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1.
Eur J Cell Biol ; 103(4): 151451, 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39217678

RESUMO

The microenvironments of urinary systems play crucial roles in the development and metastasis of cancers due to their generation of complex temporal and spatial fluidic profiles. Because of their versatility in creating desired biomimetic flow, cone-and-plate bioreactors offer great potential for bladder cancer research. In this study, we construct a biocompatible cone-and-plate device coupled with a torque sensor, enabling the application and real-time monitoring of stable shear stress up to 50 dyne/cm². Under a stable shear stress stimulation at 12 dyne/cm2, bladder cancer cell BFTC-905 is arrested at the G1 phase with decreased cell proliferation after 24-hour treatment. This effect is associated with increased cyclin-dependent kinase inhibitors p21 and p27, inhibiting cyclin D1/CDK4 complex with dephosphorylation of serine 608 on the retinoblastoma protein. Consequently, an increase in cyclin D3 and decreases in cyclin A2 and cyclin E2 are observed. Moreover, we demonstrate that the shear stress stimulation upregulates the expression of autophagy-related proteins Beclin-1, LC3B-I and LC3B-II, while caspase cleavages are not activated under the same condition. The design of this system and its application shed new light on flow-induced phenomena in the study of urothelial carcinomas.

2.
Virology ; 600: 110211, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39276669

RESUMO

Human Papillomavirus serotype 16 (HPV16) capsid protein (L1) pentamers canonically assemble into T = 7 icosahedral capsids. Such virus-like particles are the basis of the HPV vaccine. We examined assembly of L1 pentamers in response to pH, mild oxidants, and ionic strength and found a mixture of closed, roughly spherical structures from ∼20 to ∼70 nm in diameter, indicating the presence of many kinetically accessible energy minima. Using bulk and single particle techniques we observed that the size distribution changes but does not reach homogeneity. Though heterogenous in size, particles showed uniform responses to low ionic strength dissociation, thermal unfolding, and susceptibility to protease digestion. These assays suggest maturation over time, but at different rates. Cysteine oxidation further stabilized particles at early, but not late, times without changing general characteristics including thermal stability and protease digestion. These data show complex assembly paths to species of different sizes, but with locally similar interactions.

3.
Small ; : e2404573, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39279611

RESUMO

Achieving a narrow emission bandwidth is long pursued for display applications. Among all primary colors, obtaining pure red emission with high visual perception is the most challenging. In this work, CsPbI3 halide perovskite nanoplatelets (NPLs) with rigorously controlled 2D  [PbI6]4- octahedron layer number (n) are demonstrated. A perovskite core-PbSO4 shell structure is designed to prevent aggregation and fusion between NPLs, enabling consistent thickness and quantum confinement strength for each NPL. Consequently, exact n = 4 CsPbI3 NPLs are demonstrated, exhibiting emission peaks around 630 nm, with very narrow spectral bandwidths of <24 nm and high absolute photoluminescence quantum yields up to 85%. The emission of n = 4 NPLs falls exactly within the pure-red region, closely aligning with the International Telecommunication Union Recommendation BT.2020  standard. Measurements suggest predominant stability and color homogeneity compared to traditional red-emitting CsPbIxBr3- x nanocrystals. Finally, proof-of-concept pure-red emissive light-emitting diodes (LEDs) are demonstrated by integrating n = 4 CsPbI3 NPLs films with a blue LED chip, showing an excellent external quantum efficiency of 18.3% and high brightness exceeding 3 × 106 nits. Stringent requirements for future display technologies, are satisfied based on the high color purity, stability, and brightness of CsPbI3 NPLs.

4.
ACS Nano ; 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39270050

RESUMO

Cu-based catalysts are promising candidates for CO2 reduction owing to the favorable energetics of Cu sites for CO2 adsorption and transformation. However, CO2 reduction involving insurmountable activation barriers and various byproducts remains a significant challenge to achieve high activity and selectivity. Herein, a photocatalyst constructed with single-Ru-site-on-Cu-nanoparticle on Bi4Ti3O12 exhibits exceptional activity and selectivity for CO2 conversion to CO. The experimental and theoretical results consistently reveal that the Ru-Cu dual sites allow the rapid transfer of photogenerated carriers for closely interacting with CO2 molecules. Importantly, the Ru-Cu dual sites exhibit extremely strong CO2 adsorption ability, and the Gibbs free energy of the rate-determining step (*CO2 to *COOH) has been significantly reduced, synergistically enhancing the entire CO2 conversion process. The optimal BTOCu2Ru0.5 photocatalyst manifests a high performance for selective reduction of CO2 to CO, yielding 10.84 µmol over 15 mg of photocatalyst in 4 h (180.67 µmol·g-1·h-1) under a 300 W Xe lamp without any photosensitizer and sacrificial reagent, outperforming all bismuth-based materials and being one of the best photocatalysts ever reported under similar reaction conditions. This work presents a strategy for the rational design of multiple metal sites toward efficient photocatalytic reduction of CO2.

5.
Rev Sci Instrum ; 95(9)2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39235296

RESUMO

Disabled people with a high cervical cord injury or quadriplegia face difficulties when controlling a computer. This study presents a digital mouth-controlled mouse-control aid called the bite-press mouth-controlled mouse (BPMCM) to replace the traditional computer mouse. The BPMCM is equipped with a joystick and micro switch, and the disabled person uses neck and head movements to push the joystick and control the cursor position while the three mouse functions (i.e., left-click, right-click, and drag) are activated by bite-pressing for different time intervals. The proposed design eliminates the sip-and-puff technique and the need to recite orders for reduced adaptation time and increased convenience. Furthermore, this design supports plug-and-play and hot plugging in modern mainstream operating systems that can often be directly operated via mouse functions. Experimental results demonstrated that disabled people using a BPMCM were as capable as healthy participants in operating a computer, with both experiments completed within 5 min, and voluntary disabled people immediately adapted to the BPMCM. The proposed design is expected to allow disabled people to operate computers at the same level as healthy participants. The BPMCM also required only half the physical exertion of other mouth-controlled mouse-control aids that require orders to be recited.


Assuntos
Pessoas com Deficiência , Desenho de Equipamento , Boca , Quadriplegia , Quadriplegia/fisiopatologia , Humanos , Masculino , Adulto , Feminino
6.
J Chin Med Assoc ; 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39285524

RESUMO

BACKGROUND: Limited knowledge exists regarding the interrelations between sleep quality and resilience within the demographic of healthy, community-residing middle-aged and older adults, with a particular dearth of information regarding sex-specific associations. This study aimed to examine the sex-specific associations between sleep quality, resilience, and biomarkers in community-dwelling middle-aged and older adults. METHODS: This cross-sectional study was conducted using data from the 2022 Gan-Dau Healthy Longevity Plan survey initiated by the locality-based community hospital, Taipei Municipal Gan-Dau Hospital (TMGDH). A total of 770 participants (240 men, 530 women) who met the inclusion criteria were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while resilience was measured using the Brief Resilience Scale (BRS). Patient demographic data, including age, education, marital status, and depression level, were also collected. The sex-specific associations between sleep quality and resilience were first examined using multivariate generalized linear models (GLMs). In addition, the associations between sleep quality, resilience, and selected biomarkers were examined using multivariate GLMs. RESULTS: Approximately 55% of men and 60% of women reported poor sleep quality. Individuals with good sleep quality had significantly lower levels of depressive symptoms (p=0.028 for men, p<0.001 for women) and fewer chronic conditions (p=0.0015 for men, p<0.001 for women). Notably, women in the "poor sleep quality" group exhibited higher proportions of low habitual sleep efficiency (35.9%) and frequent use of sleeping medications (23.2%), whereas the proportions were lower in men in the "poor sleep quality" group (29.8% and 9.9%, respectively). Good sleep quality was associated with better resilience in both men (mean BRS score: good sleep quality=25.1 [standard deviation (SD) 4.3] vs. poor sleep quality=23.4 [SD 4.7], p=0.044) and women (mean BRS score: good sleep quality=24.3 [SD 5.1] vs. poor sleep quality=22.3 [SD 5.4], p<0.001). After adjusting for depressive symptoms and chronic conditions, this association remained significant for men (p=0.022) and women (p=0.001). In addition, greater depressive symptoms were associated with poorer resilience in both sexes (p<0.001). No significant associations were noted between sleep quality or resilience and the selected biomarkers. CONCLUSION: This study highlights the association between sleep quality and resilience in older adults. Good sleep quality is related to better resilience, but greater depressive symptoms are also linked to poorer resilience in both sexes. Nevertheless, the low habitual sleep efficiency and frequent use of sleeping medications in women but not men with poor sleep quality highlight the need to explore sex-specific approaches to address the interplay of sleep quality, resilience and other demographic factors (such as depressive symptoms) in healthy aging.

7.
BMC Urol ; 24(1): 202, 2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-39277711

RESUMO

Objective To analyzed the safety and efficacy of percutaneous nephrolithotomy (PCNL) in lateral decubitus position and prone position for upper ureteral calculi. Methods Databases including PubMed, Springer, ScienceDirect, Wiley Online Library, CNKI, CSPD and VIP were searched for clinical controlled studies involved with lateral decubitus position and prone position PCNL from their establishment to November 2023.Studies were enrolled according to inclusion and exclusion criteria. the dates were compared by Review Manager 5.4 software. Results seven studies were eligible, including 807 cases. The Meta-analysis showed that, blood loss and perioperative complication rate of lateral decubitus position PCNL group were significantly different from those of the prone position PCNL group (P < 0.05). There was no significant difference between the two groups regarding hospital time, operative time, channel establishment time and stone-free rate (P>0.05).Conclusions The lateral decubitus position can reduce blood loss and perioperative complication rate. The lateral decubitus position PCNL is safe and effective for upper ureteral calculi which was deserved clinical popularizing use.


Assuntos
Nefrolitotomia Percutânea , Posicionamento do Paciente , Cálculos Ureterais , Humanos , Nefrolitotomia Percutânea/efeitos adversos , Nefrolitotomia Percutânea/métodos , Posicionamento do Paciente/efeitos adversos , Posicionamento do Paciente/métodos , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Decúbito Ventral , Resultado do Tratamento , Cálculos Ureterais/cirurgia
9.
J Nutr Biochem ; 134: 109737, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39147244

RESUMO

This study aimed to identify metabolic alterations in the small intestine of newborn rats with intrauterine growth restriction (IUGR), a condition linked to intestinal dysfunction. Pregnant Sprague Dawley rats underwent bilateral uterine artery ligation on gestational day 17 to induce intrauterine growth restriction or sham surgery. Rat pups were delivered spontaneously on gestational day 22. Small intestine tissues were collected on postnatal days 0 and 7 from offspring. Liquid chromatography-mass spectrometry analysis was performed to investigate untargeted metabolomic profiles. Western blot analysis assessed protein expression of key regulators. Newborn rats with intrauterine growth restriction exhibited distinct small intestine metabolic profiles compared to controls on postnatal day 0. Notably, significant alterations were observed in purine metabolism, the pentose phosphate pathway, and related pathways. Western blot analysis revealed a decrease expression in transketolase, a key enzyme of the pentose phosphate pathway, suggesting impaired activity of the pentose phosphate pathway. Additionally, decreased expression of tight junction proteins ZO-1 and occludin indicated compromised intestinal barrier function in rats with intrauterine growth restriction. Similar metabolic disruptions persisted on postnatal day 7, with further reductions in tricarboxylic acid cycle intermediates and folate biosynthesis precursors. Interestingly, lysyl-glycine, a protein synthesis marker, was elevated in rats with intrauterine growth restriction. Our findings reveal a distinct metabolic signature in the small intestine of neonatal rats with intrauterine growth restriction, characterized by disruptions in the pentose phosphate pathway, purine metabolism, and energy production pathways. These novel insights suggest potential mechanisms underlying IUGR-associated intestinal dysfunction and impaired growth.

10.
Phytomedicine ; 133: 155904, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39151265

RESUMO

BACKGROUND: Panax ginseng C. A. Mey is a precious medicinal resource that could be used to treat a variety of diseases. Saponins are the most important bioactive components of, and rare ginsenosides (Rg3, Rh2, Rk1 and Rg5, etc.) refer to the chemical structure changes of primary ginsenosides through dehydration and desugarization reactions, to obtain triterpenoids that are easier to be absorbed by the human body and have higher activity. PURPOSE: At present, the research of P. ginseng. is widely focused on anticancer related aspects, and there are few studies on the antibacterial and skin protection effects of rare ginsenosides. This review summarizes the rare ginsenosides related to bacterial inhibition and skin protection and provides a new direction for P. ginseng research. METHODS: PubMed and Web of Science were searched for English-language studies on P. ginseng published between January 2002 and March 2024. Selected manuscripts were evaluated manually for additional relevant references. This review includes basic scientific articles and related studies such as prospective and retrospective cohort studies. CONCLUSION: This paper summarizes the latest research progress of several rare ginsenosides, discusses the antibacterial effect of rare ginsenosides, and finds that ginsenosides can effectively protect the skin and promote wound healing during use, so as to play an efficient antibacterial effect, and further explore the other medicinal value of ginseng. It is expected that this review will provide a wider understanding and new ideas for further research and development of P. ginseng drugs.


Assuntos
Ginsenosídeos , Panax , Ginsenosídeos/farmacologia , Ginsenosídeos/química , Panax/química , Humanos , Antibacterianos/farmacologia , Antibacterianos/química , Animais
11.
Cell Biosci ; 14(1): 106, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39180059

RESUMO

BACKGROUND: The impact of acrylamide (ACR) on learning and memory has garnered considerable attention. However, the targets and mechanisms are still unclear. RESULTS: Elongation factor 2 (eEF2) was significantly upregulated in the results of serum proteomics. Results from in vitro and in vivo experiments indicated a notable upregulation of Eukaryotic elongation factor 2 kinase (eEF2K), the sole kinase responsible for eEF2 phosphorylation, following exposure to ACR (P < 0.05). Subsequent in vitro experiments using eEF2K siRNA and in vivo experiments with eEF2K-knockout mice demonstrated significant improvements in abnormal indicators related to ACR-induced learning and memory deficits (P < 0.05). Proteomic analysis of the hippocampus revealed Lpcat1 as a crucial downstream protein regulated by eEF2K. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses indicated that eEF2K may play a role in the process of ACR-induced learning and memory impairment by affecting ether lipid metabolism. CONCLUSIONS: In summary, eEF2K as a pivotal treatment target in the mechanisms underlying ACR-induced learning and memory impairment, and studies have shown that it provides robust evidence for potential clinical interventions targeting ACR-induced impairments.

12.
Nat Commun ; 15(1): 7241, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39174557

RESUMO

Type 2 alveolar epithelial (AT2) cells of the lung are fundamental in regulating alveolar inflammation in response to injury. Impaired mitochondrial long-chain fatty acid ß-oxidation (mtLCFAO) in AT2 cells is assumed to aggravate alveolar inflammation in acute lung injury (ALI), yet the importance of mtLCFAO to AT2 cell function needs to be defined. Here we show that expression of carnitine palmitoyltransferase 1a (CPT1a), a mtLCFAO rate limiting enzyme, in AT2 cells is significantly decreased in acute respiratory distress syndrome (ARDS). In mice, Cpt1a deletion in AT2 cells impairs mtLCFAO without reducing ATP production and alters surfactant phospholipid abundance in the alveoli. Impairing mtLCFAO in AT2 cells via deleting either Cpt1a or Acadl (acyl-CoA dehydrogenase long chain) restricts alveolar inflammation in ALI by hindering the production of the neutrophilic chemokine CXCL2 from AT2 cells. This study thus highlights mtLCFAO as immunometabolism to injury in AT2 cells and suggests impaired mtLCFAO in AT2 cells as an anti-inflammatory response in ARDS.


Assuntos
Lesão Pulmonar Aguda , Células Epiteliais Alveolares , Carnitina O-Palmitoiltransferase , Ácidos Graxos , Mitocôndrias , Oxirredução , Síndrome do Desconforto Respiratório , Animais , Carnitina O-Palmitoiltransferase/metabolismo , Carnitina O-Palmitoiltransferase/genética , Mitocôndrias/metabolismo , Células Epiteliais Alveolares/metabolismo , Ácidos Graxos/metabolismo , Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/patologia , Lesão Pulmonar Aguda/imunologia , Lesão Pulmonar Aguda/genética , Camundongos , Síndrome do Desconforto Respiratório/metabolismo , Síndrome do Desconforto Respiratório/imunologia , Síndrome do Desconforto Respiratório/patologia , Síndrome do Desconforto Respiratório/genética , Masculino , Humanos , Quimiocina CXCL2/metabolismo , Quimiocina CXCL2/genética , Camundongos Endogâmicos C57BL , Neutrófilos/imunologia , Neutrófilos/metabolismo , Camundongos Knockout , Acil-CoA Desidrogenase de Cadeia Longa/metabolismo , Acil-CoA Desidrogenase de Cadeia Longa/genética , Inflamação/metabolismo , Inflamação/patologia , Alvéolos Pulmonares/metabolismo , Alvéolos Pulmonares/patologia , Alvéolos Pulmonares/imunologia , Trifosfato de Adenosina/metabolismo , Pneumonia/metabolismo , Pneumonia/imunologia , Pneumonia/patologia , Pneumonia/genética
14.
Nanotechnology ; 35(44)2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39094606

RESUMO

Cesium lead bromide (CsPbBr3) perovskite nanocrystals are becoming a popular alternative to chalcogenide quantum dots because of their bright green fluorescence and high color purity. However, owing to the poor stability caused by their highly ionic nature and the dynamic binding of long-chain capping ligands, their practical applications are limited. Although (3-aminopropyl)triethoxysilane (APTES) is a frequently used insulating material for wrapping CsPbBr3nanocrystals, it often causes surface etching. To address this issue, we introduced oleic acid into the anti-solvent toluene to inhibit the etching effect of APTES using a modified room-temperature ligand-assisted reprecipitation process. We utilized in situ time-dependent photoluminescence measurements to study the formation kinetics of CsPbBr3nanocrystals and determine the optimal ligands ratio. This innovative approach enables precise control over CsPbBr3@SiO2nanoparticles synthesis, yielding uniformly shaped nanocrystals with a silica shell, a consistent size around 10.17 ± 1.6 nm, and enhanced photoluminescence quantum yields ranging from 90% and 100%. The photoluminescence lifetimes of our CsPbBr3@SiO2nanoparticles were significantly prolonged owing to a reduction in non-radiative recombination. This boosts their stability in thermal and polar solvent environments, making them superior candidates for use in photonic devices.

15.
J Formos Med Assoc ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39013749

RESUMO

BACKGROUND: Secondary pneumonia has a significant clinical impact on critically ill patients with COVID-19. AIM: Considering potential geographic variations, this study explores the clinical implications of secondary pneumonia within East Asian populations. METHODS: This multicenter, retrospective cohort study enrolled critical COVID-19 patients requiring intensive care units (ICUs) admission in Taiwan from December 31, 2020, to June 1, 2022. FINDINGS: Among the 187 critical COVID-19 patients, 80 (42.8%) developed secondary pneumonia. The primary causative pathogens were gram-negative bacilli (GNB) (76.8%). Gram-positive cocci and fungi were mainly observed during the initial two weeks of ICU stay. Notably, the incidence of pulmonary aspergillosis was 9.2% during the first week of ICU stay and all Staphylococcus aureus were susceptible to methicillin. Multi-drug resistant organisms (MDROs) were responsible for 28.3% of the cases, exhibiting significantly longer ICU stays compared to the non-MDRO group (median, 27 vs. 14 days, P < 0.001). In the multivariate analysis, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were associated with a significantly increased risk of secondary pneumonia. In-hospital mortality was significantly higher in patients with secondary pneumonia than in those without (37.7% vs. 16.7%, P = 0.02) and survival analysis demonstrated gram-negative bacilli-related secondary pneumonia contributed to a worse prognosis. CONCLUSIONS: Secondary pneumonia in critical COVID-19 patients significantly raised in-hospital mortality and extended hospital and ICU stays. Moreover, the presence of GNB notably predicted an unfavorable prognosis.

16.
Mil Med Res ; 11(1): 46, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992778

RESUMO

BACKGROUND: Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke characterized by high mortality and low rates of full recovery. This study aimed to investigate the epidemiological characteristics of SAH between 1990 and 2021. METHODS: Data on SAH incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021 were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage changes (EAPCs) were calculated to evaluate changes in the age-standardized rate (ASR) of incidence and mortality, as well as trends in SAH burden. The relationship between disease burden and sociodemographic index (SDI) was also analyzed. RESULTS: In 2021, the incidence of SAH was found to be 37.09% higher than that in 1990; however, the age-standardized incidence rates (ASIRs) showed a decreased [EAPC: -1.52; 95% uncertainty interval (UI) -1.66 to -1.37]. Furthermore, both the number and rates of deaths and DALYs decreased over time. It was observed that females had lower rates compared to males. Among all regions, the high-income Asia Pacific region exhibited the highest ASIR (14.09/100,000; 95% UI 12.30/100,000 - 16.39/100,000) in 2021, with an EPAC for ASIR < 0 indicating decreasing trend over time for SAH ASIR. Oceania recorded the highest age-standardized mortality rates (ASMRs) and age-standardized DALYs rates among all regions in 2021 at values of respectively 8.61 (95% UI 6.03 - 11.95) and 285.62 (95% UI 209.42 - 379.65). The burden associated with SAH primarily affected individuals aged between 50 - 69 years old. Metabolic risks particularly elevated systolic blood pressure were identified as the main risk factors contributing towards increased disease burden associated with SAH when compared against environmental or occupational behavioral risks evaluated within the GBD framework. CONCLUSIONS: The burden of SAH varies by gender, age group, and geographical region. Although the ASRs have shown a decline over time, the burden of SAH remains significant, especially in regions with middle and low-middle SDI levels. High systolic blood pressure stands out as a key risk factor for SAH. More specific supportive measures are necessary to alleviate the global burden of SAH.


Assuntos
Carga Global da Doença , Hemorragia Subaracnóidea , Humanos , Hemorragia Subaracnóidea/epidemiologia , Masculino , Feminino , Incidência , Pessoa de Meia-Idade , Idoso , Adulto , Carga Global da Doença/tendências , Anos de Vida Ajustados por Deficiência/tendências , Saúde Global/estatística & dados numéricos , Idoso de 80 Anos ou mais
18.
Clin Nurs Res ; 33(6): 460-469, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39076023

RESUMO

This study aims to use patient feature and catheterization technology feature variables to train the corresponding machine learning (ML) models to predict peripherally inserted central catheters-deep vein thrombosis (PICCs-DVT) and analyze the importance of the two types of features to PICCs-DVT from the aspect of "input-output" correlation. To comprehensively and systematically summarize the variables used to describe patient features and catheterization technical features, this study combined 18 literature involving the two types of features in predicting PICCs-DVT. A total of 21 variables used to describe the two types of features were summarized, and feature values were extracted from the data of 1,065 PICCs patients from January 1, 2021 to August 31, 2022, to construct a data sample set. Then, 70% of the sample set is used for model training and hyperparameter optimization, and 30% of the sample set is used for PICCs-DVT prediction and feature importance analysis of three common ML classification models (i.e. support vector classifier [SVC], random forest [RF], and artificial neural network [ANN]). In terms of prediction performance, this study selected four metrics to evaluate the prediction performance of the model: precision (P), recall (R), accuracy (ACC), and area under the curve (AUC). In terms of feature importance analysis, this study chooses a single feature analysis method based on the "input-output" sensitivity principle-Permutation Importance. For the mean model performance, the three ML models on the test set are P = 0.92, R = 0.95, ACC = 0.88, and AUC = 0.81. Specifically, the RF model is P = 0.95, R = 0.96, ACC = 0.92, AUC = 0.86; the ANN model is P = 0.92, R = 0.95, ACC = 0.88, AUC = 0.81; the SVC model is P = 0.88, R = 0.94, ACC = 0.85, AUC = 0.77. For feature importance analysis, Catheter-to-vein rate (RF: 91.55%, ANN: 82.25%, SVC: 87.71%), Zubrod-ECOG-WHO score (RF: 66.35%, ANN: 82.25%, SVC: 44.35%), and insertion attempt (RF: 44.35%, ANN: 37.65%, SVC: 65.80%) all occupy the top three in the ML models prediction task of PICCs-DVT, showing relatively consistent ranking results. The ML models show good performance in predicting PICCs-DVT and reveal a relatively consistent ranking of feature importance from the data. The important features revealed might help clinical medical staff to better understand and analyze the formation mechanism of PICCs-DVT from a data-driven perspective.


Assuntos
Cateterismo Periférico , Aprendizado de Máquina , Trombose Venosa , Humanos , Cateterismo Periférico/efeitos adversos , Cateterismo Venoso Central/efeitos adversos , Redes Neurais de Computação
19.
Telemed J E Health ; 30(9): 2477-2482, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38934135

RESUMO

Background: Blurry images in teledermatology and consultation increased the diagnostic difficulty for both deep learning models and physicians. We aim to determine the extent of restoration in diagnostic accuracy after blurry images are deblurred by deep learning models. Methods: We used 19,191 skin images from a public skin image dataset that includes 23 skin disease categories, 54 skin images from a public dataset of blurry skin images, and 53 blurry dermatology consultation photos in a medical center to compare the diagnosis accuracy of trained diagnostic deep learning models and subjective sharpness between blurry and deblurred images. We evaluated five different deblurring models, including models for motion blur, Gaussian blur, Bokeh blur, mixed slight blur, and mixed strong blur. Main Outcomes and Measures: Diagnostic accuracy was measured as sensitivity and precision of correct model prediction of the skin disease category. Sharpness rating was performed by board-certified dermatologists on a 4-point scale, with 4 being the highest image clarity. Results: The sensitivity of diagnostic models dropped 0.15 and 0.22 on slightly and strongly blurred images, respectively, and deblurring models restored 0.14 and 0.17 for each group. The sharpness ratings perceived by dermatologists improved from 1.87 to 2.51 after deblurring. Activation maps showed the focus of diagnostic models was compromised by the blurriness but was restored after deblurring. Conclusions: Deep learning models can restore the diagnostic accuracy of diagnostic models for blurry images and increase image sharpness perceived by dermatologists. The model can be incorporated into teledermatology to help the diagnosis of blurry images.


Assuntos
Aprendizado Profundo , Dermatologia , Dermatopatias , Telemedicina , Humanos , Dermatopatias/diagnóstico , Dermatopatias/diagnóstico por imagem , Dermatologia/métodos , Fotografação
20.
Neurologist ; 29(5): 265-274, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38853723

RESUMO

OBJECTIVES: In this study, we investigated the difference in risk factors between the 2 diseases, aiming to further clarify who needs to do ischemic cerebrovascular disease (ICVD)-related screening among coronary artery disease (CAD) patients. METHODS: Clinical data of 326 patients with first-episode CAD from June 1, 2017, to July 31, 2020, in the Chinese PLA General Hospital were retrospectively reviewed. Outcomes, including clinical features and laboratory examination, were taken. Features related to ICVD including the extension of intracranial arterial (internal carotid artery intracranial segment, middle cerebral artery M1 segment, anterior cerebral A1 segment, vertebrobasilar artery intracranial segment, posterior cerebral artery P1 segment) and carotid arterial (internal carotid artery extracranial segment, common carotid artery, subclavian artery) stenosis were detected. Risk factors for the occurrence of ICVD in patients with CAD were analyzed. RESULTS: Among patients with the onset of CAD, in comparison of the nonstenosis and stenosis of intracranial artery subgroups, there were statistical differences in the onset age, hypertension, and duration of hypertension as well as the biochemical indicators, including high-density lipoprotein and glycosylated hemoglobin. In addition, statistical differences were detected in the onset age as well as the biochemical indicators, including glycosylated hemoglobin and blood glucose serum protein, along with the difference in the degree of cardiovascular stenosis. CONCLUSIONS: The onset age of CAD was shown to serve as a vital risk factor for ICVD. The primary prevention of ICVD in patients with CAD should lay more emphasis on the management of hypertension and diabetes.


Assuntos
Doença da Artéria Coronariana , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fatores de Risco , Idoso , Estudos Retrospectivos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/etiologia , Constrição Patológica , Adulto , Hipertensão/complicações , Idade de Início
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