RESUMEN
COVID-19 is not only associated with substantial acute liver and kidney injuries, but also with an elevated risk of post-acute sequelae involving the kidney and liver system. We aimed to investigate whether COVID-19 exposure increases the long-term risk of kidney and liver disease, and what are the magnitudes of these associations. We searched PubMed, Embase, Web of Science, ClinicalTrials.gov, and the Living Overview of the Evidence COVID-19 Repository for cohort studies estimating the association between COVID-19 and kidney and liver outcomes. Random-effects meta-analyses were performed to combine the results of the included studies. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Fifteen cohort studies with more than 32 million participants were included in the systematic review COVID-19 was associated with a 35% greater risk of kidney diseases (10 more per 1000 persons; low certainty evidence) and 54% greater risk of liver disease (3 more per 1000 persons; low certainty evidence). The absolute increases due to COVID-19 for acute kidney injury, chronic kidney disease, and liver test abnormality were 3, 8, and 3 per 1000 persons, respectively. Subgroup analyses found no differences between different type of kidney and liver diseases. The findings provide further evidence for the association between COVID-19 and incident kidney and liver conditions. The absolute magnitude of the effect of COVID-19 on kidney and liver outcomes was, however, relatively small.
Asunto(s)
COVID-19 , Hepatopatías , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Hepatopatías/epidemiología , Hepatopatías/etiología , Hepatopatías/virología , Enfermedades Renales/epidemiología , Enfermedades Renales/etiología , Enfermedades Renales/virología , Factores de Riesgo , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/virologíaRESUMEN
BACKGROUND: Molnupiravir has been considered a promising candidate for COVID-19. Its efficacy and safety in non-severe COVID-19 patients and the differences between patients with different risk factors need further evaluation. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials that allocated adult patients with non-severe COVID-19 to molnupiravir or a control. We used random-effects models, and conducted subgroup analyses and meta-regression for COVID-19 patients with high-risk factors. The GRADE approach was used to rate the certainty of evidence. RESULTS: Fourteen trials with 34â570 patients were included. Moderate- to low-certainty evidence showed that molnupiravir was associated with a reduction in the risk of hospitalization (relative risk [RR]â=â0.63, 95% CI: 0.47-0.85), risk of mechanical ventilation (RRâ=â0.37, 95% CI: 0.19-0.72) and time to symptom resolution (mean differences [MD]â=â-2.91 days, 95% CI: -3.66 to -2.16). However, no significant differences were found in adverse events, all-cause mortality, rate of and time to viral clearance, or duration of hospitalization. For the rate of viral clearance, subgroup effects were found between trials with low and high risk of bias (Pâ=â0.001) and between trials with male or female majority (Pâ<â0.001). For admission to hospital, subgroup effects were also found between trials with ≥50% and <50% of the participants being female (Pâ=â0.04). Meta-regression showed a significant association between higher trial mean age and elevated risk of hospitalization (Pâ=â0.011), and female majority and elevated risk of hospitalization (Pâ=â0.011). CONCLUSIONS: Molnupiravir was found to be effective in non-severe COVID-19, but the efficacy varied with age and sex.
Asunto(s)
COVID-19 , Adulto , Humanos , Masculino , Femenino , Ensayos Clínicos Controlados Aleatorios como Asunto , HospitalizaciónRESUMEN
PURPOSE: Malnutrition is highly prevalent in head and neck cancer (HNC) patients, with weight loss being one of the major nutritional indicators. The objective of this study was to investigate the impact of weight loss on treatment interruptions and unplanned hospital admissions in HNC patients undergoing radiotherapy (RT) with or without chemotherapy. METHODS: In this retrospective cohort study, consecutive HNC patients who started RT between January 2011 and December 2019 were included. Data from a total of 1086 subjects with 747 (68.8%) nasopharyngeal carcinomas (NPCs) and 31.2% (N=339) non-NPC patients were analysed. Body weight (BW) was measured before, during, and after RT treatment. Factors associated with ≥10% weight loss, treatment interruption, and unplanned admissions were analysed using multivariate logistic regression. RESULTS: The prevalence of ≥10% weight loss was 26.8% (N=288), with 32.7% (N=243) in NPC and 13.5% (N=45) in non-NPC patients. The prevalence of RT delay in patients with ≥10% vs. <10% weight loss was 6.2% vs. 7.0% (p=0.668) in NPC patients and 42.2% vs. 50.5% (p=0.300) in non-NPC patients. The prevalence of unplanned admissions in patients with ≥10% vs. <10% weight loss was 51.9% vs. 25.3% (p<0.001) in NPC patients and 68.9% vs. 27.0% (p<0.001) in non-NPC patients. CONCLUSION: In our study, ≥10% weight loss was found to be associated with a higher rate of unplanned admissions but not with RT delay or chemotherapy interruption. CLINICAL IMPLICATIONS: With the knowledge of the impact of weight loss on hospital admissions and the characteristics of patients with weight loss, nutritional intervention can be effectively focused on the stratification of patients for intensive nutritional support to reduce weight loss.
Asunto(s)
Neoplasias de Cabeza y Cuello , Pérdida de Peso , Humanos , Estudios Retrospectivos , Hong Kong/epidemiología , Neoplasias de Cabeza y Cuello/radioterapia , HospitalesRESUMEN
Studying the transport of petroleum hydrocarbons in cadmium-/naphthalene-contaminated calcareous soils is crucial to comprehensive assessment of environmental risks and developing appropriate strategies to remediate petroleum hydrocarbons pollution in karst areas. In this study, n-hexadecane was selected as a model petroleum hydrocarbon. Batch experiments were conducted to explore the adsorption behavior of n-hexadecane on cadmium-/naphthalene-contaminated calcareous soils at various pH, and column experiments were performed to investigate the transport and retention of n-hexadecane under various flow velocity. The results showed that Freundlich model better described the adsorption behavior of n-hexadecane in all cases (R2 > 0.9). Under the condition of pH = 5, it was advantageous for soil samples to adsorb more n-hexadecane, and the maximum adsorption content followed the order of: cadmium/naphthalene-contaminated > uncontaminated soils. The transport of n-hexadecane in cadmium/naphthalene-contaminated soils at various flow velocity was well described by two kinetic sites model of Hydrus-1D with R2 > 0.9. Due to the increased electrostatic repulsion between n-hexadecane and soil particles, n-hexadecane was more easily able to breakthrough cadmium/naphthalene-contaminated soils. Compared to low flow velocity (1 mL/min), a higher concentration of n-hexadecane was determined at high flow velocity, with 67, 63, and 45% n-hexadecane in effluent from cadmium-contaminated soils, naphthalene-contaminated soils, and uncontaminated soils, respectively. These findings have important implications for the government of groundwater in calcareous soils from karst areas.
Asunto(s)
Petróleo , Contaminantes del Suelo , Cadmio/análisis , Hidrocarburos , Naftalenos , Suelo/química , Contaminantes del Suelo/análisisRESUMEN
Mitochondrial genome is a powerful molecule marker to explore phylogenetic relationships and reveal molecular evolution in ichthyological studies. Gerres species play significant roles in marine fishery, but its evolution has received little attention. To date, only two Gerres mitochondrial genomes were reported. In the present study, three mitogenomes of Gerres (Gerres filamentosus, Gerres erythrourus, and Gerres decacanthus) were systemically investigated. The lengths of the mitogenome sequences were 16,673, 16,728, and 16,871 bp for G. filamentosus, G. erythrourus, and G. decacanthus, respectively. Most protein-coding genes (PCGs) were initiated with the typical ATG codon and terminated with the TAA codon, and the incomplete termination codon T/TA could be detected in the three species. The majority of AT-skew and GC-skew values of the 13 PCGs among the three species were negative, and the amplitude of the GC-skew was larger than the AT-skew. The genetic distance and Ka/Ks ratio analyses indicated 13 PCGs were suffering purifying selection and the selection pressures were different from certain deep-sea fishes, were which most likely due to the difference in their living environment. The phylogenetic tree was constructed by molecular method (Bayesian Inference (BI) and maximum Likelihood (ML)), providing further supplement to the scientific classification of fish. Three Gerres species were differentiated in late Cretaceous and early Paleogene, and their evolution might link with the geological events that could change their survival environment.
Asunto(s)
Peces/genética , Genoma Mitocondrial/genética , Perciformes/genética , Animales , Teorema de Bayes , Codón/genética , Evolución Molecular , Filogenia , Alimentos MarinosRESUMEN
Electrical Impedance Tomography (EIT) systems have shown great promise in many fields such as real-time wearable healthcare imaging, but their fixed number of electrodes and placement locations limit the system's flexibility and adaptability for further advancement. In this article, we propose a flexible and reconfigurable EIT system (Flexi-EIT) based on digital active electrode (DAE) architecture to address these limitations. By integrating a reconfigurable number of up to 32 replaceable DAEs into the flexible printed circuit (FPC) based wearable electrode belt, we can enable rapid, reliable, and easy placement while maintaining high device flexibility and reliability. We also explore hardware-software co-optimization image reconstruction solutions to balance the size and accuracy of the model, the power consumption, and the real-time latency. Each DAE is designed using commercial chips and fabricated on a printed circuit board (PCB) measuring 13.1 mm × 24.4 mm and weighing 2 grams. In current excitation mode, it can provide programmable sinusoidal current signal output with frequencies up to 100 kHz and amplitudes up to 1 mA p-p that meets IEC 60601-1 standard. In voltage acquisition mode, it can pre-amplify, filter, and digitize the external response voltage signal, improving the robustness of the system while avoiding the need for subsequent analog signal processing circuits. Measured results on a mesh phantom demonstrate that the Flexi-EIT system can be easily configured with different numbers of DAEs and scan patterns to provide EIT measurement frames at 38 fps and real-time EIT images with at least 5 fps, showing the potential to be deployed in a variety of application scenarios and providing the optimal balance of system performance and hardware resource usage solutions.
Asunto(s)
Programas Informáticos , Tomografía , Impedancia Eléctrica , Reproducibilidad de los Resultados , ElectrodosRESUMEN
In recent years, radiomics has emerged as a novel research methodology that plays a crucial role in the diagnosis and treatment of ischemic stroke. By integrating multimodal medical imaging techniques such as computed tomography and magnetic resonance imaging, radiomics offers in-depth insights into aspects such as the extent of brain tissue damage and hemodynamics. These data help physicians to accurately assess patient condition, select optimal treatment strategies, and predict recovery trajectories and long-term prognoses, thereby enhancing treatment efficacy and reducing the risk of complications. With the anticipated further advancements in radiomic technology, this methodology has great potential for expanded applications in the early detection, treatment, and prognosis of ischemic stroke. The present narrative review explores the burgeoning field of radiomics and its transformative impact on ischemic stroke.
Asunto(s)
Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Radiómica , Pronóstico , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Accidente Cerebrovascular/diagnóstico por imagenRESUMEN
Emergency and critical illnesses refer to severe diseases or conditions characterized by rapid changes in health that may endanger life within a short period [...].
RESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Chinese Medicine (TCM) represents a rich repository of empirically-developed traditional medicines. The findings call for more rigorous study into the efficacy, safety, and mechanisms of action of TCM remedies to strengthen the evidence base. AIM OF THE STUDY: To systematically review the quality of insomnia clinical practice guidelines that involve TCM recommendations and to summarize the certainty of evidence supporting the recommendations, strength, and consistency of recommendations, providing valuable research references for the development of future insomnia guidelines. MATERIALS AND METHODS: We systematically searched PubMed, Web of Science, Embase, CNKI, Wanfang, Chinese Biomedical Literature Database, Chinese Medical Association, Chinese Sleep Research Society, Medsci, Medlive, British National Institute of Health and Clinical Excellence (NICE), and the International Guidelines Collaboration Network (GIN) for clinical practice guidelines on insomnia from inception to March 5, 2023. Four evaluators conducted independent assessments of the quality of the guidelines by employing the AGREE II tool. Subsequently, the guideline recommendations were consolidated and presented as evidence maps. RESULTS: Thirteen clinical practice guidelines addressing insomnia, encompassing 211 recommendations (consisting of 127 evidence-based and 84 expert consensus recommendations), were deemed eligible for inclusion in our analysis. The evaluation results revealed an overall suboptimal quality, with the "scope and purpose" domain achieving the highest score (58.1%), while the "applicability" domain garnered the lowest score (13.0%). Specifically, it was observed that 74.8% (n = 95) of the evidence-based recommendations were supported by evidence of either very low or low certainty, in contrast to the expert consensus recommendations, which accounted for 61.9% (n = 52). We subsequently synthesized 44 recommendations into four evidence maps, focusing on proprietary Chinese medicines, Chinese medicine prescriptions, acupuncture, and massage, respectively. Notably, Chinese herbal remedies and acupuncture exhibited robust support, substantiated by high-certainty evidence, exemplified by interventions such as Xuefu Zhuyu decoction, spleen decoction, body acupuncture, and ear acupuncture, resulting in solid recommendations. Conversely, proprietary Chinese medicines needed more high-certainty evidence, predominantly yielding weak recommendations. As for other therapies, the level of certainty was predominantly categorized as low or very low. Recommendations about magnetic therapy, bathing, and fumigation relied primarily on expert consensus, needing more substantive clinical research evidence, consequently forming weak recommendations. Hot ironing and acupoint injection recommendations were weakly endorsed, primarily based on observational studies. Furthermore, interventions like qigong, gua sha, and moxibustion displayed a relatively limited number of clinical studies, necessitating further exploration to ascertain their efficacy. CONCLUSIONS: Our analysis revealed a need for substantial improvement in the quality of all the included guidelines related to insomnia. Notably, recommendations for Traditional Chinese Medicine (TCM) treatments predominantly rely on low-certainty evidence. This study represents a pioneering effort in the utilization of recommendation mapping to both present and identify existing gaps in the evidence landscape within TCM therapies, thus setting the stage for future research initiatives. The evidence supporting TCM therapy recommendations must be fortified to achieve a more substantial level of recommendation and higher certainty. Consequently, there exists a critical and pressing demand for high-quality clinical investigations dedicated to TCM, with a specific focus on ascertaining its long-term efficacy, safety, and potential side effects in the context of insomnia treatment. These endeavors are poised to establish a robust scientific foundation to inform the development of TCM therapy recommendations within the insomnia guidelines.
Asunto(s)
Terapia por Acupuntura , Moxibustión , Qigong , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Medicina Tradicional China , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Guías de Práctica Clínica como Asunto/normasRESUMEN
The emergence of hypervirulent Klebsiella pneumoniae (hvKp) poses a significant public health threat, particularly regarding its carriage in the healthy population. However, the genomic epidemiological characteristics and population dynamics of hvKp within a single patient across distinct infection episodes remain largely unknown. This study aimed to investigate the clonal replacement of hvKp K2-ST881 and K54-ST29 lineage strains in a single patient experiencing multiple-site infections during two independent episodes. Two strains, designated EDhvKp-1 and EDhvKp-2, were obtained from blood and cerebrospinal fluid during the first admission, and the strain isolated from blood on the second admission was named EDhvKp-3. Whole-genome sequencing, utilizing both short-read Illumina and long-read Oxford Nanopore platforms, was conducted. In silico multilocus sequence typing (MLST), identification of antimicrobial resistance and virulence genes, and the phylogenetic relationship between our strains and other K. pneumoniae ST881 and ST29 genomes retrieved from the public database were performed. Virulence potentials were assessed through a mouse lethality assay. Our study indicated that the strains were highly susceptible to multiple antimicrobial agents. Plasmid sequence analysis confirmed that both virulence plasmids, pEDhvKp-1 (166,008 bp) and pEDhvKp-3 (210,948 bp), belonged to IncFIB type. Multiple virulence genes, including rmpA, rmpA2, rmpC, rmpD, iroBCDN, iucABCD, and iutA, were identified. EDhvKp-1 and EDhvKp-2 showed the closest relationship to strain 502 (differing by 51 SNPs), while EDhvKp-3 exhibited 69 SNPs differences compared to strain TAKPN-1, which all recovered from Chinese patients in 2020. In the mouse infection experiment, both ST881 EDhvKp-1 and ST29 EDhvKp-3 displayed similar virulence traits, causing 90 and 100% of the mice to die within 72 h after intraperitoneal infection, respectively. Our study expands the spectrum of hvKp lineages and highlights genomic alterations associated with clonal switching between two distinct lineages of hvKP that successively replaced each other in vivo. The development of novel strategies for the surveillance, diagnosis, and treatment of high-risk hvKp is urgently needed.
RESUMEN
Cardio-metabolic traits have been reported to be associated with the development of sepsis. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability, or are confounded by environmental factors. We performed three analyses to explore the relationships between cardio-metabolic traits and sepsis. Mendelian randomization (MR) study to evaluate the causal effects of multiple cardio-metabolic traits on sepsis. Global genetic correlation analysis to explore the correlations between cardio-metabolic traits and sepsis. Local genetic correlation (GC) analysis to explore shared genetic heritability between cardio-metabolic traits and sepsis. Some loci were further examined for related genes responsible for the causal relationships. Genetic associations were obtained from the UK Biobank data or published large-scale genome-wide association studies with sample sizes between 200,000 to 750,000. In MR, we found causality between BMI and sepsis (OR: 1.53 [1.4-1.67]; p < 0.001). Body mass index (BMI), which is confirmed by sensitivity analyses and multivariable MR adjusting for confounding factors. Global GC analysis showed a significant correlation between BMI and sepsis (rg = 0.55, p < 0.001). More cardio-metabolic traits were identified to be correlated to the sepsis onset such as CRP (rg = 0.37, p = 0.035), type 2 diabetes (rg = 0.33, p < 0.001), HDL (rg = - 0.41, p < 0.001), and coronary artery disease (rg = 0.43, p < 0.001). Local GC revealed some shared genetic loci responsible for the causality. The top locus 1126 was located at chromosome 7 and comprised genes HIBADH, JAZF1, and CREB5. The present study provides evidence for an independent causal effect of BMI on sepsis. Further detailed analysis of the shared genetic heritability between cardio-metabolic traits and sepsis provides the opportunity to improve the preventive strategies for sepsis.
Asunto(s)
Diabetes Mellitus Tipo 2 , Sepsis , Humanos , Estudio de Asociación del Genoma Completo , Diabetes Mellitus Tipo 2/genética , Causalidad , Fenotipo , Sepsis/genética , Análisis de la Aleatorización MendelianaRESUMEN
OBJECTIVE: This study provides a comprehensive overview of the knowledge structure and research hotspots regarding barriers and strategies for the implementation of clinical practice guidelines. METHODS: Publications on barriers and strategies for guideline implementation were searched for on Web of Science Core Collection from database inception to October 24, 2022. R package bibliometrix, VOSviewer, and CiteSpace were used to conduct the analysis. RESULTS: The search yielded 21,768 records from 3,975 journals by 99,998 authors from 3,964 institutions in 186 countries between 1983 and 2022. The number of published papers had a roughly increasing trend annually. The United States, the United Kingdom, and Canada contributed the majority of records. The University of Toronto, the University of Washington, and the University of Sydney were the biggest node in their cluster on the collaboration network map. The three journals that published the greatest number of relevant studies were Implementation Science, BMJ Open, and BMC Health Services Research. Grimshaw JM was the author with the most published articles, and was the second most co-cited author. Research hotspots in this field focused on public health and education, evidence-based medicine and quality promotion, diagnosis and treatment, and knowledge translation and barriers. Challenges and barriers, as well as societal impacts and inequalities, are likely to be key directions for future research. CONCLUSIONS: This is the first bibliometric study to comprehensively summarize the research trends of research on barriers and strategies for clinical practice guideline implementation. A better understanding of collaboration patterns and research hotspots may be useful for researchers. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A247.
RESUMEN
Importance: Large language models (LLMs) may facilitate the labor-intensive process of systematic reviews. However, the exact methods and reliability remain uncertain. Objective: To explore the feasibility and reliability of using LLMs to assess risk of bias (ROB) in randomized clinical trials (RCTs). Design, Setting, and Participants: A survey study was conducted between August 10, 2023, and October 30, 2023. Thirty RCTs were selected from published systematic reviews. Main Outcomes and Measures: A structured prompt was developed to guide ChatGPT (LLM 1) and Claude (LLM 2) in assessing the ROB in these RCTs using a modified version of the Cochrane ROB tool developed by the CLARITY group at McMaster University. Each RCT was assessed twice by both models, and the results were documented. The results were compared with an assessment by 3 experts, which was considered a criterion standard. Correct assessment rates, sensitivity, specificity, and F1 scores were calculated to reflect accuracy, both overall and for each domain of the Cochrane ROB tool; consistent assessment rates and Cohen κ were calculated to gauge consistency; and assessment time was calculated to measure efficiency. Performance between the 2 models was compared using risk differences. Results: Both models demonstrated high correct assessment rates. LLM 1 reached a mean correct assessment rate of 84.5% (95% CI, 81.5%-87.3%), and LLM 2 reached a significantly higher rate of 89.5% (95% CI, 87.0%-91.8%). The risk difference between the 2 models was 0.05 (95% CI, 0.01-0.09). In most domains, domain-specific correct rates were around 80% to 90%; however, sensitivity below 0.80 was observed in domains 1 (random sequence generation), 2 (allocation concealment), and 6 (other concerns). Domains 4 (missing outcome data), 5 (selective outcome reporting), and 6 had F1 scores below 0.50. The consistent rates between the 2 assessments were 84.0% for LLM 1 and 87.3% for LLM 2. LLM 1's κ exceeded 0.80 in 7 and LLM 2's in 8 domains. The mean (SD) time needed for assessment was 77 (16) seconds for LLM 1 and 53 (12) seconds for LLM 2. Conclusions: In this survey study of applying LLMs for ROB assessment, LLM 1 and LLM 2 demonstrated substantial accuracy and consistency in evaluating RCTs, suggesting their potential as supportive tools in systematic review processes.
Asunto(s)
Sesgo , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Reproducibilidad de los Resultados , Lenguaje , Medición de Riesgo/métodosRESUMEN
Dopamine was used to modify polytetrafluoroethylene (PTFE) in order to obtain functional polydopamine (PDA) surface-modified PTFE microporous film (PTFE@PDA). Ag was deposited on the surface of PTFE@PDA using electroless plating in order to obtain Ag-wrapped PTFE@PDA film (PTFE@Ag). A liquid-phase chemical reduction method was employed to prepare nickel nanochains. A Ni@PVDF cast film was obtained by mechanically blended nickel nanochains and polyimide (PVDF). The above two films were hot pressed to give a flexible, ultra-thin, and highly effective electromagnetic shielding composite film with a "3+2" layered structure. IR, XRD, and TEM results showed the PTFE@PDA film surface was coated by a tight plating layer of Ag particles with a particle size of 100~200 nm. PTFE@Ag+Ni@PVDF composite film exhibited excellent electromagnetic shielding effectiveness, with the conductivity of 7507.5 S/cm and the shielding effectiveness of 69.03 dB in the X-band range. After a 2000-cycle bending, this value still remained at 51.90 dB. Furthermore, the composite film presented excellent tensile strength of 62.1 MPa. It has great potential for applications in flexible and wearable intelligent devices.
RESUMEN
After germination, plants go through two phases of vegetative development - juvenile and adult - before entering the reproductive phase. These phases have varying characteristics and timing across plant species, making it challenging to determine if different vegetative traits correspond to the same or distinct developmental processes. miR156 has been identified as the primary regulator of vegetative phase change in plants, with the miR156-SPLs (SQUAMOSA Promoter Binding Protein-Likes) module playing a crucial role in regulating age-related agronomic traits in various crops. Such traits include disease resistance, optimal plant breeding, and secondary metabolism regulation. However, it is unknown whether miR156-SPLs contribute to the critical agronomic traits of pepper (Capsicum annuum L.). Thus, this study seeks to identify miR156 and SPLs genes in pepper, analyze their evolutionary links with model plants, and confirm their expression patterns using gene expression assays. The study also examines the relationship between miR156 expression levels in two cultivars of pepper and specific traits associated with the juvenile-to-adult transition. The results indicate that leaf shape and the number of leaf veins are correlated to the timing expression of miR156. Our study represents an important resource for identifying age-dependent agronomic traits in pepper and lays the foundation for future systematic regulation of miR156-SPLs to advance pepper development.
Asunto(s)
Capsicum , MicroARNs , Capsicum/genética , Capsicum/metabolismo , MicroARNs/genética , MicroARNs/metabolismo , Fitomejoramiento , Hojas de la Planta/genética , Hojas de la Planta/metabolismo , Regiones Promotoras Genéticas , Regulación de la Expresión Génica de las PlantasRESUMEN
PURPOSE: Various studies have analyzed sepsis subtypes, yet the reproducibility of such results remains unclear. This study aimed to determine the reproducibility of sepsis subtypes across multiple cohorts. METHODS: The study examined 63,547 sepsis patients from six distinct cohorts who had similar sepsis-related characteristics (vital signs, lactate, sequential organ failure assessment score, bilirubin, serum, urine output, and Glasgow coma scale). Identical cluster analysis techniques were used, employing 27 clustering schemes, and normalized mutual information (NMI), a metric ranging from 0 to 1 with higher values indicating better concordance, was employed to quantify the clustering solutions' reproducibility. Principal component analysis (PCA) was utilized to obtain the disease axis, and its uniformity across cohorts was evaluated through patterns of feature loading and correlation. RESULTS: The reproducibility of sepsis clustering subtypes across the various studies was modest (median NMI ranging from 0.08 to 0.54). The top-down transfer learning method (model trained on cohorts with greater severity was transferred to cohorts with lower severity score) had a higher NMI value than the bottom-up approach (median [Q1, Q3]: 0.64 [0.49, 0.78] vs. 0.23 [0.2, 0.31], p < 0.001). The reproducibility was greater when the transfer solution was performed within United States (US) cohorts. The PCA analysis revealed that the correlation pattern between variables was consistent across all cohorts, and the first two disease axes were the "shock axis" and "systemic inflammatory response syndrome (SIRS) axis." CONCLUSIONS: Cluster analysis of sepsis patients across various cohorts showed modest reproducibility. Sepsis heterogeneity is better characterized through continuous disease axes that coexist to varying degrees within the same individual instead of mutually exclusive subtypes.
Asunto(s)
Sepsis , Humanos , Reproducibilidad de los Resultados , Sepsis/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Puntuaciones en la Disfunción de Órganos , Estudios RetrospectivosRESUMEN
Sepsis is a complex and heterogeneous syndrome that remains a serious challenge to healthcare worldwide. Patients afflicted by severe sepsis or septic shock are customarily placed under intensive care unit (ICU) supervision, where a multitude of apparatus is poised to produce high-granularity data. This reservoir of high-quality data forms the cornerstone for the integration of AI into clinical practice. However, existing reviews currently lack the inclusion of the latest advancements. This review examines the evolving integration of artificial intelligence (AI) in sepsis management. Applications of artificial intelligence include early detection, subtyping analysis, precise treatment and prognosis assessment. AI-driven early warning systems provide enhanced recognition and intervention capabilities, while profiling analyzes elucidate distinct sepsis manifestations for targeted therapy. Precision medicine harnesses the potential of artificial intelligence for pathogen identification, antibiotic selection, and fluid optimization. In conclusion, the seamless amalgamation of artificial intelligence into the domain of sepsis management heralds a transformative shift, ushering in novel prospects to elevate diagnostic precision, therapeutic efficacy, and prognostic acumen. As AI technologies develop, their impact on shaping the future of sepsis care warrants ongoing research and thoughtful implementation.
RESUMEN
The complete mitochondrial genome (mitogenome) of Miroplana shenzhensis Yu & Wang, 2013 is reported in the present study, representing the second mitogenome recorded in the suborder Maricola. The circular mitogenome is 14,344 bp in length, containing 12 protein-coding genes, 2 ribosomal RNAs and 22 transfer RNAs. Comparative analysis on mitochondrial gene order reveals a rearrangement in the suborder Maricola, indicating that mitochondrial gene order is conserved only in Continenticola, and is divergent across Tricladida. Phylogenetic analysis shows M. shenzhensis is clustered with an another marine triclad, forming a well-supported monophyletic group of Maricloan.