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Cellular nanoparticles (CNPs), fabricated by coating natural cell membranes onto nanoparticle cores, have been widely used to replicate cellular functions for various therapeutic applications. Specifically, CNPs act as cell decoys, binding harmful molecules or infectious pathogens and neutralizing their bioactivity. This neutralization strategy leverages the target's functional properties rather than its structure, resulting in broad-spectrum efficacy. Since their inception, CNP platforms have undergone significant advancements to enhance their neutralizing capabilities and efficiency. This review traces the research advances of CNP technology as multiplex countermeasures across four categories with progressive functions: neutralization through cell membrane binding, simultaneous neutralization using both cell membrane and nanoparticle core, continuous neutralization via enzymatic degradation, and enhanced neutralization through membrane modification. The review highlights the structure-property relationship in CNP designs, showing the functional advances of each category of CNP. By providing an overview of CNPs in multiplex neutralization of a wide range of chemical and biological threat agents, this article aims to inspire the development of more advanced CNP nanoformulations and uncover innovative applications to address unresolved medical challenges.
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Selective S-C bond cleavage of disulfides presents a significant challenge due to the fact that S-S bonds are weaker than S-C bonds. In this study, we present a novel chloride-induced Selectfluor radical cation process for converting readily available symmetrical disulfides into unsymmetrical ß-fluorodisulfides through selective S-C bond cleavage. Mechanistic investigations and DFT calculations suggest the involvement of a chlorinated disulfide radical, which subsequently reacts with alkenes to form ß-fluorodisulfides via the atom transfer radical addition (ATRA) mechanism. Furthermore, this method exhibits broad functional group tolerance, enabling the synthesis of various target products in moderate to good yields.
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Aptamers are single-stranded oligonucleotides that fold into defined architectures for specific target binding. In this study, aptamers are selected that specifically bind to small-molecule neurotoxins and encapsulate them into cell membrane-coated nanoparticles (referred to as 'cellular nanoparticles' or 'CNPs') for effective neutralization of neurotoxins. Specifically, six different aptamers are selected that bind to saxitoxin (STX) or tetrodotoxin (TTX) and encapsulate them into metal-organic framework cores, which are then coated with neuronal cell membrane. The resulting CNPs exhibit high colloidal stability, minimal aptamer leakage, and effective protection of aptamer payloads against enzyme degradation. This detoxification platform combines membrane-enabled broad-spectrum neutralization with aptamer-based specific toxin binding, offering dual-modal neutralization mechanisms for efficient neurotoxin neutralization. The in vitro neutralization efficacy is demonstrated using a neuron osmotic swelling assay, a Na+ flux fluorescence assay, and a cytotoxicity assay. The in vivo neutralization efficacy is further validated using mouse models of STX and TTX intoxication in both therapeutic and preventative regimens. Overall, integrating aptamers with CNPs combines the strengths of both technologies, resulting in a robust solution for broad-spectrum toxin-neutralization applications.
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OBJECTIVE: To identify the determinants of family resilience in the recovery of individuals with schizophrenia using Walsh's family resilience framework. DESIGN: A cross-sectional study. METHODS: In Northeast China, 403 patients diagnosed with schizophrenia were enrolled for this study, assessing family resilience, family communication, social support, illness knowledge, hope and family functioning. Regression analyses were conducted using SPSS 27.0, and mediation effects were examined using Mplus 7.0. RESULTS: Logistic regression showed that female gender and having a sibling as a caregiver were negatively associated with family resilience, while a higher educational level was positively associated. Mediation analysis showed that family functioning and hope levels mediated the impact of family communication, social support and disease knowledge on family resilience, confirming their crucial roles. CONCLUSION: Family functioning and hope are central in mediating the relationships between family communication, social support, illness knowledge and family resilience in families dealing with schizophrenia. IMPACT: The findings of this study enable psychiatric nurses and policymakers to devise intervention strategies that enhance family resilience among patients with schizophrenia, thereby facilitating their recovery and well-being. PATIENT OR PUBLIC CONTRIBUTION: No patient or public engagement.
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Older adults diagnosed with schizophrenia face unique public health challenges, with specific treatment needs, complex care demands, accelerated aging, and increased susceptibility to health issues. This phenomenological study explored the existential realities and needs of older adults diagnosed with schizophrenia. Fifteen participants, with a mean age of 69.47 (SD ± 9.47) years, ranging from 62 to 79 years old and hailing from rural regions, participated in the study. Four main themes and eight sub-themes emerge: compounding the burden (challenges in symptom management, comorbidities); the abyss of a life filled with emptiness (loss of mental pillars, living in agony); living on the margins of society (the vicious cycle of social and self-isolation, unattainable social welfare); and glimmer of light in the darkness (support systems, self-adjustment). The study calls for healthcare professionals to improve follow-up care efficiency, strengthen engagement, understand patients' living conditions and needs, enforce existing welfare policies for older mentally ill patients, and enhance their mental health and quality of life.
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Envejecimiento , Investigación Cualitativa , Esquizofrenia , Humanos , Anciano , Femenino , Masculino , Esquizofrenia/complicaciones , Esquizofrenia/terapia , Persona de Mediana Edad , Envejecimiento/psicología , Calidad de Vida/psicologíaRESUMEN
Neurotoxins pose significant challenges in defense and healthcare due to their disruptive effects on nervous tissues. Their extreme potency and enormous structural diversity have hindered the development of effective antidotes. Motivated by the properties of cell membrane-derived nanodiscs, such as their ultrasmall size, disc shape, and inherent cell membrane functions, here, we develop neuronal membrane-derived nanodiscs (denoted "Neuron-NDs") as a countermeasure nanomedicine for broad-spectrum neurotoxin detoxification. We fabricate Neuron-NDs using the plasma membrane of human SH-SY5Y neurons and demonstrate their effectiveness in detoxifying tetrodotoxin (TTX) and botulinum toxin (BoNT), two model toxins with distinct mechanisms of action. Cell-based assays confirm the ability of Neuron-NDs to inhibit TTX-induced ion channel blockage and BoNT-mediated inhibition of synaptic vesicle recycling. In mouse models of TTX and BoNT intoxication, treatment with Neuron-NDs effectively improves survival rates in both therapeutic and preventative settings. Importantly, high-dose administration of Neuron-NDs shows no observable acute toxicity in mice, indicating its safety profile. Overall, our study highlights the facile fabrication of Neuron-NDs and their broad-spectrum detoxification capabilities, offering promising solutions for neurotoxin-related challenges in biodefense and therapeutic applications.
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Membrana Celular , Nanoestructuras , Neuronas , Neurotoxinas , Tetrodotoxina , Humanos , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Animales , Ratones , Tetrodotoxina/química , Tetrodotoxina/farmacología , Neurotoxinas/química , Neurotoxinas/toxicidad , Neurotoxinas/farmacología , Nanoestructuras/química , Membrana Celular/metabolismo , Membrana Celular/efectos de los fármacos , Toxinas Botulínicas/química , Toxinas Botulínicas/farmacología , Toxinas Botulínicas/metabolismo , Inactivación MetabólicaRESUMEN
Many current electronic medical record (EMR) sharing schemes that use proxy re-encryption and blockchain do not fully consider the potential threat of malicious node impersonation attacks. This oversight could lead to data leakage as attackers masquerade as legitimate users or proxy nodes during the sharing process. To deal with this problem, we propose an EMR sharing scheme based on proxy re-encryption and blockchain to protect against impersonation attacks. First, we prevent the potential threat of impersonation attacks by generating a shared temporary key and assigning tasks to multiple proxy nodes. Second, we use a random function to ensure that the selection of encrypted proxy nodes is fair. Third, we use a combination of blockchain and the InterPlanetary File System to solve the problem of insufficient storage capacity of shared processes and ensure the storage security of EMRs. Through the security proof, our scheme guarantees anti-impersonation, anti-collusion, and anti-chosen plaintext attack capability in the sharing process of EMRs. Additionally, experiments on the blockchain platform, namely Chain33, show that our scheme significantly increases efficiency.
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OBJECTIVES: This study explores the combinations of conditional variables contributing to depressive symptoms in rural children. METHODS: We analyzed data from 715 children from a rural mental health database, conducting detailed follow-up investigations on 129 children in Zhejiang and Henan provinces. We used fuzzy set Qualitative Comparative Analysis (fsQCA) and regression analysis to identify causal pathways leading to depression. RESULTS: The results indicate that depression in rural children does not stem from a single, necessary condition but arises from multiple factors. Our findings highlight significant contributions from both maternal and paternal involvement. Specifically, maternal involvement, combined synergistically with peer support and problematic behaviors, as well as paternal involvement, together with peer support and anxiety, significantly affects depressive outcomes. Additionally, anxiety and strong peer relationships independently have a substantial impact on these outcomes. Effective mitigation strategies involve active parental engagement and robust peer support, reducing the influence of risk factors such as problematic behaviors and anxiety. LIMITATIONS: The generalizability of the results is limited by cultural and geographical variations. The study also does not account for all potential factors influencing depression in rural children. CONCLUSION: Depression in rural children results from multiple interacting factors. Tailored interventions addressing these specific combinations are recommended.
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Grupo Paritario , Población Rural , Humanos , China/epidemiología , Masculino , Femenino , Niño , Población Rural/estadística & datos numéricos , Factores de Riesgo , Apoyo Social , Depresión/epidemiología , Depresión/psicología , Lógica Difusa , Responsabilidad Parental/psicología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Adolescente , Problema de Conducta/psicologíaRESUMEN
Bone metabolism plays a crucial role in maintaining normal bone tissue homeostasis and function. Imbalances between bone formation and resorption can lead to osteoporosis, osteoarthritis, and other bone diseases. The dynamic and complex process of bone remodeling is driven by various factors, including epigenetics. Histone modification, one of the most important and well-studied components of epigenetic regulation, has emerged as a promising area of research in bone metabolism. Different histone proteins and modification sites exert diverse effects on osteogenesis and osteoclastogenesis. In this review, we summarize recent progress in understanding histone modifications in bone metabolism, including specific modification sites and potential regulatory enzymes. Comprehensive knowledge of histone modifications in bone metabolism could reveal new therapeutic targets and treatment strategies for bone diseases.
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INTRODUCTION: Health care workers represent a substantial demographic whose welfare and work efficiency are crucial to public health and societal well-being. However, the prevalence of sexual dysfunction within this group is often overlooked, despite its significant occurrence. OBJECTIVE: To evaluate the worldwide prevalence of sexual dysfunction among health care workers. METHODS: A comprehensive systematic review and meta-analysis of observational studies ranging from 2003 to 2023 were performed to compile prevalence estimates of sexual dysfunction among health care workers. A random effects model was implemented to amalgamate the prevalence analysis. Study heterogeneity was discerned by I2 and χ2 statistics. To assess potential publication bias, an Egger's test and a funnel plot were employed. RESULTS: This meta-analysis incorporated 39 studies from 16 countries, encompassing 44 017 health care workers. The pooled prevalence of sexual dysfunction among health care workers was 46.79% (95% CI, 38.09%-55.68%), with a slightly higher prevalence of 49.57% (95% CI, 38.18%-61.01%) among clinical health care workers. The most prevalent forms of sexual dysfunction identified were loss of libido (51.26%), erectile dysfunction (36.99%), sexual dissatisfaction (36.90%), pain during intercourse (28.23%), orgasmic disorders (25.13%), low sexual arousal (23.54%), and lubrication disorders (22.62%). Among various health care professions, nurses exhibited the highest prevalence of sexual dysfunction (56.29%), followed by doctors (37.63%) and other health care workers (24.96%). Additionally, female health care workers experienced a higher prevalence of sexual dysfunction (47.61%) as compared with their male counterparts (32.01%). CONCLUSION: This study indicates that nearly half of health care professionals report experiencing sexual dysfunction, with loss of libido being the most common manifestation. Addressing this issue requires a multistakeholder approach.
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Personal de Salud , Disfunciones Sexuales Fisiológicas , Femenino , Humanos , Masculino , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Prevalencia , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Psicológicas/epidemiologíaRESUMEN
Neurotransmitters are key modulators in neuro-immune circuits and have been linked to tumor progression. Medullary thyroid cancer (MTC), an aggressive neuroendocrine tumor, expresses neurotransmitter calcitonin gene-related peptide (CGRP), is insensitive to chemo- and radiotherapies, and the effectiveness of immunotherapies remains unknown. Thus, a comprehensive analysis of the tumor microenvironment would facilitate effective therapies and provide evidence on CGRP's function outside the nervous system. Here, we compare the single-cell landscape of MTC and papillary thyroid cancer (PTC) and find that expression of CGRP in MTC is associated with dendritic cell (DC) abnormal development characterized by activation of cAMP related pathways and high levels of Kruppel Like Factor 2 (KLF2), correlated with an impaired activity of tumor infiltrating T cells. A CGRP receptor antagonist could offset CGRP detrimental impact on DC development in vitro. Our study provides insights of the MTC immunosuppressive microenvironment, and proposes CGRP receptor as a potential therapeutic target.
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Péptido Relacionado con Gen de Calcitonina , Carcinoma Neuroendocrino , Células Dendríticas , Neoplasias de la Tiroides , Microambiente Tumoral , Microambiente Tumoral/inmunología , Humanos , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/metabolismo , Neoplasias de la Tiroides/inmunología , Neoplasias de la Tiroides/patología , Péptido Relacionado con Gen de Calcitonina/metabolismo , Carcinoma Neuroendocrino/genética , Carcinoma Neuroendocrino/metabolismo , Carcinoma Neuroendocrino/patología , Carcinoma Neuroendocrino/inmunología , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Cáncer Papilar Tiroideo/metabolismo , Cáncer Papilar Tiroideo/inmunología , Cáncer Papilar Tiroideo/genética , Cáncer Papilar Tiroideo/patología , Receptores de Péptido Relacionado con el Gen de Calcitonina/metabolismo , AMP Cíclico/metabolismo , Linfocitos Infiltrantes de Tumor/inmunología , Linfocitos Infiltrantes de Tumor/metabolismo , Neurotransmisores/metabolismo , Regulación Neoplásica de la Expresión Génica , Línea Celular Tumoral , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/farmacología , Análisis de la Célula IndividualRESUMEN
BACKGROUND: IFIH1 variants have been reported to be associated with immune-related disorders with/without seizures. It is unknown whether IFIH1 variants are associated with common epilepsy without acquired causes and the mechanism underlying phenotypic variation remains elusive. METHODS: Trio-based whole-exome sequencing was performed on patients with febrile seizures or epilepsy with antecedent febrile seizures. Previously reported variants were systematically reviewed to investigate genotype-phenotype associations. RESULTS: Two de novo heterozygous and three biallelic missense variants were identified in five patients with generalised epilepsy with antecedent febrile seizures. The variants were predicted to be damaging by in silico tools and were associated with hydrogen bonding changes to neighbouring amino acids or decreased protein stability. Patients exhibited an early onset age and became seizure-free with favourable outcome. Further analysis revealed that de novo missense variants located in the Hel region resulted in seizures with multiple neurological abnormalities, while those in the pincer domain or C-terminal domain led to seizures with normal neurodevelopment, suggesting a sub-molecular effect. Biallelic missense variants, which were inherited from unaffected parents and presented low allele frequencies in general populations, were associated with seizures without neurological abnormalities. Truncation variants were related to refractory epilepsy and severe developmental delay, suggesting a genotype-phenotype correlation. IFIH1 is predominantly expressed in the neonatal stage and decreases dramatically in the adulthood, which is consistent with the early onset age and favourable outcome of the patients. CONCLUSIONS: IFIH1 variants are potentially associated with generalised epilepsy with antecedent febrile seizures. The sub-molecular implication and genotype-phenotype association help explain phenotype variations of IFIH1 variants.
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Epilepsia Generalizada , Secuenciación del Exoma , Estudios de Asociación Genética , Helicasa Inducida por Interferón IFIH1 , Mutación Missense , Convulsiones Febriles , Humanos , Convulsiones Febriles/genética , Epilepsia Generalizada/genética , Masculino , Femenino , Helicasa Inducida por Interferón IFIH1/genética , Mutación Missense/genética , Preescolar , Lactante , Niño , Predisposición Genética a la Enfermedad , Adulto , FenotipoRESUMEN
PURPOSE: There is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer (MTC). The level of preoperative Ctn may influence the extent of surgery. METHODS: This retrospective multicenter cohort study involved 149 MTC patients from 6 centers between 2013 to 2023. Clinical characteristics, surgical procedure and clinical outcomes were compared between Ctn-screened and Non-screened group. Kaplan-Meier method was used to estimate recurrence-free survival (RFS) and overall survival (OS). RESULTS: In total, 127 MTC patients with preoperative Ctn screening and 22 MTC patients without screening were analyzed. MTC patients with preoperative Ctn screening underwent more radical surgical procedures including total thyroidectomy and lymph node dissection, compared to those without screening (84.3% vs. 68.2% and 91.3% vs. 72.7%, respectively). The rate of recurrence and death were lower in the Ctn-screened group (16.1% vs. 36.4%, 0.8% vs. 18.2%, respectively). The survival curve showed a significantly better overall survival in Ctn-screened group than Non-screened group (HR:17.932, 95% CI 1.888-170.294, p-value = 0.001), while no significant difference was observed of RFS between two groups (HR:1.6, 95% CI 0.645-3.966, p-value = 0.307). CONCLUSION: Preoperative Ctn screening can prompt surgeons choosing more radical initial surgical treatment for MTC patients, potentially leading to better long-term outcomes. Further evaluation of the cost-effectiveness of routine Ctn screening in thyroid nodule patients is warranted.
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Calcitonina , Carcinoma Neuroendocrino , Neoplasias de la Tiroides , Tiroidectomía , Humanos , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/mortalidad , Estudios Retrospectivos , Femenino , Masculino , Calcitonina/sangre , Persona de Mediana Edad , Carcinoma Neuroendocrino/sangre , Carcinoma Neuroendocrino/cirugía , Carcinoma Neuroendocrino/mortalidad , Carcinoma Neuroendocrino/diagnóstico , Adulto , Pronóstico , Anciano , Cuidados Preoperatorios/métodosRESUMEN
Neurotoxins are known for their extreme lethality. However, due to their enormous diversity, effective and broad-spectrum countermeasures are lacking. This study presents a dual-modal cellular nanoparticle (CNP) formulation engineered for continuous neurotoxin neutralization. The formulation involves encapsulating the metabolic enzyme N-sulfotransferase (SxtN) into metal-organic framework (MOF) nanoparticle cores and coating them with a natural neuronal membrane, termed "Neuron-MOF/SxtN-NPs". The resulting nanoparticles combine membrane-enabled broad-spectrum neurotoxin neutralization with enzyme payload-enabled continuous neurotoxin neutralization. The studies confirm the protection of the enzyme payload by the MOF core and validate the continuous neutralization of saxitoxin (STX). In vivo studies conducted using a mouse model of STX intoxication reveal markedly improved survival rates compared with control groups. Furthermore, acute toxicity assessments show no adverse effects associated with the administration of Neuron-MOF/SxtN-NPs in healthy mice. Overall, Neuron-MOF/SxtN-NPs represent a unique biomimetic nanomedicine platform poised to effectively neutralize neurotoxins, marking an important advancement in the field of countermeasure nanomedicine.
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BACKGROUND: Electronic symptom monitoring via patient-reported outcome in surgical oncology is limited owing to lengthy instruments and non-specific items in common patient-reported outcome instruments. To establish electronic symptom monitoring through a clinically relevant and fit-for-purpose core set of patient-reported outcome in patients undergoing lung cancer surgery. MATERIALS AND METHODS: One qualitative (Cohort 1) and two prospective studies (Cohorts 2 and 3) were conducted between 2018 and 2023. Patients undergoing lung cancer surgery were recruited. Items of symptoms and daily functioning were generated through extensive interviews in Cohort 1 and incorporated into a smartphone-based platform to establish the electronic Perioperative Symptom Assessment for Lung surgery (ePSA-Lung). This tool was finalized and validated in Cohort 2. Patients in Cohort 3 were longitudinally monitored for the first year post-surgery using the validated ePSA-Lung. RESULTS: In total, 1,037 patients scheduled for lung cancer surgery were recruited. The 11-item draft PSA-Lung was generated based on qualitative interview with 39 patients and input from a Delphi study involving 42 experts. A 9-item ePSA-Lung was finalized by assessing 223 patients in the validation cohort; the results supported the instrument's understandability, reliability, sensitivity, and surgical specificity. In Cohort 3 (n=775), compliance ranged from 63.21% to 84.76% during the one-year follow-up after discharge. Coughing, shortness of breath, and disturbed sleep were the most severe symptoms after discharge. Longitudinally, patients who underwent single-port video-assisted thoracic surgery had a lower symptom burden than those who underwent multi-port video-assisted thoracic surgery or thoracotomy (all symptoms, P<0.001). CONCLUSION: The ePSA-Lung is valid, concise, and clinically applicable as it supports electronic symptom monitoring in surgical oncology care. The need for long-term extensive care was identified for patients after discharge, even in early-stage cancer with potential curative treatment.
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Effectively neutralizing inflammatory cytokines is crucial for managing a variety of inflammatory disorders. Current techniques that target only a subset of cytokines often fall short due to the intricate nature of redundant and compensatory cytokine networks. A promising solution to this challenge is using cell membrane-coated nanoparticles (CNPs). These nanoparticles replicate the complex interactions between cells and cytokines observed in disease pathology, providing a potential avenue for multiplex cytokine scavenging. While the development of CNPs using experimental animal models has shown great promise, their effectiveness in scavenging multiple cytokines in human diseases has yet to be demonstrated. To bridge this gap, this study selected macrophage membrane-coated CNPs (MФ-CNPs) and assessed their ability to scavenge inflammatory cytokines in serum samples from patients with COVID-19, sepsis, acute pancreatitis, or type-1 diabetes, along with synovial fluid samples from patients with rheumatoid arthritis. The results show that MФ-CNPs effectively scavenge critical inflammatory cytokines, including interleukin (IL)-6, IL-8, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α, in a dose-dependent manner. Overall, this study demonstrates MФ-CNPs as a multiplex cytokine scavenging formulation with promising applications in clinical settings to treat a range of inflammatory disorders.
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COVID-19 , Citocinas , Macrófagos , Nanopartículas , Humanos , Citocinas/metabolismo , Nanopartículas/química , COVID-19/inmunología , Macrófagos/metabolismo , Macrófagos/inmunología , Inflamación/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/inmunología , Sepsis/metabolismo , Sepsis/inmunología , Pancreatitis/inmunología , Pancreatitis/metabolismo , Masculino , Artritis Reumatoide/inmunología , Artritis Reumatoide/metabolismo , Femenino , Persona de Mediana Edad , SARS-CoV-2/inmunologíaRESUMEN
PURPOSE: Aztreonam/avibactam is effective against serious infections caused by Gram-negative bacteria including Enterobacterales harboring metallo-ß-lactamases. While the utility of this combination has been established in vitro and in clinical trials, the purpose of this study is to enhance our understanding of the underlying mechanism responsible for their activities through metabolomic profiling of a multidrug-resistant Escherichia coli clinical isolate. METHODS: Metabolomic analyses of time-dependent changes in endogenous bacterial metabolites in a clinical isolate of a multidrug-resistant E. coli treated with aztreonam and avibactam were performed. E. coli metabolomes were compared at 15 min, 1 h and 24 h following treatments with either avibactam (4 mg/L), aztreonam (4 mg/L), or aztreonam (4 mg/L) + avibactam (4 mg/L). RESULTS: Drug treatment affected 326 metabolites with magnitude changes of at least 2-fold, most of which are involved primarily in peptidoglycan biosynthesis, nucleotide metabolism, and lipid metabolism. The feedstocks for peptidoglycan synthesis were depleted by aztreonam/avibactam combination; a significant downstream increase in nucleotide metabolites and a release of lipids were observed at the three timepoints. CONCLUSION: The findings indicate that the aztreonam/avibactam combination accelerates structural damage to the bacterial membrane structure and their actions were immediate and sustained compared to aztreonam or avibactam alone. By inhibiting the production of crucial cell wall precursors, the combination may have inflicted damages on bacterial DNA.
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Antibacterianos , Compuestos de Azabiciclo , Aztreonam , Farmacorresistencia Bacteriana Múltiple , Sinergismo Farmacológico , Escherichia coli , Metabolómica , Aztreonam/farmacología , Compuestos de Azabiciclo/farmacología , Escherichia coli/efectos de los fármacos , Escherichia coli/metabolismo , Escherichia coli/genética , Antibacterianos/farmacología , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/tratamiento farmacológico , Metaboloma/efectos de los fármacosRESUMEN
PURPOSE: Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This meta-synthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness. METHODS: We systematically searched seven databases [PubMed, CINAHL, Medline (OVID), PsycINFO (OVID), Cochrane, Embase, and ProQuest] in May 2023 and included the studies if they reported the barriers or/and facilitators to seek healthcare in rural patients with mental illness. We conducted hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed. RESULTS: The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007 to 2023. We ultimately identified themes at three levels: navigating the terrain of vulnerability and empowerment (the individual with mental illness), navigating the terrain of external environment (the external environment) and connectivity within the healthcare ecosystem for mental health (the health service system). CONCLUSIONS: We must design more effective strategies to improve mental healthcare access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.
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Accesibilidad a los Servicios de Salud , Trastornos Mentales , Aceptación de la Atención de Salud , Población Rural , Humanos , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Investigación Cualitativa , Conducta de Búsqueda de Ayuda , Servicios de Salud MentalRESUMEN
PURPOSE: To examine whether a 7-day or 24-h recall period of Perioperative Symptom Assessment for Patients Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge. METHODS: A total of 377 patients were recruited in a cohort study of patients who underwent lung surgery. We measured patient symptoms daily and weekly using the two recall period versions of the PSA-Lung scale, respectively. The psychometric properties of both versions were calculated. Spearman rank correlation coefficients and kappa (k) coefficients were used to measure the association between items score measured by the two version scales each week. Cohen's d effect size and mixed linear model were used to measure responsiveness to change over time. RESULTS: Spearman rank correlation coefficients between the symptom scores generated by the 7-day and 24-h versions (range 0.48-0.77; all P < 0.05). The correlations increased in patients in stable condition (weekly symptom change < 2). Cronbach's α coefficients for both ratings were > 0.87 and both had good test-retest reliability. The longitudinal analysis and Cohen's d effect sizes showed that both ratings had good ability to detect changes in all items. CONCLUSION: The 7-day retrospective scale was as effective as the 24-h retrospective scale in terms of psychometric performance. In the stage where the patient's symptoms change rapidly, it is recommended to use the 24-h retrospective scale for symptom monitoring. On the contrary, in a stable state, it can be considered to use the 7-day retrospective scale for monitoring to reduce the patient's burden.
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Alta del Paciente , Psicometría , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Evaluación de Síntomas , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Calidad de Vida , Estudios de Cohortes , Adulto , Pulmón/cirugía , Pulmón/fisiopatologíaRESUMEN
Objective: Research shows that the effect of acute stress on intentional memory suppression could be modulated by individual differences in psychological traits. However, whether acute stress distinctly affects intentional memory suppression in high trait ruminators, a high at-risk group of stress-related disorders, and the neural correlations, remains unclear. Method: 55 healthy college students were divided into high and low trait ruminators (HTR and LTR), Following stress manipulation, a Think/No Think task assessed the memory suppression performance. Functional near-infrared spectroscopy was applied to explore the neural correlates. Psychophysiological interaction analyses were used to assess how the functional connectivity between a seed region and another brain region was modulated by tasks during memory suppression, further mediating memory suppression performance and state rumination. Results: The HTR exhibited poorer memory suppression performance than the LTR under the stress condition. Aberrant activation patterns and task-modulated functional connectivity in the dorsal prefrontal cortex (DLPFC) and superior temporal gyrus (STG) were observed only in the HTR during memory suppression under the stress condition. The effect of memory suppression performance on the state rumination of individuals was significantly mediated by the task-modulated functional connectivity between the DLPFC and STG. Conclusions: The findings could provide insights for prevention or early intervention in the development of stress-related disorders in HTR.