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BACKGROUND: Rhizosphere microorganisms are vital in plants' growth and development and these beneficial microbes are recruited to the root-zone soil when experiencing various environmental stresses. However, the effect of white grub (Maladera verticalis) larvae feeding on the structure and function of rhizosphere microbial communities of aerobic rice (Oryza sativa L.) is unclear. RESULTS: In this study, we compared physicochemical properties, enzyme activities, and microbial communities using 18 samples under healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soils at the Yunnan of China. 16 S rRNA and ITS amplicons were sequenced using Illumina high throughput sequencing. M. verticalis larvae feeding on aerobic rice can influence rhizosphere soil physicochemical properties and enzyme activities, which also change rhizosphere microbial communities. The healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soil microorganisms had distinct genus signatures, such as possible_genus_04 and Knoellia genera in healthy aerobic rice rhizosphere soils and norank_f__SC - I-84 and norank_f__Roseiflexaceae genera in M. verticalis larvae-feeding aerobic rice rhizosphere soils. The pathway of the metabolism of terpenoids and polyketides and carbohydrate metabolism in rhizosphere bacteria were significantly decreased after M. verticalis larvae feeding. Fungal parasite-wood saprotroph and fungal parasites were significantly decreased after M. verticalis larvae feeding, and plant pathogen-wood saprotroph and animal pathogen-undefined saprotroph were increased after larvae feeding. Additionally, the relative abundance of Bradyrhizobium and Talaromyces genera gradually increased with the elevation of the larvae density. Bacterial and fungal communities significantly correlated with soil physicochemical properties and enzyme activities, respectively. CONCLUSIONS: Based on the results we provide new insight for understanding the adaptation of aerobic rice to M. verticalis larvae feeding via regulating the rhizosphere environment, which would allow us to facilitate translation to more effective measures.
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Oryza , Animales , Oryza/microbiología , Larva , Rizosfera , China , Bacterias , Suelo/química , Microbiología del SueloRESUMEN
Objective: Asthma is a chronic heterogeneous airway disease, and imbalanced T-helper type 1 (Th1) and Th2 cell-mediated inflammation contribute to its pathogenesis. Although it has been suggested that androgen and estrogen were involved in development of asthma, the underlying mechanisms remained largely unclear. Studies have demonstrated that Runx3 could promote naive CD4+ T cells to differentiate into Th1 cells. Hence, our study aimed to explore the potential regulatory mechanism of androgen and estrogen on asthma via modulating Runx3. Methods: First, clinical assessments and pulmonary function tests were conducted on 35 asthma patients and 24 healthy controls. The concentrations of androgen, estrogen, and androgen estrogen ratios were assessed in peripheral blood samples of asthma patients and healthy controls. Then, a murine asthma model was established to explore the effects of estrogen and androgen (alone or in combination) on asthma. Third, an in vitro assay was used to explore the mechanism of combination of androgen and estrogen in asthma. Results: We observed decreased androgen and increased estrogen levels in asthma patients compared with healthy controls. In mice with experimental asthma, there were increased serum concentrations of estrogen and decreased serum concentrations of androgen, intervention with combination of androgen and estrogen alleviated airway inflammations, increased Runx3 expressions and elevated Th1 differentiation. In CD4+ T cells co-cultured with bronchial epithelial cells (BECs), treatment with androgen plus estrogen combination promoted Th1 differentiation, which was mitigated by Runx3 knockdown in BECs and enhanced by Runx3 overexpression. Conclusion: These findings suggest that androgen estrogen combination modulate the Th1/Th2 balance via regulating the expression of Runx3 in BECs, thereby providing experimental evidence supporting androgen and estrogen combination as a novel therapy for asthma.
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Andrógenos , Asma , Subunidad alfa 3 del Factor de Unión al Sitio Principal , Estrógenos , Adulto , Animales , Femenino , Humanos , Masculino , Ratones , Persona de Mediana Edad , Andrógenos/sangre , Asma/tratamiento farmacológico , Asma/inmunología , Asma/sangre , Estudios de Casos y Controles , Diferenciación Celular/efectos de los fármacos , Subunidad alfa 3 del Factor de Unión al Sitio Principal/genética , Subunidad alfa 3 del Factor de Unión al Sitio Principal/metabolismo , Modelos Animales de Enfermedad , Células TH1/inmunología , Células TH1/efectos de los fármacos , Células Th2/inmunología , Células Th2/efectos de los fármacosRESUMEN
BACKGROUND: Brain tumor patients undergoing craniotomy are significantly associated with the development of venous thromboembolism (VTE), while the contributing factors remains controversial. Our study aimed to investigate the prevalence and risk factors for VTE in postoperational brain tumor patients. METHODS: We searched the PubMed, Embase, Web of Science, Medline, and Cochrane Library databases from their inception to July 2023. Article selection, data extraction, and study quality assessment were performed independently by two reviewers. Publication bias was assessed using Egger's and Begg's tests. Stata 15.0 software was used for data analysis. RESULTS: A total of 25 studies were considered, with a total of 49,620 brain tumor individuals. The pooled prevalence of VTE during hospitalization in postoperational brain tumor patients was 9% [95% CI: (0.08, 0.10)]. Moreover, our results demonstrated that patients with VTE were older than those without VTE [mean difference [MD] = 8.14, 95% CI: (4.97, 11.30)]. The following variables were significantly associated with VTE: prior history of VTE [OR = 7.81, 95% CI: (3.62, 16.88)], congestive heart failure [OR = 2.33, 95% CI: (1.08-5.05)], diabetes [OR = 1.87, 95% CI: (1.12-3.10)], hypertension [OR = 1.27, 95% CI: (1.07-1.50)], steroid use [OR = 1.63, 95% CI: (1.41, 1.88)], high white blood cells counts [MD = 0.32, 95% CI: (0.01, 0.63)], and high fibrinogen levels [MD = 0.19, 95% CI: (0.08, 0.30)]. CONCLUSION: This meta-analysis identified risk factors for postoperational VTE in patients with brain tumor, which can serve as a theoretical foundation for medical staff to manage and treat VTE. TRIAL REGISTRATION: CRD42023357459.
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Neoplasias Encefálicas , Tromboembolia Venosa , Humanos , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiología , Tromboembolia Venosa/cirugía , Prevalencia , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/cirugía , Craneotomía/efectos adversos , Factores de RiesgoRESUMEN
OBJECTIVE: This study aimed to validate the iScore, ASTRAL score, DRAGON score, and THRIVE score for assessing large vessel occlusion-acute ischemic stroke (AIS-LVO) and establish a predictive model for AIS-LVO patients that has better performance to guide clinical practice. METHODS: We retrospectively included 439 patients with AIS-LVO and collected baseline data from all of them. External validation of the iScore, ASTRAL score, DRAGON score, and THRIVE score was performed. All variables were compared between groups via univariate analysis, and the results are expressed as ORs and 95% CIs. Independent variables with P<0.25 were included in the multivariate logistic analysis, and statistically significant differences (P<0.05) were identified as risk factors for prognosis in AIS-LVO patients. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to evaluate the predictive value of our model. RESULTS: Our external validation resulted in an iScore under the curve (AUC) of 0.8475, an ASTRAL AUC of 0.8324, a DRAGON AUC of 0.8196, and a THRIVE AUC of 0.8039. In our research, multivariate Cox regression revealed 8 independent predictors. We used a nomogram to visualize the results of the data analysis. The AUC for the training cohort was 0.8855 (95% CI, 0.8487-0.9222), and that in the validation cohort was 0.8992 (95% CI, 0.8496-0. 9488). CONCLUSIONS: In this study, we verified that the above scores have excellent efficacy in predicting the prognosis of AIS-LVO patients. The nomogram we developed was able to predict the prognosis of AIS-LVO more accurately and may contribute to personalized clinical decision-making and treatment for future clinical work.
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INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is highly prevalent and underdiagnosed worldwide. The validity and reliability of COPD Population Screening (COPD-PS) questionnaire are not properly known in a large-sample Chinese population. METHODS: This is a national multicenter prospective study that enrolled 1,824 outpatients from 12 hospital sites in China. Scores of the Chinese version of COPD-PS questionnaire, demographic data, and clinical information were collected. The validity and the test-retest reliability were evaluated. RESULTS: 1,824 participants were involved in this study, and 404 (22.1%) were diagnosed with COPD. The overall area under the curve (AUC) of the receiver operating characteristic (ROC) for COPD-PS questionnaire was 0.761 (95% CI: 0.734-0.787). A cut-off point of 4 was recommended, corresponding to a sensitivity of 74.50% and a specificity of 64.37%. The COPD-PS questionnaire showed an overall Pearson's correlation of 0.88. CONCLUSIONS: The COPD-PS questionnaire can be used in screening COPD patients from the general Chinese population with respiratory symptoms.
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Enfermedad Pulmonar Obstructiva Crónica , Humanos , Reproducibilidad de los Resultados , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Tamizaje Masivo , Encuestas y CuestionariosRESUMEN
In recent years, adsorption-based membranes have been widely investigated to remove and separate textile pollutants. However, cyclic adsorption-desorption to reuse a single adsorbent and clear scientific evidence for the adsorption-desorption mechanism remains challenging. Herein, silk nanofibers were used to assess the adsorption potential for the typical anionic dyes from an aqueous medium, and they show great potential toward the removal of acid dyes from the aqueous solution with an adsorption rate of â¼98% in a 1 min interaction. Further, we measured the filtration proficiency of a silk nanofiber membrane in order to propose a continuous mechanism for the removal of acid blue dye, and a complete rejection was observed with a maximum permeability rate of â¼360 ± 5 L·m-2·h-1. The Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy studies demonstrate that this fast adsorption occurs due to multiple interactions between the dye molecule and the adsorbent substrate. The as-prepared material also shows remarkable results in desorption. A 50-time cycle exhibits complete adsorption and desorption ability, which not only facilitates high removal aptitude but also produces less solid waste than other conventional adsorbents. Additionally, fluorescent 2-bromo-2-methyl-propionic acid (abbreviated as EtOxPY)-silk nanofibers can facilitate to illustrate a clear adsorption and desorption mechanism. Therefore, the above-prescribed results make electrospun silk nanofibers a suitable choice for removing anionic dyes in real-time applications.
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Colorantes , Membranas Artificiales , Nanofibras , Seda , Descoloración del Agua , Contaminantes Químicos del Agua , Ácidos/química , Adsorción , Aniones/química , Colorantes/química , Filtración/instrumentación , Filtración/métodos , Concentración de Iones de Hidrógeno , Cinética , Nanofibras/química , Espectroscopía de Fotoelectrones , Seda/química , Espectroscopía Infrarroja por Transformada de Fourier , Descoloración del Agua/instrumentación , Descoloración del Agua/métodos , Contaminantes Químicos del Agua/químicaRESUMEN
BACKGROUND: Healthy aging index (HAI) could predict adverse health consequences including mortality and disability independent of age and comorbidity. We investigated the role of HAI on trajectories of disability throughout later life based on a nationally representative sample. METHODS: We examined 1733 participants aged over 60 years from the China Health and Retirement Longitudinal Study (CHARLS) followed for 7 years/4 waves repeatedly. Systolic blood pressure [SBP], cognitive function, cystatin C, peak expiratory flow [PEF], and fasting glucose were categorized using tertile or clinical reference range, and scored as 0 (healthiest), 1 (less healthy) and 2 (least healthy) respectively to further generate HAI summary scores (range 0-10). Disability was defined as the sum of impaired activities of daily living (ADL) and instrumental activities of daily living (IADL). We used linear mixed-effects model to study the association between HAI and trajectories of disability. RESULTS: A total of 10.5% of participants represented in the healthiest group and 22.5% ended up as the least healthy. After adjusting for all potential confounders, disability progression was significantly faster (ß = 0.27, 95% CI 0.11-0.42) in the least healthy group when comparing with the healthiest. CONCLUSION: Our findings suggest that HAI is associated with disability progression among adults aged over 60 years old. It might be beneficial for future interventions to specifically target older adults with high HAI scores as a means of reducing disability.
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Personas con Discapacidad , Envejecimiento Saludable , Actividades Cotidianas , Anciano , China/epidemiología , Estudios de Cohortes , Evaluación de la Discapacidad , Humanos , Estudios LongitudinalesRESUMEN
T helper 17 (Th17) cells has proven to be crucial in the pathogenesis of severe asthma. Although it is known that Suppressor of cytokine signaling 3 (SOCS3) is involved in differentiation of Th17 cells but, how it affects severe asthma is uncertain. Since previous studies indicated that Methtyl-CpG binding domain protein 2 (MBD2) null mice was deficient in Th17 cell differentiation, the aim of the present study was to understand how MBD2 interacts with SOCS3 to regulate Th17 cell differentiation in severe asthma. Here, we show that SOCS3 expression was significantly decreased in Th17-mediated severe asthmatic mice, accompanied by elevated STAT3 phosphorylation and RORγt expression. Knock-down of SOCS3 promoted the differentiation of naïve T cells into Th17 cells through STAT3/RORγt pathway. Meanwhile, MBD2 was overexpressed in Th17-mediated severe asthmatic mice. Intervention of MBD2 expression lead to a negative change of SOCS3 expression, whereas the differentiation of Th17 cells showed positive change. In addition, MBD2 knockout (MBD2-KO) mice displayed increased SOCS3 expression and decreased Th17 differentiation after severe asthma modeling. Taken together, our results suggest that MBD2 might facilitate Th17 cell differentiation via down-regulating SOCS3 expression in severe asthma. These findings uncover new roles for SOCS3 and MBD2, and provide a potential target for treatment of severe asthma.
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Asma/genética , Proteínas de Unión al ADN/genética , Pulmón/inmunología , Proteína 3 Supresora de la Señalización de Citocinas/genética , Células Th17/inmunología , Alérgenos/administración & dosificación , Animales , Asma/inducido químicamente , Asma/inmunología , Asma/patología , Diferenciación Celular , Proteínas de Unión al ADN/inmunología , Modelos Animales de Enfermedad , Femenino , Regulación de la Expresión Génica , Humanos , Lipopolisacáridos/administración & dosificación , Pulmón/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Miembro 3 del Grupo F de la Subfamilia 1 de Receptores Nucleares/genética , Miembro 3 del Grupo F de la Subfamilia 1 de Receptores Nucleares/inmunología , Ovalbúmina/administración & dosificación , Fosforilación , Pyroglyphidae/química , Pyroglyphidae/inmunología , Factor de Transcripción STAT3/genética , Factor de Transcripción STAT3/inmunología , Índice de Severidad de la Enfermedad , Transducción de Señal , Proteína 3 Supresora de la Señalización de Citocinas/inmunología , Células Th17/patologíaRESUMEN
Multiple myeloma (MM) cells are characterized by high protein synthesis resulting in chronic endoplasmic reticulum (ER) stress, which is adaptively managed by the unfolded protein response. Inositol-requiring enzyme 1α (IRE1α) is activated to splice X-box binding protein 1 (XBP1) mRNA, thereby increasing XBP1s protein, which in turn regulates genes responsible for protein folding and degradation during the unfolded protein response. In this study, we examined whether IRE1α-XBP1 pathway is a potential therapeutic target in MM using a small-molecule IRE1α endoribonuclease domain inhibitor MKC-3946. MKC-3946 triggered modest growth inhibition in MM cell lines, without toxicity in normal mononuclear cells. Importantly, it significantly enhanced cytotoxicity induced by bortezomib or 17-AAG, even in the presence of bone marrow stromal cells or exogenous IL-6. Both bortezomib and 17-AAG induced ER stress, evidenced by induction of XBP1s, which was blocked by MKC-3946. Apoptosis induced by these agents was enhanced by MKC-3946, associated with increased CHOP. Finally, MKC-3946 inhibited XBP1 splicing in a model of ER stress in vivo, associated with significant growth inhibition of MM cells. Taken together, our results demonstrate that blockade of XBP1 splicing by inhibition of IRE1α endoribonuclease domain is a potential therapeutic option in MM.
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Proteínas de Unión al ADN/genética , Endorribonucleasas/antagonistas & inhibidores , Mieloma Múltiple/tratamiento farmacológico , Proteínas Serina-Treonina Quinasas/antagonistas & inhibidores , Empalme del ARN/efectos de los fármacos , Factores de Transcripción/genética , Animales , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Benzoquinonas/farmacología , Células de la Médula Ósea/citología , Células de la Médula Ósea/efectos de los fármacos , Células de la Médula Ósea/metabolismo , Ácidos Borónicos/farmacología , Ácidos Borónicos/uso terapéutico , Bortezomib , Muerte Celular/efectos de los fármacos , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Estrés del Retículo Endoplásmico/efectos de los fármacos , Endorribonucleasas/metabolismo , Activación Enzimática/efectos de los fármacos , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/uso terapéutico , Humanos , Interleucina-6/farmacología , Lactamas Macrocíclicas/farmacología , Ratones , Mieloma Múltiple/genética , Mieloma Múltiple/patología , Proteínas Serina-Treonina Quinasas/metabolismo , Pirazinas/farmacología , Pirazinas/uso terapéutico , Empalme del ARN/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , Factores de Transcripción del Factor Regulador X , Transducción de Señal/efectos de los fármacos , Células del Estroma/citología , Células del Estroma/efectos de los fármacos , Células del Estroma/metabolismo , Respuesta de Proteína Desplegada/efectos de los fármacos , Proteína 1 de Unión a la X-Box , eIF-2 Quinasa/metabolismoRESUMEN
Phenolamides are important secondary metabolites in plant species. They play important roles in plant defense responses against pathogens and insect herbivores, protection against UV irradiation and floral induction and development. However, the accumulation and variation in phenolamides content in diverse maize lines and the genes responsible for their biosynthesis remain largely unknown. Here, we combined genetic mapping, protein regulatory network and bioinformatics analysis to further enhance the understanding of maize phenolamides biosynthesis. Sixteen phenolamides were identified in multiple populations, and they were all significantly correlated with one or several of 19 phenotypic traits. By linkage mapping, 58, 58, 39 and 67 QTLs, with an average of 3.9, 3.6, 3.6 and 4.2 QTLs for each trait were mapped in BBE1, BBE2, ZYE1 and ZYE2, explaining 9.47%, 10.78%, 9.51% and 11.40% phenotypic variation for each QTL on average, respectively. By GWAS, 39 and 36 significant loci were detected in two different environments, 3.3 and 2.8 loci for each trait, explaining 10.00% and 9.97% phenotypic variation for each locus on average, respectively. Totally, 58 unique candidate genes were identified, 31% of them encoding enzymes involved in amine and derivative metabolic processes. Gene Ontology term analysis of the 358 protein-protein interrelated genes revealed significant enrichment in terms relating to cellular nitrogen metabolism, amine metabolism. GRMZM2G066142, GRMZM2G066049, GRMZM2G165390 and GRMZM2G159587 were further validated involvement in phenolamides biosynthesis. Our results provide insights into the genetic basis of phenolamides biosynthesis in maize kernels, understanding phenolamides biosynthesis and its nutritional content and ability to withstand biotic and abiotic stress.
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Background: ORIN1001, a first-in-class oral IRE1-α endoribonuclease inhibitor to block the activation of XBP1, is currently in clinical development for inhibiting tumor growth and enhancing the effect of chemical or targeted therapy. Early establishment of a population pharmacokinetic (PopPK) model could characterize the pharmacokinetics (PK) of ORIN1001 and evaluate the effects of individual-specific factors on PK, which will facilitate the future development of this investigational drug. Methods: Non-linear mixed effect model was constructed by Phoenix NLME software, utilizing the information from Chinese patients with advanced solid tumors in a phase I clinical trial (Register No. NCT05154201). Statistically significant PK covariates were screened out by a stepwise process. The final model, after validating by the goodness-of-fit plots, non-parametric bootstrap, visual predictive check and test of normalized prediction distribution errors, was further applied to simulate and evaluate the impact of covariates on ORIN1001 exposure at steady state up to 900 mg per day as a single agent. Results: A two-compartment model with first-order absorption (with lag-time)/elimination was selected as the best structural model. Total bilirubin (TBIL) and lean body weight (LBW) were considered as the statistically significant covariates on clearance (CL/F) of ORIN1001. They were also confirmed to exert clinically significant effects on ORIN1001 steady-state exposure after model simulation. The necessity of dose adjustments based on these two covariates remains to be validated in a larger population. Conclusion: The first PopPK model of ORIN1001 was successfully constructed, which may provide some important references for future research.
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OBJECTIVE: Dysphagia is a common condition that can independently lead to death in patients in the intensive care unit (ICU), particularly those who require mechanical ventilation. Despite extensive research on the predictors of dysphagia development, consistency across these studies is lacking. Therefore, this study aimed to identify predictors and summarize existing prediction models for dysphagia in ICU patients undergoing invasive mechanical ventilation. METHODS: We searched five databases: PubMed, EMBASE, Web of Science, Cochrane Library, and the China National Knowledge Infrastructure. Studies that developed a post-extubation dysphagia risk prediction model in ICU were included. A meta-analysis of individual predictor variables was performed with mixed-effects models. The risk of bias was assessed using the prediction model risk of bias assessment tool (PROBAST). RESULTS: After screening 1,923 references, we ultimately included nine studies in our analysis. The most commonly identified risk predictors included in the final risk prediction model were the length of indwelling endotracheal tube ≥72 h, Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥15, age ≥65 years, and duration of gastric tube ≥72 h. However, PROBAST analysis revealed a high risk of bias in the performance of these prediction models, mainly because of the lack of external validation, inadequate pre-screening of variables, and improper treatment of continuous and categorical predictors. CONCLUSIONS: These models are particularly susceptible to bias because of numerous limitations in their development and inadequate external validation. Future research should focus on externally validating the existing model in ICU patients with varying characteristics. Moreover, assessing the acceptance and effectiveness of the model in clinical practice is needed. LEVEL OF EVIDENCE: NA Laryngoscope, 134:517-525, 2024.
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Trastornos de Deglución , Respiración Artificial , Humanos , Anciano , Respiración Artificial/efectos adversos , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Unidades de Cuidados Intensivos , Cuidados Críticos , SesgoRESUMEN
BACKGROUND: Visitation has a positive effect on patients and families, yet, it can disrupt intensive care unit (ICU) care and increase the risk of patient infections, which previously favoured face-to-face visits. The coronavirus disease 2019 (COVID-19) pandemic has raised the importance of virtual visits and led to their widespread adoption globally, there are still many implementation barriers that need to be improved. Therefore, this review aimed to explore the use of ICU virtual visit technology during the COVID-19 pandemic and the barriers and facilitators of virtual visits to improve virtual visits in ICUs. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six databases (CINAHL, China National Knowledge Infrastructure [CNKI], PubMed, Cochrane, VIP and Wang Fang databases) were searched for empirical studies published between 1 January 2020 and 22 October 2023. Studies that investigated and reported barriers to and facilitators of implementing virtual visits in ICUs during the COVID-19 pandemic were included. Evidence from the included studies was identified and thematically analysed using Thomas and Harden's three-step approach. Study quality was appraised with the Mixed-Methods Appraisal Tool. RESULTS: A total of 6770 references were screened, of which 35 studies met the inclusion criteria after a full-text review. Eight main barriers to virtual visits use were identified: technical difficulties; insufficient resources; lack of physical presence and nonverbal information; low technical literacy; differences in families' perceptions of visual cues; privacy and ethics issues; inequitable access and use of virtual visit technology; and lack of advance preparation. Four facilitating factors of virtual visit use were identified: providing multidimensional professional support; strengthening coordination services; understanding the preferences of patients and their families; and enhancing privacy and security protection. In the quality appraisal of 35 studies, 12 studies were rated as low, five as medium and 18 as high methodological quality. CONCLUSION: This review identified key facilitating factors and barriers to ICU virtual visits, which can foster the development of infrastructure, virtual visiting workflows, guidelines, policies and visiting systems to improve ICU virtual visiting services. Further studies are necessary to identify potential solutions to the identified barriers.
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OBJECTIVE: Early prediction of the onset, progression and prognosis of acute ischemic stroke (AIS) is helpful for treatment decision-making and proactive management. Although several biomarkers have been found to predict the progression and prognosis of AIS, these biomarkers have not been widely used in routine clinical practice. Xanthine oxidase (XO) is a form of xanthine oxidoreductase (XOR), which is widespread in various organs of the human body and plays an important role in redox reactions and ischemiaâreperfusion injury. Our previous studies have shown that serum XO levels on admission have certain clinical predictive value for AIS. The purpose of this study was to utilize serum XO levels and clinical data to establish machine learning models for predicting the onset, progression, and prognosis of AIS. METHODS: We enrolled 328 consecutive patients with AIS and 107 healthy controls from October 2020 to September 2021. Serum XO levels and stroke-related clinical data were collected. We established 5 machine learning models-the logistic regression (LR), support vector machine (SVM), decision tree, random forest, and K-nearest neighbor (KNN) models-to predict the onset, progression, and prognosis of AIS. The area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, negative predictive value, and positive predictive value were used to evaluate the predictive performance of each model. RESULTS: Among the 5 machine learning models predicting AIS onset, the AUROC values of 4 prediction models were over 0.7, while that of the KNN model was lower (AUROC = 0.6708, 95% CI 0.576-0.765). The LR model showed the best AUROC value (AUROC = 0.9586, 95% CI 0.927-0.991). Although the 5 machine learning models showed relatively poor predictive value for the progression of AIS (all AUROCs <0.7), the LR model still showed the highest AUROC value (AUROC = 0.6543, 95% CI 0.453-0.856). We compared the value of 5 machine learning models in predicting the prognosis of AIS, and the LR model showed the best predictive value (AUROC = 0.8124, 95% CI 0.715-0.910). CONCLUSIONS: The tested machine learning models based on serum levels of XO could predict the onset and prognosis of AIS. Among the 5 machine learning models, we found that the LR model showed the best predictive performance. Machine learning algorithms improve accuracy in the early diagnosis of AIS and can be used to make treatment decisions.
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Accidente Cerebrovascular Isquémico , Xantina Oxidasa , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico , Pronóstico , Modelos Estadísticos , Aprendizaje Automático , BiomarcadoresRESUMEN
BACKGROUND: This study examines the extent to which depressive symptoms mediate the link between childhood friendship (CF) and physical function among middle-aged and older adults in China. METHODS: China Health and Retirement Longitudinal Study (CHARLS) data were used; specifically, CHARLS life history survey (conducted from June 1-December 31, 2014) and follow-up health survey (conducted from July 1-September 30, 2015) data were used. The Sobel test, Bootstrap test and multivariable logistic regression were performed to examine the mediating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between CF (measured by a standardized retrospective questionnaire) and physical function, which was measured by basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and grip strength. RESULTS: A total of 12,170 participants aged 45 years or older were included in this cross-sectional study. After controlling for covariates, low-quality CF was associated with an increased prevalence of BADL disability (OR = 1.18; 95 % CI = 1.05-1.32), IADL disability (OR = 1.25; 95 % CI = 1.12-1.40), and low grip strength (OR = 1.21; 95 % CI = 1.09-1.34). The proportion of the mediating effect of depressive symptoms was 48 % for CF and BADL, 40 % for CF and IADL, and 11 % for CF and grip strength. Depressive symptoms and worse CF have a joint effect on BADL disability (OR = 3.30; 95 % CI = 2.82-3.85), IADL disability (OR = 3.52; 95 % CI = 3.03-4.09), and low grip strength (OR = 1.65; 95 % CI = 1.43-1.92). LIMITATIONS: Not all potential confounding factors (such as childhood behavioural problems, genetic factors, and memory function) were measured in the analysis, and there may have been recall bias in the retrospective collection of CF data. CONCLUSIONS: Individuals with high-quality CF were more likely to have a decreased prevalence of impaired physical function in later life. Depressive symptoms acted as a mediator associated with the development of CF.
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Actividades Cotidianas , Depresión , Amigos , Humanos , Masculino , Femenino , China/epidemiología , Estudios Longitudinales , Depresión/epidemiología , Anciano , Persona de Mediana Edad , Estudios Transversales , Amigos/psicología , Jubilación/estadística & datos numéricos , Jubilación/psicología , Fuerza de la Mano , PrevalenciaRESUMEN
IMPORTANCE: Patients in neuro-ICU are at a high risk of developing nosocomial CRKP infection owing to complex conditions, critical illness, and frequent invasive procedures. However, studies focused on constructing prediction models for assessing the risk of CRKP infection in neurocritically ill patients are lacking at present. Therefore, this study aims to establish a simple-to-use nomogram for predicting the risk of CRKP infection in patients admitted to the neuro-ICU. Three easily accessed variables were included in the model, including the number of antibiotics used, surgery, and the length of neuro-ICU stay. This nomogram might serve as a useful tool to facilitate early detection and reduction of the CRKP infection risk of neurocritically ill patients.
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Enterobacteriaceae Resistentes a los Carbapenémicos , Infección Hospitalaria , Infecciones por Klebsiella , Humanos , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Klebsiella pneumoniae , Nomogramas , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/tratamiento farmacológico , Farmacorresistencia Bacteriana , Factores de Riesgo , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/tratamiento farmacológico , Unidades de Cuidados IntensivosRESUMEN
OBJECTIVE: This study aimed to develop and apply a nomogram with good accuracy to predict the risk of CRAB infections in neuro-critically ill patients. In addition, the difficulties and expectations of application such a tool in clinical practice was investigated. METHODS: A mixed methods sequential explanatory study design was utilized. We first conducted a retrospective study to identify the risk factors for the development of CRAB infections in neuro-critically ill patients; and further develop and validate a nomogram predictive model. Then, based on the developed predictive tool, medical staff in the neuro-ICU were received an in-depth interview to investigate their opinions and barriers in using the prediction tool during clinical practice. The model development and validation is carried out by R. The transcripts of the interviews were analyzed by Maxqda. RESULTS: In our cohort, the occurrence of CRAB infections was 8.63% (47/544). Multivariate regression analysis showed that the length of neuro-ICU stay, male, diabetes, low red blood cell (RBC) count, high levels of procalcitonin (PCT), and number of antibiotics ≥ 2 were independent risk factors for CRAB infections in neuro-ICU patients. Our nomogram model demonstrated a good calibration and discrimination in both training and validation sets, with AUC values of 0.816 and 0.875. Additionally, the model demonstrated good clinical utility. The significant barriers identified in the interview include "skepticism about the accuracy of the model", "delay in early prediction by the indicator of length of neuro-ICU stay", and "lack of a proper protocol for clinical application". CONCLUSIONS: We established and validated a nomogram incorporating six easily accessed indicators during clinical practice (the length of neuro-ICU stay, male, diabetes, RBC, PCT level, and the number of antibiotics used) to predict the risk of CRAB infections in neuro-ICU patients. Medical staff are generally interested in using the tool to predict the risk of CRAB, however delivering clinical prediction tools in routine clinical practice remains challenging.
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Infecciones por Acinetobacter , Acinetobacter baumannii , Carbapenémicos , Unidades de Cuidados Intensivos , Nomogramas , Humanos , Acinetobacter baumannii/efectos de los fármacos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Infecciones por Acinetobacter/epidemiología , Factores de Riesgo , Anciano , Antibacterianos/uso terapéutico , Antibacterianos/farmacología , Adulto , Enfermedad CríticaRESUMEN
Liver-specific Ern1 knockout impairs tumor progression in mouse models of hepatocellular carcinoma (HCC). However, the mechanistic role of IRE1α in human HCC remains unclear. In this study, we show that XBP1s, the major downstream effector of IRE1α, is required for HCC cell survival both in vitro and in vivo. Mechanistically, XBP1s transactivates LEF1, a key co-factor of ß-catenin, by binding to its promoter. Moreover, XBP1s physically interacts with LEF1, forming a transcriptional complex that enhances classical Wnt signaling. Consistently, the activities of XBP1s and LEF1 are strongly correlated in human HCC and with disease prognosis. Notably, selective inhibition of XBP1 splicing using an IRE1α inhibitor significantly repressed the viability of tumor explants as well as the growth of tumor xenografts derived from patients with distinct Wnt/LEF1 activities. Finally, machine learning algorithms developed a powerful prognostic signature based on the activities of XBP1s/LEF1. In summary, our study uncovers a key mechanistic role for the IRE1α-XBP1s pathway in human HCC. Targeting this axis could provide a promising therapeutic strategy for HCC with hyperactivated Wnt/LEF1 signaling.
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Background: Asthma treatment is difficult due to disease heterogeneity and comorbidities. In addition, the development of drugs targeting the underlying mechanisms of asthma remains slow. We planned to identify the most upregulated differentially expressed long noncoding RNA in asthma to explore its regulatory patterns and pathways in asthma. Methods: We sensitized mice using a mixture of ovalbumin, house dust mites, and lipopolysaccharide to establish an asthma mouse model. We also sensitized asthma cells with TGF-ß1 in an in vitro model. We performed a microarray analysis to identify the lncRNA with the differential expression level in model mice. We applied hematoxylin and eosin and Masson's trichrome stainings to mouse tissues to quantify the tissue damage extent. Next, we assess the levels of lncRNA CRNDE, miR-29a-3p, TGF-ß1, MCL-1, E-cadherin, vimentin, and snail. We counted the percentages of Th17 cells using flow cytometry. Finally, we performed a dual-luciferase reporter assay to assess the association between lncRNA CRNDE and miR-29a-3p. Results: We successfully established asthma mouse/cell models and selected the lncRNA CRNDE for our study. Transfection of si-CRNDE reduced the degree of injury and inflammation in the mouse model and reversed the TGF-ß1-induced epithelial-mesenchymal transition (EMT) in the cell model. Moreover, the E-cadherin level was upregulated, and the levels of IL-17A, vimentin, snail, and α-SMA were downregulated. We also discovered that lncRNA CRNDE negatively regulated miR-29a-3p and that this one in turn inhibited MCL-1 in mice. After lncRNA CRNDE expression downregulation, the level of miR-29a-3p was increased, and we detected reduced levels of MCL-1 and EMTs. Conclusions: lncRNA CRNDE expression downregulation led to reduced inflammation and reduced lung damage in mice with induced asthma, it inhibited the EMTs of lung epithelial cells via the miR-29a-3p/MCL-1 pathway, and it reduced the levels of Th17/IL-17A cells to reduce asthma signs.
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Asma , MicroARNs , ARN Largo no Codificante , Ratones , Animales , MicroARNs/genética , MicroARNs/metabolismo , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Factor de Crecimiento Transformador beta1/metabolismo , Vimentina/metabolismo , Transición Epitelial-Mesenquimal/genética , Interleucina-17/genética , Interleucina-17/metabolismo , Proteína 1 de la Secuencia de Leucemia de Células Mieloides/metabolismo , Células Th17/metabolismo , Células Epiteliales/metabolismo , Asma/genética , Asma/metabolismo , Cadherinas/metabolismo , Pulmón/metabolismo , Inflamación/metabolismo , Proliferación Celular/genéticaRESUMEN
BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) are the most common device-associated infections in hospitals and can be prevented. To identify the risk factors and develop a risk prediction model for CAUTIs among neurosurgical intensive care unit (NICU) patients. METHODS: All patients admitted to the NICU of a tertiary hospital between January 2019 and January 2020 were enrolled. Two decision tree models were applied to analyze the risk factors associated with CAUTIs in NICU patients. The performance of the decision tree model was evaluated. RESULTS: A total of 537 patients admitted to the NICU with indwelling catheters were recruited for this study. The rate of CAUTIs was 4.44 per 1000 catheter days, and Escherichia coli was the predominant pathogen causing CAUTIs among indwelling catheter patients. The classification and regression tree model displayed good power of prediction (area under the curve : 0.920). Nine CAUTI risk factors (age ≥60 years (P = 0.004), Glasgow Coma Scale score ≤8 (P = 0.009), epilepsy at admission (P = 0.007), admission to the hospital during the summer (P < 0.001), ventilators use (P = 0.007), receiving less than 2 types of antibiotics (P < 0.001), albumin level <35 g/L (P = 0.002), female gender (P = 0.002), and having an indwelling catheter for 7-14 days (P = 0.001) were also identified. CONCLUSION: We developed a novel scoring model for predicting the risk of CAUTIs in patients with neuro-critical illness in daily clinical practice. This model identified several risk factors for CAUTI among NICU patients, novel factors including epilepsy and admission during the summer, can be used to help providers prevent and reduce the risk of CAUTI among vulnerable groups.