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1.
Sci Total Environ ; 785: 147236, 2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33932661

RESUMEN

Haze has become an important factor to harm people's health. In the face of the harm of haze, people express risk perception behavior through publishing online comments on haze news. To a certain extent, online comments affect the government's decision to deal with haze. However, most of the previous efforts only focused on several cities from a micro perspective whereas the existing research lacks to explore the regional differences of risk perception behavior of the whole country from a macro perspective. The macro perspective of research can help policymakers to formulate strategies of haze control according to local conditions. Therefore, it is important to understand the risk perception behavior of publishing online comments and haze from the macro perspective. In this study, we use quantitative methods to study the spatial-temporal characteristics of online comments and PM2.5 in 334 cities in China from 2014 to 2018. From the spatial perspective, the spatial characteristics of online comments are quite different from those of PM2.5 at the city level. It can be seen that the spatial mismatch can affect the government's strategy of haze control according to local conditions. From the perspective of influencing factors, we find that the risk perception behavior of publishing online comments conforms to the theory of environmental risk perception. Firstly, the local social development level is the largest driving force accelerating risk perception behavior. Secondly, information channel also has significantly positive effect on public risk perception behavior. Finally, the harmful degree of haze has the least positive effect on people's risk perception behavior. This gives us enlightenment. The number of online comments does not reflect the harmful degree of haze in different regions. We suggest that online comments should not be the main reference factor for policymakers to make strategies.

2.
Neural Netw ; 141: 281-293, 2021 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-33933888

RESUMEN

This article is devoted to the H∞ estimation problem for stochastic semi-Markovian switching complex-valued neural networks subject to incomplete measurement outputs, where the time-varying delay also depends on another semi-Markov process. A sequence of random variables with known statistical property is introduced to depict the missing measurement phenomenon. Based on the generalized Itoˆ's formula in complex form concerning with the semi-Markovian systems, complex-valued reciprocal convex inequality as well as intensive stochastic analysis method, some mode-dependent sufficient conditions are presented guaranteeing the estimation error system to be exponentially mean-square stable with a prespecified H∞ disturbance attenuation level. In addition, the mode-dependent estimator gain matrices are appropriately designed according to the feasible solutions of certain complex matrix inequalities. In the end, one numerical example is provided to illustrate effectiveness of the theoretical results.

3.
Cell Biol Int ; 2021 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-33945659

RESUMEN

The importance of flow shear stress (SS) on the differentiation of endothelial progenitor cells (EPCs) has been demonstrated in various studies. Cholesterol retention and miRNA regulation have been also proposed as relevant factors involved in this process, though evidence regarding their regulatory roles in the differentiation of EPCs is currently lacking. In the present study on high shear stress (HSS)-induced differentiation of EPCs, we investigated the importance of ABCA1, an important regulator in cholesterol efflux, and miR-25-5p, a potential regulator of endothelial reconstruction. We first revealed an inverse correlation between miR-25-5p and ABCA1 expression levels in EPCs under HSS treatment; their direct interaction was subsequently validated by a dual luciferase reporter assay. Further studies using flow cytometry and qPCR demonstrated that both miR-25-5p overexpression and ABCA1 inhibition led to elevated levels of specific markers of endothelial cells (ECs), with concomitant down-regulation of smooth muscle cell (SMC) markers. Finally, knockdown of ABCA1 in EPCs significantly promoted tube formation, which confirmed our conjecture. Our current results suggest that miR-25-5p might regulate the differentiation of EPCs partially through targeting ABCA1, and such a mechanism might account for HSS-induced differentiation of EPCs. This article is protected by copyright. All rights reserved.

4.
Fitoterapia ; : 104914, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33940066

RESUMEN

Two novel sulfur-containing dibenzofurans, sorbusins A (1) and B (2), two unprecedented biphenyl glycosides, 2'-hydroxyaucuparin 2'-O-ɑ-L-rhamnoside (3) and noraucuparin 5-O-ɑ-L-rhamnoside (4), and four known analogues (5-8), were isolated from Sorbus pohuashanensis suspension cell induced by yeast extract. Their structures were elucidated based on spectroscopic analyses and quantum calculation of 13C NMR data. Structurally, compound 1 possessed a rare naturally occurring benzothiazole moiety and represents the first example of thiazole fused dibenzofuran. A plausible biosynthetic pathway for the sulfur-containing dibenzofurans is proposed. These dibenzofuran and biphenyl phytoalexins were evaluated for their antimicrobial activities against pathogenic fungi and drug-resistant bacteria. Compound 7 exhibited significant antibacterial activity against methicinllin-resistant Staphylococcus aureus with an MIC value of 3.13 µg/mL.

5.
J Colloid Interface Sci ; 596: 89-99, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33838328

RESUMEN

Construction of binder-free electrodes with hierarchical core-shell nanostructures is considered to be an effective route to promote the electrochemical performance of supercapacitors. In this work, the porous Ni0.5Mn0.5Co2O4 nanoflowers anchored on nickel foam are utilized as framework for further growing Co3O4 nanowires, resulting in the hierarchical sea urchin-like Ni0.5Mn0.5Co2O4@Co3O4 core-shell microspheres on nickel foam. Owing to the advantages brought by unique porous architecture and synergistic effect of the multi-component composites, the as-prepared electrode exhibits a high specific capacitance (931 F/g at 1 A/g), excellent rate performance (77% capacitance retention at 20 A/g) and outstanding cycle stability (92% retention over 5000 cycles at 5 A/g). Additionally, the assembled Ni0.5Mn0.5Co2O4@Co3O4//AC (activated carbon) asymmetric supercapacitor achieves a high energy density (50 Wh/kg at 750 W/kg) and long durability (88% retention after 5000 cycles).

6.
Curr Med Sci ; 41(2): 336-341, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33877551

RESUMEN

Placenta accreta spectrum disorder (PASD) and placenta previa (PP) are two of the most hideous obstetric complications which are usually associated with a history of cesarean section (CS). Moreover, women with PASD, PP and/or a cesarean scarred uterus are more likely to have adverse pregnancy outcomes, including blood transfusion, hysterectomy, pelvic organs damage, postpartum hemorrhage, disseminated intravascular coagulation, multi-organ dysfunction syndrome and even maternal or fetal death. This study aimed to investigate the efficacy of precesarean internal iliac artery balloon catheterization (BC) for managing severe hemorrhage caused by PASD and PP with a history of CS. This participant-assigned interventional study was conducted in Tongji Hospital. We recruited 128 women with suspected PASD, PP and a history of CS. Women in the BC group accepted precesarean BC of bilateral internal iliac arteries before the scheduled cesarean delivery. Women in the control group underwent a conventional cesarean delivery. Intraoperative hemorrhage, transfusion volume, radiation dose, exposure time, complications and neonatal outcomes were discussed. There were significant differences in calculated blood loss (CBL) between BC group and control group (1015.0±144.9 vs. 1467.0±171.0 mL, P=0.04). Precesarean BC could reduce intraoperative red blood cell (RBC) transfusion as compared with control group (799.5±136.1 vs. 1286.0±161.6 mL, P=0.02) and lessen the rate of using blood products (57.1% vs. 76.4%, P=0.02). The incidence of hysterectomy was also lower in BC group than in control group. Postpartum outcomes showed no significant differences between the two groups, except that postoperation hospitalization was longer in BC group than in control group (6.7±0.4 vs. 5.8±0.2 days, P=0.03). Precesarean BC of internal iliac artery is an effective method for managing severe hemorrhage caused by PASD and PP with a cesarean scarred uterus, as it could reduce intraoperative blood loss, lessen intraoperative RBC transfusions and potentially decrease hysterectomies.

7.
Aging (Albany NY) ; 132021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879635

RESUMEN

Colorectal cancer (CRC), a common malignant tumor in the digestive tract, is a leading cause of cancer-related death. SPRY4 has been reported to act as a tumor suppressor gene in various tumors. This study aims to assess the role of SPRY4 in colorectal cancer (CRC) and uncover its underlying mechanisms. Firstly, the expression levels of SPRY4 were measured in CRC cell lines. SPRY4-overexpressing or silencing plasmids were transfected into CRC cells to regulate its expression level. CCK-8, colony formation, EdU assay, wound-healing and Transwell assays were performed to determine cell proliferation, invasion and migration abilities. Then, apoptosis was measured by flow cytometry analysis, and the expression of apoptosis-related protein was analyzed by western-blotting. Next, the in vivo tumorigenesis assay was performed in nude mice. According to the results, there was a lower expression of SPRY4 in CRC cell lines compared with normal cell line, and the overexpression of SPRY4 significantly suppressed cell proliferation, migration and invasion, and promoted apoptosis in SW480 cells. Moreover, the enhanced proliferation, invasion and migration upon SPRY4 silencing was reversed by EZH2 inhibition. In addition, we found that the overexpression of SPRY4 inhibited tumorigenesis in vivo by diminishing the size and weight of the tumors. Our study indicates that SPRY4 might be a potential tumor suppressor gene and prognostic factor for patients with CRC.

8.
Ann Surg Oncol ; 2021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33880671

RESUMEN

BACKGROUND: The effects of video-assisted thoracoscopic surgery (VATS) and traditional thoracotomy with respect to patient-reported outcomes (PROs) have only been assessed for early-stage lung cancer. This study was a longitudinal PRO assessment to compare the effects of these surgeries for locally advanced (stage II and III) lung cancer from the patients' perspective. METHODS: We investigated lung cancer patients from a previous prospective, multicentre study. Longitudinal data of clinical characteristics and PROs were collected. PROs were obtained preoperatively, daily in the hospital postoperatively, and weekly up to 4 weeks after discharge or the beginning of postoperative adjuvant therapy. Symptoms and impact on daily functioning and quality of life (QOL) were assessed by using the MD Anderson Symptom Inventory for lung cancer and a single-item QOL scale. Trajectories of PROs over the investigation period were compared. RESULTS: Overall, 117 primary lung cancer patients (stage II or III), including 63 and 54 patients who underwent VATS and traditional thoracotomy, respectively, were included. During postoperative hospitalization, VATS patients reported milder disturbed sleep (p = 0.048), drowsiness (p = 0.008), and interference with activity (p = 0.001), as well as better work ability (p < 0.0001), walking ability (p < 0.0001), and life enjoyment (p = 0.004). Post-discharge, VATS patients had less distress (p = 0.039), milder pain (p = 0.006), better work ability (p = 0.001), and better QOL (p = 0.047). CONCLUSIONS: Locally advanced lung cancer patients who underwent VATS had lower postoperative symptom burden, less daily function interference, and better QOL than those who underwent thoracotomy.

9.
BMC Genomics ; 22(1): 284, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874907

RESUMEN

BACKGROUND: Night-break (NB) has been proven to repress flowering of short-day plants (SDPs). Long-noncoding RNAs (lncRNAs) play key roles in plant flowering. However, investigation of the relationship between lncRNAs and NB responses is still limited, especially in Chenopodium quinoa, an important short-day coarse cereal. RESULTS: In this study, we performed strand-specific RNA-seq of leaf samples collected from quinoa seedlings treated by SD and NB. A total of 4914 high-confidence lncRNAs were identified, out of which 91 lncRNAs showed specific responses to SD and NB. Based on the expression profiles, we identified 17 positive- and 7 negative-flowering lncRNAs. Co-expression network analysis indicated that 1653 mRNAs were the common targets of both types of flowering lncRNAs. By mapping these targets to the known flowering pathways in model plants, we found some pivotal flowering homologs, including 2 florigen encoding genes (FT (FLOWERING LOCUS T) and TSF (TWIN SISTER of FT) homologs), 3 circadian clock related genes (EARLY FLOWERING 3 (ELF3), LATE ELONGATED HYPOCOTYL (LHY) and ELONGATED HYPOCOTYL 5 (HY5) homologs), 2 photoreceptor genes (PHYTOCHROME A (PHYA) and CRYPTOCHROME1 (CRY1) homologs), 1 B-BOX type CONSTANS (CO) homolog and 1 RELATED TO ABI3/VP1 (RAV1) homolog, were specifically affected by NB and competed by the positive and negative-flowering lncRNAs. We speculated that these potential flowering lncRNAs may mediate quinoa NB responses by modifying the expression of the floral homologous genes. CONCLUSIONS: Together, the findings in this study will deepen our understanding of the roles of lncRNAs in NB responses, and provide valuable information for functional characterization in future.

10.
Lipids Health Dis ; 20(1): 36, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874960

RESUMEN

BACKGROUND: Several studies have found that a low baseline low -density lipoprotein cholesterol (LDL-C) concentration was associated with poor prognosis in patients with acute coronary syndrome (ACS), which is called the "cholesterol paradox". Low LDL-C concentration may reflect underlying malnutrition, which was strongly associated with increased mortality. The aim of this study was to investigate the cholesterol paradox in patients with CAD and the effects of malnutrition. METHOD: A total of 41,229 CAD patients admitted to Guangdong Provincial People's Hospital in China were included in this study from January 2007 to December 2018 and divided into two groups (LDL-C < 1.8 mmol/L, n = 4863; LDL-C ≥ 1.8 mmol/L, n = 36,366). The Kaplan-Meier method and Cox regression analyses were used to assess the association between LDL-C levels and long-term all-cause mortality and the effect of malnutrition. RESULT: In this real-world cohort (mean age 62.9 years; 74.9% male), there were 5257 cases of all-cause death during a median follow-up of 5.20 years [interquartile range (IQR): 3.05-7.78 years]. Kaplan-Meier analysis showed that low LDL-C levels were associated with a worse prognosis. After adjusting for baseline confounders (e.g., age, sex and comorbidities, etc.), multivariate Cox regression analysis revealed that a low LDL-C level (< 1.8 mmol/L) was not significantly associated with all-cause mortality (adjusted HR, 1.04; 95% CI, 0.96-1.24). After adjustment for nutritional status, the risk of all-cause mortality in patients with low LDL-C levels decreased (adjusted HR, 0.90; 95% CI, 0.83-0.98). In the final multivariate Cox model, a low LDL-C level was related to better prognosis (adjusted HR, 0.91; 95% CI, 0.84-0.99). CONCLUSION: This study demonstrated that the cholesterol paradox existed in CAD patients but disappeared after accounting for the effects of malnutrition.

11.
Artículo en Inglés | MEDLINE | ID: mdl-33886272

RESUMEN

A zirconium-based metal-organic framework (MOF) was successfully constructed via solvothermal assembly of a triphenylamine-based tricarboxylate ligand and Zr(IV) salt, the structure simulation of which revealed that it possesses a two-dimensional layered framework with a relatively rare dodecnuclear Zr12 cluster as the inorganic building unit. The inherent photo-responsive property derived from the incorporated photochromic triphenylamine groups combined with its high stability makes the constructed MOF an efficient heterogeneous photocatalyst for the oxidation of sulfides, which is a fundamentally important reaction type in both environmental and pharmaceutical industries. The photocatalytic activity of the constructed MOF was first investigated under various conditions with thioanisole as a representative sulfide substrate. The MOF exhibited both high efficiency and selectivity on aerobic oxidation of thioanisole in methanol utilizing molecular oxygen in air as the oxidant under blue light irradiation for 10 h. Its high photocatalytic performance was also observed when extending the sulfide substrate to diverse thioanisole derivatives and even a sulfur-containing nerve agent simulant (2-chloroethyl ethyl sulfide). The high photocatalytic efficiency and selectivity to a broad set of sulfide substrates make the triphenylamine-incorporating zirconium-based MOF a highly promising heterogeneous photocatalyst.

12.
Nano Lett ; 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33890468

RESUMEN

Outdoor personal thermal comfort is of substantial significance to ameliorate the health conditions of pedestrian and outdoor laborer. However, the uncontrollable sunlight, substantial radiative loss, and intense temperature fluctuations in the outdoor environment present majestic challenges to outdoor personal thermal management. Here, we report an eco-friendly passive nanostructured textile which harvests energy from the sun and the outer space for optional localized heating and cooling. Compared to conventional heating/cooling textiles like black/white cotton, its heating/cooling mode enables a skin simulator temperature increase/decrease of 8.1 °C/6 °C, respectively, under sunlight exposure. Meanwhile, the temperature gradient created between the textile and human skin allows a continuous electricity generation with thermoelectric modules. Owing to the exceptional outdoor thermoregulation ability, this Janus textile is promising to help maintain a comfortable microclimate for individuals in outdoor environment and provide a platform for pervasive power generation.

13.
Nicotine Tob Res ; 2021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33876246

RESUMEN

OBJECTIVE: Quitting smoking usually results in weight gain, rising the concern that weight gain after smoking cessation may attenuate the benefits of smoking quitting on cardiovascular health. We aimed to examine the risk of cardiovascular disease (CVD) among smoking quitters compared with smokers, stratified by post-cessation weight change. METHODS: We searched PubMed, Scopus, and Web of Science for eligible studies published before September 2020. Cohort studies examining the relative risk (RR) of CVD among smoking quitters stratified by post-cessation weight change, with smokers being treated as the reference, were included. Two investigators extracted the key characteristics of each included study using a standard electronic form. RESULTS: We identified 9 studies for this meta-analysis. Compared with smokers, the pooled RRs (95% confidence interval) of CVD among quitters with weight gain and among those without were 0.74 [0.66, 0.83]) and 0.86 [0.80, 0.92]), with no evidence of heterogeneity between studies being observed. Moreover, the associations appeared to be significantly stronger among quitters with weight gain than those without, particularly in the analysis of coronary heart disease and stroke (pooled RRs = 0.65 [0.59, 0.71] vs. 0.79 [0.71, 0.88] for coronary heart disease and 0.67 [0.62, 0.73] vs. 0.76 [0.72, 0.81] for stroke, respectively; P for interaction < 0.05). CONCLUSIONS: Smoking cessation was associated with a significantly lower risk of CVD and all-cause mortality, regardless of post-cessation weight gain. A greater risk reduction among quitters with weight gain than those without merits further investigations.

14.
Biomed Res Int ; 2021: 6620746, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33860042

RESUMEN

The mixed reality (MR) technique has recently been widely used in the orthopedic surgery with satisfactory results reported. However, few studies have focused on the application of MR in the Lumbar fracture (LF). In this retrospective study, our aim is to analyze some findings by investigating the feasibility of MR applied to lumbar fracture treatment. Posterior vertebrectomy has been operated on 7 patients. The MR-based intraoperative three-dimensional image-guided navigation system (MITINS) was used to assist implantation of pedicle screws. The feasibility and safety of pedicle screw implantation were assessed by postsurgery radiography. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to assess the pain level and recovery situation before and after surgery. 57 pedicle screws were safely and precisely placed into three-dimensional lumbar models by using MITINS. No screw was found outside the pedicle of the models, and it was not necessary for the X-ray to provide extra locative information during the operation with the use of MITINS. In summary, the application of MITINS is feasible, safe, and accurate while the lumbar fracture surgery is processing, providing satisfactory assistance for spine surgeons.

15.
J Nutr Biochem ; : 108645, 2021 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-33838230

RESUMEN

Nonalcoholic fatty liver disease (NAFLD) is a chronic disease affecting the health of many people worldwide. Previous studies have shown that dietary calcium supplementation may alleviate NAFLD, but the underlying mechanism is not clear. In this study investigating the effect of calcium on hepatic lipid metabolism, 8-week-old male C57BL/6J mice were divided into four groups (n = 6): (a) mice given a normal chow containing 0.5% calcium (CN0.5), (b) mice given a normal chow containing 1.2% calcium (CN1.2), (c) mice given a high-fat diet (HFD) containing 0.5% calcium (HFD0.5), and (d) mice fed a high-fat diet containing 1.2% calcium (HFD1.2). To understand the underlying mechanism, cells were treated with oleic acid and palmitic acid to mimic the HFD conditions in vitro. The results showed that calcium alleviated the increase in triglyceride accumulation induced by oleic acid/palmitic acid in HepG2, AML12, and primary hepatocyte cells. Our data demonstrated that calcium supplementation alleviated high fat diet-induced hepatic steatosis through increased liver lipase activity, proving calcium is involved in the regulation of hepatic lipid metabolism. Moreover, calcium also increased the level of glycogen in the liver, and at the same time had the effect of reducing glycolysis and promoting glucose absorption. Calcium addition increased calcium levels in the mitochondria and cytoplasm. Taken together, we concluded that calcium supplementation could relieve high fat diet-induced hepatic steatosis by changing energy metabolism and lipase activity.

16.
Biomed Phys Eng Express ; 7(3)2021 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-33794517

RESUMEN

Developmental dysplasia of the hip (DDH) is a common orthopedic disease. A simple and cost-effective scientific tool for assisting the early diagnosis of DDH is urgently needed. This study proposed a new artificial intelligence (AI) model for automated measure of the CE angle to aid the diagnosis of DDH by modifying the Mask R-CNN algorithm.13228 anteroposterior pelvic x-ray images were collected from the PACS system of the second Hospital of Jilin University, of which 104 images were randomly selected as test data. The rest of x-ray images were labelled and preprocessed for model development. The new AI model was the constructed based modified Mask R-CNN model to detect key points for CE angle measurement. The performance of AI model on measuring CE angle was verified by comparing with three attending orthopaedic doctors. The mean CE angles on left and right pelvis measured by the AI model was 29.46 ± 6.98°and 27.92 ± 6.56°, respectively, while the mean CE angle measured by the three doctors was 29.85 ± 6.92°and 27.75 ± 6.45°, respectively. AI model displayed a higly consistency with the doctors in measuring CE angles. Besides, AI model showed a much high efficiency in term of measuring time-consumption. In this study, we successfully constructed a new effective model for measuring CE angle by identifying key points, which provided a new intelligent measurement tool for orthopedic image measurement and evaluation.

17.
Stroke ; 52(5): 1545-1556, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33874750

RESUMEN

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791.

18.
Helicobacter ; : e12810, 2021 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-33904635

RESUMEN

OBJECTIVE: This study aimed to determine the prevalence and risk factors of Helicobacter pylori infection across all age groups in Wuwei City, a high-risk area for gastric cancer in Northwest China. METHODS: We conducted this study from 2016 to 2017 in an urban and a rural community in Wuwei City. Stool antigen tests targeted individuals aged 0 to 3 years old, and 13 C-urea breath tests targeted individuals aged above 3 years. We selected participants based on hierarchical cluster sampling. We assessed the association between variables and H. pylori infection based on logistic regression models. RESULTS: Ultimately, the results of 2,163 participants (age: 0 to 77 years old) were included (1,238 minors and 925 adults) in the analysis. The overall prevalence of H. pylori infection was 35.6%. It increased with age, reaching the peak in the 30 to 39 age group, and then began to decline. In multivariate analysis, age was positively associated with prevalence of H. pylori infection, and factors negatively associated with the prevalence were drinking running water, the frequency of yoghurt consumption, and an annual household income of Renminbi (¥) 30,000-100,000 or 100,000 above. In the subgroup analyses, however, the same variables associated differently in different age groups. Additionally, we interestingly noticed that boarding, eating at school cafeterias over six times per week, and frequently drinking untreated water were independent predictors of H. pylori infection in junior and senior high school students. CONCLUSION: The prevalence of H. pylori infection is moderate and closely associated with the socioeconomic conditions of Wuwei City, as well as the sanitary situations and dietary habits of the participants in the city. Boarding, eating at school, and drinking untreated water are the main factors explaining the rising infection rate in junior-senior high school students.

19.
Clin Respir J ; 2021 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-33896114

RESUMEN

BACKGROUND: A pandemic caused by SARS-CoV-2 has infected more than 79 million people and killed exceeding 1.7 million people around the world by the end of 2020. METHOD: We obtained the clinical data of all diagnosed patients and lung function test of followed-up patients in Fuyang, Anhui province to investigate laboratory predictors of severe COVID-19 and the impairment of lung function. RESULTS: Of the 155 patients, 87(56.13%) were males. The mean age was 41.95 (SD 15.34) years. Only 30(19.35%) patients had critical condition. Fever (84.52%) were the most common symptoms, and short of breath was more common in severe patients (P<0.01). Lymphopenia was observed in most patients (74, 47.7%). It showed the elevation of CRP in 100 (64.5%) patients, the elevation of SAA or IL-6 in 104 (67.1%) patients. The calculated cut-off value of CRP was 19.35 mg/mL, the AUC was 0.777, sensitivity was 73.3%, specificity was 69.6%; SAA was 73.55 mg/L, 0.679, 83.3%, 56.8% respectively; IL-6 was 18.85 pg/mL, 0.797, 83.3%, 64.8%; D-Dimer was 0.325 mg/L, 0.673, 66.7% and 68.8%. The combination of CRP, SAA, IL-6 and D-Dimer was 0.823 in AUC, 73.3% in sensitivity and 78.4% in specificity. 12(42.86%) followed-up patients had completely normal lung function indicators. CONCLUSION: Elevated CRP, SAA, IL-6 and D-Dimer can be predictors to severe COVID-19. The combination of these four indicators can improve the effectivity and specificity of assessing severe COVID-19. Most of the followed-up patients showed no abnormalities in lung function test. Abnormal lung function is mainly reflected in the diffusion function.

20.
Med J Aust ; 2021 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-33899216

RESUMEN

OBJECTIVES: To determine whether a multifaceted primary health care intervention better controlled cardiovascular disease (CVD) risk factors in patients with high risk of CVD than usual care. DESIGN, SETTING: Parallel arm, cluster randomised trial in 71 Australian general practices, 5 December 2016 - 13 September 2019. PARTICIPANTS: General practices that predominantly used an electronic medical record system compatible with the HealthTracker electronic decision support tool, and willing to implement all components of the INTEGRATE intervention. INTERVENTION: Electronic point-of-care decision support for general practices; combination cardiovascular medications (polypills); and a pharmacy-based medication adherence program. MAIN OUTCOME MEASURES: Proportion of patients with high CVD risk not on an optimal preventive medication regimen at baseline who had achieved both blood pressure and low-density lipoprotein (LDL) cholesterol goals at study end. RESULTS: After a median 15 months' follow-up, primary outcome data were available for 4477 of 7165 patients in the primary outcome cohort (62%). The proportion of patients who achieved both treatment targets was similar in the intervention (423 of 2156; 19.6%) and control groups (466 of 2321; 20.1%; relative risk, 1.06; 95% CI, 0.85-1.32). Further, no statistically significant differences were found for a number of secondary outcomes, including risk factor screening, preventive medication prescribing, and risk factor levels. Use of intervention components was low; it was highest for HealthTracker, used at least once for 347 of 3236 undertreated patients with high CVD risk (10.7%). CONCLUSIONS: Despite evidence for the efficacy of its individual components, the INTEGRATE intervention was not broadly implemented and did not improve CVD risk management in participating Australian general practices. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12616000233426 (prospective).

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