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1.
Heliyon ; 10(18): e37798, 2024 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-39315191

RESUMO

Background: Preventing postoperative complications and accelerating patient recovery are critical issues in clinical treatment and nursing care. This meta-analysis aimed to evaluate the effects of oscillatory positive expiratory pressure therapy (OPEPT) in patients undergoing thoracic or abdominal surgery. Methods: We searched PubMed, the Cochrane Library, Web of Science, EBSCO, SinoMed, Weipu, WanFang, and China National Knowledge Infrastructure (CNKI) for randomized controlled trials (RCTs) on the role of OPEPT on patients undergoing thoracic and upper abdominal surgeries. Two researchers independently conducted literature screening, quality assessment, and data extraction based on the inclusion and exclusion criteria, and used the RevMan 5.4 software to perform the meta-analysis. Results: A total of 13 RCTs involving 1166 patients undergoing thoracic or abdominal surgery were included. The meta-analysis results showed that the decreases in FEV1[MD = 0.30, 95%CI (0.22, 0.38), P < 0.001] and FVC levels [MD = 0.38, 95%CI (0.26, 0.49), P < 0.001] were statistically less in the OPEPT group than those in the control group. OPEPT could increase the postoperative drainage volume [MD = 91.53, 95%CI (57.55, 125.50), P < 0.001] and reduce the length of hospital stay [MD = -1.85, 95%CI (-3.42, -0.28), P = 0.02]. no significant effects on the FEV1/FVC [MD = 2.60, 95%CI (-0.46, 5.67), P = 0.10] and the indwelling time of drainage tube [MD = -1.39, 95%CI (-3.18, 0.41), P = 0.13] between patients undergoing OPEPT and routine care. No publication bias was detected amongst the synthesized outcomes (all P > 0.05). Conclusion: OPEPT, with its promising therapeutic approach, has shown to positively influence the recovery process for patients undergoing thoracic and upper abdominal surgeries. More high-quality, large-sample studies are needed in the future to explore the efficacy and safety of OPEPT.

2.
Med Phys ; 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39167055

RESUMO

BACKGROUND: Adaptive radiotherapy (ART) workflows have been increasingly adopted to achieve dose escalation and tissue sparing under shifting anatomic conditions, but the necessity of recontouring and the associated time burden hinders a real-time or online ART workflow. In response to this challenge, approaches to auto-segmentation involving deformable image registration, atlas-based segmentation, and deep learning-based segmentation (DLS) have been developed. Despite the particular promise shown by DLS methods, implementing these approaches in a clinical setting remains a challenge, namely due to the difficulty of curating a data set of sufficient size and quality so as to achieve generalizability in a trained model. PURPOSE: To address this challenge, we have developed an intentional deep overfit learning (IDOL) framework tailored to the auto-segmentation task. However, certain limitations were identified, particularly the insufficiency of the personalized dataset to effectively overfit the model. In this study, we introduce a personalized hyperspace learning (PHL)-IDOL segmentation framework capable of generating datasets that induce the model to overfit specific patient characteristics for medical image segmentation. METHODS: The PHL-IDOL model is trained in two stages. In the first, a conventional, general model is trained with a diverse set of patient data (n = 100 patients) consisting of CT images and clinical contours. Following this, the general model is tuned with a data set consisting of two components: (a) selection of a subset of the patient data (m < n) using the similarity metrics (mean square error (MSE), peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), and the universal quality image index (UQI) values); (b) adjust the CT and the clinical contours using a deformed vector generated from the reference patient and the selected patients using (a). After training, the general model, the continual model, the conventional IDOL model, and the proposed PHL-IDOL model were evaluated using the volumetric dice similarity coefficient (VDSC) and the Hausdorff distance 95% (HD95%) computed for 18 structures in 20 test patients. RESULTS: Implementing the PHL-IDOL framework resulted in improved segmentation performance for each patient. The Dice scores increased from 0.81 ± $ \pm $ 0.05 with the general model, 0.83 ± 0.04 $ \pm 0.04$ for the continual model, 0.83 ± 0.04 $ \pm 0.04$ for the conventional IDOL model to an average of 0.87 ± 0.03 $ \pm 0.03$ with the PHL-IDOL model. Similarly, the Hausdorff distance decreased from 3.06 ± 0.99 $ \pm 0.99$ with the general model, 2.84 ± 0.69 $ \pm 0.69$ for the continual model, 2.79 ± 0.79 $ \pm 0.79$ for the conventional IDOL model and 2.36 ± 0.52 $ \pm 0.52$ for the PHL-IDOL model. All the standard deviations were decreased by nearly half of the values comparing the general model and the PHL-IDOL model. CONCLUSION: The PHL-IDOL framework applied to the auto-segmentation task achieves improved performance compared to the general DLS approach, demonstrating the promise of leveraging patient-specific prior information in a task central to online ART workflows.

3.
Folia Neuropathol ; 62(2): 187-196, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39165205

RESUMO

INTRODUCTION: The aim of the study was to explore the value of serum procalcitonin to albumin (PCT/ALB) and C-reactive protein to albumin (CRP/ALB) ratios in evaluating the condition and prognosis of craniocerebral trauma (CT). MATERIAL AND METHODS: 158 patients with CT admitted to the emergency department of our hospital from January 2020 to June 2022 were selected as the study subjects. According to the Glasgow coma scale (GCS) score, 158 patients with CT were grouped in a mild group (GCS score 13-15 points, n = 68), a moderate group (GCS score 9-12 points, n = 61), and a severe group (GCS score 3-8 points, n = 29). Besides, according to the patient's Glasgow prognosis (GOS) score, 158 patients with CT were divided into a good prognosis group (GOS score 4-5 points, n = 110) and a poor prognosis group (GOS score 1-3 points, n = 48). Serum PCT/ALB and CRP/ALB levels of different groups were compared. The correlation between PCT/ALB and CRP/ALB ratios and the score of GCS and GOS was explored using Pearson correlation analysis. Prognosis-related influencing factors were found out through multivariate logistic regression. The value of serum PCT/ALB and CRP/ALB ratios in evaluating the condition and prognosis of CT was evaluated by the ROC curve. RESULTS: Patients in the moderate and severe groups had much higher ratios of PCT/ALB and CRP/ALB and sharply lower GCS scores than those in the mild group ( p < 0.001). Compared with the patients in the moderate group, those in the severe group had much higher PCT/ALB and CRP/ALB ratios and obviously lower GCS scores ( p < 0.001). Patients with poor prognosis had markedly higher PCT/ALB and CRP/ALB ratios and memorably lower GOS score than the patients with good prognosis ( p < 0.001). A negative correlation between PCT, CRP, PCT/ALB ratio, CRP/ALB ratio and GCS scores ( r = -0.821, -0.857, -0.750, -0.766, p < 0.001) and GOS scores ( r = -0.636, -0.628, -0.595, -0.628, p < 0.001) was revealed by Pearson correlation analysis. ALB was correlated positively with GCS score and GOS score ( r = 0.381, 0.413, p < 0.001). Multivariate logistic regression analysis exhibited that PCT/ALB ratio and CRP/ALB ratio were related to poor prognosis of CT patients ( p < 0.05). ROC curve analysis showed that the combined PCT/ALB ratio and CRP/ALB area under the curve (AUC) were 0.883 and 0.860, respectively, which were used to assess the severity and predict prognosis of patients with CT. CONCLUSIONS: PCT/ALB and CRP/ALB ratios were positively correlated with the severity and prognosis of patients with CT, and were risk factors for poor prognosis. Early determination of changes in PCT/ALB and CRP/ALB ratios had a certain clinical value for evaluating the condition and prognosis of CT patients.


Assuntos
Proteína C-Reativa , Traumatismos Craniocerebrais , Pró-Calcitonina , Humanos , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Prognóstico , Masculino , Feminino , Traumatismos Craniocerebrais/sangue , Pessoa de Meia-Idade , Adulto , Pró-Calcitonina/sangue , Escala de Coma de Glasgow , Idoso , Albumina Sérica/análise , Biomarcadores/sangue , Adulto Jovem
4.
Commun Stat Simul Comput ; 53(7): 3285-3301, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39184174

RESUMO

In scientific studies with low-prevalence outcomes, probability sampling may be supplemented by nonprobability sampling to boost the sample size of desired subpopulation while remaining representative to the entire study population. To utilize both probability and nonprobability samples appropriately, several methods have been proposed in the literature to generate pseudo-weights, including ad-hoc weights, inclusion probability adjusted weights, and propensity score adjusted weights. We empirically compare various weighting strategies via an extensive simulation study, where probability and nonprobability samples are combined. Weight normalization and raking adjustment are also considered. Our simulation results suggest that the unity weight method (with weight normalization) and the inclusion probability adjusted weight method yield very good overall performance. This work is motivated by the Buckeye Teen Health Study, which examines risk factors for the initiation of smoking among teenage males in Ohio. To address the low response rate in the initial probability sample and low prevalence of smokers in the target population, a small convenience sample was collected as a supplement. Our proposed method yields estimates very close to the ones from the analysis using only the probability sample and enjoys the additional benefit of being able to track more teens with risky behaviors through follow-ups.

5.
Ann Ital Chir ; 95(4): 690-698, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39186343

RESUMO

AIM: Remimazolam, known for its rapid onset, quick metabolism, and short recovery time from sedation, offers significant advantages in clinical anesthesia. Previous studies have primarily investigated its application in adult surgical anesthesia, with less focus on its utilization in pediatric patients. Therefore, we aimed to explore the 50% effective dose (ED50) and 95% effective dose (ED95) of remimazolam for laryngeal mask airway (LMA) insertion during general anesthesia in pediatric strabismus correction surgery and investigate its dose-response relationship, thereby providing valuable reference data for safer and more rational clinical use of remimazolam. METHODS: This study included 32 patients aged 3-12 years undergoing strabismus correction surgery at Ningbo Aier Guangming Eye Hospital in 2024. The dosage of remimazolam was determined according to the Dixon 'up-and-down' sequential method: the starting induction dose was 0.2 mg/kg, with a step dose of 0.05 mg/kg. In cases of positive anesthetic effect, the subsequent patient received a reduced step dose, while in cases of negative anesthetic effect, the next subject received an increased step dose. The trial was terminated upon observing seven "positive-negative" crossover points. Furthermore, the ED50 and ED95, along with their 95% confidence intervals (95% CI) were calculated using the Probit regression analysis. Additionally, vital signs of the patients, such as peripheral oxygen (SpO2), heart rate, and blood pressure, along with the incidence of adverse events, were monitored. RESULTS: The ED50 of remimazolam for LMA insertion in pediatric strabismus correction surgery was 0.300 mg/kg (95% CI 0.276-0.323 mg/kg), and the ED95 was 0.369 mg/kg (95% CI 0.324-0.414 mg/kg). Throughout the surgery, SpO2, heart rate, and blood pressure remained stable without any significant fluctuations. CONCLUSIONS: The ED50 and ED95 of remimazolam for LMA insertion in pediatric strabismus correction surgery are 0.300 mg/kg and 0.369 mg/kg, respectively. This study demonstrates that remimazolam is both safe and effective for LMA insertion during general anesthesia in pediatric strabismus correction surgery.


Assuntos
Anestesia Geral , Relação Dose-Resposta a Droga , Máscaras Laríngeas , Estrabismo , Humanos , Anestesia Geral/métodos , Pré-Escolar , Criança , Estrabismo/cirurgia , Masculino , Feminino , Benzodiazepinas/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem
6.
Sci Total Environ ; 951: 175729, 2024 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-39214367

RESUMO

The development of environmentally responsive biodegradable polymers is a promising solution for balancing the stability and degradability of biodegradable plastics. In this study, a commercial biodegradable polyester, poly(butylene adipate-co-butylene terephthalate) (PBAT), was used as the substrate and was synthetically modified with a small amount of anionic sodium 1-3-isophthalate-5-sulfonate (SIPA) to obtain the ionized random poly(butylene adipate-co-butylene terephthalate-co-butylene 5-sodiosulfoisophthalate) (PBATS). The introduction of the sodium sulfonate ionic group enhanced the mechanical and heat-resistant properties of the material, while significantly improving the hydrophilicity and water absorption of the copolyesters of PBATSs and endowing them with special pH-responsive degradation properties. Compared with PBAT, PBATS copolyesters could accelerate degradation in acidic or alkaline buffer solutions and natural seawater, while degradation was inhibited in neutral buffer solutions at pH 7.2. Degradation experiments in simulated gastric, intestinal, and body fluids revealed that the copolyester showed specific and rapid degradation in acidic gastric fluids. This environmentally-responsive degradable material greatly expands the special applications of biodegradable polyesters in the fields of environmental remediation and medical applications.


Assuntos
Poliésteres , Poliésteres/química , Concentração de Íons de Hidrogênio , Biodegradação Ambiental , Plásticos Biodegradáveis/química , Poluentes Químicos da Água/química
7.
J Hazard Mater ; 478: 135333, 2024 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-39116751

RESUMO

The synthesis of novel water-soluble polymers with biodegradability is an effective way to mitigate their negative environmental impacts. In this study, semi-aromatic copolyester poly(butylene succinate-co-butylene terephthalate) (PBST) with exceptional biodegradability is used as the resin matrix. Anionic sodium 1-3-isophthalate-5-sulfonate (SIPA) is introduced as a fourth monomer to prepare random poly(butylene succinate-co-butylene terephthalate-co-butylene 5-sodiosulfoisophthalate) (PBSTS) copolyesters by melt copolymerization. The incorporation of ionic groups enhances the hydrophilicity and water absorption of the copolyesters, resulting in water-soluble materials that exhibit ionic and temperature responsivity. Furthermore, the ionized biodegradable copolyesters demonstrate distinct pH-dependent degradation, which is accelerated at pH = 5.5 and 8.5 but inhibited at pH = 7.2. Degradation assessments in simulated body fluids reveal that the PBSTS copolyesters exhibit significant degradation in gastric fluids at pH = 1.5 with minimal degradation in intestinal fluids at pH = 6.8 and in body fluids at pH = 7.0. This unique degradation performance highlights the potential of these materials for addressing the challenges associated with selective drug delivery and localized controlled release in the human body.

8.
Front Pharmacol ; 15: 1391356, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39170708

RESUMO

Background: Teriparatide is approved for osteoporosis. Post-marketing surveillance is critical given its widespread use. Objective: To investigate adverse events (AEs) associated with teriparatide using the FAERS database, compare association strengths for key AEs, and explore potential applications to provide clinical reference. Methods: FAERS data from 2004 to 2023 were analyzed. Reports where teriparatide was the primary suspect drug were included. Adverse events were mapped to System Organ Classes and Preferred Terms. Disproportionality analysis using ROR, PRR, BCPNN and EBGM algorithms was conducted to detect safety signals. Results: Out of 107,123 reports with teriparatide as the primary suspect, key AEs identified included pain in extremity (PRR: 4.54), muscle spasms (PRR: 5.11), fractures (PRR range: 17.67-552.95), and increased calcium levels (PRR: 50.73). Teriparatide exhibited a stronger association with increased calcium levels (PRR: 50.73) compared to fractures (PRR range: 17.67-552.95). Notably, only 10.86% of AE reports were submitted by physicians and another 10% by other health professionals. Subset analyses showed a higher consistency of reported AEs from health professionals compared to the general dataset. Off-label uses were noted in conditions such as arthritis (0.57%) and cancer (0.12%). For osteoporosis, main AEs were pain (18.2%), fractures (12.4%), muscle spasms (7.7%), and nausea (6.5%), while glucocorticoid-induced osteoporosis AEs included fractures (24.1%), pain (13.2%), decreased bone density (9.8%), and nausea (5.1%). Conclusion: Our findings provide real-world safety data on teriparatide, revealing key AEs and their association strengths. The low proportion of reports by healthcare professionals suggests the need for cautious interpretation. Continuous vigilance and further research are imperative to guide teriparatide's clinical use.

9.
Front Microbiol ; 15: 1427143, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39113839

RESUMO

Introduction: Chitin, abundant in marine environments, presents significant challenges in terms of transformation and utilization. A strain, T22.7.1T, with notable chitin deacetylation capabilities, was isolated from the rhizosphere of Acanthus ebracteatus in the North Sea of China. Comparative 16S rDNA sequence analysis showed that the new isolate had the highest sequence similarity (99.79%) with Rhodococcus indonesiensis CSLK01-03T, followed by R. ruber DSM 43338T, R. electrodiphilus JC435T, and R. aetherivorans 10bc312T (98.97%, 98.81%, and 98.83%, respectively). Subsequent genome sequencing and phylogenetic analysis confirmed that strain T22.7.1T belongs to the R. indonesiensis species. However, additional taxonomic characterization identified strain T22.7.1T as a novel type strain of R. indonesiensis distinct from CSLK01-03T. Methods: This study refines the taxonomic description of R. indonesiensis and investigates its application in converting chitin into chitosan. The chitin deacetylase (RiCDA) activity of strain T22.7.1T was optimized, and the enzyme was isolated and purified from the fermentation products. Results: Through optimization, the RiCDA activity of strain T22.7.1T reached 287.02 U/mL, which is 34.88 times greater than the original enzyme's activity (8.0 U/mL). The natural CDA enzyme was purified with a purification factor of 31.83, and the specific activity of the enzyme solution reached 1200.33 U/mg. RiCDA exhibited good pH and temperature adaptability and stability, along with a wide range of substrate adaptabilities, effectively deacetylating chitin, chitooligosaccharides, N-acetylglucosamine, and other substrates. Discussion: Product analysis revealed that RiCDA treatment increased the deacetylation degree (DD) of natural chitin to 83%, surpassing that of commercial chitosan. Therefore, RiCDA demonstrates significant potential as an efficient deacetylation tool for natural chitin and chitooligosaccharides, highlighting its applicability in the biorefining of natural polysaccharides.

10.
Biomed Phys Eng Express ; 10(5)2024 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-39094590

RESUMO

Purpose. Secondary skin collimation (SSC) is essential for shielding normal tissues near tumors during electron and orthovoltage radiation treatments. Traditional SSC fabrication methods, such as crafting in-house lead sheets, are labor-intensive and produce SSCs with low geometric accuracy. This study introduces a workflow that integrated 3D scanning and 3D printing technologies with an in-house mold process, enabling the production of patient-specific SSCs within six hours.Methods. An anthropomorphic head phantom was scanned with a handheld 3D scanner. The resulting scan data was imported into 3D modeling software for design. The completed model was exported to a 3D printer as a printable file. Subsequently, molten Cerrobend was poured into the mold and allowed to set, completing the SSC production. Geometric accuracy was assessed using CT images, and the shielding effectiveness was evaluated through film dosimetry.Results. The 3D printed mold achieved submillimeter accuracy (0.5 mm) and exhibited high conformity to the phantom surface. It successfully endured the weight and heat of the Cerrobend during pouring and curing. Dosimetric analysis conducted with radiochromic film demonstrated good agreement between the measured and expected attenuation values of the SSC slab, within ±3%.Conclusions. This study presents a proof of concept for novel mold room workflows that produce patient-specific SSCs within six hours, a significant improvement over the traditional SSC fabrication process, which takes 2-3 days. The submillimeter accuracy and versatility of 3D scanning and printing technologies afford greater design freedom and enhanced delivery accuracy for cases involving irregular geometries.


Assuntos
Imagens de Fantasmas , Impressão Tridimensional , Pele , Humanos , Tomografia Computadorizada por Raios X/métodos , Software , Cabeça , Desenho de Equipamento , Proteção Radiológica/métodos , Proteção Radiológica/instrumentação , Dosimetria Fotográfica/métodos , Dosimetria Fotográfica/instrumentação
11.
Br J Hosp Med (Lond) ; 85(8): 1-17, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39212551

RESUMO

Aims/Background: In an era where patient-centred care is paramount, effectively managing and analyzing hospital complaints is crucial for improving service quality and patient satisfaction. This study examines hospital complaints to enhance management practices by differentiating between surgery-related and non-surgery-related grievances. By identifying patterns in complaint types and outcomes, we aim to inform targeted quality improvement strategies that address specific patient concerns and boost operational efficiency. Methods: The study utilized data from an internal complaint management system over one year. Complaints were categorized as either surgery-related or non-surgery-related. Descriptive statistics and cross-tabulation analysis were employed to examine the data. The sample comprised 132 complaints, with 67 being surgery-related and 65 non-surgery-related. Results: The analysis revealed that surgery-related complaints frequently involved issues with 'Patient Communication' and 'Surgical Error', while non-surgery-related complaints were primarily about the 'Medical Treatment Process'. The Surgery Department received the highest number of complaints, indicating a critical area for intervention. Additionally, the correlation between complaint types and outcomes provided insights into potential areas for improvement. Conclusion: The findings highlight the need for targeted communication training and procedural enhancements in surgical departments. Non-surgical departments should focus on improving treatment protocols and transparency. These strategies can reduce complaints and improve patient satisfaction. Future research should develop and test interventions based on these insights to further enhance healthcare quality.


Assuntos
Satisfação do Paciente , Humanos , Comunicação , Procedimentos Cirúrgicos Operatórios , Melhoria de Qualidade , Erros Médicos/prevenção & controle , Assistência Centrada no Paciente , Administração Hospitalar , Qualidade da Assistência à Saúde , Centro Cirúrgico Hospitalar/organização & administração
12.
Polymers (Basel) ; 16(16)2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-39204497

RESUMO

Developing recyclable and self-healing non-isocyanate polyurethane (NIPU) from renewable resources to replace traditional petroleum-based polyurethane (PU) is crucial for advancing green chemistry and sustainable development. Herein, a series of innovative cross-linked Poly(hydroxyurethane-urea)s (PHUUs) were prepared using renewable carbon dioxide (CO2) and vanillin, which displayed excellent thermal stability properties and solvent resistance. These PHUUs were constructed through the introduction of reversible hydrogen and imine bonds into cross-linked polymer networks, resulting in the cross-linked PHUUs exhibiting thermoplastic-like reprocessability, self healing, and closed-loop recyclability. Notably, the results indicated that the VL-TTD*-50 with remarkable hot-pressed remolding efficiency (nearly 98.0%) and self-healing efficiency (exceeding 95.0%) of tensile strength at 60 °C. Furthermore, they can be degraded in the 1M HCl and THF (v:v = 2:8) solution at room temperature, followed by regeneration without altering their original chemical structure and mechanical properties. This study presents a novel strategy for preparing cross-linked PHUUs with self-healing and closed-loop recyclability from renewable resources as sustainable alternatives for traditional petroleum-based PUs.

14.
Expert Opin Drug Saf ; : 1-10, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39016171

RESUMO

BACKGROUND: Osteoporosis (OP), characterized by low bone mass and increased fracture risk, is a prevalent skeletal disorder. Teriparatide (TP) and abaloparatide (ABL) are anabolic agents that may reduce fracture incidence, but their impact on musculoskeletal and connective tissue disorders (MCTD) risk is uncertain. RESEARCH DESIGN AND METHODS: A retrospective, observational disproportionality analysis was conducted utilizing FAERS data from Q1 2004 to Q3 2023, where TP or ABL was identified as the primary suspect drug. Multiple data mining algorithms, including reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS), were employed to detect MCTD safety signals. RESULTS: A total of 366,747 TP-related and 422,377 ABL-related cases were identified, predominantly among female patients aged ≥45 years. The top specific AEs involved musculoskeletal, connective tissue, and administration site disorders. Comparative analysis revealed a higher frequency of AEs related to the nervous, cardiovascular, and gastrointestinal systems for ABL compared to TP. Both drugs exhibited strong signals for arthralgia, limb pain, back pain, muscle spasms, bone pain, muscle pain, and muscle weakness. CONCLUSION: The analysis suggests a potential MCTD risk with TP and ABL treatment in OP patients, highlighting the need for AE monitoring and management in clinical practice. This contributes to a better understanding of the safety profiles of these anabolic medications.

15.
Medicine (Baltimore) ; 103(30): e39063, 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39058881

RESUMO

BACKGROUND: Remimazolam, a recently developed anesthetic characterized by its rapid and ultra-short-acting properties, exhibits pharmacological attributes that make it potentially suitable for painless surgical abortion procedures. The objective of this study was to determine the effective dose of remimazolam when administered in combination with sufentanil, with the intention of inhibiting body movement during surgical abortion. Additionally, a secondary objective was to assess the recovery profile from general anesthesia. METHODS: The study enrolled a total of 25 healthy women aged 20 to 40, with a body mass index between 18 and 28 kg/m2, in their first trimester of pregnancy (up to 12 weeks), and American Society of Anesthesiologists status I and II. Anesthesia induction was initiated by administering sufentanil at a dose of 0.1 µg/kg. The modified Dixon up-and-down method was employed to determine the induction dose of remimazolam for each patient. RESULTS: The 50% and 95% effective dose of remimazolam for inhibitory effects of body movement was estimated using centered isotonic regression to be 0.145 mg/kg (95% CI: 0.115, 0.207), and 0.242 mg/kg (95% CI: 0.232, 0.620), respectively. Five out of 25 (20%) experienced hiccups, with 1 patient having persistent hiccups until the end of the surgery. The mean time to first eye-opening was 51.4 ±â€…20.5 seconds, and the time to obey verbal command was 54.5 ±â€…20.6 seconds. Upon arrival at the postanesthesia care unit, 95.7% of the patients achieved a Modified Aldrete score ≥ 9. CONCLUSIONS: The 50% and 95% effective dose of remimazolam for inhibiting body movement during surgical abortion when used in combination with 0.1 µg/kg of sufentanil were 0.145 mg/kg and 0.242 mg/kg, respectively.


Assuntos
Aborto Induzido , Sufentanil , Humanos , Feminino , Adulto , Sufentanil/administração & dosagem , Aborto Induzido/métodos , Gravidez , Adulto Jovem , Benzodiazepinas/administração & dosagem , Movimento/efeitos dos fármacos , Relação Dose-Resposta a Droga , Período de Recuperação da Anestesia , Anestesia Geral/métodos , Hipnóticos e Sedativos/administração & dosagem
16.
Nat Commun ; 15(1): 6425, 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39080287

RESUMO

Skillful subseasonal forecasts are crucial for various sectors of society but pose a grand scientific challenge. Recently, machine learning-based weather forecasting models outperform the most successful numerical weather predictions generated by the European Centre for Medium-Range Weather Forecasts (ECMWF), but have not yet surpassed conventional models at subseasonal timescales. This paper introduces FuXi Subseasonal-to-Seasonal (FuXi-S2S), a machine learning model that provides global daily mean forecasts up to 42 days, encompassing five upper-air atmospheric variables at 13 pressure levels and 11 surface variables. FuXi-S2S, trained on 72 years of daily statistics from ECMWF ERA5 reanalysis data, outperforms the ECMWF's state-of-the-art Subseasonal-to-Seasonal model in ensemble mean and ensemble forecasts for total precipitation and outgoing longwave radiation, notably enhancing global precipitation forecast. The improved performance of FuXi-S2S can be primarily attributed to its superior capability to capture forecast uncertainty and accurately predict the Madden-Julian Oscillation (MJO), extending the skillful MJO prediction from 30 days to 36 days. Moreover, FuXi-S2S not only captures realistic teleconnections associated with the MJO but also emerges as a valuable tool for discovering precursor signals, offering researchers insights and potentially establishing a new paradigm in Earth system science research.

17.
Artigo em Inglês | MEDLINE | ID: mdl-39027884

RESUMO

Purpose: This study aims to automate the Monte Carlo (MC) workflow utilized for radiotherapy dosimetry, focusing on an Elekta LINAC delivery system. It addresses the challenge of integrating MC simulations into routine clinical practice, making this accurate yet complex method more accessible and efficient for radiotherapy dosimetry. Methods and Materials: We developed a user-friendly software featuring a graphical user interface (GUI) that integrates EGSnrc for MC simulations. The software streamlines the process from retrieving Digital Imaging and Communications in Medicine (DICOM) data to executing dose calculations and comparing dose distributions. To validate our proposed tool, we compared its computed doses for IMRT and VMAT plans from the Pinnacle TPS for an Elekta Versa HD linear accelerator against MC simulation results. This comparison utilized our in-house software and GUI as the tool, covering various treatment sites and prescriptions. Results: The automated MC workflow demonstrated high accuracy in dose calculations and streamlined integration with clinical workflows. The comparison between the MC-simulated and TPS-calculated doses revealed excellent agreement, highlighting the reliability of MC for independent dose verification in complex treatment scenarios. Conclusions: The automated MC workflow developed represents a substantial improvement in the practicality and efficiency of MC simulations in radiotherapy. This advancement not only simplifies the dosimetry process but also ensures high accuracy, establishing it as a valuable tool for routine patient-specific quality assurance and the development of specialized treatment procedures.

18.
Curr Issues Mol Biol ; 46(6): 5682-5700, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38921011

RESUMO

It is known that sialyllactose (SL) in mammalians is a major source of sialic acid (Sia), which can further form cytidine monophosphate sialic acid (CMP-Sia), and the final product is polysialic acid (polySia) using polysialyltransferases (polySTs) on the neural cell adhesion molecule (NCAM). This process is called NCAM polysialylation. The overexpression of polysialylation is strongly related to cancer cell migration, invasion, and metastasis. In order to inhibit the overexpression of polysialylation, in this study, SL was selected as an inhibitor to test whether polysialylation could be inhibited. Our results suggest that the interactions between the polysialyltransferase domain (PSTD) in polyST and CMP-Siaand the PSTD and polySia could be inhibited when the 3'-sialyllactose (3'-SL) or 6'-sialyllactose (6'-SL) concentration is about 0.5 mM or 6'-SL and 3 mM, respectively. The results also show that SLs (particularly for 3'-SL) are the ideal inhibitors compared with another two inhibitors, low-molecular-weight heparin (LMWH) and cytidine monophosphate (CMP), because 3'-SL can not only be used to inhibit NCAM polysialylation, but is also one of the best supplements for infant formula and the gut health system.

19.
Biomimetics (Basel) ; 9(6)2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38921223

RESUMO

The beetle, of the order Coleoptera, possesses outstanding flight capabilities. After completing flight, they can fold their hindwings under the elytra and swiftly unfold them again when they take off. This sophisticated hindwing structure is a result of biological evolution, showcasing the strong environmental adaptability of this species. The beetle's hindwings can provide biomimetic inspiration for the design of flapping-wing micro air vehicles (FWMAVs). In this study, the Asian ladybird (Harmonia axyridis Pallas) was chosen as the bionic research object. Various kinematic parameters of its flapping flight were analyzed, including the flight characteristics of the hindwings, wing tip motion trajectories, and aerodynamic characteristics. Based on these results, a flapping kinematic model of the Asian ladybird was established. Then, three bionic deployable wing models were designed and their structural mechanical properties were analyzed. The results show that the structure of wing vein bars determined the mechanical properties of the bionic wing. This study can provide a theoretical basis and technical reference for further bionic wing design.

20.
Sci Rep ; 14(1): 13489, 2024 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-38866931

RESUMO

Chieh-qua (Benincasa hispida Cogn. var. Chieh-qua How.) fruit development starts post pollination. With the continuous expansion of the fruit, the soluble solid content of the fruit decreases. Because there are no reports on the early development of Chieh-qua fruit, this study compared fruit transcriptomes at 0-, 3-, and 7 day post pollination (dpp). 104,747 unigenes were assembled from clean reads and compared using six public databases for similarity searching. Compared with those of 0 dpp (C), there were differences in the expression of 12,982 and 6541 genes in the fruit tissue at 3 dpp and 7 dpp, respectively. Compared with 3 dpp (B), there were 14,314 differentially expressed genes in the fruit at 7 dpp (A). Based on the analysis of transcription factors, 213 nucleotides in the MYB superfamily were identified; among them, 94 unigenes of the MYB superfamily were differentially expressed at the three stages. In the pairwise comparison of differential expression, eight unigenes (Gene_id: TRINITY_DN32880_c1_g2, TRINITY_DN35142_c2_g2, TRINITY_DN32454_c11_g6, TRINITY_DN34105_c2_g7, TRINITY_DN32758_c3_g3, TRINITY_DN33604_c4_g10, TRINITY_DN34466_c3_g1, TRINITY_DN35924_c3_g2) were homologous to those of MYB59, MYB-GT3b, MYB18, MYB4, MYB108, MYB306, MYB340, and MYB-bHLH13. These unigenes differed significantly among the three stages. Furthermore, MYB59 and MYB18 exhibited higher expression at 7 dpp. MYB4, MYB-GT3b, MYB108, and MYB306 showed the highest expression levels in fruits at 3 dpp. In addition, MYB340 and MYB-bHLH13 showed higher expression levels during the unpollinated stage. MYB59, MYB-GT3b, MYB18, MYB4, MYB108, MYB306, MYB340, and MYB-bHLH13 may play crucial roles in Chieh-qua fruit development, defense, and blossoming. This study provides a basis for further investigation of MYB superfamily genes involved in early fruit expansion in chieh-qua.


Assuntos
Frutas , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas , Fatores de Transcrição , Frutas/genética , Frutas/crescimento & desenvolvimento , Frutas/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Perfilação da Expressão Gênica/métodos , Transcriptoma , RNA-Seq/métodos , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Anotação de Sequência Molecular
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