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1.
Food Chem ; 452: 139424, 2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38754167

RESUMO

This study explores the influence of incorporating L-cysteine (L-Cys), chitosan (CTS), and citric acid (CA) on the enzymatic modification of potato starch (EPS) films to enhance anti-browning properties. Four types of EPS composite films were evaluated for preserving fresh-cut potato slices at low temperatures to inhibit browning. Their thermal, physiochemical, mechanical, and digestibility properties were assessed. Results indicate that the addition of CTS, CA, and L-Cys improved the anti-browning activity of the EPS films by increasing film thickness and reducing water vapor permeability (WVP), oxygen transmission rate (OTR), ultraviolet (UV) transmittance, and tensile strength (TS). Furthermore, these additives improved the film's microstructure, resulting in reinforced intermolecular interactions, increased elongation at break, heightened crystallinity, enhanced thermal stability, and favorable gastrointestinal digestibility. Overall, EPS/CTS/L-Cys/CA composite films show promise as edible packaging materials with effective anti-browning properties.

2.
Sci Total Environ ; 931: 172938, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38703850

RESUMO

Cadmium (Cd) is a widely distributed typical environmental pollutant and one of the most toxic heavy metals. It is well-known that environmental Cd causes testicular damage by inducing classic types of cell death such as cell apoptosis and necrosis. However, as a new type of cell death, the role and mechanism of pyroptosis in Cd-induced testicular injury remain unclear. In the current study, we used environmental Cd to generate a murine model with testicular injury and AIM2-dependent pyroptosis. Based on the model, we found that increased cytoplasmic mitochondrial DNA (mtDNA), activated mitochondrial proteostasis stress occurred in Cd-exposed testes. We used ethidium bromide to generate mtDNA-deficient testicular germ cells and further confirmed that increased cytoplasmic mtDNA promoted AIM2-dependent pyroptosis in Cd-exposed cells. Uracil-DNA glycosylase UNG1 overexpression indicated that environmental Cd blocked UNG-dependent repairment of damaged mtDNA to drive the process in which mtDNA releases to cytoplasm in the cells. Interestingly, we found that environmental Cd activated mitochondrial proteostasis stress by up-regulating protein expression of LONP1 in testes. Testicular specific LONP1-knockdown significantly reversed Cd-induced UNG1 protein degradation and AIM2-dependent pyroptosis in mouse testes. In addition, environmental Cd significantly enhanced the m6A modification of Lonp1 mRNA and its stability in testicular germ cells. Knockdown of IGF2BP1, a reader of m6A modification, reversed Cd-induced upregulation of LONP1 protein expression and pyroptosis activation in testicular germ cells. Collectively, environmental Cd induces m6A modification of Lonp1 mRNA to activate mitochondrial proteostasis stress, increase cytoplasmic mtDNA content, and trigger AIM2-dependent pyroptosis in mouse testes. These findings suggest that mitochondrial proteostasis stress is a potential target for the prevention of testicular injury.


Assuntos
Cádmio , Mitocôndrias , Piroptose , Testículo , Animais , Cádmio/toxicidade , Masculino , Camundongos , Testículo/efeitos dos fármacos , Testículo/metabolismo , Piroptose/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/efeitos dos fármacos , Poluentes Ambientais/toxicidade , Proteostase , Proteínas Mitocondriais/metabolismo , Exposição Ambiental/efeitos adversos , DNA Mitocondrial , Proteases Dependentes de ATP/metabolismo , Estresse Proteotóxico
3.
Ecotoxicol Environ Saf ; 274: 116191, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38460408

RESUMO

The reproduction toxicity of pubertal exposure to Microcystin-LR (MC-LR) and the underlying mechanism needs to be further investigated. In the current study, pubertal male ICR mice were intraperitoneally injected with 2 µg/kg MC-LR for four weeks. Pubertal exposure to MC-LR decreased epididymal sperm concentration and blocked spermatogonia proliferation. In-vitro studies found MC-LR inhibited cell proliferation of GC-1 cells and arrested cell cycle in G2/M phase. Mechanistically, MC-LR exposure evoked excessive reactive oxygen species (ROS) and induced DNA double-strand break in GC-1 cells. Besides, MC-LR inhibited DNA repair by reducing PolyADP-ribosylation (PARylation) activity of PARP1. Further study found MC-LR caused proteasomal degradation of SIRT6, a monoADP-ribosylation enzyme which is essential for PARP1 PARylation activity, due to destruction of SIRT6-USP10 interaction. Additionally, MG132 pretreatment alleviated MC-LR-induced SIRT6 degradation and promoted DNA repair, leading to the restoration of cell proliferation inhibition. Correspondingly, N-Acetylcysteine (NAC) pre-treatment mitigated the disturbed SIRT6-USP10 interaction and SIRT6 degradation, causing recovered DNA repair and subsequently restoration of cell proliferation inhibition in MC-LR treated GC-1 cells. Together, pubertal exposure to MC-LR induced spermatogonia cell cycle arrest and sperm count reduction by oxidative DNA damage and simultaneous SIRT6-mediated DNA repair failing. This study reports the effect of pubertal exposure to MC-LR on spermatogenesis and complex mechanism how MC-LR induces spermatogonia cell proliferation inhibition.


Assuntos
Toxinas Marinhas , Microcistinas , Sirtuínas , Espermatogônias , Animais , Masculino , Camundongos , Apoptose , Proliferação de Células , Quebras de DNA de Cadeia Dupla/efeitos dos fármacos , Reparo do DNA , Toxinas Marinhas/metabolismo , Toxinas Marinhas/toxicidade , Camundongos Endogâmicos ICR , Microcistinas/metabolismo , Microcistinas/toxicidade , Sêmen , Sirtuínas/efeitos dos fármacos , Sirtuínas/metabolismo , Espermatogônias/efeitos dos fármacos , Espermatogônias/metabolismo
4.
Physiol Plant ; 176(2): e14205, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38439620

RESUMO

Rhizobia and arbuscular mycorrhizal fungi (AMF) are symbiotic microorganisms important for plants grown in nutrient-deficient and heavy metal-contaminated soils. However, it remains unclear how plants respond to the coupled stress by heavy metal and nitrogen (N) deficiency under co-inoculation. Here, we investigated the synergistic effect of Mesorhizobium huakuii QD9 and Funneliformis mosseae on the response of black locust (Robinia pseudoacacia L.) grown in sand culture to cadmium (Cd) under N deficiency conditions. The results showed that single inoculation of AMF improved the growth and Cd resistance of black locust, co-inoculation improved the most. Compared to non-inoculated controls, co-inoculation mediated higher biomass and antioxidant enzyme activity, reduced oxidative stress, and promoted nodulation, mycorrhizal colonization, photosynthetic capacity, and N, P, Fe and Mg acquisition when exposed to Cd. This increase was significantly higher under N deficiency compared to N sufficiency. In addition, the uptake of Cd by co-inoculated black locust roots increased, but Cd translocation to the above-ground decreased under both N deficiency and sufficiency. Thus, in the tripartite symbiotic system, not merely metabolic processes but also Cd uptake increased under N deficiency. However, enhanced Cd detoxification in the roots and reduced allocation to the shoot likely prevent Cd toxicity and rather stimulated growth under these conditions.


Assuntos
Micorrizas , Rhizobium , Robinia , Cádmio/toxicidade , Areia , Antioxidantes
5.
Nutrients ; 16(3)2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38337739

RESUMO

OBJECTIVES: This study aims to examine the relationship between dietary inflammatory index (DII) and bone mineral density (BMD) changes among Chinese pregnant women, offering valuable insights for dietary guidance during pregnancy. METHODS: 289 pregnant women were enrolled in this cohort. Serum inflammatory factors and ultrasonic BMD were measured at the first, second, and the third trimesters. DII scores were calculated based on a semi-quantitative food frequency questionnaire (FFQ) and divided into tertiles. We compared the differences in inflammatory factors in serum across the tertiles of DII and changes in BMD at the second and third trimesters across the tertiles. RESULTS: The participants with higher DII scores had higher total energy intakes than those with lower DII scores. The serum level of interleukin-6 (IL-6) was significantly different across the tertiles of the DII. Women who had lower DII scores had higher T-scores and Z-scores in the BMD assessment. In the test of trends, after adjusting potential covariates, including educational level, physical activity, body mass index, and calcium, vitamin D, or multivitamin supplements, DII values were determined to be positively related to the maternal BMD lost. CONCLUSIONS: DII was positively associated with serum IL-6. Meanwhile, higher DII scores were associated with more bone mass loss in pregnant women. We recommend adhering to a lower-DII diet to preserve BMD during pregnancy.


Assuntos
Densidade Óssea , Gestantes , Humanos , Feminino , Gravidez , Estudos Prospectivos , Interleucina-6 , Dieta , Inflamação
6.
Environ Pollut ; 345: 123456, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38307241

RESUMO

The role of rhizobia in alleviating cadmium (Cd) stress in woody legumes is still unclear. Therefore, two types of black locust (Robinia pseudoacacia L.) with high and low Cd accumulation abilities were selected from 11 genotypes in China, and the effects of rhizobium (Mesorhizobium huakuii GP1T11) inoculation on the growth, CO2 and H2O gas exchange parameters, Cd accumulation, and the absorption of mineral elements of the high (SX) and low Cd-accumulator (HB) were compared. The results showed that rhizobium-inoculation significantly increased biomass, shoot Cd contents, Cd accumulation, root-to-shoot translocation factor (TF) and the absorption and accumulation of mineral elements in both SX and HB. Rhizobium-inoculation increased chlorophyll a and carotenoid contents, and the intercellular carbon dioxide concentrations in HB plants. Under Cd exposure, the high-accumulator SX exhibited a significant decrease in photosynthetic CO2 fixation (Pn) and an enhanced accumulation of Cd in leaves, but coped with Cd exposure by increasing chlorophyll synthesis, regulating stomatal aperture (Gs), controlling transpiration (Tr), and increasing the absorption and accumulation of mineral elements. In contrast, the low-accumulator HB was more sensitive to Cd exposure despite preferential accumulation of Cd in roots, with decreased chlorophyll and carotenoid contents, but significantly increased root biomass. Compared to the low-accumulator HB, non-inoculated Cd-exposed SX plants had higher chlorophyll contents, and rhizobium-inoculated Cd-exposed SX plants had higher Pn, Tr, and Gs as well as higher levels of P, K, Fe, Ca, Zn, and Cu. In conclusion, the high- and low-Cd-accumulator exhibited different physiological responses to Cd exposure. Overall, rhizobium-inoculation of black locust promoted the growth and heavy metal absorption, providing an effective strategy for the phytoremediation of heavy metal-contaminated soils by this woody legume.


Assuntos
Metais Pesados , Rhizobium , Robinia , Poluentes do Solo , Cádmio/toxicidade , Robinia/fisiologia , Clorofila A , Dióxido de Carbono/análise , Metais Pesados/farmacologia , Clorofila , Minerais , Carotenoides , Biodegradação Ambiental , Poluentes do Solo/análise
7.
BMC Health Serv Res ; 24(1): 239, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38395852

RESUMO

BACKGROUND: The incidence of pancreatic cancer is rising. With improvements in knowledge for screening and early detection, earlier detection of pancreatic cancer will continue to be more common. To support workforce planning, our aim is to perform a model-based analysis that simulates the potential impact on the healthcare workforce, assuming an earlier diagnosis of pancreatic cancer. METHODS: We developed a simulation model to estimate the demand (i.e. new cases of pancreatic cancer) and supply (i.e. the healthcare workforce including general surgeons, medical oncologists, radiation oncologists, pain medicine physicians, and palliative care physicians) between 2023 and 2027 in Victoria, Australia. The model compares the current scenario to one in which pancreatic cancer is diagnosed at an earlier stage. The incidence of pancreatic cancer in Victoria, five-year survival rates, and Victoria's population size were obtained from Victorian Cancer Registry, Cancer Council NSW, and Australian Bureau of Statistics respectively. The healthcare workforce data were sourced from the Australian Government Department of Health and Aged Care's Health Workforce Data. The model was constructed at the remoteness level. We analysed the new cases and the number of healthcare workforce by profession together to assess the impact on the healthcare workforce. RESULTS: In the status quo, over the next five years, there will be 198 to 220 stages I-II, 297 to 330 stage III, and 495 to 550 stage IV pancreatic cancer cases diagnosed annually, respectively. Assuming 20-70% of the shift towards pancreatic cancer's earlier diagnosis (shifting from stage IV to stages I-II pancreatic cancer within one year), the stages I-II cases could increase to 351 to 390 or 598 to 665 per year. The shift to early diagnosis led to substantial survival gains, translating into an additional 284 or 795 out of 5246 patients with pancreatic cancer remaining alive up to year 5 post-diagnosis. Workforce supply decreases significantly by the remoteness levels, and remote areas face a shortage of key medical professionals registered in delivering pancreatic cancer care, suggesting travel necessities by patients or clinicians. CONCLUSION: Improving the early detection and diagnosis of pancreatic cancer is expected to bring significant survival benefits, although there are workforce distribution imbalances in Victoria that may affect the ability to achieve the anticipated survival gain.


Assuntos
Neoplasias Pancreáticas , Médicos , Humanos , Idoso , Vitória/epidemiologia , Recursos Humanos , Mão de Obra em Saúde , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/terapia
8.
J Am Geriatr Soc ; 72(4): 1048-1059, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38217343

RESUMO

BACKGROUND: A mismatch between myocardial oxygen supply and demand is the most common cause of ischemic myocardial injury in older persons. The subendocardial viability ratio (SEVR) can usefully estimate the degree of myocardial perfusion relative to left-ventricular workload. The aim of the present study was to evaluate the ability of SEVR to predict long-term mortality in the older population. Additionally, we aimed to identify the SEVR cutoff value best predicting total mortality. METHODS: This is a multicenter, longitudinal study involving a large population of individuals older than 80 years living in nursing homes. Patients with cancer, severe dementia, and very low level of autonomy were excluded from the study. Participants were monitored for 10 years. Adverse outcomes were recorded every 3 months from inclusion to the end of the study. SEVR reflects the balance between subendocardial oxygen supply and demand, and was estimated non-invasively by analyzing the carotid pressure waveform recorded by applanation arterial tonometry. RESULTS: A total of 828 people were enrolled (mean age: 87.7 ± 4.7 years, 78% female). 735 patients died within 10 years and 24 were lost to follow-up. SEVR was inversely associated with mortality at univariate Cox-regression model (risk ratio, 0.683 per unit increase in SEVR; 95% confidence interval (CI) [0.502-0.930], p = 0.015) and in a model including age, sex, body mass index, Activity of Daily Living index and Mini-Mental State Examination score (risk ratio, 0.647; 95% CI [0.472-0.930]). The lowest tertile of SEVR was associated with higher 10-years total mortality than the middle (p < 0.001) and the highest (p < 0.004) tertile. A SEVR cutoff value of 83% was identified as the best predictor of total mortality. CONCLUSIONS: SEVR may be considered as a marker of "cardiovascular frailty." An accurate non-invasive estimation of SEVR could be a useful and independent parameter to assess survival probability in very old adults. TRIAL REGISTRATION: NCT00901355, registered on ClinicalTrials.gov website.


Assuntos
Miocárdio , Oxigênio , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Longitudinais
9.
J Adv Nurs ; 80(2): 484-499, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37675947

RESUMO

AIMS: To examine the prevalence and associated factors of chemotherapy-related cognitive impairment (CRCI) in older breast cancer survivors (BCS). DESIGN: Systematic review. DATA SOURCES: We searched EMBASE, PubMed, PsychInfo, CINAHL, Cochrance Library, Web of Science, CNKI and SinoMed, without language restrictions, for studies published from the establishment of the database to September 2022. REVIEW METHODS: Two researchers independently examined the full texts, data extraction and quality assessment, and any discrepancies were resolved through discussion with a third reviewer. Quality of evidence was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Scale. RESULTS: The seven included studies showed that the estimated prevalence of CRCI in older BCS ranged from 18.6% to 27% on objective neuropsychological tests and from 7.6% to 49% on subjective cognitive assessments. The areas most affected were attention, memory, executive functioning and processing speed. CRCI was associated with 10 factors in six categories, including sociodemographic (e.g. age, education level), physiological (e.g. sleep disorders, fatigue and comorbidities), psychological (e.g. anxiety, depression), treatment modalities (e.g. chemotherapy cycles, chemotherapy regimens), genetic (e.g. APOE2, APOE4) and lifestyle factor (e.g. physical inactivity). CONCLUSION: CRCI is multifactorial and has a relatively high prevalence. However, the results of subjective and objective cognitive examinations were inconsistent, possibly due to variations in tools used to evaluate different definitions of CRCI. Nevertheless, as there are few published studies of older BCS, this conclusion still require verification by well-designed studies in the future. IMPACT: We found that the prevalence of CRCI in older adults is relatively high and multifactorial, providing evidence for further health care for this population. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Comprometimento Cognitivo Relacionado à Quimioterapia , Estados Unidos , Humanos , Idoso , Feminino , Prevalência , Neoplasias da Mama/tratamento farmacológico , Estilo de Vida
10.
Sci Total Environ ; 908: 168383, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-37951264

RESUMO

Intrauterine growth retardation (IUGR) is a major cause of perinatal morbidity and mortality. Previous studies showed that 1-nitropyrene (1-NP), an atmospheric pollutant, induces placental dysfunction and IUGR, but the exact mechanisms remain uncertain. In this research, we aimed to explore the role of mitophagy on 1-NP-evoked placental progesterone (P4) synthesis inhibition and IUGR in a mouse model. As expected, P4 levels were decreased in 1-NP-exposed mouse placentas and maternal sera. Progesterone synthases, CYP11A1 and 3ßHSD1, were correspondingly declined in 1-NP-exposed mouse placentas and JEG-3 cells. Mitophagy, as determined by LC3B-II elevation and TOM20 reduction, was evoked in 1-NP-exposed JEG-3 cells. Mdivi-1, a specific mitophagy inhibitor, relieved 1-NP-evoked downregulation of progesterone synthases in JEG-3 cells. Additional experiments showed that ULK1/FUNDC1 signaling was activated in 1-NP-exposed JEG-3 cells. ULK1 inhibitor or FUNDC1-targeted siRNA blocked 1-NP-induced mitophagy and progesterone synthase downregulation in JEG-3 cells. Further analysis found that mitochondrial reactive oxygen species (ROS) were increased and GCN2 was activated in 1-NP-exposed JEG-3 cells. GCN2iB, a selective GCN2 inhibitor, and MitoQ, a mitochondria-targeted antioxidant, attenuated GCN2 activation, FUNDC1-mediated mitophagy, and downregulation of progesterone synthases in JEG-3 cells. In vivo, gestational MitoQ supplement alleviated 1-NP-evoked reduction of placental P4 synthesis and IUGR. These results suggest that FUNDC1-mediated mitophagy triggered by mitochondrial ROS may contribute partially to 1-NP-induced placental P4 synthesis inhibition and IUGR.


Assuntos
Mitofagia , Placenta , Humanos , Camundongos , Feminino , Gravidez , Animais , Progesterona , Espécies Reativas de Oxigênio , Linhagem Celular Tumoral , Retardo do Crescimento Fetal , Mitocôndrias/fisiologia , Proteínas de Membrana/genética , Proteínas Mitocondriais/genética
11.
Clin Transl Sci ; 2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38129988

RESUMO

Unesbulin is being investigated in combination with dacarbazine (DTIC) as a potential therapeutic agent in patients with advanced leiomyosarcoma (LMS). This paper reports the pharmacokinetics (PK) of unesbulin, DTIC, and its unreactive surrogate metabolite 5-aminoimidazole-4-carboxamide (AIC) in 29 patients with advanced LMS. Drug interactions between DTIC (and AIC) and unesbulin were evaluated. DTIC (1000 mg/m2 ) was administered to patients with LMS via 1-hour intravenous (IV) infusion on Day 1 of every 21-day (q21d) cycle. Unesbulin dispersible tablets were administered orally twice weekly (BIW), starting on Day 2 of every cycle, except for Cycle 2 (C2), where unesbulin was dosed either on Day 1 together with DTIC or on Day 2, 1 day after DTIC administration. The PK of DTIC, AIC, and unesbulin in Cycle 1 (C1) and C2 were estimated using noncompartmental analysis. DTIC and AIC were measurable immediately after the start of infusion and reached Cmax immediately or shortly after end of infusion at 1.0 and 1.4 hours (Tmax ), respectively. Coadministration of unesbulin orally at 200 mg or above with DTIC inhibited cytochrome P450 (CYP)1A2-mediated DTIC metabolism, resulting in 66.7% reduction of AIC exposures. Such inhibition could be mitigated when unesbulin was dosed the day following DTIC infusion. Repeated unesbulin dosing demonstrated evidence of clinical CYP1A2 induction and increased AIC Cmax by 69.4% and AUCinf by 57.9%. No meaningful difference in unesbulin PK was observed between C2 and C1. The combination therapy of 1000 mg/m2 IV DTIC q21d and 300 mg unesbulin BIW in a staggered regimen is well tolerated in patients with LMS.

12.
J Cancer ; 14(18): 3561-3565, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38021153

RESUMO

Background: Patients with cancer showed a high incidence of venous thromboembolism (VTE) with a poor prognosis. The risk factors for VTE in different types of cancers may differ. Methods: The clinical features and laboratory test results of cancer patients with VTE in Henan Provincial People's Hospital from 2014 to 2020 were evaluated and compared. Results: Among the eligible patients, gastrointestinal cancer (GI cancer), lung cancer and gynecological cancer accounted for the top three. This study included 49 patients with GI cancer, 31 with lung cancer and 31 with gynecological cancer. The proportion of patients who underwent surgery in GI cancer or gynecological cancer group was significantly higher than that for lung cancer (69.4% and 80.6% vs 12.9%, both P<0.001). Red blood cell (RBC) and hemoglobin (HGB) levels were lower in the gynecological cancer group than that in the lung cancer group (P = 0.014 and 0.029, respectively), while red cell distribution width (RDW) was higher in the GI cancer group than that in the lung cancer group and gynecological cancer group (P = 0.047 and 0.010, respectively). Prothrom bin time (PT) was shorter in the gynecological cancer group than that in the GI and lung cancer group (P = 0.003 and P = 0.002, respectively). The activated partial thromboplastin time (APTT) in the lung cancer group was longer than that in the GI and gynecological cancer group (P = 0.029 and 0.003, respectively). There was no difference in LOS and successful treatment rate among the groups. However, the VTE cure rate in the gynecological cancer group is higher than that in the GI cancer group (90.3% vs 61.2%, P = 0.005). The probability of continuing to take anticoagulants after discharge in the gynecological cancer group is lower than that in the GI and lung cancer groups (6.5% vs 30.6% and 32.3%, P = 0.011 and 0.022 respectively). Conclusion: VTE risk factors of different types of cancers and laboratory test results were not exactly the same. Thrombosis prevention and treatment should be implemented according to the characteristics of the different types of cancer.

13.
BMJ Open ; 13(11): e073254, 2023 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-37993164

RESUMO

OBJECTIVE: Aortic stenosis (AS) is one of the most common acquired cardiac valvular diseases. The success of transcatheter aortic valve implantation (TAVI) for severe AS has led to increasing interest in its use to earlier disease-moderate AS (MAS). DESIGN: Model-based study using a Markov microsimulation technique to evaluate the long-term costs and benefits associated with 'early' TAVI. Key data inputs were sourced from the international literature and costs were obtained from Australian sources. SETTING: Australian health care system perspective. PARTICIPANTS: 10 000 hypothetical MAS patients with or without left ventricular diastolic dysfunction or impaired left ventricular ejection fraction. INTERVENTION: Comparing early TAVI to medical management over a life time horizon for MAS patients aged >65 years. We evaluated the cost-effectiveness of offering early TAVI in five scenarios (10%, 25%, 50%, 75% and 90% take-up rates). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure is quality-adjusted life years (QALY) gained and the incremental cost-utility ratio (ICUR). Secondary outcomes are life-years gained and the number of heart failure case avoided. RESULTS: Offering early TAVI for MAS patients resulted in both higher healthcare costs and greater benefits (an increase of 3.02 QALYs or 3.99 life-years) per person treated. The ICUR was around $A10 867 and $A11 926 per QALY gained for all five scenarios, with the total cost of early TAVI to the healthcare system being anticipated to be up to $A3.66 billion. Sensitivity analyses indicated a 100% probability of being cost-effective with a willingness to pay threshold of $A50 000/QALY. The benefits remained, even with assumptions of high levels of repeat valve replacement after TAVI. CONCLUSION: While ongoing randomised controlled trials will define the benefit of TAVI to MAS patients, these results suggest that this intervention is likely to be cost-effective.


Assuntos
Estenose da Valva Aórtica , Substituição da Valva Aórtica Transcateter , Humanos , Estenose da Valva Aórtica/cirurgia , Austrália , Análise Custo-Benefício , Fatores de Risco , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda
14.
BMC Pulm Med ; 23(1): 411, 2023 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-37898737

RESUMO

OBJECTIVES: To examine the characteristics of blood lymphocyte subsets in dermatomyositis-interstitial lung disease (DM-ILD) inflicted patients with positive anti-melanoma differentiation-associated gene 5 (anti-MDA5), as well as its prognosis value in this set of patients. METHODS: Data were retrospectively collected from 253 DM-ILD patients from three hospitals in China between January 2016 to January 2021. Patients were grouped into anti-MDA5 antibody positive group (MDA5+ DM-ILD) and anti-MDA5 antibody negative group (MDA5- DM-ILD) based on myositis-specific autoantibody test results. Demographic characteristics, lymphocyte subsets patterns and other clinical features were compared between the two groups. The association of lymphocyte subsets with 180-day mortality was investigated using survival analysis in MDA5+ DM-ILD. RESULTS: Out of 253 eligible patients with DM-ILD, 59 patients were anti-MDA5+ and 194 were anti-MDA5-. Peripheral blood lymphocyte count, CD3+ count, percentage of CD3+, CD3+CD4+ count, and CD3+CD8+ count was lower in MDA5+ DM-ILD than in MDA5- DM-ILD- (all P < 0.001) as well as CD3-CD19+ count (P = 0.04). In MDA5+ DM-ILD, CD3+CD8+ count ≤ 49.22 cell/µL (HR = 3.81, 95%CI [1.20,12.14]) and CD3-CD19+ count ≤ 137.64 cell/µL (HR = 3.43, 95%CI [1.15,10.24]) were independent predictors of mortality. CD3+CD8+ count ≤ 31.38 cell/µL was associated with a higher mortality risk in all DM-ILD patients (HR = 8.6, 95%CI [2.12,31.44]) after adjusting for anti-MDA5 and other clinical characteristics. CONCLUSION: Significant lymphocytes decrease was observed in MDA5+ DM-ILD patients. CD3+CD8+ cell count was associated with worse prognosis in both MDA5+ DM-ILD and all DM-ILD patients.


Assuntos
Dermatomiosite , Doenças Pulmonares Intersticiais , Humanos , Prognóstico , Estudos Retrospectivos , Helicase IFIH1 Induzida por Interferon , Doenças Pulmonares Intersticiais/complicações , Autoanticorpos , Subpopulações de Linfócitos , Contagem de Linfócitos
15.
Infect Drug Resist ; 16: 4919-4928, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37534063

RESUMO

Purpose: This study aims to analyze the distribution of human papillomavirus (HPV) genotypes and the associations of demographic characteristics with HPV infection among women with condyloma acuminatum (CA) in Henan Province of China. Methods: From January 2019 to October 2022, 702 women with CA were sampled for HPV subtypes and surveyed by questionnaire at Henan Provincial People's Hospital. The HPV genotype was tested by flow-through hybridization after polymerase chain reaction (PCR). Results: The location of warts was mainly vulva. The age of the subjects was mainly distributed in the 20-29-year-old, followed by 30-39-year-old. The most common subtypes were HPV 6 (43.59%), 11 (24.93%), 16 (11.82%), 52 (7.83%), 58 (7.55%), 51 (7.26%), 61 (5.70%), 39 (5.56%), 18 (5.13%), and 54 (4.70%), our results also suggested that HPV 6 and 11 were the dominant genotypes in each age group. The infection of low-risk HPV (LR-HPV) (74.50%) and single HPV (47.01%) were the main categories. In terms of educational level, women with senior high school or above were inclined to infect single and pure-LR HPV. Unmarried status, sometimes or never condom use increased the chances of multiple, pure high-risk (HR) and mixed HPV infections. Women with multiple sex partners were more likely to cause multiple and mixed HPV infections. Conclusion: Our experimental data on the prevalence and subtype distribution of HPV in women with CA could provide valuable reference for preventing CA in Henan Province. The application of the nine-valent vaccine provides a broad prospect for female CA prevention.

16.
Food Chem Toxicol ; 179: 113967, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37506864

RESUMO

Cadmium (Cd), one of the most common contaminants in diet and drinking water, impairs testicular germ cell development and spermatogenesis. Autophagy is essential for maintaining Sertoli cell function and Sertoli-germ cell communication. However, the role of Sertoli cell autophagy in Cd-caused spermatogenesis disorder remains unclear. Here, the mice of autophagy-related gene 5 (Atg5) knockouts in Sertoli cells were used to investigate the effect of autophagy deficiency on Cd-impaired spermatogenesis and its underlying mechanisms. Results showed that Sertoli cell-specific knockout of Atg5 exacerbated Cd-reduced sperm count and MVH (a specific marker for testicular germ cells) level in mice. Additionally, Sertoli cell Atg5 deficiency reduced the number of spermatocytes and decreased the level of meiosis-related proteins (SYCP3 and STRA8) in Cd-treated mouse testes. Loss of Atg5 in Sertoli cell exacerbated Cd-reduced the level of retinoic acid (RA) and retinal dehydrogenase (ALDH1A1 and ALDH1A) in mouse testes. Meanwhile, we found that the level of transcription factor WT1 was significantly downregulated in Atg5-/- plus Cd-treated testes. Further experiments showed that Wt1 overexpression restored Cd-decreased the levels of ALDH1A1 in Sertoli cells. Collectively, the above data suggest that knockout of Atg5 in Sertoli cell enhances the susceptibility of Cd-impaired testicular spermatogenesis. These findings provide new insights into autophagy of Sertoli cell preventing environmental toxicants-impaired testicular spermatogenesis.


Assuntos
Infertilidade Masculina , Testículo , Humanos , Masculino , Camundongos , Animais , Células de Sertoli , Cádmio/metabolismo , Sêmen , Espermatogênese , Camundongos Knockout , Proteína 5 Relacionada à Autofagia
17.
Value Health Reg Issues ; 38: 38-44, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37454646

RESUMO

OBJECTIVES: Underutilization and insufficient availability of dual-energy X-ray absorptiometry (DXA) in diagnosing osteoporosis in China could be changed by adopting unindicated quantitative computed tomography. We aimed to assess the cost-effectiveness of quantitative computed tomography (QCT) as a screening tool for osteoporosis in China. METHODS: A Markov microsimulation model was developed to assess the long-term costs and quality-adjusted life-years (QALYs) saved associated with 2 examinations as opportunistic screening for osteoporosis in a general population without prior histories of fracture. The diagnostic performance of both examinations was incorporated into the model. In lifetime modeling, opportunistically screened people may face the risk of experiencing hip, vertebral, and wrist fractures depending on their osteoporosis, age, and sex. Model parameters were informed by published literature. RESULTS: The base-case result showed that QCT was associated with higher costs ($6054 vs $5883) and higher benefits (10.081 vs 10.071 QALYs) in comparison with DXA, making QCT a cost-effective option for opportunistic screening (incremental cost-effectiveness ratio of US $16 430/QALY). Screening with QCT led to fewer fractures over the lifetime simulation: for every 10 000 people screened, 129 fractures (32 hip, 78 vertebral, and 19 wrist fractures) could be avoided because of the early initiation of antiosteoporotic treatment. CONCLUSIONS: Using QCT to screen people for osteoporosis is more cost-effective than standard practice in China, where access to DXA is minimal. This finding could support opportunistic osteoporosis screening using QCT in other countries with similar status.


Assuntos
Fraturas Ósseas , Osteoporose , Humanos , Análise Custo-Benefício , Osteoporose/diagnóstico por imagem , Programas de Rastreamento , Fraturas Ósseas/epidemiologia , China , Tomografia
18.
PLoS One ; 18(6): e0287710, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37384626

RESUMO

OBJECTIVES: Sedentary behaviour (SB) is associated with increased incidence of chronic diseases such as type 2 diabetes (T2D), cardiovascular disease, cancers, and premature mortality. SB interventions in workplaces are effective in reducing sitting time. Previous economic evaluations have not specifically used changes in sitting time to estimate the long-term impact of SB on chronic disease-related health and cost outcomes. This research evaluated the cost-effectiveness of three hypothetical SB interventions: behavioural (BI), environmental (EI) and multi-component intervention (MI), implemented in the Australian context, using a newly developed epidemiological model that estimates the impact of SB as a risk factor on long-term population health and associated cost outcomes. METHOD: Pathway analysis was used to identify the resource items associated with implementing each of the three interventions using a limited societal perspective (included costs: health sector, individuals and industry; excluded costs: productivity). The effectiveness of the modelled interventions in reducing daily sitting time (informed by published meta-analyses) was modelled for the Australian working population aged 20-65 years. A multi-cohort Markov model was developed to simulate the 2019 Australian population and estimate the incidence, prevalence and mortality of five diseases causally related to excessive sitting time, over the life course. Monte-Carlo simulations were used to calculate each intervention's mean incremental costs and benefits (quantified as health adjusted life years HALYs) compared to a do-nothing comparator. RESULTS: When implemented at the national level, the interventions were estimated to reach 1,018 organisations with 1,619,239 employees. The estimated incremental cost of SB interventions was A$159M (BI), A$688M (EI) and A$438M (MI) over a year. Incremental health-adjusted life years (HALYs) gained by BI, EI and MI were 604, 919 and 349, respectively. The mean ICER for BI was A$251,863 per HALY gained, A$737,307 for EI and A$1,250,426 for MI. Only BI had any probability (2%) of being cost-effective at a willingness-to-pay threshold of A$50,000 per HALY gained from a societal perspective. CONCLUSION: SB interventions are not cost-effective when a reduction in sitting time is the outcome measure of interest. The cost-effectiveness results are heavily driven by the cost of the sit-stand desks and the small HALYs gained from reducing sitting time. Future research should focus on capturing non-health-benefits of these interventions, such as productivity, work satisfaction, and other health benefits: metabolic, physical, and musculoskeletal outcomes. Importantly, the health benefits of simultaneously reducing sitting time and increasing standing time for such interventions should be captured with the joint effects of these risk factors appropriately considered.


Assuntos
Diabetes Mellitus Tipo 2 , Comportamento Sedentário , Humanos , Análise de Custo-Efetividade , Postura Sentada , Austrália/epidemiologia
19.
Ecotoxicol Environ Saf ; 259: 115027, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37207578

RESUMO

Our previous study showed 1-Nitropyrene (1-NP) exposure disrupted testicular testosterone synthesis in mouse, but the exact mechanism needs further investigation. The present research found 4-phenylbutyric acid (4-PBA), an endoplasmic reticulum (ER) stress inhibitor, recovered 1-NP-induced ER stress and testosterone synthases reduction in TM3 cells. GSK2606414, a protein kinase-like ER kinase (PERK) kinase inhibitor, attenuated 1-NP-induced PERK-eukaryotic translation initiation factor 2α (eIF2α) signaling activation and downregulation of steroidogenic proteins in TM3 cells. Both 4-PBA and GSK2606414 attenuated 1-NP-induced steroidogenesis disruption in TM3 cells. Further studies used N-Acetyl-L-cysteine (NAC) as a classical antioxidant to explore whether oxidative stress-activated ER stress mediated 1-NP-induced testosterone synthases reduction and steroidogenesis disruption in TM3 cells and mouse testes. The results showed NAC pretreatment mitigated oxidative stress, and subsequently attenuated ER stress, particularly PERK-eIF2α signaling activation, and downregulation of testosterone synthases in 1-NP-treated TM3 cells. More importantly, NAC extenuated 1-NP-induced testosterone synthesis in vitro and in vivo. The current work indicated that oxidative stress-caused ER stress, particularly PERK-eIF2α pathway activation, mediates 1-NP-downregulated steroidogenic proteins and steroidogenesis disruption in TM3 cells and mouse testes. Significantly, the current study provides a theoretical basis and demonstrates the experimental evidence for the potential application of antioxidant, such as NAC, in public health prevention, particularly in 1-NP-induced endocrine disorder.


Assuntos
Antioxidantes , Testículo , Masculino , Camundongos , Animais , Testículo/metabolismo , Antioxidantes/metabolismo , Fator de Iniciação 2 em Eucariotos/metabolismo , Estresse do Retículo Endoplasmático/fisiologia , Testosterona/metabolismo , Estresse Oxidativo , Acetilcisteína/farmacologia , Acetilcisteína/metabolismo
20.
Front Oncol ; 13: 1079719, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874092

RESUMO

Objective: Non-small cell lung cancer (NSCLC) patients present a high incidence of venous thromboembolism (VTE) with poor prognosis. It is crucial to identify and diagnose VTE early. The study aimed to identify potential protein biomarkers and mechanism of VTE in NSCLC patients via proteomics research. Methods: Proteomic analysis of the human plasma was performed through data-independent acquisition mass spectrometry for 20 NSCLC patients with VTE, and 15 NSCLC patients without VTE. Significantly differentially expressed proteins were analyzed by multiple bioinformatics method for further biomarker analysis. Results: A total of 280 differentially expressed proteins were identified in VTE and non-VTE patients, where 42 were upregulated and 238 were downregulated. These proteins were involved in acute-phase response, cytokine production, neutrophil migration and other biological processes related to VTE and inflammation. Five proteins including SAA1, S100A8, LBP, HP and LDHB had significant change between VTE and non-VTE patients, with the area under the curve (AUC) were 0.8067, 0.8308, 0.7767, 0.8021, 0.8533, respectively. Conclusions: SAA1, S100A8, LBP, HP and LDHB may serve as potential plasma biomarkers for diagnosis VTE in NSCLC patients.

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