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1.
ACS Nano ; 18(11): 8437-8451, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38501308

RESUMO

Molecular imaging in the second near-infrared window (NIR-II) provides high-fidelity visualization of biopathological events in deep tissue. However, most NIR-II probes produce "always-on" output and demonstrate poor signal specificity toward biomarkers. Herein, we report a series of hemicyanine reporters (HBCs) with tunable emission to NIR-II window (715-1188 nm) and structurally amenable to constructing activatable probes. Such manipulation of emission wavelengths relies on rational molecular engineering by integrating benz[c,d]indolium, benzo[b]xanthonium, and thiophene moieties to a conventional hemicyanine skeleton. In particular, HBC4 and HBC5 possess bright and record long emission over 1050 nm, enabling improved tissue penetration depth and superior signal to background ratio for intestinal tract mapping than NIR-I fluorophore HC1. An activatable inflammatory reporter (AIR-PE) is further constructed for pH-triggered site-specific release in colon. Due to minimized background interference, oral gavage of AIR-PE allows clear delineation of irritated intestines and assessment of therapeutic responses in a mouse model of inflammatory bowel disease (IBD) through real-time NIRF-II imaging. Benefiting from its high fecal clearance efficiency (>90%), AIR-PE can also detect IBD and evaluate the effectiveness of colitis treatments via in vitro optical fecalysis, which outperforms typical clinical assays including fecal occult blood testing and histological examination. This study thus presents NIR-II molecular scaffolds that are not only applicable to developing versatile activatable probes for early diagnosis and prognostic monitoring of deeply seated diseases but also hold promise for future clinical translations.


Assuntos
Carbocianinas , Doenças Inflamatórias Intestinais , Imagem Óptica , Animais , Camundongos , Prognóstico , Imagem Óptica/métodos , Corantes Fluorescentes , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Diagnóstico Precoce
2.
PLoS One ; 19(1): e0297063, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38261557

RESUMO

BACKGROUND: Delirium, a common occurrence in clinical work, can be divided into three subtypes according to Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5). Each subtype has its special significance and focus. As the primary caregivers and observer of delirious patients, nurses should be able to quickly and accurately indentify each subtype. Therefore, it is necessary to clarify nurses' assessment ability of delirium subtypes. However, there is currently no suitable questionnaire available for investigating nurses' assessment ability of delirium subtypes. OBJECTIVE: To develop a scientifically validated questionnaire for assessing nursing assessment ability of delirium subtypes based on Knowledge-Attitude-Practice(KAP) Model. METHODS: The questionnaire was conducted from October 2021 to February 2022 to assess the KAP status of nurses the regarding delirium subtype. A two-round Delphi Method was employed to revise the draft questionnaire, ensuring the importance and rationality of each item. Ten experts specializing in critically ill patients, clinical nursing, and nursing management were invited from seven provinces in China for the Delphi process. Additionally, we validated the reliability and validity of the questionnaire. RESULTS: The return rate in the first and second rounds were 83% and 100%, respectively. The individual authority coefficients for the two rounds of correspondence ranged from 0.787 to 0.987, while the overall authority coefficient of experts was 0.866. Kendall's coefficient of coordination for the importance scores were found to be 0.192 and 0.156, respectively, whereas those for rationality scores were calculated as 0.149 and 0.141, respectively. Notably, all mean values of importance and rationality scores in the two rounds were exceeded a threshold of 4.10 across both rounds of assessment with coefficient variations (CV) ranging from 0.00 to 0.19 for importance ratings and 0.00 to 0.16 for rationality ratings, both of which were <0.25. Experts proposed modifications to eleven items while introducing four new ones into consideration during this process; thus ensuring that reliability and validity standards were met by the final questionnaire design which consists of a total of thirty-seven items distributed across four dimensions: delirium subtype-related knowledge, assessment attitude, assessment practice, and knowledge source-thereby establishing its clinical relevance as a reliable scientific instrument. CONCLUSION: The development process is both scientific and theoretical, encompassing reliable expert correspondence results and a diverse range of question formats. As thus, effectively captures the current landscape of delirium subtypes assessment among clinical nurses from multiple perspectives, including knowledge level and source, attitude, assessment behavior, and assessment barriers. It offers comprehensive and detailed insights.


Assuntos
Delírio , Processos Grupais , Humanos , Consenso , Reprodutibilidade dos Testes , China
3.
Int Urol Nephrol ; 56(1): 45-53, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37676386

RESUMO

PURPOSE: Previously, we designed a ureteral access sheath with the capability of renal pelvic pressure (RPP) measurement and a medical perfusion and aspiration platform, allowing for the intelligent control of RPP. However, the effect of different RPP levels on perfusion fluid absorption remains unclear. This randomized controlled trial aimed to investigate the effects of exhaled ethanol concentration monitoring and intelligent pressure control on perfusion fluid absorption during flexible ureteroscopic lithotripsy. METHODS: Eighty patients scheduled for flexible ureteroscopic lithotripsy were randomly divided into four groups. In groups A, B, and C, the RPPs were set at 0, - 5, and - 10 mmHg, respectively. Group D was regarded as the controls with unfixed RPP. Isotonic saline containing 1% ethanol was used as the irrigation fluid, with an average irrigation flow rate of 100 mL/min. The primary outcome of this study was the absorption of perfusion fluid that was calculated based on the exhaled ethanol concentration. The secondary outcomes included duration of operation and amounts of perfusion fluid used. Postoperative complications, pre- and postoperative renal function, infection markers, and blood gas analysis were also recorded for safety assessment. RESULTS: In all, 76 patients were involved in this study, whose demographic characteristics and preoperative conditions were comparable among groups. Under the same perfusion flow rate, the groups with fixed RPP exhibited reduced absorption of perfusion fluid, duration of operation, and perfusion volume. In particular, the lowest values were observed in group C (RPP = - 10 mmHg). In contrast to the unfixed RPP group, no considerable difference were observed in levels of BUN, Scr, WBC, CRP, and blood gas values among the fixed RPP groups. Moreover, postoperative complications showed no significant difference among groups. CONCLUSION: In flexible ureteroscopic lithotripsy, the groups with fixed RPP had less absorption of perfusion fluid and perfusion volume, shorter duration of surgery, and higher safety than the unfixed group.


Assuntos
Litotripsia , Ureteroscopia , Humanos , Pelve Renal , Perfusão , Litotripsia/efeitos adversos , Complicações Pós-Operatórias
4.
Integr Zool ; 2023 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-37849408

RESUMO

Microcystin-leucine arginine (MC-LR), a representative cyanobacterial toxin, poses an increasing and serious threat to aquatic ecosystems. Despite investigating its toxic effects in various organisms and cells, the toxicity to tissue regeneration and stem cells in vivo still needs to be explored. Planarians are ideal regeneration and toxicology research models and have profound implications in ecotoxicology evaluation. This study conducted a systemic toxicity evaluation of MC-LR, including morphological changes, growth, regeneration, and the underlying cellular and molecular changes after MC-LR exposure, which were investigated in planarians. The results showed that exposure to MC-LR led to time- and dose-dependent lethal morphological changes, tissue damage, degrowth, and delayed regeneration in planarians. Furthermore, MC-LR exposure disturbed the activities of antioxidants, including total superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, and total antioxidant capacity, leading to oxidative stress and DNA damage, and then reduced the number of dividing neoblasts and promoted apoptosis. The results demonstrated that oxidative stress and DNA damage induced by MC-LR exposure caused apoptosis. Excessive apoptosis and suppressed neoblast activity led to severe homeostasis imbalance. This study explores the underlying mechanism of MC-LR toxicity in planarians and provides a basis for the toxicity assessment of MC-LR to aquatic organisms and ecological risk evaluation.

5.
Front Bioeng Biotechnol ; 11: 1201957, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37691904

RESUMO

Introduction: Candida genus plays a crucial role in cigar fermentation, and strains from different sources might have differences in metabolic characteristics. Therefore, this study conducted directional isolation of Candida strains from cigar tobacco leaves and compared their fermentabilities to screen suitable strains for cigar fermentation, thereby improving the cigar quality. Methods: First, the Candida strains from cigars tobacco leaves in different production areas were directionally isolated by pure culture. Then, the isolated strains were screened based on chemical indexes and flavor component contents. Finally, the fermentabilities of preferred strains were verified by sensory evaluation. Results: Five strains of C. parapsilosis and four strains of C. metapsilosis were obtained through directional isolation. By comparing the physicochemical indexes of nine strains of Candida, it was found that C. parapsilosis P1 and C. metapsilosis M4 not only reduced the alkaloids content (by 25.3% and 32.6%, respectively) but also increased the flavor components content (by 25.2% and 18.9%, respectively). Among them, P1 could raise the content of chlorophyll degradation products, carotenoid degradation products, and Maillard reaction products, and enhance the beany and nutty flavor of cigars. M4 could raise the content of chlorophyll degradation products, cembranoids degradation products, and Maillard reaction products, and improve the baking, nutty, cocoa, and honey flavor of the cigar. Discussion: In this study, the Candida strains were directionally isolated from cigars tobacco leaves in different production areas, and two functional strains suitable for cigar fermentation were screened based on physicochemical indexes and sensory evaluation, which would contribute to the directed regulation of cigar quality and flavor diversification.

6.
Pharmacoecon Open ; 7(5): 823-840, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37296268

RESUMO

BACKGROUND: Patients with Crohn's disease (CD) or ulcerative colitis (UC) frequently experience fatigue, although it is often overlooked in medical research and practice. AIMS: To explore patients' experience of fatigue and evaluate content validity, psychometric properties, and score interpretability of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) in patients with CD or UC. METHODS: Concept elicitation and cognitive interviews were conducted with participants aged ≥ 15 years with moderately-to-severely active CD (N = 30) or UC (N = 33). To evaluate psychometric properties (reliability and construct validity) and interpretation of FACIT-Fatigue scores, data from two clinical trials were analyzed [ADVANCE (CD): N = 850; U-ACHIEVE (UC): 248]. Meaningful within-person change was estimated using anchor-based methods. RESULTS: Almost all interview participants reported experiencing fatigue. Over 30 unique fatigue-related impacts were reported per condition. The FACIT-Fatigue was interpretable for most patients. FACIT-Fatigue items had good internal consistency (Cronbach's α 0.86-0.88 for CD and 0.94-0.96 for UC); the total score displayed acceptable test-retest reliability (intraclass correlation coefficients > 0.60 for CD and > 0.90 for UC). FACIT-Fatigue scores had acceptable convergent validity with similar measures. A 7-10 point improvement for CD and 4-9 point improvement for UC on the FACIT-Fatigue total score may represent meaningful improvements. CONCLUSIONS: These results highlight the importance of fatigue among adolescents and adults with CD or UC and provide evidence that the FACIT-Fatigue is content valid and produces reliable, valid, and interpretable scores in these populations. Care should be taken if using the questionnaire with adolescents who may be less familiar with the word "fatigue." Clinical trial registration numbers NCT03105128 (date of registration: 4 April 2017) and NCT02819635 (date of registration: 28 June 2016).

7.
J Environ Manage ; 341: 118033, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37156023

RESUMO

Overusing non-degradable plastics causes a series of environmental issues, inferring a switch to biodegradable plastics. Polyhydroxyalkanoates (PHAs) are promising biodegradable plastics that can be produced by many microbes using various substrates from waste feedstock. However, the cost of PHAs production is higher compared to fossil-based plastics, impeding further industrial production and applications. To provide a guideline for reducing costs, the potential cheap waste feedstock for PHAs production have been summarized in this work. Besides, to increase the competitiveness of PHAs in the mainstream plastics economy, the influencing parameters of PHAs production have been discussed. The PHAs degradation has been reviewed related to the type of bacteria, their metabolic pathways/enzymes, and environmental conditions. Finally, the applications of PHAs in different fields have been presented and discussed to induce comprehension on the practical potentials of PHAs.


Assuntos
Plásticos Biodegradáveis , Poli-Hidroxialcanoatos , Poli-Hidroxialcanoatos/metabolismo , Plásticos Biodegradáveis/metabolismo , Plásticos , Bactérias/metabolismo , Indústrias
8.
J Clin Med ; 12(3)2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36769601

RESUMO

PURPOSE: To evaluate the effectiveness of donor in vitro fertilization (IVF-D) and donor artificial insemination (AI-D) in clinical outcomes, risks, and costs. METHODS: This study analyzed the cycle changes and clinical outcomes in 20,910 IVF-D and 16,850 AI-D cycles between 2013 and 2021 in the Reproductive and Genetic Hospital of CITIC-Xiangya. A cost-effectiveness analysis was performed to evaluate the costs per couple and per live birth cycle in the two treatment groups. RESULTS: IVF-D had higher pregnancy and live birth rates than AI-D (p < 0.001). The cumulative pregnancy and live birth rates for three AI-D cycles were 41.01% and 32.42%, respectively, higher than the rates for one or two AI-D cycles. The multiple birth and birth defect rate of AI-D was lower than that of IVF-D significantly. IVF-D mean cost per couple was higher than that of AI-D (CNY32,575 vs. CNY11,062, p < 0.001), with a mean cost difference of CNY21,513 (95% confidence interval, CNY20,517-22,508). The mean costs per live birth cycle for IVF-D and AI-D were CNY49,411 and CNY31,246, respectively. CONCLUSION: AI-D is more cost-effective and poses a lower risk for infertility couples than IVF-D, and patients should undergo three AI-D cycles to obtain the highest success rate.

9.
Workplace Health Saf ; 71(2): 68-77, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36514253

RESUMO

BACKGROUND: Returning to work after childbirth is a common reason for women to stop breastfeeding. This study aimed to assess breastfeeding practices and breastfeeding support available to employed women in China, and factors affecting breastfeeding duration. METHODS: A cross-sectional survey of 1,243 breastfeeding women employed full-time was conducted. Participants completed a sociodemographic questionnaire and the Workplace Breastfeeding Support Scale (WBSS). Multiple linear regression analysis was used to explore the factors that are associated with breastfeeding. RESULTS: The mean exclusive breastfeeding duration and any breastfeeding duration of full-time employed women were 5.7 ± 0.5 months and 9.8 ± 1.5 months, respectively. The total WBSS score was 46.6 ± 5.3 (M ± SD). Generally, women perceived coworkers (M [SD] = 4.8 [1.0]) and supervisors (M [SD] = 5.7 [1.2]) to be supportive of breastfeeding. Lower scores on the WBSS were related to lack of technical and facility support, indicating no access to a refrigerator to store breast milk (M [SD] = 2.0 [1.5]) or to a breast pump (M [SD] = 1.7 [1.7]). Similarly, a private area for expressing breast milk (M [SD] = 1.4 [1.0]) was unavailable. Maternity leave, residential province, ethnicity, education level, average monthly household income, main reason for stopping exclusive breastfeeding, commute time greater than 1 hour, and the total WBSS score were also factors influencing breastfeeding duration of the full-time employed women. CONCLUSIONS: There were gaps in breastfeeding practices and workplace breastfeeding support of Chinese full-time employed women when compared with the World Health Organization recommendations. Occupational health providers should consider these findings when developing programs to support breastfeeding in the workplace.


Assuntos
Aleitamento Materno , Mulheres Trabalhadoras , Feminino , Humanos , Gravidez , Prevalência , Estudos Transversais , Emprego , Local de Trabalho , China
10.
Int J Gen Med ; 15: 4837-4847, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35585999

RESUMO

Purpose: To investigate the correlation and prognostic significance of low triiodothyronine (T3) syndrome and norepinephrine dosage in patients with sepsis and septic shock. Methods: This single-center, retrospective, cohort study enrolled 169 patients with sepsis and septic shock that were admitted to the intensive care unit of First Hospital of Nanchang, Nanchang, China from June 2017 to July 2019. All included patients were followed up for 28 days or died, whichever was earlier. Patients with free T3 (FT3) of <3.1 pmol/L were considered with low T3 syndrome. The correlation and prognostic significance of the FT3 and maximum dosage of norepinephrine (MDN) within 72 h, as well as other clinical indicators, were analyzed by using correlation analysis, principal component analysis, receiver operating characteristic curve, Youden index, and logistic regression. Results: A total of 138 patients were allocated to the low T3 group. FT3 inversely correlated with the Sequential Organ Failure Assessment (SOFA) score within 24 h, fluid resuscitation volume within 24 h, and lactic acid levels, and positively correlated with the mean arterial pressure. The critical values of age, SOFA, and MDN for predicting the 28-day mortality were 79.5 years, 8.5 points, and 0.61 µg/kg/min, respectively. The mortality of the low T3 and normal T3 groups was similar. Considering the MDN of 0.61 µg/kg/min as the cutoff value, the mortality between the two groups was significantly different. Conclusion: Among patients with sepsis and septic shock, FT3 was inversely correlated with the disease severity. An MDN ≥ 0.61 µg/kg/min within 72 h may be an important prognostic indicator.

11.
Front Psychiatry ; 13: 1017283, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36819944

RESUMO

Background: Delirium, a confused transient state of consciousness, can be divided into hyperactive, hypoactive, mixed, and no motor subtypes, according to different clinical manifestations. Several studies have investigated delirium subtypes in the knowledge dimension, but few studies have investigated delirium subtype in the attitude and practice dimensions. The barriers, knowledge sources, and practice details regarding subtype assessment are unclear. Objectives: This study had three objectives. First, we planned to investigate the KAP status regarding delirium and subtypes for nurses. Second, we wanted to identify factors affecting clinical nurses' KAP scores. Third, this study expected to explore more details regarding delirium and subtypes assessment, including assessment barriers, assessment instruments, and knowledge sources. Methods: This multicentre cross-section study was conducted in 10 tertiary hospitals in three provinces, China, from January to April 2022. We investigated 477 nurses from six departments with a high prevalence. The self-developed KAP questionnaire regarding delirium and subtypes assessment had four parts: knowledge, attitude, practice, and source. Its reliability and validity were verified effectively by 2-round Delphi expert consultation. Results: A total of 477 nurses from the general intensive care unit (ICU), specialty ICU, orthopedics, thoracic surgery, operating room, and geriatrics were 28.3, 22.4, 22.2, 10.5, and 5.2%, respectively. The total KAP score regarding delirium and subtypes assessment was 60.01 ± 6.98, and the scoring rate was 73.18%. The scoring rate for knowledge, attitude, and practice was 58.55, 83.94, and 51.70%, respectively. More than half (54.1%) were unaware of the delirium subtypes assessment instruments. A total of 451 (94.6%) participants recognized the importance of nursing work for delirium prevention. A total of 250 (52.4%) nurses occasionally or sometimes assessed delirium subtypes, and 143 (30.0%) never assessed for delirium subtypes. We found that age, department, technical title, familiarity with delirium, familiarity with delirium subtypes, delirium training, and subtype training affected the total KAP scores. ICU nurses achieved the highest scores. Conclusion: Chinese nurses' KAP status regarding delirium and subtypes assessment were barely acceptable, and the attitude score was positive, but knowledge and practice needed improvement. Meanwhile, the department was one of the significant KAP factors, and ICU nurses did better in delirium and subtype assessment in knowledge and practice dimension than other departments. Systematic and scientific training processes including subtype content and assessment tools are required. Experience still drives nurses' assessments of delirium and subtype. Adding the delirium assessment into routine tasks should be considered.

12.
BMC Public Health ; 21(1): 1619, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488700

RESUMO

BACKGROUND: To evaluate global burden of refraction disorders by year, age, region, gender, socioeconomic status and other national characteristics in terms of disability adjusted life years (DALYs) and prevalence from Global Burden of Disease (GBD) study 2019 and World Bank Open Data 2019. METHODS: Global, regional, and national DALY numbers, crude DALY rates, age-standardized DALY and prevalence rates of refraction disorders were acquired from the GBD study 2019. Mobile cellular subscriptions, urban population, GDP per capita, access to electricity and total fertility rate were obtained from the World Bank to explore the factors that influenced the health burden of refraction disorders. Kruskal-Wallis test, linear regression and multiple linear regression were performed to evaluate the associations between the health burden with socioeconomic levels and other national characteristics. Wilcoxon Signed-Rank Test was used to investigate the gender disparity. RESULTS: Globally, age-standardized DALY rates of refraction disorders decreased from 88.9 (95% UI: 60.5-120.3) in 1990 to 81.5 (95% UI: 55.0-114.8) in 2019, and might fall to 73.16 (95% UI: 67.81-78.51) by 2050. Age-standardized prevalence rates would also reduce to 1830 (95% UI: 1700-1960) by 2050, from 2080 (95% UI: 1870-2310) in 1990 to 1960 (95% UI: 1750-2180) in 2019. In low SDI region, age-standardized DALY rates (equation: Y = 114.05*X + 27.88) and prevalence rates (equation: Y = 3171.1*X + 403.2) were positively correlated with SDI in linear regression respectively. East Asia had the highest blindness rate caused by refraction disorders in terms of age-standardized DALY rates (11.20, 95% UI: 7.38-16.36). Gender inequality was found among different age groups and SDI regions. CONCLUSION: Health burden of refraction disorders decreased in recent years, and may continue to alleviate in the next three decades. Older ages, females and lower socioeconomic status were associated with higher refraction disorders health burden.


Assuntos
Pessoas com Deficiência , Carga Global da Doença , Idoso , Feminino , Saúde Global , Humanos , Pessoa de Meia-Idade , Prevalência , Anos de Vida Ajustados por Qualidade de Vida
13.
Transl Vis Sci Technol ; 10(9): 23, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34406340

RESUMO

Purpose: This study aimed to quantitative assess the fundus tessellated density (FTD) and associated factors on the basis of fundus photographs using artificial intelligence. Methods: A detailed examination of 3468 individuals was performed. The proposed method for FTD measurements consists of image preprocessing, sample labeling, deep learning segmentation model, and FTD calculation. Fundus tessellation was extracted as region of interest and then the FTD could be obtained by calculating the average exposed choroid area of per unit area of fundus. Besides, univariate and multivariate linear regression analysis have been conducted for the statistical analysis. Results: The mean FTD was 0.14 ± 0.08 (median, 0.13; range, 0-0.39). In multivariate analysis, FTD was significantly (P < 0.001) associated with thinner subfoveal choroidal thickness, longer axial length, larger parapapillary atrophy, older age, male sex and lower body mass index. Correlation analysis suggested that the FTD increased by 33.1% (r = 0.33, P < .001) for each decade of life. Besides, correlation analysis indicated the negative correlation between FTD and spherical equivalent (SE) in the myopia participants (r = -0.25, P < 0.001), and no correlations between FTD and SE in the hypermetropia and emmetropic participants. Conclusions: It is feasible and efficient to extract FTD information from fundus images by artificial intelligence-based imaging processing. FTD can be widely used in population screening as a new quantitative biomarker for the thickness of the subfoveal choroid. The association between FTD with pathological myopia and lower visual acuity warrants further investigation. Translational Relevance: Artificial intelligence can extract valuable clinical biomarkers from fundus images and assist in population screening.


Assuntos
Inteligência Artificial , Miopia Degenerativa , Idoso , Estudos Transversais , Fundo de Olho , Humanos , Masculino , Tomografia de Coerência Óptica
14.
Drug Des Devel Ther ; 15: 111-124, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33469264

RESUMO

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death across the globe. Its repeated exacerbation will seriously worsen the quality of life, aggravate the patients' symptoms, and bring a heavy burden on the patients and the society. Understanding the current status of drug therapy and the role of pharmaceutical care is essential for the management of COPD. In addition to the drugs already on the market, recent clinical trials also show that emerging novel drugs for treating COPD are being developed to prevent the symptoms, reduce the frequency of acute exacerbation, and improve the quality of life. Recent progress in new drug research should lead to novel treatment options for COPD patients in future clinical practice. The pharmaceutical care has shown significantly favourable impacts on addressing drug-related problems, supporting its vital role in the management of COPD, especially when there are a wide range of therapeutic agents. This review not only provides an overview of current treatment strategies but also further underlines the importance of new drug development and pharmaceutical care for patients with COPD.


Assuntos
Broncodilatadores/uso terapêutico , Conduta do Tratamento Medicamentoso , Farmacêuticos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Humanos
15.
Sensors (Basel) ; 20(1)2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31861735

RESUMO

Wireless body area networks (WBANs) have attracted great attention from both industry and academia as a promising technology for continuous monitoring of physiological signals of the human body. As the sensors in WBANs are typically battery-driven and inconvenient to recharge, an energy efficient resource allocation scheme is essential to prolong the lifetime of the networks, while guaranteeing the rigid requirements of quality of service (QoS) of the WBANs in nature. As a possible alternative solution to address the energy efficiency problem, energy harvesting (EH) technology with the capability of harvesting energy from ambient sources can potentially reduce the dependence on the battery supply. Consequently, in this paper, we investigate the resource allocation problem for EH-powered WBANs (EH-WBANs). Our goal is to maximize the energy efficiency of the EH-WBANs with the joint consideration of transmission mode, relay selection, allocated time slot, transmission power, and the energy constraint of each sensor. In view of the characteristic of the EH-WBANs, we formulate the energy efficiency problem as a discrete-time and finite-state Markov decision process (DFMDP), in which allocation strategy decisions are made by a hub that does not have complete and global network information. Owing to the complexity of the problem, we propose a modified Q-learning (QL) algorithm to obtain the optimal allocation strategy. The numerical results validate the effectiveness of the proposed scheme as well as the low computation complexity of the proposed modified Q-learning (QL) algorithm.


Assuntos
Algoritmos , Monitorização Fisiológica/métodos , Tecnologia sem Fio , Eletrocardiografia , Eletromiografia , Humanos , Cadeias de Markov , Monitorização Fisiológica/instrumentação , Razão Sinal-Ruído
16.
Huan Jing Ke Xue ; 39(3): 1413-1420, 2018 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-29965490

RESUMO

Fifty-five soil samples were collected across the central and eastern Qinghai-Tibetan Plateau during July to August in 2013. These were analyzed for the sixteen polycyclic aromatic hydrocarbons (PAHs) called out by the USA EPA. The concentration characteristics, sources, and potential ecological risk assessment of the sixteen PAHs in the soils were investigated. The soils were extracted by ultrasonic extraction, purified by an HLB solid-phase extraction column, and quantified by gas chromatography-mass spectrometry (GC-MS). The total PAH concentrations ranged from 40.47 to 1276.40 µg·kg-1, with a mean of 267.97 µg·kg-1. Low-ring PAHs (two and three rings PAHs) were dominant in all samples, and the proportion of phenanthrene was the highest. The sources of PAHs were assessed by diagnostic ratios and a principal component analysis (PCA), which indicated that the main sources of the PAHs originated from petroleum and biomass combustion. The toxic equivalent concentration (TEQ) concentration of benzopyrene-(a)-pyrene (TEQBaP) in soils ranged from 3.73 to 79.32 µg·kg-1, with an average concentration of 12.84 µg·kg-1. The TEQBaP in 4% of the soil samplings exceeded the Dutch target reference value (33.00 µg·kg-1), suggesting that a small portion of the soils in the Qinghai-Tibetan Plateau have potential ecological risk.

17.
Ying Yong Sheng Tai Xue Bao ; 28(1): 199-209, 2017 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-29749204

RESUMO

The Shiyang River Basin is an important ecological area of the Eastern Hexi Corridor, and is one of the most prominent areas of water conflict and ecological environment problems. An assessment of ecosystem quality in the Shiyang River Basin can provide a reference for ecological protection in arid inland basin. Based on the concept of ecosystem quality and the statistical yearbook, remotely sensed and land cover data, an evaluation index was established with consideration of three aspects of ecosystem (i.e., productivity, stability and bearing capacity). Kruskal-Wallis (Φ2) test and entropy method were applied to determine the weights of evaluation index. With the assistance of RS, GIS and SPSS software, a comprehensive evaluation and change analysis of ecosystem quality and corresponding index were conducted for various ecosystem types in the Shiyang River Basin in 2000, 2005, 2010 and 2015. Results showed that the average ecosystem quality of the Shiyang River Basin was 57.76, and presented an obvious decrease with a magnitude of 0.72 per year du-ring 2000-2015. The spatial pattern of ecosystem quality was that the upstream was better than the midstream, and the midstream was superior to the downstream. The mean values of production capacity, stability and carrying capacity of ecosystem were 67.52, 45.37, and 58.53, respectively. Production capacity and stability had increased slightly, while carrying capacity gradually decreased. Considering various ecosystem types, the highest quality was detected for forest ecosystem with average annual value of 78.12, and this ecosystem presented the lowest decreasing magnitude of 0.28 per year; for grassland, farmland and urban ecosystems, the average annual value was 62.45, 58.76 and 50.29, respectively; the quality of wetland ecosystem was the lowest, and suffered the largest decline with an average rate of 0.98 per year.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Sistemas de Informação Geográfica , China , Monitoramento Ambiental , Rios
18.
Eye Vis (Lond) ; 3: 13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27175371

RESUMO

BACKGROUND: The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. METHODS: Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. RESULTS: Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. CONCLUSIONS: Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.

19.
J Comput Assist Tomogr ; 40(3): 402-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26854413

RESUMO

OBJECTIVES: Our aim was to assess image quality and radiation dose of low-voltage high-pitch computed tomography angiography of the infrarenal aorta and lower extremities and evaluate the efficacy of test injection technique using a monitoring scan at knee level. METHODS: A total of 60 patients with suspected peripheral arterial disease were divided into 2 groups: group 1 (30 patients, 80 kVp, high pitch [3.2], and hybrid iterative reconstruction [sinogram-affirmed iterative reconstruction]) and group 2 (30 patients, 120 kVp, low pitch [1.0], and filtered back projection reconstruction). The test injection technique at knee level was used to determine the scan delay time in group 1. The image quality and radiation exposure were compared. RESULTS: There were significant differences between the 2 groups in mean (SD) arterial attenuation (80 vs 120 kVp: 507.78 [103.01] vs 317.54 [62.03] Hounsfield units, P < 0.001), mean (SD) signal-to-noise ratio (51.04 [20.29] vs 34.66 [9.94], P < 0.001), and contrast-to-noise ratio (44.83 [17.93] vs 28.26 [9.60], P < 0.001). No difference in subjective image quality was found between the 2 groups (all P > 0.05). The imaging time was significantly shorter in group 1 (2.70 [0.11] vs 14.65 [0.90s], P < 0.001). The mean (SD) effective dose was significantly lower in the 80 kVp group (0.76 [0.06] vs 4.29 [0.63] mSv, P < 0.001). CONCLUSIONS: The 80-kVp high-pitch computed tomography angiography of the lower limbs using sinogram-affirmed iterative reconstruction yields reduction of radiation exposure as well as obtains acceptable image quality if acquisition protocols are used in conjunction with the test injection technique using monitoring scan at knee level to determine the delay time.


Assuntos
Doenças da Aorta/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Meios de Contraste/administração & dosagem , Doença Arterial Periférica/diagnóstico por imagem , Exposição à Radiação/prevenção & controle , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Aorta Abdominal/diagnóstico por imagem , Arteriopatias Oclusivas/diagnóstico por imagem , Feminino , Humanos , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Joelho/irrigação sanguínea , Joelho/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Exposição à Radiação/análise , Proteção Radiológica , Intensificação de Imagem Radiográfica , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
20.
PLoS One ; 11(1): e0145407, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26745375

RESUMO

As computer science and complex network theory develop, non-cooperative games and their formation and application on complex networks have been important research topics. In the inter-firm innovation network, it is a typical game behavior for firms to invest in their alliance partners. Accounting for the possibility that firms can be resource constrained, this paper analyzes a coordination game using the Nash bargaining solution as allocation rules between firms in an inter-firm innovation network. We build an extended inter-firm n-player game based on nonidealized conditions, describe four investment strategies and simulate the strategies on an inter-firm innovation network in order to compare their performance. By analyzing the results of our experiments, we find that our proposed greedy strategy is the best-performing in most situations. We hope this study provides a theoretical insight into how firms make investment decisions.


Assuntos
Comportamento Cooperativo , Teoria dos Jogos , Algoritmos , Investimentos em Saúde
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