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BACKGROUND: To investigate the correlation between maternal glucose and lipid metabolism indexes and blood-lipid ratio in the first trimester and large-for- gestational-age (LGA) infants. METHODS: Women in the first trimester of pregnancy who underwent regular obstetric examination in the obstetric outpatient department of the Affiliated Hospital of Chengde Medical College from June 2018 to March 2019 were included according to the standard. Basic information were collected based on questionnaires at the first visit of pregnant women, including early fasting blood glucose (FBG), fasting insulin (FINS), glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC), apolipoprotein A1 (APO-A1), apolipoprotein B (APO-B), lipoprotein a (LP(a)), LDL/HDL, TG/HDL, TC/HDL, APO-B/APO-A1 ratio, birth weight of newborns, gestational age at delivery etc. RESULTS: A total of 418 cases were included for analysis. The incidence rate of LGA infants was 13.88%, and that of small-for-gestational-age (SGA) infants was 4.78%. Univariate analysis revealed that the age, pre-pregnancy body mass index (BMI), weight gain during pregnancy, APO-B/APO-A1 between LGA group and appropriate-for-gestational-age (AGA) group were significantly different (P < 0.05); multivariate stepwise logistic regression analysis indicated that the correlation between maternal age, pre-pregnancy BMI, weight gain during pregnancy, APO-B/APO-A1 level and LGA were statistically significant (P < 0.05); compared with the reference range of APO-B/APO-A1 of 0.46-0.65, values < 0.46 and > 0.65 were protective factor of LGA (P < 0.05). The receiver operating curve(ROC) indicated that the area under the curve (AUC)s for predicting LGA using maternal age, pre-pregnancy BMI, weight gain during pregnancy, and early pregnancy APO-B/APO-A1 were 0.585, 0.606, 0.637, 0.531, respectively. The AUC for a combined prediction model was 0.742, showing greater predictive value than any other factors individually. CONCLUSION: Maternal age, pre-pregnancy BMI, weight gain during pregnancy, and APO-B/APO-A1 levels in first trimester are significant factors influencing the occurrence of LGA infants, and the combination of the four factors would have certain predictive value for LGA.
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Recém-Nascido Grande para a Idade Gestacional , Lipídeos , Humanos , Feminino , Recém-Nascido , Gravidez , Peso ao Nascer , Primeiro Trimestre da Gravidez , Triglicerídeos , Idade Gestacional , Lipoproteínas HDL , Aumento de Peso , Índice de Massa CorporalRESUMO
The optimal dosing regimen for meropenem in critically ill patients undergoing continuous renal replacement therapy (CRRT) remains undefined due to small studied sample sizes and uninformative pharmacokinetic (PK)/pharmacodynamic (PD) analyses in reported studies. The present study aimed to perform a population PK/PD meta-analysis of meropenem using available literature data to suggest the optimal treatment regimen. A total of 501 meropenem concentration measurements from 78 adult CRRT patients pooled from nine published studies were used to develop the population PK model for meropenem. PK/PD target (40% and 100% of the time with the unbound drug plasma concentration above the MIC) marker-based efficacy and risk of toxicity (trough concentrations of >45 mg/L) for short-term (30 min), prolonged (3 h), and continuous (24 h) infusion dosing strategies for meropenem were investigated. The impact of CRRT dose and identified covariates on the PD probability of target attainment (PTA) and predicted toxicity was also examined. Meropenem concentration data were adequately described by a two-compartment model with linear elimination. Trauma was identified as a pronounced modifier for endogenous clearance of meropenem. Simulations demonstrated that adequate PK/PD targets and low risk of toxicity could be achieved in non-trauma CRRT patients receiving meropenem regimens of 1 g every 6 h infused over 30 min, 1 g every 8 h infused over 3 h, and 2 to 4 g every 24 h infused over 24 h. The impact of CRRT dose (25 to 50 mL/kg/h) on PTA was clinically irrelevant, and continuous infusion of 3 to 4 g every 24 h was suitable for trauma CRRT patients (MICs of ≤0.5 mg/L). A population PK model was developed for meropenem in CRRT patients, and different dosing regimens were proposed for non-trauma and trauma CRRT patients.
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Terapia de Substituição Renal Contínua , Estado Terminal , Adulto , Antibacterianos/farmacologia , Estado Terminal/terapia , Humanos , Meropeném/farmacocinética , Testes de Sensibilidade Microbiana , Estudos Prospectivos , Terapia de Substituição RenalRESUMO
Temperature-sensing media based on the fluorescence intensity ratio (FIR) of upconversion materials that suffer from low sensitivity owing to the small energy gap still have a need for new compounds with strong upconversion luminescence (UCL). In this work, a series of MSc2O4:Er3+/Yb3+ (M = Mg, Ca, Sr, and Ba) nanocrystals were prepared by a hydrothermal method using NaOH alkaline solution. The structure, morphology, and UCL characteristics of materials were investigated, and the red UCL of the CaSc2O4:Er3+/Yb3+ sample was dramatically enhanced by a factor of â¼12, â¼23, and â¼2000 compared with SrSc2O4, MgSc2O4, and BaSc2O4 samples, respectively. By adjusting alkali ions (Li+, Na+, K+), the UCL intensities of CaSc2O4:Er3+/Yb3+ and SrSc2O4:Er3+/Yb3+ samples were further improved, especially in the presence of Li+ ions. Excellent temperature-sensing behaviors are realized for CaSc2O4:Er3+/Yb3+ and SrSc2O4:Er3+/Yb3+ samples in the presence of Li+ ions, in which the maximum absolute sensitivity SA values are about 0.0041 and 0.0036 K-1 at 600 K and the corresponding relative sensitivity SR values are expressed as 1197/T2 and 1129/T2 (the current optimal SR = 1289/T2), respectively. The intense UCL and excellent SA and SR values indicate that CaSc2O4:Er3+/Yb3+ and SrSc2O4:Er3+/Yb3+ materials are promising candidates for application in high-temperature sensors working under 980 nm excitation.
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OBJECTIVES: Extended-interval dosing of tobramycin is widely applied in patients with the Hartford nomogram as a representative, while this dosing approach has not been extensively evaluated in critically ill patients. The goal of this study was to characterize the pharmacokinetics of tobramycin and to evaluate the appropriateness of the Hartford nomogram in critically ill patients. METHODS: A retrospective analysis was performed based on a medical critical care database. The extracted concentration data of tobramycin were used for the construction of the population pharmacokinetic model using a non-linear mixed-effects modelling approach. Real-world data-based simulations were conducted to evaluate the pharmacodynamic target attainment (Cmax/MIC ≥10) and safety (concentration <0.5 mg/L for at least 4 h) of the Hartford nomogram. RESULTS: A population pharmacokinetic model was built based on 307 measurements in 140 unique patients and externally validated by an independent study dataset. A two-compartment model was optimal for the structure model and creatinine clearance remained as the only covariate in the final model correlating to the clearance of tobramycin. Simulations indicated that the Hartford nomogram is effective for infections due to pathogens with an MIC of ≤1 mg/L, but not with an MIC of 2 mg/L. The percentage of patients who reached the non-toxicity target was quite low under the Hartford nomogram and a further extension of the dosing interval was necessary to minimize the toxicity. CONCLUSIONS: The Hartford nomogram was not suitable for critically ill patients with pathogen MICs of 2 mg/L and drug monitoring is required to manage efficacy and toxicity.
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Estado Terminal , Tobramicina , Antibacterianos/uso terapêutico , Humanos , Nomogramas , Estudos RetrospectivosRESUMO
Appropriate antibiotic dosing to ensure early and sufficient target attainment is crucial for improving clinical outcome in critically ill patients. Parametric survival analysis is a preferred modeling method to quantify time-varying antibiotic exposure - response effects, whereas bias may be introduced in hazard functions and survival functions when competing events occur. This study investigated predictors of in-hospital mortality in critically ill patients treated with meropenem by pharmacometric multistate modeling. A multistate model comprising five states (ongoing meropenem treatment, other antibiotic treatment, antibiotic treatment termination, discharge, and death) was developed to capture the transitions in a cohort of 577 critically ill patients treated with meropenem. Various factors were investigated as potential predictors of the transitions, including patient demographics, creatinine clearance calculated by Cockcroft-Gault equation (CLCRCG ), time that unbound concentrations exceed the minimum inhibitory concentration (fT>MIC ), and microbiology-related measures. The probabilities to transit to other states from ongoing meropenem treatment increased over time. A 10 mL/min decrease in CLCRCG was found to elevate the hazard of transitioning from states of ongoing meropenem treatment and antibiotic treatment termination to the death state by 18%. The attainment of 100% fT>MIC significantly increased the transition rate from ongoing meropenem treatment to antibiotic treatment termination (by 9.7%), and was associated with improved survival outcome. The multistate model prospectively assessed predictors of death and can serve as a useful tool for survival analysis in different infection scenarios, particularly when competing risks are present.
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Antibacterianos , Estado Terminal , Humanos , Meropeném/farmacologia , Estado Terminal/terapia , Testes de Sensibilidade MicrobianaRESUMO
In this work, a novel boehmite-modified carbon adsorbent (BMCC) derived from moldy corn was used for simultaneous removal of P and bisphenol A (BPA) from livestock wastewater. The results showed that BMCC had a high specific surface area (308.82 m2/g) with boehmite nanoparticles anchored on its surface. BMCC showed high P and BPA decontamination capabilities (40.98 mg/g for P and 54.65 mg/g for BPA by Langmuir model). The adsorbed amount of P declined as pH increased from 4 to 10, while the adsorbed amount of BPA remained steady until pH increased to 10. After 6 cycles of BMCC use, the P and BPA adsorption efficiencies reduced by 21.75 % and 19.41 %, respectively. The adsorption of P was dominated by electrostatic attraction and complexation, while the adsorption of BPA was controlled by hydrogen bonding, electrostatic interaction, and π-π association. In conclusion, BMCC is an effective treatment for decontaminating P- and BPA-contaminated livestock wastewater.
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Hidróxido de Alumínio , Óxido de Alumínio , Carbono , Fenóis , Poluentes Químicos da Água , Animais , Águas Residuárias , Gado , Fósforo , Descontaminação , Cinética , Compostos Benzidrílicos , Adsorção , Concentração de Íons de HidrogênioRESUMO
OBJECTIVES: Competing risk models were used in this study. The purpose of this study was to assess the predictive usefulness of lymph node characteristics in elderly patients with stage III serous ovarian cancer. METHODS: We conducted a retrospective analysis on 148,598 patients from 2010 to 2016 using the surveillance, epidemiology, and end results database. Lymph node characteristics were collected and examined, including the number of lymph nodes retrieved the number of lymph nodes examined (ELN) and the number of positive lymph nodes (PN). Using competing risk models, we evaluated the connection between these variables and overall survival (OS) and disease-specific survival (DSS). RESULTS: This study included a total of 3457 ovarian cancer patients. Multivariate analysis using the COX proportional hazards model found that ELN>22 was an independent predictive factor for both OS (hazard ratio [HR] [95% CI]=0.688 [0.553 to 0.856], P <0.05) and DSS (HR [95% CI]=0.65 [0.512 to 0.826], P <0.001), PN>8 was identified as a significant risk factor for both OS (HR [95% CI]=0.908 [0.688 to 1.199], P =0.497) and DSS (HR [95% CI]=0.926 [0.684 to 1.254], P =0.62). Subsequently, using the competing risk model, ELN>22 was found to be an independent protective factor for DSS (HR [95% CI]=0.738 [0.574 to 0.949], P =0.018), while PN>8 was identified as a risk factor for DSS (HR [95% CI]=0.999 [0.731 to 1.366], P =1). CONCLUSIONS: Our findings demonstrate the robustness of the competing risk model to evaluate the results of the COX proportional hazards model analysis.
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Linfonodos , Neoplasias Ovarianas , Humanos , Feminino , Idoso , Prognóstico , Estudos Retrospectivos , Estadiamento de Neoplasias , Linfonodos/patologia , Carcinoma Epitelial do Ovário/patologiaRESUMO
Appropriate antibiotic dosing in critically ill patients requires concentration monitoring due to the occurrence of pathophysiological changes and frequent extracorporeal therapy that could significantly alter the normal pharmacokinetics of drugs. Herein, we describe an ultra-performance liquid chromatography with photodiode array (UPLC-PDA) for the simultaneous concentration determination of seven frequently used antibiotics (meropenem, cefotaxime, cefoperazone, piperacillin, linezolid, moxifloxacin, and tigecycline) in plasma from critically ill patients. The analytes were extracted from 200 µL human plasma by the addition of methanol for protein precipitation. The chromatographic separation was achieved using an ACQUITY UPLC HSS T3 column (2.1 × 50 mm, 1.8 µm) with a water (containing 0.1% trifluoroacetic acid)/acetonitrile linear gradient at a flow rate of 0.5 mL/min in a 4.5 min turn-around time. PDA detection wavelength was set individually for the analytes. The method was fully validated according to the European Medicines Agency (EMA) guideline. The lower limits of quantification for the analytes were between 0.05 and 0.8 µg/mL. The method is accurate (intra/inter-assay bias -8.4 to +12.4%) and precise (intra/inter-assay coefficient of variations 0.9-10.1%) over the clinically relevant plasma concentration ranges (upper limits of quantification 5-400 µg/mL). The applicability of the method has been successfully demonstrated by analyzing plasma samples collected from critically ill patients undergoing continuous renal replacement therapy.
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Antibacterianos , Preparações Farmacêuticas , Cromatografia Líquida de Alta Pressão , Cromatografia Líquida , Humanos , Reprodutibilidade dos Testes , Espectrometria de Massas em TandemRESUMO
The performance, mechanisms, and effects of various coexisting ions on phosphorus (P) adsorptive capture in biogas slurry using MgO-doped biochar (MBC) were investigated. The results revealed that in comparison to the pristine biochar, the introduction of MgO significantly improved the P adsorptive capture feasibility of MBC. In addition, the process of P capture by MBC was not affected by the initial pH of the solution. The process of P capture could reach equilibrium within 120 min and be simulated using both the pseudo-first-order and the pseudo-second-order kinetic models. In addition, the highest P capture capacity calculated from the Langmuir isotherm model was approximately 129.35 mg/g. The coexisting of cations including NH4+, Ca2+, Cu2+, Cd2+, Pb2+, Zn2+, and Cr3+ in higher concentrations of promoted P adsorptive capture through precipitation and ionic atmosphere effects. The presence of coexisting ions including SO42-, HCO3-, and fulvic acid (FA) had a certain inhibitory effect on the P adsorptive capture through competitive adsorption with phosphate. The existence of monovalent ions such as K+, Na+, Cl-, and NO3- had no significant effect on P adsorptive capture. The adsorptive capture of P by MBC was affected by various processes including electrostatic attraction and surface complexation, and the presence of different coexisting substances had different impacts on the P adsorption. Adding to these, the P in the biogas slurry was completely adsorbed by the MBC during the experiment, indicating that MBC is a promising composite in the engineering application for the capture of P from wastewater.
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Lycium , Poluentes Químicos da Água , Fosfatos , Magnésio , Biocombustíveis , Óxido de Magnésio/química , Arquivamento , Carvão Vegetal/química , Adsorção , CinéticaRESUMO
CeO2-based nanomaterials have received tremendous attention due to their variety of applications. This paper is focused on the recent advances in facet-controlled CeO2-based nanomaterials by the hydrothermal method. CeO2-based nanomaterials with controllable size and exposed facets can be prepared by adjusting the reaction parameters. Moreover, doping and loading metals can improve the oxygen storage capacity (OSC) of CeO2 and its catalytic activity. Various research studies on catalytic applications such as CO oxidation, water-gas shift reaction (WGSR), decomposition of hydrocarbons, and photocatalytic reaction have been carried out to exhibit the high potential of facet-controlled CeO2 nanomaterials. This review will provide readers with various ideas for facet-controlled CeO2-based nanomaterials.
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Finding a low-cost and suitable adsorbent is still in urgent need for efficient decontamination of As(III) and As(V) elements from the polluted waters. A novel zirconium hydroxide nanoparticle encapsulated magnetic biochar composite (ZBC) derived from rice residue was synthesized for the adsorptive capture of As(III) and As(V) from aqueous solutions. The results revealed that ZBC showed an acceptable magnet separation ability and its surface was encapsulated with lots of hydrous zirconium oxide nanoparticles. Compared to As(III), the adsorption of As(V) onto ZBC was mainly dependent on the pH of the solution. The intraparticle diffusion model described the adsorption process. ZBC showed satisfactory adsorption performances to As(III) and As(V) with the highest adsorption quantity of 107.6 mg/g and 40.8 mg/g at pH 6.5 and 8.5, respectively. The adsorption of As(III) and As(V) on ZBC was almost impervious with the ionic strength while the presence of coexisting ions, especially phosphate, significantly affected the adsorption process. The processes of complexation reaction and electrostatic attraction contributed to the adsorption of As(III) and As(V) onto ZBC. ZBC prepared from kitchen rice residue was found to be a low cost environmentally friendly promising adsorbent with high removal capacity for As(III) and As(V) and could be recycled easily from contaminated waters.
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Arsênio , Nanopartículas , Oryza , Poluentes Químicos da Água , Purificação da Água , Adsorção , Arsênio/análise , Carvão Vegetal , Concentração de Íons de Hidrogênio , Hidróxidos , Cinética , Fenômenos Magnéticos , Poluentes Químicos da Água/análise , ZircônioRESUMO
Removal of toxic chemicals from the environment using novel adsorbents is of great concern. In this study, a novel composite of molybdenum trioxide (MoO3)-engineered biochar (MoO3-BC) was derived from corn straw and synthesized for the removal of Pb(II) from water. The pyrolysis temperature of 600 °C was suitable for the thermal self-assembly of MoO3-BC. Although MoO3-BC had lower SBET (59.3 m2/g) than the pristine BC (157.8 m2/g), it had a stronger adsorption affinity to Pb(II). The Pb(II) removal capacity of MoO3-BC was 229.87 mg/g at pH 4.0, and the adsorptive removal of Pb(II) was fit using a pseudo-second-order model and the Langmuir model. High temperature favored the removal of Pb(II) by MoO3-BC; However, the removal of Pb(II) was inhibited with increasing the ion strength. The MoO3-BC revealed an acceptable stability and reusability, since the removal efficiency of Pb(II) remained above 80.7%, even after 8 cycles. The MoO3-BC effectively reduced ≥99.9% of Pb(II) in the polluted irrigation water. The Pb(II) removal mechanisms involved surface electrostatic attraction, ion exchange and surface complexation. These findings conclude that the MoO3-BC is a novel composite that can be used for the removal of Pb from contaminated water. More studies are needed to investigate the potentiality of MoO3-biochar composite for the removal of other metals from water in a mono and competitive sorption system.
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Chumbo , Poluentes Químicos da Água , Adsorção , Carvão Vegetal , Cinética , Água , Poluentes Químicos da Água/análiseRESUMO
A novel composite of hydroxyapatite tailored hierarchical porous biochar (HA-HPB) was synthesized and used for the adsorptive immobilization of Cd(II) and Pb(II) in water and soil. The hierarchical porous biochar (HPB) was prepared from rice husk through a molten-salt-assisted pyrolysis approach; then, a series of HA-HPB (with 0.5, 1, 2, 3, and 4 g of HPB) was prepared with co-precipitation procedure. All HA-HPBs, particularly HA-3HPB, revealed significantly higher removal efficiency of Cd(II) and Pb(II) (≥99.5%) in water than pristine biochar (5.79 - 24.12%). The immobilization efficiency of HA-3HPB for Cd(II) and Pb(II) was slightly inhibited by the ionic strength and co-existing cations. The Langmuir adsorption capacities of Cd(II) and Pb(II) were 88.1 and 110.2 mg/g, respectively. Ion exchange, complexation, cation-π interaction, and precipitation were the key mechanisms involved in the immobilization of Cd(II) and Pb(II) using HA-3HPB. The HA-3HPB reduced the availability of soil Cd (63.5 - 87.8%) and Pb (64.6 - 92.9%) compared to the unamended soil, and thus reduced their content in the Chinese cabbage shoots by 69.3 -95.4% for Cd and 66.5 -97.2% for Pb. These findings demonstrate the effectiveness of HA-HPB for remediation of Cd(II) and Pb(II) contaminated water and soil and mitigating the potential risks.
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Poluentes do Solo , Solo , Cádmio/análise , Cádmio/toxicidade , Carvão Vegetal , Durapatita , Chumbo/toxicidade , Porosidade , Poluentes do Solo/análise , Poluentes do Solo/toxicidade , ÁguaRESUMO
Pharmacokinetic drug-drug interactions (DDIs) occur when a drug alters the absorption, transport, distribution, metabolism or excretion of a co-administered agent. The occurrence of pharmacokinetic DDIs may result in the increase or the decrease of drug concentrations, which can significantly affect the drug efficacy and safety in patients. Enzyme-mediated DDIs are of primary concern, while the transporter-mediated DDIs are less understood but also important. In this review, we presented an overview of the different mechanisms leading to DDIs, the in vitro experimental tools for capturing the factors affecting DDIs, and in silico methods for quantitative predictions of DDIs. We also emphasized the power and strategy of physiologically based pharmacokinetic (PBPK) models for the assessment of DDIs, which can integrate relevant in vitro data to simulate potential drug interaction in vivo. Lastly, we pointed out the future directions and challenges for the evaluation of pharmacokinetic DDIs.
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Metal organic-frameworks (MOFs) are novel materials that have attracted increasing attention for applications in a wide range of research, owing to their unique advantages including their small particle size, porous framework structure and high specific surface area. Because of their adjustable size, nanoscale MOFs (nano-MOFs) can be prepared as carriers of biotherapy drugs, thus enabling biotherapeutic applications. Nano-MOFs' metal ion catalytic activity and organic group functional characteristics can be exploited in biological treatments. Furthermore, the applications of nano-MOFs can be broadened by hybridization with other materials to form composites. This review focuses on the preparation and recent advances in nano-MOFs as drug carriers, therapeutic materials and functionalized materials in drug delivery and tumor therapy based on the single/multiple stimulus response of drug release to achieve the targeted therapy, offering a comprehensive reference for drug carrier design. At the end, the current challenges and prospects are discussed to provide significant insight into the design and applications of nano-MOFs in drug delivery and tumor therapy.
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The electrochemical behaviors of Al(III) deposits on Ni substrates were investigated in LiCl-KCl-AlCl3 (2 wt.%) molten salts. Various electrochemical methods, including cyclic voltammetry (CV), square wave voltammetry (SWV), and open circuit chronopotentiometry (OCP) were used to explore the deposition processes of Al(III) on Ni substrates. Five kinds of Al-Ni alloys phase were firstly electrodeposited by the regulation of deposition potential form LiCl-KCl-AlCl3 (2 wt.%) molten salts at 753 K. The formation of Al-Ni alloys, such as AlNi3, Ni5Al3, AlNi, Al3Ni2, and Al3Ni were confirmed by X-ray diffractometer (XRD) and the cross-section morphologies were investigated by scanning electron microscope (SEM). Meanwhile, it was found that the temperature of molten salt was another key parameter for the controlling of alloys phase. No Al-Ni alloys phase other than AlNi3 and Ni5Al3 could be deposited at 703 K.
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The Sc2O3: Er3+, Yb3+ nanoparticles (NPs) with the size of about 19 nm were synthesized by a simple oleic acid-mediated hydrothermal (HT) process. X-ray diffraction (XRD), transmission electron microscopy (TEM), upconversion luminescence (UCL) spectra, and decay curves were used to characterize the resulting samples. The Sc2O3: Er3+, Yb3+ NPs made by HT method exhibit the stronger UCL, of which the red UCL are enhanced by a factor of 4, in comparison with those samples prepared by solvothermal (ST) method at the same optimized lanthanide ion concentrations. The UCL enhancement can be attributed to the reduced surface groups and longer lifetimes. Under 980 nm wavelength excitation, the decay curves of Er3+: (2H11/2, 4S3/2) â 4I15/2 and 4F9/2 â 4I15/2 emissions for Sc2O3: Er3+, Yb3+ NPs samples are both close to each other, resulting from the cross relaxation energy transfer from Er3+ to Yb3+, followed by an energy back transfer within the same Er3+-Yb3+ pair. Also, under the relatively low-power density, the slopes of the linear plots of log(I) vs. log(P) for red and green emissions are 2.5 and 2.1, implying the existence of three-photon processes. Our results indicate that Sc2O3: Er3+, Yb3+ NPs is an excellent material for achieving intense UCL with small size in the biological fields.