD. Green fluorescent protein (GFP) is used for labeling the characteristic targets in bioimaging analysis. Cx3cr1-GFP mice are widely used in studying the liver macrophages such as the NAFLD model. Here, we have developed a tool for two-photon microscopic observation to study the interactions between LDs labeled with LD2 and liver capsule macrophages labeled with GFP in vivo. LD2, a small-molecule two-photon excitation fluorescent probe for LDs, exhibits deep-red (700 nm) fluorescence upon excitation at 880 nm, high cell staining ability and photostability, and low cytotoxicity. This probe can clearly observe LDs through two-photon microscopy (TPM) and enables the simultaneous imaging of GFP+ liver capsule macrophages (LCMs) in vivo in the liver capsule of Cx3cr1-GFP mice. In the NAFLD mouse model, Cx3cr1+ LCMs and LDs increased with the progress of fatty liver disease, and spatiotemporal changes in LCMs were observed through intravital 3D TPM images. LD2 will aid in studying the interactions and immunological roles of hepatic macrophages and LDs to better understand NAFLD.


Asunto(s)
Gotas Lipídicas , Hígado , Macrófagos , Animales , Gotas Lipídicas/química , Gotas Lipídicas/metabolismo , Ratones , Macrófagos/metabolismo , Hígado/diagnóstico por imagen , Hígado/metabolismo , Hígado/patología , Proteínas Fluorescentes Verdes/metabolismo , Proteínas Fluorescentes Verdes/química , Enfermedad del Hígado Graso no Alcohólico/diagnóstico por imagen , Enfermedad del Hígado Graso no Alcohólico/patología , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Microscopía de Fluorescencia por Excitación Multifotónica/métodos , Colorantes Fluorescentes/química , Ratones Endogámicos C57BL
14.
Nanoscale Horiz ; 9(8): 1301-1310, 2024 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-38808378

RESUMEN

The increasing demand for natural and safer alternatives to traditional hair dyes has led to the investigation of nanomaterials as potential candidates for hair coloring applications. MXene nanosheets have emerged as a promising alternative in this context due to their unique optical and electronic properties. In this study, we aimed to evaluate the potential of Ti3C2Tx (Tx = -O, -OH, -F, etc.) MXene nanosheets as a hair dye. MXene nanosheet-based dyes have been demonstrated to exhibit not only coloring capabilities but also additional properties such as antistatic properties, heat dissipation, and electromagnetic wave shielding. Additionally, surface modification of MXene using collagen reduces the surface roughness of hair and upregulates keratinocyte markers KRT5 and KRT14, demonstrating the potential for tuning its physicochemical and biological properties. This conceptual advancement highlights the potential of MXene nanosheets to go beyond simple cosmetic improvements and provide improved comfort and safety by preventing the presence of hazardous ingredients and solvents while providing versatility.

15.
Sci Rep ; 14(1): 10462, 2024 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714885

RESUMEN

Respiratory infections are common causes of acute exacerbation of chronic obstructive lung disease (AECOPD). We explored whether the pathogens causing AECOPD and clinical features changed from before to after the coronavirus disease 2019 (COVID-19) outbreak. We reviewed the medical records of patients hospitalized with AECOPD at four university hospitals between January 2017 and December 2018 and between January 2021 and December. We evaluated 1180 patients with AECOPD for whom medication histories were available. After the outbreak, the number of patients hospitalized with AECOPD was almost 44% lower compared with before the outbreak. Patients hospitalized with AECOPD after the outbreak were younger (75 vs. 77 years, p = 0.003) and more often stayed at home (96.6% vs. 88.6%, p < 0.001) than patients of AECOPD before the outbreak. Hospital stay was longer after the outbreak than before the outbreak (10 vs. 8 days. p < 0.001). After the COVID-19 outbreak, the identification rates of S. pneumoniae (15.3 vs. 6.2%, p < 0.001) and Hemophilus influenzae (6.4 vs. 2.4%, p = 0.002) decreased, whereas the identification rates of P. aeruginosa (9.4 vs. 13.7%, p = 0.023), Klebsiella pneumoniae (5.3 vs. 9.8%, p = 0.004), and methicillin-resistant Staphylococcus aureus (1.0 vs. 2.8%, p = 0.023) increased. After the outbreak, the identification rate of influenza A decreased (10.4 vs. 1.0%, p = 0.023). After the outbreak, the number of patients hospitalized with AECOPD was lower and the identification rates of community-transmitted pathogens tended to decrease, whereas the rates of pathogens capable of chronic colonization tended to increase. During the period of large-scale viral outbreaks that require quarantine, patients with AECOPD might be given more consideration for treatment against strains that can colonize chronic respiratory disease rather than community acquired pathogens.


Asunto(s)
COVID-19 , Hospitalización , Enfermedad Pulmonar Obstructiva Crónica , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , Masculino , Femenino , Anciano de 80 o más Años , SARS-CoV-2/aislamiento & purificación , Persona de Mediana Edad , Pandemias , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Progresión de la Enfermedad , Estudios Retrospectivos , Streptococcus pneumoniae/aislamiento & purificación , Streptococcus pneumoniae/patogenicidad , Haemophilus influenzae/aislamiento & purificación
16.
BioData Min ; 17(1): 14, 2024 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-38796471

RESUMEN

BACKGROUND: Supervised machine learning models have been widely used to predict and get insight into diseases by classifying patients based on personal health records. However, a class imbalance is an obstacle that disrupts the training of the models. In this study, we aimed to address class imbalance with a conditional normalizing flow model, one of the deep-learning-based semi-supervised models for anomaly detection. It is the first introduction of the normalizing flow algorithm for tabular biomedical data. METHODS: We collected personal health records from South Korean citizens (n = 706), featuring genetic data obtained from direct-to-customer service (microarray chip), medical health check-ups, and lifestyle log data. Based on the health check-up data, six chronic diseases were labeled (obesity, diabetes, hypertriglyceridemia, dyslipidemia, liver dysfunction, and hypertension). After preprocessing, supervised classification models and semi-supervised anomaly detection models, including conditional normalizing flow, were evaluated for the classification of diabetes, which had extreme target imbalance (about 2%), based on AUROC and AUPRC. In addition, we evaluated their performance under the assumption of insufficient collection for patients with other chronic diseases by undersampling disease-affected samples. RESULTS: While LightGBM (the best-performing model among supervised classification models) showed AUPRC 0.16 and AUROC 0.82, conditional normalizing flow achieved AUPRC 0.34 and AUROC 0.83 during fifty evaluations of the classification of diabetes, whose base rate was very low, at 0.02. Moreover, conditional normalizing flow performed better than the supervised model under a few disease-affected data numbers for the other five chronic diseases - obesity, hypertriglyceridemia, dyslipidemia, liver dysfunction, and hypertension. For example, while LightGBM performed AUPRC 0.20 and AUROC 0.75, conditional normalizing flow showed AUPRC 0.30 and AUROC 0.74 when predicting obesity, while undersampling disease-affected samples (positive undersampling) lowered the base rate to 0.02. CONCLUSIONS: Our research suggests the utility of conditional normalizing flow, particularly when the available cases are limited, for predicting chronic diseases using personal health records. This approach offers an effective solution to deal with sparse data and extreme class imbalances commonly encountered in the biomedical context.

17.
BMC Pulm Med ; 24(1): 162, 2024 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-38570737

RESUMEN

BACKGROUND: Endobronchial valve (EBV) therapy, a validated method for bronchoscopic lung volume reduction (BLVR) in severe emphysema, has been explored for persistent air-leak (PAL) management. However, its effectiveness and safety in the Asian population require further real-world evaluation. In this study, we assessed the outcomes of treatment with EBV within this demographic. METHODS: We conducted a retrospective analysis of medical records from 11 Korean centers. For the emphysema cohort, inclusion criteria were patients diagnosed with emphysema who underwent bronchoscopy intended for BLVR. We assessed these patients for clinical outcomes of chronic obstructive pulmonary disease. All patients with PAL who underwent treatment with EBV were included. We identified the underlying causes of PAL and evaluated clinical outcomes after the procedure. RESULTS: The severe emphysema cohort comprised 192 patients with an average age of 70.3 years, and 95.8% of them were men. Ultimately, 137 underwent treatment with EBV. Three months after the procedure, the BLVR group demonstrated a significant improvement in forced expiratory volume in 1 s (+160 mL vs. +30 mL; P = 0.009). Radiographic evidence of lung volume reduction 6 months after BLVR was significantly associated with improved survival (adjusted hazard ratio 0.020; 95% confidence interval 0.038-0.650; P = 0.010). Although pneumothorax was more common in the BLVR group (18.9% vs. 3.8%; P = 0.018), death was higher in the no-BLVR group (38.5% vs. 54.5%, P = 0.001), whereas other adverse events were comparable between the groups. Within the subset of 18 patients with PAL, the predominant causes of air-leak included spontaneous secondary pneumothorax (44.0%), parapneumonic effusion/empyema (22.2%), and post-lung resection surgery (16.7%). Following the treatment, the majority (77.8%) successfully had their chest tubes removed. Post-procedural complications were minimal, with two incidences of hemoptysis and one of empyema, all of which were effectively managed. CONCLUSIONS: Treatment with EBV provides substantial clinical benefits in the management of emphysema and PAL in the Asian population, suggesting a favorable outcome for this therapeutic approach.


Asunto(s)
Enfisema , Empiema , Neumotórax , Enfisema Pulmonar , Masculino , Humanos , Anciano , Femenino , Neumotórax/etiología , Neumotórax/cirugía , Estudios Retrospectivos , Neumonectomía/efectos adversos , Volumen Espiratorio Forzado , Broncoscopía/métodos , Empiema/etiología , Empiema/cirugía , Resultado del Tratamiento
18.
Tissue Eng Regen Med ; 21(5): 673-693, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38578424

RESUMEN

BACKGROUND: Mesenchymal stem cells (MSCs) are undifferentiated cells that can differentiate into specific cell lineages when exposed to the right conditions. The ability of MSCs to differentiate into particular cells is considered very important in biological research and clinical applications. MSC spheroids are clusters of MSCs cultured in three dimensions, which play an important role in enhancing the proliferation and differentiation of MSCs. MSCs can also participate in vascular formation by differentiating into endothelial cells and secreting paracrine factors. Vascularization ability is essential in impaired tissue repair and function recovery. Therefore, the vascularization ability of MSCs, which enhances angiogenesis and accelerates tissue healing has made MSCs a promising tool for tissue regeneration. However, MSC spheroids are a relatively new research field, and more research is needed to understand their full potential. METHODS: In this review, we highlight the importance of MSC spheroids' vascularization ability in tissue engineering and regenerative medicine while providing the current status of studies on the MSC spheroids' vascularization and suggesting potential future research directions for MSC spheroids. RESULTS: Studies both in vivo and in vitro have demonstrated MSC spheroids' capacity to develop into endothelial cells and stimulate vasculogenesis. CONCLUSION: MSC spheroids show potential to enhance vascularization ability in tissue regeneration. Yet, further research is required to comprehensively understand the relationship between MSC spheroids and vascularization mechanisms.


Asunto(s)
Células Madre Mesenquimatosas , Neovascularización Fisiológica , Regeneración , Esferoides Celulares , Humanos , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/metabolismo , Esferoides Celulares/citología , Animales , Regeneración/fisiología , Ingeniería de Tejidos/métodos , Medicina Regenerativa/métodos , Diferenciación Celular
19.
J Inflamm (Lond) ; 21(1): 13, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38654364

RESUMEN

BACKGROUND: Exposure to noxious particles, including cigarette smoke and fine particulate matter (PM2.5), is a risk factor for chronic obstructive pulmonary disease (COPD) and promotes inflammation and cell death in the lungs. We investigated the combined effects of cigarette smoking and PM2.5 exposure in patients with COPD, mice, and human bronchial epithelial cells. METHODS: The relationship between PM2.5 exposure and clinical parameters was investigated in patients with COPD based on smoking status. Alveolar destruction, inflammatory cell infiltration, and pro-inflammatory cytokines were monitored in the smoking-exposed emphysema mouse model. To investigate the mechanisms, cell viability and death and pyroptosis-related changes in BEAS-2B cells were assessed following the exposure to cigarette smoke extract (CSE) and PM2.5. RESULTS: High levels of ambient PM2.5 were more strongly associated with high Saint George's respiratory questionnaire specific for COPD (SGRQ-C) scores in currently smoking patients with COPD. Combined exposure to cigarette smoke and PM2.5 increased mean linear intercept and TUNEL-positive cells in lung tissue, which was associated with increased inflammatory cell infiltration and inflammatory cytokine release in mice. Exposure to a combination of CSE and PM2.5 reduced cell viability and upregulated NLRP3, caspase-1, IL-1ß, and IL-18 transcription in BEAS-2B cells. NLRP3 silencing with siRNA reduced pyroptosis and restored cell viability. CONCLUSIONS: PM2.5 aggravates smoking-induced airway inflammation and cell death via pyroptosis. Clinically, PM2.5 deteriorates quality of life and may worsen prognosis in currently smoking patients with COPD.

20.
Ann Occup Environ Med ; 36: e8, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38623262

RESUMEN

Background: Studies on the association between job satisfaction and depression have often been reported. However, no study has examined how job satisfaction impacts depression while considering satisfaction with other aspects of life. In this study, we evaluated the effect of job satisfaction on depression after adjusting for satisfaction with other domains of life. Methods: We used data from the 16th wave of the Korean Welfare Panel Study. A total of 3568 current employees without depression who completed a survey were included. Depression was measured using the abbreviated version of the CES-D scale. Various types of satisfaction, including job satisfaction, were measured using single-item questions and a 5-point Likert scale. The association between job satisfaction and depression after considering satisfaction with other life domains was analyzed using a multiple logistic regression model. Results: Crude models showed a significant association between job satisfaction and depression in males (odds ratio [OR]: 7.90; 95% confidence interval [CI]: 4.11-15.23) and females (OR: 7.12; 95% CI: 4.40-11.50). When adjusted for sociodemographic factors, health-related factors, and work-related factors, the association remained significant in males (OR: 6.20; 95% CI: 3.10-12.41) and females (OR: 6.28; 95% confidence interval (CI): 3.79-10.40). However, when satisfaction with other life domains was included, the association remained significant only in females (OR: 3.55; 95% CI: 1.93-6.50). Conclusions: This study shows an association between job satisfaction and depression in Korean employees. However, when satisfaction with other life domains was considered, this association remained significant only in women. Regular screening of job satisfaction should be considered as a means of preventing and managing depression among female employees.

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