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2.
Adv Sci (Weinh) ; : e2404792, 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39119825

RESUMEN

Fluorogens with aggregation-induced emission (AIEgens) are promising agents for two-photon fluorescence (TPF) imaging. However, AIEgens' photophysical properties are fixed and unoptimizable once synthesized. Therefore, it is urgent and meaningful to explore an efficient post-regulation strategy to optimize AIEgens' photophysical properties. Herein, a general and efficient post-regulation strategy is reported. By simply tuning the ratio of inert AIEgens within binary nanoparticles (BNPs), the fluorescence quantum yield and two-photon absorption cross-section of functional AIEgens are enhanced by 8.7 and 5.4 times respectively, which are not achievable by conventional strategies, and the notorious phototoxicity is almost eliminated. The experimental results, theoretical simulation, and mechanism analysis demonstrated its feasibility and generality. The BNPs enabled deep cerebrovascular network imaging with ≈1.10 mm depth and metastatic cancer cell detection with single-cell resolution. Furthermore, the TPF imaging quality is improved by the self-supervised denoising algorithm. The proposed binary molecular post-regulation strategy opened a new avenue to efficiently boost the AIEgens' photophysical properties and consequently TPF imaging quality.

3.
Angew Chem Int Ed Engl ; : e202408918, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39013139

RESUMEN

The excessive and prolonged use of antibiotics contributes to the emergence of drug-resistant S. aureus strains and potential dysbacteriosis-related diseases, necessitating the exploration of alternative therapeutic approaches. Herein, we present a light-activated nanocatalyst for synthesizing in-situ antimicrobials through photoredox-catalytic click reaction, achieving precise, site-directed elimination of S. aureus skin infections. Methylene blue (MB), a commercially available photosensitizer, was encapsulated within the CuII-based metal-organic framework, MOF-199, and further enveloped with Pluronic F-127 to create the light-responsive nanocatalyst MB@PMOF. Upon exposure to red light, MB participates in a photoredox-catalytic cycle, driven by the 1,3,5-benzenetricarboxylic carboxylate salts (BTC-) ligand presented in the structure of MOF-199. This light-activated MB then catalyzes the reduction of CuII to CuI through a single-electron transfer (SET) process, efficiently initiating the click reaction to form active antimicrobial agents under physiological conditions. Both in vitro and in vivo results demonstrated the effectiveness of MB@PMOF-catalyzed drug synthesis in inhibiting S. aureus, including their methicillin-resistant strains, thereby accelerating skin healing in severe bacterial infections. This study introduces a novel design paradigm for controlled, on-site drug synthesis, offering a promising alternative to realize precise treatment of bacterial infections without undesirable side effects.

5.
Clin Transplant ; 38(7): e15382, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38973768

RESUMEN

INTRODUCTION: Adults residing in deprived neighborhoods face various socioeconomic stressors, hindering their likelihood of receiving live-donor kidney transplantation (LDKT) and preemptive kidney transplantation (KT). We quantified the association between residential neighborhood deprivation index (NDI) and the likelihood of LDKT/preemptive KT, testing for a differential impact by race and ethnicity. METHODS: We studied 403 937 adults (age ≥ 18) KT candidates (national transplant registry; 2006-2021). NDI and its 10 components were averaged at the ZIP-code level. Cause-specific hazards models were used to quantify the adjusted hazard ratio (aHR) of LDKT and preemptive KT across tertiles of NDI and its 10 components. RESULTS: Candidates residing in high-deprivation neighborhoods were more likely to be female (40.1% vs. 36.2%) and Black (41.9% vs. 17.7%), and were less likely to receive both LDKT (aHR = 0.66, 95% confidence interval [CI]: 0.64-0.67) and preemptive KT (aHR = 0.60, 95% CI: 0.59-0.62) than those in low-deprivation neighborhoods. These associations differedby race and ethnicity (Black: aHRLDKT = 0.58, 95% CI: 0.55-0.62; aHRpreemptive KT = 0.68, 95% CI: 0.63-0.73; Pinteractions: LDKT < 0.001; Preemptive KT = 0.002). All deprivation components were associated with the likelihood of both LDKT and preemptive KT (except median home value): for example, higher median household income (LDKT: aHR = 1.08, 95% CI: 1.07-1.09; Preemptive KT: aHR = 1.10, 95% CI: 1.08-1.11) and educational attainments (≥high school [LDKT: aHR = 1.17, 95% CI: 1.15-1.18; Preemptive KT: aHR = 1.23, 95% CI: 1.21-1.25]). CONCLUSION: Residence in socioeconomically deprived neighborhoods is associated with a lower likelihood of LDKT and preemptive KT, differentially impacting minority candidates. Identifying and understanding which neighborhood-level socioeconomic status contributes to these racial disparities can be instrumental in tailoring interventions to achieve health equity in LDKT and preemptive KT.


Asunto(s)
Trasplante de Riñón , Donadores Vivos , Características del Vecindario , Humanos , Femenino , Masculino , Donadores Vivos/provisión & distribución , Persona de Mediana Edad , Adulto , Estudios de Seguimiento , Pronóstico , Características de la Residencia , Fallo Renal Crónico/cirugía , Factores Socioeconómicos , Sistema de Registros/estadística & datos numéricos , Factores de Riesgo , Adulto Joven , Adolescente
6.
Environ Sci Technol ; 58(29): 13145-13156, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-38980824

RESUMEN

Electrode scaling poses a critical barrier to the adoption of electrochemical processes in wastewater treatment, primarily due to electrode inactivation and increased internal reactor resistance. We introduce an antiscaling strategy using tip-enhanced electric fields to redirect scale-forming compounds (e.g., Mg(OH)2 and CaCO3) from the electrode-electrolyte interface to the bulk solution. Our study utilized Cu nanowires (Cu NW) with high-curvature nanostructures as the cathode, in contrast to Cu nanoparticles (Cu NP), Cu foil (CF), and Cu mesh (CM), to evaluate the electrochemical nitrate reduction reaction (NO3RR) performance in hard water conditions. The Cu NW/CF cathode demonstrated superior NO3RR efficiency, with an apparent rate constant (Kapp) of 1.04 h-1, significantly outperforming control electrodes under identical conditions (Kapp < 0.051 h-1). Through experimental and theoretical analysis, including COMSOL simulations, we show that the high-curvature design of Cu NW induced localized electric field enhancements, propelling OH- ions away from the electrode surface into the bulk solution, thus mitigating scale formation on the cathode. Testing with real nitrate-contaminated wastewater confirms that the Cu NW/CF cathode maintained excellent denitrification efficiency over a 60-day period. This study offers a promising perspective on preventing electrode scaling in electrochemical wastewater treatment, paving the way for more efficient and sustainable practices.


Asunto(s)
Electrodos , Aguas Residuales , Aguas Residuales/química , Cobre/química , Purificación del Agua/métodos , Nitratos/química
7.
Am J Cardiol ; 225: 118-124, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-38844195

RESUMEN

Cardiometabolic co-morbidities, diabetes (DM), hypertension (HTN), and obesity contribute to cardiovascular disease. Circulating biomarkers facilitate prognostication for patients with cardiovascular disease. We explored the relation between cardiometabolic co-morbidity burden in patients with chronic coronary disease and biomarkers of myocardial stretch, injury, inflammation, and platelet activity. We analyzed participants from the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trials biorepository with plasma biomarkers (N-terminal probrain natriuretic peptide, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein, interleukin-6, soluble CD40 ligand, and growth differentiation factor-15) and clinical risk factors (hemoglobin A1c [HbA1c], systolic blood pressure [SBP], and body mass index [BMI]) at baseline. We defined cardiometabolic co-morbidities as DM, HTN, and obesity at baseline. Co-morbidity burden is characterized by the number and severity of co-morbidities. Controlled co-morbidities were defined as HbA1c <7% for those with DM, SBP <130 mm Hg for those with HTN, and BMI <30 kg/m2. Severely uncontrolled was defined as HbA1c ≥8%, SBP ≥160 mm Hg, and BMI ≥35 kg/m2. We performed linear regression analyses to examine the association between co-morbidity burden and log-transformed biomarker levels, adjusting for age, gender, estimated glomerular filtration rate controlled for hemodialysis, and left ventricular ejection fraction. A total of 752 participants (mean age 66 years, 19% women, 84% White) were included in this analysis. Self-reported Black race, current smokers, history of myocardial infarction, and heart failure had a greater cardiometabolic co-morbidity burden. The presence of ≥1 severely uncontrolled co-morbidity was associated with significantly higher baseline levels of high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein, interleukin-6, and growth differentiation factor-15 than participants with no co-morbidities. In conclusion, increasing cardiometabolic co-morbidity burden in patients with chronic coronary disease is associated with higher levels of circulating biomarkers of myocardial injury and inflammation.


Asunto(s)
Biomarcadores , Comorbilidad , Troponina T , Humanos , Femenino , Masculino , Biomarcadores/sangre , Persona de Mediana Edad , Anciano , Troponina T/sangre , Obesidad/epidemiología , Obesidad/complicaciones , Obesidad/sangre , Hipertensión/epidemiología , Hipertensión/sangre , Enfermedad Crónica , Proteína C-Reactiva/metabolismo , Proteína C-Reactiva/análisis , Diabetes Mellitus/epidemiología , Diabetes Mellitus/sangre , Hemoglobina Glucada/metabolismo , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/sangre , Factores de Riesgo Cardiometabólico , Fragmentos de Péptidos/sangre , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/epidemiología , Interleucina-6/sangre , Péptido Natriurético Encefálico/sangre
8.
Asian J Surg ; 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38849244
9.
Chem Sci ; 15(24): 9287-9297, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38903221

RESUMEN

We describe a dynamic crystalline material that integrates mechanical, thermal, and light modes of operation, with unusual robustness and resilience and a variety of both slow and fast kinematic effects that occur on very different time scales. In the mechanical mode of operation, crystals of this material are amenable to elastic deformation, and they can be reversibly morphed and even closed into a loop, sustaining strains of up to about 2.6%. Upon release of the external force, the crystals resume their original shape without any sign of damage, demonstrating outstanding elasticity. Application of torque results in plastic twisting for several rotations without damage, and the twisted crystal can still be bent elastically. The thermal mode of operation relies on switching the lattice at least several dozen times. The migration of the phase boundaries depends on the crystal habit. It can be precisely controlled by temperature, and it is accompanied by both slow and fast motions, including shear deformation and leaping. Parallel boundaries result in a thermomechanical effect, while non-parallel boundaries result in a thermosalient effect. Finally, the photochemical mode of operation is driven by isomerization and can be thermally reverted. The structure of the crystal can also be switched photochemically, and the generation of a bilayer induces rapid bending upon exposure to ultraviolet light, an effect that further diversifies the mechanical response of the material. The small structural changes, low-energy and weak intramolecular hydrogen bonds, and shear deformation, which could dissipate part of the elastic energy, are considered to be the decisive factors for the conservation of the long-range order and the extraordinary diversity in the response of this, and potentially many other dynamic crystalline materials.

10.
Calcif Tissue Int ; 115(1): 41-52, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38743269

RESUMEN

Previous observational studies have suggested that anti-Müllerian hormone (AMH) and reproductive factors are linked to reduced bone mineral density (BMD) and an increased risk of osteoporosis (OP) in women. However, related studies are limited, and these traditional observational studies may be subject to residual confounders and reverse causation, while also lacking a more comprehensive observation of various reproductive factors. Univariate and multivariate two-sample Mendelian randomization analyses were conducted to determine the causal associations of AMH levels and six reproductive factors with BMD and OP, using the random-effects inverse-variance weighted method. Heterogeneity was assessed using Cochran's Q-statistic, and sensitivity analyses were performed to identify causal correlations. Age at menarche (AAM) was negatively associated with total body BMD (TB-BMD) in females aged 45-60 and over 60 years, as well as with heel bone mineral density (eBMD). Conversely, age at natural menopause (ANM) was positively associated with TB-BMD in the same age ranges and with eBMD. ANM was only causally associated with self-reported OP and showed no significant correlation with definitively diagnosed OP. Neither AMH level nor other reproductive factors were significantly associated with a genetic predisposition to BMD at any age and OP. Later AAM and earlier ANM are significantly genetically causally associated with decreased BMD but not with OP. AMH levels, length of menstrual cycle, age at first birth, age at last birth, and number of live births, in terms of genetic backgrounds, are not causally related to BMD or OP.


Asunto(s)
Hormona Antimülleriana , Densidad Ósea , Análisis de la Aleatorización Mendeliana , Osteoporosis , Humanos , Hormona Antimülleriana/sangre , Femenino , Densidad Ósea/genética , Densidad Ósea/fisiología , Persona de Mediana Edad , Osteoporosis/genética , Menopausia/genética , Menopausia/sangre , Predisposición Genética a la Enfermedad , Menarquia/genética , Adulto , Factores de Riesgo
11.
Artículo en Inglés | MEDLINE | ID: mdl-38803181

RESUMEN

AIMS: The aim of this study was to reveal the hepatic cell landscape and function in the progression of NAFLD to NASH. BACKGROUND: Non-alcoholic steatohepatitis (NASH) is the progressive form and turning point of nonalcoholic fatty liver disease (NAFLD), which severely causes irreversible cirrhosis as well as hepatocellular carcinoma. The mechanism underlying the progression of NAFLD to NASH has not been revealed. Unraveling the mechanism of action of NAFLD-NASH is an important goal in improving the survival of patients with liver disease. OBJECTIVE: The aim of this study is to discover heterogeneous hepatic cells during the progression of NAFLD to NASH. METHODS: Single-nucleus RNA-seq (snRNA-seq) data containing NASH in NAFLD samples were obtained from the Gene Expression Omnibus (GEO) database. Cell types in liver tissues from NASH and NAFLD were identified after dimensionality reduction analysis, cluster analysis, and cell annotation. The cell pathways in which differences existed were identified by analyzing metabolic pathways in Hepatic cells. We also identified cell subpopulations in Hepatic cells. The developmental trajectories of Hepatic cells were characterized by pseudotime trajectory analysis. Single-cell regulatory network inference and clustering analysis identified key transcription factors and gene regulatory networks in Hepatic cells. Moreover, cell communication analysis determined the potential interactions between Hepatic cells and immune cells, and heapatic stellate cells. RESULTS: Seven cell types were identified in NAFLD and NASH. The proportion of Hepatic cells was lower in NASH and showed greater energy metabolism and glucose metabolism activity. Hepatic cells exhibited heterogeneity, showing two cell subpopulations, Hepatic cells 1 and Hepatic cells 2. Dysregulation of lipid metabolism in Hepatic Cell 2 resulted in lipid accumulation in the liver, which might be involved in the progression of NAFLD. Four key transcription factors, BHLHE40, NFEL2L, RUNX1, and INF4A, were primarily found in Hepatic cells 2. The transcription factors within the hepatic cells 2 subpopulation mainly regulated genes related to lipid metabolism, energy metabolism, and inflammatory response. The cell communication analysis showed that hepatocyte interactions with immune cells were associated with inflammatory responses, while interactions with hepatic astrocytes were associated with liver injury and hepatocyte fibrosis. CONCLUSION: The hepatic cells 2 might promote the progression of NAFLD to NASH by regulating metabolic activity, which might contribute to liver injury through inflammation.

12.
Plants (Basel) ; 13(10)2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-38794393

RESUMEN

Pectin is a structural polysaccharide and a major component of plant cell walls. Pectate lyases are a class of enzymes that degrade demethylated pectin by cleaving the α-1,4-glycosidic bond, and they play an important role in plant growth and development. Currently, little is known about the PL gene family members and their involvement in salt stress in potato. In this study, we utilized bioinformatics to identify members of the potato pectate lyase gene family and analyzed their gene and amino acid sequence characteristics. The results showed that a total of 27 members of the pectate lyase gene family were identified in potato. Phylogenetic tree analysis revealed that these genes were divided into eight groups. Analysis of their promoters indicated that several members' promoter regions contained a significant number of hormone and stress response elements. Further, we found that several members responded positively to salt treatment under single salt and mixed salt stress. Since StPL18 exhibited a consistent expression pattern under both single and mixed salt stress conditions, its subcellular localization was determined. The results indicated that StPL18 is localized in the endoplasmic reticulum membrane. The results will establish a foundation for analyzing the functions of potato pectate lyase family members and their expression under salt stress.

13.
Transplantation ; 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38771099

RESUMEN

BACKGROUND: Recent data suggest patients with graft failure had better access to repeat kidney transplantation (re-KT) than transplant-naive dialysis accessing first KT. This was postulated to be because of better familiarity with the transplant process and healthcare system; whether this advantage is equitably distributed is not known. We compared the magnitude of racial/ethnic disparities in access to re-KT versus first KT. METHODS: Using United States Renal Data System, we identified 104 454 White, Black, and Hispanic patients with a history of graft failure from 1995 to 2018, and 2 357 753 transplant-naive dialysis patients. We used adjusted Cox regression to estimate disparities in access to first and re-KT and whether the magnitude of these disparities differed between first and re-KT using a Wald test. RESULTS: Black patients had inferior access to both waitlisting and receiving first KT and re-KT. However, the racial/ethnic disparities in waitlisting for (adjusted hazard ratio [aHR] = 0.77; 95% confidence interval [CI], 0.74-0.80) and receiving re-KT (aHR = 0.61; 95% CI, 0.58-0.64) was greater than the racial/ethnic disparities in first KT (waitlisting: aHR = 0.91; 95% CI, 0.90-0.93; Pinteraction = 0.001; KT: aHR = 0.68; 95% CI, 0.64-0.72; Pinteraction < 0.001). For Hispanic patients, ethnic disparities in waitlisting for re-KT (aHR = 0.83; 95% CI, 0.79-0.88) were greater than for first KT (aHR = 1.14; 95% CI, 1.11-1.16; Pinteraction < 0.001). However, the disparity in receiving re-KT (aHR = 0.76; 95% CI, 0.72-0.80) was similar to that for first KT (aHR = 0.73; 95% CI, 0.68-0.79; Pinteraction = 0.55). Inferences were similar when restricting the cohorts to the Kidney Allocation System era. CONCLUSIONS: Unlike White patients, Black and Hispanic patients with graft failure do not experience improved access to re-KT. This suggests that structural and systemic barriers likely persist for racialized patients accessing re-KT, and systemic changes are needed to achieve transplant equity.

15.
Fish Shellfish Immunol ; 150: 109569, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38641216

RESUMEN

Phlorotannins are phenolic compounds with diverse biological activities, yet their efficacy in aquatic animals currently remains unclear. This investigation scrutinized the influence of phlorotannins on the growth, immunity, antioxidant capacity, and intestinal microbiota in Litopenaeus vannamei, concurrently evaluating the potential adverse effects of phlorotannins on L. vannamei. A base diet without phlorotannins supplementation was used as a control, and 4 groups of diets with different concentrations (0, 0.5, 1.0, 2.0 g kg-1) of phlorotannins were formulated and fed to juvenile shrimp (0.25 ± 0.01 g) for 60 days followed by a 24-h challenge with Vibrio parahaemolyticus with triplicate in each group. Compared with the control, dietary 2.0 g kg-1 phlorotannins significantly improved the growth of the shrimp. The activities of enzymes related to cellular immunity, humoral immunity, and antioxidants, along with a notable upregulation in the expression of related genes, significantly increased. After V. parahaemolyticus challenge, the cumulative survival rates of the shrimp demonstrated a positive correlation with elevated concentrations of phlorotannins. In addition, the abundance of Bacteroidetes and functional genes associated with metabolism increased in phlorotannins supplementation groups. Phlorotannins did not elicit any detrimental effects on the biological macromolecules or histological integrity of the hepatopancreas or intestines. Simultaneously, it led to a significant reduction in malondialdehyde content. All results indicated that phlorotannins at concentrations of 2.0 g kg-1 can be used as safe feed additives to promote the growth, stimulate the immune response, improve the antioxidant capacity and intestinal health of L. vannamei, and an protect shrimp from damage caused by oxidative stress.


Asunto(s)
Alimentación Animal , Dieta , Suplementos Dietéticos , Microbioma Gastrointestinal , Penaeidae , Taninos , Vibrio parahaemolyticus , Animales , Penaeidae/inmunología , Penaeidae/crecimiento & desarrollo , Penaeidae/efectos de los fármacos , Penaeidae/microbiología , Alimentación Animal/análisis , Dieta/veterinaria , Microbioma Gastrointestinal/efectos de los fármacos , Taninos/farmacología , Taninos/administración & dosificación , Vibrio parahaemolyticus/fisiología , Suplementos Dietéticos/análisis , Relación Dosis-Respuesta a Droga , Distribución Aleatoria , Inmunidad Innata/efectos de los fármacos
16.
J Perianesth Nurs ; 2024 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-38678461

RESUMEN

PURPOSE: To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery. DESIGN: Delphi method inquiry to 15 clinical and nursing experts. METHODS: On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established. FINDINGS: The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (P < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery. CONCLUSIONS: The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.

17.
Nanomaterials (Basel) ; 14(7)2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38607177

RESUMEN

Covalent organic frameworks (COFs) have been widely used in photocatalytic hydrogen peroxide (H2O2) production due to their favorable band structure and excellent light absorption. Due to the rapid recombination rate of charge carriers, however, their applications are mainly restricted. This study presents the design and development of two highly conjugated triazine-based COFs (TBP-COF and TTP-COF) and evaluates their photocatalytic H2O2 production performance. The nitrogen-rich structures and high degrees of conjugation of TBP-COF and TTP-COF facilitate improved light absorption, promote O2 adsorption, enhance their redox power, and enable the efficient separation and transfer of photogenerated charge carriers. There is thus an increase in the photocatalytic activity for the production of H2O2. When exposed to 10 W LED visible light irradiation at a wavelength of 420 nm, the pyridine-based TTP-COF produced 4244 µmol h-1 g-1 of H2O2 from pure water in the absence of a sacrificial agent. Compared to TBP-COF (1882 µmol h-1 g-1), which has a similar structure but lacks pyridine sites, TTP-COF demonstrated nearly 2.5 times greater efficiency. Furthermore, it exhibited superior performance compared to most previously published nonmetal COF-based photocatalysts.

18.
Medicine (Baltimore) ; 103(14): e37704, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38579068

RESUMEN

BACKGROUND: Posterior mediastinal leiomyosarcoma is an extremely rare malignant mesenchymal tumor with no special clinical symptoms, which is easily confused with some common tumors in the posterior mediastinum, affecting the accuracy of the first diagnosis by clinicians and delaying the treatment of patients. CASE SUMMARY: We report a 59-year-old woman with a space-occupying lesion in the posterior mediastinum. The patient was mistakenly diagnosed with lumbar muscle or vertebral body lesions due to chest and back pain and underwent conservative treatment, but her symptoms did not improve significantly and she gradually developed pain in both lower limbs. Chest computed tomography (CT) scan indicated the left lower lung paraspinal space and underwent standard single-aperture video-assisted thoracoscopic surgery (VATS), which was pathologically confirmed as posterior mediastinal leiomyosarcoma. CONCLUSION: Complete surgical resection of posterior mediastinal leiomyosarcoma can achieve good clinical results.


Asunto(s)
Leiomiosarcoma , Neoplasias del Mediastino , Humanos , Femenino , Persona de Mediana Edad , Mediastino/patología , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/cirugía , Leiomiosarcoma/patología , Neoplasias del Mediastino/diagnóstico , Neoplasias del Mediastino/cirugía , Neoplasias del Mediastino/patología , Tórax/patología , Tomografía Computarizada por Rayos X/métodos
19.
Kidney Med ; 6(3): 100778, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38435069

RESUMEN

Rationale & Objective: This study aimed to assess the effect of exposure to organic pollutants in adults with chronic kidney disease (CKD). Study Design: This was a cross-sectional and longitudinal analysis. Setting and Participants: Forty adults enrolled in the Chronic Renal Insufficiency Cohort (CRIC). Exposures: Exposure at baseline and longitudinally to various organic chemical pollutants. Outcomes: The outcomes were as follows: death; composite of congestive heart failure, myocardial infarction, and stroke; event-free survival from kidney failure or ≥50% decline in estimated glomerular filtration rate (eGFR); and longitudinal trajectory of eGFR. Analytical Approach: We used high-performance liquid chromatography with tandem mass spectrometry to measure urinary concentrations of bisphenols, phthalates, organophosphate pesticides, polycyclic aromatic hydrocarbons, melamine, and cyanuric acid at years 1, 3, and 5 after enrollment in the CRIC. Univariate and multivariable logistic regression were used to examine the association of individual compounds and classes of pollutants with the outcomes. The Cox proportional hazards model and Kaplan-Meier method were used to calculate hazard ratios and 95% CIs for each class of pollutants. Results: Median baseline eGFR and urinary protein-to-creatinine ratio were 33 mL/min/1.73 m2 and 0.58 mg/g, respectively. Of 52 compounds assayed, 30 were detectable in ≥50% of participants. Urinary chemical concentrations were comparable in patients with CKD and healthy individuals from contemporaneous National Health and Nutrition Examination Survey cohorts. Phthalates were the only class with a trend toward higher exposure in patients with CKD. There was an inverse relationship between exposure and the eGFR slopes for bisphenol F, mono-(3-carboxypropyl) phthalate, mono-benzyl phthalate, mono-[2-(carboxymethyl)hexyl] phthalate, and melamine. There were no associations between organic pollutant exposure and cardiovascular outcomes. Limitations: Small sample size, evaluation of single rather than combined exposures. Conclusions: Simultaneous measurement of multiple organic pollutants in adults with CKD is feasible. Exposure levels are comparable with healthy individuals. Select contaminants, especially in the phthalate class, may be associated with more rapid deterioration in kidney function.


The effect of exposure to organic pollutants has not been studied in adults with chronic kidney disease. (CKD). To fill this gap, we measured the exposure to a wide range of chemicals that are found in plastics, personal care products, and food preparation. Overall, the exposure was similar to that noted in the healthy population living in the United States. Only select compounds, mainly phthalates, demonstrated a trend with a more rapid decline in kidney function. These findings provide a useful reference for future studies that aim to evaluate organic pollutant exposure in patients with CKD. This is significant because these exposures represent a modifiable risk factor for disease progression through alterations in diet or lifestyle.

20.
Sensors (Basel) ; 24(5)2024 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-38474962

RESUMEN

To evaluate the lifetime and reliability of long-life, high-reliability products under limited resources, accelerated degradation testing (ADT) technology has been widely applied. Furthermore, the Bayesian evaluation method for ADT can comprehensively utilize historical information and overcome the limitations caused by small sample sizes, garnering significant attention from scholars. However, the traditional ADT Bayesian evaluation method has inherent shortcomings and limitations. Due to the constraints of small samples and an incomplete understanding of degradation mechanisms or accelerated mechanisms, the selected evaluation model may be inaccurate, leading to potentially inaccurate evaluation results. Therefore, describing and quantifying the impact of model uncertainty on evaluation results is a challenging issue that urgently needs resolution in the theoretical research of ADT Bayesian methods. This article addresses the issue of model uncertainty in the ADT Bayesian evaluation process. It analyzes the modeling process of ADT Bayesian and proposes a new model averaging evaluation method for ADT Bayesian based on relative entropy, which, to a certain extent, can resolve the issue of evaluation inaccuracy caused by model selection uncertainty. This study holds certain theoretical and engineering application value for conducting ADT Bayesian evaluation under model uncertainty.

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