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1.
J Dermatol ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39258818

RESUMEN

We aimed to analyze the clinical profile and malignancy indicators in dermatomyositis (DM) with anti-transcriptional intermediary factor 1 antibody (anti-TIF1γ-Ab). A comparison was made between clinical information of anti-TIF1γ DM patients with and without malignancy. Additionally, a review of the literature on anti-TIF1γ DM and malignancy was conducted by searching PubMed and EMBASE databases. In our cohort of 37 patients, 27.0% (10/37) developed malignancy. The timeframe during which these 10 patients developed malignancy ranged from 21 months prior to the diagnosis of DM to 36 months following the diagnosis of DM. Specifically, one patient was diagnosed with breast cancer at the age of 36. Comparing the groups with and without malignancy, we found that age over 65 years (40% vs 7.4%, P = 0.035), a shorter duration from the onset of symptoms to the diagnosis of DM (2.5 vs 10 months, P = 0.003), and higher erythrocyte sedimentation rate (ESR) levels (23 vs 10 mm/h, P = 0.048) were found to be associated with an increased risk of malignancy. Conversely, the presence of Gottron's papules (63% vs 20%, P = 0.029) may suggest a lower likelihood of malignancy. The literature review revealed that the prevalence of myositis-associated malignancy was 40.7% (340/836), with variations ranging from 19% to 82.9% across different series. In summary, factors such as age over 65 years, a shorter duration between symptom onset and diagnosis of DM, and elevated ESR levels may indicate an increased risk of malignancy in anti-TIF1γ DM patients.

2.
Angew Chem Int Ed Engl ; : e202413074, 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39133520

RESUMEN

C(sp3) centers adjacent to (hetero)aryl groups are widely present in physiologically active molecules. Metal-hydride-catalyzed hydroalkylation of alkenes represents an efficient means of forging C(sp3)-C(sp3) bonds, boasting advantages as a wide source of substrates, mild reaction conditions, and facile selectivity manipulation. Nevertheless, the hydroalkylation of vinylarenes encounters constraints in terms of substrate scope, necessitating the employment of activated alkyl halides or alkenes containing chelating groups, remains a challenge. In this context, we report a general nickel-hydride-catalyzed hydroalkylation protocol for vinylarenes. Remarkably, this system enables α-selective hydroalkylation of both aryl and heteroaryl alkenes under an extra ligand-free condition, demonstrating excellent coupling efficiency and selectivity. Furthermore, through the incorporation of chiral bisoxazoline ligands, we have achieved regio- and enantioselective hydroalkylation of vinylpyrroles, thereby facilitating the synthesis of α-branched alkylated pyrrole derivatives.

3.
Front Immunol ; 15: 1421684, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39170619

RESUMEN

Introduction: Immune-related epidermal necrolysis (irEN), including Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN), represents a potentially lethal reaction to immune checkpoint inhibitors. An optimal treatment strategy remains undefined. This study evaluates the effectiveness and safety of combination therapy with corticosteroids and tumor necrosis factor inhibitors (TNFi) in treating irEN patients. Methods: In this single-center, prospective, observational study, patients with irEN received either corticosteroid monotherapy or a combination therapy of corticosteroids and TNFi (etanercept for SJS, infliximab for TEN). The primary endpoint was re-epithelization time, with secondary endpoints including corticosteroid exposure, major adverse event incidence, acute mortality rates, and biomarkers indicating disease activity and prognosis. The study was registered at the Chinese Clinical Trial Registry (ChiCTR2100051052). Results: Thirty-two patients were enrolled (21 SJS, 11 TEN); 14 received combination therapy and 18 received corticosteroid monotherapy. IrEN typically occurred after 1 cycle of ICI administration, with a median latency of 16 days. Despite higher SCORTEN scores in the combination group (3 vs. 2, p = 0.008), these patients experienced faster re-epithelization (14 vs. 21 days; p < 0.001), shorter corticosteroid treatment duration (22 vs. 32 days; p = 0.005), and lower prednisone cumulative dose (1177 mg vs. 1594 mg; p = 0.073). Major adverse event rates were similar between groups. Three deaths occurred due to lung infection or disseminated intravascular coagulation, with mortality rates for both groups lower than predicted. Potential risk factors for increased mortality included continuous reduction in lymphocyte subset counts (CD4+ T cells, CD8+ T cells, natural killer cells) and consistent rises in inflammatory markers (serum ferritin, interleukin-6, TNF-α). Re-epithelization time negatively correlated with body mass index and positively correlated with epidermal detachment area and serum levels of interleukin-6 and TNF-α. Conclusions: Corticosteroids combined with TNFi markedly promote re-epithelization, reduce corticosteroid use, and decrease acute mortality in irEN patients without increasing major adverse events, offering a superior alternative to corticosteroid monotherapy. Inflammatory markers and lymphocyte subsets are valuable for assessing disease activity and prognosis.


Asunto(s)
Corticoesteroides , Quimioterapia Combinada , Inhibidores de Puntos de Control Inmunológico , Síndrome de Stevens-Johnson , Inhibidores del Factor de Necrosis Tumoral , Humanos , Síndrome de Stevens-Johnson/etiología , Síndrome de Stevens-Johnson/mortalidad , Síndrome de Stevens-Johnson/tratamiento farmacológico , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Corticoesteroides/uso terapéutico , Adulto , Anciano , Inhibidores del Factor de Necrosis Tumoral/uso terapéutico , Inhibidores del Factor de Necrosis Tumoral/efectos adversos , Etanercept/efectos adversos , Etanercept/uso terapéutico , Resultado del Tratamiento , Infliximab/uso terapéutico , Infliximab/efectos adversos
4.
Opt Lett ; 49(17): 4891-4894, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39207990

RESUMEN

We experimentally demonstrate a liquid crystal (LC)-integrated EIT metasurface for active THz polarization conversion and asymmetric transmission. By controlling the LC orientation under static magnetic field anchoring and an adjustable electric field, the device realizes the active control from the OFF state to the ON state, corresponding to the orthogonal polarization excitation modes of the EIT metasurface. Furthermore, based on the different polarization responses at forward and backward incidences, we achieve asymmetric transmission at the EIT peak and two nearby resonances, with its isolation actively manipulated by the external electric field. This study on dynamic polarization conversion and asymmetric transmission by a LC-integrated metasurface offers a promising route for active THz devices, applicable to THz communication, switching, and sensing systems.

5.
Exp Dermatol ; 33(5): e15103, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38794829

RESUMEN

Erythrodermic psoriasis (EP) is a rare and life-threatening disease, the pathogenesis of which remains to be largely unknown. Metabolomics analysis can provide global information on disease pathophysiology, candidate biomarkers, and potential intervention strategies. To gain a better understanding of the mechanisms of EP and explore the serum metabolic signature of EP, we conducted an untargeted metabolomics analysis from 20 EP patients and 20 healthy controls. Furthermore, targeted metabolomics for focused metabolites were identified in the serum samples of 30 EP patients and 30 psoriasis vulgaris (PsV) patients. In the untargeted analysis, a total of 2992 molecular features were extracted from each sample, and the peak intensity of each feature was obtained. Principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA) revealed significant difference between groups. After screening, 98 metabolites were found to be significantly dysregulated in EP, including 67 down-regulated and 31 up-regulated. EP patients had lower levels of L-tryptophan, L-isoleucine, retinol, lysophosphatidylcholine (LPC), and higher levels of betaine and uric acid. KEGG analysis showed differential metabolites were enriched in amino acid metabolism and glycerophospholipid metabolism. The targeted metabolomics showed lower L-tryptophan in EP than PsV with significant difference and L-tryptophan levels were negatively correlated with the PASI scores. The serum metabolic signature of EP was discovered. Amino acid and glycerophospholipid metabolism were dysregulated in EP. The metabolite differences provide clues for pathogenesis of EP and they may provide insights for therapeutic interventions.


Asunto(s)
Metabolómica , Análisis de Componente Principal , Psoriasis , Humanos , Psoriasis/sangre , Psoriasis/metabolismo , Metabolómica/métodos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Cromatografía Liquida , Betaína/sangre , Biomarcadores/sangre , Triptófano/sangre , Triptófano/metabolismo , Lisofosfatidilcolinas/sangre , Isoleucina/sangre , Ácido Úrico/sangre , Vitamina A/sangre , Estudios de Casos y Controles , Espectrometría de Masas , Dermatitis Exfoliativa/sangre , Glicerofosfolípidos/sangre , Análisis Discriminante , Regulación hacia Abajo , Análisis de los Mínimos Cuadrados , Cromatografía Líquida con Espectrometría de Masas
6.
Int J Dermatol ; 2024 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-38736134

RESUMEN

BACKGROUND: Palmoplantar pustulosis (PPP) is a chronic inflammatory disease of ill-defined etiopathology. Recent studies have proposed complete blood count-based hematological parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), as biomarkers to monitor disease status in many inflammatory diseases. This study aimed to analyze for the first time the clinical significance of hematological parameters, including NLR, monocyte/lymphocyte ratio (MLR), PLR, mean platelet volume (MPV), plateletcrit (PCT), and pan-immune-inflammation value (PIV) in PPP patients. METHODS: We retrospectively investigated the clinical and laboratory data of 237 patients with PPP and 250 sex-age-matched healthy controls (HCs). Hematological parameters were compared between patients with PPP and HCs. The correlations between these parameters and disease severity, as well as treatment response, were analyzed. RESULTS: NLR, MLR, MPV, PCT, and PIV values were significantly higher in PPP patients than in HCs. But in receiver-operating characteristic analyses, only monocyte count (Youden Index = 0.53), PCT (Youden Index = 0.65), and PIV (Youden Index = 0.52) performed relatively accurate distinguishment between moderate-to-severe cases and mild cases. PCT and PIV values were significantly correlated with disease severity. After treatment, both PIV and PCT values decreased significantly in the responder group but not in the non-responder group. CONCLUSIONS: Hematological parameters altered significantly in PPP patients. PCT and PIV can be used as simple and inexpensive biomarkers for systemic inflammation in PPP patients.

9.
Heliyon ; 10(5): e27355, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38449598

RESUMEN

Background and aim: Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening complication, and patients who experience it are formally assigned to stage T4 in the TNM system, while many clinicians informally assign them to stage C in the more widely used Barcelona Clinic Liver Cancer (BCLC) system. The present study explored whether these re-staging practices are appropriate for HCC patients who suffer tumor rupture. Methods: We retrospectively reviewed the records of 1952 HCC patients who underwent hepatic resection at our hospital between January 2017 and June 2021. We compared recurrence-free and overall survival between 143 patients who had BCLC stage A or B disease at the time of spontaneous rupture and 449 patients who had BCLC stage C disease without rupture. Results: Overall survival rate was significantly higher among the 143 patients (1, 3, 5-year survival rate was 80.3%, 60.4%, 51.4%) with rupture than among the 449 (1, 3, 5-year survival rate was 69.5%, 41.5%, 32.4%) with BCLC stage C disease (hazard ratio 1.65, 95% confidence interval 1.29 to 2.12). The two groups had similar recurrence-free survival (hazard ratio 1.19, 95% confidence interval 0.92 to 1.53), but most patients with rupture were able to receive interventional and potentially curative treatments after recurrence, whereas most patients in BCLC stage C received interventional or supportive care. Similar results were obtained after propensity score matching. Conclusion: HCC patients who experience spontaneous rupture tumor while in BCLC stage A or B have better prognosis than patients in BCLC stage C without rupture. Our results suggest that HCC patients who suffer rupture in BCLC stage A or B should not be assigned to BCLC stage C.

10.
Dermatol Ther (Heidelb) ; 14(4): 893-906, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38483777

RESUMEN

INTRODUCTION: The necessity for tuberculosis preventive treatment (TPT) and routine T-SPOT.TB monitoring in patients with psoriasis and tuberculosis infection (TBI) undergoing interleukin (IL)-17A inhibitor therapy remains uncertain. This study aims to evaluate the long-term safety of IL-17A inhibitors administered without TPT and analyze changes in T-SPOT.TB among these patients. It also identifies risk factors for TBI in patients with psoriasis. METHODS: This single-center prospective study enrolled adult patients with plaque psoriasis and TBI receiving IL-17A inhibitors. TBI was defined as positive T-SPOT.TB results (≥ 6 spots) without symptoms or evidence of active tuberculosis (ATB). TPT administration was based on contraindications, tuberculosis risk factors, and patient preferences. The primary endpoint was the incidence of ATB over 2 years. Secondary outcomes included T-SPOT.TB changes and TBI risk factors. RESULTS: Of the 129 patients with psoriasis and TBI enrolled in the study, 97 (75.2%) did not receive TPT, while 32 (24.8%) did. Among them, 109 patients (84.5%) completed the 2-year follow-up. During the 235 person-years of observation, no ATB cases were identified. Median T-SPOT.TB values showed no significant changes from baseline to year 2 in both the non-TPT (20 vs. 17 spots, p = 0.975) and TPT groups (55 vs. 58 spots, p = 0.830). T-SPOT.TB reversed in 14 patients (12.8%), mostly in the non-TPT group. Moreover, for TBI risk factor analysis, a cohort of 212 patients with psoriasis with negative baseline T-SPOT.TB was evaluated, revealing a TBI prevalence of 37.8%. Logistic regression analysis highlighted age ≥ 45 years (odds ratio [OR] 2.44, 95% confidence interval [CI] 1.50-3.99, p < 0.001) and body mass index (BMI) < 24.0 kg/m2 (OR 2.12, 95% CI 1.27-3.54, p = 0.004) as independent risk factors for TBI. CONCLUSION: IL-17A inhibitors do not appear to reactivate tuberculosis in patients with psoriasis and TBI, potentially reducing the need for routine TBI screening and preventive treatment. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2100045823.

11.
Small ; 20(28): e2308483, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38329171

RESUMEN

Phosphates featuring a 3D framework offer a promising alternative to aqueous sodium-ion batteries, known for their safety, cost-effectiveness, scalability, high power density, and tolerance to mishandling. Nevertheless, they often suffer from poor reversible capacity stemming from limited redox couples. Herein, N-containing Na2VTi(PO4)3 is synthesized for aqueous sodium-ion storage through multi-electron redox reactions. It demonstrates a capacity of 155.2 mAh g-1 at 1 A g-1 (≈ 5.3 C) and delivers an ultrahigh specific energy of 55.9 Wh kg-1 in a symmetric aqueous sodium-ion battery. The results from in situ X-ray diffraction analysis, ex situ X-ray photoelectron spectroscopy analysis, and first-principle calculations provide insights into the local chemical environment of sodium ions, the mechanisms underlying capacity decay during cycling, and the dynamics of ion and electron transfer at various states of charge. This understanding will contribute to the advancement of electrode materials for aqueous sodium-ion batteries.

13.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1042536

RESUMEN

Background/Aims@#The global proportion of hepatocellular carcinoma (HCC) attributable to metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. The MAFLD diagnostic criteria allows objective diagnosis in the presence of steatosis plus defined markers of metabolic dysfunction, irrespective of concurrent liver disease. We aimed to determine the total global prevalence of MAFLD in HCC cohorts (total-MAFLD), including the proportion with MAFLD as their sole liver disease (single-MAFLD), and the proportion of those with concurrent liver disease where MAFLD was a contributary factor (mixed-MAFLD). @*Methods@#This systematic review and meta-analysis included studies systematically ascertaining MAFLD in HCC cohorts, defined using international expert panel criteria including ethnicity-specific BMI cut-offs. A comparison of clinical and tumour characteristics was performed between single-MAFLD, mixed-MAFLD, and non-MAFLD HCC. @*Results@#22 studies (56,565 individuals with HCC) were included. Total and single-MAFLD HCC prevalence was 48.7% (95% confidence interval [CI] 34.5–63.0%) and 12.4% (95% CI 8.3–17.3%), respectively. In HCC due to chronic hepatitis B, C, and alcohol-related liver disease, mixed-MAFLD prevalence was 40.0% (95% CI 30.2–50.3%), 54.1% (95% CI 40.4–67.6%) and 64.3% (95% CI 52.7–75.0%), respectively. Mixed-MAFLD HCC had significantly higher likelihood of cirrhosis and lower likelihood of metastatic spread compared to single-MAFLD HCC, and a higher platelet count and lower likelihood of macrovascular invasion compared to non-MAFLD HCC. @*Conclusions@#MAFLD is common as a sole aetiology, but more so as a co-factor in mixed-aetiology HCC, supporting the use of positive diagnostic criteria.

14.
Ying Yong Sheng Tai Xue Bao ; 34(10): 2619-2628, 2023 Oct.
Artículo en Chino | MEDLINE | ID: mdl-37897268

RESUMEN

Determining the differences of water use characteristics of a tree species with different origins (natural forests and introduced plantations) is significantly important for forest sustainable management. Pinus sylvestris var. mongolica is an important tree species of afforestation in the 'Three North' project in China. In this study, with Pinus sylvestris var. mongolica from two origins, we monitored the sap flow velocity of sapwood (Js) of trees by thermal dissipation sap flow probes, and analyzed the relationship between water transportation and the environmental factors during the growing season. The results showed that under the typical sunny day, daily sap flow velocity (Js-daily) of trees from plantations was significantly higher than that from natural forests. The mean value of Js-daily was 132.98 and 114.86 cm·d-1 for the two origins, respectively. Trees from plantations showed higher water transportation potential than natural forests. Vapor pressure deficit (VPD) mainly showed the driving effect on the water use process of trees from natural forests. In the plantations, there was an obvious threshold effect, and the inflection point of VPD was about 1.91 kPa, with the boundary function of Js-hour increased to the maximum of 17.88 cm·h-1. Atmospheric driven transpiration potential (Js-hour/VPD) of P. sylvestris var. mongolica trees with two origins decreased with the aggravation of soil drought, but sensitivity to drought was higher in the plantations than in the natural forests, suggesting the strong ability of Pinus sylvestris var. mongolica to regulate water use process.


Asunto(s)
Pinus sylvestris , Pinus , Pinus sylvestris/fisiología , Agua/análisis , Bosques , Árboles , Suelo , China
15.
Sensors (Basel) ; 23(19)2023 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-37836853

RESUMEN

Segmental stress during the construction process plays a pivotal role in assessing the safety and quality of shield tunnels. Fiber Bragg grating (FBG) sensing technology has been proposed for tunnel segment stress monitoring. A laboratory test was conducted to validate the reliable strain measurement of FBG sensors. The field in situ monitoring of a sewerage shield tunnel was carried out to examine the longitudinal and circumferential stresses experienced by the segments throughout the construction phase. The cyclic fluctuations in stress were found to be synchronized with the variations in shield thrust. A comparison was made between the longitudinal and circumferential stress variations observed during the shield-driving and segment-assembly processes. Additionally, the time required for the grouting to reach its full curing strength was estimated, revealing its impact on the stress levels and range of the pipe segment. The findings of this study offer an enhanced understanding of the stress state and health condition of small-diameter shield tunnels, which can help in optimizing the design and construction process of tunnel segments, as well.

16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 45(4): 683-688, 2023 Aug.
Artículo en Chino | MEDLINE | ID: mdl-37654150

RESUMEN

Immune-mediated dermatoses are the skin diseases caused by the breakdown of immune tolerance,including lupus erythematosus and dermatomyositis.The imbalance between regulatory T cells (Tregs) and effector T cells (Teffs) plays a key role in the pathogenesis of these diseases.Low-dose interleukin-2 can preferentially activate Tregs and reverse the imbalance between Tregs and Teffs to recover the immune tolerance,which has attracted attention in the treatment of immune-mediated dermatoses.This review summarizes the research progress in the immunomodulatory mechanism and clinical application of low-dose interleukin-2 in immune-mediated dermatoses,providing a new idea for the clinical treatment of these diseases.


Asunto(s)
Lupus Eritematoso Sistémico , Enfermedades de la Piel , Humanos , Interleucina-2 , Linfocitos T Reguladores , Enfermedades de la Piel/tratamiento farmacológico
17.
Am J Clin Dermatol ; 24(6): 991-1002, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37386353

RESUMEN

BACKGROUND AND OBJECTIVE: Pustular psoriasis is a chronic and recurrent autoimmune disease, although little is known about the disease burden of pustular psoriasis in China. We analyzed the characteristics and disease burdens of patients from Beijing who had generalized pustular psoriasis (GPP) or palmoplantar pustulosis (PPP). METHODS: This multicenter retrospective cohort study used a regional electronic health database that covered 30 public hospitals in Beijing. From June 2016 to June 2021, all patients with a diagnosis of GPP, PPP, or psoriasis vulgaris (PV) were identified by International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. The GPP and PPP cohorts were separately matched with patients with PV in a 3:1 ratio for comparisons. Demographic data, clinical characteristics, healthcare resource utilization, and costs were collected. Descriptive and comparative analyses were used to compare the cohorts. RESULTS: There were 744 patients with GPP (46.8% men; age 42.14 ± 21.47 years) and 4808 patients with PPP (35.5% men; age 51.65 ± 16.12 years); 14.5% of patients with GPP had concomitant PV and 7.5% of patients with PPP had concomitant PV. Relative to matched patients with PV, patients with GPP had a higher prevalence of erythrodermic psoriasis (5.9% vs 0.4%, p < 0.0001), psoriatic arthritis (3.1% vs 1.5%, p = 0.007), and organ failure (1.1% vs 0.2%, p = 0.002). Relative to matched patients with PV, patients with PPP had a higher prevalence of cerebrovascular disease (4.7% vs 1.2%, p < 0.0001), thyroid dysfunction (3.9% vs 3.3%, p = 0.035), and type 2 diabetes mellitus (6.8% vs 5.9%, p = 0.030). More patients with GPP than patients with PV received systemic non-biological agents (27.9% vs 3.3%, p < 0.0001) and biologic agents (4.8% vs 2.0%, p = 0.010). More patients with PPP than patients with PV received topical agents (50.9% vs 34.7%, p < 0.0001) and systemic non-biological agents (17.8% vs 2.7%, p < 0.0001). More patients with GPP than patients with PV required inpatient hospitalization (22.0% vs 7.8%, p < 0.0001). Hospitalization stay was longer in patients with GPP than patients with PV (11.72 ± 0.45 vs 10.38 ± 0.45 days, p = 0.022). More patients with PPP than patients with PV had emergency visits (16.3% vs 12.8%, p < 0.0001). The GPP and PPP cohorts and their matched PV cohorts had no significant differences in costs. However, patients with PPP had lower outpatient costs than patients with PV (368.20 ± 8.19 vs 445.38 ± 5.90 Chinese Yuan per patient per month, p < 0.0001). CONCLUSIONS: Patients from Beijing with GPP and PPP had higher disease burdens than matched PV cohorts, including the prevalence of comorbidities, healthcare resource utilization, and medication burden. However, the economic burden of pustular psoriasis was similar to that of PV. Practical and specific therapies are needed to reduce the burdens of pustular psoriasis.


Asunto(s)
Artritis Psoriásica , Diabetes Mellitus Tipo 2 , Psoriasis , Masculino , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Femenino , Diabetes Mellitus Tipo 2/epidemiología , Estudios Retrospectivos , Psoriasis/epidemiología , Psoriasis/terapia , Psoriasis/diagnóstico , Artritis Psoriásica/epidemiología , Comorbilidad , Enfermedad Aguda , Enfermedad Crónica
18.
Complex Intell Systems ; : 1-27, 2023 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-37361969

RESUMEN

Healthcare tends to be one of the most complicated sectors, and hospitals exist at the core of healthcare activities. One of the most significant elements in hospitals is service quality level. Moreover, the dependency between factors, dynamic features, as well as objective and subjective uncertainties involved endure challenges to modern decision-making problems. Thus, in this paper, a decision-making approach is developed for hospital service quality assessment, using a Bayesian copula network based on a fuzzy rough set within neighborhood operators as a basis of that to deal with dynamic features as well as objective uncertainties. In the copula Bayesian network model, the Bayesian Network is utilized to illustrate the interrelationships between different factors graphically, while Copula is engaged in obtaining the joint probability distribution. Fuzzy rough set theory within neighborhood operators is employed for the subjective treatment of evidence from decision makers. The efficiency and practicality of the designed method are validated by an analysis of real hospital service quality in Iran. A novel framework for ranking a group of alternatives with consideration of different criteria is proposed by the combination of the Copula Bayesian Network and the extended fuzzy rough set technique. The subjective uncertainty of decision makers' opinions is dealt with in a novel extension of fuzzy Rough set theory. The results highlighted that the proposed method has merits in reducing uncertainty and assessing the dependency between factors of complicated decision-making problems.

19.
Expert Rev Clin Immunol ; 19(5): 499-516, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36970858

RESUMEN

INTRODUCTION: Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease belonging to the localized form of pustular psoriasis. It is characterized by sterile pustule formation in palms and soles and a recurrent disease course. Although we have many treatments for PPP, there is no authoritative guidance. AREAS COVERED: A thorough search of PubMed was conducted to identify studies in PPP from 1973 onwards, with additional references to specific articles. Any treatment methods were outcomes of interest, including topical treatment, systemic treatment, biologics, other targeted treatments, phototherapy, and tonsillectomy. EXPERT OPINION: Topical corticosteroids are suggested as first-line therapy. Oral acitretin has become the most applied systemic retinoid recommended in PPP without joint involvement. For patients with arthritis, immunosuppressants like cyclosporin A and methotrexate are more recommended. UVA1, NB-UVB, and 308-nm excimer laser are effective phototherapy options. The combinations of topical or systemic agents and phototherapy may enhance the efficacy, particularly in recalcitrant cases. Secukinumab, ustekinumab, and apremilast are the most investigated targeted therapies. However, heterogeneous reported outcomes in clinical trials provided low-to-moderate quality evidence of their efficacy. Future studies are required to address these evidence gaps. We suggest managing PPP based on the acute phase, maintenance phase, and comorbidities.


Asunto(s)
Fármacos Dermatológicos , Psoriasis , Humanos , Psoriasis/tratamiento farmacológico , Ciclosporina/uso terapéutico , Acitretina/uso terapéutico , Inmunosupresores/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Enfermedad Crónica
20.
Trop Med Infect Dis ; 8(2)2023 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-36828487

RESUMEN

The construction of the Yangtze River Economic Belt (YEB) is a great national economic development strategy in China. As the YEB covers most endemic provinces of schistosomiasis japonica featured by low endemicity, this study aimed to investigate the spatiotemporal distribution pattern of Oncomelania hupensis (O. hupensis), which serves as the only intermediate host of Schistosoma japonicum in the YEB. Annual data reflecting the distribution of O. hupensis from 2015 to 2021 were collected from the National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention. Spatial autocorrelation analysis, hotspot analysis and space-time scan analysis were performed to explore the aggregation features and spatiotemporal dynamics of the snail distribution. The distribution of both total snail habitats (during 2015-2021) and emerging snail habitats (in 2016, 2018 and 2020) showed spatial autocorrelation (Z = 15.8~16.1, p < 0.05; Z = 2.3~7.5, p < 0.05). Hotspot (high-value areas in space) counties were mainly clustered in the alluvial plain of the middle and lower reaches of the YEB. Eight spatial and temporal clusters of snail habitats were scanned and were mainly concentrated in the counties of Anhui, Jiangxi, Hubei, Hunan and Jiangsu provinces along the Yangtze River. The YEB carries a tremendous burden of O. hupensis. Surveillance and risk identification based on the snail presence should be strengthened to provide reference for protecting humans and public health security in the YEB.

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