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1.
Cancer ; 130(11): 2031-2041, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38294959

RESUMEN

INTRODUCTION: It was hypothesized that use of proton beam therapy (PBT) in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiation and consolidative immune checkpoint inhibition is associated with fewer unplanned hospitalizations compared with intensity-modulated radiotherapy (IMRT). METHODS: Patients with locally advanced non-small cell lung cancer treated between October 2017 and December 2021 with concurrent chemoradiation with either IMRT or PBT ± consolidative immune checkpoint inhibition were retrospectively identified. Logistic regression was used to assess the association of radiation therapy technique with 90-day hospitalization and grade 3 (G3+) lymphopenia. Competing risk regression was used to compare G3+ pneumonitis, G3+ esophagitis, and G3+ cardiac events. Kaplan-Meier method was used for progression-free survival and overall survival. Inverse probability treatment weighting was applied to adjust for differences in PBT and IMRT groups. RESULTS: Of 316 patients, 117 (37%) received PBT and 199 (63%) received IMRT. The PBT group was older (p < .001) and had higher Charlson Comorbidity Index scores (p = .02). The PBT group received a lower mean heart dose (p < .0001), left anterior descending artery V15 Gy (p = .001), mean lung dose (p = .008), and effective dose to immune circulating cells (p < .001). On inverse probability treatment weighting analysis, PBT was associated with fewer unplanned hospitalizations (adjusted odds ratio, 0.55; 95% CI, 0.38-0.81; p = .002) and less G3+ lymphopenia (adjusted odds ratio, 0.55; 95% CI, 0.37-0.81; p = .003). There was no difference in other G3+ toxicities, progression-free survival, or overall survival. CONCLUSIONS: PBT is associated with fewer unplanned hospitalizations, lower effective dose to immune circulating cells and less G3+ lymphopenia compared with IMRT. Minimizing dose to lymphocytes may be warranted, but prospective data are needed.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Quimioradioterapia , Hospitalización , Neoplasias Pulmonares , Terapia de Protones , Radioterapia de Intensidad Modulada , Humanos , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/terapia , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Radioterapia de Intensidad Modulada/métodos , Radioterapia de Intensidad Modulada/efectos adversos , Femenino , Masculino , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/mortalidad , Anciano , Persona de Mediana Edad , Hospitalización/estadística & datos numéricos , Terapia de Protones/métodos , Terapia de Protones/efectos adversos , Quimioradioterapia/métodos , Quimioradioterapia/efectos adversos , Estudios Retrospectivos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Linfopenia/etiología , Anticuerpos Monoclonales
2.
Psychol Sci ; 35(4): 345-357, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38407962

RESUMEN

A major challenge in assessing psychological constructs such as impulsivity is the weak correlation between self-report and behavioral task measures that are supposed to assess the same construct. To address this issue, we developed a real-time driving task called the "highway task," in which participants often exhibit impulsive behaviors mirroring real-life impulsive traits captured by self-report questionnaires. Here, we show that a self-report measure of impulsivity is highly correlated with performance in the highway task but not with traditional behavioral task measures of impulsivity (47 adults aged 18-33 years). By integrating deep neural networks with an inverse reinforcement learning (IRL) algorithm, we inferred dynamic changes of subjective rewards during the highway task. The results indicated that impulsive participants attribute high subjective rewards to irrational or risky situations. Overall, our results suggest that using real-time tasks combined with IRL can help reconcile the discrepancy between self-report and behavioral task measures of psychological constructs.


Asunto(s)
Conducta Impulsiva , Refuerzo en Psicología , Adulto , Humanos , Autoinforme , Encuestas y Cuestionarios , Aprendizaje
3.
Kidney Blood Press Res ; 49(1): 326-335, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38657581

RESUMEN

INTRODUCTION: End-stage renal disease (ESRD) is a growing disease worldwide, including Korea. This is an important condition that affects patient outcome. To provide optimal management for mineral disturbance, vascular calcification, and bone disease in ESRD patients, the Korean dialysis cohort for mineral, vascular calcification, and fracture (ORCHESTRA) study was conducted by enrolling Korean dialysis patients. METHODS: Sixteen university-affiliated hospitals and one Veterans' Health Service Medical Center participated in this study. This prospective cohort study enrolled approximately 900 consecutive patients on dialysis between May 2019 and January 2021. Enrolled subjects were evaluated at baseline for demographic information, laboratory tests, radiologic imaging, and bone mineral densitometry (BMD) scans. After enrollment, regular assessments of the patients were performed, and their biospecimens were collected according to the study protocol. The primary outcomes were the occurrence of major adverse cardiovascular events, invasive treatment for peripheral artery disease, and osteoporotic fractures. The secondary outcomes were hospitalization for cerebrovascular disease or progression of abdominal aortic calcification. Participants will be assessed for up to 3 years to determine whether primary or secondary outcomes occur. RESULTS: Between May 2019 and January 2021, all participating centers recruited 900 consecutive dialysis patients, including 786 undergoing hemodialysis (HD) and 114 undergoing peritoneal dialysis (PD). The mean age of the subjects was 60.4 ± 12.3 years. Males accounted for 57.7% of the total population. The mean dialysis vintage was 6.1 ± 6.0 years. The HD group was significantly older, had a longer dialysis vintage, and more comorbidities. Overall, the severity of vascular calcification was higher and the level of BMD was lower in the HD group than in the PD group. CONCLUSION: This nationwide, multicenter, prospective cohort study focused on chronic kidney disease-mineral and bone disorder and aimed to provide clinical evidence to establish optimal treatment guidelines for Asian dialysis patients.


Asunto(s)
Fallo Renal Crónico , Diálisis Renal , Calcificación Vascular , Humanos , Diálisis Renal/efectos adversos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , República de Corea/epidemiología , Fallo Renal Crónico/terapia , Fallo Renal Crónico/complicaciones , Anciano , Estudios de Cohortes , Densidad Ósea
4.
BMC Nephrol ; 25(1): 142, 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38649936

RESUMEN

BACKGROUND: IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis, although the definitive markers are unknown. We aimed to investigate the clinical significance of urinary cytokines in patients with IgAN. METHODS: From 2009 to 2018, the patients were divided into three groups: IgAN (n = 191), disease control (n = 53), and normal control (n = 76). We used a multiplex enzyme-linked immunosorbent assay to measure 16 selected urinary inflammatory cytokines, evaluated the correlation between clinical and pathological features following regression analysis on progression. RESULTS: The IgAN group exhibited significantly different levels of urinary cytokines compared to the normal control and disease control groups. Urinary levels of B-cell-activating factor, vascular endothelial growth factor receptor-2, monocyte chemoattractant protein-1, C-X-C motif chemokine 10, C-X-C motif ligand 16, epidermal growth factor (EGF), endocan, endostatin, growth/differentiation factor-15 (GDF-15), interleukin-6 (IL-6), mannose-binding lectin, transferrin receptor, and kidney injury molecule-1 were significantly correlated with both the estimated glomerular filtration rate and urine protein-creatinine ratio. In a multivariate Cox regression analysis, urinary EGF (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.17-0.95, P = 0.04), GDF-15 (HR 2.45, 95% CI 1.01-5.94, P = 0.048), and IL-6 (HR 3.02, 95% CI 1.05-8.64, P = 0.04) were associated with progression in IgAN. CONCLUSIONS: Urinary inflammatory biomarkers may serve as alternative predictive biomarkers in patients with IgAN. Further studies are needed to elucidate the physiological mechanisms and confirm the results.


Asunto(s)
Biomarcadores , Citocinas , Glomerulonefritis por IGA , Humanos , Glomerulonefritis por IGA/orina , Glomerulonefritis por IGA/diagnóstico , Masculino , Femenino , Biomarcadores/orina , Adulto , Citocinas/orina , Persona de Mediana Edad , Tasa de Filtración Glomerular , Progresión de la Enfermedad , Factor de Crecimiento Epidérmico/orina , Relevancia Clínica
5.
J Am Soc Nephrol ; 34(5): 857-875, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36720675

RESUMEN

SIGNIFICANCE STATEMENT: eGFR slope has been used as a surrogate outcome for progression of CKD. However, genetic markers associated with eGFR slope among patients with CKD were unknown. We aimed to identify genetic susceptibility loci associated with eGFR slope. A two-phase genome-wide association study identified single nucleotide polymorphisms (SNPs) in TPPP and FAT1-LINC02374 , and 22 of them were used to derive polygenic risk scores that mark the decline of eGFR by disrupting binding of nearby transcription factors. This work is the first to identify the impact of TPPP and FAT1-LINC02374 on CKD progression, providing predictive markers for the decline of eGFR in patients with CKD. BACKGROUND: The incidence of CKD is associated with genetic factors. However, genetic markers associated with the progression of CKD have not been fully elucidated. METHODS: We conducted a genome-wide association study among 1738 patients with CKD, mainly from the KoreaN cohort study for Outcomes in patients With CKD. The outcome was eGFR slope. We performed a replication study for discovered single nucleotide polymorphisms (SNPs) with P <10 -6 in 2498 patients with CKD from the Chronic Renal Insufficiency Cohort study. Several expression quantitative trait loci (eQTL) studies, pathway enrichment analyses, exploration of epigenetic architecture, and predicting disruption of transcription factor (TF) binding sites explored potential biological implications of the loci. We developed and evaluated the effect of polygenic risk scores (PRS) on incident CKD outcomes. RESULTS: SNPs in two novel loci, TPPP and FAT1-LINC02374 , were replicated (rs59402340 in TPPP , Pdiscovery =7.11×10 -7 , PCRIC =8.13×10 -4 , Pmeta =7.23×10 -8 ; rs28629773 in FAT1-LINC02374 , Pdiscovery =6.08×10 -7 , PCRIC =4.33×10 -2 , Pmeta =1.87×10 -7 ). The eQTL studies revealed that the replicated SNPs regulated the expression level of nearby genes associated with kidney function. Furthermore, these SNPs were near gene enhancer regions and predicted to disrupt the binding of TFs. PRS based on the independently significant top 22 SNPs were significantly associated with CKD outcomes. CONCLUSIONS: This study demonstrates that SNP markers in the TPPP and FAT1-LINC02374 loci could be predictive markers for the decline of eGFR in patients with CKD.


Asunto(s)
Estudio de Asociación del Genoma Completo , Insuficiencia Renal Crónica , Humanos , Estudios de Cohortes , Marcadores Genéticos , Insuficiencia Renal Crónica/genética , Sitios de Carácter Cuantitativo , Polimorfismo de Nucleótido Simple , Progresión de la Enfermedad , Predisposición Genética a la Enfermedad
6.
Int J Mol Sci ; 25(10)2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38791177

RESUMEN

Acute rejection (AR) is critical for long-term graft survival in kidney transplant recipients (KTRs). This study aimed to evaluate the efficacy of the integrated risk score of omics-based biomarkers in predicting AR in KTRs. This prospective, randomized, controlled, multicenter, pilot study enrolled 40 patients who recently underwent high-immunologic-risk kidney transplantation (KT). Five omics biomarkers were measured, namely, blood mRNA (three-gene signature), urinary exosomal miRNA (three-gene signature), urinary mRNA (six-gene signature), and two urinary exosomal proteins (hemopexin and tetraspanin-1) at 2 weeks and every 4 weeks after KT for 1 year. An integrated risk score was generated by summing each biomarker up. The biomarker group was informed about the integrated risk scores and used to adjust immunosuppression, but not the control group. The outcomes were graft function and frequency of graft biopsy. Sixteen patients in the biomarker group and nineteen in the control group completed the study. The mean estimated glomerular filtration rate after KT did not differ between the groups. Graft biopsy was performed in two patients (12.5%) and nine (47.4%) in the biomarker and control groups, respectively, with the proportion being significantly lower in the biomarker group (p = 0.027). One patient (6.3%) in the biomarker group and two (10.5%) in the control group were diagnosed with AR, and the AR incidence did not differ between the groups. The tacrolimus trough level was significantly lower in the biomarker group than in the control group at 1 year after KT (p = 0.006). Integrated omics biomarker monitoring may help prevent unnecessary or high-complication-risk biopsy and enables tailored immunosuppression by predicting the risk of AR in KTRs.


Asunto(s)
Biomarcadores , Rechazo de Injerto , Trasplante de Riñón , Humanos , Trasplante de Riñón/efectos adversos , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/sangre , Masculino , Femenino , Biomarcadores/sangre , Biomarcadores/orina , Proyectos Piloto , Persona de Mediana Edad , Estudios Prospectivos , Adulto , Factores de Riesgo , Supervivencia de Injerto , MicroARNs/sangre , MicroARNs/genética , Medición de Riesgo
7.
Int J Mol Sci ; 25(8)2024 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-38674120

RESUMEN

Hematopoietic acute radiation syndrome (H-ARS) involves injury to multiple organ systems following total body irradiation (TBI). Our laboratory demonstrated that captopril, an angiotensin-converting enzyme inhibitor, mitigates H-ARS in Göttingen minipigs, with improved survival and hematopoietic recovery, as well as the suppression of acute inflammation. However, the effects of captopril on the gastrointestinal (GI) system after TBI are not well known. We used a Göttingen minipig H-ARS model to investigate captopril's effects on the GI following TBI (60Co 1.79 or 1.80 Gy, 0.42-0.48 Gy/min), with endpoints at 6 or 35 days. The vehicle or captopril (0.96 mg/kg) was administered orally twice daily for 12 days, starting 4 h post-irradiation. Ilea were harvested for histological, protein, and RNA analyses. TBI increased congestion and mucosa erosion and hemorrhage, which were modulated by captopril. GPX-4 and SLC7A11 were downregulated post-irradiation, consistent with ferroptosis at 6 and 35 days post-irradiation in all groups. Interestingly, p21/waf1 increased at 6 days in vehicle-treated but not captopril-treated animals. An RT-qPCR analysis showed that radiation increased the gene expression of inflammatory cytokines IL1B, TNFA, CCL2, IL18, and CXCL8, and the inflammasome component NLRP3. Captopril suppressed radiation-induced IL1B and TNFA. Rectal microbiome analysis showed that 1 day of captopril treatment with radiation decreased overall diversity, with increased Proteobacteria phyla and Escherichia genera. By 6 days, captopril increased the relative abundance of Enterococcus, previously associated with improved H-ARS survival in mice. Our data suggest that captopril mitigates senescence, some inflammation, and microbiome alterations, but not ferroptosis markers in the intestine following TBI.


Asunto(s)
Síndrome de Radiación Aguda , Captopril , Modelos Animales de Enfermedad , Ferroptosis , Microbioma Gastrointestinal , Inflamación , Porcinos Enanos , Irradiación Corporal Total , Animales , Síndrome de Radiación Aguda/tratamiento farmacológico , Porcinos , Inflamación/patología , Captopril/farmacología , Irradiación Corporal Total/efectos adversos , Ferroptosis/efectos de los fármacos , Microbioma Gastrointestinal/efectos de los fármacos , Intestinos/microbiología , Intestinos/patología , Intestinos/efectos de los fármacos , Intestinos/efectos de la radiación , Masculino , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología
8.
Arch Orthop Trauma Surg ; 144(5): 2109-2118, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38466373

RESUMEN

INTRODUCTION: Fractures of the distal femur with metaphyseal comminution and complete intra-articular involvement (AO/OTA classifications 33C2 and 33C3) present challenges for reduction and fixation. However, an optimal fixation method remains unknown. This study aimed to compare the clinical and radiographic outcomes of locking extramedullary plating (LEP) and retrograde intramedullary nailing (RIN) for complete distal femoral intra-articular fractures with metaphyseal comminution. MATERIALS AND METHODS: Between January 2016 and May 2022, 80 patients (45 men and 35 women; average age, 56.7 years) diagnosed with AO/OTA 33C2 and 33C3 were treated with either LEP or RIN and followed up for at least one year. Post-operative evaluations included radiographic assessments of bone union rate, timing, and alignment. Clinically, the knee joint range of motion (ROM), lower extremity functional scale (LEFS), and Kellgren and Lawrence (KL) grade were analyzed. The complications were also compared. RESULTS: 36 underwent LEP and 44 underwent RIN. Bone union was observed in 69.4% and 63.6% of the patients in the LEP and RIN groups, respectively (p = 0.64). The average union time was 6.9 months for the LEP group and 6.6 months for the RIN group (p = 0.51). A tendency toward varus deformity was observed in the RIN group, although the difference was not statistically significant. No significant differences were observed in knee ROM, LEFS, or KL grade. Complications included non-union (33.8%; RIN, 11; LEP, 16), varus deformity (5%; RIN, 4; LEP, 0), infection (1.3%; RIN, 0; LEP, 1), heterotrophic ossification (1.3%; RIN, 0; LEP, 1), and wound dehiscence (2.5%; RIN, 2; LEP, 0). CONCLUSIONS: The surgical fixation methods, RIN and LEP, for complete distal femoral intra-articular fractures with metaphyseal comminution showed similar clinical and radiological outcomes. However, regardless of the type of fixation device used, there was a reduced rate of bone union owing to high energy and a less favorable prognosis.


Asunto(s)
Placas Óseas , Fracturas del Fémur , Fijación Intramedular de Fracturas , Fracturas Conminutas , Humanos , Persona de Mediana Edad , Femenino , Masculino , Fijación Intramedular de Fracturas/métodos , Fijación Intramedular de Fracturas/instrumentación , Fracturas del Fémur/cirugía , Fracturas del Fémur/diagnóstico por imagen , Anciano , Fracturas Conminutas/cirugía , Fracturas Conminutas/diagnóstico por imagen , Adulto , Estudios Retrospectivos , Fracturas Intraarticulares/cirugía , Fracturas Intraarticulares/diagnóstico por imagen , Rango del Movimiento Articular
9.
Behav Res Methods ; 56(6): 5947-5958, 2024 09.
Artículo en Inglés | MEDLINE | ID: mdl-38228815

RESUMEN

The flanker task (Eriksen & Eriksen, Perception & Psychophysics, 16(1), 143-149, 1974) has been highly influential and widely used in studies of visual attention. Its simplicity has made it popular to include it in experimental software packages and online platforms. The spacing flanker task (SFT), in which the distance between the target and flankers varies, is useful for studying the distribution of attention across space as well as inhibitory control. Use of the SFT requires that the viewing environment (e.g., stimulus size and viewing distance) be controlled, which is a challenge for online delivery. We implement and evaluate an online version of the SFT that includes two calibration pretests to provide the necessary control. Test-retest and split-half reliability of the online version was compared with a laboratory version on measures of inhibitory control and measures of the distribution of attention across space. Analyses show that the online SFT is comparable to laboratory testing on all measures. Results also identify two measures with good test-retest reliability that hold promise for studying performance in the SFT: the mean flanker effect (ICC = 0.745) and RTs on incongruent trials across distances (ICC = 0.65-0.71).


Asunto(s)
Atención , Inhibición Psicológica , Percepción Espacial , Humanos , Atención/fisiología , Reproducibilidad de los Resultados , Percepción Espacial/fisiología , Femenino , Masculino , Adulto Joven , Adulto , Tiempo de Reacción/fisiología , Adolescente
10.
J Infect Dis ; 227(10): 1185-1193, 2023 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-36374933

RESUMEN

BACKGROUND: Urine exosomal bkv-miR-B1-5p is associated with BK virus (BKV) nephropathy (BKVN); however, its posttransplantation changes and predictability for BKVN have not been determined in kidney transplant recipients (KTRs). METHODS: Urine exosomal bkv-miR-B1-5p and urine and plasma BKV DNA were measured at 2 weeks and 3, 6, and 12 months posttransplant in 83 KTRs stratified into biopsy-proven or presumptive BKVN, BKV viruria, and no evidence of BKV reactivation. Joint model, multivariable Cox model and receiver operating characteristic curve (ROC) were used to investigate the association of each assay with the following events: a composite of biopsy-proven or presumptive BKVN, and biopsy-proven BKVN. RESULTS: Urine exosomal bkv-miR-B1-5p and urine and plasma BKV DNA showed similar posttransplant time-course changes. Joint models incorporating serial values demonstrated significant associations of all assays with the events, and Cox analyses using single time point values at 2 weeks posttransplant showed that only urine exosomal bkv-miR-B1-5p was significantly associated with the events, although it did not outperform urine BKV DNA in ROC analyses. CONCLUSIONS: Urine exosomal bkv-miR-B1-5p was associated with BKVN as were urine and plasma BKV DNA loads on serial follow-up, and might have potential as a predictive marker for BKVN during the early posttransplant period. CLINICAL TRIALS REGISTRATION: Clinical Research Information Service (https://cris.nih.go.kr/cris/), KCT0001010.


Asunto(s)
Virus BK , Enfermedades Renales , Trasplante de Riñón , MicroARNs , Infecciones por Polyomavirus , Infecciones Tumorales por Virus , Humanos , ADN Viral , Enfermedades Renales/complicaciones , Trasplante de Riñón/efectos adversos , Infecciones por Polyomavirus/diagnóstico , Receptores de Trasplantes
11.
FASEB J ; 36(5): e22272, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35436011

RESUMEN

The transition of fibroblasts into myofibroblasts is a crucial step in kidney fibrosis. However, the biological processes involved in this transdifferentiation are incompletely understood. In this study, we discovered that the midbody plays a role in the fibroblast-myofibroblast transition by mediating TGF-ß/Smad signaling. Combining bulk RNA-seq, histology, and the western blot of unilateral ureteral obstruction kidneys, we demonstrated that the pathway related to microtubules is implicated in kidney fibrosis, and the blocking of microtubule dynamics by colchicine improved kidney fibrosis. Subsequently, to explore microtubule-based organelles in detail, we cultured NRK-49F (rat kidney fibroblast cell line) and HKC-8 (human proximal tubule cell line) under transforming growth factor-ß1 (TGF-ß1) stimulation, which caused deciliation in both cell lines during epithelial-mesenchymal and fibroblast-myofibroblast transition. We identified another microtubule-based organelle, the midbody, whose formation is promoted by TGF-ß1 in fibroblasts as a result of proliferation in contrast to tubular cells. Notably, TGF-ß receptors were present in the midbody of both cell lines. In TGF-ß1-treated fibroblasts, colchicine or Hedgehog pathway inhibitor 4 impaired the midbody formation, and attenuated the upregulation of canonical TGF-ß/Smad signaling and α-SMA expression. These findings offer novel insight into the midbody as an active organelle involved in fibroblast-myofibroblast transition by mediating TGF-ß/Smad signaling, which could be a potential therapeutic target.


Asunto(s)
Enfermedades Renales , Miofibroblastos , Animales , Colchicina/farmacología , Transición Epitelial-Mesenquimal , Femenino , Fibroblastos/metabolismo , Fibrosis , Proteínas Hedgehog/metabolismo , Humanos , Enfermedades Renales/patología , Masculino , Miofibroblastos/metabolismo , Ratas , Transducción de Señal/fisiología , Factor de Crecimiento Transformador beta1/metabolismo
12.
Eur Spine J ; 32(8): 2875-2881, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37029807

RESUMEN

INTRODUCTION: Endoscopic techniques are becoming popular among spine surgeons because of their advantages. Though the advantages of endoscopic spine surgery are evident and patients can be discharged home within hours of surgery, readmissions can be sought for incomplete relief of leg pain, recurrent disc herniation, and recurrent leg pain. We aim to find out the factors related to the readmission of patients treated for lumbar pathologies. MATERIALS AND METHODS: This is a retrospective analysis of the data between the time duration of 2012 and 2022. Patients in the age group of 18-85 years, with lumbar disc herniation treated by transforaminal endoscopic lumbar procedures, were included. The patients who were readmitted within 90 days were included in the R Group and those who were not were included in the NR group. Univariable and multivariable logistic regression analyses were used to find the risk factors for 90-day readmission. RESULTS: There were a total of 1542 patients enrolled in this study. Sex, number of episodes before admission, hypertension, smoking, BMI, migration, disc height, disc height index, spondylolisthesis, instability, pelvic tilt (PT), and disc cross-sectional area (CSA) were found significant on univariable analysis. Age, spondylolisthesis, instability and muscle CSA were the only variables that were found to be statistically significant on multivariable analysis. CONCLUSIONS: This study shows that the elderly age group, presence of spondylolisthesis, segmental instability and decreased muscle cross-sectional area are independent risk factors for 90-day hospital readmissions. Patients having the above risk factors should be carefully counseled regarding the possibility of readmission in the future.


Asunto(s)
Discectomía , Desplazamiento del Disco Intervertebral , Vértebras Lumbares , Readmisión del Paciente , República de Corea/epidemiología , Factores de Riesgo , Readmisión del Paciente/estadística & datos numéricos , Vértebras Lumbares/cirugía , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Endoscopía/estadística & datos numéricos , Discectomía/estadística & datos numéricos , Desplazamiento del Disco Intervertebral/epidemiología , Dolor
13.
J Am Soc Nephrol ; 33(1): 186-200, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34725107

RESUMEN

BACKGROUND: Tertiary lymphoid tissues (TLTs) are ectopic lymphoid tissues found in chronically inflamed organs. Although studies have documented TLT formation in transplanted kidneys, the clinical relevance of these TLTs remains controversial. We examined the effects of TLTs on future graft function using our histologic TLT maturity stages and the association between TLTs and Banff pathologic scores. We also analyzed the risk factors for the development of TLTs. METHODS: Serial protocol biopsy samples (0 hour, 1, 6, and 12 months) without rejection were retrospectively analyzed from 214 patients who underwent living donor kidney transplantation. TLTs were defined as lymphocyte aggregates with signs of proliferation and their stages were determined by the absence (stage I) or presence (stage II) of follicular dendritic cells. RESULTS: Only 4% of patients exhibited TLTs at the 0-hour biopsy. Prevalence increased to almost 50% at the 1-month biopsy, and then slightly further for 12 months. The proportion of advanced stage II TLTs increased gradually, reaching 19% at the 12-month biopsy. Presence of stage II TLTs was associated with higher risk of renal function decline after transplantation compared with patients with no TLT or stage I TLTs. Stage II TLTs were associated with more severe tubulitis and interstitial fibrosis/tubular atrophy at 12 months and predicted poorer graft function independently from the degree of interstitial inflammation. Pretransplantation rituximab treatment dramatically attenuated the development of stage II TLTs. CONCLUSIONS: TLTs are commonly found in clinically stable transplanted kidneys. Advanced stage II TLTs are associated with progressive graft dysfunction, independent of interstitial inflammation.


Asunto(s)
Coristoma/patología , Enfermedades Renales/patología , Trasplante de Riñón/efectos adversos , Tejido Linfoide , Disfunción Primaria del Injerto/etiología , Disfunción Primaria del Injerto/patología , Adulto , Anciano , Biopsia , Femenino , Tasa de Filtración Glomerular , Humanos , Enfermedades Renales/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
14.
Sensors (Basel) ; 23(13)2023 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-37447913

RESUMEN

This study proposes a novel hybrid simulation technique for analyzing structural deformation and stress using light detection and ranging (LiDAR)-scanned point cloud data (PCD) and polynomial regression processing. The method estimates the edge and corner points of the deformed structure from the PCD. It transforms into a Dirichlet boundary condition for the numerical simulation using the particle difference method (PDM), which utilizes nodes only based on the strong formulation, and it is advantageous for handling essential boundaries and nodal rearrangement, including node generation and deletion between analysis steps. Unlike previous studies, which relied on digital images with attached targets, this research uses PCD acquired through LiDAR scanning during the loading process without any target. Essential boundary condition implementation naturally builds a boundary value problem for the PDM simulation. The developed hybrid simulation technique was validated through an elastic beam problem and a three-point bending test on a rubber beam. The results were compared with those of ANSYS analysis, showing that the technique accurately approximates the deformed edge shape leading to accurate stress calculations. The accuracy improved when using a linear strain model and increasing the number of PDM model nodes. Additionally, the error that occurred during PCD processing and edge point extraction was affected by the order of polynomial regression equation. The simulation technique offers advantages in cases where linking numerical analysis with digital images is challenging and when direct mechanical gauge measurement is difficult. In addition, it has potential applications in structural health monitoring and smart construction involving machine leading techniques.


Asunto(s)
Nube Computacional , Psicoterapia , Simulación por Computador , Modelos Lineales , Registros
15.
Sensors (Basel) ; 23(5)2023 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-36904724

RESUMEN

The importance of monitoring the electron density uniformity of plasma has attracted significant attention in material processing, with the goal of improving production yield. This paper presents a non-invasive microwave probe for in-situ monitoring electron density uniformity, called the Tele-measurement of plasma Uniformity via Surface wave Information (TUSI) probe. The TUSI probe consists of eight non-invasive antennae and each antenna estimates electron density above the antenna by measuring the surface wave resonance frequency in a reflection microwave frequency spectrum (S11). The estimated densities provide electron density uniformity. For demonstration, we compared it with the precise microwave probe and results revealed that the TUSI probe can monitor plasma uniformity. Furthermore, we demonstrated the operation of the TUSI probe beneath a quartz or wafer. In conclusion, the demonstration results indicated that the TUSI probe can be used as an instrument for a non-invasive in-situ method for measuring electron density uniformity.

16.
Nano Lett ; 22(24): 10232-10239, 2022 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-36367407

RESUMEN

Patterned electrodes were developed for use in solid-state lithium-ion batteries, with the ultimate goal to promote fast-charging attributes through improving electrochemically activated surfaces within electrodes. By a conventional photolithography, patterned arrays of SnO2 nanowires were fabricated directly on the current collector, and empty channel structures formed between the resulting arrays were customized through modifying the size and interval of the SnO2 patterns. The composite electrolyte comprising Li7La3Zr2O12 and poly(ethylene oxide) was exploited to secure intimate interfacial contact at the electrode/electrolyte junction while preserving ionic conductivity in the bulk electrolyte. The potential and limitation of the electrode patterning approach were then explored experimentally. For example, the electrochemical behaviors of patterned electrodes were investigated as a function of variations in microchannel structures, and compared with those of conventional film-type electrodes. The findings show promise to improve electrode dynamics when electrochemical reaction kinetics could be hindered by poor interfacial characteristics on electrodes.

17.
Environ Res ; 214(Pt 4): 114072, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35987372

RESUMEN

Radioactive elements released into the environment by accidental discharge constitute serious health hazards to humans and other organisms. In this study, three gasified biochars prepared from feedstock mixtures of wood, chicken manure, and food waste, and a KOH-activated biochar (40% food waste + 60% wood biochar (WFWK)) were used to remove cesium (Cs+) and strontium (Sr2+) ions from water. The physicochemical properties of the biochars before and after adsorbing Cs+ and Sr2+ were determined using X-ray diffraction (XRD), Fourier-transform infrared (FT-IR) spectroscopy, extended X-Ray absorption fine structure (EXAFS) spectroscopy, X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). The WFWK exhibited the highest adsorption capacity for Cs+ (62.7 mg/g) and Sr2+ (43.0 mg/g) among the biochars tested herein. The removal of radioactive 137Cs and 90Sr exceeded 80% and 47%, respectively, in the presence of competing ions like Na+ and Ca2+. The functional groups present in biochar, including -OH, -NH2, and -COOH, facilitated the adsorption of Cs+ and Sr2+. The Cs K-edge EXAFS spectra revealed that a single coordination shell was assigned to the Cs-O bonding at 3.11 Å, corresponding to an outer-sphere complex formed between Cs and the biochar. The designer biochar WFWK may be used as an effective adsorbent to treat radioactive 137Cs- and 90Sr-contaminated water generated during the operation of nuclear power plants and/or unintentional release, owing to the enrichment effect of the functional groups in biochar via alkaline activation.


Asunto(s)
Eliminación de Residuos , Contaminantes Químicos del Agua , Adsorción , Cesio/química , Carbón Orgánico , Alimentos , Humanos , Cinética , Espectroscopía Infrarroja por Transformada de Fourier , Estroncio , Agua , Contaminantes Químicos del Agua/análisis
18.
BMC Med Educ ; 22(1): 10, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980077

RESUMEN

BACKGROUND: The virtual conference format has become an essential tool for professional development of researchers around the world since the outbreak of the COVID-19 pandemic. This study aims to identify empirical evidence of the benefits and challenges of virtual conferences by investigating participants' experiences with them. METHODS: The study participants were delegates to the 40th annual meeting of the Korean Society of Nephrology, which was held virtually in September, 2020. A questionnaire was developed and implemented among the conference attendees. The 44-item questionnaire included five sub-scales related to participant perceptions of the virtual conference, which were (a) convenience and accessibility, (b) planning and organization, (c) technology use, (d) social exchanges, and (e) overall satisfaction, their preferences of conference formats, and their views of future projections for a virtual conference. RESULTS: A total of 279 delegates completed and returned the questionnaires (18.8% response rate). Participants varied in gender, age, profession, work location, and prior experience with conferences. On a four-point Likert scale (1 = "strongly disagree" and 4 = "strongly agree"), participants showed positive perceptions of the virtual conference in general, where the total mean (M) was 3.03 and less positive perceptions on social exchanges (M = 2.72). Participant perceptions of the virtual conference differed across age groups, professions, and prior experience with conferences (p < .05). Approximately half of the participants (n = 139) preferred the virtual format, and 33% (n = 92) preferred the conventional format. Participant preferences for the virtual format were somewhat evenly distributed between asynchronous (32.9%) and synchronous (29.1%) modes. Participants predicted a virtual conference would continue to be a popular delivery format after the end of the COVID-19. CONCLUSIONS: Although participants had positive perceptions of the virtual conference, more support needs to be offered to those who may be less comfortable with using technology or with online interactions, and there is a need for improvement in supporting social exchange among attendees. Also, it is suggested that a blend of asynchronous and synchronous delivery methods should be considered to meet the varied needs of attendees.


Asunto(s)
COVID-19 , Pandemias , Humanos , SARS-CoV-2 , Encuestas y Cuestionarios
19.
Sensors (Basel) ; 22(15)2022 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-35897990

RESUMEN

As the importance of measuring electron density has become more significant in the material fabrication industry, various related plasma monitoring tools have been introduced. In this paper, the development of a microwave probe, called the measurement of lateral electron density (MOLE) probe, is reported. The basic properties of the MOLE probe are analyzed via three-dimensional electromagnetic wave simulation, with simulation results showing that the probe estimates electron density by measuring the surface wave resonance frequency from the reflection microwave frequency spectrum (S11). Furthermore, an experimental demonstration on a chamber wall measuring lateral electron density is conducted by comparing the developed probe with the cutoff probe, a precise electron density measurement tool. Based on both simulation and experiment results, the MOLE probe is shown to be a useful instrument to monitor lateral electron density.


Asunto(s)
Electrones , Microondas , Simulación por Computador , Monitoreo Fisiológico , Vibración
20.
Int J Mol Sci ; 23(19)2022 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-36232330

RESUMEN

Total body irradiation (TBI) can result in death associated with hematopoietic insufficiency. Although radiation causes apoptosis of white blood cells, red blood cells (RBC) undergo hemolysis due to hemoglobin denaturation. RBC lysis post-irradiation results in the release of iron into the plasma, producing a secondary toxic event. We investigated radiation-induced iron in the spleens of mice following TBI and the effects of the radiation mitigator captopril. RBC and hematocrit were reduced ~7 days (nadir ~14 days) post-TBI. Prussian blue staining revealed increased splenic Fe3+ and altered expression of iron binding and transport proteins, determined by qPCR, western blotting, and immunohistochemistry. Captopril did not affect iron deposition in the spleen or modulate iron-binding proteins. Caspase-3 was activated after ~7-14 days, indicating apoptosis had occurred. We also identified markers of iron-dependent apoptosis known as ferroptosis. The p21/Waf1 accelerated senescence marker was not upregulated. Macrophage inflammation is an effect of TBI. We investigated the effects of radiation and Fe3+ on the J774A.1 murine macrophage cell line. Radiation induced p21/Waf1 and ferritin, but not caspase-3, after ~24 h. Radiation ± iron upregulated several markers of pro-inflammatory M1 polarization; radiation with iron also upregulated a marker of anti-inflammatory M2 polarization. Our data indicate that following TBI, iron accumulates in the spleen where it regulates iron-binding proteins and triggers apoptosis and possible ferroptosis.


Asunto(s)
Síndrome de Radiación Aguda , Ferroptosis , Animales , Antiinflamatorios , Captopril , Modelos Animales de Enfermedad , Ferritinas , Hierro/metabolismo , Ratones , Bazo/metabolismo
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