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1.
Ann Plast Surg ; 92(4S Suppl 2): S275-S278, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38556689

RESUMEN

INTRODUCTION: Body contouring procedures are commonly performed in the United States for patients seeking to sculpt specific areas of their bodies. The aim of this study was to provide an updated analysis of the factors that influence medical malpractice litigation surrounding body contouring surgery. METHODS: The following terms were used to search the Westlaw Campus Legal research Database for cases with earliest documentation after January 2013: ("contouring" OR "abdominoplasty" OR "liposuction" OR "tummy tuck" OR "body lift" OR "thigh lift" OR "arm lift" OR "brachioplasty" OR "thighplasty" OR "lipectomy" OR "panniculectomy") AND "surgery" AND "medical malpractice." Cases were only included if there was a complaint of medical malpractice subsequent to a body contouring procedure, and details of the cases were provided. Information was collected on the location of the lawsuit, the earliest year of available case documentation, patient demographics, procedure(s) performed, alleged injury, specialty involvement, and verdicts. RESULTS: A total of 32 cases were included in the study. Most of the patients involved in the cases were women (n = 30, 93.8%) and alive (n = 28, 87.5%). New York state had the most cases (n = 7, 21.9%). Abdominoplasty (56.3%), liposuction (53.1%), and buttock augmentations (15.6%) were the most common procedures. Plastic surgeons were involved in 93.8% (n = 30) of the cases, and anesthesia, emergency medicine, dermatology, and oncology were also involved. Claims of malpractice most often discussed negligent technique (71.9%) and poor postoperative management (62.5%). Common postoperative complications were infection/sepsis (40.6%), scarring (31.3%), and emotional distress/prolonged pain (31.3%). One available ruling was in favor of the plaintiff. CONCLUSION: Although many of the cases in this analysis cited negligent technique, none were founded in their argument. Because involvement in these cases can place a burden on attending physicians, clear expectations of postoperative infections, scarring, and prolonged pain should be addressed during the informed consent process.


Asunto(s)
Contorneado Corporal , Mala Praxis , Cirujanos , Humanos , Femenino , Estados Unidos , Masculino , Contorneado Corporal/efectos adversos , Cicatriz , Dolor , Bases de Datos Factuales
2.
Pharmacoepidemiol Drug Saf ; 33(4): e5778, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38556812

RESUMEN

PURPOSE: In rare diseases, real-world evidence (RWE) generation is often restricted due to small patient numbers and global geographic distribution. A federated data network (FDN) approach brings together multiple data sources harmonized for collaboration to increase the power of observational research. In this paper, we review how to increase reproducibility and transparency of RWE studies in rare diseases through disease-specific FDNs. METHOD: To be successful, a multiple stakeholder scientific FDN collaboration requires a strong governance model in place. In such a model, each database owner remains in full control regarding the use of and access to patient-level data and is responsible for data privacy, ethical, and legal compliance. Provided that all this is well documented and good database descriptions are in place, such a governance model results in increased transparency, while reproducibility is achieved through data curation and harmonization, and distributed analytical methods. RESULTS: Leveraging the OHDSI community set of methods and tools, two rare disease-specific FDNs are discussed in more detail. For multiple myeloma, HONEUR-the Haematology Outcomes Network in Europe-has built a strong community among the data partners dedicated to scientific exchange and research. To advance scientific knowledge in pulmonary hypertension (PH) an FDN, called PHederation, was established to form a partnership of research institutions with PH databases coming from diverse origins.


Asunto(s)
Enfermedades Raras , Humanos , Enfermedades Raras/epidemiología , Reproducibilidad de los Resultados , Bases de Datos Factuales , Europa (Continente)
3.
COPD ; 21(1): 2327352, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38573027

RESUMEN

Accumulating evidence has highlighted the importance of immune cells in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, the understanding of the causal association between immunity and COPD remains incomplete due to the existence of confounding variables. In this study, we employed a two-sample Mendelian randomization (MR) analysis, utilizing the genome-wide association study database, to investigate the causal association between 731 immune-cell signatures and the susceptibility to COPD from a host genetics perspective. To validate the consistency of our findings, we utilized MR analysis results of lung function data to assess directional concordance. Furthermore, we employed MR-Egger intercept tests, Cochrane's Q test, MR-PRESSO global test, and "leave-one-out" sensitivity analyses to evaluate the presence of horizontal pleiotropy, heterogeneity, and stability, respectively. Inverse variance weighting results showed that seven immune phenotypes were associated with the risk of COPD. Analyses of heterogeneity and pleiotropy analysis confirmed the reliability of MR results. These results highlight the interactions between the immune system and the lungs. Further investigations into their mechanisms are necessary and will contribute to inform targeted prevention strategies for COPD.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/genética , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Reproducibilidad de los Resultados , Bases de Datos Factuales
4.
Law Hum Behav ; 48(1): 33-49, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38573703

RESUMEN

OBJECTIVE: Two experiments examined the potential for inconclusive forensic decisions to disadvantage the innocent. HYPOTHESES: Both experiments tested the hypothesis that inconclusive decisions produce more incriminating legal judgments than do clearly exculpatory forensic decisions. Experiment 2 also examined whether this hypothesized effect conformed to a confirmation bias, a communication error, or perceptual accuracy. METHOD: In Experiment 1 (N = 492), a forensic expert testified that physical evidence recovered from a crime scene either matched or did not match a suspect's evidence or produced an inconclusive result. In Experiment 2 (N = 1,002), a forensic expert testified that physical evidence recovered from a crime scene either matched or did not match a suspect's evidence, produced an inconclusive result, or was unsuitable for analysis. A fifth condition omitted the forensic evidence and expert testimony. RESULTS: The inconclusive decision produced less incriminating legal judgments than did the match forensic decision (|d|average = 0.96), more incriminating legal judgments than did the no-match forensic decision (|d|average = 0.62), and equivalent legal judgments to the unsuitable decision (|d|average = 0.12) and to legal judgments made in the absence of forensic evidence (|d|average = 0.07). These results suggest that participants interpreted the inconclusive decision to be forensically neutral, which is consistent with a communication error. CONCLUSION: The findings provide preliminary support for the idea that inconclusive decisions can put the innocent at risk of wrongful conviction by depriving them of a clearly exculpatory forensic decision. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Comunicación , Crimen , Humanos , Bases de Datos Factuales , Testimonio de Experto , Juicio
5.
Law Hum Behav ; 48(1): 50-66, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38573704

RESUMEN

OBJECTIVE: Interviewers often face the challenge of obtaining information from suspects who are willing to speak but are motivated to conceal incriminating information. The Shift-of-Strategy (SoS) approach is an interviewing technique designed to obtain new information from such suspects. This study provides a robust empirical test of the SoS approach using more complex crime events and longer interviews than previously tested as well as testing a new variation of the approach (SoS-Reinforcement) that included a strategic summary of the suspect's statement. We compared this new variation with a standard version of the approach (SoS-Standard) and an interviewing approach that involved no confrontation of discrepancies in the suspects' statements (Direct). HYPOTHESES: We predicted that the two SoS versions would outperform the Direct condition in terms of participants' disclosure of previously unknown information. We also predicted that SoS-Reinforcement would outperform SoS-Standard. Finally, we expected that participants in the SoS conditions would not assess the interview or the interviewer more poorly than participants in Direct. METHOD: A total of 300 participants completed an online mock crime procedure, and they were subsequently interviewed with one of the three interviewing techniques. Following the interview, participants provided assessments of their experiences being interviewed. RESULTS: Participants in both SoS-Standard (d = 0.49, 95% confidence interval [CI: 0.21, 0.78]) and SoS-Reinforcement (d = 0.59, 95% CI [0.30, 0.87]) disclosed more previously unknown information than participants in the Direct condition, but SoS-Reinforcement did not outperform SoS-Standard (d = 0.08, 95% CI [-0.20, 0.36]). Participants in SoS-Reinforcement assessed their experience more negatively than those in Direct. No such differences were observed in the remaining two-way comparisons. CONCLUSIONS: The study provides support for the effectiveness of eliciting new information through the SoS approach and illuminates possible experiential downsides with being subjected to the SoS-Reinforcement approach. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Crimen , Revelación , Humanos , Bases de Datos Factuales
6.
J Consult Clin Psychol ; 92(4): 236-248, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38573714

RESUMEN

BACKGROUND: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. METHOD: Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. RESULTS: The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. CONCLUSION: This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Ansiedad , Terapia Cognitivo-Conductual , Adulto , Humanos , Persona de Mediana Edad , Trastornos de Ansiedad , Bases de Datos Factuales , Pesar
7.
J Consult Clin Psychol ; 92(4): 199-201, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38573712

RESUMEN

Prior to the advent of multiculturalism, mainstream psychology mirrored the Euro-American culture. In contrast, multiculturalism acts as a prism that reveals the diversity in the human condition. Since most empirical research is still conducted on Western, educated, industrialized, rich, and democratic populations, we need to construct a representative map of the human psychological and behavioral phenome. To work toward this goal, multicultural psychologists go beyond personal transformation and openness to the other. They question power relations, oppose oppressive systems, address psychology's fallacy of neutrality, and engage in social justice action. Specifically, multicultural psychologists work to restore the humanity of both the oppressed and the oppressor. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Diversidad Cultural , Justicia Social , Humanos , Bases de Datos Factuales
8.
Langenbecks Arch Surg ; 409(1): 117, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38598044

RESUMEN

BACKGROUND: The oncologic safety and surgical completeness of remote-access thyroidectomies are not yet clearly established. This study evaluates the oncologic outcomes and surgical completeness of three prevalent remote-access thyroidectomies: the gasless transaxillary approach (GTAA), bilateral axillo-breast approach (BABA), and transoral approach (TOA), in comparison with conventional transcervical thyroidectomy (CTT). METHODS: Literature searches were conducted in PubMed, EMBASE, and the Cochrane Library databases, covering the period from 2000 to 2023. Network meta-analyses were performed on selected studies, focusing on recurrence and surgical completeness. Surgical completeness was assessed using stimulated serum thyroglobulin levels and the count of retrieved lymph nodes. RESULTS: The review included 48 studies, encompassing a total of 16,356 patients. The number of retrieved lymph nodes was comparable among BABA, TOA, and CTT, while GTAA might be less effective. Stimulated serum thyroglobulin levels showed no significant differences across the four groups. However, the proportion of patients with stimulated thyroglobulin levels below 1.0 ng/mL was significantly lower in GTAA compared to the other groups. The overall recurrence rates were 1.31% for CTT, 0.89% for GTAA, 0.62% for BABA, and 0% for TOA, with no significant differences in recurrence rates when adjusted for follow-up duration. CONCLUSIONS: This study demonstrated that the oncologic outcomes of GTAA, BABA, and TOA are comparable to those of CTT, based on recurrence rates. In terms of surgical completeness, BABA and TOA showed equivalence to CTT, whereas GTAA might be inferior to the other techniques.


Asunto(s)
Tiroglobulina , Tiroidectomía , Humanos , Metaanálisis en Red , Mama , Bases de Datos Factuales
9.
Environ Geochem Health ; 46(5): 155, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38592550

RESUMEN

Recent studies have found arsenic contamination of drinking water in some parts of Iran, as in many other countries. Thus, a comprehensive systematic review is necessary to assess the distribution and concentration of arsenic in drinking water sources. For this purpose, articles published from the first identification until December 2023, were retrieved from various national and international databases. Of all the studies examined (11,726), 137 articles were selected for review based on their conceptual relationship to this survey. A review of the extracted studies presented that ICP methods (ICP-MS, ICP-OES, 56%) and atomic absorption spectrophotometry (AAS, 34.1%) were the two most commonly used techniques for the analysis of arsenic in water samples. The order of arsenic content in the defined study areas is descending, as follows: northwest ˃ southeast ˃ southwest ˃ northeast. A review of studies performed in Iran depicted that provinces such as Kurdistan, Azerbaijan, and Kerman have the highest arsenic concentrations in water resources. Accordingly, the maximum concentration of arsenic was reported in Rayen, Kerman, and ranged from < 0.5-25,000 µg/L. The primary cause of elevated arsenic levels in water resources appears to be geologic structure, including volcanic activity, biogeochemical processes, sulfur-bearing volcanic rocks, Jurassic shale, the spatial coincidence of arsenic anomalies in tube wells and springs, and, to some extent, mining activities. The findings of the presented survey indicate that it is essential to take serious measures at the national level to minimize the health risks of arsenic contamination from drinking water consumption.


Asunto(s)
Arsénico , Agua Potable , Irán , Bases de Datos Factuales , Geología
10.
Front Cell Infect Microbiol ; 14: 1371727, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38585653

RESUMEN

Background: Gut microbiota studies in the field of endocrinology metabolism have attracted increasing attention in recent years. To comprehensively assess the evolving landscape of this research field, we conducted a thorough bibliometric analysis of gut microbiota studies in endocrinology metabolism indexed in the Web of Science database. Methods: We collected and analyzed 3,339 original research articles and reviews published from 1972 to 2023. Using various bibliometric indicators, we investigated publication trends, country contributions, international collaborations, prolific authors, top journals, and influential articles. Results: Our analysis revealed a significant upsurge in publications after 2010, indicating a growing scientific interest in microbiota and endocrinology metabolism. Keyword and thematic analyses have identified gut microbiota, obesity, diabetes, and inflammation as core research themes. Additionally, the roles of probiotics and prebiotics are increasingly researched for their therapeutic effects in shaping the microbiota. Conclusion: This study reveals that research in endocrinology metabolism is increasingly decoding the connection between gut microbiota and diseases. There's also a growing focus on microbiota manipulation, which points to a shift towards personalized medicine. Future research should focus on integrating these findings into clinical practice, moving from lab-based studies to real-world patient care.


Asunto(s)
Microbioma Gastrointestinal , Microbiota , Humanos , Bibliometría , Bases de Datos Factuales , Inflamación
11.
Eat Weight Disord ; 29(1): 25, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38587606

RESUMEN

PURPOSE: The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time. METHODS: We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy. RESULTS: Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection. CONCLUSIONS: As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status. LEVEL OF EVIDENCE: Level II, controlled trials without randomization.


Asunto(s)
Señales (Psicología) , Alimentos , Humanos , Bases de Datos Factuales , Dieta Saludable , 60408 , Recién Nacido , Lactante , Preescolar , Niño , Adolescente
12.
PLoS One ; 19(4): e0301912, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38598492

RESUMEN

BACKGROUND: Atherosclerosis (AS) is a primary contributor to cardiovascular disease, leading to significant global mortality rates. Developing effective diagnostic indicators and models for AS holds the potential to substantially reduce the fatalities and disabilities associated with cardiovascular disease. Blood sample analysis has emerged as a promising avenue for facilitating diagnosis and assessing disease prognosis. Nonetheless, it lacks an accurate model or tool for AS diagnosis. Hence, the principal objective of this study is to develop a convenient, simple, and accurate model for the early detection of AS. METHODS: We downloaded the expression data of blood samples from GEO databases. By dividing the mean values of housekeeping genes (meanHGs) and applying the comBat function, we aimed to reduce the batch effect. After separating the datasets into training, evaluation, and testing sets, we applied differential expression analyses (DEA) between AS and control samples from the training dataset. Then, a gradient-boosting model was used to evaluate the importance of genes and identify the hub genes. Using different machine learning algorithms, we constructed a prediction model with the highest accuracy in the testing dataset. Finally, we make the machine learning models publicly accessible by shiny app construction. RESULTS: Seven datasets (GSE9874, GSE12288, GSE20129, GSE23746, GSE27034, GSE90074, and GSE202625), including 403 samples with AS and 325 healthy subjects, were obtained by comprehensive searching and filtering by specific requirements. The batch effect was successfully removed by dividing the meanHGs and applying the comBat function. 331 genes were found to be related to atherosclerosis by the DEA analysis between AS and health samples. The top 6 genes with the highest importance values from the gradient boosting model were identified. Out of the seven machine learning algorithms tested, the random forest model exhibited the most impressive performance in the testing datasets, achieving an accuracy exceeding 0.8. While the batch effect reduction analysis in our study could have contributed to the increased accuracy values, our comparison results further highlight the superiority of our model over the genes provided in published studies. This underscores the effectiveness of our approach in delivering superior predictive performance. The machine-learning models were then uploaded to the Shiny app's server, making it easy for users to distinguish AS samples from normal samples. CONCLUSIONS: A prognostic Shiny application, built upon six potential atherosclerosis-associated genes, has been developed, offering an accurate diagnosis of atherosclerosis.


Asunto(s)
Aterosclerosis , Enfermedades Cardiovasculares , Humanos , Genes Esenciales , Algoritmos , Aterosclerosis/diagnóstico , Aterosclerosis/genética , Bases de Datos Factuales
13.
Medicine (Baltimore) ; 103(16): e37782, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38640278

RESUMEN

This research aimed to summarize the research development and hot points in on the connection between sport and nutrition overall through bibliometric analysis. We collected the publications in the last 10 years (2013-2023) related to between sport and nutrition in the Web of Science database, and applied Citespace to assess the knowledge mapping. The results showed as follows that the number of manuscripts about sport and nutrition totaled 10,016, with a faster increase after 2019. The country, institution, and author with the most publications are the USA, University of California System, Burke, Louise M. In addition, the most co-cited reference is Journal of the Academy of Nutrition and Dietetics (2016) (199). Based on a 10-year bibliometric investigation, we know the USA, the University of California System has become one of this discipline's major research forces. Research on sport and nutrition benefits from the best partnerships between industrialized nations and prominent universities.


Asunto(s)
Estado Nutricional , Deportes , Humanos , Academias e Institutos , Bibliometría , Bases de Datos Factuales
14.
Medicine (Baltimore) ; 103(16): e37796, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38640283

RESUMEN

BACKGROUND: Asthma ranks among the most prevalent non-communicable diseases worldwide. Previous studies have elucidated the significant role of the immune system in its pathophysiology. Nevertheless, the immune-related mechanisms underlying asthma are complex and still inadequately understood. Thus, our objective was to investigate novel key biomarkers and immune infiltration characteristics associated with asthma by employing integrated bioinformatics tools. METHODS: In this study, we conducted a weighted gene co-expression network analysis (WGCNA) to identify key modules and genes potentially implicated in asthma. Functional annotation of these key modules and genes was carried out through gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Additionally, we constructed a protein-protein interaction (PPI) network using the STRING database to identify 10 hub genes. Furthermore, we evaluated the relative proportion of immune cells in bronchial epithelial cell samples from 20 healthy individuals and 88 asthmatic patients using CIBERSORT. Finally, we validated the hub genes and explored their correlation with immune infiltration. RESULTS: Furthermore, 20 gene expression modules and 10 hub genes were identified herein. Among them, complement component 3 (C3), prostaglandin I2 receptor (PTGIR), parathyroid hormone-like hormone (PTHLH), and C-X3-C motif chemokine ligand 1 (CX3CL1) were closely correlated with the infiltration of immune cells. They may be novel candidate biomarkers or therapeutic targets for asthma. Furthermore, B cells memory, and plasma cells might play an important role in immune cell infiltration after asthma. CONCLUSIONS: C3, PTGIR, CX3CL1, and PTHLH have important clinical diagnostic values and are correlated with infiltration of multiple immune cell types in asthma. These hub genes, B cells memory, and plasma cells may become important biological targets for therapeutic asthma drug screening and drug design.


Asunto(s)
Asma , Células Epiteliales , Humanos , Asma/genética , Biomarcadores , Biología Computacional , Bases de Datos Factuales , Redes Reguladoras de Genes
15.
Genome Biol ; 25(1): 104, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38641842

RESUMEN

Single-cell sequencing datasets are key in biology and medicine for unraveling insights into heterogeneous cell populations with unprecedented resolution. Here, we construct a single-cell multi-omics map of human tissues through in-depth characterizations of datasets from five single-cell omics, spatial transcriptomics, and two bulk omics across 125 healthy adult and fetal tissues. We construct its complement web-based platform, the Single Cell Atlas (SCA, www.singlecellatlas.org ), to enable vast interactive data exploration of deep multi-omics signatures across human fetal and adult tissues. The atlas resources and database queries aspire to serve as a one-stop, comprehensive, and time-effective resource for various omics studies.


Asunto(s)
Ascomicetos , Multiómica , Adulto , Humanos , Bases de Datos Factuales , Feto , Perfilación de la Expresión Génica
16.
Child Care Health Dev ; 50(3): e13262, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38606885

RESUMEN

BACKGROUND: While constraint-induced movement therapy is strongly recommended as an intervention for infants with unilateral cerebral palsy, the optimal dosage remains undefined. This systematic review aims to identify the most effective level of intensity of constraint-induced movement therapy to enhance manual function in infants at high risk of asymmetric brain lesions or unilateral cerebral palsy diagnosis. METHODS: This systematic review with meta-analysis encompassed a comprehensive search across four electronic databases to identify articles that met the following criteria: randomised controlled trials, children aged 0-6 with at high risk or with unilateral cerebral palsy, and treatment involving constraint-induced movement therapy for upper limb function. Studies with similar outcomes were pooled by calculating the standardised mean difference score for each subgroup, and subgroups were stratified every 30 h of total intervention dosage (30-60, 61-90, >90 h). Risk of bias was assessed with Cochrane Collaboration's tool. RESULTS: Seventeen studies were included. Meta-analyses revealed significant differences among subgroups. The 30-60 h subgroup showed a weak effect for spontaneous use of the affected upper limb during bimanual performance, grasp function, and parents' perception of how often children use their affected upper limb. Additionally, this subgroup demonstrated a moderate effect for the parents' perception of how effectively children use their affected upper limb. CONCLUSIONS: Using a dosage ranging from 30 to 60 h when applying a constraint-induced movement therapy protocol holds promise as the most age-appropriate and cost-effectiveness approach for improving upper limb functional outcomes and parent's perception.


Asunto(s)
Parálisis Cerebral , Modalidades de Fisioterapia , Niño , Humanos , Lactante , Parálisis Cerebral/terapia , Bases de Datos Factuales , Movimiento , Extremidad Superior , Recién Nacido , Preescolar
17.
J Cancer Res Clin Oncol ; 150(4): 192, 2024 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-38613698

RESUMEN

OBJECTIVE: To date, there have been few studies examining the prognostic implications of histological subtypes in ureteral cancer. And chemotherapy plays a crucial role in the treatment of ureteral cancer, while many factors influence the efficacy of chemotherapy. This study aimed to utilize the Surveillance, Epidemiology and End Results database to assess the impact of histological type on ureteral cancer prognostic outcomes and discovered how histological type and T-stage influence the efficacy of chemotherapy. METHODS: Based on Surveillance, Epidemiology, and End Results Program, we reviewed 8915 records of patients with primary ureteral cancer from 18 centers between 2000 and 2018. We focused on the overall survival and cancer-specific survival of the records and used Kaplan‒Meier method to calculate survival curves. RESULTS: In the comparison of prognostic outcomes, atypical subtypes exhibited a less favorable prognosis compared to typical ureteral carcinoma. Notably, patients diagnosed with papillary urothelial carcinoma demonstrated the most favorable overall survival (p = 0.005). Statistically significant benefits were observed in the prognosis of patients with non-papillary urothelial carcinoma who received chemotherapy (HR = 0.860, 95% CI 0.764-0.966, p = 0.011), while chemotherapy did not yield a statistically significant effect on the prognosis of patients with papillary urothelial carcinoma (HR = 1.055, 95% CI 0.906-1.228, p = 0.493). Chemotherapy had an adverse impact on the prognosis of patients with T1 ureteral cancer (HR = 1.235, 95% CI 1.016-1.502, p = 0.034), whereas it exhibited a positive prognostic effect for T3/T4 cases (HR = 0.739, 95% CI 0.654-0.835, p < 0.001). CONCLUSIONS: Histological type affects the prognosis of ureteral cancer. And evaluation of cancer histological type and T stage in ureteral cancer patients prior to chemotherapy is mandatory.


Asunto(s)
Carcinoma de Células Transicionales , Neoplasias Ureterales , Neoplasias de la Vejiga Urinaria , Humanos , Neoplasias Ureterales/tratamiento farmacológico , Pronóstico , Bases de Datos Factuales
18.
Helicobacter ; 29(2): e13074, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38615332

RESUMEN

BACKGROUND: Helicobacter pylori is considered a true human pathogen for which rising drug resistance constitutes a drastic concern globally. The present study aimed to reconstruct a genome-scale metabolic model (GSMM) to decipher the metabolic capability of H. pylori strains in response to clarithromycin and rifampicin along with identification of novel drug targets. MATERIALS AND METHODS: The iIT341 model of H. pylori was updated based on genome annotation data, and biochemical knowledge from literature and databases. Context-specific models were generated by integrating the transcriptomic data of clarithromycin and rifampicin resistance into the model. Flux balance analysis was employed for identifying essential genes in each strain, which were further prioritized upon being nonhomologs to humans, virulence factor analysis, druggability, and broad-spectrum analysis. Additionally, metabolic differences between sensitive and resistant strains were also investigated based on flux variability analysis and pathway enrichment analysis of transcriptomic data. RESULTS: The reconstructed GSMM was named as HpM485 model. Pathway enrichment and flux variability analyses demonstrated reduced activity in the ribosomal pathway in both clarithromycin- and rifampicin-resistant strains. Also, a significant decrease was detected in the activity of metabolic pathways of clarithromycin-resistant strain. Moreover, 23 and 16 essential genes were exclusively detected in clarithromycin- and rifampicin-resistant strains, respectively. Based on prioritization analysis, cyclopropane fatty acid synthase and phosphoenolpyruvate synthase were identified as putative drug targets in clarithromycin- and rifampicin-resistant strains, respectively. CONCLUSIONS: We present a robust and reliable metabolic model of H. pylori. This model can predict novel drug targets to combat drug resistance and explore the metabolic capability of H. pylori in various conditions.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Humanos , Helicobacter pylori/genética , Claritromicina/farmacología , Rifampin/farmacología , Infecciones por Helicobacter/tratamiento farmacológico , Bases de Datos Factuales
19.
Accid Anal Prev ; 200: 107566, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38574604

RESUMEN

In this paper, a framework is outlined to generate realistic artificial data (RAD) as a tool for comparing different models developed for safety analysis. The primary focus of transportation safety analysis is on identifying and quantifying the influence of factors contributing to traffic crash occurrence and its consequences. The current framework of comparing model structures using only observed data has limitations. With observed data, it is not possible to know how well the models mimic the true relationship between the dependent and independent variables. Further, real datasets do not allow researchers to evaluate the model performance for different levels of complexity of the dataset. RAD offers an innovative framework to address these limitations. Hence, we propose a RAD generation framework embedded with heterogeneous causal structures that generates crash data by considering crash occurrence as a trip level event impacted by trip level factors, demographics, roadway and vehicle attributes. Within our RAD generator we employ three specific modules: (a) disaggregate trip information generation, (b) crash data generation and (c) crash data aggregation. For disaggregate trip information generation, we employ a daily activity-travel realization for an urban region generated from an established activity-based model for the Chicago region. We use this data of more than 2 million daily trips to generate a subset of trips with crash data. For trips with crashes crash location, crash type, driver/vehicle characteristics, and crash severity. The daily RAD generation process is repeated for generating crash records at yearly or multi-year resolution. The crash databases generated can be employed to compare frequency models, severity models, crash type and various other dimensions by facility type - possibly establishing a universal benchmarking system for alternative model frameworks in safety literature.


Asunto(s)
Accidentes de Tránsito , Transportes , Humanos , Accidentes de Tránsito/prevención & control , Viaje , Bases de Datos Factuales , Chicago
20.
Front Immunol ; 15: 1375171, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38566986

RESUMEN

Background: The underlying molecular pathways of idiopathic pulmonary fibrosis (IPF), a progressive lung condition with a high death rate, are still mostly unknown. By using microarray datasets, this study aims to identify new genetic targets for IPF and provide light on the genetic factors that contribute to the development of IPF. Method: We conducted a comprehensive analysis of three independent IPF datasets from the Gene Expression Omnibus (GEO) database, employing R software for data handling and normalization. Our evaluation of the relationships between differentially expressed genes (DEGs) and IPF included differential expression analysis, expression quantitative trait loci (eQTL) analysis, and Mendelian Randomization(MR) analyses. Additionally, we used Gene Set Enrichment Analysis (GSEA) and Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis to explore the functional roles and pathways of these genes. Finally, we validated the results obtained for the target genes. Results: We identified 486 highly expressed genes and 468 lowly expressed genes that play important roles in IPF. MR analysis identified six significantly co-expressed genes associated with IPF, specifically C12orf75, SPP1, ZG16B, LIN7A, PPP1R14A, and TLR2. These genes participate in essential biological processes and pathways, including macrophage activation and neural system regulation. Additionally, CIBERSORT analysis indicated a unique immune cell distribution in IPF, emphasized the significance of immunological processes in the disease. The MR analysis was consistent with the results of the analysis of variance in the validation cohort, which strengthens the reliability of our MR findings. Conclusion: Our findings provide new insights into the molecular basis of IPF and highlight the promise of therapeutic interventions. They emphasize the potential of targeting specific molecular pathways for the treatment of IPF, laying the foundation for further research and clinical work.


Asunto(s)
Perfilación de la Expresión Génica , Fibrosis Pulmonar Idiopática , Humanos , Reproducibilidad de los Resultados , Fibrosis Pulmonar Idiopática/genética , Bases de Datos Factuales , Ontología de Genes , Proteínas de la Membrana , Proteínas de Transporte Vesicular
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