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1.
J Stud Alcohol Drugs ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38900056

RESUMO

OBJECTIVE: Men's coercive condom use resistance (CUR) with female partners is common and is associated with greater alcohol consumption than men's noncoercive CUR engagement. Prior research indicates that emotion-related factors are relevant to alcohol-involved coercive CUR. Thus, in this alcohol administration study, we examined emotional factors as distal and proximal predictors of alcohol-involved coercive CUR among young men who have sex with women. METHOD: Non-problem drinking young adult men who have sex with women (N = 282) were recruited from the local community, and as part of a larger study, completed a background survey and an in-lab alcohol administration session that included a mood induction and sexual scenario task using a 2 (sober vs. intoxicated) x 2 (positive mood vs. negative mood) experimental design. RESULTS: Path analysis testing a moderated mediation model revealed that for participants in the sober, positive mood, and intoxicated, negative mood conditions, there was a positive association between distal ER difficulties and motives to have sex to cope with negative emotions. Additionally, distal ER difficulties were positively associated with proximal difficulties modulating one's emotions among intoxicated participants. Among those with greater proximal difficulties modulating their emotions, state anger was positively associated with coercive CUR intentions. CONCLUSIONS: Results demonstrate the importance of alcohol intoxication, emotions and emotion regulation, and sexual coping motives in men's coercive CUR likelihood, demonstrating potential malleable targets for prevention efforts.

2.
J Sex Res ; : 1-16, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38913125

RESUMO

Coerced condomless sex is a prevalent form of sexual coercion that is associated with severe negative health consequences. This scoping review addresses the current lack of synthesized qualitative evidence on coerced condomless sex. Our systematic literature search yielded 21 articles that met review eligibility criteria. Themes of coerced condomless sex were organized into three categories (tactics, motives, and sequelae) and presented separately for studies based on whether researchers stipulated pregnancy promotion intent as underlying the behavior. Coerced condomless sex perpetration tactics ranged from verbal pressure to physical assault. Besides pregnancy promotion, perpetration motives included control, dominance, entrapment, enhancing sexual experiences, and avoiding conflict. Following coerced condomless sex, victims reported developing protective strategies. They also reported experiencing various negative emotional, relational, and physical health effects. Interventions that specifically address coerced condomless sex perpetration and provide supportive programs for those who have experienced coercive condomless sex may be beneficial.

3.
Int Ophthalmol ; 44(1): 249, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38907177

RESUMO

OBJECTIVE: To investigate the macular morphological and visual outcomes of combined idiopathic epiretinal membrane (iERM) removal with triamcinolone acetonide (TA) injection based on consideration of the ectopic inner foveal layer (EIFL) staging scheme. METHODS: Retrospective case-control study. The clinical data of 84 eyes of 84 patients who underwent vitrectomy for iERM between 2018 and 2022 were reviewed. The enrolled subjects were divided into the TA and non-TA groups. Fifty-one eyes received intravitreal TA injection following vitrectomy and ERM peeling (TA group), and 33 were only treated by standard vitrectomy and ERM peeling (non-TA group). Preoperative and postoperative EIFL stages, central foveal thickness (CFT), and best-corrected visual acuity (BCVA) were compared between both groups. RESULTS: After a mean follow-up of 7.69 ± 3.68 months, both groups exhibited significant improvement in EIFL stages (P < 0.01), with no discernible advantage observed in the TA group. The TA and non-TA groups demonstrated improvement in the EIFL stages in 56.86 and 63.64% of eyes, respectively (P = 0.43). The CFT and BCVA significantly improved in both groups at the final visit (P < 0.01). However, CFT in the non-TA group displayed a more significant reduction during the follow-up (P < 0.03). Subgroup analysis revealed no significant differences in postoperative CFT and BCVA between the two groups in cases with or without continuous EIFL (P > 0.10). CONCLUSION: Our findings indicate that combined intravitreal TA injection following ERM removal conferred no significant benefits in alleviating macular thickening or improving visual acuity in iERM.


Assuntos
Membrana Epirretiniana , Fóvea Central , Glucocorticoides , Injeções Intravítreas , Tomografia de Coerência Óptica , Triancinolona Acetonida , Acuidade Visual , Vitrectomia , Humanos , Membrana Epirretiniana/diagnóstico , Membrana Epirretiniana/cirurgia , Estudos Retrospectivos , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Glucocorticoides/administração & dosagem , Fóvea Central/patologia , Vitrectomia/métodos , Triancinolona Acetonida/administração & dosagem , Estudos de Casos e Controles , Idoso , Pessoa de Meia-Idade , Seguimentos , Resultado do Tratamento
4.
Chem Pharm Bull (Tokyo) ; 72(6): 584-595, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38945947

RESUMO

In order to introduce a cost-effective strategy method for commercial scale dry granulation at the early clinical stage of drug product development, we developed dry granulation process using formulation without API, fitted and optimized the process parameters adopted Design of Experiment (DOE). Then, the process parameters were confirmed using one formulation containing active pharmaceutical ingredient (API). The results showed that the roller pressure had significant effect on particle ratio (retained up to #60 mesh screen), bulk density and tapped density. The roller gap had significant influence on particle ratio and specific energy. The particle ratio was significantly affected by the mill speed (second level). The tabletability of the powder decreased after dry granulation. The effect of magnesium stearate on the tabletability was significant. In the process validation study, the properties of the prepared granules met the requirements for each response studied in the DOE. The prepared tablets showed higher tensile strength, good content uniformity of filled capsules, and the dissolution profiles of which were consistent with that of clinical products. This drug product process development and research strategies could be used as a preliminary experiment for the dry granulation process in the early clinical stage.


Assuntos
Comprimidos , Comprimidos/química , Tamanho da Partícula , Composição de Medicamentos , Pós/química , Ácidos Esteáricos/química , Resistência à Tração , Excipientes/química , Solubilidade
5.
Asia Pac J Ophthalmol (Phila) ; 13(3): 100067, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38750958

RESUMO

OBJECTIVE: To identify the risk factors for the development of diabetic retinopathy (DR), diabetic macular edema (DME), and sight-threatening DR (STDR) based on a city-wide diabetes screening program. RESEARCH DESIGN AND METHODS: Diabetic patients were prospectively recruited between June 2016 and December 2022. All patients underwent dilated fundus photography centered on the disc and macula or macular spectral domain optical coherence tomography (SD-OCT) scan. Complete medical history was documented. Systematic examination, blood analysis, and urinalysis were performed. Multivariate logistic regression analysis adjusting for age and sex was conducted. RESULTS: Out of 7274 diabetic patients, 6840 had gradable images, among which 3054 (42.0%) were graded as DR, 1153 (15.9%) as DME, and 1500 (20.6%) as STDR. The factors associated with DR, DME, and STDR included younger age (odds ratio [OR]: 0.96, 0.97, and 0.96 respectively), lower BMI (OR: 0.97, 0.95, and 0.95 respectively), longer duration of diabetes (OR: 1.07, 1.03, and 1.05 respectively) and positive of urinary albumin (OR: 2.22, 2.56, and 2.88 respectively). Other associated factors included elevated blood urea nitrogen (OR: 1.22, 1.28, and 1.27 respectively), higher LDL-cholesterol, lower blood hemoglobin (OR: 0.98, 0.98, and 0.98), insulin intake, presence of diabetic foot pathologies and diabetic peripheral neuropathy. We also identified novel risk factors, including high serum potassium (OR: 1.37, 1.46, and 1.55 respectively), high-serum sodium (OR: 1.02, 1.02, and 1.04 respectively). Better family income was a protective factor for DR, DME, and STDR. Alcohol consumption once a week was also identified as a protective factor for DR. CONCLUSIONS: Similar risk factors for DR, DME, and STDR were found in this study. Our data also indicates high serum sodium, high serum potassium, low blood hemoglobin, and level of family income as novel associated factors for DR, DME, and STDR, which can help with DR monitoring and management.


Assuntos
Retinopatia Diabética , Edema Macular , Tomografia de Coerência Óptica , Humanos , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/diagnóstico , Masculino , Fatores de Risco , Edema Macular/etiologia , Edema Macular/epidemiologia , Edema Macular/diagnóstico , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia de Coerência Óptica/métodos , Idoso , Acuidade Visual , Adulto , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia
6.
JAMA Neurol ; 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38805216

RESUMO

Importance: Comparisons are limited for immediate-intensive and delayed-intensive statin for secondary stroke prevention and neuroprotection in patients with acute mild ischemic stroke or transient ischemic attack (TIA) from atherosclerosis. Objective: To estimate whether immediate-intensive statin therapy is safe and can lower the risk of recurrent stroke compared with delayed-intensive statin in patients with acute mild ischemic stroke or high-risk TIA from atherosclerosis. Design, Setting, and Participants: The Intensive Statin and Antiplatelet Therapy for High-Risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial, a double-blind, placebo-controlled, 2 × 2 factorial, randomized clinical trial enrolled patients from September 2018 to October 2022. The trial was conducted at 222 hospitals in China. Patients aged 35 to 80 years with mild ischemic stroke or high-risk TIA of presumed atherosclerosis within 72 hours of symptom onset were assessed. Interventions: Patients were randomly assigned to receive immediate-intensive atorvastatin (80 mg daily on days 1-21; 40 mg daily on days 22-90) or 3-day delayed treatment (placebo for days 1-3, followed by placebo and atorvastatin, 40 mg daily on days 4-21, and then atorvastatin, 40 mg daily on days 22-90). Main Outcomes and Measures: The primary efficacy outcome was new stroke within 90 days, and a secondary efficacy outcome was poor functional outcome. Moderate to severe bleeding was the primary safety outcome. Results: A total of 11 431 patients were assessed for eligibility, and 6100 patients (median [IQR] age, 65 [57-71] years; 3915 men [64.2%]) were enrolled, with 3050 assigned to each treatment group. Within 90 days, new stroke occurred in 245 patients (8.1%) in the immediate-intensive statin group and 256 patients (8.4%) in the delayed group (hazard ratio, 0.95; 95% CI, 0.80-1.13). Poor functional outcome occurred in 299 patients (9.8%) and 348 patients (11.4%) in the immediate-intensive and delayed-intensive statin groups, respectively (odds ratio, 0.83; 95% CI, 0.71-0.98). Moderate to severe bleeding occurred in 23 of 3050 patients (0.8%) and 17 of 3050 patients (0.6%), in the immediate-intensive and delayed-intensive statin groups, respectively. Conclusions and Relevance: Immediate-intensive statin initiated within 72 hours did not reduce the risk of stroke within 90 days and may be associated with improved functional outcomes without significant difference in moderate to severe bleeding, compared with 3-day delayed-intensive statin in Chinese patients with acute mild ischemic stroke or TIA from atherosclerosis. Trial Registration: ClinicalTrials.gov Identifier: NCT03635749.

7.
Physiol Plant ; 176(3): e14324, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38705866

RESUMO

Broomrape (Orobanche cumana) negatively affects sunflower, causing severe yield losses, and thus, there is a need to control O. cumana infestation. Brassinosteroids (BRs) play key roles in plant growth and provide resilience to weed infection. This study aims to evaluate the mechanisms by which BRs ameliorate O. cumana infection in sunflower (Helianthus annuus). Seeds were pretreated with BRs (1, 10, and 100 nM) and O. cumana inoculation for 4 weeks under soil conditions. O. cumana infection significantly reduced plant growth traits, photosynthesis, endogenous BRs and regulated the plant defence (POX, GST), BRs signalling (BAK1, BSK1 to BSK4) and synthesis (BRI1, BR6OX2) genes. O. cumana also elevated the levels of malondialdehyde (MDA), hydroxyl radical (OH-), hydrogen peroxide (H2O2) and superoxide (O2 •-) in leaves/roots by 77/112, 63/103, 56/97 and 54/89%, as well as caused ultrastructural cellular damages in both leaves and roots. In response, plants activated a few enzymes, superoxide dismutase (SOD), peroxidase (POD) and reduced glutathione but were unable to stimulate the activity of ascorbate peroxidase (APX) and catalase (CAT) enzymes. The addition of BRs (especially at 10 nM) notably recovered the ultrastructural cellular damages, lowered the production of oxidative stress, activated the key enzymatic antioxidants and induced the phenolic and lignin contents. The downregulation in the particular genes by BRs is attributed to the increased resilience of sunflower via a susceptible reaction. In a nutshell, BRs notably enhanced the sunflower resistance to O. cumana infection by escalating the plant immunity responses, inducing systemic acquired resistance, reducing oxidative or cellular damages, and modulating the expression of BR synthesis or signalling genes.


Assuntos
Brassinosteroides , Helianthus , Orobanche , Sementes , Helianthus/efeitos dos fármacos , Helianthus/imunologia , Helianthus/fisiologia , Brassinosteroides/farmacologia , Brassinosteroides/metabolismo , Orobanche/fisiologia , Orobanche/efeitos dos fármacos , Sementes/efeitos dos fármacos , Sementes/imunologia , Plantas Daninhas/efeitos dos fármacos , Plantas Daninhas/fisiologia , Doenças das Plantas/parasitologia , Doenças das Plantas/imunologia , Imunidade Vegetal/efeitos dos fármacos , Regulação da Expressão Gênica de Plantas/efeitos dos fármacos , Fotossíntese/efeitos dos fármacos , Raízes de Plantas/imunologia , Raízes de Plantas/efeitos dos fármacos , Peróxido de Hidrogênio/metabolismo , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/imunologia , Proteínas de Plantas/metabolismo , Proteínas de Plantas/genética , Malondialdeído/metabolismo
8.
Heliyon ; 10(9): e29963, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38707420

RESUMO

Under the new coronavirus epidemic, the implementation of public health measures has generated some resistance in countries around the world. The essence of examining the human rights claims of those who oppose the epidemic is that they have a too narrow understanding of individual human rights and ignore the obligation implications of human rights itself. From the historical point of view, health and epidemic prevention is the objective necessity of the survival and development of human society; From the ethical point of view, the joint fight against the epidemic is the moral obligation of the coordinated development of individuals and society. From the normative point of view, the management of infectious diseases is the basic consensus established by many international conventions. To correct the narrow understanding of individual human rights concept, the global human rights concept should be established in pandemic governance, and the concept of human health community should be shaped in the pandemic convention to build governance consensus, implement the same health concept to clarify the scope of governance, implement the principle of common but differentiated responsibilities, and strengthen the participation of individuals and communities in public health governance to improve governance paths. To shape a more reasonable and effective pandemic governance order.

9.
Artigo em Inglês | MEDLINE | ID: mdl-38588036

RESUMO

BACKGROUND: Myomectomy is the preferred treatment for women with uterine fibroids and fertility requirements. There are three modalities are used in clinical practice for myomectomy: abdominal myomectomy (AM), laparoscopic myomectomy (LM), and robot-assisted laparoscopic myomectomy (RLM). OBJECTIVES: To compare the perioperative and postoperative outcomes of RLM, AM, and LM. SEARCH STRATEGY: We searched PubMed, Web of Science, Embase, and Clinical Trials for relevant literature published between January 2000 and January 2023. SELECTION CRITERIA: We included all studies reporting peri- and postoperative outcomes of myomectomy in patients with uterine myomas. Surgical treatments were classified as RLM, LM, or AM. DATA COLLECTION AND ANALYSIS: Two or more authors selected studies independently, assessed risk of bias, and extracted data. We derived mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CIs) for each outcome, subgrouping trials by the patient characteristics and myoma characteristics. We used the I2 statistic to quantify heterogeneity and the random-effects model for meta-analysis when appropriate. We used the funnel plot to assess the publication bias. MAIN RESULTS: A total of 32 studies with 6357 patients were included, of which 1982 women had undergone RLM. The operating time was significantly longer (MD = 43.58, 95% confidence interval [CI]: 25.22-61.93, P < 0.001), and the incidence of cesarean section after myomectomy was significantly lower (OR = 0.27, 95% CI: 0.10-0.78, P = 0.02) in RLM than in LM. Compared with AM, the operation time, blood loss, blood transfusion rate, complication rate, total cost, length of hospital stay, and pregnancy rate of patients with RLM were significantly different. CONCLUSIONS: The safety and effectiveness of RLM are superior to those of AM but inferior to those of LM.

10.
Psychiatry Investig ; 21(3): 219-229, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38569580

RESUMO

OBJECTIVE: We used polysomnography (PSG) monitoring and neuropsychological scales to explore the characteristics of coronavirus disease-2019 (COVID-19) patients diagnosed with post-traumatic stress disorder (PTSD) in Wuhan, two years after the onset of the COVID-19 pandemic. METHODS: A total of 42 patients in the Sleep Medicine Center were diagnosed with insomnia between December 2021 and May 2022; they were divided into the PTSD group (patients with PTSD diagnosed with insomnia after COVID-19 infection) and the non-PTSD group (patients with insomnia without PTSD). A healthy control group was simultaneously included. RESULTS: The PTSD group was more significant than the non-PTSD group in partial manifestations of sleep disorders, neuropsychological clinical symptoms, and partial PSG data. Patients with different COVID-19 subtypes showed significant differences in the course of disease, sleep disorders, neuropsychological clinical symptoms, relevant scale scores, and PSG data analysis. CONCLUSION: The emotional anxiety and depression of COVID-19 patients diagnosed with PTSD two years after the COVID-19 pandemic in Wuhan are more significant, and will not be self-alleviated with the passage of time. It is necessary to continue to pay attention to the PTSD symptoms and sleep psychology of COVID-19 infected patients, and take appropriate measures. Patients with severe and critical COVID-19 have more severe sleep and mental disorders, and there is a significant correlation between the duration of the disease and the severity of mental and mental disorders and sleep disorders after recovery.

11.
BMC Ophthalmol ; 24(1): 102, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38443874

RESUMO

BACKGROUND: This study aimed to investigate the functional and anatomical outcomes of subthreshold micropulse laser (SMPL) therapy in eyes with early postoperative macular thickening after idiopathic epiretinal membrane (iERM) removal. METHODS: This was a prospective and interventional study. Forty-eight eyes from 48 patients with macular edema at 1 month after iERM removal were randomly divided into two groups. Patients in the SMPL group (n = 24) received SMPL therapy while no special intervention was used for the observation group (n = 24). Baseline demographic data and clinical findings before and at 1 and 3 months after SMPL treatment or observation, including best-corrected visual acuity (BCVA) and the changes in central subfield thickness (CST) and average macular thickness (AMT), were analyzed. RESULTS: An improvement in BCVA with a decrease in CST and AMT from baseline to the 3-month follow-ups were observed in both SMPL and observation groups. No significant difference in BCVA was observed between the SMPL group and observation group either in the 1-month (0.26 [0.15, 0.52] vs. 0.26 [0.15, 0.39], P = 0.852) or the 3-month (0.15 [0.10, 0.30] vs. 0.23 [0.15, 0.30], P = 0.329) follow-up. There was a greater reduction in CST in the SMPL group versus observation group between baseline and the 3-month follow-up (-77.8 ± 72.3 µm vs. -45.0 ± 46.9 µm, P = 0.049). The alteration in AMT did not differ between the two groups in either 1-month (-16.5 ± 20.1 µm vs. -19.7 ± 16.3 µm, P = 0.547) or 3-month (-36.9 ± 26.9 µm vs. -34.0 ± 20.1 µm, P = 0.678) follow-up. CONCLUSIONS: SMPL therapy led to a significant decrease in CST at the 3-month follow-up while did not significantly improve the visual acuity in patients with postoperative macular thickening following iERM surgery. TRIAL REGISTRATION: The study was registered on Aug 27, 2020 (Trial Registration Number: ChiCTR 2000037227).


Assuntos
Membrana Epirretiniana , Terapia a Laser , Terapia com Luz de Baixa Intensidade , Humanos , Membrana Epirretiniana/cirurgia , Estudos Prospectivos , Olho , Transtornos da Visão
12.
Small ; : e2400083, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38501844

RESUMO

Temperature is one of the governing factors affecting friction of solids. Undesired high friction state has been generally reported at cryogenic temperatures due to the prohibition of thermally activated processes, following conventional Arrhenius equation. This has brought huge difficulties to lubrication at extremely low temperatures in industry. Here, the study uncovers a hydrogen-correlated sub-Arrhenius friction behavior in hydrogenated amorphous carbon (a-C:H) film at cryogenic temperatures, and a stable ultralow-friction over a wide temperature range (103-348 K) is achieved. This is attributed to hydrogen-transfer-induced mild structural ordering transformation, confirmed by machine-learning-based molecular dynamics simulations. The anomalous sub-Arrhenius temperature dependence of structural ordering transformation rate is well-described by a quantum mechanical tunneling (QMT) modified Arrhenius model, which is correlated with quantum delocalization of hydrogen in tribochemical reactions. This work reveals a hydrogen-correlated friction mechanism overcoming the Arrhenius temperature dependence and provides a new pathway for achieving ultralow friction under cryogenic conditions.

13.
J Sex Res ; : 1-8, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38551371

RESUMO

Sexual aggression (SA) is a significant public health problem, with the majority of SA involving alcohol. The present study examined associations between alcohol expectancies for sexual enhancement, event-level alcohol use, and the likelihood of SA perpetration. Young, adult non-problem drinking men participated in a laboratory session and completed a background survey that included measures of alcohol expectancies. Subsequently, men completed 6-week and 3-month follow-up surveys in which they reported their sexual experiences each day during the intervening 6-week period using Timeline Followback procedures. The analytic sample consisted of the 421 men (Mage = 24.66, SD = 2.69) who reported having sex at least once during the follow-up period. Multilevel models showed a significant alcohol expectancies X alcohol use interaction at the between-person level: Controlling for time and alcohol expectancies for aggression, stronger alcohol expectancies for sexual enhancement were associated with greater SA perpetration likelihood among men who consumed high amounts of alcohol before sexual encounters but not among men who consumed low amounts. Alcohol prevention programs should consider addressing men's alcohol expectancies for sexual enhancement to reduce risk for SA perpetration.

14.
J Stud Alcohol Drugs ; 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38411165

RESUMO

OBJECTIVE: Victims of sexual violence experience detrimental physical and mental health consequences. Therefore, developing programs to prevent sexual violence is of utmost importance. Our previous work provided preliminary support for the efficacy of brief mindfulness and cognitive restructuring (CR) interventions in reducing sexual violence intentions. Because alcohol use and alcohol expectancies (AE) have been identified as risk factors for sexual violence, this secondary data analysis aimed to examine whether alcohol use and men's expectations that alcohol may affect women's vulnerability of being sexually coerced moderate the usefulness of these two interventions on nonconsensual sex intentions. METHOD: Single, young, heterosexual, heavy episodic drinking men with sexual violence histories were randomly assigned to receive mindfulness or CR skills training, or attention control. Half of the participants in each intervention condition were then randomized to alcohol or sober conditions. All participants read a hypothetical sexual scenario and rated their intention to engage in nonconsensual sex with their hypothetical sexual partner. RESULTS: Mindfulness was effective in lowering nonconsensual sex intentions among sober men with high AE for women's vulnerability and intoxicated men with low AE for women's vulnerability to sexual coercion. CR was effective in lowering nonconsensual sex intentions among intoxicated men with low and moderate AE for women's vulnerability to sexual coercion. CONCLUSIONS: Our results provide preliminary evidence for the efficacy of mindfulness and CR in lowering nonconsensual sex intentions under certain circumstances and highlight men's AE about women's vulnerability to sexual coercion as a critical factor that interacts with alcohol use to influence the efficacy of mindfulness and CR.

15.
J Prim Care Community Health ; 15: 21501319241233410, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38400584

RESUMO

We examined healthcare costs at HonorHealth, a community-based academic health center comprised of 5 hospitals and numerous ambulatory care facilities. Patient encounters that resulted in admission in 2019 were included in the study. Mean costs in 2019 for high costs and high needs (HCHN) patients were compared with all remaining patients using a framework developed by the National Academy of Medicine. HCHN patients were older (71 vs 52 years), with a lower percentage of females (41.7% vs 59.8%), more frequently White (90.1% vs 87.5%), less frequently married (52.4% vs 54.5%), with a longer length of stay (6.5 vs 3.0 days) and higher mean charges ($134 743 vs $16 414). The mean cost per patient in the HCHN group decreased by age group ($192, 963, $165 200, $144 584, $134 795, and $108 356) for 0 to 18, 19 to 44, 45 to 64, 65 to 84, and 85+ years, respectively. HCHN patients were more publicly insured (49% vs 38%). Targeted interventions to treat HCHN may lead to lower healthcare costs and improved health outcomes within this system.


Assuntos
Hospitalização , Hospitais Comunitários , Feminino , Humanos , Recém-Nascido , Custos de Cuidados de Saúde , Tempo de Internação
16.
J Pharmacol Exp Ther ; 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38296646

RESUMO

We recently showed that riboflavin is a selected substrate of BCRP over P-gp and demonstrated its prediction performance in preclinical DDI studies. The aim of this study was to investigate the suitability of riboflavin to assess BCRP inhibition in humans. First, we assessed the substrate potential of riboflavin towards other major drug transporters using established transfected cell systems. Riboflavin is a substrate for OAT1, OAT3, and MATE2-K with uptake ratios ranging from 2.69 to 11.6 but riboflavin is not a substrate of OATP1B1, OATP1B3, OCT2, and MATE1. The effects of BMS-986371, a potent in vitro inhibitor of BCRP (IC 50 0.40 µM), on the pharmacokinetics of riboflavin, isobutyryl carnitine, and arginine were then examined in healthy male adults (N = 14 or 16) following oral administration of methotrexate (MTX) (7.5 mg) and enteric coated (EC) sulfasalazine (SSZ) (1,000 mg) alone or in combination with BMS-986371 (150 mg). Oral administration of BMS-986371 increased the AUCs of rosuvastatin and immediate-release (IR) SSZ to 1.38- and 1.51-fold , respectively, and significantly increased AUC(0-4h), AUC(0-24h), and C max of riboflavin by 1.25-, 1.14-, and 1.11-fold (P-values of 0.003, 0.009, and 0.025, respectively) compared to the MTX/SSZ EC alone group. In contrast, BMS-986371 did not significantly influence the AUC(0-24h) and C max values of isobutyryl carnitine and arginine (0.96- to 1.07-fold, respectively; P > 0.05). Overall, these data indicate that plasma riboflavin is a promising biomarker of BCRP that may offer a possibility to assess drug candidate as a BCRP modulator in early drug development. Significance Statement Endogenous compounds that serve as biomarkers for clinical inhibition of BCRP are not currently available. This study provides the initial evidence that riboflavin is a promising BCRP biomarker in humans. For the first time, the value of leveraging the substrate of BCRP with acceptable prediction performance in clinical studies is shown. Additional clinical investigations with known BCRP inhibitors are needed to fully validate and showcase the utility of this biomarker.

17.
J Environ Manage ; 352: 120053, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38211429

RESUMO

The combination of chemical phosphorus (P) inactivation and submerged macrophyte transplantation has been widely used in lake restoration as it yields stronger effects than when applying either method alone. However, the dose effect of chemical materials on P inactivation when used in combination with submerged macrophytes and the influences of the chemicals used on the submerged macrophytes growth remain largely unknown. In this study, we investigated P inactivation in both the water column and the sediment, and the responses of submerged macrophytes to Lanthanum modified bentonite (LMB) in an outdoor mesocosm experiment where Vallisneria denseserrulata were transplanted into all mesocosms and LMB was added at four dosage levels, respectively: control (LMB-free), low dosage (570 g m-2), middle dosage (1140 g m-2), and high dosage (2280 g m-2). The results showed that the combination of LMB dosage and V. denseserrulata reduced TP in the water column by 32%-38% compared to V. denseserrulata alone, while no significant difference was observed among the three LMB treatments. Porewater soluble reactive P, two-dimensional diffusive gradient in thin films (DGT)-labile P concentrations, and P transformation in the 0-1 cm sediment layer exhibited similar trends along the LMB dosage gradient. Besides, LMB inhibited plant growth and reduced the uptake of mineral elements (i.e., calcium, manganese, iron, and magnesium) in a dosage-dependent manner with LMB. LMB may reduce plant growth by creating a P deficiency risk for new ramets and by interfering with the uptake of mineral elements. Considering both the dose effect of LMB on P inactivation and negative effect on macrophyte growth, we suggest a "small dosage, frequent application" method for LMB application to be used in lake restoration aiming to recover submerged macrophytes and clear water conditions.


Assuntos
Fósforo , Poluentes Químicos da Água , Bentonita , Lantânio , Poluentes Químicos da Água/análise , Lagos , Água
18.
Int J Pharm ; 653: 123813, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38272192

RESUMO

Punch sticking during tablet manufacturing is a prevalent issue for many active pharmaceutical ingredients (APIs) encountered by the pharmaceutical industry. Tenofovir amibufenamide fumarate (TMF), a heavyweight drug for the treatment of hepatitis B, was selected as a model drug due to its tendency to punch sticking during tablet compression. In this study, the cause of sticking was explored by investigating crystal habits, excipients and structure characteristics. The difference in sticking of three crystal habits can be visually represented through direct compression experiments on powdered samples and analysis of crystal surfaces. The excipients play a direct role in decreasing the probability of sticking, and the extent of sticking can be assessed by measuring the tensile strength of the tablet. Additionally, the plasticity index was utilized to theoretically analyze the potential enhancements of four excipients. These experimental results indicate that the block-shaped crystals have superior ability of anti-sticking and that suitable excipients can significantly improve the sticking situation of TMF. Ultimately, the phenomenon of punch sticking was additionally examined through computational calculations, focusing on the mechanical characteristics of TMF molecules and intermolecular interactions. The strategy of combining experiments and simulation calculations has broader significance for the study of drug production.


Assuntos
Excipientes , Excipientes/química , Comprimidos/química , Pressão , Resistência à Tração , Tenofovir , Composição de Medicamentos/métodos
20.
J Interpers Violence ; 39(3-4): 910-920, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37650629

RESUMO

Sexual coercion (SC), the use of nonphysical tactics to obtain sexual contact with a nonconsenting partner, is a prevalent form of sexual misconduct that is associated with several physical and psychological health concerns. Therefore, effective preventative interventions to reduce SC prevalence are needed. Alcohol consumption and difficulties in emotion regulation (ER) are two risk factors that contribute to SC. Cognitive restructuring (CR) has the potential to reduce SC intentions by improving ER through actively challenging one's thoughts to modify emotions. This study represents a secondary data analysis to examine the effectiveness of a brief, web-based CR intervention in reducing SC intentions. To test whether the intervention would remain beneficial in the presence of alcohol, we tested effects among intoxicated versus sober participants. Young, male, heavy episodic drinkers with a history of sexual aggression (N = 137) were randomized into a CR intervention versus control condition as well as alcohol consumption versus no alcohol condition. Then, participants completed a sexual aggression analog scenario. General linear regression analyses showed that intoxicated men reported stronger SC intentions than sober men. Additionally, relative to controls, men in the CR condition who had better preexisting ER cognitive reappraisal skills had significantly lower SC intentions. Our findings provide preliminary support for CR as an effective strategy to reduce SC intentions among sexually aggressive, heavy episodic drinking men with better cognitive reappraisal skills. If findings are replicated, this brief, web-based CR intervention could overcome potential challenges in dissemination and be easily applied in clinical settings.


Assuntos
Intoxicação Alcoólica , Regulação Emocional , Humanos , Masculino , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Intoxicação Alcoólica/prevenção & controle , Intoxicação Alcoólica/psicologia , Coerção , Terapia de Reestruturação Cognitiva , Etanol , Intenção , Comportamento Sexual , Adulto Jovem
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