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1.
Bioorg Med Chem Lett ; 99: 129598, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38169246

RESUMEN

The synthesis of compounds based on fragments derived from natural products (NPs) serves as a source of inspiration for the design of pseudo-natural products (PNPs), to identify bioactive molecules that exhibit similar characteristics to NPs. These novel molecular scaffolds exhibit previously unexplored biological activities as well. This study reports the development and synthesis of a novel pentacyclic ring system, the indole-pyrimidine-quinoline (IPQ) scaffold. The design of this scaffold was based on the structural characteristics of four natural products, namely tryptanthrin, luotonin A, rutaecarpine, and camptothecin. Several successive steps accomplished the effective synthesis of the IPQ scaffold. The constituent components of the pentacycle, containing the indole, quinazolinone, pyrimidone, and quinoline units, possess significant biological significance. Compound 1a demonstrated noteworthy anti-tumor activity efficacy against A549 cell lines among the tested compounds. The compound 1a was observed to elicit cell cycle arrest in both the G2/M and S phases, as well as trigger apoptosis in A549 cells. These effects were attributed to its ability to modulate the activation of mitochondrial-related mitogen-activated protein kinase (MAPK) signaling pathways.


Asunto(s)
Antineoplásicos , Productos Biológicos , Quinolinas , Antineoplásicos/química , Apoptosis , Productos Biológicos/farmacología , Productos Biológicos/química , Camptotecina/farmacología , Puntos de Control del Ciclo Celular , Línea Celular Tumoral , Quinolinas/farmacología , Indoles/química , Indoles/farmacología , Pirimidinas
2.
Chem Biodivers ; 21(5): e202302064, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38390665

RESUMEN

Based on our previous research, a 3D-QSAR model (q2=0.51, ONC=5, r2=0.982, F=271.887, SEE=0.052) was established to predict the inhibitory effects of triazole Schiff base compounds on Fusarium graminearum, and its predictive ability was also confirmed through the statistical parameters. According to the results of the model design, 30 compounds with superior bioactivity compared to the template molecule 4 were obtained. Seven of these compounds (DES2-6, DES9-10) with improved biological activity and readily available raw materials were successfully synthesized. Their structures were confirmed through HRMS, NMR, and single crystal X-ray diffraction analysis (DES-5). The bioactivity of the final products was investigated through an in vitro antifungal assay. There was little difference in the EC50 values between the experimental and predicted values of the model, demonstrating the reliability of the model. Especially, DES-3 (EC50=9.915 mg/L) and DES-5 (EC50=9.384 mg/L) exhibited better inhibitory effects on Fusarium graminearum compared to the standard drug (SD) triadimenol (EC50=10.820 mg/L). These compounds could serve as potential new fungicides for future research. The interaction between the final products and isocitrate lyase (ICL) was investigated through molecular docking. Compounds with R groups that have a higher electron-donating capacity were found to be biologically active.


Asunto(s)
Antifúngicos , Fusarium , Pruebas de Sensibilidad Microbiana , Relación Estructura-Actividad Cuantitativa , Bases de Schiff , Triazoles , Bases de Schiff/química , Bases de Schiff/farmacología , Bases de Schiff/síntesis química , Triazoles/química , Triazoles/farmacología , Triazoles/síntesis química , Antifúngicos/farmacología , Antifúngicos/síntesis química , Antifúngicos/química , Fusarium/efectos de los fármacos , Estructura Molecular , Simulación del Acoplamiento Molecular
3.
Bioorg Chem ; 137: 106579, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37149949

RESUMEN

Plasminogen Kringle 5 is one of the most potent cytokines identified to inhibit the proliferation and migration of vascular endothelial cells. Herein, six aptamer candidates that specifically bind to Kringle 5 were generated by the systematic evolution of ligands by exponential enrichment (SELEX). After 10 rounds of screening against Kringle 5, a highly enriched ssDNA pool was sequenced and the representative aptamers were subjected to binding assays to evaluate their affinity and specificity. The preferred aptamer KG-4, which demonstrated a low dissociation constant (Kd) of âˆ¼ 432 nM and excellent selectivity for Kringle 5. A conserved "motif" of eight bases located at the stem-loop intersection, common to the aptamer, was further confirmed as the recognition element for binding with Kringle 5. The bulge formed by the motif and depression on the lysine binding site of Kringle 5 were both located at the binding interface, and the "induced fit" between their structures played a central role in the recognition process. Kringle 5 interacts KG-4 primarily through enthalpy-driven van der Waals forces and hydrogen bond. The key nucleotides A34 and C35 at motif on KG-4 and the positively charged amino acids in the loop 1 and loop 4 regions on Kringle 5 play a major role in the interaction. Furthermore, KG-4 dose-dependently reduced the proliferation inhibition of vascular endothelial cells by Kringle 5 and had a blocking effect on the function of Kringle 5 in inhibiting migration and promoting apoptosis of vascular endothelial cells in vitro. This study put a new light on protein-aptamer binding mechanism and may provide insight into the treatment of ischemic diseases by target depletion of Kringle 5.


Asunto(s)
Aptámeros de Nucleótidos , Células Endoteliales , Humanos , Células Endoteliales/metabolismo , Plasminógeno/química , Plasminógeno/metabolismo , Sitios de Unión , Aptámeros de Nucleótidos/química
4.
Alzheimers Dement ; 19(8): 3365-3378, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-36790027

RESUMEN

INTRODUCTION: Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. METHODS: A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models. RESULTS: Incident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs. DISCUSSION: Dementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.


Asunto(s)
Demencia , Caracteres Sexuales , Humanos , Masculino , Femenino , Factores de Riesgo , Consumo de Bebidas Alcohólicas , Demencia/epidemiología , Factores Sexuales
5.
J Aging Phys Act ; 31(4): 589-599, 2023 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-36516851

RESUMEN

This randomized controlled trial (NCT03475316) examined the relative efficacy of 6 months of social ballroom dancing and treadmill walking on a composite executive function score, generated from digit symbol substitution test, flanker interference, and walking while talking tasks. Brain activation during functional magnetic resonance imaging (fMRI) versions of these executive function tasks were secondary outcomes. Twenty-five dementia-at-risk older adults (memory impairment screen score of ≥3 to ≤6 and/or an Alzheimer's disease-8 Dementia Screening Interview of ≥1) were randomized in June 2019 to March 2020-16 completed the intervention before study termination due to the COVID-19 (eight in each group). Composite executive function scores improved post-intervention in both groups, but there was no evidence for between-group differences. Social dancing, however, generated greater improvements on digit symbol substitution test than treadmill walking. No intervention-related differences were observed in brain activation-although less hippocampal atrophy (tertiary) was observed following social dancing than treadmill walking. These preliminary findings are promising but need to be confirmed in future large-scale and sufficiently powered randomized controlled trials.


Asunto(s)
Enfermedad de Alzheimer , COVID-19 , Baile , Humanos , Anciano , Función Ejecutiva/fisiología , Baile/fisiología , Caminata/fisiología , Plasticidad Neuronal , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
Mov Disord ; 37(11): 2217-2225, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36054306

RESUMEN

BACKGROUND: Although men and women with the LRRK2 G2019S variant appear to be equally likely to have Parkinson's disease (PD), the sex-distribution among glucocerebrosidase (GBA) variant carriers with PD, including limited to specific variant severities of GBA, is not well understood. Further, the sex-specific genetic contribution to PD without a known genetic variant is controversial. OBJECTIVES: To better understand sex differences in genetic contribution to PD, especially sex-specific frequencies among GBA variant carriers with PD (GBA PD) and LRRK2-G2019S variant carriers with PD (LRRK2 PD). METHODS: We assess differences in the sex-specific frequency in GBA PD, including in subsets of GBA variant severity, LRRK2 PD, and idiopathic PD in an Ashkenazi Jewish cohort with PD. Further, we expand prior work evaluating differences in family history of parkinsonism. RESULTS: Both idiopathic PD (267/420 men, 63.6%) (P < 0.001) and GBA PD overall (64/107, 59.8%) (P = 0.042) were more likely to be men, whereas no difference was seen in LRRK2 PD (50/99, 50.5%) and LRRK2/GBA PD (5/10, 50%). However, among GBA PD probands, severe variant carriers were more likely to be women (15/19 women, 79.0%) (P = 0.005), whereas mild variant carriers (44/70 men, 62.9%) (P = 0.039) and risk-variant carriers (15/17 men, 88.2%) (P = 0.001) were more likely to be men. CONCLUSIONS: Our study demonstrates that the male-sex predominance present in GBA PD overall was not consistent across GBA variant severities, and a female-sex predominance was present among severe GBA variant carriers. Therefore, research and trial designs for PD should consider sex-specific differences, including across GBA variant severities. © 2022 International Parkinson and Movement Disorder Society.


Asunto(s)
Glucosilceramidasa , Enfermedad de Parkinson , Femenino , Masculino , Humanos , Glucosilceramidasa/genética , Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina/genética , Mutación , Heterocigoto , Enfermedad de Parkinson/genética
7.
Eur J Neurol ; 29(10): 2925-2933, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35748730

RESUMEN

BACKGROUND AND PURPOSE: Motoric cognitive risk syndrome (MCR) is a gait-based pre-dementia syndrome associated with risk of dementia. Ascertaining subjective cognitive and motoric complaints may facilitate early and remote identification of individuals with MCR as they are reported to precede and predict objective cognitive and motoric impairments in aging. METHODS: The validity of five subjective motoric complaint (SMC) questions and 10 subjective cognitive complaint (SCC) questions was examined for discriminating MCR in 538 non-demented community-dwelling adults. Backward logistic regression was used to identify questions to develop a weighted score to define subjective MCR (MCR-S). Receiver operating characteristic analysis was applied to determine the discriminative ability of MCR-S for the objective MCR (MCR-O) definition based on SCCs and objectively measured gait. Cox proportional hazard models adjusted for potential confounders were used to examine the predictive validity of MCR-S for incident dementia. RESULTS: Five subjective complaint questions (three SCC and two SMC) were associated with MCR-O. They were combined to define an MCR-S score (range 0-7) which yielded an area under the curve of 0.89 for discriminating MCR-O from receiver operating characteristic analysis. An optimal cut-score of 2 on the MCR-S score was determined to have good sensitivity (84%) and specificity (82%) for MCR-O. Over a median follow-up of 2.5 years, 29 participants developed dementia. Both MCR-S (adjusted hazard ratio 2.39) and MCR-O at baseline (adjusted hazard ratio 3.16) predicted risk of incident dementia. CONCLUSIONS: Subjective MCR had high concordance with MCR-O and can provide a remote screening assessment for MCR-O, which can identify those at high risk for dementia.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Demencia , Cognición , Trastornos del Conocimiento/diagnóstico , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/diagnóstico , Demencia/complicaciones , Demencia/diagnóstico , Humanos , Pruebas Neuropsicológicas , Estudios Prospectivos , Factores de Riesgo , Síndrome
8.
J Int Neuropsychol Soc ; 28(3): 292-299, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-33745492

RESUMEN

OBJECTIVE: To compare the predictive validity of learning and retention measures from the picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT + IR) for identifying incident mild cognitive impairment (MCI). METHODS: Learning was defined by the sum of free recall (FR) and retention by delayed free recall (DFR) tested 15-20 min later. Totally, 1422 Baltimore Longitudinal Study of Aging (BLSA) participants (mean age 69.6 years, 54% male, mean 16.7 years of education) without dementia or MCI received the pFCSRT + IR at baseline and were followed longitudinally. Cox proportional hazards models were used to evaluate the effect of baseline learning and retention on risk of MCI. RESULTS: In total, 187 participants developed MCI over a median of 8.1 years of follow-up. FR and DFR each predicted incident MCI adjusting for age, sex, and education. Also, each independently predicted incident MCI in the presence of the other with similar effect sizes: around 20% decrease in the hazard of MCI corresponding to one standard deviation increase in FR or DFR. CONCLUSION: The practice of preferring retention over learning to predict incident MCI should be reconsidered. The decision to include retention should be guided by time constraints and patient burden.


Asunto(s)
Enfermedad de Alzheimer , Disfunción Cognitiva , Anciano , Enfermedad de Alzheimer/psicología , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Señales (Psicología) , Progresión de la Enfermedad , Femenino , Humanos , Estudios Longitudinales , Masculino , Pruebas Neuropsicológicas , Pronóstico
9.
Yi Chuan ; 44(3): 230-244, 2022 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-35307646

RESUMEN

The abnormal expressions of minichromosome maintenance protein 2 (MCM2) are closely related to the development of various kinds of cancers. We aimed to explore the functions and potential molecular mechanisms of MCM2 gene in cholangiocarcinoma (CCA) cell lines (Huh28 and RBE). First, the cell counting kit-8 (CCK-8), plate clone formation, transwell and invasion assays showed that MCM2 promotes the proliferation, migration and invasion of CCA cells. Flow cytometry assays showed that MCM2 significantly promotes the cell cycle, and inhibits the apoptosis of CCA cells. Further, by analyzing the RNA sequencing data of cholangiocarcinoma, we found that MCM2 gene is significantly negatively correlated with p53 signaling pathway. Quantitative real time polymerase chain reaction (qRT-PCR) and Western blotting (WB) assays confirmed that MCM2 in CCA cells significantly down-regulated the mRNA and protein expression levels of p53 and BAX, and up-regulated the mRNA and protein expression levels of BCL2 and CCND1. Flow cytometry, qRT-PCR and WB assays confirmed that MCM2 promotes CCA through p53 pathway. Finally, we found that MCM2 is up-regulated in CCA tissues compared to the matched non-tumor cholangiocarcinoma tissues, and the high expressions of MCM2 are significantly associated with the poor clinical outcomes of CCA patients. In conclusion, this study revealed that MCM2 promotes the development of CCA by reducing the p53 pathway, and its high expression levels predict poor prognosis in CCA patients. These results provide a theoretical basis for the development of new clinical diagnosis and treatment of cholangiocarcinoma in the future.


Asunto(s)
Neoplasias de los Conductos Biliares , Colangiocarcinoma , Neoplasias de los Conductos Biliares/genética , Neoplasias de los Conductos Biliares/metabolismo , Neoplasias de los Conductos Biliares/patología , Conductos Biliares Intrahepáticos/metabolismo , Conductos Biliares Intrahepáticos/patología , Línea Celular Tumoral , Proliferación Celular/genética , Colangiocarcinoma/genética , Colangiocarcinoma/metabolismo , Colangiocarcinoma/patología , Regulación Neoplásica de la Expresión Génica , Humanos , Componente 2 del Complejo de Mantenimiento de Minicromosoma/genética , Componente 2 del Complejo de Mantenimiento de Minicromosoma/metabolismo , Transducción de Señal , Proteína p53 Supresora de Tumor/genética , Proteína p53 Supresora de Tumor/metabolismo
10.
J Exp Bot ; 72(10): 3582-3596, 2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-33677565

RESUMEN

Maize is a model plant species often used for genetics and genomics research because of its genetic diversity. There are prominent morphological, genetic, and epigenetic variations between tropical and temperate maize lines. However, the genome-wide chromatin conformations of these two maize types remain unexplored. We applied a Hi-C approach to compare the genome-wide chromatin interactions between temperate inbred line D132 and tropical line CML288. A reconstructed maize three-dimensional genome model revealed the spatial segregation of the global A and B compartments. The A compartments contain enriched genes and active epigenome marks, whereas the B compartments are gene-poor, transcriptionally silent chromatin regions. Whole-genome analyses indicated that the global A compartment content of CML288 was 3.12% lower than that of D132. Additionally, global and A/B sub-compartments were associated with differential gene expression and epigenetic changes between two inbred lines. About 25.3% of topologically associating domains (TADs) were determined to be associated with complex domain-level modifications that induced transcriptional changes, indicative of a large-scale reorganization of chromatin structures between the inbred maize lines. Furthermore, differences in chromatin interactions between the two lines correlated with epigenetic changes. These findings provide a solid foundation for the wider plant community to further investigate the genome-wide chromatin structures in other plant species.


Asunto(s)
Cromatina , Zea mays , Epigénesis Genética , Genoma , Genómica , Zea mays/genética
11.
Eur J Neurol ; 28(6): 1859-1867, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33780585

RESUMEN

BACKGROUND AND PURPOSE: Motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by cognitive complaints and slow gait. MCR is associated with increased risk of cognitive decline and incident dementia. Predictors of transition to dementia in MCR patients are still obscure. METHODS: We examined clinical, biological and lifestyle parameters related to conversion to dementia using Cox models in 439 older adults with prevalent MCR (mean age 79.87 ± 8.13 years, 70% women) from two cohorts, 268 from the Chicago-based Rush Memory and Aging project (MAP) and 171 from the Religious Orders Study (ROS), which enrolled religious clergy across the United States. RESULTS: In the pooled sample, 439 (13.2%) had prevalent MCR (268 MAP and 171 ROS). There were 140 (31.9%) incident dementia cases over a median follow up of 4.0 years. Age predicted conversion from MCR to dementia in both cohorts. Male gender was a risk factor only in ROS. In the pooled data, only higher depressive symptoms were associated with higher risk of conversion to dementia (adjusted hazard ratio [aHR] 1.13, 95% CI 1.03-1.24). Lower cognitive activity participation (aHR 0.59, 95% CI 0.44-0.79) and apolipoprotein E ε4 allele (aHR 2.57, 95% CI 1.48-4.45) predicted conversion to dementia in MAP. CONCLUSIONS: Depressive symptoms and other cohort-specific risk factors were identified as predictors of transition to dementia in individuals with MCR. These findings suggest common pathological mechanisms underlying mood, gait and cognitive declines in aging, which could help develop preventive strategies.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Demencia , Anciano , Anciano de 80 o más Años , Cognición , Disfunción Cognitiva/epidemiología , Estudios de Cohortes , Demencia/epidemiología , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Estudios Retrospectivos , Factores de Riesgo
12.
BMC Psychiatry ; 21(1): 363, 2021 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-34284741

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic profoundly impacts on mental health, yet it is still unclear whether COVID-19 distress makes people more vulnerable to suicidal behavior. The present study aims to examine the association between COVID-19 related psychological distress and risk for suicide attempt, and moderators of this association, among hotline callers. METHODS: This case-control study was conducted at the largest psychological support hotline in China. Hotline callers who sought help for psychological distress and reported whether or not they attempted suicide in the last 2 weeks (recent suicide attempt) were analyzed. The primary predictor of recent suicide attempt was the presence or absence of COVID-19 related psychological distress. Demographic variables and common risk and protective factors for suicidal behavior were also studied. Callers with COVID-19 related distress (COVID-19 callers) and those without such distress (non-COVID-19 callers) were compared on these variables. Recent suicide attempt was regressed on COVID-19 related distress and the other variables, and significant interaction terms of aforementioned predictors by COVID-19 related distress, to identify variables that moderate the association of COVID-19 related distress and recent suicide attempt. RESULTS: Among 7337 included callers, there were 1252 COVID-19 callers (17.1%) and 6085 non-COVID-19 callers (82.9%). The COVID-19 callers were less likely to report recent suicide attempt (n = 73, 5.8%) than the non-COVID-19 callers (n = 498, 8.2%, P = 0.005). The COVID-19 callers were also less likely to have high scores on depressive symptoms (22.6% vs 26.3%, P < 0.001) and psychological distress (19.5% vs 27.3%, P < 0.001), and were more likely to have high hopefulness scores (46.5% vs 38.0%, P < 0.001). Tests of moderating effects showed that acute life events were associated with one-half lower risk (P = 0.021), and a trend that suicide attempt history was associated with two-thirds greater risk (P = 0.063) for recent suicide attempt, among COVID-19 callers than non-COVID-19 callers. CONCLUSIONS: The COVID-19 calls are from individuals with lower suicide-related risk compared to more typical callers. Acute stressful life events provided a key context for suicide attempt in non-COVID-19 callers, i.e., more typical calls.


Asunto(s)
COVID-19 , Distrés Psicológico , Estudios de Casos y Controles , China/epidemiología , Líneas Directas , Humanos , SARS-CoV-2 , Intento de Suicidio
13.
Am J Emerg Med ; 46: 503-507, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33191047

RESUMEN

BACKGROUND: Misdiagnosis of cerebrovascular disease among Emergency Department (ED) patients with headache has been reported. We hypothesized that markers of substandard diagnostic processes would be associated with subsequent ischemic cerebrovascular events among patients discharged from the ED with a headache diagnosis even after adjusting for demographic variables and medical history. METHODS: We conducted a case-control study of adult ED patients diagnosed with a primary headache disorder at Montefiore Medical Center from 9/1/2013-9/1/2018. Cases were defined as patients hospitalized for an ischemic stroke or TIA within 365 days of their index ED visit. Control patients were defined as those who lacked a subsequent hospitalization for cerebrovascular disease. Pre-specified demographic, clinical, and diagnostic process factors were compared between groups; conditional logistic regression was used to assess the separate and joint influence of baseline features on risk of cerebral ischemia. RESULTS: A total of 93 consecutive headache patients with a subsequent ischemic stroke/TIA hospitalization were matched to 93 controls (n = 186). Cases were older than controls and more likely to have traditional cerebrovascular risk factors. Neurological consultation was obtained more often for cases (13% vs. 4%; P = 0.03), cases were in the ED for longer (6 vs. 5 h, P = 0.03), and more frequently received neuroimaging (80% vs. 48%; P < 0.0001). Rates of neurological examination, documented differential diagnoses, and clear discharge follow up plans were similar between cases and controls. In our conditional logistic regression model, only history of prior stroke/TIA was associated with increased odds of subsequent cerebral ischemia. CONCLUSION: Factors associated with diagnostic process failures did not increase the odds of subsequent ischemic stroke/TIA hospitalization following ED headache visit in our study.


Asunto(s)
Trastornos Cerebrovasculares/diagnóstico , Servicio de Urgencia en Hospital , Cefalea/diagnóstico , Ataque Isquémico Transitorio/epidemiología , Accidente Cerebrovascular Isquémico/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Diagnóstico Diferencial , Errores Diagnósticos/estadística & datos numéricos , Documentación , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Examen Neurológico/estadística & datos numéricos , Neurología , Alta del Paciente , Derivación y Consulta/estadística & datos numéricos , Factores de Riesgo
14.
Aust N Z J Psychiatry ; 54(12): 1182-1191, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33050732

RESUMEN

OBJECTIVES: This study aimed to assess the association of the quality scores of hotline psychological intervention and the reduction of subsequent suicidal acts among high suicidal risk callers. METHODS: High-risk callers at a national crisis hotline service in China were recruited and prospectively followed for up to 3 months after receiving a hotline psychological intervention. The quality of the intervention was evaluated by supervisors who listened to the tape-recorded calls using the Counseling Skills Rating Scale for Psychological Support Hotlines, which assessed three counseling domains: process, attitude and communication skill. The primary outcome was the occurrence of suicidal acts during the follow-up period. Secondary outcomes were before versus after changes during the intake intervention call in hopefulness, psychological stress and suicide intention reported by the callers. RESULTS: Over the 3-month follow-up, 45 of 778 high-risk callers reported 61 suicide attempts, and 3 other callers died by suicide. Subsequent suicidal act was significantly more common in callers classified as being at higher risk during the intake call. Higher scores on the quality of suicidality assessing of the Counseling Skills Rating Scale for Psychological Support Hotlines were associated with reduced risk of suicidal acts during follow-up (hazard ratio = 0.38, 95% confidence interval = [0.18, 0.85]). Higher scores on the communication skill domain were associated with increases in hopefulness (ß = 0.09) after the intervention, and higher scores on the counseling process domain (ß = -0.12) and higher suicidal risk scores (ß = -0.12) were associated with decreased suicide intention after intervention. CONCLUSION: Several characteristics of a hotline intervention for suicide prevention were associated with decreased risk of suicidal acts during follow-up. Intervention skill training for hotline operators should emphasize these specific counseling skills.


Asunto(s)
Líneas Directas , Ideación Suicida , Intervención en la Crisis (Psiquiatría) , Humanos , Estudios Prospectivos , Intervención Psicosocial
15.
Pharmacol Res ; 139: 113-119, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30408573

RESUMEN

INTRODUCTION: Polypharmacy, defined as the use of 5 or more medications is associated with multiple adverse outcomes in older adults, including falls and slow gait velocity. However, the relationship between polypharmacy and cortical control of locomotion has not been reported. The purpose of this study was to examine the relationship between polypharmacy and activation patterns in the prefrontal cortex (PFC), a brain region involved in higher order control of locomotion during attention-demanding conditions. METHODS: Using Functional Near Infrared Spectroscopy (fNIRS) to quantify PFC oxygenated hemoglobin (HbO2) levels, we performed a cross sectional analysis of 325 community dwelling adults age ≥65 years, and examined HbO2 levels during single tasks (Single-Task-Walk (STW), (talking, cognitive interference (Alpha)) and Dual-Task Walk (DTW)). RESULTS: The prevalence of polypharmacy was 33% (n = 104) amongst the 325 participants (mean age 76.4 ± 6.7 years, 56% women). Among the 221 participants with no polypharmacy there was an increase in HbO2 levels from STW to DTW (estimate = -0.625; p = <0.001) and from Alpha to DTW (estimate=-0.079; p = 0.031). Polypharmacy status, however, moderated the change in HbO2 levels comparing the two single tasks to the dual-task walking condition. Specifically, the presence of polypharmacy was associated with an attenuated increase in HbO2 levels from STW to DTW (estimate = 0.149; p = 0.027) and with a decline in HbO2 levels from Alpha to DTW (estimate = 0.169; p = 0.009) after adjustments for potential confounders including medical comorbidities and the use of high-risk medications. CONCLUSION: The results of this study further support the need for clinicians to reduce polypharmacy in older adults, given its significant association with the PFC hemodynamic response during attention-demanding locomotion.


Asunto(s)
Polifarmacia , Corteza Prefrontal/fisiología , Caminata/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Vida Independiente , Masculino , Oxihemoglobinas/metabolismo
16.
Stat Med ; 38(4): 650-659, 2019 02 20.
Artículo en Inglés | MEDLINE | ID: mdl-30368844

RESUMEN

In noninferiority (NI) trials, an ongoing methodological challenge is how to handle in the analysis the subjects who are nonadherent to their assigned treatment. Some investigators perform the intent-to-treat (ITT) as the primary analysis and the per-protocol (PP) analysis as sensitivity analysis, whereas others do the reverse since ITT results may be anticonservative in the NI setting. But even when there is agreement between the ITT and PP approaches, NI of the experimental therapy to the comparator is not guaranteed. We propose that a tipping point method be used to further assess the impact of nonadherence on the results of a NI trial. In this approach, data from the nonadherers obtained after treatment discontinuation is not used, and their outcomes under the counterfactual situation of complete adherence are considered missing. The tipping point analysis indicates how sensitive the NI trial results are to the values of these missing counterfactual outcomes. The advantages of this approach are that a model or mechanism for the missing outcomes does not have to be assumed, and all subjects who were randomized are included in the analysis. We consider both binary and continuous outcomes and propose extensions to accommodate different types of nonadherence. The methods are illustrated with examples from two NI trials, one to evaluate different doses of radiation therapy to treat painful bone metastases and the other to compare treatments for reducing depression in adolescents.


Asunto(s)
Interpretación Estadística de Datos , Estudios de Equivalencia como Asunto , Cooperación del Paciente/estadística & datos numéricos , Adolescente , Terapia Cognitivo-Conductual/métodos , Depresión/terapia , Humanos , Cumplimiento de la Medicación/estadística & datos numéricos , Modelos Estadísticos , Resultado del Tratamiento
17.
Alzheimers Dement ; 15(7): 870-877, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31164315

RESUMEN

INTRODUCTION: To report clinical predictors of transition to dementia in motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by cognitive complaints and slow gait. METHODS: We examined if cognitive or motoric impairments predicted transition to dementia in 610 older adults with MCR from three cohorts. Association of cognitive (logical memory, clinical dementia rating, cognitive complaint severity, and Mini-Mental State Examination) and motoric factors (gait velocity) with dementia risk was computed using Cox models. RESULTS: There were 156 incident dementias (134 Alzheimer's disease). In the pooled sample, logical memory (adjusted hazard ratio [aHR] 0.91), cognitive complaint severity (aHR 1.53), and Mini-Mental State Examination (aHR 0.75) predicted transition of MCR to dementia. Clinical dementia rating score ≥0.5 predicted dementia (aHR 3.18) in one cohort. Gait velocity did not predict dementia. DISCUSSION: While MCR is a motoric-based predementia syndrome, severity of cognitive but not motoric impairments predicts conversion to dementia.


Asunto(s)
Trastornos del Conocimiento/diagnóstico , Demencia/diagnóstico , Marcha/fisiología , Síntomas Prodrómicos , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas/estadística & datos numéricos , Estudios Prospectivos , Factores de Riesgo , Estados Unidos
18.
J Cell Mol Med ; 22(9): 4496-4506, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29993187

RESUMEN

Aplastic anaemia (AA) is a life-threatening hematopoietic disorder characterized by hypoplasia and pancytopenia with increasing fat cells in the bone marrow (BM). The BM-derived mesenchymal stem cells (MSCs) from AA are more susceptible to be induced into adipogenic differentiation compared with that from control, which may be causatively associated with the fatty BM and defective hematopoiesis of AA. Here in this study, we first demonstrated that levamisole displayed a significant suppressive effect on the in vitro adipogenic differentiation of AA BM-MSCs. Mechanistic investigation revealed that levamisole could increase the expression of ZFP36L1 which was subsequently demonstrated to function as a negative regulator of adipogenic differentiation of AA BM-MSCs through lentivirus-mediated ZFP36L1 knock-down and overexpression assay. Peroxisome proliferator-activated receptor gamma coactivator 1 beta (PPARGC1B) whose 3'-untranslated region bears adenine-uridine-rich elements was verified as a direct downstream target of ZFP36L1, and knock-down of PPARGC1B impaired the adipogenesis of AA BM-MSCs. Collectively, our work demonstrated that ZFP36L1-mediated post-transcriptional control of PPARGC1B expression underlies the suppressive effect of levamisole on the adipogenic differentiation of AA BM-MSCs, which not only provides novel therapeutic targets for alleviating the BM fatty phenomenon of AA patients, but also lays the theoretical and experimental foundation for the clinical application of levamisole in AA therapy.


Asunto(s)
Adipocitos/efectos de los fármacos , Adipogénesis/efectos de los fármacos , Anemia Aplásica/genética , Factor 1 de Respuesta al Butirato/genética , Proteínas Portadoras/genética , Levamisol/farmacología , Células Madre Mesenquimatosas/efectos de los fármacos , Adipocitos/metabolismo , Adipocitos/patología , Adipogénesis/genética , Adolescente , Adulto , Anemia Aplásica/metabolismo , Anemia Aplásica/patología , Células de la Médula Ósea/efectos de los fármacos , Células de la Médula Ósea/metabolismo , Células de la Médula Ósea/patología , Factor 1 de Respuesta al Butirato/agonistas , Factor 1 de Respuesta al Butirato/metabolismo , Proteínas Portadoras/metabolismo , Estudios de Casos y Controles , Diferenciación Celular , Femenino , Regulación de la Expresión Génica , Genes Reporteros , Humanos , Luciferasas/genética , Luciferasas/metabolismo , Masculino , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/patología , Persona de Mediana Edad , Cultivo Primario de Células , Proteínas de Unión al ARN , Transducción de Señal
20.
Brain Cogn ; 125: 14-22, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29807266

RESUMEN

BACKGROUND: Gait alterations were documented in diabetic patients. However, the effect of diabetes on cortical control of gait has not been reported. We evaluated the effect of diabetes on prefrontal cortex (PFC) Oxygenated Hemoglobin (HbO2) levels during active walking in older adults. METHODS: Of the total sample (n = 315; mean age = 76.84 ±â€¯6.71ys; % female = 56.5) 43 participants (13.7%) had diabetes. The experimental paradigm consisted of two single tasks: Normal-Walk (NW); and Cognitive Interference (Alpha); and one dual-task condition consisting of the two single tasks, Walk-While-Talk (WWT). Functional Near-Infrared-Spectroscopy (fNIRS) was used to quantify PFC HbO2 levels. RESULTS: Older adults without diabetes showed higher PFC HbO2 levels in WWT compared to both NW and Alpha. HbO2 levels during NW were not different between the two groups. Consistent with Neural Inefficiency, older adults with diabetes exhibited higher HbO2 levels during Alpha while performing significantly worse than those without diabetes. Moreover, the presence of diabetes was associated with attenuated HbO2 levels during WWT. This pattern is consistent with Capacity Limitations suggesting a failure to recruit brain resources vis-à-vis the more cognitively challenging WWT condition. CONCLUSIONS: A distinct functional neural signature of diabetes was established during active and attention demanding walking among older adults without overt neurological disease.


Asunto(s)
Diabetes Mellitus/fisiopatología , Marcha/fisiología , Corteza Prefrontal/fisiopatología , Habla/fisiología , Caminata/fisiología , Anciano , Anciano de 80 o más Años , Atención/fisiología , Diabetes Mellitus/diagnóstico por imagen , Femenino , Humanos , Masculino , Oxihemoglobinas , Corteza Prefrontal/diagnóstico por imagen , Espectroscopía Infrarroja Corta
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