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1.
Heliyon ; 10(5): e26965, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38562495

RESUMO

This paper introduces a novel, Simple-based Dynamic Decentralized Community Detection Algorithm (S-DCDA) for Socially Aware Networks. This algorithm aims to address the resource-intensive nature, instabilities and inaccuracies of traditional distributed community detection algorithms. The dynamics of decentralization is evident in the threefold nature of the algorithm: (i) each node of the community is the core of the entire network or community for a certain period of time dependent on their need, (ii) nodes are not centralized around themselves, requiring the consent of the other node to join a community, and (iii) Communities start from a single node to form an initial scale community, the number of nodes and the relationship among them are constantly changing. The algorithm requires low processor performance and memory capacity size of each node, to a certain extent, effectively improve the accuracy and stability of community detection and maintenance. Experimental results demonstrate that in comparison to classical and classical-based improved community detection algorithms, S-DCDA yields superior detection results.

2.
Cancer Discov ; 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38563585

RESUMO

Glioblastoma (GBM) exhibits profound metabolic plasticity for survival and therapeutic resistance, while the underlying mechanisms remain unclear. Here, we show that GBM stem cells (GSCs) reprogram the epigenetic landscape by producing substantial amounts of phosphocreatine (PCr). This production is attributed to the elevated transcription of brain-type creatine kinase (CKB), mediated by Zinc finger E-box binding homeobox 1 (ZEB1). PCr inhibits the poly-ubiquitination of the chromatin regulator bromodomain containing protein 2 (BRD2) by outcompeting the E3 ubiquitin ligase SPOP for BRD2 binding. Pharmacological disruption of PCr biosynthesis by cyclocreatine leads to BRD2 degradation and a decrease in its targets' transcription, which inhibits chromosome segregation and cell proliferation. Notably, cyclocreatine treatment significantly impedes tumor growth and sensitizes tumors to a BRD2 inhibitor in mouse GBM models without detectable side effects. These findings highlight that high production of PCr is a druggable metabolic feature of GBM and a promising therapeutic target for GBM treatment.

3.
Food Chem Toxicol ; 188: 114632, 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38583503

RESUMO

PFOA is one of the most representative compounds in the family of perfluorinated organic compounds. Due to its varying toxicity, alternatives to PFOA are beginning to emerge. HFPO-TA is an alternative for PFOA. It is currently unclear whether HFPO-TA affects glucose and lipid metabolism. In this study, rats were used as an animal model to investigate the effects of HFPO-TA on liver glucose and lipid metabolism. We found that HFPO-TA can affect glucose tolerance. Through omics analysis and molecular detection, it was found that HFPO-TA mainly affects the PPAR signaling pathway in the liver of rats, inhibiting liver glycolysis while promoting glucose production. HFPO-TA not only promotes the synthesis of fatty acids in the liver, but also promotes the breakdown of fatty acids, which ultimately leads to the disruption of hepatic glucose and lipid metabolism. The effects of HFPO-TA on metabolism are discussed in this paper to provide a reference for the risk assessment of this PFOA substitute.

4.
Polymers (Basel) ; 16(7)2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38611211

RESUMO

This research aimed to provide an understanding of the selection and safe application of pipeline liner materials for hydrogen transport by examining the permeation properties and mechanisms of hydrogen within polymers commonly used for this purpose, such as high-density polyethylene (HDPE) and ethylene-vinyl alcohol copolymer (EVOH), through molecular simulation. The study was carried out within defined operational parameters of temperature (ranging from room temperature to 80 °C) and pressure (from 2.5 to 10 MPa) that are pertinent to hydrogen pipeline infrastructures. The results reveal that with an increase in temperature from 30 °C to 80 °C, the solubility, diffusion, and permeability coefficients of hydrogen in HDPE increase by 18.7%, 92.9%, and 129.0%, respectively. Similarly, in EVOH, these coefficients experience increments of 15.9%, 81.6%, and 112.7%. Conversely, pressure variations have a negligible effect on permeability in both polymers. HDPE exhibits significantly higher hydrogen permeability compared to EVOH. The unique chain segment configuration of EVOH leads to the formation of robust hydrogen bonds among the hydroxyl groups, thereby impeding the permeation of hydrogen. The process by which hydrogen is adsorbed in polymers involves aggregation at low potential energy levels. During diffusion, the hydrogen molecule primarily vibrates within a limited range, with intermittent occurrences of significant hole-to-hole transitions over larger distances. Hydrogen exhibits a stronger interaction with HDPE compared to EVOH, leading to a higher number of adsorption sites and increased hydrogen adsorption capacity in HDPE. Hydrogen molecules move more actively in HDPE than in EVOH, exhibiting greater hole amplitude and more holes in transition during the diffusion process.

5.
Behav Sci (Basel) ; 14(3)2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38540465

RESUMO

Focus back effort, concentration effort, and focus back state are factors associated with mind wandering. Focus back effort, proposed in alignment with the definition of focus back state, has been previously regarded as one manifestation of concentration effort. The primary goals of the current study are to explore the relationship between concentration effort, focus back effort, focus back state, and mind wandering. To shed light on the issue, we assessed the level of each cognitive measure in a single task. The findings revealed significant correlations between concentration effort, focus back effort, focus back state, and mind wandering. Mediation analysis suggested that focus back effort played a mediating role in the relationship between concentration effort and focus back state. Additionally, we observed that these measures independently influenced task performance through their impact on mind wandering. Our results provide potential avenues for interventions aimed at addressing individuals' mind wandering and enhancing task performance.

6.
Int J Biol Macromol ; 266(Pt 1): 131164, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38547940

RESUMO

The biological potency of pectin is intricately intertwined with its intricate molecular architecture. The fine structure of pectin is influenced by the extraction method, while the specific impact of these methods on the fine structure and the affected attributes thereof remains enigmatic. This study delves into the profound analysis of eight distinct extraction methods influence on the structure and biological activity of citrus peel pectin. The findings demonstrate that citric acid ultrasound-assisted microwave extraction yields pectin (PectinCA-US/MV) with higher viscosity and a dense, rigid chain. Pectin extracted with acetic acid ultrasound (PectinAA-US) and citric acid ultrasound (PectinCA-US) exhibits elevated galacturonic acid (GalA) levels and reduced D-galactose (Gal) content, enhancing antioxidant activity. Eight pectin-chitosan (CS) hydrogels, especially PectinCA-US/MV-CS, demonstrate commendable thermal stability, rheological properties, self-healing capability, and swelling behavior. This study characterizes citrus peel pectin properties from different extraction methods, laying a foundation for its application in food, pharmaceuticals, and industry.

7.
Appl Nurs Res ; 75: 151763, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38490794

RESUMO

BACKGROUND: Previous studies have identified the antecedents of the lifestyle of many patients with chronic diseases. However, the mechanism of social support affecting the lifestyle of patients with chronic diseases is unclear, and the role of health literacy in social support affecting the lifestyle of patients with chronic diseases has not been found. Therefore, this study aims to explore the status quo of social support, health literacy and healthy lifestyle of patients with chronic diseases in China and the relationship among them. METHODS: Through convenient sampling, 356 patients with chronic diseases were surveyed using a health promoting lifestyle scale, a chronic disease patients' health literacy scale and a social support scale. RESULTS: There was a pairwise positive correlation between social support, health lifestyle and health literacy (R = 0.397,0.356,0.556, P < 0.01). After controlling gender, age and education level, it is found that social support has a positive impact on health lifestyle, and health literacy plays an intermediary role between social support and health lifestyle, accounting for 45.78 % of the total effect. CONCLUSION: To promote the healthy lifestyle of patients with chronic diseases and delay the development of the disease, we should strengthen social support for patients with chronic diseases; We should simultaneously take various measures to improve their health literacy.


Assuntos
Letramento em Saúde , Humanos , Estudos Transversais , Doença Crônica , Estilo de Vida Saudável , Apoio Social
8.
Front Pharmacol ; 15: 1348360, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476325

RESUMO

Background: Cardiogenic shock (CS) is the primary cause of death in patients suffering acute myocardial infarction. As an emerging and efficacious therapeutic approach, Chinese herbal injections (CHIs) are gaining significant popularity in China. However, the optimal CHIs for treating CS remain uncertain. Method: We searched eight databases from inception to 30 September 2023. Subsequently, we conducted the Bayesian network meta-analysis (NMA). Interventions were ranked based on the surface under the cumulative ranking curve (SUCRA) probability values. To compare the effects of CHIs on two distinct outcomes, a clustering analysis was performed. Furthermore, the quality of the studies was assessed. Results: For the study, we included 43 RCTs, encompassing 2,707 participants. The study evaluated six herbal injections, namely, Shenfu injection (SF), Shengmai injection (SM), Shenmai injection (Sm), Danshen injection (DS), Huangqi injection (HQ), and Xinmailong injection (XML). The analysis findings suggested that Sm (MD = -1.05, 95% CI: -2.10, -0.09) and SF (MD = -0.81, 95% CI: -1.40, -0.25) showed better efficacy compared to Western medicine (WM) alone in reducing in-hospital mortality. The SUCRA values revealed that Sm + WM ranked first in terms of in-hospital mortality, cardiac index (CI), and hourly urine output but second in improving left ventricular ejection fraction (LVEF) and mean arterial pressure (MAP). SF + WM, however, had the greatest impact on raising the clinical effective rate. In MAP, SM + WM came out on top. Moreover, in terms of safety, only 14 studies (31.8%), including five types of CHIs: SF, Sm, SM, HQ, and XML, observed adverse drug reactions. Conclusion: To summarize, this analysis discovered that, in terms of patients suffering from CS, CHIs + WM yielded significantly greater advantages than WM alone. Based on in-hospital mortality and the remaining outcomes, Sm performed excellently among all the involved CHIs. Systematic Review Registration: https:// www.Crd.york.ac.uk/prospero/, identifier: CRD42022347053.

9.
Front Aging Neurosci ; 16: 1334887, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476661

RESUMO

Transcutaneous vagus nerve stimulation (tVNS) is an emerging non-invasive technique designed to stimulate branches of the vagus nerve distributed over the body surface. Studies suggest a correlation between the brain-gut-microbiota (BGM) axis and the pathogenesis of Alzheimer's disease (AD). The BGM axis represents a complex bidirectional communication system, with the vagus nerve being a crucial component. Therefore, non-invasive electrical stimulation of the vagus nerve might have the potential to modify-most of the time probably in a non-physiological way-the signal transmission within the BGM axis, potentially influencing the progression or symptoms of AD. This review explores the interaction between percutaneous vagus nerve stimulation and the BGM axis, emphasizing its potential effects on AD. It examines various aspects, such as specific brain regions, gut microbiota composition, maintenance of intestinal environmental homeostasis, inflammatory responses, brain plasticity, and hypothalamic-pituitary-adrenal (HPA) axis regulation. The review suggests that tVNS could serve as an effective strategy to modulate the BGM axis and potentially intervene in the progression or treatment of Alzheimer's disease in the future.

10.
CNS Neurosci Ther ; 30(2): e14615, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38358054

RESUMO

Neurological and psychiatric diseases can lead to motor, language, emotional disorder, and cognitive, hearing or visual impairment By decoding the intention of the brain in real time, the Brain-computer interface (BCI) can first assist in the diagnosis of diseases, and can also compensate for its damaged function by directly interacting with the environment; In addition, provide output signals in various forms, such as actual motion, tactile or visual feedback, to assist in rehabilitation training; Further intervention in brain disorders is achieved by close-looped neural modulation. In this article, we envision the future BCI digital prescription system for patients with different functional disorders and discuss the key contents in the prescription the brain signals, coding and decoding protocols and interaction paradigms, and assistive technology. Then, we discuss the details that need to be specially included in the digital prescription for different intervention technologies. The third part summarizes previous examples of intervention, focusing on how to select appropriate interaction paradigms for patients with different functional impairments. For the last part, we discussed the indicators and influencing factors in evaluating the therapeutic effect of BCI as intervention.


Assuntos
Encefalopatias , Interfaces Cérebro-Computador , Doenças do Sistema Nervoso , Humanos , Doenças do Sistema Nervoso/terapia , Encéfalo , Eletroencefalografia/métodos
11.
Sensors (Basel) ; 24(3)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38339660

RESUMO

Multi-spectral imaging technologies have made great progress in the past few decades. The development of snapshot cameras equipped with a specific multi-spectral filter array (MSFA) allow dynamic scenes to be captured on a miniaturized platform across multiple spectral bands, opening up extensive applications in quantitative and visualized analysis. However, a snapshot camera based on MSFA captures a single band per pixel; thus, the other spectral band components of pixels are all missed. The raw images, which are captured by snapshot multi-spectral imaging systems, require a reconstruction procedure called demosaicing to estimate a fully defined multi-spectral image (MSI). With increasing spectral bands, the challenge of demosaicing becomes more difficult. Furthermore, the existing demosaicing methods will produce adverse artifacts and aliasing because of the adverse effects of spatial interpolation and the inadequacy of the number of layers in the network structure. In this paper, a novel multi-spectral demosaicing method based on a deep convolution neural network (CNN) is proposed for the reconstruction of full-resolution multi-spectral images from raw MSFA-based spectral mosaic images. The CNN is integrated with the channel attention mechanism to protect important channel features. We verify the merits of the proposed method using 5 × 5 raw mosaic images on synthetic as well as real-world data. The experimental results show that the proposed method outperforms the existing demosaicing methods in terms of spatial details and spectral fidelity.

12.
Cogn Emot ; : 1-18, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38381089

RESUMO

The present study investigated the effect of social feedback on the experiences of our actions and the outcomes (e.g. temporal binding between an action and its outcome, reflecting individuals' causal beliefs modulated by their agency judgments). In Experiment 1a, participants freely decided (voluntary action) their action timing to cause an outcome, which was followed by social feedback. A larger temporal binding (TB) following negative vs. positive events was found. This effect appeared neither in the random context where the causal belief between the action and outcome was absent (Experiment 1b) nor in the involuntary action context where participants' action timing was instructed (Experiment 1c). Experiments 2a and 2b examined the effect when the action-outcome was occluded, including reversing the order of outcome and feedback in Experiment 2b. Experiments 3a and 3b investigated the effect with only social feedback or only action-outcome presented. Results revealed that the effect found in Experiment 1 was driven by social feedback and independent of the availability of the action-outcome and the position of social feedback. Our findings demonstrate a stronger temporal integration of the action and its outcome following negative social feedback, reflecting fluctuations in sense of agency when faced with social feedback.

13.
Eur J Ophthalmol ; : 11206721241229474, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38298013

RESUMO

OBJECTIVES: To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs) on controlling myopia progression in children and adolescents, and to compare it with orthokeratology (Ortho-K) and single vision lenses (SVLs). METHODS: We conducted a systematic search of PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP, and WanFang Data databases for randomized controlled trials (RCTs) and cohort studies that investigated the effects of PDSCLs on myopia control in children and adolescents. The published languages were limited to English and Chinese. The risk bias tool provided by the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by Egger`s test. RESULTS: We included 21 studies, comprising 13 RCTs and 8 cohort studies, with a total of 1337 participants in the PDSCLs group, 428 in the Ortho-K group, and 707 in the SVLs group. The meta-analysis indicated no significant difference between PDSCLs and Ortho-K in controlling the increase of diopter (MD = 0.01, 95% CI: -0.06, 0.09; P = 0.69) and axial length (MD = -0.01, 95% CI: -0.02, 0.00; P = 0.28). Compared with SVLs, PDSCLs had a better effect in controlling the increase of diopter (MD = 0.23, 95% CI: 0.17, 0.28; P < 0.00001) and axial length (MD = -0.11, 95% CI: -0.12, -0.09; P < 0.00001) in children and adolescents. CONCLUSIONS: Children and adolescents wearing PDSCLs can achieve better myopia control than those wearing SVLs, and their effect is comparable to that of Ortho-K.

14.
Cogn Sci ; 48(1): e13403, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38196383

RESUMO

The retrospective view of temporal binding (TB), the temporal contraction between one's actions and their effects, proposes that TB is influenced by what happens after the action. However, the role of the interaction between multiple sources of information following the action in the formation of TB has received limited attention. The current study aims to address this gap by investigating the combined influence of social feedback and outcome valence (i.e., positive or negative outcomes) on TB. In Experiment 1, the valenced outcome was followed by either positive or negative social feedback. The results showed that negative social feedback enlarged the difference between TB over negative and positive outcomes relative to positive social feedback. The modulatory effect of social feedback on TB was not observed in the absence of causal beliefs between actions and outcomes (Experiment 2). These results highlight the importance of considering the complex interplay between cognitive, emotional, and social factors in shaping our subjective temporal experience.


Assuntos
Emoções , Intenção , Humanos , Retroalimentação , Estudos Retrospectivos
15.
J Nutr Biochem ; 123: 109501, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37890710

RESUMO

Perfluorooctanoic acid (PFOA) is a persistent environmental pollutant that can accumulate in the kidneys and eventually cause kidney damage. Rutin (RUTIN) is a natural flavonoid with multiple biological activities, and its use in against kidney damage has been widely studied in recent years. It is not yet known whether rutin protects against kidney damage caused by PFOA. In this study, 30 ICR mice were randomly divided into three groups: CTRL group, PFOA group and PFOA+RUTIN group. The mice were fed continuously by gavage for 28 days. Renal pathological changes were assessed by HE and PASM staining, and serum renal function and lipid indicators were measured. RNA-seq and enrichment analysis using GO, KEGG and PPI to detect differential expression of genes in treatment groups. Kidney tissue protein expression was determined by Western blot. Research has shown that rutin can improve glomerular and tubular structural damage, and increase serum CREA, HDL-C levels and decrease LDH, LDL-C levels. The expression of AQP1 and ACOT1 was up-regulated after rutin treatment. Transcriptomic analysis indicated that PFOA and rutin affect the transcriptional expression of genes related to lipid metabolism and oxidative stress, and may affected by PI3K-Akt, PPAR, NRF2/KEAP1 signaling pathways. In conclusion, rutin ameliorated renal damage caused by PFOA exposure, and this protective effect may be exerted by ameliorating oxidative stress and regulating lipid metabolism.


Assuntos
Metabolismo dos Lipídeos , Rutina , Camundongos , Animais , Rutina/farmacologia , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Camundongos Endogâmicos ICR , Fator 2 Relacionado a NF-E2/genética , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo , Rim/metabolismo
16.
Immunol Invest ; 52(8): 1008-1022, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37962037

RESUMO

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive intracellular lipid accumulation, oxidative stress, and inflammation. Cinnamyl alcohol (CA), one of the cinnamon extracts, has been shown to exhibit anti-oxidative and anti-inflammatory activities. We proposed that CA was beneficial to NAFLD. METHODS: Serum cytokines and components of the lipid metabolism were determined in children with NAFLD against age-matched comparisons. A NAFLD mouse model was established by high fat and high carbohydrate (HFHC) diet in male C57BL/6 mouse pups, followed by administration of CA. The effects of CA on lipid metabolism, oxidative stress, and inflammation in hepatic tissues were assessed. RESULTS: Abnormal lipid metabolism and inflammatory responses were observed in the children with NAFLD as compared with the controls. CA reduced the weight of obese mice without affecting food intake as well as alleviating liver injury caused by HFHC feeding. CA was found to mitigate dyslipidemia and reduce hepatic steatosis in HFHC-fed mice by down-regulating genes related to lipogenesis, including peroxisome proliferator-activated receptor gamma (PPARγ), sterol regulatory element-binding transcription factor-1c (SREBP-1c), and acetyl-CoA carboxylase 1 (ACC1). Additionally, CA treatment reversed HFHC-induced oxidative stress and inflammation, evidenced by the decreased liver reactive oxygen species (ROS), hepatic inflammatory cytokine levels, and F4/80-positive macrophage infiltration in HFHC diet mice. CA reduced the protein levels of pyrin domain-containing protein 3 (NLRP3), adapter protein apoptosis-associated speck-like protein (ASC), and caspase-1 in the liver tissues significantly. CONCLUSION: CA alleviates HFHC-induced NAFLD in mice, which is associated with the amelioration in lipid metabolism, oxidative stress, and inflammation.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Obesidade Pediátrica , Criança , Humanos , Masculino , Animais , Camundongos , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade Pediátrica/metabolismo , Dieta Hiperlipídica , Camundongos Endogâmicos C57BL , Fígado/metabolismo , Inflamação/metabolismo , Estresse Oxidativo , Citocinas/metabolismo
17.
Biochem Genet ; 2023 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-37999875

RESUMO

The dehydration response element-binding (DREB) transcription factor is a subfamily of AP2/ERF. It actively responds to various abiotic stresses in plants. As one of the representative plants, Panax notoginseng is sensitive to Nitrogen (N). Here, bioinformatics analysis, the identification, chromosomal location, phylogeny, structure, cis-acting elements, and collinearity of PnDREBs were analyzed. In addition, the expression levels of PnDREBs were analyzed by quantitative reverse transcription PCR. In this study, 54 PnDREBs were identified and defined as PnDREB1 to PnDREB54. They were divided into 6 subfamilies (A1-A6). And 44 PnDREBs were irregularly distributed on 10 of 12 chromosomes. Each group showed specific motifs and exon-intron structures. By predicting cis-acting elements, the PnDREBs may participate in biotic stress, abiotic stress, and hormone induction. Collinear analysis showed that fragment duplication events were beneficial to the amplification and evolution of PnDREB members. The expression of PnDREBs showed obvious tissue specificity in its roots, flowers, and leaves. In addition, under the action of ammonium nitrogen and nitrate nitrogen at the 15 mM level, the level of PnDREB genes expression in roots varied to different degrees. In this study, we identified and characterized PnDREBs for the first time, and analyzed that PnDREBs may be related to the response of P. Notoginseng to N sensitiveness. The results of this study lay a foundation for further research on the function of PnDREBs in P. Notoginseng.

18.
Pers Soc Psychol Bull ; : 1461672231210451, 2023 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-37997808

RESUMO

Studies have found large differences in masks use during the pandemic. We found evidence that cultural tightness explains mask use differences and this association was more robust in tight situations like subways. In Study 1, we observed 23,551 people's actual mask use in public places around China. People wore masks more in tight situations; however, differences did not extend to outdoor streets and public parks, where norms are looser. We replicated this finding using a data from 15,985 people across China. Finally, in a preregistered study we observed mask use with the removal of COVID-19 restrictions, people still wore masks more in tight situations like subways than in loose situations of parks. These findings suggest that norm tightness has a lasting association with people's health-protective behaviors, especially in tight situations. It provides insight into how different cultures might respond with future pandemics and in what situations people adopt health-protective behaviors.

19.
Infect Drug Resist ; 16: 6549-6566, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37817839

RESUMO

Purpose: The aim of this study was to establish risk prediction and prognosis models for multidrug-resistant bacterial infections (MDRB) in elderly patients with pulmonary infections in a multicenter setting. Patients and Methods: This study is a retrospective cohort analysis in Anhui province of China. Data dimension reduction and feature selection were performed using the lasso regression model. Multifactorial regression analysis to identify risk factors associated with MDRB infection and prognosis. The relevant risks of each patient in the prognostic training cohort were scored based on prognostic independent risk factors. Subsequently, patients were classified into high-risk and low-risk groups, and survival differences were compared between them. Finally, models were established based on independent risk factors for infection, risk groups, and independent prognostic factors, and were presented on nomograms. The predictive accuracy of the model was assessed using corresponding external validation set data. Results: The study cohort comprised 994 elderly patients with pulmonary infection. Multivariate analysis revealed that endotracheal intubation, previous antibiotic use beyond 2 weeks, and concurrent respiratory failure or cerebrovascular disease were independent risk factors associated with the incidence of MDRB infection. Cox regression analysis identified respiratory failure, malnutrition, an APACHE II score of at least 20, and higher blood creatinine levels as independent prognostic risk factors. The models were validated using an external validation dataset from multiple centers, which demonstrated good diagnostic ability and a good fit with a fair benefit. Conclusion: In conclusion, our study provides an appropriate and generalisable assessment of risk factors affecting infection and prognosis in patients with MDRB, contributing to improved early identification of patients at higher risk of infection and death, and appropriately guiding clinical management.

20.
BMC Med Educ ; 23(1): 812, 2023 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-37891526

RESUMO

BACKGROUND: The simulated three-dimensional (3D) printed anatomical model of the aorta, which has become the norm in medical education, has poor authenticity, tactility, feasibility, and interactivity. Therefore, this study explored the educational value and effect of mixed reality (MR) combined with a 3D printed model of aortic disease in training surgical residents. METHOD: Fifty-one resident physicians who rotated in vascular surgery were selected and divided into traditional (27) and experimental (24) teaching groups using the random number table method. After undergoing the experimental and traditional training routines on aortic disease, both the groups took a theoretical test on aortic disease and an assessment of the simulation based on the Michigan Standard Simulation Experience Scale (MiSSES) template. Their scores and assessment results were compared. The study was conducted at the Department of Vascular Surgery of Peking University People's Hospital, Beijing, China. RESULTS: In the theoretical test on aortic disease, the experimental teaching group obtained higher mean total scores (79.0 ± 9.1 vs. 72.6 ± 7.5, P = 0.013) and higher scores in anatomy/ pathophysiology (30.8 ± 5.4 vs. 24.8 ± 5.8; P < 0.001) than the traditional teaching group. The differences in their scores in the differential diagnosis (25.8 ± 3.0 vs. 23.3 ± 4.9; P = 0.078) and treatment (22.5 ± 11.8 vs. 24.5 ± 8.2; P = 0.603) sessions were insignificant. The MR-assisted teaching stratified the vascular residents through the MiSSES survey. Overall, 95.8% residents (23/24) strongly or somewhat agreed that the MR was adequately realistic and the curriculum helped improve the ability to understanding aortic diseases. Further, 91.7% residents (22/24) strongly or somewhat agreed that the MR-assisted teaching was a good training tool for knowledge on aortic diseases. All residents responded with "Good" or "Outstanding" on the overall rating of the MR experience. CONCLUSIONS: MR combined with the 3D printed model helped residents understand and master aortic disease, particularly regarding anatomy and pathophysiology. Additionally, the realistic 3D printing and MR models improved the self-efficacy of residents in studying aortic diseases, thus greatly stimulating their enthusiasm and initiative to study.


Assuntos
Doenças da Aorta , Realidade Aumentada , Internato e Residência , Humanos , Estudos de Casos e Controles , Procedimentos Cirúrgicos Vasculares , Impressão Tridimensional , Competência Clínica
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