Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.000
Filtrar
1.
Ther Adv Med Oncol ; 16: 17588359241286222, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39483137

RESUMEN

Background and objectives: To evaluate the prognostic value of an integrated model consisting of tumour response to induction chemotherapy (IC) and gross tumour volume (GTV) after IC in nasopharyngeal carcinoma (NPC) and elucidate optimal cumulative cisplatin dose (CCD) in concurrent chemoradiotherapy (CCRT) for different subgroups. Design and methods: This retrospective study enrolled 896 patients with NPC diagnosed from 2010 to 2017 receiving IC plus radiotherapy. The primary endpoint was disease-free survival (DFS). Cut-off points for GTV were combined with IC response to develop an integrated model. Propensity score matching (PSM) was used to adjust for potential confounders. Survival outcomes and acute toxicity were compared between the different CCD groups. Results: Unsatisfactory IC response and large GTV after IC were correlated with poor survival outcomes; the AUC increased to 0.668 when these factors were incorporated. The integrated model classified patients into three groups. After PSM, radiotherapy alone and CCRT demonstrated similar efficacy in the low-risk group (complete response (CR)/partial response (PR) and GTV <68 cm3 after IC). In the intermediate-risk group (CR/PR but GTV ⩾68 cm3), CCD of >200 mg/m2 and 101-200 mg/m2 increased the 5-year DFS rates (83.7% vs 81.1% vs 65.3%, p = 0.042). In the high-risk group (stable disease/progressive disease and any GTV), the use of different CCDs did not result in significantly different survival outcomes (p = 0.793). Additionally, high CCD was significantly associated with increased incidence of grade 1-4 acute toxicity. Conclusion: The integrated model incorporating IC response and GTV after IC demonstrates satisfactory value in risk stratification and the potential to guide individualised decision-making in CCD selection. Balancing toxicity and efficacy, RT alone seems to be the optimal treatment for patients in low-risk groups and 200 mg/m2 might be the optimal dose for intermediate-risk groups. Moreover, increasing CCD does not benefit patients in high-risk groups, and treatment options for these patients require further consideration.

2.
BMC Med Educ ; 24(1): 1129, 2024 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-39394585

RESUMEN

OBJECTIVES: Internships in the pharmacy departments of training hospitals represent a crucial stage in the professional development of pharmacy students. However, the quality of internship training varies significantly across training hospitals in China, and there is a lack of standardized readiness evaluation tools. Therefore, the purpose of this study was to develop a self-assessment tool to evaluate the preparedness of training hospitals for providing internship training. METHODS: This study employed an exploratory mixed-methods approach and was conducted in two phases. In the first phase, during 2021, focus groups were conducted with 16 interns from three tertiary hospitals in Henan Province. In 2022, 14 preceptors from tertiary hospitals in various provinces were interviewed either one-on-one or in focus groups. The interview data were analyzed using thematic analysis to compile a set of self-assessment indicators for internship training readiness. Subsequently, the initial draft of the self-assessment tool for internship training readiness was developed by integrating the indicators derived from the interviews and literature review. In the second phase, the Delphi method was utilized. In 2023, the experts participated in two rounds of correspondence (21 experts in the first round and 19 in the second round), and consensus was reached on the indicators of the self-assessment tool after the two rounds. Meanwhile, these experts assessed the current status of internship training in training hospitals across China. RESULTS: The qualitative findings of the first phase included five themes and 22 sub-themes, which were integrated with the indicators derived from the literature review to develop an initial indicator framework for the second phase. This initial framework comprised five domains and 37 items. The second phase involved two rounds of expert surveys, with effective response rates of 90.48% and 89.47%, respectively. Ultimately, the self-assessment tool for evaluating the readiness of pharmacy departments in training hospitals for internships included five dimensions and 35 secondary indicators: (1) organizational structure, (2) training content, (3) training mode, (4) effectiveness evaluation, and (5) emergency management. Additionally, experts assessed the readiness of pharmacy departments in Chinese training hospitals for internships, yielding varied results. Emergency management preparedness scored the highest, followed by organizational structure and training content preparation. However, the modes of internship training and the evaluation of training effectiveness received lower scores. CONCLUSION: The developed tool provides a comprehensive self-assessment checklist for the pharmacy departments of training hospitals and possesses the potential to enhance the development of more effective internship training programs.


Asunto(s)
Autoevaluación (Psicología) , Humanos , China , Residencias en Farmacia/normas , Grupos Focales , Técnica Delphi , Servicio de Farmacia en Hospital/normas , Estudiantes de Farmacia , Masculino , Femenino , Educación en Farmacia/normas
3.
PLoS One ; 19(10): e0306383, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39388423

RESUMEN

INTRODUCTION: Studies in recent years have shown that high uric acid causes harm to the human body, which has become a serious public health problem. Elevated serum uric acid has been shown to be associated with obesity, but the relationship between BMI and uric acid (UA) remains controversial. Although the association between BMI and UA has been well studied, the effect of phosphorus levels in vivo on this association remains unclear. This study aimed to determine the relationship between BMI and serum uric acid and the effect of phosphorus on the relationship between the two. RESEARCH DESIGN AND METHODS: The present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) continuous 2007-2018 cycle. We included 10786 participants aged 20 years and over. Multivariable linear regression was performed to assess the association between BMI and serum uric acid. phosphorus was stratified into low phosphorus (<3.3 mg/dl), middle phosphorus (3.3-3.9 mg/dl) and high phosphorus (>3.9 mg/dl). Correction of the effect of phosphorus was assessed by testing the interaction between BMI and UA in multivariate linear regression. RESULTS: In this cross-sectional study, we found that BMI was positively associated with UA in the female population but not significantly in the male population or in the total population. In multiple regression analysis, UA was 0.51 higher in the highest female BMI group than in the lowest group (p = 0.0001). The relationship between BMI and UA differed significantly by gender under the influence of phosphorus, with men and women in Model II having a greater elevation of UA in men than in women within most groups. (BMI >30, phosphorus >3.9 mg/dl, ß:0.83 95% CI: 0.43, 1.23 vs ß: 0.79 95% CI: 0.30, 1.29). In addition, phosphorus significantly altered the positive association between BMI and UA in most models. CONCLUSION: Our results indicate significant associations between BMI and uric acid in women, with higher BMI values likely to be associated with a higher risk of hyperuricemia, suggesting that uric acid levels in obese people should be closely monitored in clinical practice. Phosphorus and BMI have an interactive effect in elevating UA and should be noted as indicators of phosphorus in clinical practice.


Asunto(s)
Índice de Masa Corporal , Encuestas Nutricionales , Fósforo , Ácido Úrico , Humanos , Ácido Úrico/sangre , Femenino , Masculino , Fósforo/sangre , Adulto , Persona de Mediana Edad , Estudios Transversales , Anciano , Adulto Joven , Obesidad/sangre
4.
BMC Cancer ; 24(1): 1254, 2024 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-39390445

RESUMEN

OBJECTIVE: Radiotherapy is a crucial treatment modality for pelvic cancers, but uncertainties persist in defining the clinical target volume (CTV) for the inguinal lymphatic drainage region. Suboptimal CTV delineation may compromise treatment efficacy and result in subpar disease control. This study aimed to investigate and map the distribution of lymph node metastases (LNM) in the groin area to facilitate an improved and detailed CTV definition using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS: Inguinal LNM in patients with biopsy-proven pelvic malignancies were identified using 18F-FDG PET/CT scan. The longitudinally nearest axial plane was determined based on six typical bony landmarks, and the axial direction relative to the femoral artery of LNM was recorded. The distances from the LNM to the nearest edge of the femoral artery were measured on the axial plane. An optimal margin to cover 95% of LNM was estimated to develop contouring recommendations. RESULTS: In this study, 500 positive LNM were identified by 18F-FDG PET/CT among 185 patients with primary pelvic malignancies. Relative to the femoral artery, lymph nodes were distributed laterally (10:00-11:00, n = 35), anteriorly (12:00-1:00, n = 213), and medially (2:00-4: 00, n = 252). For CTV delineation, the recommended distances from the femoral artery on the SFH were lateral 19 mm, anterior 19 mm, and medial 25 mm; on the SGT were lateral 26 mm, anterior 20 mm, and medial 25 mm; on the SPS were lateral 28 mm, anterior 29 mm, and medial 26 mm; on the IPS were anterior 29 mm and medial 28 mm; on the IIT were anterior 27 mm and medial 27 mm; on the ILT were anterior 25 mm and medial 23 mm. Use interpolation to contour the area between six axial slices, including any radiographically suspicious LNM. CONCLUSIONS: Using 18F-FDG PET/CT, we investigated the distribution pattern of inguinal LNM and propose a more comprehensive guideline for inguinal CTV delineation.


Asunto(s)
Fluorodesoxiglucosa F18 , Ganglios Linfáticos , Metástasis Linfática , Tomografía Computarizada por Tomografía de Emisión de Positrones , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Femenino , Masculino , Persona de Mediana Edad , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Anciano , Adulto , Metástasis Linfática/diagnóstico por imagen , Anciano de 80 o más Años , Conducto Inguinal/diagnóstico por imagen , Conducto Inguinal/patología , Neoplasias Pélvicas/diagnóstico por imagen , Neoplasias Pélvicas/patología , Neoplasias Pélvicas/radioterapia , Radiofármacos , Ingle/diagnóstico por imagen , Ingle/patología , Adulto Joven
5.
Natl Sci Rev ; 11(11): nwae247, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39440264

RESUMEN

Edge detection is a fundamental operation for feature extraction in image processing. The all-optical method has aroused growing interest owing to its ultra-fast speed, low energy consumption and parallel computation. However, current optical edge detection methods are generally limited to static devices and fixed functionality. Herein, we propose a fast-switchable scheme based on a ferroelectric liquid crystal topological structure. The self-assembled chiral lamellar superstructure, directed by the azimuthally variant photo-alignment agent, can be dynamically controlled by the polarity of the external electric field and respectively generates the vector beams with nearly orthogonal polarization distribution. Even after thousands of cycles, the horizontal and vertical edges of the object are selectively enhanced with an ultra-fast switching time of ∼57 µs. Broadband edge-enhanced imaging is efficiently demonstrated. This work extends the ingenious building of topological heliconical superstructures and offers an important glimpse into their potential in the emerging frontiers of optical computing for artificial intelligence.

6.
J Affect Disord ; 369: 800-812, 2024 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-39395677

RESUMEN

AIM: This study aims to elucidate the impact of childhood sexual abuse (CSA) on major depressive disorder (MDD) and alcohol use disorder (AUD) globally, regionally, and nationally, informing targeted public health interventions and policy. METHODS: Using data from the Global Burden of Disease (GBD) Study 2019, we assessed the impact of CSA on MDD and AUD, analyzing disability-adjusted life years (DALYs) per 100,000 population. Our analysis included age, sex, geographic locations, temporal trends in age-standardized rates (ASR), and examined the relationship between the social development index (SDI) and the burden of these disorders. RESULTS: From 1990 to 2019, the global ASR for MDD attributable to CSA increased by 1.9 %, while AUD decreased by 17.1 %. Significant gender disparities emerged, with females showing higher ASRs for MDD and males for AUD. The highest burden was observed in the 35-44 age group. Geographical analysis revealed the highest ASRs for MDD in Sub-Saharan Africa and for AUD in Eastern Europe, Central Europe, and High-income North America. A U-shaped relationship between SDI and disorder burdens was also identified. CONCLUSIONS: Our findings indicate a slight increase in MDD and a significant decrease in AUD burdens globally due to CSA, underscoring the need for targeted interventions considering gender, geographical, and developmental differences. This calls for strategies tailored to each country's unique development, culture, and regional specifics.

7.
BMJ Open ; 14(10): e087701, 2024 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-39375182

RESUMEN

BACKGROUND: Adverse drug reaction (ADR) reporting systems are critical for monitoring and managing drug safety. However, various factors influence the willingness to use these systems. This study aimed to investigate the willingness to use ADR reporting systems through an integrated model of the Technology Acceptance Model (TAM) and Task-Technology Fit (TTF) theory, conducting a multicentre qualitative study from the user's perspective. METHODS: This study used qualitative research methods, including in-depth interviews with clinicians, nurses, pharmacists and administrators who reported ADRs through the National Adverse Drug Reaction Monitoring System (NADRMS) and the China Hospital Pharmacovigilance System (CHPS). The interviews were audio-recorded, transcribed verbatim and analysed using QDA Miner software for data management and thematic analysis. RESULTS: Eighteen healthcare workers from five healthcare organisations participated in the study. They found the ease of use and usefulness of the current NADRMS and CHPS to be acceptable. The essential technical requirements identified included accuracy, standardisation, timeliness and confidentiality. However, challenges such as inaccurate information capture, unstable interfacing with medical record systems, low reporting efficiency and lack of data sharing were highlighted. Overall, front-line healthcare workers exhibited a generally negative attitude towards using NADRMS and CHPS, driven more by necessity than preference. Factors influencing their willingness to use these systems included ease of use, practicality, risk perception and social impact, with varying attitudes and requirements observed between user groups. CONCLUSION: This study provides practical recommendations that can be readily implemented to enhance the effectiveness and sustainability of ADR reporting systems. While front-line users in China acknowledged the systems' ease of use and usefulness, they also noted significant gaps in technological adaptation. They expressed the need for improvements in data openness and sharing, accessibility and system intelligence.


Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos , Actitud del Personal de Salud , Farmacovigilancia , Investigación Cualitativa , Humanos , China , Masculino , Femenino , Personal de Salud/psicología , Adulto , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Entrevistas como Asunto
8.
Int Immunopharmacol ; 143(Pt 2): 113311, 2024 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-39454411

RESUMEN

The BCR:ABL T315I mutation presents a significant challenge in the current management of Chronic Myeloid Leukemia (CML), highlighting the need to identify novel targets and drugs. In our study, we observed the elevated expression of UBE2Q1 in KBM5-T315I cells compared to KBM5 cells, where it interacted with DDX3, regulating its ubiquitination. Furthermore, we found that Bortezomib (BTZ) targeted UBE2Q1, reducing its protein level expression. Consequently, BTZ dose-dependently inhibited the growth vitality of KBM5-T315I cells, inducing increased ROS production, mitochondrial membrane potential collapse, cytochrome C release, and expression of apoptosis-related proteins. These events collectively induced apoptosis in KBM5-T315I cells. Moreover, BTZ enhanced the therapeutic effects of anti-PD-1 treatment. In NOD/SCID mice bearing KBM5-T315I cell line xenografts, BTZ administration (2 mg/kg, ip, every other day for 4 weeks) significantly inhibited the growth of KBM5-T315Iderived xenografts and extended survival. In conclusion, our study sheds new light on the BTZ-induced apoptosis mechanism, suggesting the potential of BTZ as a promising chemo-immunotherapy agent against BCR:ABL T315I mutation CML.

9.
J Pharm Policy Pract ; 17(1): 2417410, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39469317

RESUMEN

Background: This study aims to identify the factors that influence medical workers' enthusiasm for reporting adverse drug reactions (ADRs). Understanding these factors is essential to implement targeted interventions that can improve and refine pharmacovigilance systems. Methods: We adopted the Capability, Opportunity, Motivation, and Behavior model (COM-B) model as the theoretical framework and conducted qualitative research using in-depth interviews with clinicians, nurses, pharmacists, and administrators. 24 one-on-one interviews were conducted and audio-recorded. The interviews were transcribed verbatim, and subjected to thematic analysis to uncover the key factors affecting ADR reporting among medical staff. Results: The participation included 24 healthcare workers from six different healthcare organisations. Analysis revealed that decreased motivation to report ADRs was due to inadequate judgment or inconsistent judgment criteria within the capability domain, poor awareness of ADRs and deficient communication skills within the psychological domain, unclear responsibilities within the motivation domain, and limited or no access to necessary resources within the opportunity domain. Facilitators of ADR reporting included sufficient cognitive and operational abilities, spontaneous and incentivized motivation, clear responsibilities and role expectations, and robust social support. Conclusion: There is a critical need to develop comprehensive interventions that address the identified factors influencing ADR reporting. By improving the motivation of medical staff to report ADRs, the pharmacovigilance system can be significantly improved.

10.
J Asian Nat Prod Res ; : 1-9, 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39329329

RESUMEN

Three new cyclopentanoid monoterpenes, neopiscrocins A-C (1-3), together with 14 known compounds (4-17), were isolated from the roots of Picrorhiza scrophulariiflora. The structres of these compounds were elucidated on the basis of their spectroscopic data. All compounds were evaluated for cytotoxicity against six human tumor cell lines (PC9, PANC1, HCT-116, Hep-G2, BGC-823, and MCF-7), hepatoprotective activity and anti-inflammatory activity.

11.
Immun Inflamm Dis ; 12(9): e70018, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39323183

RESUMEN

OBJECTIVE: The aim of this study is to assess the impact of extrathyroidal autoimmune diseases (ADs) on the clinical characteristics and efficacy of iodine-131 (131I) therapy in patients with differentiated thyroid cancer (DTC). METHODS: Patients with DTC who were received 131I therapy simultaneously were classified into the combination group (n = 35) and noncombination group (n = 146) depending on the presence of ADs. The clinical characteristics, such as gender, age, tumor lesions, lymph node metastasis, distant metastasis, 131I therapy efficacy, and use of levothyroxine, were compared between the two groups. Statistical analysis was conducted using SPSS 26.0 and R 4.0.3. RESULTS: There was a statistically significant difference in age between the combination and noncombination groups (t = -2.872, p < .01), and the optimal cutoff value was 50.5 years. Propensity score matching was completed effectively on a total of 121 patients, using age as the matching factor, comprising 32 cases in the combination group and 80 cases in the noncombination group. The baseline demographic features of the two groups were equivalent after matching (p > .05), and there was no significant difference in the therapeutic efficacy of 131I between the two groups (p > .05). In the subgroup analysis involving patients aged great than 50.5 years, the levothyroxine/weight (µg/kg) was increased in the combination group, and the difference was statistically significant (p < .05). CONCLUSION: While extrathyroidal ADs may enhance the detection of DTC among elderly women, they have no impact on the clinical characteristics of thyroid cancer or the efficacy of 131I therapy. ADs may necessitate higher per-unit dosages of levothyroxine in patients with DTC, regardless of the clinical status. Consequently, it is not essential for nuclear medicine physicians to consider the presence of ADs when designing treatment plans for patients with DTC.


Asunto(s)
Enfermedades Autoinmunes , Radioisótopos de Yodo , Neoplasias de la Tiroides , Humanos , Radioisótopos de Yodo/uso terapéutico , Femenino , Neoplasias de la Tiroides/radioterapia , Neoplasias de la Tiroides/tratamiento farmacológico , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/terapia , Masculino , Persona de Mediana Edad , Enfermedades Autoinmunes/tratamiento farmacológico , Adulto , Resultado del Tratamiento , Anciano , Tiroxina/uso terapéutico , Estudios Retrospectivos
12.
Glob Health Res Policy ; 9(1): 39, 2024 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-39327625

RESUMEN

BACKGROUND: Infectious diseases persistently pose global threats, and it is imperative to accelerate the professionalization of public health workforce. This study aimed to develop and validate the infectious disease control competency scale (IDCCS) for public health professionals to fill a theoretical gap and elevate practical capabilities by informing public health professionals' development goals. METHODS: The initial item pool was generated through a literature review, and categorized into three dimensions (knowledge, practical skills, and leadership) based on the competency iceberg model and public health leadership framework. A two-round Delphi process was conducted to determine indicators within the scale. A pilot survey was utilized for item analysis and exploratory factor analysis (EFA). A formal survey was employed for confirmatory factor analysis (CFA). The weight value of each indicator was calculated using the analytic hierarchy process. RESULTS: An initial scale with three primary items, 14 secondary items, and 81 tertiary items was generated. Twenty experts participated in the two rounds of the Delphi process. Authority coefficients exceeded 0.9 in both rounds. Kendall's W was 0.29 and 0.19, respectively (both P < 0.001). Item analysis presented a Cronbach's Alpha of 0.98, with corrected item-total correlation coefficients ranging from 0.33 to 0.78. EFA demonstrated that cumulative variance explanations for the four primary dimensions (knowledge, practical skills, leadership, and personal quality) were 77.463%, 73.976%, 81.174%, and 68.654%, respectively. CFA indicated that all composite reliability values and average variance extracted surpassed 0.8 and 0.5, respectively. The standardized factor loadings of the items ranged from 0.630 to 0.977. Among the seven model fit indices, each of the four dimensions satisfied at least five criteria. A final three-level scale comprising four primary items, 14 secondary items, and 64 tertiary items was constructed. The weight values for the four primary items were 0.4064, 0.2878, 0.2082, and 0.0981, respectively. CONCLUSIONS: The IDCCS was established to evaluate the competencies of knowledge, practical skills, leadership, and personal quality for public health professionals in infectious disease control. This scale demonstrates good reliability and validity, and can be used for performance evaluation, recruitment processes, curriculum development, and individual self-assessment.


Asunto(s)
Técnica Delphi , Humanos , Competencia Profesional/estadística & datos numéricos , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Liderazgo , Salud Pública/estadística & datos numéricos , Encuestas y Cuestionarios , Personal de Salud/estadística & datos numéricos , Personal de Salud/psicología , Reproducibilidad de los Resultados , Adulto , Femenino , Masculino
13.
Polymers (Basel) ; 16(18)2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39339141

RESUMEN

K-band radar waves have high penetration and low attenuation coefficients. However, the wavelength of this radar wave is relatively short; thus, designing and preparing both broadband and wide-angle radar wave absorbers in this band presents considerable challenges. In this study, a resin-based K-band radar wave absorber with a biomimetic lotus leaf structure was designed and formed by UV curing. Here, microscale lotus leaf papillae and antireflection structures were prepared using a DLP 3D printer, and the contact angle between the material and water droplets was increased from 56° to 130°. In addition, the influence of the geometric parameters of the lotus leaf antireflection structure on the electromagnetic absorption performance and mechanical strength was investigated. After simulation optimization, the maximum electromagnetic loss of the lotus leaf structure 3D-printed sample was -32.3 dB, and the electromagnetic loss was below -10 dB in the 20.8-26.5 GHz frequency range. When the radar incidence angle was 60°, the maximum electromagnetic loss was still less than -10 dB. The designed lotus leaf structure has a higher mechanical energy absorption per unit volume (337.22 KJ/m3) and per unit mass (0.55 KJ/Kg) than commonly used honeycomb lightweight structures during the elastic deformation stage, and we expect that the designed structure can be used as an effective lightweight material for K-band radar stealth.

14.
J Affect Disord ; 367: 573-582, 2024 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-39242042

RESUMEN

AIM: To investigate the impact of public health emergencies on the prevalence of suicidal ideation among healthcare workers (HCWs) and medical students. METHODS: The prevalence of suicidal ideation among HCWs and medical students was searched for analysis. The platforms included PubMed, medRVix, bioRvix, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Interrupted time-series analysis was employed to determine whether the COVID-19 pandemic influenced the prevalence and trends of suicidal ideation. To account for autocorrelation and heteroskedasticity, Newey-West standard errors were utilized with a lag of order one. RESULTS: Seventy studies with 145,641 HCWs and medical students from 30 countries were included in the final analysis, with 30 studies before COVID-19 and 40 studies during the pandemic. Before the pandemic outbreak (April 2020), the monthly increasing rate was 0.063 % (95 % CI: -0.009 %, 0.135 %, z = 1.73, P = 0.084). The tendency of suicidal ideation prevalence increased by 1.116 % (95%CI: 0.888 %, 1.344 %, z = 9.60, P < 0.001). In other words, the calculated monthly growth rate of suicidal ideation after the pandemic outbreak is 1.179 % (95%CI: 0.968 %, 1.391 %, z = 10.93, P < 0.001) per month. The overall growing trend of prevalence of suicidal ideation during the pandemic is 1.896 % per month in America; 1.590 % in Europe; 0.443 % (95%CI: 0.213 %, 0.673 %, z = 3.77, P < 0.001) in Asia; 1.055 % in HCWs; and 0.645 % in medical students. CONCLUSION: This study highlights that the COVID-19 pandemic can significantly impact the prevalence of suicidal ideation among HCWs and medical students, and the prevalence showed an upward trend.


Asunto(s)
COVID-19 , Personal de Salud , Análisis de Series de Tiempo Interrumpido , Estudiantes de Medicina , Ideación Suicida , Humanos , COVID-19/epidemiología , COVID-19/psicología , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Personal de Salud/psicología , Prevalencia , SARS-CoV-2 , Femenino , Adulto , Masculino , Pandemias
15.
Redox Biol ; 76: 103345, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39255694

RESUMEN

Plaque rupture with consequent thrombosis is the leading cause of acute cardiovascular events, during which macrophage death is a hallmark. Ferroptosis is a pivotal intermediate link between early and advanced atherosclerosis. Existing evidence indicates the involvement of macrophage ferroptosis in plaque vulnerability; however, the exact mechanism remains elusive. The aim of this study was to explore key ferroptosis-related genes (FRGs) involved in plaque progression and the underlying molecular mechanisms involved. The expression landscape of FRGs was obtained from atherosclerosis-related GEO datasets. Molecular mechanism studies of ferroptosis were performed using bone marrow-derived macrophages (BMDMs) and macrophage-derived foam cells (MDFCs). Bioinformatics analysis and immunohistochemistry revealed that macrophage haem oxygenase-1 (HMOX1) is the key FRG involved in plaque destabilization. Hypoxic conditions induced a significant increase in Hmox1 expression in MDFCs but not in macrophages. In addition, the beneficial or deleterious effects of Hmox1 were dependent on the degree of Hmox1 induction. Hmox1 overexpression drove inflammatory responses and ferroptotic oxidative stress in MDFCs and aggravated the plaque burden in atherosclerotic model mice. Further mechanistic investigations demonstrated that hypoxia-mediated degradation of egl-9 family hypoxia-inducible factor 3 (Egln3) stabilized Hif1a, which subsequently promoted Hmox1 transcription. Our findings suggest that high Hmox1 expression under hypoxia is deleterious to MDFC viability and plaque stability, providing a reference for the management of acute cardiovascular events.


Asunto(s)
Ferroptosis , Células Espumosas , Hemo-Oxigenasa 1 , Placa Aterosclerótica , Ferroptosis/genética , Animales , Hemo-Oxigenasa 1/metabolismo , Hemo-Oxigenasa 1/genética , Ratones , Placa Aterosclerótica/metabolismo , Placa Aterosclerótica/patología , Placa Aterosclerótica/genética , Células Espumosas/metabolismo , Células Espumosas/patología , Macrófagos/metabolismo , Modelos Animales de Enfermedad , Aterosclerosis/metabolismo , Aterosclerosis/patología , Aterosclerosis/genética , Humanos , Estrés Oxidativo , Masculino , Regulación de la Expresión Génica , Proteínas de la Membrana
16.
Green Chem ; 26(19): 10139-10151, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39247131

RESUMEN

Surface sterilization and hazardous chemical degradation under ambient conditions can provide significant benefits for public and environmental health. Materials with sterilization and chemical degradation capacity under sunlight can efficiently reduce infectious disease incidence rates and toxic chemical exposure. Utilizing renewable energy for sustainable sterilization and degradation is more desirable as it reduces the potential secondary contamination. Herein, we report functional structure design using lignin, a renewable carbon heterogeneous polymer, to synthesize a highly efficient and stable photocatalyst that degrades environmentally hazardous organic compounds rapidly. Through a hydrolysis reaction between Ti-OH and the hydroxyl groups of lignin, Ti-O-C and Ti-O-Ti bonds were established and a lignin based photocatalyst with a hollow sphere structure (Clignin@H-TiO2) was formed. The presence of a homozygous carbon modified TiO2 structure contributes to the enhanced photodegradation activity with solar light. The close hetero-interfacial contact between carbonized lignin and TiO2 further improves the photocatalytic efficiency by facilitating effective charge carrier separation. After synthesis optimization, the resulting Clignin@H-TiO2 photocatalyst exhibits excellent performance in the degradation of atenolol under solar light irradiation with 100% degradation within five minutes. Additionally, it efficiently removes approximately 50% of PFOA and kills about 90% of bacteria within three hours. The uniform distribution of lignin within the crosslinking structures ensures a durable carbon modified TiO2 framework, which remains stable after 10 cycles of usage. The robustness of the lignin-based photocatalyst enables incorporating the catalyst into diversified material formats and various usages. Coating of the photocatalyst onto device surfaces shows bacterial killing efficacy under sunlight. The photocatalysts based on lignin valorization present a green chemistry approach for environmental remediation and surface sterilization, which has long-term environmental protection benefits, with broad applications in toxin treatment and health protection against pathogen infection.

17.
Sci Rep ; 14(1): 21448, 2024 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-39271729

RESUMEN

Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) have the potential application in evaluating pathological structural change of the optic nerve. We aimed to evaluate the value of the OCT and OCTA parameters of the optic disk and macular in differentiating early chronic primary angle-closure glaucoma (CPACG) and early pituitary adenoma (PA) in case of mild visual field defects (the mean defect (MD) > 6 dB). The results showed that regarding OCTA parameters, CPACG patients had lower retinal blood flow density of most layers of the optic disk and macular than PA patients. Regarding OCT parameters, CPACG patients had thinner circumpapillary retinal nerve fiber layer (CP-RNFL) in all quadrants and average CP-RNFL, ganglion cell layer (GCL) and macular ganglion cell complex (GCC) in each quadrant of macular inner and outer rings, and inner plexus layer (IPL) of macular inner ring, superior-outer ring and temporal-outer ring than PA patients. The Z test indicated that OCTA parameters and OCT parameters had similar value in the diagnosis of disease. In conclusion, in the case of similar visual field damage, early CPACG patients have smaller blood flow density and thinner optic disk and macular than early PA. OCTA has similar performance to OCT in diagnosing CPACG and PA.


Asunto(s)
Adenoma , Glaucoma de Ángulo Cerrado , Disco Óptico , Neoplasias Hipofisarias , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Glaucoma de Ángulo Cerrado/fisiopatología , Glaucoma de Ángulo Cerrado/diagnóstico , Glaucoma de Ángulo Cerrado/patología , Glaucoma de Ángulo Cerrado/diagnóstico por imagen , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/patología , Masculino , Femenino , Persona de Mediana Edad , Adenoma/patología , Adenoma/diagnóstico por imagen , Disco Óptico/patología , Disco Óptico/diagnóstico por imagen , Adulto , Enfermedad Crónica , Células Ganglionares de la Retina/patología , Campos Visuales/fisiología , Anciano
18.
ACS ES T Eng ; 4(9): 2220-2233, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39296420

RESUMEN

Carbon-based adsorbents used to remove recalcitrant water contaminants, including perfluoroalkyl substances (PFAS), are often regenerated using energy-intensive treatments that can form harmful byproducts. We explore mechanisms for sorbent regeneration using hydrated electrons (eaq -) from sulfite ultraviolet photolysis (UV/sulfite) in water. We studied the UV/sulfite treatment on three carbon-based sorbents with varying material properties: granular activated carbon (GAC), carbon nanotubes (CNTs), and polyethylenimine-modified lignin (lignin). Reaction rates and defluorination of dissolved and adsorbed model perfluorocarboxylic acids (PFCAs), perfluorooctanoic acid (PFOA) and perfluorobutanoic acid (PFBA), were measured. Monochloroacetic acid (MCAA) was employed to empirically quantify eaq - formation rates in heterogeneous suspensions. Results show that dissolved PFCAs react rapidly compared to adsorbed ones. Carbon particles in solution decreased aqueous reaction rates by inducing light attenuation, eaq - scavenging, and sulfite consumption. The magnitude of these effects depended on adsorbent properties and surface chemistry. GAC lowered PFOA destruction due to strong adsorption. CNT and lignin suspensions decreased eaq - formation rates by attenuating light. Lignin showed high eaq - quenching, likely due to its oxygenated functional groups. These results indicate that desorbing PFAS and separating the adsorbent before initiating PFAS degradation reactions will be the best engineering approach for adsorbent regeneration using UV/sulfite.

20.
J Hazard Mater ; 479: 135683, 2024 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-39216243

RESUMEN

Hydrodechlorination has emerged as a promising technique for detoxifying chlorophenols (CPs) in wastewater, but it suffers from sluggish reaction kinetics and limited durability due to the lack of effective and stable catalysts. Herein, a composite filter consisting of melamine-sponge (MS), chitin fiber (CF) and ultrafine PdAu nanoparticles (PdAu/CF-MS) has been designed for continuous hydrodechlorination of CPs by using formic acid as a H-donor and sodium formate as a promoter. Benefitting from the dense active sites, rich porosity, and synergetic interaction of Pd/Au, the PdAu/CF-MS filter exhibits excellent hydrodechlorination performance (∼ 100 % conversion) towards 4-chlorophenol (1 mM, fluxes below 6100 mL·h-1·g-1) and outstanding durability (over 500 h at 61 mL·h-1·g-1), surpassing most reported counterparts (usually deactivated within 200 h or several cycles). Moreover, other CPs can also be effectively dechlorinated by the PdAu/CF-MS filter. The catalytic system proposed herein will provide a promising candidate for the detoxification of wastewater containing toxic CPs.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...