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1.
Nucleic Acids Res ; 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38832633

RESUMO

Addressing health and safety crises stemming from various environmental and ecological issues is a core focus of One Health (OH), which aims to balance and optimize the health of humans, animals, and the environment. While many chemicals contribute significantly to our quality of life when properly used, others pose environmental and ecological health risks. Recently, assessing the ecological and environmental risks associated with chemicals has gained increasing significance in the OH world. In silico models may address time-consuming and costly challenges, and fill gaps in situations where no experimental data is available. However, despite their significant contributions, these assessment models are not web-integrated, leading to user inconvenience. In this study, we developed a one-stop comprehensive web platform for freely evaluating the eco-environmental risk of chemicals, named ChemFREE (Chemical Formula Risk Evaluation of Eco-environment, available in http://chemfree.agroda.cn/chemfree/). Inputting SMILES string of chemicals, users will obtain the assessment outputs of ecological and environmental risk, etc. A performance evaluation of 2935 external chemicals revealed that most classification models achieved an accuracy rate above 0.816. Additionally, the $Q_{F1}^2$ metric for regression models ranges from 0.618 to 0.898. Therefore, it will facilitate the eco-environmental risk evaluation of chemicals in the OH world.

2.
Nucleic Acids Res ; 52(D1): D1556-D1568, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-37897364

RESUMO

Plant disease, a huge burden, can cause yield loss of up to 100% and thus reduce food security. Actually, smart diagnosing diseases with plant phenomics is crucial for recovering the most yield loss, which usually requires sufficient image information. Hence, phenomics is being pursued as an independent discipline to enable the development of high-throughput phenotyping for plant disease. However, we often face challenges in sharing large-scale image data due to incompatibilities in formats and descriptions provided by different communities, limiting multidisciplinary research exploration. To this end, we build a Plant Phenomics Analysis of Disease (PlantPAD) platform with large-scale information on disease. Our platform contains 421 314 images, 63 crops and 310 diseases. Compared to other databases, PlantPAD has extensive, well-annotated image data and in-depth disease information, and offers pre-trained deep-learning models for accurate plant disease diagnosis. PlantPAD supports various valuable applications across multiple disciplines, including intelligent disease diagnosis, disease education and efficient disease detection and control. Through three applications of PlantPAD, we show the easy-to-use and convenient functions. PlantPAD is mainly oriented towards biologists, computer scientists, plant pathologists, farm managers and pesticide scientists, which may easily explore multidisciplinary research to fight against plant diseases. PlantPAD is freely available at http://plantpad.samlab.cn.


Assuntos
Fenômica , Doenças das Plantas , Produtos Agrícolas , Processamento de Imagem Assistida por Computador , Fenótipo
3.
Anal Chem ; 96(19): 7421-7428, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38691506

RESUMO

Hydrodynamic dimension (HD) is the primary indicator of the size of bioconjugated particles and biomolecules. It is an important parameter in the study of solid-liquid two-phase dynamics. HD dynamic monitoring is crucial for precise and customized medical research as it enables the investigation of the continuous changes in the physicochemical characteristics of biomolecules in response to external stimuli. However, current HD measurements based on Brownian motion, such as dynamic light scattering (DLS), are inadequate for meeting the polydisperse sample demands of dynamic monitoring. In this paper, we propose MMQCM method samples of various types and HD dynamic monitoring. An alternating magnetic field of frequency ωm excites biomolecule-magnetic bead particles (bioMBs) to generate magnetization motion, and the quartz crystal microbalance (QCM) senses this motion to provide HD dynamic monitoring. Specifically, the magnetization motion is modulated onto the thickness-shear oscillation of the QCM at the frequency ωq. By analysis of the frequency spectrum of the QCM output signal, the ratio of the magnitudes of the real and imaginary parts of the components at frequency ωq ± 2ωm is extracted to characterize the particle size. Using the MMQCM approach, we successfully evaluated the size of bioMBs with different biomolecule concentrations. The 30 min HD dynamic monitoring was implemented. An increase of ∼10 nm in size was observed upon biomolecular structural stretching. Subsequently, the size of bioMBs gradually reduced due to the continuous dissociation of biomolecules, with a total reduction of 20∼40 nm. This HD dynamic monitoring demonstrates that the release of biomolecules can be regulated by controlling the duration of magnetic stimulation, providing valuable insights and guidance for controlled drug release in personalized precision medicine.


Assuntos
Hidrodinâmica , Técnicas de Microbalança de Cristal de Quartzo , Tamanho da Partícula , Movimento (Física)
4.
J Pineal Res ; 74(2): e12850, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36585354

RESUMO

The expansion of gene families during evolution could generate functional diversity among their members to regulate plant growth and development. Melatonin, a phylogenetically ancient molecule, is vital for many aspects of a plant's life. Understanding the functional diversity of the molecular players involved in melatonin biosynthesis, signaling, and metabolism will facilitate the regulation of plant phenotypes. However, the molecular mechanism of melatonin response signaling elements in regulating this network still has many challenges. Here, we provide an in-depth analysis of the functional diversity and evolution of molecular components in melatonin signaling pathway. Genetic analysis of multiple mutants in plant species will shed light on the role of gene families in melatonin regulatory pathways. Phylogenetic analysis of these genes was performed, which will facilitate the identification of melatonin-related genes for future study. Based on the abovementioned signal networks, the mechanism of these genes was summarized to provide reference for studying the regulatory mechanism of melatonin in plant phenotypes. We hope that this work will facilitate melatonin research in higher plants and finely tuned spatio-temporal regulation of melatonin signaling.


Assuntos
Melatonina , Melatonina/metabolismo , Filogenia , Desenvolvimento Vegetal , Plantas/metabolismo , Transdução de Sinais/genética , Regulação da Expressão Gênica de Plantas , Estresse Fisiológico
5.
Crit Care ; 27(1): 462, 2023 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-38012731

RESUMO

BACKGROUND: Prone position has been shown to improve oxygenation and survival in patients with early acute respiratory distress syndrome (ARDS). These beneficial effects are partly mediated by improved ventilation/perfusion (V/Q) distribution. Few studies have investigated the impact of early versus delayed proning on V/Q distribution in patients with ARDS. The aim of this study was to assess the regional ventilation and perfusion distribution in early versus persistent ARDS after prone position. METHODS: This is a prospective, observational study from June 30, 2021, to October 1, 2022 at the medical ICU in Zhongda Hospital, Southeast University. Fifty-seven consecutive adult patients with moderate-to-severe ARDS ventilated in supine and prone position. Electrical impedance tomography was used to study V/Q distribution in the supine position and 12 h after a prone session. RESULTS: Of the 57 patients, 33 were early ARDS (≤ 7 days) and 24 were persistent ARDS (> 7 days). Oxygenation significantly improved after proning in early ARDS (157 [121, 191] vs. 190 [164, 245] mm Hg, p < 0.001), whereas no significant change was found in persistent ARDS patients (168 [136, 232] vs.177 [155, 232] mm Hg, p = 0.10). Compared to supine position, prone reduced V/Q mismatch in early ARDS (28.7 [24.6, 35.4] vs. 22.8 [20.0, 26.8] %, p < 0.001), but increased V/Q mismatch in persistent ARDS (23.8 [19.8, 28.6] vs. 30.3 [24.5, 33.3] %, p = 0.006). In early ARDS, proning significantly reduced shunt in the dorsal region and dead space in the ventral region. In persistent ARDS, proning increased global shunt. A significant correlation was found between duration of ARDS onset to proning and the change in V/Q distribution (r = 0.54, p < 0.001). CONCLUSIONS: Prone position significantly reduced V/Q mismatch in patients with early ARDS, while it increased V/Q mismatch in persistent ARDS patients. Trial registration ClinicalTrials.gov (NCT05207267, principal investigator Ling Liu, date of registration 2021.08.20).


Assuntos
Pulmão , Síndrome do Desconforto Respiratório , Adulto , Humanos , Perfusão , Decúbito Ventral , Respiração , Respiração Artificial/métodos , Síndrome do Desconforto Respiratório/terapia , Estudos Prospectivos
6.
Altern Ther Health Med ; 29(7): 138-147, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37442186

RESUMO

Purpose: Fentanyl is approved for use in many countries as an analgesic for patients requiring mechanical ventilation. However, it redistributes and accumulates easily in the plasma because of its long half-life. Remifentanil is a short context-sensitive half-life analgesic with a lower risk of redistribution and accumulation. Materials and methods: We conducted a multicenter, randomized, double-blind, non-inferiority trial. Critically ill patients requiring mechanical ventilation were randomly allocated to receive an infusion of either remifentanil or fentanyl for up to 72 h. The primary outcome was the analgesic success rate. A 95% confidence interval lower boundary greater than -8% for the difference between the groups was considered to indicate non-inferiority between the drugs. Results: A total of 137 patients received remifentanil (69) or fentanyl (68). Remifentanil's non-inferiority to fentanyl concerning its analgesic success rate was established (difference, 5.97%; 95% confidence interval: -3.99% to 16.35%). Mechanical ventilation duration, extubation duration, successful extubation, intensive care unit discharge, intensive care unit length of stay, and adverse events did not differ significantly between the two groups. Conclusions: Remifentanil was non-inferior to fentanyl regarding the analgesic success rate in critically ill patients requiring mechanical ventilation.

7.
Dermatol Ther ; 35(3): e15262, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34897933

RESUMO

Even though a variety of treatments for androgenetic alopecia (AGA) currently have been using in clinical, satisfactory therapeutic methods are still lacking. We aimed to compare and rank these treatments for AGA according to their differences in efficacy via Bayesian network meta-analysis, suggesting the optimal therapy for clinical utility to refer. A systematic search of PubMed, Embase, Web of Science, and Cochrane Library database was performed and we included eligible randomized controlled trials. We compared differences in treatment effects of monotherapies and combination therapies using the Bayesian network model. The average difference in alteration from baseline of hair density and hair diameter, and variation value (mean ± SD) between the pre- and post-intervention was selected for main outcome measure and secondary outcome measure. Total 49 RCTs involving 3133 patients and six interventions were included. Regardless of based on hair density or hair diameter, topical/systemic combined with adjunctive therapeutics had the best treatment efficacy among all interventions (MD: 40.11; 95% CrI 25.65-54.59), followed by topical combined with systemic medical therapeutics (MD: 36.41; 95% CrI 17.54-55.24). In addition, in terms of hair density, treatment efficacy had significant difference sequentially among topical medical therapeutics (MD: 22.15; 95% CrI 12.88-31.42), systemic medical therapeutics (MD: 19.91; 95% CrI 6.504-33.22), and adjunctive therapeutics (MD: 18.60; 95% CrI 8.020-29.10) compared to placebo. In recent years, combination therapies are showing significant promise as potential therapies. Taken together with the outcomes of this study, despite the specific mechanism of the effect of combination therapies was not clear and further studies are needed, it may be the best treatment for AGA.


Assuntos
Alopecia , Cabelo , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Teorema de Bayes , Humanos , Metanálise em Rede , Resultado do Tratamento
8.
Opt Express ; 28(15): 22462-22477, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32752506

RESUMO

The next frontier in photonics will rely on the synergistic combination of disparate material systems. One unique organic molecule is azobenzene. This molecule can reversibly change conformations when optically excited in the blue (trans-to-cis) or mid-IR (cis-to-trans). Here, we form an oriented monolayer of azobenzene-containing 4-(4-diethylaminophenylazo)pyridine (Aazo) on SiO2 optical resonators. Due to the uniformity of the Aazo layers, quality factors over 106 are achieved. To control the photo-response, the density of Aazo groups is tuned by integrating methyl spacer molecules. Using a pair of lasers, the molecule is reversibly flipped between molecular conformations, inducing a refractive index change which results in a resonant wavelength shift. The magnitude of the shift scales with the relative surface density of Aazo. To investigate reproducibility and stability of the organic monolayer, three switching cycles are demonstrated, and the performance is consistent even after a device is stored in air for 6 months.

9.
Crit Care ; 24(1): 433, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32665010

RESUMO

PURPOSE: Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. METHODS: The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings. RESULTS: A total of 10,275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51-0.70; p < 0.001)). Patients in the CVP group received more fluid on day 1 and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p = 0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p = 0.04 for the ACME). CONCLUSION: CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.


Assuntos
Pressão Venosa Central/fisiologia , Avaliação de Resultados em Cuidados de Saúde/normas , Sepse/terapia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Hidratação/métodos , Hidratação/normas , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Prognóstico , Estudos Retrospectivos , Sepse/fisiopatologia , Vasoconstritores/farmacologia , Vasoconstritores/uso terapêutico
10.
Med Sci Monit ; 25: 6474-6481, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31462627

RESUMO

BACKGROUND The objective of this study was to assess the diagnostic value of platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and neutrophil/lymphocyte ratio (NLR) as biomarkers in patients with rheumatoid arthritis (RA) and rheumatoid arthritis-associated interstitial lung disease (RA-ILD). MATERIAL AND METHODS Demographic and laboratory data were acquired for 198 RA and 103 RA-ILD patients and 290 healthy controls. The subjects were categorized into female and male groups and further subcategorized based on age into <60 years and ≥60 years subgroups. One-way analysis of variance (ANOVA), receiver operating characteristics (ROC), Pearson analysis, multiple linear regression analysis, and logistic regression analysis were performed to analyze the association of PLR, NLR, and LMR with RA and RA-ILD. RESULTS Mean PLR and NLR were lowest in the control group, followed by the RA and RA-ILD groups (p<0.05). Mean LMR was lowest in the RA-ILD group, followed by the RA and control groups (p<0.05). The area under the ROC (AUROC) values of the PLR to distinguish between RA and controls, RA-ILD and controls, and RA-ILD and RA were 0.676, 0.776, and 0.650, respectively (p<0.001). Multiple linear regression analysis suggested a significantly positive association between the level of PLR and the level of DAS28 (p<0.001). The odds ratio of PLR was 1.101 for RA (p=0.023) and 1.217 for RA-ILD (p<0.001) when compared to the controls. CONCLUSIONS PLR may be applied as a new biomarker for predicting and diagnosing RA and RA-ILD and for distinguishing RA-ILD patients from RA patients and healthy subjects.


Assuntos
Artrite Reumatoide/patologia , Biomarcadores/sangue , Plaquetas/patologia , Doenças Pulmonares Intersticiais/patologia , Linfócitos/patologia , Monócitos/patologia , Neutrófilos/patologia , Artrite Reumatoide/sangue , Artrite Reumatoide/complicações , Feminino , Humanos , Modelos Logísticos , Doenças Pulmonares Intersticiais/sangue , Doenças Pulmonares Intersticiais/complicações , Masculino , Pessoa de Meia-Idade , Curva ROC
11.
Am J Respir Crit Care Med ; 207(4): 491-492, 2023 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-36198173
13.
Mol Ther ; 24(4): 770-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26758691

RESUMO

Primary hyperoxaluria type 1 (PH1) is an autosomal recessive, metabolic disorder caused by mutations of alanine-glyoxylate aminotransferase (AGT), a key hepatic enzyme in the detoxification of glyoxylate arising from multiple normal metabolic pathways to glycine. Accumulation of glyoxylate, a precursor of oxalate, leads to the overproduction of oxalate in the liver, which accumulates to high levels in kidneys and urine. Crystalization of calcium oxalate (CaOx) in the kidney ultimately results in renal failure. Currently, the only treatment effective in reduction of oxalate production in patients who do not respond to high-dose vitamin B6 therapy is a combined liver/kidney transplant. We explored an alternative approach to prevent glyoxylate production using Dicer-substrate small interfering RNAs (DsiRNAs) targeting hydroxyacid oxidase 1 (HAO1) mRNA which encodes glycolate oxidase (GO), to reduce the hepatic conversion of glycolate to glyoxylate. This approach efficiently reduces GO mRNA and protein in the livers of mice and nonhuman primates. Reduction of hepatic GO leads to normalization of urine oxalate levels and reduces CaOx deposition in a preclinical mouse model of PH1. Our results support the use of DsiRNA to reduce liver GO levels as a potential therapeutic approach to treat PH1.


Assuntos
Oxirredutases do Álcool/genética , Oxalato de Cálcio/metabolismo , Hiperoxalúria Primária/terapia , RNA Interferente Pequeno/administração & dosagem , Animais , RNA Helicases DEAD-box/metabolismo , Modelos Animais de Doenças , Glioxilatos/urina , Humanos , Hiperoxalúria Primária/enzimologia , Hiperoxalúria Primária/urina , Fígado/metabolismo , Camundongos , Nanopartículas/química , RNA Interferente Pequeno/farmacologia , Ribonuclease III/metabolismo
14.
Environ Sci Pollut Res Int ; 31(24): 35353-35368, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38724849

RESUMO

In this work, an efficient utilization method for red mud (RM) is provided through recycling RM as a mineral admixture for the preparation of foamed concrete (FC). Specifically, FC with different RM contents was prepared and investigated in terms of workability, mechanical properties, and hydration products. Results show that adding RM can significantly shorten the setting time, while it inevitably weakens the mechanical properties and fluidity of FC. However, the compressive strength of FC can still meet the strength predicted by the specification requirements when the RM replaces cement with 60% content (3d > 1.6 MPa). Most importantly, the heavy metals leaching from RM-based FC under the action of rain is still unclear, so a device for simulating stormwater runoff was designed to test the heavy metal leaching risk of RM-based FC. The findings indicate that the solidification of cement and the high basicity of the matrix can effectively reduce the leaching risk of heavy metals from RM in FC. Although the pore structure analysis demonstrates that the porosity and connected pores of FC will be deteriorated as RM concentration increases. The results are of great significance for the recycling of waste and the sustainable development of building materials.


Assuntos
Materiais de Construção , Metais Pesados , Metais Pesados/química , Reciclagem , Porosidade
15.
ACS Sens ; 8(11): 4031-4041, 2023 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-37943682

RESUMO

The occurrence and development of diseases are closely related to overexpression of specific biomarkers in the serum of patients. Rapid and sensitive biomarker detection is beneficial for early diagnosis and treatment. However, the current laboratory processes and assays for biomarker detection are expensive and time-consuming, and their operation also requires a large number of professionals. We developed a magnetically modulated differential quartz crystal microbalance (MMD-QCM) method combined with magnetic bead (MB) labels for rapid and highly sensitive quantitative detection of prostate-specific antigen (PSA). Because MBs exhibit magnetized rotation motion under an applied AC magnetic field, a pair of QCMs are utilized to measure the difference between the magnetic motion intensities of the MBs and the MB-PSA immune complex to determine the PSA concentration. Experimental results demonstrate that the proposed method can be adopted to determine the PSA concentration in a wide range of 0.01-1000 ng/mL as well as exhibit a low detection limit of 0.065 ng/mL. In addition, the proposed scheme enables fast detection and low sample consumption. The single detection process takes less than 4 h and requires only 113 µL of sample solution. The proposed detection strategy is superior to the existing detection method and can be effectively used in early screening and prognostic diagnosis of cancer and other related diseases owing to its simplicity, low cost, and high speed.


Assuntos
Antígeno Prostático Específico , Técnicas de Microbalança de Cristal de Quartzo , Masculino , Humanos , Técnicas de Microbalança de Cristal de Quartzo/métodos , Próstata , Biomarcadores , Fenômenos Magnéticos
16.
J Agric Food Chem ; 71(19): 7192-7200, 2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37144888

RESUMO

Pesticide registration is a scientific, legal, and administrative process that checks if a pesticide is safe and effective for its intended use before it can be used. The toxicity test is a key part of pesticide registration, which includes human health and ecological effect testing. Different countries adopt their own toxicity test criteria for pesticide registration guidelines. However, these differences, which may help accelerate the progress of pesticide registration and reduce the number of animals used, are yet to be explored and compared. Herein, we outlined the details and compared the differences between the toxicity tests in the United States, the European Union, Japan, and China. Some differences lie in the types and waiver policy, while others are in new approach methodologies (NAMs). On the basis of these differences, there is great potential for the optimization of NAMs during the toxicity tests. It is expected that this perspective can contribute to developing and adopting NAMs.


Assuntos
Praguicidas , Animais , Humanos , Estados Unidos , Praguicidas/toxicidade , União Europeia , Japão , Testes de Toxicidade/métodos , China
17.
Materials (Basel) ; 16(3)2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36770082

RESUMO

Because of the excellent thermal conduction, corrosion resistance, and tribological properties, copper-based friction materials (CBFMs) were widely used in airplanes, high-speed trains, and wind power generation. With operating speed continuously increasing, CBFMs are suffering more complicated and extreme working conditions, which would cause abnormal abrasion. This paper presents an experiment to investigate how the tribological behaviors of CBFMs are regulated by granulation technology. Samples were prepared by the method of granulation and cool-pressed sinter. The tribological properties of specimens with different granule sizes were studied. The results showed that granulation could improve the tribological properties of CBFMs. The friction coefficient (COF) increased first and then decreased with increasing granule size. Specimen fabricated with 5-8 mm granules obtained the lowest COF, which was reduced by 22.49% than that made of powders. Moreover, the wear rate decreased first and then increased as granule size increased. The wear rate of samples prepared by granules 3-5 mm was lower than that of all of the other samples. This is because the structured samples prepared by wet granulation can promote the formation of secondary plateaus, which are beneficial for enhancing tribological properties. This makes granulation a promising method for enhancing the tribological performances of CBFMs.

18.
Eur J Med Res ; 28(1): 329, 2023 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-37689707

RESUMO

BACKGROUND: Although the mean arterial pressure (MAP) target of 65 mmHg was achieved, diastolic blood pressure (DBP) was still low in some septic shock patients. The effects of DBP on the prognosis and optimal target for patients with septic shock are unclear. We sought to investigate the relationship between DBP and 28-day mortality in septic shock patients. METHODS: In this retrospective observational study, we obtained data from the Chinese Database in Intensive Care (CDIC). We included patients with an admission diagnosis of septic shock and shock was controlled. DBP was measured every 1 h, and the mean DBP during the first 24 h (mDBP24h) was recorded. The primary outcome was 28-day mortality. Multivariable logistic regression determined the relationship between mDBP24h and 28-day mortality. RESULTS: In total, 1251 patients were finally included. The 28-day mortality of included septic shock patients was 28.3%. The mDBP24h, not mSBP24h, was higher among 28-day survivors compared with non-survivors. 28-day mortality was inversely associated with mDBP24h (unadjusted OR 0.814 per 10 mmHg higher mDBP24h, P = 0.003), with a stepwise increase in 28-day mortality at lower mDBP24h. The 28-day mortality of patients with mDBP24h < 59 mmHg had an absolute risk reduction of 9.4% (P = 0.001). And mDBP24h < 59 mmHg was the remaining high risk factor inversely associated with 28-day mortality after multivariable adjustment (adjusted OR 1.915, 95% CI 1.037-3.536, P = 0.038), while mMAP24h and mSBP24h were not. CONCLUSION: In patients with septic shock after initial resuscitation, we observed an inverse association between mDBP24h and 28-day mortality. The poor outcomes in patients with mDBP24h < 59 mmHg provide indirect evidence supporting a further DBP goal of 59 mmHg for patients with septic shock after MAP of 65 mmHg was achieved.


Assuntos
Choque Séptico , Humanos , Pressão Sanguínea , Ressuscitação , Estudos Retrospectivos , Choque Séptico/mortalidade
19.
Trials ; 24(1): 266, 2023 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-37041561

RESUMO

BACKGROUND: Acute respiratory syndrome distress (ARDS) is a clinical common syndrome with high mortality. Electrical impedance tomography (EIT)-guided positive end-expiratory pressure (PEEP) titration can achieve the compromise between lung overdistension and collapse which may minimize ventilator-induced lung injury in these patients. However, the effect of EIT-guided PEEP titration on the clinical outcomes remains unknown. The objective of this trial is to investigate the effects of EIT-guided PEEP titration on the clinical outcomes for moderate or severe ARDS, compared to the low fraction of inspired oxygen (FiO2)-PEEP table. METHODS: This is a prospective, multicenter, single-blind, parallel-group, adaptive designed, randomized controlled trial (RCT) with intention-to-treat analysis. Adult patients with moderate to severe ARDS less than 72 h after diagnosis will be included in this study. Participants in the intervention group will receive PEEP titrated by EIT with a stepwise decrease PEEP trial, whereas participants in the control group will select PEEP based on the low FiO2-PEEP table. Other ventilator parameters will be set according to the ARDSNet strategy. Participants will be followed up until 28 days after enrollment. Three hundred seventy-six participants will be recruited based on a 15% decrease of 28-day mortality in the intervention group, with an interim analysis for sample size re-estimation and futility assessment being undertaken once 188 participants have been recruited. The primary outcome is 28-day mortality. The secondary outcomes include ventilator-free days and shock-free days at day 28, length of ICU and hospital stay, the rate of successful weaning, proportion requiring rescue therapies, compilations, respiratory variables, and Sequential Organ Failure Assessment (SOFA). DISCUSSION: As a heterogeneous syndrome, ARDS has different responses to treatment and further results in different clinical outcomes. PEEP selection will depend on the properties of patients and can be individually achieved by EIT. This study will be the largest randomized trial to investigate thoroughly the effect of individual PEEP titrated by EIT in moderate to severe ARDS patients to date. TRIAL REGISTRATION: ClinicalTrial.gov NCT05207202. First published on January 26, 2022.


Assuntos
Síndrome do Desconforto Respiratório do Recém-Nascido , Síndrome do Desconforto Respiratório , Adulto , Recém-Nascido , Humanos , Respiração com Pressão Positiva/efeitos adversos , Pulmão , Síndrome do Desconforto Respiratório/terapia , Prognóstico , Tomografia Computadorizada por Raios X , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto
20.
Materials (Basel) ; 15(22)2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36431603

RESUMO

The experimental temperature is 613.15~763.15 K, and the strain rate is 0.01~10 s-1. The hot compression creep test of the 6082-T6 aluminum alloy sample is carried out by Gleeble-3500 hot compression simulation compressor, and its creep behavior is studied by scanning electron microscope. The results show that the DRX crystal has an irregular shape and that content of the Mg phase, Si phase, and Mn phase in the crystal are the main factors to change the color of DRX crystal. Temperature and strain rate are important factors affecting dynamic recrystallization. Reducing temperature and increasing strain rate will weaken dynamic recrystallization, and DRX critical condition and peak stress (strain) will increase. The constitutive equation of hot creep of 6082 aluminum alloy was established by introducing the work hardening rate-rheological stress curve, and the relationship between DRX critical condition, peak stress (strain) and parameter Z during creep was explored. Based on the Av rami equation, the prediction equation of the DRX volume fraction is established. With the increase of strain, DRX volume fraction is characterized by slow increase, then rapid increase and then slowly increase. In the hot -forming extrusion process of 6082 aluminum alloy, according to the volume fraction prediction equation, the DRX can be reduced, and the internal structure of the material can be optimized by changing the extrusion conditions and particle size.

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