RESUMO
ConspectusThe development of catalytic activation modes provides a reliable and effective platform for designing new enantioselective reactions and preparing chiral molecules with diverse structures. Chiral aldehyde catalysis is an attractive concept in asymmetric catalysis, which utilizes a chiral aldehyde catalyst to promote the asymmetric hydroamination of allylic amines, the asymmetric α-functionalization of primary amines, or the asymmetric transamination of α-keto esters. Typically, the chiral aldehyde-catalyzed asymmetric α-functionalization of primary amines provides an efficient and straightforward method for the synthesis of α-functionalized chiral amines, which does not require any additional protection or deprotection manipulations of the amine group. However, achieving catalytic stereoselective transformations with high efficiency and enantioselectivity by this strategy has remained an intractable challenge.This Account summarizes our endeavors in the development and application of chiral aldehyde catalysis. Using a chiral aldehyde as a catalyst, we reported the catalytic asymmetric α-C alkylation of 2-aminomalonate with 3-indolylmethanol in 2014, which represents the first chiral aldehyde-catalyzed asymmetric α-functionalization of an activated primary amine. Subsequently, several axially chiral aldehyde catalysts were continuously prepared by using chiral BINOL as the starting material, and their applications in asymmetric synthesis were explored. On the one hand, they were used as organocatalysts to realize the various transformations of α-amino acid esters, such as asymmetric 1,4-addition toward conjugated enones/α,ß-unsaturated diesters and cyclic 1-azadienes as well as asymmetric α-arylation/allylation and benzylation with corresponding halohydrocarbons. Notably, taking advantage of the difference in the distribution of catalytic sites between two chiral aldehyde catalysts, we disclosed chiral aldehyde-catalyzed diastereodivergent 1,6-conjugated addition and Mannich reactions. On the other hand, the potential for the cooperative catalysis of a chiral aldehyde with a transition metal has also been demonstrated. Enabled by the combination of a chiral aldehyde, a palladium complex, and a Lewis acid, the enantioselective α-allylation of amino acid esters with allyl alcohol esters was established. Moreover, the ternary catalytic system has been successfully used for the α-functionalization of amino acid esters with 1,3-dienes, allenes, allenylic alcohol esters, 1,3-disubstituted allyl alcohol esters, and arylmethanol esters as well as the asymmetric cascade Heck-alkylation reaction. The combination of a chiral aldehyde and nickel complex allows for the asymmetric α-propargylation of amino acid esters with propargylic alcohol esters and provides excellent enantioselectivities. These transformations provide a large library of optically active amines and amino acids. With those chiral amino acid esters as key building blocks, the synthesis or formal synthesis of multiple natural products and biologically significant unnatural molecules was accomplished. This includes the stereodivergent synthesis of natural pyrrolizidine alkaloid NP25302 and the formal synthesis of natural product (S)-hypoestestatin 1 and manzacidin C, clinical candidate compound (+)-AG-041R, and somatostatin mimetics. It is fully anticipated that chiral aldehyde catalysis will soon witness rapid expansion both in the development of novel asymmetric transformations and in innovative applications for constructing optically active nitrogen-containing molecules with significant values.
RESUMO
Liquid metal (LM) nanodroplets possess intriguing surface properties, thus offering promising potential in chemical synthesis, catalysis, and biomedicine. However, the reaction kinetics and product growth at the surface of LM nanodroplets are significantly influenced by the interface involved, which has not been thoroughly explored and understood. Here, we propose an interface engineering strategy, taking a spontaneous galvanic reaction between Ga0 and AuCl4- ions as a representative example, to successfully modulate the growth of heterostructures on the surface of Ga-based LM nanodroplets by establishing a dielectric interface with a controllable thickness between LM and reactive surroundings. Combining high-resolution electron energy-loss spectroscopy (EELS) analysis and theoretical simulation, it was found that the induced charge distribution at the interface dominates the spatiotemporal distribution of the reaction sites. Employing tungsten oxide (WOx) with varying thicknesses as the demonstrated dielectric interface of LM, Ga@WOx@Au with distinct core-shell-satellite or dimer-like heterostructures has been achieved and exhibited different photoresponsive capabilities for photodetection. Understanding the kinetics of product growth and the regulatory strategy of the dielectric interface provides an experimental approach to controlling the structure and properties of products in LM nanodroplet-involved chemical processes.
RESUMO
BACKGROUND: In the American population, the relationship between the triglyceride-glucose (TyG) index and TYG combined with indicators of obesity and cardiovascular disease (CVD) and its mortality has been less well studied. METHODS: This cross-sectional study included 11,937 adults from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Cox proportional hazards model, binary logistic regression analyses, restricted cubic spline (RCS), and receiver operating characteristic (ROC) were used to analyze the relationship between TyG and its combined obesity-related indicators and CVD and its mortality. Mediation analysis explored the mediating role of glycated hemoglobin and insulin in the above relationships. RESULTS: In this study, except for no significant association between TyG and CVD mortality, TyG, TyG-WC, TyG-WHtR, and TyG-BMI were significantly and positively associated with CVD and CVD mortality. TyG-WHtR is the strongest predictor of CVD mortality (HR 1.66, 95% CI 1.21-2.29). The TyG index correlated better with the risk of coronary heart disease (OR 2.52, 95% CI 1.66-3.83). TyG-WC correlated best with total CVD (OR 2.37, 95% CI 1.77-3.17), congestive heart failure (OR 2.14, 95% CI 1.31-3.51), and angina pectoris (OR 2.38, 95% CI 1.43-3.97). TyG-WHtR correlated best with myocardial infarction (OR 2.24, 95% CI 1.45-3.44). RCS analyses showed that most of the above relationships were linear (P-overall < 0.0001, P-nonlinear > 0.05). Otherwise, ROC curves showed that TyG-WHtR and TyG-WC had more robust diagnostic efficacy than TyG. In mediation analyses, glycated hemoglobin mediated in all the above relationships and insulin-mediated in partial relationships. CONCLUSIONS: TyG-WC and TyG-WtHR enhance CVD mortality prediction, diagnostic efficacy of CVD and its mortality, and correlation with some CVD over and above the current hottest TyG. TyG-WC and TyG-WtHR are expected to become more effective metrics for identifying populations at early risk of cardiovascular disease and improve risk stratification.
Assuntos
Doenças Cardiovasculares , Adulto , Humanos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Hemoglobinas Glicadas , Inquéritos Nutricionais , Insulina , Glucose , Obesidade/diagnóstico , Obesidade/epidemiologia , TriglicerídeosRESUMO
INTRODUCTION: This study examines the associations of gum treatment with cognitive decline and dementia risk among older adults with periodontal symptoms in the USA. METHODS: A cohort of 866 adults aged ≥50 with periodontal symptoms was recruited for the 2008 Health and Retirement Study "Dental Health Experimental Module" and followed until 2020. Cognitive function was assessed with the Telephone Interview for Cognitive Status (TICS). Dementia status was ascertained with the Langa-Weir algorithm based on TICS scores and proxy assessments. Linear mixed-effects model and multivariable Cox regression models were utilized to analyze the associations of gum treatment with cognitive decline and the risk of dementia, respectively. RESULTS: Of 866 participants (mean age 67.7, 61.4% women), 105 (12.1%) developed dementia with a median follow-up of 9 (IQR, 6-10) years. The dementia incidence rates were lower in the group with gum treatment (7.4 vs. 12.9 per 1,000 person-years). Compared with participants who did not have gum treatment, those with gum treatment experienced a decline in TICS score that was on average 0.025 (95% CI, 0.005-0.044) points less per year and a 38% lower incidence of dementia (hazard ratio, 0.62; 95% CI, 0.41-0.93). These associations were consistent across participants with a different severity of periodontal symptoms and sociodemographic characteristics (age, sex, race, ethnicity, and education) except for income levels. CONCLUSION: Prompt gum treatment for older adults with periodontal symptoms may be beneficial for their cognitive health.
RESUMO
BACKGROUND: Information on the influences of daily eating frequency (DEF) and nighttime fasting duration (NFD) on biological aging is minimal. Our study investigated the potential associations of DEF and NFD with accelerated aging. METHODS: Out of 24212 participants in NHANES 2003-2010 and 2015-2018, 4 predicted age metrics [homeostatic dysregulation (HD), Klemera-Doubal method (KDM), phenoAge (PA), and allostatic load (AL)] were computed based on 12 blood chemistry parameters. Utilizing 24-h dietary recall, DEF was measured by the frequency of eating occurrences, while NFD was determined by assessing the timing of the initial and final meals throughout the day. Weighted multivariate linear regression models and restricted cubic spline (RCS) were utilized to examine the associations. RESULTS: Compared to DEF of ≤ 3.0 times, subjects with DEF ≥ 4.6 times demonstrated lower KDM residual [ß: -0.57, 95% confidence-interval (CI): (-0.97, -0.17)] and PA residual [ß: -0.47, 95% CI: (-0.69, -0.25)]. In comparison to NFD between 10.1 and 12.0 h, individuals with NFD ≤ 10.0 h were at higher HD [ß: 0.03, 95% CI: (0.01, 0.04)], KDM residual [ß: 0.34, 95% CI: (0.05, 0.63)], and PA residual [ß: 0.38, 95% CI: (0.18, 0.57)]. Likewise, those with NFD ≥ 14.1 h also had higher HD [ß: 0.02, 95% CI: (0.01, 0.04)] and KDM residual [ß: 0.33, 95% CI: (0.03, 0.62)]. The results were confirmed by the dose-response relationships of DEF and NFD with predicted age metrics. Lactate dehydrogenase (LDH) and globulin (Glo) were acknowledged as implicated in and mediating the relationships. CONCLUSIONS: DEF below 3.0 times and NFD less than 10.0 or more than 14.1 h were independently associated with higher predicted age metrics.
Assuntos
Envelhecimento , Jejum , Comportamento Alimentar , Inquéritos Nutricionais , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Envelhecimento/fisiologia , Idoso , Fatores de Tempo , Estados Unidos , Estudos TransversaisRESUMO
Wastewater treatment contributes substantially to methane (CH4) emissions, yet monitoring and tracing face challenges because the treatment processes are often treated as a "black box". Particularly, despite growing interest, the amount of CH4 carryover and influx from the sewer and its impacts on overall emissions remain unclear. This study quantified CH4 emissions from six wastewater treatment plants (WWTPs) across China, utilizing existing multizonal odor control systems, with a focus on Beijing and Guiyang WWTPs. In the Beijing WWTP, almost 90% of CH4 emissions from the wastewater treatment process were conveyed through sewer pipes, affecting emissions even in the aerobic zone of biological treatment. In the Guiyang WWTP, where most CH4 from the sewer was released at the inlet well, a 24 h online monitoring revealed CH4 fluctuations linked to neighborhood water consumption and a strong correlation to influent COD inputs. CH4 emission factors monitored in six WWTPs range from 1.5 to 13.4 gCH4/kgCODrem, higher than those observed in previous studies using A2O technology. This underscores the importance of considering CH4 influx from sewer systems to avoid underestimation. The odor control system in WWTPs demonstrates its potential as a cost-effective approach for tracing, monitoring, and mitigating CH4.
Assuntos
Metano , Esgotos , Águas Residuárias , Metano/análise , Águas Residuárias/química , Eliminação de Resíduos Líquidos , China , Monitoramento AmbientalRESUMO
CONTEXT: Water intake in drinks and food is essential for life. Multiple guidelines exist to help give recommendations for healthy water intake and urine output, but few of these are specific to patients with lower urinary tract symptoms. METHODS: A debate held at the International Consultation on Incontinence-Research Society meeting, held in Bristol in June 2024, considered ways to improve this situation. RESULTS AND CONCLUSION: There are challenges in measuring both total water intake and also urine output, but we suggest that urine output may be the most helpful measure to focus on for future guidelines for patients.
RESUMO
AIMS: The integration of artificial intelligence (AI) into functional urology management must be assessed for its clinical utility, but hopefully will change, perhaps to revolutionize the way LUTD and other conditions are assessed, the aim being to offer patients more rapid and effective management which enhances patient outcomes. The aim of this proposal, discussed at the ICI-RS annual meeting, is to evaluate the available evidence on AI and the way it might change the approach to urodynamic (UDS) diagnoses, including overactive bladder syndrome (OAB), and perhaps other LUTDs such as bladder outflow obstruction. METHODS: A compendium of discussion based on the current evidence related to AI and its potential applications in UDS and OAB. RESULTS: AI-powered diagnostic tools are being developed to analyze complex datasets from urodynamic studies, imaging, and other diagnostic tests. AI systems can leverage large volumes of clinical data to recommend personalized treatment plans based on individual patient profiles to optimize surgical procedures, enhance diagnostic precision, tailor the therapy, reduce the risk of complications, and improve outcomes. In the future, AI will be able to provide tailored counseling regarding the outcomes and potential side effects of drugs and procedures to a given patient. CONCLUSION: AI's role in functional urology has been poorly investigated, and its implementation across several areas may improve clinical care and the pathophysiological understanding of functional urologic conditions.
RESUMO
In recent years, doping engineering, which is widely studied in theoretical and experimental research, is an effective means to regulate the crystal structure and physical properties of two-dimensional materials and expand their application potential. Based on different types of element dopings, different 2D materials show different properties and applications. In this paper, the characteristics and performance of rich layered 2D materials under different types of doped elements are comprehensively reviewed. Firstly, 2D materials are classified according to their crystal structures. Secondly, conventional experimental methods of charge doping and heterogeneous atom substitution doping are summarized. Finally, on the basis of various theoretical research results, the properties of several typical 2D material representatives under charge doping and different kinds of atom substitution doping as well as the inspiration and expansion of doping systems for the development of related fields are discussed. Through this review, researchers can fully understand and grasp the regulation rules of different doping engineering on the properties of layered 2D materials with different crystal structures. It provides theoretical guidance for further improving and optimizing the physical properties of 2D materials, improving and enriching the relevant experimental research and device application development.
RESUMO
With the ability to generate in situ real-time electric signals, electrochemically active biofilm (EAB) sensors have attracted wide attention as a promising water biotoxicity early-warning device. Organic matters serving as the electron donors potentially affect the electric signal's output and the sensitivity of the EAB sensor. To explore the influence of organic matters on EAB sensor's performance, this study tested six different organic matters during the sensor's inoculation. Besides the acetate, a conventional and widely used organic matter, propionate and lactate were also found capable of starting up the sensor. Moreover, the propionate-fed (PF) sensor delivered the highest sensitivity, which are respectively 1.4 times and 2.8 times of acetate-fed (AF) sensor and lactate-fed (LF) sensor. Further analysis revealed that EAB of PF sensor had more vulnerable intracellular metabolism than the others, which manifested as the most severe energy metabolic suppression and reactive oxygen species attack. Regarding the microbial function, a two-component system that was deemed as an environment awareness system was found in the EAB of PF, which also contributed to its high sensitivity. Finally, PF sensor was tested in real water environment to deliver early-warning signals.
Assuntos
Acetatos , Biofilmes , Técnicas Eletroquímicas , Propionatos , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Técnicas Eletroquímicas/instrumentação , Técnicas Eletroquímicas/métodos , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodosRESUMO
BACKGROUND: Healthy dietary patterns have been negatively associated with methylation-based measures of biological age, yet previous investigations have been unable to establish the relationship between them and biological aging assessed through blood chemistry-based clinical biomarkers. We sought to assess the associations of 4 dietary metrics with 4 measures of biological age. METHODS: Among 16,666 participants in NHANES 1999-2018, 4 dietary metrics [Dietary inflammatory index (DII), Dietary approaches to stop hypertension index (DASH), Alternate mediterranean diet score (aMED), and Healthy eating index-2015 (HEI-2015)] were calculated through the 'dietaryindex' R package. Twelve blood chemistry parameters were utilized to compute 4 indicators of biological age [homeostatic dysregulation (HD), allostatic load (AL), Klemera-Doubal method (KDM), and phenotypic age (PA)]. Binomial logistic regression models and restricted cubic spline (RCS) regression were employed to evaluate the associations. RESULTS: All 4 dietary metrics were significantly associated with biological age acceleration or deceleration. In comparison to the lowest DII, the odds ratios (ORs) for accelerated HD, AL, KDM, and PA were 1.25 (1.08,1.45), 1.29 (1.11,1.50), 1.34 (1.08,1.65), and 1.61 (1.39,1.87) for the highest. The multivariable-adjusted ORs of the highest quartile of DASH, aMED, and HEI-2015 were 0.85 (0.73,0.97), 0.88 (0.74,1.04), and 0.84 (0.74,0.96) for HD, 0.64 (0.54,0.75), 0.61 (0.52,0.72), and 0.70 (0.59,0.82) for AL, 0.68 (0.54,0.85), 0.62 (0.50,0.76), and 0.71 (0.58,0.87) for KDM, and 0.50 (0.42,0.59), 0.64 (0.54,0.76), and 0.51 (0.44,0.58) for PA when compared with the lowest level. The findings were validated by the best-fitting dose-response curves for the associations. Among participants consuming dietary supplements (Pinteraction < 0.05), the positive effects of a healthy dietary pattern on biological aging were more pronounced. Systemic immune inflammation index (SII) and atherogenic index of plasma (AIP) were identified as being involved in and mediating the associations. CONCLUSIONS: Biological aging assessed through blood chemistry-based clinical biomarkers is negatively associated with diet quality. The anti-aging benefits of improving the diet may be due to its ability to reduce inflammation and lower blood lipids.
Assuntos
Envelhecimento , Dieta Saudável , Inquéritos Nutricionais , Humanos , Masculino , Feminino , Dieta Saudável/métodos , Dieta Saudável/estatística & dados numéricos , Inquéritos Nutricionais/métodos , Inquéritos Nutricionais/estatística & dados numéricos , Envelhecimento/fisiologia , Pessoa de Meia-Idade , Adulto , Idoso , Biomarcadores/sangue , Abordagens Dietéticas para Conter a Hipertensão/métodos , Abordagens Dietéticas para Conter a Hipertensão/estatística & dados numéricos , Estados UnidosRESUMO
BACKGROUND: Alopecia significantly affects the mental health and social relationship of women since childbearing age, highlighting the need for a safe, effective, and convenient treatment. METHODS: The authors have conducted a prospective self-controlled trial involving 15 female patients at childbearing age with alopecia. These patients received a subcutaneous scalp injection of platelet-rich plasma once every 4 weeks for 3 treatments in total. Outcome measurements were included below: changes in hair density (hair/cm 2 ), hair follicle density (hair follicle/cm 2 ), and overall photographic assessment (improved or not) at 4, 12, and 24 weeks right after the first treatment. RESULTS: Comparing the photographs taken before and after the intervention, 67% of patients' hair density increased from 151 ± 39.82 hairs/cm 2 (preintervention) to 170.96 ± 37.14 hairs/cm 2 (at 24-week follow-up), representing an approximate increase of 19 hairs/cm 2 . Meanwhile, hair follicle density increased by approximately 15 follicles/cm 2 after 24 weeks since the first treatment, rising from 151.04 ± 41.99 follicles/cm 2 to 166.72 ± 37.13 follicles/cm 2 . The primary adverse reactions observed were local swelling and pain due to injections. CONCLUSION: Local injection of nonactivated platelet-rich plasma with low leukocytes concentration could be an effective strategy to alleviate alopecia symptoms in female patients.
Assuntos
Alopecia , Plasma Rico em Plaquetas , Humanos , Feminino , Alopecia/terapia , Estudos Prospectivos , Adulto , Folículo Piloso , Adulto Jovem , Injeções Subcutâneas , Resultado do Tratamento , Couro Cabeludo , CabeloRESUMO
AIM: To evaluate the association between oral hygiene behaviour and cognitive decline in adults. The outcomes include changes in global cognitive function, visual attention, task switching and the risk of dementia. DESIGN: We conducted a systematic review following the preferred reporting items for systematic reviews and meta-analyses guidelines. DATA SOURCES: A systematic search of 11 databases and grey literature sources was conducted from inception to January 2024. We included interventional trials or cohort studies that investigated the effect of oral hygiene behaviours (e.g., toothbrushing, mouth washing, flossing, using toothpicks and cleaning dentures) on cognitive decline in adults. METHODS: Data extraction and risk of bias assessment were performed by two independent reviewers with expertise in conducting systematic reviews. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed with the I2 statistic and χ2 test. RESULTS: A total of eight studies (six intervention studies and two cohort studies) met inclusion criteria, including 261,772 participants. Follow-up periods ranged from 30 days to 48 months for interventions and 9 to 18 years for cohorts. Toothbrushing was associated with a significantly slower decline in global cognitive overtime. Toothbrushing in older adults with moderate/severe dementia could achieve significant changes in cognitive decline. There was no significant difference between the effectiveness of toothbrushing performed by professionals and caregivers. Other oral hygiene behaviours, including dental flossing, using mouthwash, using toothpicks and cleaning dentures, were not associated with the risk of dementia. CONCLUSIONS: Toothbrushing is linked to a decreased risk of dementia and improved global cognitive function. Promoting toothbrushing at least twice daily may significantly reduce the risk of cognitive decline and dementia. IMPACT: These findings highlight the urgent need for programmes that encourage daily toothbrushing, particularly in nursing home settings and among older adults with moderate-to-severe dementia.
RESUMO
Recently, halide perovskites (HPs) and layered two-dimensional (2D) materials have received significant attention from industry and academia alike. HPs are emerging materials that have exciting photoelectric properties, such as a high absorption coefficient, rapid carrier mobility and high photoluminescence quantum yields, making them excellent candidates for various optoelectronic applications. 2D materials possess confined carrier mobility in 2D planes and are widely employed in nanostructures to achieve interfacial modification. HP/2D material interfaces could potentially reveal unprecedented interfacial properties, including light absorbance with desired spectral overlap, tunable carrier dynamics and modified stability, which may lead to several practical applications. In this review, we attempt to provide a comprehensive perspective on the development of interfacial engineering of HP/2D material interfaces. Specifically, we highlight the recent progress in HP/2D material interfaces considering their architectures, electronic energetics tuning and interfacial properties, discuss the potential applications of these interfaces and analyze the challenges and future research directions of interfacial engineering of HP/2D material interfaces. This review links the fields of HPs and 2D materials through interfacial engineering to provide insights into future innovations and their great potential applications in optoelectronic devices.
RESUMO
This study aimed to examine and compare the associations between education, social media use, and advance care planning (ACP) discussion among Chinese older adults in mainland China (Wuhan), Taiwan (Taichung), and the United States (Honolulu). Community-dwelling older adults (≥ 55) were recruited from 2017 to 2018. The ACP discussion rate in Wuhan, Taichung, and Honolulu were 15.2 %, 19.2 %, and 31.3 %, respectively. Logistic regression models revealed that education was positively associated with ACP discussion in Taichung and Honolulu. Social media use was positively associated with ACP discussions in Wuhan and Honolulu, and it attenuated the association between education and ACP discussion in Honolulu. The present study contributes to previous studies by comparing the associations between education, social media use, and ACP discussion in different settings within the same ethnicity. Policy and practice implications were also discussed.
Assuntos
Planejamento Antecipado de Cuidados , Mídias Sociais , Humanos , Estados Unidos , Idoso , Escolaridade , Etnicidade , ChinaRESUMO
OBJECTIVE: To evaluate the impact of a function-focused multicomponent exercise program on long-term nursing home (LTNH) residents' ability to maintain activities of daily living (ADL), physical performance, cognitive function, quality of life, and frailty. METHODS: This multicenter single-group pre-post quasi-experimental study involved 148 participants from 16 LTNHs in Gipuzkoa, Spain. Participants underwent a twice-weekly, 6-month function-focused multicomponent exercise program and were assessed both before and after the intervention. RESULTS: Following the intervention, participants significantly maintained ADL ability, improved physical performance and quality of life, and reduced frailty (all p < 0.05). Cognitive function showed a positive trend. Subgroup analysis showed consistent improvements across demographics and health variables. CONCLUSIONS: The exercise program effectively maintained or improved ability to perform ADL, cognitive function, physical performance, and quality of life while reducing frailty in LTNH residents, irrespective of individual characteristics. This highlights the importance of exercise interventions to preserve overall function and wellbeing in this population. TRIAL REGISTRATION: NCT04221724.
RESUMO
Few studies have compared pain management provided by informal and formal caregivers of older adults in China at the end of life. This study aims to address this gap by investigating the association between formal and informal care and painfulness at the end of life among older adults in China. Specifically, the study focuses on the influence of various types of informal care. Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018, which is the largest nationally representative study of older adults in China, with a sample size of 21,849 deceased participants. Results from multiple logistic regressions suggest that informal care is associated with a more painful end-of-life experience compared to formal care, with care provided by adult children being a more favorable option within informal care. These findings underscore the urgent need to prioritize education on death and dying, improve the formal care system, and enhance professionalism within informal care.
RESUMO
Chronic airway inflammation mediated by CD8+ T lymphocytes contributes to the pathogenesis of Chronic obstructive pulmonary disease (COPD). Deciphering the fingerprint of the chronic inflammation orchestrated by CD8+ T cells may allow the development of novel approaches to COPD management. Here, the expression of IL-27 and IFN-γ+ CD8+ Tc1 cells were evaluated in patients with COPD and in cigarette smoke-exposed mice. The production of IL-27 by marrow-derived dendritic cells (mDCs) in response to cigarette smoke extract (CSE) was assessed. The role of IL-27 in IFN-γ+ CD8+ Tc1 cells was explored. We demonstrated that elevated IL-27 was accompanied by an exaggerated IFN-γ+ CD8+ Tc1 response in a smoking mouse model of emphysema. We noted that lung dendritic cells were one of the main sources of IL-27 during chronic cigarette smoke exposure. Moreover, CSE directly induced the production of IL-27 by mDCs in vitro. IL-27 negatively regulated the differentiation of IFN-γ+ CD8+ Tc1 cells isolated from cigarette smoke-exposed mice in a STAT1- and STAT3-independent manner. Systemic administration of recombinant IL-27 attenuated IFN-γ+ CD8+ Tc1 response in the late phase of cigarette smoke exposure. Our results uncovered that IL-27 negatively regulates IFN-γ+ CD8+ Tc1 response in the late stage of chronic cigarette smoke exposure, which may provide a new strategy for the anti-inflammatory treatment of smoking-related COPD/emphysema.
Assuntos
Diferenciação Celular , Fumar Cigarros , Interferon gama , Interleucinas , Enfisema Pulmonar , Linfócitos T Citotóxicos , Idoso , Animais , Feminino , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Diferenciação Celular/imunologia , Fumar Cigarros/efeitos adversos , Fumar Cigarros/imunologia , Modelos Animais de Doenças , Inflamação/etiologia , Inflamação/imunologia , Interferon gama/imunologia , Interleucinas/imunologia , Enfisema Pulmonar/etiologia , Enfisema Pulmonar/imunologia , Linfócitos T Citotóxicos/imunologiaRESUMO
BACKGROUND AND AIMS: Although many studies revealed transcriptomic subtypes of HCC, concordance of the subtypes are not fully examined. We aim to examine a consensus of transcriptomic subtypes and correlate them with clinical outcomes. APPROACH AND RESULTS: By integrating 16 previously established genomic signatures for HCC subtypes, we identified five clinically and molecularly distinct consensus subtypes. STM (STeM) is characterized by high stem cell features, vascular invasion, and poor prognosis. CIN (Chromosomal INstability) has moderate stem cell features, but high genomic instability and low immune activity. IMH (IMmune High) is characterized by high immune activity. BCM (Beta-Catenin with high Male predominance) is characterized by prominent ß-catenin activation, low miRNA expression, hypomethylation, and high sensitivity to sorafenib. DLP (Differentiated and Low Proliferation) is differentiated with high hepatocyte nuclear factor 4A activity. We also developed and validated a robust predictor of consensus subtype with 100 genes and demonstrated that five subtypes were well conserved in patient-derived xenograft models and cell lines. By analyzing serum proteomic data from the same patients, we further identified potential serum biomarkers that can stratify patients into subtypes. CONCLUSIONS: Five HCC subtypes are correlated with genomic phenotypes and clinical outcomes and highly conserved in preclinical models, providing a framework for selecting the most appropriate models for preclinical studies.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Masculino , Feminino , Carcinoma Hepatocelular/patologia , beta Catenina/genética , Neoplasias Hepáticas/patologia , Consenso , Proteômica , Genômica , FenótipoRESUMO
BACKGROUND: Patients undergoing gastrectomy for gastric cancer are more likely to develop gallstones than the general population. Prophylactic cholecystectomy remains controversial. METHODS: Studies from 2000-2022 were systematically searched in the PubMed, EMBASE, and Cochrane Library databases. The search included simultaneous cholecystectomy or risk factors for gallstone formation with gastrectomy alone. Major prognostic factors included complications and mortality, and risk factor analyses included age, sex, TNM stage, gastrectomy type, lymph node dissection, diabetes, and duodenal exclusion. Random effects regression models were used to analyze risk estimates and data were presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). RESULTS: There were no significant differences in postoperative morbidity (OR 1.12, 95% CI 0.90-1.39; p = 0.33, I2 = 11%) and mortality (OR 1.23, 95% CI 0.62-2.43; p = 0.56, I2 = 0%) between gastrectomy alone and simultaneous cholecystectomy. Older age (OR 1.48, 95% CI 1.36-1.59; p < 0.001, I2 = 59%), male sex (OR 1.38, 95% CI 1.10-1.71; p = 0.004, I2 = 77%), total gastrectomy (OR 1.50, 95% CI 1.25-1.81; p < 0.001, I2 = 72%), diabetes mellitus (OR 1.38, 95% CI 1.17-1.63; p < 0.001, I2 = 8%), and duodenal exclusion (OR 1.77, 95% CI 1.47-2.15; p < 0.001, I2 = 30%) were risk factors for cholecystolithiasis. CONCLUSIONS: Simultaneous cholecystectomy did not increase the incidence of postoperative complications or mortality. Older age, male sex, total gastrectomy, duodenal exclusion, and diabetes were risk factors for gallstone development after gastrectomy.