RESUMO
Background As a complex organic pollutant, polycyclic aromatic hydrocarbons (PAHs) exposure shares the common exposure characteristics of multiple hydroxyl metabolites. Most studies have analyzed independent effect of each PAHs metabolite and have adjusted for the potential confounding effects induced by other metabolites concomitantly, without considering possible interactions among them. Proper statistical methods are needed to study their toxic effects. Objective To explore the applicability of logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) in evaluating the correlation between mixed exposures to exogenous chemicals and health outcomes, compare the advantages and limitations of the three models, and propose analytical strategies for evaluating the health effects of mixed chemical exposure for application in the analysis of the association between PAHs exposure and cognition. Methods Urine samples were collected of workers from a coke oven plant and a water treatment plant in Shanxi Province, who participated in their routine employee healthexamination. Mono-hydroxylated PAHs were detected by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS), cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). A cut-off value of MoCA less than 26 was considered mild cognitive impairment (MCI). According to a predetermined inclusion and exclusion criteria, 1 051 cases were included in the final data analysis. Logistic regression, WQS regression, and BKMR were used to analyze the relationship between PAHs metabolites and MCI. Results The prevalence rate of reporting MCI among the 1 051 workers was 21.7% (228/1 051). The concentration of 2-hydroxynathalene (2-OHNAP) was the highest among the 11 PAHs metabolites with a median concentration of 0.30 μg·L−1, followed by 9-hydroxyphenanthrene (9-OHPHE) (0.26 μg·L−1). There were significant differences between the two groups in 2-OHNAP, 1-hydroxynaphthalene (1-OHNAP), 2-hydroxyfluorene (2-OHFLU), 9-OHPHE, 1-hydroxyphenanthrene (1-OHPHE), and 1-hydroxypyrene (1-OHPYR) (all Ps<0.05). In the logistic regression, 2-OHNAP and 2-OHPHE were associated with MCI, and the OR (95%CI) for reporting MCI was 1.28 (1.01-1.67) and 1.27 (1.00-1.72) for each 10-fold increase in 2-OHNAP and 2-OHPHE concentrations, respectively. In the WQS regression analysis, the WQS index was positively correlated with the prevalence rate of reporting MCI (OR=1.37, 95%CI: 1.10-1.72). In the BKMR analysis, compared with the median exposure levels of all chemicals, the overall effect was statistically significant when all PAHs metabolites concentrations were at or above their 30th percentile; when all exposures were at the 75th percentile, the risk of reporting MCI increased by 6%. Conclusion Based on the results of these three models, 2-OHNAP and 2-OHPHE are the most important factors related to cognitive. It is recommended to use a combination of traditional logistic regression and either WQS or BKMR to study the association between PAHs and MCI.
RESUMO
Catheter-associated urinary tract infection (CAUTI) is the most common complication in patients with indwelling catheterization. The incidence of CAUTI in my country is still at a relatively high level compared with foreign countries, especially for the ICU, which has a high usage rate of urinary catheters, to focus on prevention and control. This article focuses on studying the risk factors of CAUTI in critically ill patients and discusses targeted preventive care measures. This article investigates and examines the clinical data of CAUTI in critically ill patients. After statistical analysis, the risk factors that affect CAUTI are summarized, so as to derive the cause of CAUTI in order to strengthen clinical care and to further study the prevention, control, and nursing of CAUTI to provide reference. Clinical data shows that the CAUTI infection rate of patients with catheter indwelling ≥7 days is greater than that of patients with catheter indwelling days less than 7 days. The CAUTI infection rate of the patients who change the urine collection bag every day or ≥7 days is greater than that of the patients who change the urine collection bag within 2 to 4 days.
RESUMO
Abstract@#Nowadays, sports APPs are gradually diversifying based on the rapid development of the Internet and artificial intelligence. Various sports apps are active in the public s field of vision. This article reviewed the research progress of college students used of sports APP on their training habits. The result found that proper use of sports APP could promote college students sports behavior and sports habits. The use of such apps could help college students improve their body shape physical function, but it was difficult to maintain the effect after the end of the athletic behavior. It is recommended that schools use APPs to form teacher and student sports communication communities and conduct different types of sports challenges. At the same time, the government enacts college and personal reward systems to encourage sport participation among students, thereby increasing the intention to continue using sports APPs. More longitudinal follow up researches are expected to evaluate effectiveness of different sports APPs on sport habit formulation.
RESUMO
Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.
RESUMO
Objective To examine the association between body mass index (BMI)and cardiovascular events in elderly hypertensive patients.Methods A total of 2267 elderly(age≥65) hypertensive patients undergoing long-term physical examination at Henan Province People's Hospital were included in this cohort study,and were divided into three groups:an underweight group(BMI≤ 18.4 kg/m2,n=125),a normal group(BMI=18.5-23.9 kg/m2,n=912),an overweight group(BMI=24.0 27.9 kg/m2,n=884),and an obesity group(BMI≥28.0 kg/ m2,n=346)for a six-year follow up period.The incidences of cardiovascular events were collected and analyzed for all groups.The Cox proportional hazards regression model was used to analyze all possible risk factors for all-cause deaths and cardiovascular events.Results There were 2 267 patients,including 1 260 male and 1 007 female patients,with a mean age of(75.7 ± 6.1)years.The Cox proportional hazards regression model showed that being underweight(BMI≤18.4 kg/m2)was a risk factor with a 1.8 times higher risk for all cause death and a 1.5 times higher risk for cardiovascular death than having a normal weight(RR=1.8,95 ％ CI:1.3-2.6;RR=1.5,95％ CI:1.3-1.7).Being overweight (BMI=24 27.9 kg/m2)was a protective factor with a 0.6 times lower risk for all-cause death and a 0.7 times lower risk for cardiovascular death,compared with the normal group (RR=0.6,95％ CI:0.5-0.8;RR=0.7,95％ CI:0.6-0.9).Obesity(BMI≥28.0kg/m2)was a protective factor for cardiovascular death with a lower relative risk of 0.9,compared with the normal group(RR=0.9,95％CI:0.9-1.0).Conclusions Paradoxically,being overweight is associated with a low mortality and a favorable cardiovascular prognosis,whereas being underweight carries a poor prognosis in elderly hypertensive patients.
RESUMO
The steroidal enzyme cytochrome P45017alpha catalyzes the conversion of progesterone and pregnenolone into androgens, androstenedione and dehydroepiandrosterone, respectively, the direct precursors of estrogens and testosterone. Dihydrotestosterone is the principal active androgen in the prostate, testosterone is also an active stimulant of the growth of prostatic cancer tissue. Inhibition of this enzyme as a mechanism for inhibiting androgen biosynthesis could be a worthwhile therapeutic strategy for the treatment of PCA. In this paper, four categories of steroidal inhibitors of cytochrome P45017alpha will be reviewed, a diverse range of steroidal inhibitors had been synthesized and shown to be potent inhibitors of P45017alpha.
