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1.
Small ; 20(15): e2307680, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38012528

ABSTRACT

Self-powered vibration sensor is highly desired for distributed and continuous monitoring requirements of Industry 4.0. Herein, a flexible fiber-shaped triboelectric nanogenerator (F-TENG) with a coaxial core-shell structure is proposed for the vibration monitoring. The F-TENG exhibits higher adaptability to the complex surfaces, which has an outstanding application prospect due to vital compensation for the existing rigid sensors. Initially, the contact characteristics between the dielectric layers, that related to the perceiving performance of the TENG, are theoretically analyzed. Such a TENG with 1D structure endows high sensitivity, allowing for accurately responding to a wide range of vibration frequencies (0.1 to 100 Hz). Even applying to the real diesel engine, the error in detecting the vibration frequencies is only 0.32% compared with the commercial vibration sensor, highlighting its potential in practical application. Further, assisted by deep learning, the recognition accuracy in monitoring nine operating conditions of the system achieves 97.87%. Overall, the newly designed F-TENG with the merits of high-adaptability, cost-efficiency, and self-powered, has offered a promising solution to fulfill an extensive range of vibration sensing applications in the future.

2.
Pediatr Dermatol ; 41(3): 480-482, 2024.
Article in English | MEDLINE | ID: mdl-38456206

ABSTRACT

This study focused on evaluating Extension for Community Healthcare Outcomes (ECHO) participating primary care clinician's (PCC's) diagnostic and treatment accuracy of pediatric dermatologic conditions. To evaluate this, pediatric cases presented to Dermatology ECHO by PCCs with questions regarding diagnosis, treatment regimen, or both were analyzed. After PCC case presentation, the hub team of dermatologists facilitated case-based discussion and provided the presenter with mentorship and guidance regarding diagnosis and treatment of their patient.


Subject(s)
Dermatology , Quality Improvement , Skin Diseases , Humans , Dermatology/standards , Child , Skin Diseases/therapy , Skin Diseases/diagnosis , Community Health Services , Male , Female , Pediatrics/standards , Child, Preschool , Primary Health Care , Infant , Adolescent , Quality of Health Care
3.
Ecotoxicol Environ Saf ; 281: 116661, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38954907

ABSTRACT

OBJECTIVE: Baicalin has antioxidative, antiviral, and anti-inflammatory properties. However, its ability to alleviate oxidative stress (OS) and DNA damage in liver cells exposed to aflatoxin B1 (AFB1), a highly hepatotoxic compound, remains uncertain. In this study, the protective effects of baicalin on AFB1-induced hepatocyte injury and the mechanisms underlying those effects were investigated. METHODS: Stable cell lines expressing CYP3A4 were established using lentiviral vectors to assess oxidative stress levels by conducting assays to determine the content of reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD). Additionally, DNA damage was evaluated by 8-hydroxy-2-deoxyguanosine (8-OHdG) and comet assays. Transcriptome sequencing, molecular docking, and in vitro experiments were conducted to determine the mechanisms underlying the effects of baicalin on AFB1-induced hepatocyte injury. In vivo, a rat model of hepatocyte injury induced by AFB1 was used to evaluate the effects of baicalin. RESULTS: In vitro, baicalin significantly attenuated AFB1-induced injury caused due to OS, as determined by a decrease in ROS, MDA, and SOD levels. Baicalin also considerably decreased AFB1-induced DNA damage in hepatocytes. This protective effect of baicalin was found to be closely associated with the TP53-mediated ferroptosis pathway. To elaborate, baicalin physically interacts with P53, leading to the suppression of the expression of GPX4 and SLC7A11, which in turn inhibits ferroptosis. In vivo findings showed that baicalin decreased DNA damage and ferroptosis in AFB1-treated rat liver tissues, as determined by a decrease in the expression of γ-H2AX and an increase in GPX4 and SLC7A11 levels. Overexpression of TP53 weakened the protective effects of baicalin. CONCLUSIONS: Baicalin can alleviate AFB1-induced OS and DNA damage in liver cells via the TP53-mediated ferroptosis pathway. In this study, a theoretical foundation was established for the use of baicalin in protecting the liver from the toxic effects of AFB1.

4.
Mol Phylogenet Evol ; 189: 107914, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37666378

ABSTRACT

Phylogenetic studies in the phylogenomics era have demonstrated that reticulate evolution greatly impedes the accuracy of phylogenetic inference, and consequently can obscure taxonomic treatments. However, the systematics community lacks a broadly applicable strategy for taxonomic delimitation in groups characterized by pervasive reticulate evolution. The red-fruit genus, Stranvaesia, provides an ideal model to examine the influence of reticulation on generic circumscription, particularly where hybridization and allopolyploidy dominate the evolutionary history. In this study, we conducted phylogenomic analyses integrating data from hundreds of single-copy nuclear (SCN) genes and plastomes, and interrogated nuclear paralogs to clarify the inter/intra-generic relationship of Stranvaesia and its allies in the framework of Maleae. Analyses of phylogenomic discord and phylogenetic networks showed that allopolyploidization and introgression promoted the origin and diversification of the Stranvaesia clade, a conclusion further bolstered by cytonuclear and gene tree discordance. With a well-inferred phylogenetic backbone, we propose an updated generic delimitation of Stranvaesia and introduce a new genus, Weniomeles. This new genus is distinguished by its purple-black fruits, thorns trunk and/or branches, and a distinctive fruit core anatomy characterized by multilocular separated by a layer of sclereids and a cluster of sclereids at the top of the locules. Through this study, we highlight a broadly-applicable workflow that underscores the significance of reticulate evolution analyses in shaping taxonomic revisions from phylogenomic data.


Subject(s)
Dreams , Rosaceae , Phylogeny , Rosaceae/genetics
5.
Sensors (Basel) ; 23(8)2023 Apr 20.
Article in English | MEDLINE | ID: mdl-37112465

ABSTRACT

To address the problems of low monitoring area coverage rate and the long moving distance of nodes in the process of coverage optimization in wireless sensor networks (WSNs), a multi-strategy improved sparrow search algorithm for coverage optimization in a WSN (IM-DTSSA) is proposed. Firstly, Delaunay triangulation is used to locate the uncovered areas in the network and optimize the initial population of the IM-DTSSA algorithm, which can improve the convergence speed and search accuracy of the algorithm. Secondly, the quality and quantity of the explorer population in the sparrow search algorithm are optimized by the non-dominated sorting algorithm, which can improve the global search capability of the algorithm. Finally, a two-sample learning strategy is used to improve the follower position update formula and to improve the ability of the algorithm to jump out of the local optimum. Simulation results show that the coverage rate of the IM-DTSSA algorithm is increased by 6.74%, 5.04% and 3.42% compared to the three other algorithms. The average moving distance of nodes is reduced by 7.93 m, 3.97 m, and 3.09 m, respectively. The results mean that the IM-DTSSA algorithm can effectively balance the coverage rate of the target area and the moving distance of nodes.

6.
J Environ Manage ; 331: 117278, 2023 Apr 01.
Article in English | MEDLINE | ID: mdl-36634423

ABSTRACT

Methane production through anaerobic digestion (AD) of municipal sludge is economic and eco-friendly, which is commonly affected by temperature and pollutants residues. However, little is known about methanogenesis in psychrophilic AD (PAD) with temperature variations that simulating seasonal variations and with antibiotic stress. Here, two groups of AD systems with oxytetracycline (OTC) were operated with temperature maintained at 35 °C and 15 °C or variation to explore the influence to methanogenesis. The acetic acid was noticeably accumulated in OTC groups initially (P < 0.001). Methane production was noticeably inhibited initially in PAD with OTC, but had been stimulated later at 35 °C. The dominant acetoclastic methanogens Methanosaeta gradually decreased to 15.48% and was replaced by methylotrophic Methanomethylovorans (73.43%) in PAD with OTC. Correspondingly, the abundances of functional genes related to methylotrophic methanogenesis were also higher in these groups. Besides, genes involving in methane oxidation had over 50 times higher abundances in PAD with OTC groups in the second phase. Further investigation is essential to understand the main dynamics of methanogenesis in PAD and to clear the related molecular mechanism for future methane production regulation in sludge systems.


Subject(s)
Oxytetracycline , Sewage , Sewage/chemistry , Anti-Bacterial Agents , Anaerobiosis , Bioreactors , Methane
7.
Neurochem Res ; 47(9): 2856-2864, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35906352

ABSTRACT

Methamphetamine (METH), the most widely distributed psychostimulant, aberrantly activates the reward system in the brain to induce addictive behaviors. The presynaptic protein "Piccolo", encoded by Pclo, was identified as a METH-responsive protein with enhanced expression in the nucleus accumbens (NAc) in mice. Although the physiological and pathological significance of Piccolo has been identified in dopaminergic signaling, its role in METH-induced behavioral abnormalities and the underlying mechanisms remain unclear. To clarify such functions, mice with Piccolo knockdown in the NAc (NAc-miPiccolo mice) by local injection of an adeno-associated virus vector carrying miRNA targeting Pclo were generated and investigated. NAc-miPiccolo mice exhibited suppressed hyperlocomotion, sensitization, and conditioned place preference behavior induced by systemic administration of METH. The excessive release of dopamine in the NAc was reduced in NAc-miPiccolo mice at baseline and in response to METH. These results suggest that Piccolo in the NAc is involved in METH-induced behavioral alterations and is a candidate therapeutic target for the treatment of drug addiction.


Subject(s)
Central Nervous System Stimulants , Methamphetamine , Animals , Central Nervous System Stimulants/pharmacology , Dopamine/metabolism , Methamphetamine/pharmacology , Mice , Nucleus Accumbens/metabolism , Reward
8.
Acta Pharmacol Sin ; 43(10): 2709-2722, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35354963

ABSTRACT

Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide. CRC is the second leading cause of cancer-related deaths. Although some progress in the treatment of CRC has been achieved, the molecular mechanism of CRC is still unclear. In this study, alcohol dehydrogenase 1C(ADH1C) was first identified as a target gene closely associated with the development of CRC by the comprehensive application of transcriptomics, proteomics, metabonomics and in silico analysis. The ADH1C mRNA and protein expression in CRC cell lines and tumor tissues was lower than that in normal intestinal epithelial cell lines and healthy tissues. Overexpression of ADH1C inhibited the growth, migration, invasion and colony formation of CRC cell lines and prevented the growth of xenograft tumors in nude mice. The inhibitory effects of ADH1C on CRC cells in vitro were exerted by reducing the expression of PHGDH/PSAT1 and the serine level. This inhibition could be partially reversed by adding serine to the culture medium. These results showed that ADH1C is a potential drug target in CRC.


Subject(s)
Alcohol Dehydrogenase , Colorectal Neoplasms , Alcohol Dehydrogenase/genetics , Alcohol Dehydrogenase/metabolism , Animals , Cell Line, Tumor , Cell Movement , Cell Proliferation/genetics , Colorectal Neoplasms/metabolism , Female , Gene Expression Regulation, Neoplastic , Humans , Metabolic Networks and Pathways , Mice , Mice, Nude , RNA, Messenger/metabolism , Serine/genetics , Serine/metabolism
9.
Acta Pharmacol Sin ; 43(11): 2977-2992, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35581292

ABSTRACT

Glioblastoma (GBM), a malignant brain tumor, is a world-wide health problem because of its poor prognosis and high rates of recurrence and mortality. Apolipoprotein C1 (APOC1) is the smallest of apolipoproteins, implicated in many diseases. Recent studies have shown that APOC1 promotes tumorigenesis and development of several types of cancer. In this study we investigated the role of APOC1 in GBM tumorigenesis. Using in silico assays we showed that APOC1 was highly expressed in GBM tissues and its expression was closely related to GBM progression. We showed that APOC1 protein expression was markedly increased in four GBM cell lines (U251, U138, A172 and U87) compared to the normal brain glia cell lines (HEB, HA1800). In U251 cells, overexpression of APOC1 promoted cell proliferation, migration, invasion and colony information, which was reversed by APOC1 knockdown. APOC1 knockdown also markedly inhibited the growth of GBM xenografts in the ventricle of nude mice. We further demonstrated that APOC1 reduced ferroptosis by inhibiting KEAP1, promoting nuclear translocation of NRF2 and increasing expression of HO-1 and NQO1 in GBM cells. APOC1 also induced ferroptosis resistance by increasing cystathionine beta-synthase (CBS) expression, which promoted trans-sulfuration and increased GSH synthesis, ultimately leading to an increase in glutathione peroxidase-4 (GPX4). Thus, APOC1 plays a key role in GBM tumorigenesis, conferring resistance to ferroptosis, and may be a promising therapeutic target for GBM.


Subject(s)
Apolipoprotein C-I , Ferroptosis , Glioblastoma , Kelch-Like ECH-Associated Protein 1 , NF-E2-Related Factor 2 , Animals , Humans , Mice , Apolipoprotein C-I/metabolism , Carcinogenesis/metabolism , Cell Line, Tumor , Cell Transformation, Neoplastic , Cystathionine beta-Synthase/metabolism , Gene Expression Regulation, Neoplastic , Glioblastoma/metabolism , Kelch-Like ECH-Associated Protein 1/metabolism , Mice, Nude , NF-E2-Related Factor 2/metabolism
10.
BMC Pediatr ; 22(1): 442, 2022 07 23.
Article in English | MEDLINE | ID: mdl-35869466

ABSTRACT

BACKGROUND: The "Law on Doctors of the People's Republic of China," which was officially implemented on March 1, 2022, emphasizes the requirements for rational drug use and the necessity for appropriate management of off-label drug use. The safety and ethical considerations related to off-label drug use are different in children than in adults. There is so far no management guideline for pediatric off-label use of drugs in China, and the applicability of foreign guidelines is limited. Establishing a localized evidence-based management guideline for pediatric off-label use of drugs to support the national legislation and clinical practice is of critical importance. METHODS: We established a guideline working group, including experts from a broad range of disciplines and developed recommendations following the guidance of the World Health Organization Handbook and the Chinese Medical Association. The following themes were identified by questionnaires and expert interviews to be of great concern in the management of off-label drug use in children: general principles and characteristics of management of pediatric off-label drug use; establishment of expert committees; evidence evaluation; risk-benefit assessment; informed consent; monitoring and assessment of the risk; and monitoring and patient education. Two rounds of Delphi surveys were organized to determine the final recommendations of this guideline. We graded the recommendations based on the body of evidence, referring to the evaluation tool of the Evidence-based management (EBMgt) and the Oxford Center for Evidence-Based Medicine: Level of Evidence (March 2009). RESULTS: We developed the first guideline for the management of pediatric off-label use of drugs in China. CONCLUSIONS: The guideline is to offer guidance for pediatricians, pharmacists, medical managers, policymakers, and primary care physicians on how to manage off-label drug use in pediatrics and to provide recommendations for Chinese healthcare policy in the future.


Subject(s)
Off-Label Use , Physicians , Adult , Child , China , Drug Labeling , Evidence-Based Medicine , Humans , Pediatricians
11.
BMC Health Serv Res ; 22(1): 626, 2022 May 10.
Article in English | MEDLINE | ID: mdl-35538575

ABSTRACT

BACKGROUND: Nursing home residents are at increased risk for hospital transfers resulting in emergency department visits, observation stays, and hospital admissions; transfers that can also result in adverse resident outcomes. Many nursing home to hospital transfers are potentially avoidable. Residents who experience repeat transfers are particularly vulnerable to adverse outcomes, yet characteristics of nursing home residents who experience repeat transfers are poorly understood. Understanding these characteristics more fully will help identify appropriate intervention efforts needed to reduce repeat transfers. METHODS: This is a mixed-methods study using hospital transfer data, collected between 2017 and 2019, from long-stay nursing home residents residing in 16 Midwestern nursing homes who transferred four or more times within a 12-month timeframe. Data were obtained from an acute care transfer tool used in the Missouri Quality Initiative containing closed- and open-ended questions regarding hospital transfers. The Missouri Quality Initiative was a Centers for Medicare and Medicaid demonstration project focused on reducing avoidable hospital transfers for long stay nursing home residents. The purpose of the analysis presented here is to describe characteristics of residents from that project who experienced repeat transfers including resident age, race, and code status. Clinical, resident/family, and organizational factors that influenced transfers were also described. RESULTS: Findings indicate that younger residents (less than 65 years of age), those who were full-code status, and those who were Black were statistically more likely to experience repeat transfers. Clinical complexity, resident/family requests to transfer, and lack of nursing home resources to manage complex clinical conditions underlie repeat transfers, many of which were considered potentially avoidable. CONCLUSIONS: Improved nursing home resources are needed to manage complex conditions in the NH and to help residents and families set realistic goals of care and plan for end of life thus reducing potentially avoidable transfers.


Subject(s)
Medicare , Nursing Homes , Aged , Emergency Service, Hospital , Hospitalization , Hospitals , Humans , Patient Transfer , United States
12.
Entropy (Basel) ; 24(6)2022 Jun 11.
Article in English | MEDLINE | ID: mdl-35741535

ABSTRACT

Vehicular edge computing is a new computing paradigm. By introducing edge computing into the Internet of Vehicles (IoV), service providers are able to serve users with low-latency services, as edge computing deploys resources (e.g., computation, storage, and bandwidth) at the side close to the IoV users. When mobile nodes are moving and generating structured tasks, they can connect with the roadside units (RSUs) and then choose a proper time and several suitable Mobile Edge Computing (MEC) servers to offload the tasks. However, how to offload tasks in sequence efficiently is challenging. In response to this problem, in this paper, we propose a time-optimized, multi-task-offloading model adopting the principles of Optimal Stopping Theory (OST) with the objective of maximizing the probability of offloading to the optimal servers. When the server utilization is close to uniformly distributed, we propose another OST-based model with the objective of minimizing the total offloading delay. The proposed models are experimentally compared and evaluated with related OST models using simulated data sets and real data sets, and sensitivity analysis is performed. The results show that the proposed offloading models can be efficiently implemented in the mobile nodes and significantly reduce the total expected processing time of the tasks.

13.
Entropy (Basel) ; 24(8)2022 Jul 31.
Article in English | MEDLINE | ID: mdl-36010719

ABSTRACT

To address the problem of a poor security image encryption algorithm based on a single chaotic map, this paper proposes a cascade modulation chaotic system (CMCS) that can generate multiple chaotic maps. On this basis, a multi-image encryption algorithm with block-scrambling-diffusion is proposed using CMCS. The algorithm makes full use of the features of CMCS to achieve the effect of one encryption at a time for images. Firstly, the key-value associated with the plaintexts is generated using a secure hash algorithm-512 (SHA-512) operation and random sequence, and the three images are fully confused by the double scrambling mechanism. Secondly, the scrambled image is converted into a bit-level matrix, and the pixel values are evenly distributed using the bit-group diffusion. Finally, the non-sequence diffusion of hexadecimal addition and subtraction rules is used to improve the security of the encryption algorithm. Experimental results demonstrate that the encryption algorithm proposed in this paper has a good encryption effect and can resist various attacks.

14.
Zhongguo Zhong Yao Za Zhi ; 47(11): 3095-3104, 2022 Jun.
Article in Zh | MEDLINE | ID: mdl-35718534

ABSTRACT

This study aims to summarize the research hotspots of Hedysari Radix and predict the research trend with bibliometric methods, which is expected to serve as a reference for future research. CiteSpace V 5.8.R2 was employed for visualization of the number, authors, author affiliations, journals, funds, and keywords of the Chinese and English articles on Hedysari Radix in China National Knowledge Infrastructure(CNKI) and Web of Science(WOS) from 2001 to 2021. A total of 693 Chinese articles and 167 English articles were finally included. According to the knowledge map, most of the articles were from China and the authors from China had a close cooperation with the related institutions in the United States and Australia. Gansu University of Chinese Medicine(288) and Lanzhou University(151) respectively came out on top of the author affiliations in the number of Chinese and English articles. The journals were mainly about Chinese medicine, mainly including Chinese Journal of Information on Traditional Chinese Medicine and Evidence-based Complementary and Alternative Medicine. Papers(191 in Chinese and 60 in English) funded by National Natural Science Foundation of China were the most. Keyword analysis suggested that the main research directions were pharmacological action and mechanism, component analysis, content determination, and industrialization of medicinal materials of Hedysari Radix and that the research hotspots were the prevention and treatment of diabetes and its complications, tumors, myocardial injury, liver fibrosis and other diseases with active components such as polysaccharides, ultrafiltrate, formononetin, and calycosin. The targets, signaling pathways, and genes related to the anti-tumor, heart protection, prevention and treatment of diabetes and its complications, and regulation of immunity should be further studied.


Subject(s)
Bibliometrics , Medicine, Chinese Traditional , China , Humans , Plant Roots , United States
15.
Opt Express ; 29(5): 6903-6914, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33726201

ABSTRACT

We theoretically investigate the second harmonic generation in tilted Dirac/Weyl semimetals with broken tilt inversion symmetry in the absence of an external magnetic field using quantum theory. An analytical formula for the second harmonic conductivity tensor is derived, and it does not depend on the chirality of Weyl node. There are two contributions to the conductivity in the low-frequency region, one coming from the intraband transitions and describing by Drude-like effects, and the other from the interband-intraband transitions due to the linear energy dispersion of Dirac/Weyl semimetals near the Dirac/Weyl points. In the high-frequency region, the appearance of prominent resonant peaks in the nonlinear conductance originates from the two-photon absorption process. It is found that Dirac/Weyl semimetals have a very high nonlinear susceptibility, and an optimal tilt of the Dirac/Weyl node for the maximum nonlinear susceptibility has been found.

16.
BMC Health Serv Res ; 21(1): 807, 2021 Aug 12.
Article in English | MEDLINE | ID: mdl-34384428

ABSTRACT

BACKGROUND: Medicine purchasing in Chinese public hospitals is decided by the hospital Pharmacy Management Committee (PMC), that is complex, subjective and requires efficient approaches to ensure transparency and consistency for the factors being considered. This study aimed to use the Evidence and Value: Impact on Decision Making (EVIDEM) framework to assess medicine in these hospitals. In this study anti-diabetic drugs DPP-4 inhibitors, which work by inhibiting the activation of the Dipeptidyl Peptidase 4 (DPP-4) inhibitors, were appraised. METHODS: Following EVIDEM methodology (EVIDEM-10th), we convened an appraisal group and asked each individual to express their perspectives by assigning weights to each criterion. A systematic literature search for information of each criterion of five DPP-4 inhibitors was completed. Then the appraisal group scored for each criterion of the five DPP-4 inhibitors. The estimated value of the five DPP-4 inhibitors was obtained by Multi-Criteria Decision Analysis (MCDA) which combined individual weighting of each criterion with individual scoring for each intervention in each criterion. RESULTS: By assigning weights, the most important criterion was the quality of evidence (4.01±0.52), and that the comparative cost consequences-non-medical cost was the least important criterion (2.87±1.03). Criteria included disease severity, size of the affected population, comparative effectiveness, type of therapeutic/preventive benefit and cost of intervention, all of which were assigned the same weight of 3.58. After MCDA, the overall value orders for each DPP-4 inhibitor included Sitagliptin (0.45), Linagliptin (0.44), Vildagliptin (0.43), Alogliptin (0.42) and Saxagliptin (0.40). CONCLUSIONS: Based on EVIDEM framework and MCDA, we found that overall value of five DPP-4 inhibitors was similar. It is feasible to use the EVIDEM framework and MCDA in purchasing medicine for Chinese public hospitals.


Subject(s)
Diabetes Mellitus, Type 2 , Dipeptidyl-Peptidase IV Inhibitors , China , Decision Making , Decision Support Techniques , Diabetes Mellitus, Type 2/drug therapy , Dipeptidyl Peptidase 4 , Hospitals, Public , Humans
17.
Article in English | MEDLINE | ID: mdl-33491595

ABSTRACT

Advance directive (AD) completion can improve transitions between hospitals and skilled nursing facilities (SNF's). One Centers for Medicare and Medicaid Services (CMS) Innovations Demonstration Project, The Missouri Quality Initiative (MOQI), focused on improving AD documentation and use in sixteen SNF's. The intervention included education, training, consultation and improvements to discussion process, policy development, increased AD enactment, and increased community education and awareness activities. An analysis was conducted of data collected from annual chart inventories occurring over four years. Using a logistic mixed model, results indicated statistical significance (p < .001) for increased AD documentation. Greatest gains occurred at project mid-point. The relationship between having an AD and occurrence of transfer to a hospital was tested on a sample of 1,563 residents with length of stays more than 30 days. Residents who did not have an AD were 29% more likely to be transferred. A logistic regression was conducted, and the results were statistically significant (p < .02).


Subject(s)
Medicare , Skilled Nursing Facilities , Advance Directives , Aged , Hospitalization , Humans , Nursing Homes , United States
20.
Med Sci Monit ; 25: 2583-2590, 2019 Apr 09.
Article in English | MEDLINE | ID: mdl-30962415

ABSTRACT

Glioblastoma multiforme (GBM) is the most common primary CNS cancer and has a poor prognosis. This study searched for significant genes and the mechanisms involved in GBM. We used the Gene Expression Omnibus (GEO) to test the WHO normal and IV glioma database, used R tool to identify the significant gene, and finally, combined these with The Cancer Genome Atlas (TCGA) to verify the significant genes. Subsequently, we explored the biological mechanisms involved. Phytanoyl-CoA 2-hydroxylase-interacting protein-like gene (PHYHIPL) is downregulated in grade IV glioma (GBM). The downregulation of PHYHIPL in GBM is accompanied by poor overall survival in the TCGA database, which indicates that PHYHIPL is a protection gene in GBM development. Bioinformatics analysis shows that the poor prognosis with downregulated PHYHIPL may be the result of the TNF signaling pathway and the IL-17 signaling pathway, but good prognosis accompanied by upregulated PHYHIPL may be the result of retrograde endocannabinoid signaling and the cAMP signaling pathway. Protein-protein interactions (PPI) net indicated that PHYHIPL may play a vital role in cell metabolism, and we hypothesize that the downregulation mechanism may be the result of mutations of the ß-catenin gene and the endogenous siRNA, as shown in previous studies. PHYHIPL may be a target gene for the treatment and prognosis of GBM.


Subject(s)
Brain Neoplasms/genetics , Brain Neoplasms/metabolism , Glioblastoma/genetics , Glioblastoma/therapy , Intracellular Signaling Peptides and Proteins/genetics , Nerve Tissue Proteins/metabolism , Coenzyme A/genetics , Coenzyme A/metabolism , Computational Biology/methods , Databases, Genetic , Gene Regulatory Networks/genetics , Glioma/genetics , Humans , Mutation/genetics , Phytanic Acid/analogs & derivatives , Phytanic Acid/metabolism , Prognosis , Signal Transduction
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