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1.
Eur J Clin Pharmacol ; 80(5): 685-696, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38329479

RESUMO

PURPOSE: To establish the population pharmacokinetics (PPK) model of cyclosporine A(CsA) in pediatric patients with thalassemia undergoing allogeneic hematopoietic stem cell transplantation (HSCT), aiming at providing a reference for clinical dose individualization of CsA. METHODS: Children with thalassemia who underwent allogeneic HSCT were enrolled retrospectively. The PPK structural model and the random variable model of CsA were established on NONMEN. And goodness of fit plots (GOFs), visual predictive check (VPC), and bootstrap and normalized prediction distribution errors (NPDE) were used to evaluate the final model. RESULTS: A one-compartment model with first-order absorption was employed to fit the base model. A total of 74 pediatric patients and 600 observations of whole blood concentration were included. The final model included weight (WT) in clearance (CL), alongside post-operative day (POD), fluconazole (FLUC), voriconazole (VORI), posaconazole (POSA), and red blood cell count (RBC) significantly. All the model evaluations were passed. CONCLUSION: In the PPK model based on the pediatric cohort on CsA with thalassemia undergoing allogeneic HSCT, WT, POD, FLUC, VORI, POSA, and RBC were found to be the significant factors influencing CL of CsA. The reliability and robustness of the final model were excellent. It is expected that the PPK model can assist in individualizing dosing strategy clinically.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Talassemia , Humanos , Criança , Ciclosporina/farmacocinética , Imunossupressores/farmacocinética , Estudos Retrospectivos , Reprodutibilidade dos Testes , Modelos Biológicos , Voriconazol , Fluconazol , Talassemia/cirurgia
2.
Angew Chem Int Ed Engl ; 63(9): e202317457, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38169125

RESUMO

Quasi-solid zinc-ion batteries using hydrogel electrolytes show great potential in energy storage devices owing to their intrinsic safety, fewer side reactions and wide electrochemical windows. However, the dendrite issues on the zinc anodes cannot be fundamentally eliminated and the intrinsic anode-electrolyte interfacial interspace is rarely investigated. Here, we design a dynamically healable gelatin-based hydrogel electrolyte with a highly reversible sol-gel transition, which can construct a conformal electrode-electrolyte interface and further evolve into a stable solid-solid interface by in situ solidification. The unique helical gelatin chain structure provides a uniform channel for zinc ion transport by the bridging effect of sulfate groups. As a consequence, the dynamically healable interface enables dendrite-free zinc anodes and repeatedly repairs the anode-electrolyte interfacial interspaces by the reversible sol-gel transition of gelatin electrolyte to retain long-lasting protection for sustainable zinc-ion batteries.

3.
Anal Chem ; 95(31): 11769-11776, 2023 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-37489945

RESUMO

Biomolecular markers, particularly circulating microRNAs (miRNAs) play an important role in diagnosis, monitoring, and therapeutic intervention of cancers. However, existing detection strategies remain intricate, laborious, and far from being developed for point-of-care testing. Here, we report a portable colorimetric sensor that utilizes the hetero-assembly of nanostructures driven by base pairing and recognition for direct detection of miRNAs. Following hybridization, two sizes of nanoparticles modified with single-strand DNA can be robustly assembled into heterostructures with strong optical resonance, exhibiting distinct structure colors. Particularly, the large nanoparticles are first arranged into nanochains to enhance scattering signals of small nanoparticles, which allows for sensitive detection and quantification of miRNAs without the requirement of target extraction, amplification, and fluorescent labels. Furthermore, we demonstrate the high specificity and single-base selectivity of testing different miRNA samples, which shows great potential in the diagnosis, staging, and monitoring of cancers. These heterogeneous assembled nanostructures provide an opportunity to develop simple, fast, and convenient tools for miRNAs detection, which is suitable for many scenarios, especially in low-resource setting.


Assuntos
Técnicas Biossensoriais , MicroRNA Circulante , MicroRNAs , Nanoestruturas , MicroRNAs/genética , Hibridização de Ácido Nucleico , Corantes , Limite de Detecção
4.
Small ; 19(28): e2301162, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36988021

RESUMO

Rapid and ultra-sensitive detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for early screening and management of COVID-19. Currently, the real-time reverse transcription polymerase chain reaction (rRT-PCR) is the primary laboratory method for diagnosing SARS-CoV-2. It is not suitable for at-home COVID-19 diagnostic test due to the long operating time, specific equipment, and professional procedures. Here an all-printed photonic crystal (PC) microarray with portable device for at-home COVID-19 rapid antigen test is reported. The fluorescence-enhanced effect of PC amplifies the fluorescence intensity of the labeled probe, achieving detection of nucleocapsid (N-) protein down to 0.03 pg mL-1 . A portable fluorescence intensity measurement instrument gives the result (negative or positive) by the color of the indicator within 5 s after inserting the reacted PC microarray test card. The N protein in inactivated virus samples (with cycle threshold values of 26.6-40.0) can be detected. The PC microarray provides a general and easy-to-use method for the timely monitoring and eventual control of the global coronavirus pandemic.


Assuntos
COVID-19 , Humanos , COVID-19/diagnóstico , SARS-CoV-2 , Proteínas do Nucleocapsídeo/análise , Proteínas do Nucleocapsídeo/genética , Técnicas de Amplificação de Ácido Nucleico , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade
5.
J Cardiovasc Nurs ; 38(3): 237-246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37027128

RESUMO

INTRODUCTION: After left ventricular assist device (LVAD) implantation, caregivers may experience increasing burden because of new roles and responsibilities. We examined the association between caregiver burden at baseline and patient recovery after long-term LVAD implantation in patients ineligible for heart transplantation. METHODS: Between October 1, 2015, and December 31, 2018, data from 60 patients with a long-term LVAD (age, 60-80 years) and caregivers through 1 postoperative year were analyzed. Caregiver burden was measured using the Oberst Caregiving Burden Scale, a validated instrument used for measuring caregiver burden. Patient recovery post-LVAD implantation was defined by change in Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) overall summary score and rehospitalizations over 1 year. Multivariable regression models (least-squares for change in KCCQ-12 and Fine-Gray cumulative incidence for rehospitalizations) were used to assess for association with caregiver burden. RESULTS: Patients were 69.4 ± 5.5 years old, 85% men, and 90% White. Over the first year post-LVAD implantation, there was a 32% cumulative probability of rehospitalization; 72% (43/60) of patients had an improvement of ≥5 points in KCCQ-12 scores. Caregivers were 61.2 ± 11.5 years old, 93% women, 81% White, and 85% married. Median Oberst Caregiving Burden Scale Difficulty and Time scores at baseline were 1.13 and 2.27, respectively. Higher caregiver burden was not significantly associated with hospitalizations or change in patient health-related quality of life during the first year post-LVAD implantation. CONCLUSIONS: Higher caregiver burden at baseline was not associated with patient recovery in the first year after LVAD implantation. Understanding the associations between caregiver burden and patient outcomes after LVAD implantation is important as excessive caregiver burden is a relative contraindication for LVAD implantation.


Assuntos
Sobrecarga do Cuidador , Insuficiência Cardíaca , Coração Auxiliar , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Cardíaca/cirurgia , Qualidade de Vida , Resultado do Tratamento , Sobrecarga do Cuidador/epidemiologia , Readmissão do Paciente/estatística & dados numéricos
6.
Angew Chem Int Ed Engl ; 62(3): e202215306, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36416188

RESUMO

The booming of aqueous zinc-ion batteries (AZIBs) draws the researchers' attention to issues of zinc metal anodes, such as uncontrollable dendrite growth, corrosion, and volume effects. Zinc powder anode is more suitable for the industrial application of AZIBs than the widely used zinc foil anode due to its low cost, tunability and processability. However, the related solutions are rarely studied because the above issues of zinc metal anode are more serious in zinc powder anode. Herein, for the first time, we design a semi-solid zinc slurry anode consisting of zinc powder and zincophilic tin additive dispersed in a conductive elastic rheological network. Zinc can be deposited homogeneously on the dispersed tin particles, which avoids agglomerative zinc deposition and alleviates volume change during repeated zinc stripping/plating. Moreover, the practical application of the full cell with slurry is very promising since its operating life can be easily extended by facile slurry renewal.

7.
Angew Chem Int Ed Engl ; 62(35): e202308017, 2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37409886

RESUMO

Aqueous zinc-ion batteries are inherently safe, but the severe dendrite growth and corrosion reaction on zinc anodes greatly hinder their practical applications. Most of the strategies for zinc anode modification refer to the research of lithium metal anodes on surface regulation without considering the intrinsic mechanisms of zinc anode. Herein, we first point out that surface modification cannot permanently protect zinc anodes due to the unavoidable surface damage during the stripping process by solid-liquid conversion. A bulk-phase reconstruction strategy is proposed to introduce abundant zincophilic sites both on the surface and inside the commercial zinc foils. The bulk-phase reconstructed zinc foil anodes exhibit uniform surfaces with high zincophilicity even after deep stripping, significantly improving the resistance to dendrite growth and side reactions. Our proposed strategy suggests a promising direction for the development of dendrite-free metal anodes for practical rechargeable batteries with high sustainability.

8.
Small ; 18(43): e2104148, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34766709

RESUMO

Aqueous zinc-ion battery is regarded as one of the promising devices for large-scale energy storage systems owing to its high safety, cost-effectiveness, and competitive electrochemical properties. However, the dendrite growth on zinc metal anodes dramatically hinders its further practical applications, and the internal mechanism of dendrite evolution is still unclear. The introduction of a protective layer on the anode interface is an effective method to avoid zinc dendrite growth. Herein, a two-dimensional (2D) atomic surface diffusion mechanism is proposed to reveal the evolution of zinc deposition from tiny protrusion to dendrite under uneven electric and ionic fields. Further, the conductive copper nitride (CN) protective layer is constructed on the zinc metal anode by a facile and scalable magnetron sputtering approach. Their protective layer possesses a high zinc affinity and high diffusion barrier for zinc atom migration, leading to spacious nucleation, and uniform zinc deposition, thus significantly boosting the electrochemical stability. For the first time, the role of the restricted 2D atomic surface diffusion mechanism in inhibiting the formation of zinc tiny protrusion that induces uneven electric and ionic fields is revealed. This work can provide a novel insight for future research on dendrite-free zinc metal anodes by interfacial modification.


Assuntos
Cobre , Zinco , Eletrodos
9.
Small ; 18(52): e2205667, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36373682

RESUMO

Aqueous zinc-ion batteries (AZIBs) have drawn the attention of numerous researchers owing to their high safety and cost-effectiveness. However, the dendrite growth and side reactions of the zinc (Zn) anodes limit their further practical applications. Herein, a porous amorphous silicon nitride protective layer with high zincophobicity is constructed on the Zn anode surface, which can guide the uniform stripping/plating of Zn2+ underneath the protective layer through its isotropic Zn affinity to alleviate the growth of dendrites and by-products. As a result, the amorphous silicon nitride-protected Zn anode can maintain a stable Coulombic efficiency (CE) of 98.8% and low voltage hysteresis for 710 cycles in the half cell. The full cell with the as-prepared Zn anode can deliver excellent electrochemical performances (89.0% capacity retention and 144.4 mAh g-1 discharge capacity after 1000 cycles at 4 A g-1 ). This work reveals the key role of uniform metal affinity induced by the amorphous materials in the interface modification of metal anodes, which is instructive for the design of stable metal anodes.


Assuntos
Líquidos Corporais , Zinco , Compostos de Silício , Eletrodos
10.
J Card Surg ; 36(9): 3119-3125, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34155679

RESUMO

BACKGROUND: Limb ischemia is a major complication of femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO). Use of ankle-brachial index (ABI) to monitor limb perfusion in VA-ECMO has not been described. We report our experience monitoring femoral VA-ECMO patients with serial ABI and the relationships between ABI and near infrared spectroscopy (NIRS). METHODS: This is a retrospective single-center review of consecutive adult patients placed on femoral VA-ECMO between January 2019 and October 2019. Data were collected on patients with paired ABI and NIRS values. Relationships between NIRS and ABI of the cannulated (E-NIRS and E-ABI) and non-cannulated legs (N-NIRS and N-ABI) along with the difference between legs (d-NIRS and d-ABI) were determined using Pearson correlation. RESULTS: Overall, 22 patients (mean age 56.5 ± 14.0 years, 72.7% male) were assessed with 295 E-ABI and E-NIRS measurements, and 273 N-ABI and N-NIRS measurements. Mean duration of ECMO support was 129.8 ± 78.3 h. ECMO-mortality was 13.6% and in-hospital mortality was 45.5%. N-ABI and N-NIRS were significantly higher than their ECMO counterparts (ABI mean difference 0.16, 95% confidence interval [CI]: 0.13-0.19, p < .0001; NIRS mean difference 2.51, 95% CI: 1.48-3.54, p < .0001). There was no correlation between E-ABI versus E-NIRS (r = .032, p = .59), N-ABI versus N-NIRS (r = .097, p = .11), or d-NIRS versus d-ABI (r = .11, p = .069). CONCLUSION: ABI is a quantitative metric that may be used to monitor limb perfusion and supplement clinical exams to identify limb ischemia in femorally cannulated VA-ECMO patients. More studies are needed to characterize the significance of ABI in femoral VA-ECMO and its value in identifying limb ischemia in this patient population.


Assuntos
Oxigenação por Membrana Extracorpórea , Adulto , Idoso , Índice Tornozelo-Braço , Feminino , Artéria Femoral , Humanos , Masculino , Pessoa de Meia-Idade , Perfusão , Estudos Retrospectivos
11.
Circ Heart Fail ; : e011705, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38910557

RESUMO

BACKGROUND: Caregivers of patients with advanced heart failure may experience burden in providing care, but whether changes in patient health status are associated with caregiver burden is unknown. METHODS: This observational study included older patients (60-80 years old) receiving advanced surgical heart failure therapies and their caregivers at 13 US sites. Patient health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (range, 0-100; higher scores are better). Caregiver burden was assessed using the Oberst Caregiving Burden Scale, which measures time on task (OCBS-time) and task difficulty (OCBS-difficulty; range, 1-5; lower scores are better). Measurements occurred before surgery and 12 months after in 3 advanced heart failure cohorts: patients receiving long-term left ventricular assist device support; heart transplantation with pretransplant left ventricular assist device support; and heart transplantation without pretransplant left ventricular assist device support. Multivariable linear regression was used to identify predictors of change in OCBS-time and OCBS-difficulty at 12 months. RESULTS: Of 162 caregivers, the mean age was 61.0±9.4 years, 139 (86%) were female, and 140 (86%) were the patient's spouse. At 12 months, 99 (61.1%) caregivers experienced improved OCBS-time, and 61 (37.7%) experienced improved OCBS-difficulty (versus no change or worse OCBS). A 10-point higher baseline 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (ß=-0.09 [95% CI, -0.14 to -0.03]; P<0.001) and OCBS-difficulty (ß=-0.08 [95% CI, -0.12 to -0.05]; P<0.001). Each 10-point improvement in the 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (ß=-0.07 [95% CI, -0.12 to -0.03]; P=0.002) and OCBS-difficulty (ß=-0.09 [95% CI, -0.12 to -0.06]; P<0.001). CONCLUSIONS: Among survivors at 12 months, baseline and change in patient health status were associated with subsequent caregiver time on task and task difficulty in dyads receiving advanced heart failure surgical therapies, highlighting the potential for serial 12-item Kansas City Cardiomyopathy Questionnaire assessments to identify caregivers at risk of increased burden. REGISTRATION: URL: https://www.clinicaltrials.gov; unique identifier: NCT02568930.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38763406

RESUMO

It is unknown whether racial disparities in access to heart transplantation (HT) are amplified when coupled with substance use. We examined patients evaluated for HT over 8 years at an urban transplant center. We evaluated substance use and race/ethnicity as independent and interactive predictors of HT and left ventricular assist device (LVAD) implantation. Of 1,148 patients evaluated for HT, substance use was cited as an ineligibility factor in 151 (13%) patients, 16 (11%) of whom ultimately received HT. Significantly more non-Hispanic Black (NHB) patients were deemed ineligible due to substance use (n = 59, 19%) compared to other races/ethnicities (non-Hispanic white: n = 68, 12%; other race/ethnicity: n = 24, p = 0.002). No racial differences were observed in the likelihood of HT among patients initially excluded for substances, but more NHB patients ultimately received LVAD than the other racial groups. This study encourages greater awareness of the role of substance use and race in the HT evaluation.

13.
Artigo em Inglês | MEDLINE | ID: mdl-38762215

RESUMO

BACKGROUND: The quality-adjusted life year (QALY) measures disease burden and treatment, combining overall survival and health-related quality of life (HRQOL). We estimated QALYs in 3 groups of older patients (60-80 years) with heart failure (HF) who underwent heart transplantation (HT, with pre-transplant mechanical circulatory support [HT MCS] or HT without pre-transplant MCS [HT Non-MCS]) or long-term MCS (destination therapy). We also identified factors associated with gains in QALYs through 24 months follow-up. METHODS: Of 393 eligible patients enrolled (10/1/15-12/31/18) at 13 U.S. sites, 161 underwent HT (n = 68 HT MCS, n = 93 HT Non-MCS) and 144 underwent long-term MCS. Survival and HRQOL data were collected through 24 months. QALY health utilities were based on patient self-report of EQ-5D-3L dimensions. Mean-restricted QALYs were compared among groups using generalized linear models. RESULTS: For the entire cohort, mean age in years closest to surgery was 67 (standard deviation, SD: 4.7), 78% were male, and 83% were White. By 18 months post-surgery, sustained significant differences in adjusted average ± SD QALYs emerged across groups, with the HT Non-MCS group having the highest average QALYs (24-month window: HT Non-MCS = 22.58 ± 1.1, HT MCS = 19.53 ± 1.33, Long-term MCS = 19.49 ± 1.3, p = 0.003). At 24 months post-operatively, a lower gain in QALYs was associated with HT MCS, long-term MCS, a lower pre-operative LVEF, NYHA class III or IV before surgery, and an ischemic or other etiology of HF. CONCLUSIONS: Determination of QALYs may provide important information for policy makers and clinicians to consider regarding benefits of HT and long-term MCS as treatment options for older patients with HF.

14.
Chem Commun (Camb) ; 59(56): 8715-8718, 2023 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-37350501

RESUMO

Amide additives acting as hydrogen-bonding ligands effectively break the cross-linking structures between water molecules and increase the entropy of mixed solvents, thus enabling a mixed solvent with an ultralow freezing point of -98 °C. Zinc-ion batteries using this hybrid solvent exhibit good cycling stability over a wide temperature range from -60 °C to 50 °C.

15.
iScience ; 26(11): 108298, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-38026179

RESUMO

Reliable monitoring the movement amplitude and dynamics during sports exercise is significant for improving training results and preventing training wound. Here, we present a printed perovskite-based photodetector for real-time and quantitative monitoring of sports motion. The ordered nucleation and growth of perovskite crystals are regulated by the 4-acetamidothiophenol (AMTP) at the interface, which promotes the size of perovskite crystals into the micrometer. Benefiting from the uniformity of the AMTP-regulated MAPbI3, the as-prepared photodetector gives great photocurrent response under indoor light or outdoor light. During the exercise, real-time monitoring sports motion is achieved through detecting the illumination changing of photodetectors attaching on the wrist and ankles. Moreover, twelve kinds of common sports can be quantitatively analyzed with the detection of illumination changing on the photodetector. Such photodetector provides an efficient measurement method of wearable electronics for sports monitoring.

16.
Nat Commun ; 14(1): 1204, 2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-36864062

RESUMO

In a flexible perovskite solar cell, the bottom interface between perovskite and the electron-transporting layer is critical in determining its efficiency and reliability. High defect concentrations and crystalline film fracturing at the bottom interface substantially reduce the efficiency and operational stability. In this work, a liquid crystal elastomer interlayer is intercalated into a flexible device with the charge transfer channel toughened by the aligned mesogenic assembly. The molecular ordering is instantly locked upon photopolymerization of liquid crystalline diacrylate monomers and dithiol-terminated oligomers. The optimized charge collection and the minimized charge recombination at the interface boost the efficiency up to 23.26% and 22.10% for rigid and flexible devices, respectively. The liquid crystal elastomer-induced suppression of phase segregation endows the unencapsulated device maintaining >80% of the initial efficiency for 1570 h. Moreover, the aligned elastomer interlayer preserves the configuration integrity with remarkable repeatability and mechanical robustness, which enables the flexible device to retain 86% of its original efficiency after 5000 bending cycles. The flexible solar cell chips are further integrated into a wearable haptic device with microneedle-based arrays of sensors to demonstrate a pain sensation system in virtual reality.

17.
Adv Mater ; 35(12): e2211363, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36626679

RESUMO

Fast and accurate detection of microbial cells in clinical samples is highly valuable but remains a challenge. Here, a simple, culture-free diagnostic system is developed for direct detection of pathogenic bacteria in water, urine, and serum samples using an optical colorimetric biosensor. It consists of printed nanoarrays chemically conjugated with specific antibodies that exhibits distinct color changes after capturing target pathogens. By utilizing the internal capillarity inside an evaporating droplet, target preconcentration is achieved within a few minutes to enable rapid identification and more efficient detection of bacterial pathogens. More importantly, the scattering signals of bacteria are significantly amplified by the nanoarrays due to strong near-field localization, which supports a visualizable analysis of the growth, reproduction, and cell activity of bacteria at the single-cell level. Finally, in addition to high selectivity, this nanoarray-based biosensor is also capable of accurate quantification and continuous monitoring of bacterial load on food over a broad linear range, with a detection limit of 10 CFU mL-1 . This work provides an accessible and user-friendly tool for point-of-care testing of pathogens in many clinical and environmental applications, and possibly enables a breakthrough in early prevention and treatment.


Assuntos
Infecções Bacterianas , Técnicas Biossensoriais , Humanos , Infecções Bacterianas/diagnóstico , Bactérias
18.
Circ Heart Fail ; 16(8): e010038, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37345518

RESUMO

BACKGROUND: Information about health-related quality of life (HRQOL) among caregivers of older patients with heart failure who receive heart transplantation (HT) and mechanical circulatory support (MCS) is sparse. We describe differences and factors associated with change in HRQOL before and early post-surgery among caregivers of older heart failure patients who underwent 3 surgical therapies: HT with pretransplant MCS (HT MCS), HT without pretransplant MCS (HT non-MCS), and long-term MCS. METHODS: Caregivers of older patients (60-80 years) from 13 US sites completed the EQ-5D-3 L visual analog scale (0 [worst]-100 [best] imaginable health state) and dimensions before and 3 and 6 months post-surgery. Analyses included linear regression, t tests, and nonparametric tests. RESULTS: Among 227 caregivers (HT MCS=54, HT non-MCS=76, long-term MCS=97; median age 62.7 years, 30% male, 84% White, 83% spouse/partner), EQ-5D visual analog scale scores were high before (84.8±14.1) and at 3 (84.7±13.0) and 6 (83.9±14.7) months post-surgery, without significant differences among groups or changes over time. Patient pulmonary hypertension presurgery (ß=-13.72 [95% CI, -21.07 to -6.36]; P<0.001) and arrhythmia from 3 to 6 months post-operatively (ß=-14.22 [95% CI, -27.41 to -1.02]; P=0.035) were associated with the largest decrements in caregiver HRQOL; patient marital/partner status (ß=6.21 [95% CI, 1.34-11.08]; P=0.013) and presurgery coronary disease (ß=8.98 [95% CI, 4.07-13.89]; P<0.001) were associated with the largest improvements. CONCLUSIONS: Caregivers of older patients undergoing heart failure surgeries reported overall high HRQOL before and early post-surgery. Understanding factors associated with caregiver HRQOL may inform decision-making and support needs. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02568930.


Assuntos
Insuficiência Cardíaca , Transplante de Coração , Coração Auxiliar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidadores , Insuficiência Cardíaca/cirurgia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais
19.
J Heart Lung Transplant ; 42(9): 1197-1204, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37088337

RESUMO

BACKGROUND: Caregiving for heart failure (HF) patients is burdensome. We examined differences in caregiver burden for 3 groups of older advanced HF patients: (1) supported with mechanical circulatory support (MCS) before heart transplantation (HT MCS), (2) awaiting transplant without MCS (HT non-MCS), and (3) prior to long-term MCS and factors associated with burden. METHOD: From October 1, 2015 to December 31, 2018, we enrolled 276 caregivers for HF patients from 13 U.S. sites: 85 HT MCS, 96 HT non-MCS, and 95 prior to long-term MCS. At enrollment, caregivers completed the Oberst Caregiving Burden Scale (15 items, 2 subscales: time (range = 1-5; higher score = more time spent on task) and difficulty (range = 1-5; higher score = higher difficulty of task) and other measures. Statistical analyses included descriptive statistics, ANOVA, chi-square tests, and linear regression. RESULT: Overall, caregivers were aged 60.8 ± 9.8 years and predominantly white, female, spouses, well educated, and reported ≥1 comorbidities. Caregivers overall reported a moderate amount of time spent on tasks and slight task difficulty. Caregivers for HT non-MCS candidates reported significantly less perceived time spent on tasks than caregivers for HT MCS candidates and caregivers for patients prior to long-term MCS (2.2 ± 0.74 vs 2.4 ± 0.74 vs 2.5 ± 0.71, respectively, p = 0.02) and less perceived difficulty of tasks (1.2 ± 0.33 vs 1.4 ± 0.53 vs 1.4 ± 0.54, respectively, p = 0.01). Caregiver and patient factors were associated with caregiver burden. CONCLUSIONS: Prior to HT and long-term MCS, caregiver burden was low to moderate. Caregiver factors were predominantly associated with caregiver burden. Understanding caregiver burden and factors affecting caregiver burden may enhance preoperative advanced therapies discussions and guide caregiver support.


Assuntos
Insuficiência Cardíaca , Transplante de Coração , Humanos , Feminino , Qualidade de Vida , Sobrecarga do Cuidador , Insuficiência Cardíaca/cirurgia , Insuficiência Cardíaca/complicações , Cuidadores
20.
Nanoscale ; 14(40): 14956-14961, 2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36178246

RESUMO

With the demand for integrated nanodevices, anisotropic conductive films are one type of interconnection structure for electronic components, which have been widely used for improving the integration of the system in printed circuit boards. This work presents a template-assisted printing strategy for the fabrication of nanoparticle-based networks with multi electrical properties. By manipulating the microfluid behavior under the guidance of the grid-shaped template, the continuity of liquid bridges can be precisely controlled in two directions. The isotropous circuits with crossbar paths, discrete paths as well as unidirectional paths are obtained, which achieve the switching of on/off states in the circuits. This work demonstrates a new type of directional circuits by the template-assisted printing method, which provides an effective fabrication strategy for electrical components and integrated systems.

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