Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 42
Filtrar
1.
Asia Pac J Oncol Nurs ; 11(10): 100580, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39351017

RESUMO

Objective: This study adopted a dyadic analysis method to examine the effect of perceived stress on emotional distress and determine whether relationship satisfaction and distress disclosure act as mediators in colorectal cancer (CRC) enterostomy patient-caregiver dyads. Methods: A total of 312 patient-caregiver dyads completed measures assessing perceived stress, relationship satisfaction, distress disclosure, and emotional distress. The data were analyzed using the actor-partner interdependence mediation model. Results: This study found that the perceived stress of patients and caregivers both had direct and indirect actor effects on emotional distress (through relationship satisfaction). Another important finding is that perceived stress had indirect actor-partner effects (through distress disclosure) on emotional distress. Conclusions: This study highlights that perceived stress, relationship satisfaction, and distress disclosure of patients and their caregivers are key factors that can be considered for improving emotional distress. It also partially confirmed the interdependence of patients with CRC and their caregivers.

2.
J Trace Elem Med Biol ; 86: 127512, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39232337

RESUMO

BACKGROUND: Prolonged exposure to excessive arsenic (As) and its compounds can cause damage to multiple systems, including respiratory, cardiovascular, immune, nervous, and endocrine systems. Manifestations include changes in skin pigmentation, excessive keratosis on palms and soles, gastrointestinal symptoms, and anemia. The liver as an important detoxification organ of the body, is a significant target organ for arsenic toxicity, and liver diseases are common. So far, the molecular mechanism has not been fully elucidated. Evidence suggests that taurodeoxycholic acid (TUDCA) has a protective role in arsenic-induced liver injury. This study aims to reveal potential target genes at the transcriptional level following TUDCA intervention, providing insights for the intervention of arsenic-induced liver injury. METHODS: The TUDCA intervention model of arsenic liver injury in C57BL/6 N mice was established. The experiment was divided into two phases and lasted for 24 weeks. The phase I trial (12 weeks) was divided into control, low, middle and high groups according to the dose of As. The phaseⅡtrial (12 weeks) was administered in combination with 10 mg/L sodium arsenite (the first stage high arsenic group) and TUDCA, so subsequent groups was named with H indicating high arsenic. Divide into four groups: control group(C), TUDCA solvent control group(H-Vehicle), TUDCA combined with As group(H-TUDCA), arsenic group (As). As was ingested through free water and TUDCA was administered to mice by gavage at a dose of 0.1 mL/10 g.b.w (100 mg/kg) once a day for 12 weeks. The differential expression gene (DEG) profile was obtained from the second batch of mouse liver tissues by RNA sequencing technology. Comparative transcriptomic analysis methods were used to identify co-varying DEGs between arsenic induction and TUDCA intervention, along with their associated pathways. QRT-PCR was utilized for validation. RESULTS: Transcriptome results showed that 487 DEGs were identified after arsenic induction. TUDCA intervention identified 231 DEGs (p-values < 0.05 and | log2(fold change) | > 1). The comparison of "AS vs C" and "H_TUDCA vs AS" identified 65 covariant DEGs, and further screened the TUDCA pathways and related genes among these genes,six pathways and 11 genes (Ccl21a, Ccr7, Mdm2, Slc2a4, Akr1b7, Pnpla3, Dusp8, Hspa1a, Cyp7a1, Cybrd1, Trpm6) were obtained. Next, we screened for covariant DEGs among the top 50 potential hub genes in arsenic-induced DEGS, and obtained 7 (Hbb-bs, Hspa1a, Mdm2, Slc2a4, Ptk6, Egr1, and Dusp8). Finally, the intersection of Hub gene and pathway gene was selected as the target genes Dusp8, Hspa1a, Mdm2 and Slc2a4. The sequencing results showed that the mRNA expressions of Dusp8, Hspa1a and Mdm2 were significantly increased after arsenic induction, while the expression of Slc2a4 was significantly decreased (P<0.05). Conversely, TUDCA intervention reversed these DEGs changes, consistent with QRT-PCR validation results. CONCLUSION: This study contributes to understanding the potential health effects of arsenic-induced liver injury, identifying new potential targets, and providing references for TUDCA intervention.

3.
Analyst ; 149(20): 5014-5021, 2024 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-39212070

RESUMO

The recombinant Cluster of Differentiation 40 Ligand (CD40L) can be expressed in various cells and is closely related to various types of cancer. This association underscores the critical need for expedited and precise measurement of CD40L levels in clinical fluid specimens. A novel optical fiber biosensor has been devised, employing single-mode fibers that are sandwiched around a coreless fiber, with the diameter refined by etching with hydrogen fluoride. This innovative configuration allows for light transmission through the evanescent field, thereby enhancing the sensor's sensitivity to changes in the surrounding refractive index. Employing chemical binding techniques, CD40 was securely immobilized onto the fiber's surface, facilitating the detection of CD40L. The sensor exhibited a sensitivity of 1.126 nm (µg mL-1)-1 and a detection limit of 0.68 nM. Furthermore, the sensor's specificity for CD40L was validated using authentic clinical serum samples spiked with artificial analytes. In addition, the specificity of CD40L of the proposed sensor was proved using natural clinical serum samples with added artificial analyte, assisted by the ELISA method, and the results ideally conformed with the detection of standard samples. With the aid of the ELISA method, the outcomes were found to be in excellent agreement with those from standard sample detection. Consequently, the findings indicate that this sensor provides a specific, label-free, and highly sensitive method for CD40L detection, showcasing its significant potential for applications in molecular biology research.


Assuntos
Técnicas Biossensoriais , Ligante de CD40 , Limite de Detecção , Fibras Ópticas , Ligante de CD40/análise , Ligante de CD40/sangue , Ligante de CD40/química , Humanos , Técnicas Biossensoriais/métodos , Ensaio de Imunoadsorção Enzimática/métodos , Antígenos CD40/análise
4.
Bioresour Technol ; 396: 130445, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38346595

RESUMO

To realize the intelligent production of straw bales and improve their economy, the density of straw bales in the working process of large-scale steel roller-type round balers must be measured in real time. Therefore, this study analyzes the forces acting on steel rollers and bales in the bale rolling process, constructs a mathematical model to predict the density of molded bales, and proposes a method for dynamically measuring the density of bales in a round bale machine. Sunflower straw was selected as the test material, and a bale density model validation test was conducted at a test stand. The results showed that the accuracy of the measured bale density of the data acquisition system ranged from 93% to 97%, verifying that the mathematical model for bale density prediction had good accuracy. This study provided an effective strategy for round baler design.


Assuntos
Modelos Teóricos
5.
BMJ Open ; 13(12): e073915, 2023 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-38149416

RESUMO

INTRODUCTION: Patients with breast cancer and endocrine therapy-related symptoms often experience pain, self-denial, anxiety, fear of recurrence and despair, which can be extremely physically and psychologically traumatising for the patients. Failure to receive effective support and management reduces adherence to medications, leading to a higher risk of relapse and mortality. Clearly, it is paramount to identify what support these patients may need and how to meet their symptom management needs. This paper outlines a protocol to synthesise qualitative evidence on endocrine therapy symptom experiences, management expectations and preferences of patients with breast cancer. METHODS AND ANALYSIS: The following databases were searched in November 2023 with no date restriction applied: The Cochrane Library, PubMed, Embase, Web of Science, Scopus, CINAHL and OpenGrey. Published studies on qualitative or mixed-method on symptom experiences and management needs during endocrine therapy in patients with breast cancer will be retrieved. We will also search for reference lists and perform a forward citation search. Before inclusion in this review, two reviewers will independently apply the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to ensure methodological validity. Any disagreements regarding the evaluation of the articles will be resolved through discussion with or by a third reviewer. Data will be extracted using the standardised data extraction tool EndNote20 for unified management, assessment, and review of information. The common sense model of self-regulation will guide data extraction and synthesis. The final synthesised findings will be graded according to the GRADE-CERQual approach to establish confidence. ETHICS AND DISSEMINATION: This systematic review addressed previously published studies without personally identifiable participant information. Ethical approval from the research committee was not required. The findings of this systematic review will be disseminated to various key stakeholders and published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42023406987.


Assuntos
Neoplasias da Mama , Recidiva Local de Neoplasia , Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Processos Mentais , Cuidados Paliativos , Pesquisa Qualitativa
6.
Commun Biol ; 6(1): 1201, 2023 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-38007539

RESUMO

Parkinson's disease (PD) is characterized by α-synuclein aggregation in dopaminergic (DA) neurons, which are sensitive to oxidative stress. Mitochondria aconitase 2 (ACO2) is an essential enzyme in the tricarboxylic acid cycle that orchestrates mitochondrial and autophagic functions to energy metabolism. Though widely linked to diseases, its relation to PD has not been fully clarified. Here we revealed that the peripheral ACO2 activity was significantly decreased in PD patients and associated with their onset age and disease durations. The knock-in mouse and Drosophila models with the A252T variant displayed aggravated motor deficits and DA neuron degeneration after 6-OHDA and rotenone-induction, and the ACO2 knockdown or blockade cells showed features of mitochondrial and autophagic dysfunction. Moreover, the transcription of autophagy-related genes LC3 and Atg5 was significantly downregulated via inhibited histone acetylation at the H3K9 and H4K5 sites. These data provided multi-dimensional evidences supporting the essential roles of ACO2, and as a potential early biomarker to be used in clinical trials for assessing the effects of antioxidants in PD. Moreover, ameliorating energy metabolism by targeting ACO2 could be considered as a potential therapeutic strategy for PD and other neurodegenerative disorders.


Assuntos
Doença de Parkinson , Humanos , Camundongos , Animais , Doença de Parkinson/metabolismo , Histonas/metabolismo , Acetilação , Mitocôndrias/metabolismo , Autofagia , Aconitato Hidratase/genética
7.
Neurogenetics ; 24(4): 231-241, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37453004

RESUMO

Brain iron accumulation disorders (BIADs) are a group of diseases characterized by iron overload in deep gray matter nuclei, which is a common feature of neurodegenerative diseases. Although genetic factors have been reported to be one of the etiologies, much more details about the genetic background and molecular mechanism of BIADs remain unclear. This study aimed to illustrate the genetic characteristics of BIADs and clarify their molecular mechanisms. A total of 84 patients with BIADs were recruited from April 2018 to October 2022 at Xuanwu Hospital. Clinical characteristics including family history, consanguineous marriage history, and age at onset (AAO) were collected and assessed by two senior neurologists. Neuroimaging data were conducted for all the patients, including cranial magnetic resonance imaging (MRI) and susceptibility-weighted imaging (SWI). Whole-exome sequencing (WES) and capillary electrophoresis for detecting sequence mutation and trinucleotide repeat expansion, respectively, were conducted on all patients and part of their parents (whose samples were available). Variant pathogenicity was assessed according to the American College of Medical Genetics and Association for Molecular Pathology (ACMG/AMP). The NBIA and NBIA-like genes with mutations were included for bioinformatic analysis, using Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genome (KEGG). GO annotation and KEGG pathway analysis were performed on Metascape platform. In the 84 patients, 30 (35.7%) were found to carry mutations, among which 20 carried non-dynamic mutations (missense, stop-gained, frameshift, inframe, and exonic deletion) and 10 carried repeat expansion mutations. Compared with sporadic cases, familial cases had more genetic variants (non-dynamic mutation: P=0.025, dynamic mutation: P=0.003). AAO was 27.85±10.42 years in cases with non-dynamic mutations, which was significantly younger than those without mutations (43.13±17.17, t=3.724, P<0.001) and those with repeated expansions (45.40±8.90, t=4.550, P<0.001). Bioinformatic analysis suggested that genes in lipid metabolism, autophagy, mitochondria regulation, and ferroptosis pathways are more likely to be involved in the pathogenesis of BIADs. This study broadens the genetic spectrum of BIADs and has important implications in genetic counselling and clinical diagnosis. Patients diagnosed as BIADs with early AAO and family history are more likely to carry mutations. Bioinformatic analysis provides new insights into the molecular pathogenesis of BIADs, which may shed lights on the therapeutic strategy for neurodegenerative diseases.


Assuntos
Encéfalo , Doenças Neurodegenerativas , Humanos , Encéfalo/patologia , Mutação , Mutação da Fase de Leitura , Doenças Neurodegenerativas/genética , Doenças Neurodegenerativas/patologia , Ferro/metabolismo
8.
Mol Neurobiol ; 60(10): 5655-5671, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37335462

RESUMO

Paired immunoglobulin-like receptor B (PirB) was identified as a myelin-associated inhibitory protein (MAIP) receptor that plays a critical role in axonal regeneration, synaptic plasticity and neuronal survival after stroke. In our previous study, a transactivator of transcription-PirB extracellular peptide (TAT-PEP) was generated that can block the interactions between MAIs and PirB. We found that TAT-PEP treatment improved axonal regeneration, CST projection and long-term neurobehavioural recovery after stroke through its effects on PirB-mediated downstream signalling. However, the effect of TAT-PEP on the recovery of cognitive function and the survival of neurons also needs to be investigated. In this study, we investigated whether pirb RNAi could alleviate neuronal injury by inhibiting the expression of PirB following exposure to oxygen-glucose deprivation (OGD) in vitro. In addition, TAT-PEP treatment attenuated the volume of the brain infarct and promoted the recovery of neurobehavioural function and cognitive function. This study also found that TAT-PEP exerts neuroprotection by reducing neuronal degeneration and apoptosis after ischemia-reperfusion injury. In addition, TAT-PEP improved neuron survival and reduced lactate dehydrogenase (LDH) release in vitro. Results also showed that TAT-PEP reduced malondialdehyde (MDA) levels, increased superoxide dismutase (SOD) activity and reduced reactive oxygen species (ROS) accumulation in OGD-injured neurons. The possible mechanism was that TAT-PEP could contribute to the damage of neuronal mitochondria and affect the expression of cleaved caspase 3, Bax and Bcl-2. Our results suggest that PirB overexpression in neurons after ischaemic-reperfusion injury induces neuronal mitochondrial damage, oxidative stress and apoptosis. This study also suggests that TAT-PEP may be a potent neuroprotectant with therapeutic potential for stroke by reducing neuronal oxidative stress, mitochondrial damage, degeneration and apoptosis in ischemic stroke.


Assuntos
Isquemia Encefálica , Disfunção Cognitiva , Traumatismo por Reperfusão , Acidente Vascular Cerebral , Humanos , Transativadores/metabolismo , Neurônios/metabolismo , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/metabolismo , Peptídeos/farmacologia , Oxigênio/metabolismo , Proteínas da Mielina/metabolismo , Apoptose , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/metabolismo , Traumatismo por Reperfusão/complicações , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo , Isquemia Encefálica/complicações , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/metabolismo
9.
Oncol Nurs Forum ; 50(3): 348-360, 2023 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-37155977

RESUMO

PROBLEM IDENTIFICATION: Improperly managed pain can negatively affect physical and mental health, quality of life, and functional status of individuals with cancer. To address nurses' experiences with and barriers to providing cancer pain management, a systematic review was conducted. LITERATURE SEARCH: PubMed®, Embase®, Web of Science, CINAHL®, Cochrane Library, CNKI, VIP Chinese Science and Technology Periodicals Full-Text Database, Wanfang, and SINOMED databases were searched for articles published from database inception through August 2022. DATA EVALUATION: Two researchers independently evaluated the studies' quality, and meta-integration was performed using thematic synthesis. Eighteen qualitative studies, including 277 nurses from 11 different countries, were included in the review. SYNTHESIS: The following three themes regarding nurses' barriers to providing cancer pain management were identified: (a) healthcare professional-related barriers, (b) patient-related barriers, and (c) organizational-related barriers. IMPLICATIONS FOR PRACTICE: This systematic review provides an evidence-based reference for nurses to manage pain among individuals with cancer and develop appropriate interventions.


Assuntos
Dor do Câncer , Neoplasias , Enfermeiras e Enfermeiros , Humanos , Dor do Câncer/tratamento farmacológico , Qualidade de Vida , Pessoal de Saúde , Dor , Pesquisa Qualitativa , Neoplasias/complicações
10.
Ann Palliat Med ; 12(3): 472-486, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37164964

RESUMO

BACKGROUND: Accurate estimation of prognosis can help provide early palliative care to patients. However, few studies have developed nomograms that are totally based on objective blood test parameters. The current study constructed a simple and objective prognostic nomogram and validated the model using advanced cancer patients. METHODS: A total of 245 patients were retrospectively analyzed (training sample, n=162; validation sample, n=54), from January 2020 to December 2021. Blood test and demographic data were collated. Cox proportional hazard regression was performed to identify the independent factors, which were built into a nomogram to visualize the probability of patient survival within 30 days. Calibration and discrimination of the model was assessed. The decision curve analysis (DCA) was developed to summarize the performance of the model in supporting decision making. RESULTS: The median survival was 17.0 [8, 37] days and 21.0 [10, 46] days for the training set and the validation set, respectively. Serum calcium (>2.65 mmol/L), neutrophil count (<2 mmol/L and >7 mmol/L), urea (>7.6 nmol/L), and glutamic oxalacetic transaminase (>40 U/L) were identified and an easily obtained nomogram predicting the 30-day probability of mortality was developed. The nomogram model had adequate discrimination and calibration. The Harrell's concordance index (C-index) of the training set and validation set was 0.69 and 0.71, respectively, while the values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.76 and 0.70, respectively. CONCLUSIONS: A simple and objective prognostic nomogram model for predicting the 30-day survival of patients with advanced cancer was developed and validated, with adequate calibration and discrimination. It is expected to guide practical prognosis evaluation in the clinical setting. Further validation is still required in a prospective, multicenter, and large sample study.


Assuntos
Neoplasias , Nomogramas , Humanos , Prognóstico , Estudos Retrospectivos , Cuidados Paliativos , Estudos Prospectivos , Testes Hematológicos
11.
Eur J Pharmacol ; 947: 175667, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-36997050

RESUMO

Post-stroke anxiety (PSA) is a kind of affective disorder occurring after a stroke, with anxiety as the primary clinical manifestation. PSA's mechanism is unclear, and there are few prevention and treatment measures. Our previous study found that HDAC3 could activate NF-κB signaling through mediated p65 deacetylation, which further influenced microglia activation. That implies HDAC3 may be the key mediator in ischemic stroke mice and modulates anxiety susceptibility to stress. This study established a PSA model in male C57BL/6 mice through photothrombotic stroke combined with chronic restrain stress. We focused on exploring whether esketamine administration can alleviate anxiety-like behavior and neuroinflammation, which may be associated with inhibiting HDAC3 expression and NF-κB pathway activation. The results showed that esketamine administration alleviated anxiety-like behavior in PSA mice. And the results showed that esketamine alleviated cortical microglial activation, altered microglial number, and kept morphology features. Furthermore, the results showed that the expression of HDAC3, phosphor-p65/p65, and COX1 significantly decreased in esketamine-treated PSA mice. Besides, we also found that esketamine reduced PGE2 expression, one of the primary regulators of negative emotions. Interestingly, our results indicate that esketamine reduced the perineuronal net (PNN) number in the pathological process of PSA. In conclusion, this study suggests esketamine could alleviate microglial activation, reduces inflammatory cytokine, and inhibits the expression of HDAC3 and NF-κB in the cortex of PSA mice to attenuate anxiety-like behavior. Our results provided a new potential therapeutic target for applying esketamine to PSA.


Assuntos
NF-kappa B , Acidente Vascular Cerebral , Masculino , Camundongos , Animais , NF-kappa B/metabolismo , Microglia/metabolismo , Camundongos Endogâmicos C57BL , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/metabolismo , Ansiedade/tratamento farmacológico , Ansiedade/etiologia
12.
Cancer Nurs ; 2023 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-36840979

RESUMO

BACKGROUND: Little is known about the psychoeducational interventions for caregivers of adolescent and young adult (AYA) cancer patients. OBJECTIVE: To evaluate the feasibility and acceptability of a needs-oriented psychoeducational intervention among caregivers of AYA cancer patients. METHODS: In this 2-arm (parallel-group), pilot randomized controlled trial, participants were randomized to the intervention or control group. Participants in the control group received usual care, whereas those in the intervention group received a needs-oriented psychoeducational intervention via WeChat as well as the usual care. Feasibility was evaluated on recruitment, attrition, and adherence rates and the data collection process. Acceptability was assessed based on participants' satisfaction with and perceived usefulness of the intervention, collected using a questionnaire. In addition, a semistructured interview was conducted to explore their experiences. RESULTS: Twenty-four caregivers of AYA cancer patients were recruited, with a consent rate of 61.5%. The attrition and response rates 5 weeks after baseline were 8.3% and 91.7%. Among the 12 participants in the intervention group, 10 (83.3%) completed all of the 5 weekly sessions. Most of the participants were satisfied with the program and perceived its usefulness. The semistructured interviews revealed 3 major categories: facilitators of participation, perception of the intervention, and perceived benefits. CONCLUSIONS: The needs-oriented psychoeducational intervention delivered through WeChat is feasible for and acceptable to caregivers of AYA cancer patients. A full-scale study is warranted to examine the effects of this intervention on caregivers' health outcomes. IMPLICATIONS FOR PRACTICE: The WeChat-based, needs-oriented psychoeducational intervention may be beneficial to improve caregivers' health outcomes.

13.
Neurol Genet ; 8(6): e200044, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36524103

RESUMO

Background and Objectives: Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a rare hereditary cerebrovascular disease caused by homozygous or compound heterozygous variations in the high-temperature requirement A serine peptidase 1 (HTRA1) gene. However, several studies in recent years have found that some heterozygous HTRA1 mutations also cause cerebral small vessel disease (CSVD). The current study aims to report the novel genotypes, phenotypes, and histopathologic results of 3 pedigrees of CSVD with heterozygous HTRA1 mutation. Methods: Three pedigrees of familiar CSVD, including 11 symptomatic patients and 3 asymptomatic carriers, were enrolled. Whole-exome sequencing was conducted in the probands for identifying rare variants, which were then evaluated for pathogenicity according to the American College of Medical Genetics and Genomics guidelines. Sanger sequencing was performed for validation of mutations in the probands and other family members. The protease activity was assayed for the novel mutations. All the participants received detailed clinical and imaging examinations and the corresponding results were concluded. Hematoma evacuation was performed for an intracerebral hemorrhage patient with the p.Q318H mutation, and the postoperative pathology including hematoma and cerebral small vessels were examined. Results: Three novel heterozygous HTRA1 mutations (p.Q318H, p.V279M, and p.R274W) were detected in the 3 pedigrees. The protease activity was largely lost for all the mutations, confirming that they were loss-of-function mutations. The patients in each pedigree presented with typical clinical and imaging features of CVSD, and some of them displayed several new phenotypes including color blindness, hydrocephalus, and multiple arachnoid cysts. In addition, family 1 is the largest pedigree with heterozygous HTRA1 mutation so far and includes homozygous twins, displaying some variation in clinical phenotypes. More importantly, pathologic study of a patient with p.Q318H mutation showed hyalinization, luminal stenosis, loss of smooth muscle cells, splitting of the internal elastic lamina, and intramural hemorrhage/dissection-like structures. Discussion: These findings broaden the mutational and clinical spectrum of heterozygous HTRA1-related CSVD. Pathologic features were similar with the previous heterozygous and homozygous cases. Moreover, clinical heterogeneity was revealed within the largest single family, and the mechanisms of the phenotypic heterogenetic remain unclear. Overall, heterozygous HTRA1-related CSVD should not be simply taken as a mild type of CARASIL as previously considered.

14.
BMJ Open ; 12(12): e066296, 2022 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-36585129

RESUMO

OBJECTIVES: To explore genetic/genomic nursing competency and associated factors among nurses from tertiary general and specialist cancer hospitals in mainland China and compare the competencies of nurses from the two types of hospitals. DESIGN AND SETTING: A cross-sectional survey was conducted from November 2019 to January 2020, wherein 2118 nurses were recruited from 8 tertiary general hospitals and 4 cancer hospitals in mainland China. We distributed electronic questionnaires to collect data on nurses' demographics, work-related variables and genomic nursing competency. PARTICIPANTS: 2118 nurses were recruited via a three-stage stratified cluster sampling method. RESULTS: More than half (59.1%, 1252/2118) of the participants reported that their curriculum included genetics/genomics content. The mean nurses' genomic knowledge score was 8.30/12 (95% CI=8.21 to 8.39). Only 5.4% had always collected a complete family history in the past 3 months. Compared with general hospital nurses, slightly more cancer hospital nurses (75.6% vs 70.6%, p=0.010) recognised the importance of genomics, while there was no significant difference in the knowledge scores (8.38 vs 8.21, p>0.05). Gender (ß=0.06, p=0.005), years of clinical nursing (ß=-0.07, p=0.002), initial level of nursing education (ß=0.10, p<0.001), membership of the Chinese Nursing Association (ß=0.06, p=0.004), whether their curriculum included genetics/genomics content (ß=0.08, p=0.001) and attitude towards becoming more educated in genetics/genomics (ß=0.25, p<0.001) were significantly associated with the nurses' genomic knowledge score. CONCLUSION: The levels of genomic knowledge among mainland Chinese nurses in tertiary hospitals were moderate. The overall genomic competency of cancer hospital nurses was comparable to that of general hospital nurses. Further genomic training is needed for nurses in China to increase their genomic competency and accelerate the integration of genomics into nursing practice.


Assuntos
Neoplasias , Enfermeiras e Enfermeiros , Humanos , Hospitais Gerais , Institutos de Câncer , Estudos Transversais , Centros de Atenção Terciária , China , Genômica/educação , Inquéritos e Questionários , Competência Clínica , Neoplasias/genética
15.
Asia Pac J Oncol Nurs ; 9(12): 100128, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36276886

RESUMO

Objective: Hospitalized cancer patients are at high risk of venous thromboembolism (VTE). However, no predictive model has been specifically developed for this population. Machine learning (ML) is advantageous for model development. This study was aimed at developing predictive models using three different ML algorithms and logistic regression for VTE risk among hospitalized cancer patients and comparing their predictive performance. Methods: A retrospective case-control study was conducted on hospitalized cancer patients at Hunan Cancer Hospital, China, between October 1, 2021, and February 30, 2022. Patients diagnosed with vein thrombosis before or after admission were excluded. Patient, tumor, treatment, and laboratory indicator information was obtained from the hospital information system. The data were randomly split into distributions of 80% for training and 20% for testing. Logistic regression and three ML algorithms-the support vector machine, random forest, and extreme gradient boosting (XGBoost)-were used to develop the models. Model performance was compared using F1, G-mean, area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall rate, and specificity. Feature rankings were achieved based on the permutation scores of the selected features in the optimal model. Results: A total of 1100 patients (mean [SD] age, 54.75 [11.08] years; 485 [44.09%] male) were included in this study. There were 340 patients (30.9%) in the VTE group. The XGBoost model achieved the best performance with the following evaluation metrics: F1 (0.750), G-mean (0.816), AUROC (0.818), accuracy (0.845), precision (0.750), recall rate (0.750), and specificity (0.888). D-dimer level, diabetes, hypertension, pleural metastasis, and hematological malignancies were identified as the five most significant features of the XGBoost model. Conclusions: Four predictive models were developed using ML algorithms. The XGBoost model was the optimal predictive model compared with the other three models. This study indicates that ML may play an important role in VTE risk estimation among hospitalized patients with cancer and provides a reference for thromboprophylaxis.

16.
BMJ Open ; 12(9): e060912, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104141

RESUMO

OBJECTIVE: This study systematically reviewed the effect of melatonin (MLT) on quality of life (QoL) and symptoms among patients with cancer. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane Library, PubMed, Embase, Web of Science, Medline, CINAHL, Scopus, ClinicalTrials.gov, China Biology Medicine (CBM), ProQuest and Open Grey were searched from inception to November 2021. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) assessing the effects of MLT on QoL, sleep quality, fatigue, depression, pain, stomatitis rate and stomatitis severity in adult patients with cancer, without language restrictions. Studies that reported the effects of MLT along with other interventions and had incomplete or absent outcome data were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data, and another two reviewers assessed the risk of bias. The risk of bias for each eligible study was assessed using the Cochrane assessment tool. The mean difference or standard mean difference (SMD) with 95% CIs was used in the computation of continuous variables to synthesise data. The relative risk was used for dichotomous outcomes. Heterogeneity was assessed and quantified (I2 statistic). RESULTS: A total of 19 qualified studies that included 2101 patients with cancer (MLT: 1078, control: 1023) were included in the meta-analysis. The results indicated that MLT had no significant effect on QoL (SMD=-0.01, 95% CI (-0.14 to 0.11), p=0.83), sleep quality (SMD=-0.18, 95% CI (-0.62 to 0.26), p=0.42), fatigue (SMD=-0.34, 95% CI (-0.73 to 0.06), p=0.10), pain (SMD=-0.34, 95% CI (-0.7 to 0.02), p=0.06) or stomatitis severity (RR=0.78, 95% CI (0.47 to 1.30), p=0.35). MLT reduced stomatitis rate among patients with cancer (RR=0.47, 95% CI (0.26 to 0.88), p=0.02), except those with head and neck cancer (RR=1.09, 95% CI (0.92 to 1.29), p=0.35). MLT eased depression in patients who received administration for more than 14 days (SMD=-0.14, 95% CI (-0.27 to -0.01), p=0.03) and those who underwent surgery (SMD=-0.17, 95% CI (-0.32 to -0.03), p=0.02). CONCLUSION: The findings showed that MLT did not improve the QoL, sleep quality, fatigue, pain or stomatitis severity among patients with cancer. It had a limited effect on decreasing the stomatitis rate and easing depression. Different treatments, durations and cancer types were the main sources of heterogeneity. Further large-scale RCTs are urgently needed. In addition, the effects of different combinations of MLT dosage and duration, administration types and joint measures are worthy of further study. PROSPERO REGISTRATION NUMBER: CRD42021292855.


Assuntos
Melatonina , Neoplasias , Estomatite , Adulto , Fadiga/etiologia , Humanos , Melatonina/uso terapêutico , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Front Neurol ; 13: 903721, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35847229

RESUMO

Objectives: To develop and validate a predictive nomogram for idiopathic rapid eye movement (REM) sleep behavior disorder (RBD) in a community population in Beijing, China. Methods: Based on the validated RBD questionnaire-Hong Kong (RBDQ-HK), we identified 78 individuals with possible RBD (pRBD) in 1,030 community residents from two communities in Beijing. The least absolute shrinkage and selection operator (LASSO) regression was applied to identify candidate features and develop the nomogram. Internal validation was performed using bootstrap resampling. The discrimination of the nomogram was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve, and the predictive accuracy was assessed via a calibration curve. Decision curve analysis (DCA) was performed to evaluate the clinical value of the model. Results: From 31 potential predictors, 7 variables were identified as the independent predictive factors and assembled into the nomogram: family history of Parkinson's disease (PD) or dementia [odds ratio (OR), 4.59; 95% confidence interval (CI), 1.35-14.45; p = 0.011], smoking (OR, 3.24; 95% CI, 1.84-5.81; p < 0.001), physical activity (≥4 times/week) (OR, 0.23; 95% CI, 0.12-0.42; p < 0.001), exposure to pesticides (OR, 3.73; 95%CI, 2.08-6.65; p < 0.001), constipation (OR, 6.25; 95% CI, 3.58-11.07; p < 0.001), depression (OR, 3.66; 95% CI, 1.96-6.75; p < 0.001), and daytime somnolence (OR, 3.28; 95% CI, 1.65-6.38; p = 0.001). The nomogram displayed good discrimination, with original AUC of 0.885 (95% CI, 0.845-0.925), while the bias-corrected concordance index (C-index) with 1,000 bootstraps was 0.876. The calibration curve and DCA indicated the high accuracy and clinical usefulness of the nomogram. Conclusions: This study proposed an effective nomogram with potential application in the individualized prediction for pRBD.

18.
Pain Res Manag ; 2022: 8943292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463627

RESUMO

Objective: This study aimed to conduct a retrospective observational study to understand the status of characteristics of pain and identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP) in advanced cancer patients. Methods: Advanced cancer patients over 18 years of age; diagnosed with cancer of any type and stage III or IV in the palliative care ward with available data were enrolled between 2018 and 2020. Demographic data and pain-related information were collected by using structured electronic extraction form from Hospital Information System (HIS). Patients who had well-controlled background pain with an intensity ≤4 on a 0-10 numerical scale for >12 hours/day, the presence of transient exacerbations of pain with moderate-severe intensity (≧5), and clearly distinguish from background pain were regarded to have suffered BTP. Spearman correlation was conducted to explore the relationship between pain score and demographics characteristics. Factors significant in univariate analysis were included in the multiple regression model to explore independent predictive factors associated with the BTP. Results: Of 798 advanced cancer patients, the mean age was 56.7 (SD = 11.84) years. Lung cancer (29.95%) was the most common cancer, and pain (93%) was the most common symptom. More than half (n = 428, 53.6%) of the patients experienced BTP. The median number of BTP episodes was 4 (IQR = 2, 7, range: 1-42). The median intensity of BTP was 6 (IQR = 6, 7, range 5-10). Patients with severe background pain or BTP had longer hospital stay and more symptoms. Besides, more severe background pain was related to higher activity of daily living. Intramuscular injection of hydromorphone hydrochloride was the main medication for BTP onset. Younger age, background pain, anorexia, and constipation were independently associated with the presentation of BTP. BTP pain intensity was independently associated with bloating. Symptom numbers were an independent factor and positively associated with BTP episodes. Conclusions: BTP resulted in poor prognosis, which has a variable presentation depending on interdependent relationships among different characteristics. Good controlling of background pain and assessment of pain-related symptoms are essential for BTP management. BTP should be managed individually, especially the invisible pain among aged patients. Furthermore, BTP-related education and training were still needed.


Assuntos
Dor Irruptiva , Dor do Câncer , Neoplasias , Adolescente , Adulto , Idoso , Analgésicos Opioides/uso terapêutico , Dor Irruptiva/tratamento farmacológico , Dor Irruptiva/epidemiologia , Dor Irruptiva/etiologia , Dor do Câncer/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Neoplasias/complicações , Manejo da Dor/métodos , Medição da Dor/métodos
20.
Am J Hosp Palliat Care ; 39(11): 1312-1324, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35041534

RESUMO

This study aimed to conduct a retrospective cross-sectional study to investigate the prevalence of symptoms and symptom clusters on sociodemographic and disease characteristics, as well as factors associated with Do-Not-Resuscitate (DNR) consent. Advanced cancer patients were enrolled between 2018 and 2020 with available data. Demographic and clinical data were obtained for analysis from Hospital Information System (HIS) in China. Symptom clusters were extracted by hierarchical cluster analysis. Chi-square test and multiple logistic regression were conducted to investigate the prevalence characteristics of symptoms and influencing factors of DNR consent, respectively. 798 advanced cancer patients were enrolled. The most prevalent symptoms were pain (93%), anorexia (36.5%), and sleep disorders (34.2%). High heart rate was associated with poor performance status and more symptoms. Three clusters were extracted: fatigue-related, respiratory-circulatory system, and digestive system symptom clusters. The incidence of symptoms was statistically significant in age, gender, education level, residence, BMI, performance status, distress score, ADL, and primary pain level. The DNR signature rate was 15.5%. Female, distant metastasis, in-ward rescue, and appearance of dyspnea were independent influencing factors of DNR signature.Chinese hospitalized cancer patients had more symptoms burden that were influenced by various demographic characteristics, especially pain and fatigue-related symptoms. Concerning the trajectory of vital signs is important among advanced cancer patients. The DNR signature rate was lower and our finding indicating an urgency to accurately assess the prognosis and give more palliative care education to enhance DNR rates and early signing in Chinese context.


Assuntos
Consentimento Livre e Esclarecido , Neoplasias , Ordens quanto à Conduta (Ética Médica) , Estudos Transversais , Fadiga/epidemiologia , Feminino , Humanos , Consentimento Livre e Esclarecido/estatística & dados numéricos , Masculino , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/terapia , Dor/epidemiologia , Cuidados Paliativos , Estudos Retrospectivos , Fatores Socioeconômicos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA