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1.
J Nurs Scholarsh ; 2024 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-38703352

RESUMO

INTRODUCTION: Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses. DESIGN: Mixed studies systematic review. METHODS: Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design. RESULTS: A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation. CONCLUSION: The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors. CLINICAL RELEVANCE: Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.

2.
NPJ Digit Med ; 6(1): 236, 2023 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-38114588

RESUMO

Conversational artificial intelligence (AI), particularly AI-based conversational agents (CAs), is gaining traction in mental health care. Despite their growing usage, there is a scarcity of comprehensive evaluations of their impact on mental health and well-being. This systematic review and meta-analysis aims to fill this gap by synthesizing evidence on the effectiveness of AI-based CAs in improving mental health and factors influencing their effectiveness and user experience. Twelve databases were searched for experimental studies of AI-based CAs' effects on mental illnesses and psychological well-being published before May 26, 2023. Out of 7834 records, 35 eligible studies were identified for systematic review, out of which 15 randomized controlled trials were included for meta-analysis. The meta-analysis revealed that AI-based CAs significantly reduce symptoms of depression (Hedge's g 0.64 [95% CI 0.17-1.12]) and distress (Hedge's g 0.7 [95% CI 0.18-1.22]). These effects were more pronounced in CAs that are multimodal, generative AI-based, integrated with mobile/instant messaging apps, and targeting clinical/subclinical and elderly populations. However, CA-based interventions showed no significant improvement in overall psychological well-being (Hedge's g 0.32 [95% CI -0.13 to 0.78]). User experience with AI-based CAs was largely shaped by the quality of human-AI therapeutic relationships, content engagement, and effective communication. These findings underscore the potential of AI-based CAs in addressing mental health issues. Future research should investigate the underlying mechanisms of their effectiveness, assess long-term effects across various mental health outcomes, and evaluate the safe integration of large language models (LLMs) in mental health care.

3.
J Med Internet Res ; 25: e48508, 2023 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-37831488

RESUMO

BACKGROUND: The ubiquity of short videos has demonstrated vast potential for health communication. An expansion of research has examined the persuasive effect of health communication in short videos, yet a synthesis of the research is lacking. OBJECTIVE: This paper aims to provide an overview of the literature by examining the persuasive effect of health communication in short videos, offering guidance for researchers and practitioners. In particular, it seeks to address 4 key research questions: What are the characteristics of short videos, samples, and research designs in short video-based health communication literature? What theories underpin the short video-based health communication literature? What are the persuasive effects of health communication in short videos? and What directions should future research in this area take? METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 10 databases up to March 10, 2023, generated 4118 results. After the full-text screening, 18 articles met the eligibility criteria. RESULTS: The current research lacks a uniform definition of short videos, demonstrates sample biases in location and education, and adopts limited methodologies. Most studies in this synthesis are theoretically grounded or use theoretical concepts, which are predominantly well examined in persuasion research. Moreover, relevant topics and suitable themes are effective in persuasive health communication outcomes, whereas the impact of diverse narrative techniques remains ambiguous. CONCLUSIONS: We recommend that future research extends the definition of short videos beyond time constraints and explores non-Western and less-educated populations. In addition, researchers should consider diverse methods to provide a more comprehensive examination and investigate the impact of audience targeting and narrative techniques in short video health communication. Finally, investigating how the unique aspects of short videos interact with or challenge traditional persuasion theories is essential.


Assuntos
Comunicação em Saúde , Comunicação Persuasiva , Humanos , Narração , Inquéritos e Questionários
4.
Microvasc Res ; 150: 104589, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37481161

RESUMO

In our previous report, we presented evidence supporting the role of miR-574-3p in downregulating the expression of cullin 2 (CUL2) in gastric cancer (GC) cells. Expanding on those findings, the present study aims to confirm the direct interaction between miR-574-3p and the 3' untranslated region (3'UTR) of CUL2, which leads to the suppression of CUL2 expression and destabilization of the VCBCR complex. Based on these discoveries, we propose a novel pathway involving miR-574-3p, HIF-1α, and VEGF that contributes to angiogenesis. Through a series of meticulous experiments, we successfully validate this hypothesis. Specifically, our observations indicate that overexpression of miR-574-3p in GC cells induces an upregulation of HIF-1α and VEGF, resulting in enhanced proliferation, migration, invasion, and tube formation of HUVEC cells. Furthermore, employing a mouse model, we demonstrate that miR-574-3p facilitates the recruitment of endothelial cells towards matrigel xenografts. Additionally, we note a parallel increase in miR-574-3p and HIF-1α levels across multiple cell lines (including AGS, SGC-7901, Hela, and 293T cells) subjected to hypoxic conditions (2 % O2 or CoCl2 treatment), as well as in the myocardial muscles of sodium nitrite-induced hypoxic mice. Further investigations reveal that HIF-1α upregulates miR-574-3p expression by directly binding to the miR-574 promoter. Collectively, these findings strongly support the existence of a positive feedback loop between miR-574-3p and HIF-1α, which facilitates angiogenesis under hypoxic conditions.


Assuntos
MicroRNAs , Fator A de Crescimento do Endotélio Vascular , Animais , Humanos , Camundongos , Linhagem Celular Tumoral , Proliferação de Células , Retroalimentação , Células Endoteliais da Veia Umbilical Humana/metabolismo , Hipóxia , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
5.
Bioengineering (Basel) ; 9(12)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36550946

RESUMO

Ovarian, cervical, and endometrial cancer are the three most common gynecological malignancies that seriously threaten women's health. With the development of molecular biology technology, immunotherapy and targeted therapy for gynecologic tumors are being carried out in clinical treatment. Extracellular vesicles are nanosized; they exist in various body fluids and play an essential role in intercellular communication and in the regulation of various biological process. Several studies have shown that extracellular vesicles are important targets in gynecologic cancer treatment as they promote tumor growth, progression, angiogenesis, metastasis, chemoresistance, and immune system escape. This article reviews the progress of research into extracellular vesicles in common gynecologic tumors and discusses the role of extracellular vesicles in gynecologic tumor treatment.

6.
ACS Appl Bio Mater ; 5(7): 3452-3460, 2022 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-35714365

RESUMO

In the present work, cytidine 5'-monophosphate capped gold nanoclusters (AuNCs@CMP) are reported as a catalyst for redox reactions, which show both oxidase- and excellent peroxidase-like activity. When employing 3,3',5,5'-tetramethylbenzidine (TMB) as a substrate in the presence of hydrogen peroxide (H2O2), the maximum velocity (Vmax) was 175 × 10-8 M s-1in vitro. Besides, the AuNCs@CMP exhibited high catalytic activity for reactive oxygen species (ROS) generation with H2O2. Particularly, they also displayed excellent catalytic activity for ROS generation in tumor cells, being activated and promoted by the tumor microenvironment (TME). Consequently, the AuNCs@CMP show an excellent antitumor effect on HeLa and SW480 cells as assayed by flow cytometry. The antitumor mechanism of AuNCs@CMP was attributed to the high ROS generation based on the specific environments of the TME. Therefore, the present study provides TME-adaptive AuNCs@CMP with excellent mimetic peroxidase activity, producing significant ROS to kill the tumor cells in TME.


Assuntos
Apoptose , Nanopartículas Metálicas , Microambiente Tumoral , Apoptose/efeitos dos fármacos , Monofosfato de Citidina/farmacologia , Ouro/farmacologia , Peróxido de Hidrogênio , Nanopartículas Metálicas/química , Nanopartículas Metálicas/uso terapêutico , Peroxidases/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Microambiente Tumoral/efeitos dos fármacos
7.
Biomater Adv ; 133: 112624, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35525736

RESUMO

Human umbilical cord mesenchymal stem cell (hucMSC) derived exosomes (EXOs) have been investigated as a new treatment for spinal cord injury (SCI) because of their anti-inflammatory, anti-apoptotic, angiogenesis-promoting, and axonal regeneration properties. The CAQK peptide found in the brains of mice and humans after trauma has recently been found to specifically bind to the injured site after SCI. Thus, we developed a nanocarrier system called EXO-C@P based on hucMSC exosomes remodelled by the CRISPR/Cas9 plasmid to control inflammation and modified by the CAQK peptide. EXO-C@P was shown to effectively accumulate at the injury site and saturate the macrophages to significantly reduce the expression of inflammatory cytokines in a mouse model of SCI. Moreover, EXO-C@P treatment improved the performance of mice in behavioural assessments and upregulated soluble tumour necrosis factor receptor-1 (sTNFR1) in serum and at the trauma site after SCI surgery, but lowered the proportion of iNOS+ cells and the concentration of proinflammatory factors. In conclusion, EXO-C@P provides an effective alternative to multiple topical administration and drug delivery approaches for the treatment of SCI. STATEMENT OF SIGNIFICANCE: SCI is a serious disease characterised by a high incidence, high disability rate, and high medical costs, and has become a global medical problem. Several studies have shown that the inflammatory response is the critical inducer of secondary injury after SCI. The inflammatory cytokine TNF-α is considered to be one of the most significant therapeutic targets for autoimmune diseases. Antibodies targeting TNF-α and sTNFR1 are capable of neutralising free TNF-α. In this study, exosomes in the CRISPR/Cas9 system were used to establish stem cells with an autoregulated and feedback-controlled TNF-α response, with these cells secreting sTNFR1, which neutralised TNF-α and antagonised the inflammation stimulated by TNF-α. Moreover, the plasmid was combined with CAQK, which targeted the injury site and promoted the recovery of SCI function.


Assuntos
Exossomos , Células-Tronco Mesenquimais , Traumatismos da Medula Espinal , Sistemas CRISPR-Cas , Citocinas/metabolismo , Exossomos/metabolismo , Retroalimentação , Humanos , Fatores Imunológicos/metabolismo , Imunoterapia , Inflamação/metabolismo , Células-Tronco Mesenquimais/metabolismo , Plasmídeos , Traumatismos da Medula Espinal/terapia , Fator de Necrose Tumoral alfa/metabolismo , Cordão Umbilical/metabolismo
8.
Environ Res ; 208: 112703, 2022 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-35016862

RESUMO

Neonicotinoid insecticides (NEOs) are commonly applied for pest control in China and around the world. Previous studies reported that NEOs are hepatotoxic to mammals. However, limited studies have explored the associations between NEOs exposure and liver disease. In the present study, we detected six parent NEOs (p-NEOs), including acetamiprid, thiacloprid, dinotefuran, clothianidin, imidacloprid, and thiamethoxam, and five characteristic metabolites (m-NEOs), including 5-hydroxy-imidacloprid, olefin-imidacloprid, N-desmethyl-acetamiprid, 1-methyl-3-(tetrahydro-3-furylmethyl) guanidine and 1-methyl-3-(tetrahydro-3-furyl methyl) urea, in blood samples collected from healthy donors (n = 100; females vs. males: 45 vs. 55; age: 22-91 years) and liver cancer patients (n = 274; females vs. males: 118 vs. 156; age: 11-88 years) in one hospital from Guangzhou city, South China. NEOs were frequently detected (61%-94%) in blood samples, with median concentrations ranging from 0.19 ng/mL to 1.28 ng/mL and 0.20 ng/mL to 2.03 ng/mL for healthy and liver cancer populations, respectively. olefin-imidacloprid was the most abundant NEOs in healthy and liver cancer populations, accounting for 23.4% and 20.7%, respectively. Significant positive correlations among most m-NEOs concentrations were found, and associations between m-NEOs and their corresponding p-NEOs were positively correlated. These findings indicated that the sources of m-NEOs were both endogenous and exogeneous. Females had higher median concentrations of NEOs and their metabolites than males. Moreover, the α-fetoprotein values and blood concentrations of target analytes (r = 0.428-0.601, p < 0.05) were positively correlated. Meanwhile, associations between the concentrations of p-NEOs and m-NEOs and liver cancer were found (odds ratio = 2.33-9.02, 95% confidence interval = 0.31-22.7, p < 0.05), indicating that human exposure to NEOs and their metabolites might increase the odds of liver cancer prevalence. Our work provided a new insight into the hepatotoxicity of NEOs and their metabolites, and human health risks of exposure to these pollutants warranted further studies.


Assuntos
Inseticidas , Neoplasias Hepáticas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , China/epidemiologia , Coleta de Dados , Feminino , Humanos , Inseticidas/análise , Inseticidas/toxicidade , Neoplasias Hepáticas/induzido quimicamente , Neoplasias Hepáticas/epidemiologia , Masculino , Mamíferos , Pessoa de Meia-Idade , Neonicotinoides/toxicidade , Nitrocompostos/toxicidade , Adulto Jovem
9.
Comput Human Behav ; 127: 107050, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34646057

RESUMO

Social media browsing is commonly seen as a trigger of unhealthy social comparison (i.e., upward contrast), which negatively affects well-being. One underlying assumption is the predominance of positive self-presentation on social media, which may have shifted during the COVID-19 pandemic when negative disclosures have become more prevalent. In this study, we conceptualize social comparison as a multi-dimensional construct based on different comparing targets and processes, and explore how individual (i.e., cognitive reappraisal) and contextual (i.e., quarantine status) factors may influence the relationships among passive social media use, social comparison and stress during the COVID-19 pandemic. Drawing on a survey with 1131 Wuhan residents in China, we found that passive social media use was positively related to both upward contrast and downward identification, which in turn predicted a higher level of stress. Cognitive reappraisal was negatively associated with unhealthy social comparison (i.e., upward contrast and downward identification) but was positively related to healthy social comparison such as upward identification. Quarantined people tended to report more upward contrast, especially when they engaged in more frequent social media browsing. This study contributes to the larger debate about the impact of social media on mental health and offers practical implications.

10.
World Neurosurg ; 152: e700-e707, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34129985

RESUMO

BACKGROUND: Adjacent segmental degeneration (ASD) is one of the common complications after posterior lumbar interbody fusion (PLIF). Both whole body vibration (WBV) and osteoporosis are important factors associated with the biomechanics of the lumbar spine. However, to the best of our knowledge, no studies have investigated the effects of osteoporosis on ASD after PLIF under WBV. METHODS: In the present study, using one normal model, one PLIF model and one PLIF with osteoporosis model of the L1-S1 segment were developed. A 5-Hz, 40-N sinusoidal vertical load was imposed on the superior surface of L1 of each model to simulate WBV, and the dynamic responses and maximal values of intradiscal pressure, shear stress on annulus fibrosus, total deformation, and disc bulge were evaluated in the L1-L2, L2-L3, L3-L4, and L5-S1 segments. RESULTS: At the L1-L2, L2-L3, and L3-L4 levels, the differences in the dynamic responses and maximal values in intradiscal pressure, shear stress, total deformation, and disc bulge between the PLIF and PLIF with osteoporosis models were slight. However, at the L5-S1 level, the dynamic response curves and maximal intradiscal pressure, shear stress, and disc bulge values in the PLIF with osteoporosis model were significantly lower than those in the PLIF model. CONCLUSIONS: Osteoporosis can mitigate the development of ASD in the lower adjacent segment but has no obvious influence on the upper adjacent segments during WBV.


Assuntos
Degeneração do Disco Intervertebral/etiologia , Vértebras Lombares/cirurgia , Osteoporose/complicações , Complicações Pós-Operatórias/epidemiologia , Fusão Vertebral/métodos , Vibração , Fenômenos Biomecânicos , Simulação por Computador , Análise de Elementos Finitos , Humanos , Disco Intervertebral/diagnóstico por imagem , Modelos Biológicos , Amplitude de Movimento Articular
11.
Health Commun ; 36(12): 1549-1559, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33950763

RESUMO

Social networks have long been viewed as a structural determinant of health. With the proliferation of digital technologies, numerous studies have examined the health implications of online social networks (OSNs). However, the mechanisms through which OSNs may influence individual health are poorly understood. Employing a social network approach, this paper presents a systematic review of the literature examining how network characteristics of OSNs are linked to individuals' health behavior and/or status. Drawing on keyword searches in nine databases, we identified and analyzed 22 relevant articles from 1,705 articles published prior to 2017. The findings show that individual health is associated with a number of network characteristics, including both individual-level attributes (e.g., centrality) and network-level attributes (e.g., density, clustering). All of the included studies (n = 22) have focused on egocentric networks, and nine studies also collected whole network data of online health communities. Based on our review, we highlight three fruitful areas in the application of OSNs in public health: (1) disease and risk detection, (2) disease prevention and intervention, and (3) health behavior change. However, the precise mechanisms and causal pathways through which OSNs affect health remain unclear. More theoretically grounded, longitudinal, and mixed methods research is needed to advance this line of research.


Assuntos
Comportamentos Relacionados com a Saúde , Rede Social , Humanos , Saúde Pública , Apoio Social
12.
Pak J Med Sci ; 37(2): 403-408, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33679922

RESUMO

OBJECTIVE: To investigate the biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion (PLIF). METHODS: This study was designed and conducted in the Traumatology and Orthopedics Laboratory, School of Chinese Medicine, Jinan University, Guangzhou, China, between December 2019 and February 2020. A healthy finite element model of L3-S1 was developed along with one PLIF model and one PLIF with osteoporosis model. Based on a hybrid test method, the inferior surface of S1 was entirely fixed, and a preload of 400N combined with an adjusted moment was imposed on the superior surface of L3 in each model to simulate flexion, extension, lateral bending and axial rotation. The intradiscal pressure (IDP), shear stress on annulus fibrosus, and the range of motion (ROM) of L3-L4 and L5-S1 were calculated and compared. RESULTS: In each direction, the highest value of IDP and shear stress on annulus fibrosus at L3-L4 and L5-S1 was found in the PLIF model, and the lowest value in the healthy model. The largest ROM at L4-L5 appeared in the healthy model, and the smallest value in the PLIF model in each direction. At L3-L4 and L5-S1, the highest ROM in most directions was found in the PLIF model, followed by the PLIF with osteoporosis model, and the lowest value in the healthy model. CONCLUSIONS: Osteoporosis can decrease IDP, shear stress on annulus fibrosus, and ROM at adjacent levels, and slow down the development of ASD after PLIF.

13.
World Neurosurg ; 146: e739-e746, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33171324

RESUMO

BACKGROUND: Adjacent segment degeneration is a common complication following anterior lumbar interbody fusion (ALIF). Osteoporosis is becoming increasingly prevalent in the elderly population and thus patients undergoing ALIF may experience osteoporosis with age. However, the influence of osteoporosis on adjacent segment degeneration after ALIF remains unclear. METHODS: Three finite element models of the L3-S1 segment, including a healthy model, an ALIF model, and an ALIF with osteoporosis model, were used for analysis. ALIF was simulated at the L4-L5 segment. Based on a hybrid test method, the models were imposed with a preload of 400 N and an adjusted moment in flexion, extension, lateral bending, and axial torsion. Intradiscal pressure, shear stress on anulus fibrosus, and range of motion at L3-L4 and L5-S1 were calculated and compared. RESULTS: In each direction, the maximal values of intradiscal pressure and shear stress on anulus fibrosus at L3-L4 and L5-S1 were found in the ALIF model, and the minimal values were found in the healthy model. At L3-L4 and L5-S1, the maximal values of range of motion in most directions were found in the ALIF model followed by the ALIF with osteoporosis model, and the minimal values were found in the healthy model. However, the maximal value of range of motion at L5-S1 in axial torsion was found in the ALIF with osteoporosis model. CONCLUSIONS: Osteoporosis may mitigate the adverse influence of ALIF on adjacent segments.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Osteoporose/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Fusão Vertebral , Análise de Elementos Finitos , Humanos , Estresse Mecânico
14.
J Am Board Fam Med ; 33(5): 655-664, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989060

RESUMO

OBJECTIVE: Practice facilitation is an effective approach to implementing quality improvement (QI) interventions in practice-based research networks (PBRNs). Regular facilitator-practice interactions are necessary for successful facilitation, and missed engagements may hinder the process of practice improvement. This study employs a mixed-methods approach to characterize the dynamics of practice facilitation and examine facilitation delays and barriers, as well as their association with the achievement of QI program goals in a PBRN initiative. METHODS: This study presents a secondary analysis of data from 226 primary care practices that participated in the Healthy Hearts in the Heartland (H3) initiative. We performed a time series analysis to identify delays in facilitation activities, and then qualitatively analyzed practice facilitators' notes (n = 4358) to uncover facilitation barriers. Finally, we assessed the relationship between delays, barriers, and QI intervention completion. RESULTS: While most facilitation activities occurred at regular, practice-specific tempos, nearly all practices experienced at least 1 delay. Practices with more delays had lower QI intervention completion rates. Practices with more delays were more likely to have encountered barriers such as lack of time and staff, lack of staff engagement, technical issues, and staff turnover. DISCUSSION AND CONCLUSION: This study is the first to quantify irregular intervals between facilitation activities and demonstrate their negative association with project completion. The analytic method can be applied to identify at-risk practices and to accelerate timely interventions in future studies. Our delay detection algorithm could inform the design of a decision support system that notifies facilitators which practices may benefit from timely attention and resources.


Assuntos
Medicina de Família e Comunidade , Atenção Primária à Saúde , Melhoria de Qualidade , Medicina de Família e Comunidade/organização & administração , Acessibilidade aos Serviços de Saúde , Humanos , Atenção Primária à Saúde/organização & administração , Melhoria de Qualidade/organização & administração
15.
J Manipulative Physiol Ther ; 43(5): 446-456, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32829947

RESUMO

OBJECTIVE: To compare the biomechanical effect of lumbar fixed-point oblique pulling manipulation and traditional oblique pulling manipulation in the treatment of protrusion of lumbar intervertebral disk, and investigate the influence of disk degeneration on the 2 manipulations. METHODS: Three finite element models including 1 normal model, 1 mild degeneration, and 1 moderate degeneration model of L3-S1 were developed to simulate 2 oblique pulling manipulations. The disk protrusion was assumed to be in the left central and subarticular zone of the L4-L5 disk, and manipulations were carried out on the right. A 15-Nm right axial rotation moment and 150-N compressive loading were imposed on the upper endplate of L3 to simulate a traditional oblique pulling manipulation. To simulate lumbar fixed-point oblique pulling manipulation, in addition to a 15-Nm moment and 150-N compressive loading imposed on the L3 upper endplate, a 50-N force was imposed on the right lateral area of the L4 spinous process in a left front direction. The displacement and stress in the left central and subarticular zone of the L4-L5 disk were calculated and compared in the 3 models. RESULTS: The average displacement and stress in the left central and subarticular zone of L4-L5 disk were higher in fixed-point oblique pulling manipulation than those in traditional oblique pulling manipulation (P < .05). In addition, the values of average stress and displacement decreased significantly with the increase of lumbar disk degeneration (P < .05). CONCLUSION: Lumbar fixed-point oblique pulling manipulation showed a better biomechanical effect than traditional oblique pulling manipulation, and lumbar disk degeneration affected the 2 manipulations adversely in the virtual treatment of protrusion of the lumbar intervertebral disk using finite element models.


Assuntos
Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares/fisiopatologia , Região Lombossacral/fisiopatologia , Fenômenos Biomecânicos/fisiologia , Análise de Elementos Finitos , Humanos , Disco Intervertebral
16.
Artigo em Inglês | MEDLINE | ID: mdl-32656549

RESUMO

The last decade has seen increased reports of mental health problems among college students, with college counseling centers struggling to keep up with the demand for services. Digital mental health tools offer a potential solution to expand the reach of mental health services for college students. In this paper, we present findings from a series of design activities conducted with college students and counseling center staff aimed at identifying needs and preferences for digital mental health tools. Results emphasize the social ecosystems and social support networks in a college student's life. Our findings highlight the predominant role of known peers, and the ancillary roles of unknown peers and non-peers (e.g., faculty, family) in influencing the types of digital mental health tools students desire, and the ways in which they want to learn about mental health tools. We identify considerations for designing digital mental health tools for college students that take into account the identified social factors and roles.

17.
Adv Ther ; 37(3): 1100-1113, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31981104

RESUMO

INTRODUCTION: The prognostic performance of scoring systems for illness severity in infectious kidney transplant recipients (KTRs) is rarely reported. We investigated the ability of the scores for the quick Sequential Organ Failure Assessment (qSOFA), Sequential Organ Failure Assessment (SOFA) and Systemic Inflammatory Response Syndrome (SIRS) to predict in-hospital mortality, intensive care unit (ICU) admission and mechanical ventilation (MV) requirement. METHODS: This was a second analysis of a retrospective observational study. Scores for SIRS, SOFA and qSOFA were calculated upon hospitalization (infection onset was before hospitalization) or on the day of infection onset (infection episodes were during hospitalization). The primary outcome was in-hospital mortality. The secondary outcomes were ICU admission and MV requirement. Binary logistic regression and area under the receiver operating characteristic curve (AUC) were employed to assess prognostic performance. RESULTS: A total of 161 infectious episodes occurred in 97 KTRs. Forty patients (41%) experienced more than one episode. The SOFA score was available in 161 infections, and scores for qSOFA and SIRS were available in 160 infections. The SIRS score was not different between KTRs with opposite outcomes. The qSOFA score was higher in infections necessitating MV. The SOFA score was significantly higher in the deceased, those needing ICU admission, MV, and for those with positive etiology results. The SOFA score was the only independent predictor of in-hospital mortality, ICU admission, and MV requirement, and the AUCs were 0.879, 0.815, and 0.784, respectively. The optimum cutoff value of predicting the three outcomes was SOFA score ≥ 3. CONCLUSIONS: The SOFA score (but not those for SIRS and qSOFA) independently predicted in-hospital mortality, ICU admission, and MV requirement in infectious KTRs.


Assuntos
Infecções/diagnóstico , Infecções/mortalidade , Transplante de Rim , Escores de Disfunção Orgânica , Adulto , Feminino , Mortalidade Hospitalar/tendências , Hospitalização/estatística & dados numéricos , Humanos , Infecções/fisiopatologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos
18.
Gene ; 733: 144383, 2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31972307

RESUMO

We elucidate in this study that up-regulation of miR-574-5p in gastric cancer cells under hypoxic conditions contributed to angiogenesis. We found that miR-574-5p and HIF-1α were up-regulated in gastric cancer cells cultured under 2% O2 or in medium containing CoCl2, and in muscle tissues of mice injected with NaNO2, indicating up-regulation of miR-574-5p in vitro or in vivo in response to hypoxic conditions. We hypothesized that up-regulation of miR-574-5p could promote angiogenesis. Transfection of gastric cancer cells with miR-574-5p mimics or inhibitor resulted in increase or decrease in the expression of VEGFA. Viability, migration, invasion and tube formation of HUVECs cultured with conditioned medium from SGC/574 cells transfected with miR-574-5p inhibitor were reduced. Tube formation of HUVECs cultured with conditioned medium from SGC-7901 cells transfected with miR-574-5p mimics was increased. An in vivo study demonstrated that inhibition of miR-574-5p in the tumor xenografts of mice reduced the expression of CD31 one of the endothelial cell markers. We identified PTPN3 a tyrosine phosphatase as a target of miR-574-5p that bound to the 3'UTR of PTPN3 mRNA to inhibit the expression of PTPN3. Furthermore, the data in this study demonstrated that inhibition of PTPN3 in gastric cancer cells enhanced phosphorylation of p44/42 MAPKs and promoted angiogenesis. We conclude that miR-574-5p in gastric cancer cells promoted angiogenesis via enhancing phosphorylation of p44/42 MAPKs by miR-574-5p inhibition of PTPN3 expression.


Assuntos
Biomarcadores Tumorais/metabolismo , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , Neovascularização Patológica , Proteína Tirosina Fosfatase não Receptora Tipo 3/metabolismo , Neoplasias Gástricas/irrigação sanguínea , Animais , Apoptose , Biomarcadores Tumorais/genética , Proliferação de Células , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Proteína Tirosina Fosfatase não Receptora Tipo 3/genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Células Tumorais Cultivadas , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto
19.
Artigo em Inglês | MEDLINE | ID: mdl-33585841

RESUMO

While the HCI field increasingly examines how digital tools can support individuals in managing mental health conditions, it remains unclear how these tools can accommodate these conditions' temporal aspects. Based on weekly interviews with five individuals with depression, conducted over six weeks, this study identifies design opportunities and challenges related to extending technology-based support across fluctuating symptoms. Our findings suggest that participants perceive events and contexts in daily life to have marked impact on their symptoms. Results also illustrate that ebbs and flows in symptoms profoundly affect how individuals practice depression self-management. While digital tools often aim to reach individuals while they feel depressed, we suggest they should also engage individuals when they are less symptomatic, leveraging their energy and motivation to build habits, establish plans and goals, and generate and organize content to prepare for symptom onset.

20.
Neurosurg Rev ; 43(3): 813-823, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30259268

RESUMO

Three fixation modalities including suture suspensory, anchor, and titanium plate are used extensively in unilateral open-door cervical laminoplasty. Nevertheless, up to now no systematic review and network meta-analysis have been published, and the differences in efficacy and safety of the three fixation modalities are still unclear. The purpose of this study is to compare the effectiveness and safety of the three fixation modalities including suture suspensory, anchor, and titanium plate in unilateral open-door cervical laminoplasty. Randomized controlled trials and cohort studies which compared the three interventions in unilateral open-door cervical laminoplasty were identified using the following databases: PubMed, Cochrane Library, Embase, Web of science, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data. Network meta-analysis was performed using R 3.4.3 software and STATA version 14.0. The results revealed that compared with suture suspensory, titanium plate and anchor showed the same effects in Japanese Orthopedic Association Scores, operative time, and blood loss. However, titanium plate showed superiority in postoperative range of motion of cervical spine, incidence of axial symptoms, and C5 paralysis; in terms of cervical curvature, titanium plate also showed better effectiveness than suture suspensory, but similar as anchor. Our network meta-analysis suggests that titanium plate is preferable to suture suspensory or anchor with more range of motion and lower incidence of axial symptoms and C5 paralysis. However, considering the limitations of this research, high-quality trials are needed in the future to evaluate the outcomes.


Assuntos
Vértebras Cervicais/cirurgia , Fixadores Internos , Procedimentos Neurocirúrgicos/métodos , Humanos , Laminoplastia , Metanálise em Rede , Resultado do Tratamento
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