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1.
Front Psychiatry ; 12: 758092, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34803768

RESUMO

Diagnosis and treatment of the patients with major depression (MD) or the combined anxiety and depression (A&D) depend on the questionnaire, sometimes accompanied by tasks such as verbal fluency task (VFT). Functional near infrared spectroscopy (fNIRS) is emerging as an auxiliary diagnostic tool to evaluate brain function, providing an objective criterion to judge psychoses. At present, the conclusions derived from VFT or rest (non-task) studies are controversial. The purpose of this study is to evaluate if task performs better than non-task in separating healthy people from psychiatric patients. In this study, healthy controls (HCs) as well as the patients with MD or A&D were recruited (n = 10 for each group) to participate in the non-task and VFT tasks, respectively, and the brain oxygenation was longitudinally evaluated by using fNIRS. An approach of spectral analysis is used to analyze cerebral hemoglobin parameters (i.e., Oxy and Deoxy), characterizing the physiological fluctuations in the non-task and task states with magnitude spectrum and average power. Moreover, the standard deviation of oxygenation responses during the non-task was compared with the peak amplitude during the task, with the aim to explore the sensitivity of the VFT task to brain activation. The results show that there is no significant difference (p > 0.05) among the three groups in average power during non-task. The VFT task greatly enhanced the magnitude spectrum, leading to significant difference (p < 0.05) in average power between any of two groups (HC, MD, and A&D). Moreover, 40% patients with A&D have an intermediate peak (around 0.05 Hz) in the magnitude spectrum when performing the VFT task, indicating its advantage in characterizing A&D. We defined a rate of the non-task standard variation to the task peak amplitude (namely, SD-to-peak rate) and found that this rate is larger than 20% in 90% of the MD subjects. By contrast, only 40% HC subjects have an SD-to-peak rate larger than 20%. These results indicate that the non-task may not be sufficient to separate MD or A&D from HC. The VFT task could enhance the characteristics of the magnitude spectrum, but its intensity needs to be elevated so as to properly explore brain functions related to psychoses.

2.
BMC Med ; 19(1): 193, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34433440

RESUMO

BACKGROUND: The optimal posttreatment surveillance strategy for nasopharyngeal carcinoma (NPC) remains unclear. Circulating cell-free Epstein-Barr virus (cfEBV) DNA has been recognized as a promising biomarker to facilitate early detection of NPC recurrence. Therefore, we aim to determine whether integrating circulating cfEBV DNA into NPC follow-up is cost-effective. METHODS: For each stage of asymptomatic nonmetastatic NPC patients after complete remission to primary NPC treatment, we developed a Markov model to compare the cost-effectiveness of the following surveillance strategies: routine follow-up strategy, i.e., (1) routine clinical physical examination; routine imaging strategies, including (2) routine magnetic resonance imaging plus computed tomography plus bone scintigraphy (MRI + CT + BS); and (3) routine 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT); cfEBV DNA-guided imaging strategies, including (4) cfEBV DNA-guided MRI + CT + BS and (5) cfEBV DNA-guided PET/CT. Clinical probabilities, utilities, and costs were derived from published studies or databases. Sensitivity analyses were performed. RESULTS: For all disease stages, cfEBV DNA-guided imaging strategies demonstrated similar survival benefits but were considerably more economical than routine imaging strategies. They only required approximately one quarter of the number of imaging studies compared with routine imaging strategies to detect one recurrence. Specifically, cfEBV DNA-guided MRI + CT + BS was most cost-effective for stage II (incremental cost-effectiveness ratio [ICER] $57,308/quality-adjusted life-year [QALY]) and stage III ($46,860/QALY) patients, while cfEBV DNA-guided PET/CT was most cost-effective for stage IV patients ($62,269/QALY). However, routine follow-up was adequate for stage I patients due to their low recurrence risk. CONCLUSIONS: The cfEBV DNA-guided imaging strategies are effective and cost-effective follow-up methods in NPC. These liquid biopsy-based strategies offer evidence-based, stage-specific surveillance modalities for clinicians and reduce disease burden for patients.


Assuntos
Infecções por Vírus Epstein-Barr , Neoplasias Nasofaríngeas , Análise Custo-Benefício , DNA , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/epidemiologia , Herpesvirus Humano 4/genética , Humanos , Biópsia Líquida , Carcinoma Nasofaríngeo/genética , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/epidemiologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/epidemiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
3.
JAMA Netw Open ; 4(5): e2111813, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-34047792

RESUMO

Importance: Married patients with cancer have better cancer-specific survival than unmarried patients. Increasing the early diagnosis and definitive treatment of cancer among unmarried patients may reduce the survival gap. Objectives: To evaluate the extent to which marriage is associated with cancer-specific survival, stage at diagnosis, and treatment among patients with 9 common solid cancers and to recommend methods for reducing the survival gap. Design, Setting, and Participants: This retrospective, population-based cohort study included patients older than 18 years who were diagnosed with 1 of 9 common cancers between January 1, 2007, and December 31, 2016. Patient data were retrieved from the Surveillance, Epidemiology, and End Results Program. Statistical analyses were performed from August 1 to October 1, 2020. Exposures: Marital status, classified as married and unmarried (including single, separated, divorced, widowed, and unmarried patients or domestic partners). Main Outcomes and Measures: The primary outcome was the time ratio (TR) of cancer-specific survival (married vs unmarried). Mediation analyses were conducted to determine the extent to which the association of marriage with cancer-specific survival was mediated by stage at diagnosis and treatment. Results: This study included 1 733 906 patients (894 379 [51.6%] women; 1 067 726 [61.6%] married; mean [SD] age, 63.76 [12.60] years). Multivariate analyses found that those who were married were associated with better cancer-specific survival than unmarried patients (TR, 1.36; 95% CI, 1.35-1.37). Early diagnosis in breast cancer, colorectal cancer, endometrial cancer, and melanoma mediated the association between marital status and cancer-specific survival (breast cancer: proportion mediated [PM], 11.4%; 95% CI, 11.2%-11.6%; colorectal cancer: PM, 10.9%; 95% CI, 10.7%-11.2%; endometrial cancer: PM, 12.9%; 95% CI, 12.5%-13.3%; melanoma: PM, 12.0%; 95% CI, 11.7-12.4%). Surgery mediated the association between marital status and cancer-specific survival in lung (PM, 52.2%; 95% CI, 51.9%-52.4%), pancreatic (PM, 28.9%; 95% CI, 28.6%-29.3%), and prostate (PM, 39.3%; 95% CI, 39.0%-39.6%) cancers. Chemotherapy mediated the association of marital status with cancer-specific survival in lung (PM, 37.7%; 95% CI, 37.6%-37.9%) and pancreatic (PM, 28.6%; 95% CI, 28.4%-28.9%) cancers. Improved cancer-specific survival associated with marriage was greater among men than women (men: TR, 1.27; 95% CI, 1.25-1.28; women: TR, 1.20; 95% CI, 1.19-1.21). The contribution of receiving an early diagnosis and treatment with surgery or chemotherapy to the association between marital status and cancer-specific survival was greater among men than women (early diagnosis: PM, 21.7% [95% CI, 21.5%-21.9%] vs PM, 20.3% [95% CI, 20.2%-20.4%]; surgery: PM, 26.6% [95% CI, 26.4%-26.7%] vs PM, 11.1% [95% CI, 11.0%-11.2%]; chemotherapy: PM, 6.8% [95% CI, 6.7%-6.8%] vs PM, 5.1% [95% CI, 5.0%-5.2%]). Conclusions and Relevance: In this study, survival disparities associated with marital status were attributable to early diagnosis in breast, colorectal, and endometrial cancers as well as melanoma and to treatment-related variables in lung, pancreatic, and prostate cancers. The findings also suggest that marriage may play a greater protective role in the cancer-specific survival of men than of women.


Assuntos
Estado Civil/estatística & dados numéricos , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/psicologia , Cônjuges/psicologia , Cônjuges/estatística & dados numéricos , Taxa de Sobrevida , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia
4.
J Mater Chem B ; 8(16): 3423-3436, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32022089

RESUMO

Wearable biochemical sensors are of great interest nowadays due to their powerful potential in personalized medicine and continuous monitoring of human health. Thus, a great deal of effort has been put into the development of such sensors to enable real-time and non-invasive quantification of various chemical constituents in the human body such as sweat, saliva, and tears. Owing to the advances in materials science and mechanical engineering, wearable biochemical sensors have been developed to probe various biomarkers and have been subsequently considered as wearable electronic devices for practical applications. In this review, we present a broad overview on the recent advances in electrochemical wearable sensors towards various organic components and ions closely linked to human health. With an emphasis on materials and manufacturing technologies of the sensing electrodes, the research status is summarized, and the challenges and opportunities in this growing field are prospected.


Assuntos
Técnicas Biossensoriais , Monitorização Fisiológica , Materiais Inteligentes/química , Dispositivos Eletrônicos Vestíveis , Humanos , Tamanho da Partícula , Medicina de Precisão , Saliva/química , Propriedades de Superfície , Suor/química , Lágrimas/química
5.
Environ Monit Assess ; 191(4): 240, 2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30911845

RESUMO

Shandong is one of the main areas for protected vegetable cultivation in China. A total of 88.5% of the facility soil samples had a pH between 7.0 and 8.4, indicating the majority of the soils were alkaline. Key properties, including total nitrogen (TN), organic matter (OM), electrical conductivity (EC), available phosphorus (AP), and available potassium (AK), showed an increasing trend with the number of years. The geoaccumulation index (Igeo) indicated that the Cd and Hg contents ranged from uncontaminated to moderate contaminated, while the risk of Hg and Cd reached the class of considerable risk as indicated by the potential ecological risk factor ([Formula: see text]). The mean of Hakanson potential ecological risk index (RI) was 234.00, with the highest contribution from Hg (55.26%), followed by Cd (38.81%). It indicated that the survey area was at the moderate-risk level and Hg had the highest potential ecological risk factor, followed by Cd.


Assuntos
Monitoramento Ambiental/métodos , Metais Pesados/química , Nutrientes/química , Solo/química , China , Ecologia , Mercúrio/análise , Medição de Risco , Poluentes do Solo/química , Verduras
6.
Artigo em Chinês | MEDLINE | ID: mdl-24579484

RESUMO

OBJECTIVE: To analyze the clinical performance of TP antibody detection by CLIA kits and evaluate whether the CLIA kits made in China is suitable for clinical use. METHODS: 1200 samples were collected from Beijing Hospital including 300 samples with confirmed TP infection and 900 healthy control samples. To detect the TP antibody of the 1200 sanples separately by the CLIA kits and the ELISA kits at the same time. The test results were analyzed with statistical methods. RESULTS: The sensitivity and specificity of the CLIA kits were 99.3% and 99.9% respectively, and positive predictive value of 99.7%, negative predictive value of 100%. With the ELISA method, the positive coincidence rate was 98.7%, the negative coincidence rate was 99.8%, and the total coincidence rate was 99.5%. CONCLUSION: The CLIA kits showed good clinical performance and the agreement rate with the ELISA kits was. The CLIA kits are suitable for clinical use.


Assuntos
Anticorpos Antibacterianos/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Medições Luminescentes/métodos , Sífilis/sangue , China , Ensaio de Imunoadsorção Enzimática/economia , Ensaio de Imunoadsorção Enzimática/instrumentação , Humanos , Medições Luminescentes/economia , Medições Luminescentes/instrumentação , Kit de Reagentes para Diagnóstico/economia , Sensibilidade e Especificidade , Sífilis/diagnóstico , Sorodiagnóstico da Sífilis
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