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1.
J Asthma ; : 1-10, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38888746

RESUMO

OBJECTIVE: To evaluate the benefits of combining omalizumab with specific immunotherapy (SCIT) in the treatment of children with bronchial asthma. METHODS: In this study, 83 children with asthma were treated at the Allergy Department of Qingdao University from January 2019 to February 2020. Participants were divided into three groups: SCIT, combination (omalizumab + SCIT), and control (standard asthma medications). We assessed Asthma Control Questionnaire (ACQ) scores, Visual Analogue Scale (VAS) scores, and lung function at baseline, 24 wk, and 48 wk. Additionally, asthma medication scores were compared at 24 and 48 wk. Adverse reactions were monitored in both the SCIT and combination groups. RESULTS: The combination group demonstrated lower ACQ scores at both 24 and 48 wk, and improved VAS scores at 48 wk compared to the other groups. Additionally, lung function parameters (FEV1 and FEF50) showed significant improvement in the combination group. Reduced asthma medication scores were noted in the combination group at 24 and 48 wk. Local adverse reactions were fewer in the combination group, and no systemic adverse reactions were reported. CONCLUSION: Combining omalizumab with SCIT provides quicker asthma control, lowers medication requirements, and enhances lung function with fewer adverse effects, making it a safe and effective treatment for children with bronchial asthma.

2.
Biochem Genet ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724713

RESUMO

As a member of Rho GAPs family, Rho GTPase-Activating Protein 17 (ARHGAP17) regulates cytoskeletal recombination, cell polarity, cell proliferation and cell migration. ARHGAP17 is identified as a tumor suppressor in numerous cancer types. Current study intends to examine ARHGAP17 expression and its possible influence on the progression of hepatocellular carcinoma (HCC). ARHGAP17 expression in HCC cells was verified by RT-PCR and western blot. The proliferation and invasion of HCC cells were evaluated by CCK8 assay and transwell assay, respectively. The mRNA expression of ARHGAP17, PCNA, E-cadherin, N-cadherin, ß-catenin, GSK-3ß, Axin1, and APC were detected by RT-PCR. The protein expression of ARHGAP17, PCNA, E-cadherin, N-cadherin, ß-catenin, p-ß-catenin, GSK-3ß, p-GSK-3ß, Axin1, and APC were detected by western blot. ARHGAP17 staining was evaluated by immunohistochemistry and immunofluorescence. ARHGAP17 expression decreased significantly in HCC tumors and HCC cells after EMT. In response to overexpression of ARHGAP17, the capacities of HCC cell proliferation and invasion were reduced significantly, which were also confirmed by tumorigenesis experiments in vivo. With overexpression of ARHGAP17 in HCC cells, the p-GSK3ß/GSK3ß decreased, while the p-ß-catenin/ß-catenin, Axin1 and APC increased. In conclusion, ARHGAP17 inhibits HCC progression by inactivating the Wnt/ß-catenin signaling pathway.

3.
J Org Chem ; 88(7): 4145-4154, 2023 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-36952394

RESUMO

An unprecedented electrochemical cross-dehydrogenative coupling reaction between isochroman and unactivated ketones to directly synthesize α-substituted isochromans has been developed. This strategy provides a facile and efficient procedure to the direct activation of C(sp3)-H bond adjacent to the O atom of isochroman. The method features high atom economy, chemical oxidant-free, and mild conditions, in which methanesulfonic acid (MsOH) acts as both electrolyte and catalyst, making the process more convenient and environmentally friendly. Gram-scale experiment and synthesis of antitumor active compounds demonstrate the great potential of this protocol for practical applications.

4.
Environ Res ; 238(Pt 1): 117176, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37729962

RESUMO

Although nonthermal plasma (NTP) technology has high removal efficiency for volatile organic compounds (VOCs), it has limited carbon dioxide (CO2) selectivity, which hinders its practical application. In this study, α-MnO2 nanorods with tunable oxygen vacancies and hydroxyl groups were synthesized by two-step hydrothermal process to enhance their activity for deep oxidation of toluene. Hydrochloric acid (HCl) was used to assist in synthesis of α-MnO2 nanorods with tunable oxygen vacancies, furtherly, more hydroxyl groups were introduced to HCl-assisted synthesized α-MnO2 by K+ supplement. The results showed that the as-synthesized nanorods exhibited superior activity, improved by nearly 30% removal efficiency of toluene compared to pristine MnO2 at SIE = 339 J/L, and reaching high COx selectivity of 72% at SIE = 483 J/L, successfully promoting the deep oxidation of toluene. It was affirmed that oxygen vacancies played an important role in toluene conversion, improving the conversion of ozone (O3) and resulting in higher mobility of surface lattice oxygen species. Besides, the enhancement of deep oxidation performance was caused by the increase of hydroxyl groups concentration. In-situ DRIFTS experiments revealed that the adsorbed toluene on catalyst surface was oxidized to benzyl alcohol by surface lattice oxygen, and hydroxyl groups were also found participating in toluene adsorption. Overall, this study provides a new approach to designing catalysts for deep oxidation of VOCs.


Assuntos
Nanotubos , Compostos Orgânicos Voláteis , Oxigênio , Óxidos , Compostos de Manganês , Tolueno , Catálise
5.
J Reconstr Microsurg ; 39(1): 59-69, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35798337

RESUMO

BACKGROUND: Prevention of nosocomial coronavirus disease 2019 (COVID-19) infection for patients undergoing flap-based reconstructive surgery is crucial to providing care and maintaining operative volume and income to support plastic surgery programs. We conducted this study to (1) determine the postoperative incidence of COVID-19 among patients undergoing flap reconstruction from December 1, 2019 to November 1, 2020 and (2) compare 30-day outcomes between patients who underwent surgery before and during the early pandemic. METHODS: We conducted an 11-month retrospective cohort study of all patients who underwent flap reconstruction across our institution. We abstracted patient demographics, intraoperative management, COVID-19 testing history, and 30-day postoperative complications from electronic health records. Nosocomial COVID-19 infection was defined as reverse transcription polymerase chain reaction (RT-PCR) viral ribonucleic acid detection within 30 days of patients' postoperative course or during initial surgical admission. We used chi-squared tests to compare postoperative outcomes between patients who underwent surgery before (prior to March 12, 2021, when our institution admitted its first COVID-19 patient) versus during (on/after March 12, 2021) the pandemic. RESULTS: Among the 220 patients (mean [standard deviation] age = 53.8 [18.1] years; female = 54.8%) who underwent flap reconstruction, none had nosocomial COVID-19 infection. Five (2%) patients eventually tested COVID-19 positive (median time from surgery to diagnosis: 9 months, range: 1.5-11 months) with one developing partial flap loss while infected. Between patients who underwent free flap surgery before and during the pandemic, there were no significant differences in 30-day takebacks (15.6% vs. 16.6%, respectively; p > 0.999), readmissions (9.4% vs. 12.6%, respectively; p = 0.53), and surgical complications (e.g., total flap loss 1.6% vs. 2.1%, p = 0.81). CONCLUSION: Robust precautions can ensure the safety of patients undergoing flap surgeries across an academic medical institution, even during periods of high COVID-19 admission rates. Further studies are needed to generate evidence-based guidelines that optimize infection control and flap survival for patients undergoing reconstruction.


Assuntos
COVID-19 , Infecção Hospitalar , Retalhos de Tecido Biológico , Humanos , Feminino , Pessoa de Meia-Idade , COVID-19/epidemiologia , Pandemias , Estudos Retrospectivos , Teste para COVID-19 , Complicações Pós-Operatórias/epidemiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/complicações , Infecção Hospitalar/epidemiologia
6.
Mol Biol Evol ; 38(9): 3556-3566, 2021 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892509

RESUMO

Speciation is a process whereby the evolution of reproductive barriers leads to isolated species. Although many studies have addressed large-effect genetic footprints in the advanced stages of speciation, the genetics of reproductive isolation in nascent stage of speciation remains unclear. Here, we show that pig domestication offers an interesting model for studying the early stages of speciation in great details. Pig breeds have not evolved the large X-effect of hybrid incompatibility commonly observed between "good species." Instead, deleterious epistatic interactions among multiple autosomal loci are common. These weak Dobzhansky-Muller incompatibilities confer partial hybrid inviability with sex biases in crosses between European and East Asian domestic pigs. The genomic incompatibility is enriched in pathways for angiogenesis, androgen receptor signaling and immunity, with an observation of many highly differentiated cis-regulatory variants. Our study suggests that partial hybrid inviability caused by pervasive but weak interactions among autosomal loci may be a hallmark of nascent speciation in mammals.


Assuntos
Especiação Genética , Hibridização Genética , Animais , Domesticação , Mamíferos , Modelos Genéticos , Isolamento Reprodutivo , Suínos/genética
7.
Org Biomol Chem ; 20(13): 2544-2561, 2022 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-35266948

RESUMO

The asymmetric Mannich reaction is an essential method in contemporary organic chemistry. As a representative of clean and green synthesis methods, photochemical and electrochemical oxidation strategies have re-emerged in recent years, providing new ideas for asymmetric Mannich reactions. Numerous chiral ß-amino carbonyl compounds have been accessed in satisfactory yields with excellent enantioselectivity via such novel asymmetric oxidative Mannich reactions. This minireview highlights plentiful advances in asymmetric oxidative Mannich reactions that rely on photoredox or anodic-oxidation and covers the literature from 2014 to date. Furthermore, the future development of this field is envisaged.


Assuntos
Estresse Oxidativo , Catálise , Eletroquímica , Estrutura Molecular , Estereoisomerismo
8.
Environ Sci Technol ; 56(22): 15449-15459, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36254461

RESUMO

The development of stable, highly active, and inexpensive catalysts for the ozone catalytic oxidation of volatile organic compounds (VOCs) is challenging but of great significance. Herein, the micro-coordination environment of Al in commercial Y zeolite was regulated by a specific dealumination method and then the dealuminated Y zeolite was used as the support of Cu-Mn oxides. The optimized catalyst Cu-Mn/DY exhibited excellent performance with around 95% of toluene removal at 30 °C. Besides, the catalyst delivered satisfactory stability in both high-humidity conditions and long-term reactions, which is attributed to more active oxygen vacancies and acidic sites, especially the strong Lewis acid sites newly formed in the catalyst. The decrease in the electron cloud density around aluminum species enhanced electron transfer at the interface between Cu-Mn oxides. Moreover, extra-framework octahedrally coordinated Al in the support promoted the electronic metal-support interaction (EMSI). Compared with single Mn catalysts, the incorporation of the Cu component changed the degradation pathway of toluene. Benzoic acid, as the intermediate of toluene oxidation, can directly ring-open on Cu-doped catalysts rather than being further oxidized to other byproducts, which increased the rate of the catalytic reaction. This work provides a new insight and theoretical guidance into the rational design of efficient catalysts for the catalytic ozonation of VOCs.

9.
J Appl Microbiol ; 133(6): 3438-3450, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35947063

RESUMO

AIMS: The purpose of this study was to explore the potential inhibitory mechanism and assess the feasibility of natamycin as an antifungal agent in the utilization of citrus storage. METHODS AND RESULTS: In this study, the mycelial growth, spore germination as well as germ tube elongations of Geotrichum citri-aurantii and Penicillium digitatum were significantly inhibited by natamycin treatment. The relative conductivities of G. citri-aurantii and P. digitatum mycelia were increased as time went by and the damages of plasma membranes were up to 17.43% and 28.61%. The mitochondria abnormalities and vacuolation were also observed in the TEM. Moreover, the sour rot and green mould decay incidences were reduced to 18.33% and 10% post incubation with G. citri-aurantii and P. digitatum under 300 mg L-1 natamycin application, respectively. For the citrus storage experiment, there was no significant difference in edible rate, juice yield, total soluble solid (TSS) content, titratable acid (TA) and decay incidences of the 'Newhall' navel orange fruit treated with 300 mg L-1 natamycin stored for 90 d. CONCLUSIONS: Natamycin could decrease the expansions of green mould and sour rot and maintain quality and improve storability on citrus fruit. SIGNIFICANCE AND IMPACT OF THE STUDY: This work explores the potential inhibition mechanism of natamycin G. citri-aurantii and P. digitatum and assesses the feasibility of natamycin as an antifungal agent in the utilization of citrus storage.


Assuntos
Citrus , Penicillium , Citrus/microbiologia , Natamicina/farmacologia , Antifúngicos/farmacologia , Aditivos Alimentares , Doenças das Plantas/prevenção & controle , Doenças das Plantas/microbiologia , Fungos , Frutas/microbiologia
10.
Qual Life Res ; 31(6): 1711-1718, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34533759

RESUMO

PURPOSE: To identify patient-level barriers and facilitators to completion of patient-reported outcomes measures (PROMs) in a hand and upper extremity clinic in Baltimore, Maryland. METHODS: We conducted 12 h of direct observation of PROM completion (October-November, 2020). Ethnographic observation memos were qualitatively analyzed for barriers and facilitators using rapid thematic analysis. Informed by observation findings, we conducted 17 semi-structured interviews with mixed-literacy patients, caregivers, and clinic staff to understand the patient experience when completing PROMs (November 2020-March 2021). We identified initial themes through inductive and deductive framework analysis and validated findings through subsequent interviews with member-checking. RESULTS: We identified nine patient-level factors that influence PROM completion: platform design, print literacy, health literacy, technology literacy, language proficiency, physical functioning, vision, cognitive functioning, and time. CONCLUSIONS: There are multiple distinct patient-level factors that affect PROM completion. Failure to consider these factors in PROM design and implementation may lower completion rates or prevent accurate completion, undermining PROM validity. Because certain factors affect minority populations at disproportionate rates, this may also contribute to existing health disparities.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Instituições de Assistência Ambulatorial , Humanos , Qualidade de Vida/psicologia
11.
Ann Plast Surg ; 88(5): 549-554, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-34510080

RESUMO

BACKGROUND: This study aimed to evaluate recent trends in utilization, reimbursement, and charges for reconstructive plastic surgery procedures billed to Medicare. METHODS: We queried the Physician/Supplier Procedure Summary from the Centers for Medicare and Medicaid Services for procedures billed by plastic surgeons to Medicare Part B between 2010 and 2019. We collected service counts, charges, and reimbursements. We adjusted utilization by Medicare enrollment and adjusted monetary values for inflation. We calculated the weighted mean charge and reimbursement, which were used to calculate the reimbursement-to-charge ratio (RCR). We examined trends over time by calculating differences and performing correlation analyses of utilization, charges, reimbursement, and RCR for all procedures and for different procedural categories. RESULTS: From 2010 to 2019, the overall enrollment-adjusted utilization for 912 reconstructive procedures decreased by 6.6% (r2 = 0.46). Utilization increased in certain procedural categories such as skin debridement (+36.9%, r2 = 0.48) and procedures of the breast (+114.9%, r2 = 0.48). Charges increased by 32.9% (r2 = 0.99), reimbursement decreased by 5.3% (r2 = 0.84), and RCR decreased by 28.7% (r2 = 0.99). Skin replacement/flaps/grafts procedures underwent the greatest relative decrease in reimbursement (-26.8%, r2 = 0.87). Reimbursement-to-charge ratio decreased for all procedural categories except for procedures of the auditory system. CONCLUSIONS: In the past decade, Medicare utilization and reimbursement for reconstructive plastic surgery procedures decreased, whereas charges increased. This resulted in decreasing reimbursement relative to charged amounts. These findings raise concerns regarding the economic viability of providing plastic surgery services to an aging population and may impact patients' ability to access affordable plastic surgical care.


Assuntos
Procedimentos de Cirurgia Plástica , Cirurgiões , Cirurgia Plástica , Idoso , Humanos , Reembolso de Seguro de Saúde , Medicare , Estados Unidos
12.
J Hand Surg Am ; 47(12): 1230.e1-1230.e17, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34763971

RESUMO

PURPOSE: Patients may receive surprise out-of-network bills even when they present to in-network facilities. Surprise bills are common following emergency care. We sought to characterize and determine risk factors for surprise billing in hand and upper extremity trauma patients in the emergency department (ED). METHODS: We used IBM MarketScan data to evaluate hand and upper extremity trauma patients who received care in the ED from 2010 to 2017. Our primary outcome was the surprise billing incidence, defined as encounters in in-network EDs with out-of-network claims. We used descriptive and bivariate analyses to characterize surprise billing and used multivariable logistic regression to evaluate independent factors associated with surprise billing. RESULTS: Of 710,974 ED encounters, 97,667 (14%) involved surprise billing. The incidence decreased from 26% in 2010 to 11% in 2017. Mean coinsurance payments were higher for surprise billing encounters and had double the growth from 2010 to 2017 compared to those without surprise billing. Receiving care from different provider types-especially therapists, radiologists, and pathologists, as well as hand surgeons-was associated with significantly higher odds of surprise billing. Transfer to another facility was not significantly associated with surprise billing. CONCLUSIONS: Although the incidence of surprise billing decreased, more than 10% of patients treated in an ED for hand trauma remain at risk. Coinsurance for surprise billing encounters increased by twice as much as encounters without surprise billing. Patients requiring services from therapists, radiologists, pathologists, and hand surgeons were at greater risk for surprise bills. The federal No Surprises Act, passed in 2020, targets surprise billing and may help address some of these issues. CLINICAL RELEVANCE: Many hand and upper extremity patients requiring ED care receive surprise bills from various sources that result in higher out-of-pocket costs.


Assuntos
Gastos em Saúde , Cirurgiões , Humanos , Estados Unidos , Serviço Hospitalar de Emergência , Mãos
13.
J Reconstr Microsurg ; 38(2): 106-114, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34425592

RESUMO

BACKGROUND: Benchtop microsurgical training models that use digital tools (smartphones, tablets, and virtual reality [VR]) for magnification are allowing trainees to practice without operating microscopes. This systematic review identifies existing microscope-free training models, compares models in their ability to enhance microsurgical skills, and presents a step-by-step protocol for surgeons seeking to assemble their own microsurgery training model. METHODS: We queried PubMed, Embase, and Web of Science databases through November 2020 for microsurgery training models and performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We collected data including training model characteristics (cost, magnification, and components) and outcomes (trainee satisfaction, image resolution, and faster suturing speed). We also conducted a complimentary Google search to identify commercially available microscope-free microsurgical training models or kits not reported in peer-reviewed literature. RESULTS: Literature search identified 1,805 publications; 24 of these met inclusion criteria. Magnification tools most commonly included smartphones (n = 10), VR simulators (n = 4), and tablets (n = 3), with magnification ranging up to ×250 magnification on digital microscopy, ×50 on smartphones, and ×5 on tablets. Average cost of training models ranged from $13 (magnification lens) to $15,000 (augmented reality model). Model were formally assessed using workshops with trainees or attendings (n = 10), surveys to end-users (n = 5), and single-user training (n = 4); users-reported satisfaction with training models and demonstrated faster suturing speed and increased suturing quality with model training. Five commercially available microsurgery training models were identified through Google search. CONCLUSION: Benchtop microsurgery trainers using digital magnification successfully provide trainees with increased ease of microsurgery training. Low-cost yet high magnification setups using digital microscopes and smartphones are optimal for trainees to improve microsurgical skills. Our assembly protocol, "1, 2, 3, Microsurgery," provides instructions for training model set up to fit the unique needs of any microsurgery trainee.


Assuntos
Realidade Aumentada , Cirurgiões , Competência Clínica , Humanos , Microscopia , Microcirurgia
14.
Angew Chem Int Ed Engl ; 61(30): e202203666, 2022 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-35621715

RESUMO

We describe the enantioselective oxidative cross-coupling of secondary amines with ketones by combining the non-natural catalytic activity of lipase with electrosynthesis. Various 2,2-disubstituted 3-carbonyl indoles with a stereogenic quaternary carbon center were synthesized from 2-substituted indoles in yields up to 78 % with good enantio- and diastereoselectivities (up to 96 : 4 e.r. and >20 : 1 d.r.). This unprecedented protocol demonstrated that hydrolase catalysis is compatible with electrosynthesis, and the reaction can be carried out in organic solvents with a broad substrate scope and good stereoselectivity. This work provides insights into enzymatic electrosynthesis.


Assuntos
Aminas , Cetonas , Catálise , Indóis , Lipase , Estresse Oxidativo , Estereoisomerismo
15.
Ann Plast Surg ; 87(1s Suppl 1): S65-S69, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34180867

RESUMO

BACKGROUND: In 2018, the Northeastern Society of Plastic Surgeons first Women in Plastic Surgery was established, reflecting the national trend to address the gender gap between men and women in surgery. Conferences, such as the annual NESPS, are important opportunities to increase visibility of female role models and resources to address deterrents to surgical careers. We thus sought to examine the participation and visibility of women in the NESPS over the last decade. METHODS: Abstracts and programs from the NESPS regional conferences between 2013 and 2019 were accessed via the publicly available past meetings archives, and registration lists were provided by the NESPS. Registrants, panelists, speakers, moderators, and first author and senior author listed for each poster presentation, podium presentation was listed, sex was determined (male or female), and sex were aggregated by category of participation. Significance was set at a P value of less than 0.05. RESULTS: Registration of women for the NESPS annual conferences was constant for 5 years (2013-2017), followed by an increase in female registrants from 27.1% in 2017 to 42.3% in 2019. Female representation among poster and podium presentations also increased from 2017 to 2019 (7.7%-23.3% poster presentations and 11.1%-23.4% podium presentations). Invited positions (speakers, panelists, and moderators) had a peak of 32.2% in 2017, but otherwise, there is no clear evidence of improved representation of women. CONCLUSIONS: We found an increase in the proportion of female registrants at the annual NESPS conferences from 2013 to 2019. However, visibility of female participants fluctuated over the same period; addressing this represents one opportunity for closing the gender gap at the NESPS. As the percentage of female trainees continues to rise, we look to female faculty to continue to participate in educational events, such as the NESPS meeting, and to be present as role models for the growing new generation of female plastic surgeons.


Assuntos
Cirurgiões , Cirurgia Plástica , Feminino , Humanos , Masculino , Sociedades Médicas
16.
Genomics ; 112(6): 4063-4071, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32650101

RESUMO

Sour rot, caused by Geotrichum citri-aurantii, is a major postharvest disease of citrus,and it causes serious economic losses. In this study, a high-quality genome sequence of G. citri-aurantii was obtained by Single Molecule Real-Time Sequencing (SMRT). Approximately 5.43 Gb of clean data were obtained and a total of 27.94-Mb genomic sequence was mapped to 10 chromosome groups after high-through chromosome conformation capture (Hi-C) assembly. In addition, three polygalacturonase genes which were related to pathogenicity in G. citri-aurantii genome were discovered. And transcriptome data of guazatine-resistance had been analyzed, the results showed that the guazatine-resistance of G. citri-aurantii was related to two ATP-binding cassette (ABC) transporter family genes, six major facilitator superfamily (MFS) transporter family genes and two multidrug and toxic compound extrusion (MATE) transporter family genes. In summary, our research may provide novel insights into the effective control of this pathogen.


Assuntos
Citrus/microbiologia , Fungicidas Industriais/farmacologia , Genoma Fúngico , Geotrichum/genética , Guanidinas/farmacologia , Farmacorresistência Fúngica/genética , Perfilação da Expressão Gênica , Genes Fúngicos , Genômica , Geotrichum/efeitos dos fármacos , Geotrichum/metabolismo , Geotrichum/patogenicidade , Proteínas de Membrana Transportadoras/genética , Poligalacturonase/genética
17.
J Hand Surg Am ; 46(3): 236-240, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33358882

RESUMO

Surprise billing occurs when insured patients receive unexpected out-of-network charges and fees even when the emergency department, facility, or primary physician who provided care is in their insurance network. This issue is particularly relevant for hand surgery. The multidisciplinary nature of hand care and the number of ancillary services involved result in various levels at which out-of-network billing can be introduced, even when the hand surgeon is in-network for the patient. In addition, surprise billing is often associated with emergency department encounters, elective surgeries, and ambulance and helicopter transfers. In this article, we review surprise billing as it pertains to hand surgery. Little is known about surprise billing in hand care; however, we believe that these practices may substantially affect the patient population. We define key elements of surprise billing, review the literature, discuss the relevance and potential of surprise billing in hand surgery in various settings, and provide an overview of the status of health policy surrounding this practice. It is imperative for hand surgery as a field to understand the prevalence, operationalization, and policies of surprise billing better to prevent the exploitation of patients.


Assuntos
Mãos , Seguro Saúde , Serviço Hospitalar de Emergência , Honorários e Preços , Mãos/cirurgia , Política de Saúde , Humanos , Estados Unidos
18.
Aesthet Surg J ; 41(12): NP2086-NP2093, 2021 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-34245237

RESUMO

BACKGROUND: The COVID-19 pandemic has led to the widespread adoption of video calling. A parallel growth in aesthetic surgery demand has been documented. OBJECTIVES: The authors sought to identify associations between video call engagement and aesthetic surgery attitudes. METHODS: We distributed a cross-sectional survey via Amazon Mechanical Turk in November 2020. Respondents were asked to report their time spent video calling, video calling applications and features (eg, virtual backgrounds) they utilized, and aesthetic surgery attitudes employing the 15-item Acceptance of Cosmetic Surgery Scale (ACSS; higher scores indicate greater acceptance). ACSS scores were compared between video call users and non-users employing t tests. Pearson's correlation coefficient was employed to quantify associations between ACSS scores and time spent on calls and multivariable analysis to estimate associations between video call engagement and ACSS scores. RESULTS: A total of 295 respondents (mean age, 37.6 years; 49.5% female) completed the survey. Across all video call applications surveyed, video call users had higher ACSS scores than non-users. Increased time respondents spent looking at their own face on video call was moderately associated with higher ACSS scores (r = 0.48, P < 0.01), whereas time spent looking at another person's face was not associated with a change in ACSS scores (r = 0.09, P = 0.11). Increased video call utilization was associated with higher ACSS scores. CONCLUSIONS: Increased video calling utilization is associated with increased acceptance of aesthetic surgery. Although the clinical significance of ACSS scores can be better elucidated, plastic surgeons should consider the effects of video calling on patient motivations for aesthetic surgery in the COVID-19 era.


Assuntos
COVID-19 , Cirurgia Plástica , Adulto , Atitude , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
19.
J Phycol ; 56(5): 1208-1215, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32306387

RESUMO

Survival of coral reef-associated Symbiodiniaceae is vital to maintain the healthy coral community in coral reefs. However, knowledge about cultivation of free-living or symbiotic Symbiodiniaceae has been limited. In this study, the response surface methodology was applied to optimize the medium for Effrenium voratum. The results showed that the impacts of nutrient components on algal growth were: FeCl3 > NaH2 PO4 >MnSO4 > MgSO4 /CoSO4 > KCl>ZnSO4 > CaCl2 /NaNO3 , among which NaH2 PO4 and FeCl3 significantly affected algal growth. The optimal medium was: natural seawater supplemented with NaH2 PO4 ·2H2 O 0.25 mM,FeCl3 ·6H2 O 14.24 µM, NaNO3 0.94 mM, MgSO4 ·7H2 O 40.63 mM, KCl 5.37 mM, CaCl2 ·2H2 O 4.08 mM, ZnSO4 ·7H2 O 0.35 µM, MnSO4 9.93 µM, and CoSO4 0.36 µM. The use of the optimized medium resulted in an increase of biomass yield (0.76 g dry weight · L-1 ) by 46% over that using the initial medium, which agreed with the predicted value (0.71 g · L-1 ). Additionally, fatty acids, mainly consisting of palmitic acid (C16:0) and ethyl carbonate (C20:0), accounted for approximately 50% of the total fatty acids in E. voratum. Interestingly, docosahexaenoic acid (DHA) accounted for 6% of total fatty acids, a high proportion that makes E. voratum a potential candidate feedstock in aquaculture for DHA production.


Assuntos
Antozoários , Dinoflagellida , Animais , Biomassa , Recifes de Corais , Meios de Cultura
20.
Med Sci Monit ; 25: 5833-5840, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31381554

RESUMO

BACKGROUND Salidroside, a natural dietary isothiocyanate, has been widely studied for its multiple effects, including promoting proliferation, anti-inflammation, and anti-apoptosis. In the present study, these effects of Salidroside were explored to assess whether it could prevent osteoarthritis (OA) in vitro. MATERIAL AND METHODS The cytotoxic and proliferating effects of Salidroside on chondrocytes were detected by use of the Cell Counting Kit 8 assay. The expression levels of proteins were detected by Western blot. The cell apoptosis level was assessed by flow cytometry, and the levels of ROS, NO, caspase 3, and caspase 9 were assessed to evaluate the level of apoptosis. The expression level of pro-inflammatory factors was detected by ELISA. RESULTS Our results demonstrated that Salidroside promotes chondrocytes proliferation, inhibits IL-1ß-induced apoptosis and inflammation, and scavenges reactive oxygen species (ROS) and NO of chondrocytes. Salidroside upregulates the level of Bcl-2 and downregulates the level of Bax. Salidroside also inhibits the production of caspase 3/9 and suppresses the phosphorylation of PI3K and AKT. CONCLUSIONS Our results suggest that Salidroside prevents OA by its powerful pro-proliferating, anti-phlogistic, and anti-apoptotic effects by inhibiting PI3K/AKT.


Assuntos
Apoptose/efeitos dos fármacos , Condrócitos/efeitos dos fármacos , Glucosídeos/farmacologia , Fenóis/farmacologia , Animais , Proliferação de Células/efeitos dos fármacos , China , Condrócitos/metabolismo , Glucosídeos/metabolismo , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Óxido Nítrico/metabolismo , Osteoartrite/tratamento farmacológico , Osteoartrite/metabolismo , Fenóis/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2 , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteína X Associada a bcl-2
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