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1.
Mol Biol Rep ; 51(1): 959, 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39230620

RESUMO

Cancer remains a global health burden, shaped by both genetic mutations and epigenetic dysregulation. Epigenetic alteration plays a pivotal role in tumorigenesis, immune response modulation, and the emergence of treatment resistance. This review emphasizes the intricate interplay between epigenetically reprogrammed cancer cells and the tumor microenvironment (TME), a relationship central to the immunoediting concept, which encompasses elimination, equilibrium, and escape phases. This review highlights the significance of CD8+ T cells as potent anticancer agents and discusses the mechanisms by which tumor cells evade immune surveillance and evolve resistance to immunotherapy. Such evasion entails the regulation of inhibitory molecules, antigen presentation machinery, and cytokine milieu. Furthermore, this review explores the complex dynamics culminating in CD8+ T cell dysfunction within the TME. In summary, this work offers insights into the indispensable role of epigenetic mechanisms in bolstering cancer cell survival amidst immunological challenges within the TME.


Assuntos
Linfócitos T CD8-Positivos , Epigênese Genética , Neoplasias , Microambiente Tumoral , Humanos , Microambiente Tumoral/imunologia , Microambiente Tumoral/genética , Neoplasias/imunologia , Neoplasias/genética , Linfócitos T CD8-Positivos/imunologia , Imunoterapia/métodos , Evasão Tumoral/genética , Animais
2.
Artigo em Inglês | MEDLINE | ID: mdl-39240583

RESUMO

Intracellular infections are difficult to treat, as pathogens can take advantage of intracellular hiding, evade the immune system, and persist and multiply in host cells. One such intracellular parasite, Leishmania, is the causative agent of leishmaniasis, a neglected tropical disease (NTD), which disproportionately affects the world's most economically disadvantaged. Existing treatments have relied mostly on chemotherapeutic compounds that are becoming increasingly ineffective due to drug resistance, while the development of new therapeutics has been challenging due to the variety of clinical manifestations caused by different Leishmania species. The antimicrobial peptide melittin has been shown to be effective in vitro against a broad spectrum of Leishmania, including species that cause the most common form, cutaneous leishmaniasis, and the most deadly, visceral leishmaniasis. However, melittin's high hemolytic and cytotoxic activity toward host cells has limited its potential for clinical translation. Herein, we report a design strategy for producing a melittin-containing antileishmanial agent that not only enhances melittin's leishmanicidal potency but also abrogates its hemolytic and cytotoxic activity. This therapeutic construct can be directly produced in bacteria, significantly reducing its production cost critical for a NTD therapeutic. The designed melittin-containing fusion crystal incorporates a bioresponsive cathepsin linker that enables it to specifically release melittin in the phagolysosome of infected macrophages. Significantly, this targeted approach has been demonstrated to be efficacious in treating macrophages infected with L. amazonensis and L. donovani in cell-based models and in the corresponding cutaneous and visceral mouse models.

3.
Clin Lung Cancer ; 2024 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-39095235

RESUMO

OBJECTIVES: Compared to low-grade irAEs, high-grade irAEs are more often dose-limiting and can alter the long-term treatment options for a patient. Predicting the incidence of high-grade irAEs would help with treatment selection and therapeutic drug monitoring. MATERIALS AND METHODS: We performed a retrospective study of 430 stage III and IV patients with non-small cell lung cancer (NSCLC) who received an immune checkpoint inhibitor (ICI), either with or without chemotherapy, at a single comprehensive cancer center from 2015 to 2022. The study team retrieved sequencing data and complete clinical information, including detailed irAEs medical records. Fisher's exact test was used to determine the association between mutations and the presence or absence of high-grade irAEs. Patients were analyzed separately based on tumor subtypes and sequencing platforms. RESULTS: High-grade and low-grade irAEs occurred in 15.2% and 46.2% of patients, respectively. Respiratory and gastrointestinal irAEs were the 2 most common irAEs. The distribution of patients with or without irAEs was similar between ICI and ICI+chemotherapy-treated patients. By analyzing the mutation data, we identified 5 genes (MYC, TEK, FANCA, FAM123B, and MET) with mutations that were correlated with an increased risk of high-grade irAEs. For the adenocarcinoma subtype, mutations in TEK, MYC, FGF19, RET, and MET were associated with high-grade irAEs; while for the squamous subtype, ERBB2 mutations were associated with high-grade irAEs. CONCLUSION: This study is the first to demonstrate that specific tumor mutations correlate with the incidence of high-grade irAEs in patients with NSCLC treated with an ICI, providing molecular guidance for treatment selection and drug monitoring.

4.
J Med Chem ; 67(16): 13703-13722, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39115891

RESUMO

Extracellular vesicles (EVs) can transfer antigens and immunomodulatory molecules, and such EVs released by antigen-presenting cells equipped with immunostimulatory functions have been utilized for vaccine formulations. A prior high-throughput screening campaign led to the identification of compound 634 (1), which enhanced EV release and increased intracellular Ca2+ influx. Here, we performed systematic structure-activity relationship (SAR) studies to investigate the scaffold for its potency as a vaccine adjuvant. Synthesized compounds were analyzed in vitro for CD63 reporter activity (a marker for EV biogenesis) in human THP-1 cells, induction of Ca2+ influx, IL-12 production, and cell viability in murine bone-marrow-derived dendritic cells. The SAR studies indicated that the ester functional group was requisite, and the sulfur atom of the benzothiadiazole ring replaced with a higher selenium atom (9f) or a bioisosteric ethenyl group (9h) retained potency. Proof-of-concept vaccination studies validated the potency of the selected compounds as novel vaccine adjuvants.


Assuntos
Adjuvantes Imunológicos , Tiadiazóis , Relação Estrutura-Atividade , Humanos , Adjuvantes Imunológicos/farmacologia , Adjuvantes Imunológicos/química , Adjuvantes Imunológicos/síntese química , Animais , Tiadiazóis/química , Tiadiazóis/farmacologia , Tiadiazóis/síntese química , Camundongos , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Células THP-1 , Vacinas/imunologia , Vacinas/química , Camundongos Endogâmicos C57BL , Feminino , Vesículas Extracelulares/química , Vesículas Extracelulares/imunologia , Vesículas Extracelulares/metabolismo
5.
Dalton Trans ; 53(34): 14391-14398, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39136437

RESUMO

The synthesis, spectroscopic characterisation and catalytic olefin polymerisation behaviour of a class of binuclear titanium bis(benzyl) complexes bearing bis-(pyridine-2-phenolate-6-methine)-[µ-(arylene-1,4-diyl-2,3-X2)] ligands [X2 = -C4H4- (1), F2 (2), H2 (3)], and mononuclear analogues, are described. These bimetallic catalyst frameworks are designed to exhibit a degree of conformational flexibility, which is regulated by steric effects and crucially permits tuning of intermetallic distances and geometry, yet their shape-persistent nature can also confer favourable entropic terms. Complexes 1-3 are characterised as two diastereomers [meso (RS) and rac (RR,SS)] in ratios of 1.32, 1.18 and 1.13 respectively, according to 1H NMR spectroscopy. In contrast to 3, [1H,1H]-ROESY experiments for 1 and 2 revealed that the X2 substituents can impose preferred conformations with syn orientations of Ti2 centres and benzyl groups, thus implying that the activated catalysts would present binding sites with the same direction of access. For ethylene-(1-octene) copolymerisation reactions, in conjunction with [Ph3C][B(C6F5)4], catalyst 1 displayed superior efficiencies and produced polymers with higher Mw values and enhanced comonomer incorporation ratios (up to 41%), when compared with the mononuclear 5m (22%). These results are indicative of enhanced comonomer enchainment and cooperative reactivity by the Ti2 sites.

6.
J Clin Pathol ; 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39168612

RESUMO

AIMS: The International Association for the Study of Lung Cancer (IASLC) has proposed a new histological grading system for invasive lung adenocarcinoma (LUAD). However, the efficacy of this grading system in predicting distant metastases in patients with LUAD remains unexplored. This study aims to assess the potential of the IASLC grading system in predicting the occurrence of brain and bone metastases in patients with resectable LUAD, thereby identifying individuals at high risk of post-surgery distant metastasis. METHODS: We retrospectively analysed clinical data and pathological reports of 174 patients with early-stage LUAD who underwent surgical resection between 2008 and 2015 at our cancer center. Patients were monitored for 5 years, and their bone and brain metastasis-free survival rates were determined. RESULTS: 28 out of 174 patients developed distant metastases in 5 years with a median overall survival of 60 months for metastasis-free patients and 38.3 months for patients with distant metastasis. Tumour grading of all samples was evaluated by both IASLC grading and predominant pattern-based grading systems. Receiver operating characteristic (ROC) curves were used to evaluate the predictive capabilities of the IASLC grading system and tumour stage for distant metastasis. Compared with the predominant pattern-based grading system, the IASLC grading system showed a better correlation with the incidence of distant metastasis and lymphovascular invasion. ROC analyses revealed that the IASLC grading system outperformed tumour stage in predicting distant metastasis. CONCLUSIONS: Our study indicates that the IASLC grading system is capable of predicting the incidence of distant metastasis among patients with early-stage invasive LUAD.

7.
Artigo em Inglês | MEDLINE | ID: mdl-39115488

RESUMO

The "International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024" updates and replaces the "Listing Criteria for Heart Transplantation: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates-2006" and the "2016 International Society for Heart Lung Transplantation Listing Criteria for Heart Transplantation: A 10-year Update." The document aims to provide tools to help integrate the numerous variables involved in evaluating patients for transplantation, emphasizing updating the collaborative treatment while waiting for a transplant. There have been significant practice-changing developments in the care of heart transplant recipients since the publication of the International Society for Heart and Lung Transplantation (ISHLT) guidelines in 2006 and the 10-year update in 2016. The changes pertain to 3 aspects of heart transplantation: (1) patient selection criteria, (2) care of selected patient populations, and (3) durable mechanical support. To address these issues, 3 task forces were assembled. Each task force was cochaired by a pediatric heart transplant physician with the specific mandate to highlight issues unique to the pediatric heart transplant population and ensure their adequate representation. This guideline was harmonized with other ISHLT guidelines published through November 2023. The 2024 ISHLT guidelines for the evaluation and care of cardiac transplant candidates provide recommendations based on contemporary scientific evidence and patient management flow diagrams. The American College of Cardiology and American Heart Association modular knowledge chunk format has been implemented, allowing guideline information to be grouped into discrete packages (or modules) of information on a disease-specific topic or management issue. Aiming to improve the quality of care for heart transplant candidates, the recommendations present an evidence-based approach.

8.
J Am Chem Soc ; 146(28): 18817-18822, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-38968608

RESUMO

NAD(H)-dependent enzymes play a crucial role in the biosynthesis of pharmaceuticals and fine chemicals, but the limited recyclability of the NAD(H) cofactor hinders its more general application. Here, we report the generation of mechano-responsive PEI-modified Cry3Aa protein crystals and their use for NADH recycling over multiple reaction cycles. For demonstration of its practical utility, a complementary Cry3Aa protein particle containing genetically encoded and co-immobilized formate dehydrogenase for NADH regeneration and leucine dehydrogenase for catalyzing the NADH-dependent l-tert-leucine (l-tert-Leu) biosynthesis has been produced. When combined with the PEI-modified Cry3Aa crystal, the resultant reaction system could be used for the efficient biosynthesis of l-tert-Leu for up to 21 days with a 10.5-fold improvement in the NADH turnover number.


Assuntos
Formiato Desidrogenases , NAD , NAD/metabolismo , NAD/química , Formiato Desidrogenases/metabolismo , Formiato Desidrogenases/química , Leucina Desidrogenase/metabolismo , Leucina Desidrogenase/química , Cristalização , Enzimas Imobilizadas/química , Enzimas Imobilizadas/metabolismo , Modelos Moleculares
9.
J Dent Educ ; 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38984429

RESUMO

BACKGROUND: Dental students' personalities are strongly correlated with their didactic and clinical performances. With the significant changes in the social environment in the past decades, students' personalities may also change dramatically. Additionally, with the increasing number of international students admitted into US dental programs, educators must pay attention to the potential personality differences between domestic and international students. BACKGROUND: A systematic review focusing on the Myers-Briggs Type Indicator personality types of dental students was conducted with 11 literature databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The quality assessment of each included article was conducted following the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analyses were conducted for each personality type within the United States in the past 50 years, and in each country in the past 20 years. RESULTS: Eighteen articles (17 reports) were included after the eligibility assessment. The longitudinal trends within the United States showed the predominant two personality types have changed from Extraversion, Sensing, Feeling, and Judging (ESFJ) and Extraversion, Sensing, Thinking, and Judging (ESTJ) to ESTJ and Introversion, Sensing, Thinking, and Judging (ISTJ) during the past 50 years. When comparing different countries, the United States, China, Korea, and Iran have the same two dominant personality types (ESTJ and ISTJ) but not the Philippines (Extraversion, Intuition, Feeling, and Perceiving and Introversion, Intuition, Feeling, and Perceiving). However, there are large variations in the prevalence of other personality types. CONCLUSION: There have been constant changes in the predominant personalities of dental students over the years. Additionally, understanding the diversity of personality types within the United States as well as among different countries could serve as the foundation for further improvements in teaching strategies and student support services.

10.
Cancer Res ; 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39047223

RESUMO

The Hippo-YAP1 pathway is an evolutionally conserved signaling cascade that controls organ size and tissue regeneration. Dysregulation of Hippo-YAP1 signaling promotes initiation and progression of several types of cancer, including gastric cancer (GC). As the Hippo-YAP1 pathway regulates expression of thousands of genes, it is important to establish which target genes contribute to the oncogenic program driven by YAP1 to identify strategies to circumvent it. Here, we identified a vital role of FOXP4 in YAP1-driven gastric carcinogenesis by maintaining stemness and promoting peritoneal metastasis. Loss of FOXP4 impaired GC spheroid formation and reduced stemness marker expression, while FOXP4 upregulation potentiated cancer cell stemness. RNA-seq analysis revealed SOX12 as downstream target of FOXP4, and functional studies established that SOX12 supports stemness in YAP1-induced carcinogenesis. A small molecule screen identified 42-(2-Tetrazolyl)rapamycin as a FOXP4 inhibitor, and targeting FOXP4 suppressed GC tumor growth and enhanced the efficacy of 5-FU chemotherapy in vivo. Collectively, these findings revealed that FOXP4 upregulation by YAP1 in GC regulates stemness and tumorigenesis by upregulating SOX12. Targeting the YAP1-FOXP4-SOX12 axis represents a potential therapeutic strategy for GC.

11.
Curr Treat Options Oncol ; 25(8): 1011-1026, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39037617

RESUMO

OPINION STATEMENT: Therapies for brain metastasis continue to evolve as the life expectancies for patients have continued to prolong. Novel advances include the use of improved technology for radiation delivery, surgical guidance, and response assessment, along with systemic therapies that can pass through the blood brain barrier. With increasing complexity of treatments and the increased need for salvage treatments, multi-disciplinary management has become significantly more important.


Assuntos
Neoplasias Encefálicas , Humanos , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/terapia , Terapia Combinada/métodos , Gerenciamento Clínico , Resultado do Tratamento , Radiocirurgia/métodos
12.
Small Methods ; : e2400465, 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39049798

RESUMO

Porous materials are excellent candidates for water remediation in environmental issues. However, it is still a key challenge to design efficient adsorbents for rapid water purification from various heavy metal ions-contaminated wastewater in one step. Here, two robust nitrogen-rich covalent organic frameworks (COFs) bearing terpyridine units on the pore walls by a "bottom-up" strategy are reported. Benefitting from the strong chelation interaction between the terpyridine units and various heavy metal ions, these two terpyridine COFs show excellent removal efficiency and capability for Pb2+, Hg2+, Cu2+, Ag+, Cd2+, Ni2+, and Cr3+ from water. These COFs are shown to remove such heavy metal ions with >90% of contents at one time after the aqueous metal ions mixture is passed through the COF filter. The nitrogen-rich features of the COFs also endow them with the capability of capturing iodine vapors, offering the terpyridine COFs the potential for environmental remediation applications.

13.
Genes (Basel) ; 15(6)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38927654

RESUMO

Glioblastoma multiforme (GBM)is the most common and aggressive primary brain tumor. Although temozolomide (TMZ)-based radiochemotherapy improves overall GBM patients' survival, it also increases the frequency of false positive post-treatment magnetic resonance imaging (MRI) assessments for tumor progression. Pseudo-progression (PsP) is a treatment-related reaction with an increased contrast-enhancing lesion size at the tumor site or resection margins miming tumor recurrence on MRI. The accurate and reliable prognostication of GBM progression is urgently needed in the clinical management of GBM patients. Clinical data analysis indicates that the patients with PsP had superior overall and progression-free survival rates. In this study, we aimed to develop a prognostic model to evaluate the tumor progression potential of GBM patients following standard therapies. We applied a dictionary learning scheme to obtain imaging features of GBM patients with PsP or true tumor progression (TTP) from the Wake dataset. Based on these radiographic features, we conducted a radiogenomics analysis to identify the significantly associated genes. These significantly associated genes were used as features to construct a 2YS (2-year survival rate) logistic regression model. GBM patients were classified into low- and high-survival risk groups based on the individual 2YS scores derived from this model. We tested our model using an independent The Cancer Genome Atlas Program (TCGA) dataset and found that 2YS scores were significantly associated with the patient's overall survival. We used two cohorts of the TCGA data to train and test our model. Our results show that the 2YS scores-based classification results from the training and testing TCGA datasets were significantly associated with the overall survival of patients. We also analyzed the survival prediction ability of other clinical factors (gender, age, KPS (Karnofsky performance status), normal cell ratio) and found that these factors were unrelated or weakly correlated with patients' survival. Overall, our studies have demonstrated the effectiveness and robustness of the 2YS model in predicting the clinical outcomes of GBM patients after standard therapies.


Assuntos
Neoplasias Encefálicas , Glioblastoma , Imageamento por Ressonância Magnética , Humanos , Glioblastoma/genética , Glioblastoma/diagnóstico por imagem , Glioblastoma/patologia , Glioblastoma/mortalidade , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/mortalidade , Masculino , Feminino , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Prognóstico , Adulto , Idoso , Progressão da Doença , Temozolomida/uso terapêutico , Genômica/métodos , Taxa de Sobrevida , Relevância Clínica
14.
Cancers (Basel) ; 16(11)2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38893130

RESUMO

The quality of radiation therapy (RT) treatment plans directly affects the outcomes of clinical trials. KBP solutions have been utilized in RT plan quality assurance (QA). In this study, we evaluated the quality of RT plans for brain and head/neck cancers enrolled in multi-institutional clinical trials utilizing a KBP approach. The evaluation was conducted on 203 glioblastoma (GBM) patients enrolled in NRG-BN001 and 70 nasopharyngeal carcinoma (NPC) patients enrolled in NRG-HN001. For each trial, fifty high-quality photon plans were utilized to build a KBP photon model. A KBP proton model was generated using intensity-modulated proton therapy (IMPT) plans generated on 50 patients originally treated with photon RT. These models were then applied to generate KBP plans for the remaining patients, which were compared against the submitted plans for quality evaluation, including in terms of protocol compliance, target coverage, and organ-at-risk (OAR) doses. RT plans generated by the KBP models were demonstrated to have superior quality compared to the submitted plans. KBP IMPT plans can decrease the variation of proton plan quality and could possibly be used as a tool for developing improved plans in the future. Additionally, the KBP tool proved to be an effective instrument for RT plan QA in multi-center clinical trials.

15.
Artigo em Inglês | MEDLINE | ID: mdl-38870268

RESUMO

BACKGROUND: Androgen could impact cervical remodelling during pregnancy, and a higher level is associated with adverse pregnancy outcomes. A population-based gestation age-specific reference interval (RI) of total testosterone (TT), androstenedione (A4), and 17-hydroxyprogesterone (17-OHP) can help to diagnose maternal hyperandrogenism. METHODS: We enrolled 600 healthy Chinese women to obtain longitudinal serum samples across gestation. The serum androgen profile was measured by liquid chromatography-tandem mass spectrometry. The equations for medians of TT, A4, and 17-OHP were generated by MedCal, and the variances adjusted for 2-level modeling were generated by MLwiN, a system for the specification and analysis of a range of multilevel models. RESULTS: A4 and TT levels increased across the gestation, and they closely correlated with each other (R = 0.90, P=<0.001), whereas 17-OHP level decreased from 5th gestational week to 16th gestational week and then increased afterward towards the end of pregnancy. Women diagnosed with preeclampsia (PE) were found to have a significantly higher level of A4, TT, and 17-OHP when compared with non-PE cases with p ≤0.01, whereas mothers carrying male versus female fetuses have comparable levels of A4, TT, and 17-OHP. CONCLUSION: The study highlights a methodology for constructing gestational age-specific TT, A4, and 17-OHP levels to provide a better interpretation of results in a cohort of healthy Chinese women. The observation in PE supports previous findings, and the higher levels of TT, A4, and 17-OHP were observed before the onset of PE.

16.
Chem Sci ; 15(22): 8545-8556, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38846386

RESUMO

A new class of amphiphilic tetradentate platinum(ii) Schiff base complexes has been designed and synthesized. The self-assembly properties by exploiting the potential Pt⋯Pt interactions of amphiphilic platinum(ii) Schiff base complexes in the solution state have been systematically investigated. The presence of Pt⋯Pt interactions has further been supported by computational studies and non-covalent interaction (NCI) analysis of the dimer of the complex. The extent of the non-covalent Pt⋯Pt and π-π interactions could be regulated by a variation of the solvent compositions and the hydrophobicity of the complexes, which is accompanied by attractive spectroscopic and luminescence changes and leads to diverse morphological transformations. The present work represents a rare example of demonstration of directed cooperative assembly of amphiphilic platinum(ii) Schiff base complexes by intermolecular Pt⋯Pt interactions in solution with an in-depth mechanistic investigation, providing guiding principles for the construction of supramolecular structures with desirable properties using platinum(ii) Schiff base building blocks.

17.
AJNR Am J Neuroradiol ; 45(7): 871-878, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38816018

RESUMO

BACKGROUND: Delayed cerebral ischemia and vasospasm are the most common causes of late morbidity following aneurysmal SAH, but their diagnosis remains challenging. PURPOSE: This systematic review and meta-analysis investigated the diagnostic performance of CTP for detection of delayed cerebral ischemia and vasospasm in the setting of aneurysmal SAH. DATA SOURCES: Studies evaluating the diagnostic performance of CTP in the setting of aneurysmal SAH were searched on the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane Methodology Register, Ovid MEDLINE, EMBASE, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Health Technology Assessment, National Health Service Economic Evaluation Database, PubMed, and Google Scholar from their inception to September 2023. STUDY SELECTION: Thirty studies were included, encompassing 1786 patients with aneurysmal SAH and 2302 CTP studies. Studies were included if they compared the diagnostic accuracy of CTP with a reference standard (clinical or radiologic delayed cerebral ischemia, angiographic spasm) for the detection of delayed cerebral ischemia or vasospasm in patients with aneurysmal SAH. The primary outcome was accuracy for the detection of delayed cerebral ischemia or vasospasm. DATA ANALYSIS: Bivariate random effects models were used to pool outcomes for sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Subgroup analyses for individual CTP parameters and early-versus-late study timing were performed. Bias and applicability were assessed using the modified QUADAS-2 tool. DATA SYNTHESIS: For assessment of delayed cerebral ischemia, CTP demonstrated a pooled sensitivity of 82.1% (95% CI, 74.5%-87.8%), specificity of 79.6% (95% CI, 73.0%-84.9%), positive likelihood ratio of 4.01 (95% CI, 2.94-5.47), and negative likelihood ratio of 0.23 (95% CI, 0.12-0.33). For assessment of vasospasm, CTP showed a pooled sensitivity of 85.6% (95% CI, 74.2%-92.5%), specificity of 87.9% (95% CI, 79.2%-93.3%), positive likelihood ratio of 7.10 (95% CI, 3.87-13.04), and negative likelihood ratio of 0.16 (95% CI, 0.09-0.31). LIMITATIONS: QUADAS-2 assessment identified 12 articles with low risk, 11 with moderate risk, and 7 with a high risk of bias. CONCLUSIONS: For delayed cerebral ischemia, CTP had a sensitivity of >80%, specificity of >75%, and a low negative likelihood ratio of 0.23. CTP had better performance for the detection of vasospasm, with sensitivity and specificity of >85% and a low negative likelihood ratio of 0.16. Although the accuracy offers the potential for CTP to be used in limited clinical contexts, standardization of CTP techniques and high-quality randomized trials evaluating its impact are required.


Assuntos
Isquemia Encefálica , Hemorragia Subaracnóidea , Vasoespasmo Intracraniano , Humanos , Vasoespasmo Intracraniano/diagnóstico por imagem , Vasoespasmo Intracraniano/etiologia , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/complicações , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/complicações , Sensibilidade e Especificidade , Angiografia Cerebral/métodos , Tomografia Computadorizada por Raios X , Imagem de Perfusão/métodos
18.
J Am Chem Soc ; 146(19): 13226-13235, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38700957

RESUMO

Strained carbon nanohoops exhibit attractive photophysical properties due to their unique π-conjugated structure. However, incorporation of such nanohoops into the pincer ligand of metal complexes has rarely been explored. Herein, a new family of highly strained cyclometalated platinum(II) nanohoops has been synthesized and characterized. Strain-promoted C-H bond activation has been observed during the metal coordination process, and Hückel-Möbius topology and random-columnar packing in the solid state are found. Transient absorption spectroscopy revealed the size-dependent excited state properties of the nanohoops. Moreover, the nanohoops have been successfully employed as active materials in the fabrication of solution-processable resistive memory devices, including the use of the smallest platinum(II) nanohoop for the fabrication of a binary memory, with low switching threshold voltages of ca. 1.5 V, high ON/OFF current ratios, and good stability. These results demonstrate that strain incorporation into the structure can be an effective strategy to fundamentally fine-tune the reactivity, optoelectronic, and resistive memory properties.

19.
IEEE J Biomed Health Inform ; 28(7): 3942-3952, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38648146

RESUMO

Seismocardiogram (SCG) signals are noninvasively obtained cardiomechanical signals containing important features for cardiovascular health monitoring. However, these signals are prone to contamination by motion noise, which can significantly impact accuracy and robustness of the measurements. A deep learning model based on the U-Net architecture is proposed to recover SCG signals contaminated by motion noise induced by walking. The model performance was evaluated through qualitative visualization, as well as quantitative analyses. Quantitative analyses included distance-based comparisons before and after applying our model. Analyses also included assessments of the model's efficacy in improving the performance of downstream tasks related to health parameter estimation during walking. Experimental findings revealed that the denoising model improved similarity to clean signals by approximately 90%. The performance of the model in enhancing heart rate estimation demonstrated a mean absolute error of 1.21 BPM and a root-mean-squared error (RMSE) of 1.97 BPM during walking after denoising with 9.16 BPM and 10.38 BPM improvements, respectively, compared to without denoising. Furthermore, the RMSEs of aortic opening and aortic closing time estimation after denoising for one dataset with catheter ground truth were 7.29 ms and 19.71 ms during walking, respectively, with 50.33 ms and 51.91 ms RMSE improvements compared to without denoising. And for another dataset with ICG-derived PEP ground truth, the RMSE of aortic opening time estimation after denoising was 10.21 ms during walking, with 38.74 ms RMSE improvement compared to without denoising. The proposed model attenuates motion noise from corrupted SCG signals while preserving cardiac information. This development paves the way for improved ambulatory cardiac health monitoring using wearable accelerometers during daily activities.


Assuntos
Frequência Cardíaca , Redes Neurais de Computação , Processamento de Sinais Assistido por Computador , Humanos , Frequência Cardíaca/fisiologia , Adulto , Masculino , Exercício Físico/fisiologia , Feminino , Caminhada/fisiologia , Adulto Jovem , Aprendizado Profundo
20.
Ecol Evol ; 14(4): e11268, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38646006

RESUMO

The cryptic invasion of golden apple snails (Pomacea canaliculata and P. maculata) in Taiwan has caused significant ecological and economical damage over the last few decades, however, their management remains difficult due to inadequate taxonomic identification, complex phylogeny, and limited population genetic information. We aim to understand the current distribution, putative population of origin, genetic diversity, and potential path of cryptic invasion of Pomacea canaliculata and P. maculata across Taiwan to aid in improved mitigation approaches. The present investigation conducted a nationwide survey with 254 samples collected from 41 locations in 14 counties or cities across Taiwan. We identified P. canaliculata and P. maculata based on mitochondrial COI and compared their genetic diversity across Taiwan, as well as other introduced and native countries (based on publicly available COI data) to understand the possible paths of invasion to Taiwan. Based on mitochondrial COI barcoding, sympatric and heterogeneous distributions of invasive P. canaliculata and P. maculata were noted. Our haplotype analysis and mismatch distribution results suggested multiple introductions of P. canaliculata in Taiwan was likely originated directly from Argentina, whereas P. maculata was probably introduced from a single, or a few, introduction event(s) from Argentina and Brazil. Our population genetic data further demonstrated a higher haplotype and genetic diversity for P. canaliculata and P. maculata in Taiwan compared to other introduced regions. Based on our current understanding, the establishment of P. canaliculata and P. maculata is alarming and widespread beyond geopolitical borders, requiring a concerted and expedited national and international invasive species mitigation program.

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