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1.
Sci Total Environ ; 806(Pt 2): 150299, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34610563

RESUMO

In the present study, we investigated the responses of microbial respiration and community structure, enzyme activity and DTPA-extractable Pb within 60 days of incubation in soils treated with Pb and nano-ZnO. The results showed that when the concentration of nano-ZnO exceeded 10 mg/kg, the concentration of DTPA-extractable Pb significantly decreased by 10.6%-21.3% on the 60th day of the experiment. The addition of nano-ZnO decreased the Pb-contaminated soil pH from 6.18 to 6.08 at 7 days, which is part of the reason for the ß-glucosidase activity change. Ten mg/kg nano-ZnO significantly reduced the qCO2 value, which represented the microbial energy demand for the conversion of carbon sources into biomass. Nano-ZnO improved the microbial diversity and richness of some metal-tolerant bacteria at 60 days. The findings provide deeper insight into the responses of soil microbes and Pb bioavailability in the presence of nano-ZnO particles.


Assuntos
Poluentes do Solo , Óxido de Zinco , Disponibilidade Biológica , Biomassa , Chumbo , Solo , Microbiologia do Solo , Poluentes do Solo/análise
2.
Int J Cardiol ; 347: 21-27, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34774886

RESUMO

BACKGROUND: Selecting best candidates for prolonged poststroke cardiac monitoring in acute ischemic stroke (AIS) patients is still challenging. We aimed to develop a machine learning (ML) model to select AIS patients at high risk of poststroke atrial fibrillation (AF) for prolonged cardiac monitoring and then to compare ML model with traditional risk scores and classic statistical logistic regression (classic-LR) model. METHODS: AIS patients from July 2012 to September 2020 across Nanjing First Hospital were collected. We performed the LASSO regression for selecting the critical features and built five ML models to assess the risk of poststroke AF. The SHAP and partial dependence plot (PDP) method were introduced to interpret the optimal model. We also compared ML model with CHADS2 score, CHA2DS2-VASc score, AS5F score, HAVOC score, and classic-LR model. RESULTS: A total of 3929 AIS patients were included. Among the five ML models, deep neural network (DNN) was the model with best performance. It also exhibited superior performance compared with CHADS2 score, CHA2DS2-VASc score, AS5F score, HAVOC score and classic-LR model. The results of SHAP and PDP method revealed age, cardioembolic stroke, large-artery atherosclerosis stroke, and NIHSS score at admission were the top four important features and revealed the DNN model had good interpretability and reliability. CONCLUSION: The DNN model achieved best performance and improved prediction performance compared with traditional risk scores and classic-LR model. The DNN model can be applied to identify AIS patients at high risk of poststroke AF as best candidates for prolonged poststroke cardiac monitoring.

3.
Medicine (Baltimore) ; 100(50): e28302, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34918709

RESUMO

ABSTRACT: Although the number of deaths due to coronavirus disease 2019 (COVID-19) is higher in men than women, prior studies have provided limited sex-stratified clinical data.We evaluated sex-related differences in clinical outcomes among critically ill adults with COVID-19.Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day in-hospital mortality, severe acute kidney injury (AKI requiring kidney replacement therapy), and respiratory failure occurring within 14 days of intensive care unit admission.A total of 4407 patients were included (median age, 62 years; 2793 [63.4%] men; 1159 [26.3%] non-Hispanic White; 1220 [27.7%] non-Hispanic Black; 994 [22.6%] Hispanic). Compared with women, men were younger (median age, 61 vs 64 years, less likely to be non-Hispanic Black (684 [24.5%] vs 536 [33.2%]), and more likely to smoke (877 [31.4%] vs 422 [26.2%]). During median follow-up of 14 days, 1072 men (38.4%) and 553 women (34.3%) died. Severe AKI occurred in 590 men (21.8%), and 239 women (15.5%), while respiratory failure occurred in 2255 men (80.7%) and 1234 women (76.5%). After adjusting for age, race/ethnicity and clinical variables, compared with women, men had a higher risk of death (OR, 1.50, 95% CI, 1.26-1.77), severe AKI (OR, 1.92; 95% CI 1.57-2.36), and respiratory failure (OR, 1.42; 95% CI, 1.11-1.80).In this multicenter cohort of critically ill adults with COVID-19, men were more likely to have adverse outcomes compared with women.


Assuntos
Injúria Renal Aguda , COVID-19 , Insuficiência Respiratória , Fatores Sexuais , Injúria Renal Aguda/virologia , Adulto , COVID-19/complicações , COVID-19/mortalidade , Estado Terminal , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Insuficiência Respiratória/virologia , Estudos Retrospectivos , Fatores de Risco
4.
Environ Pollut ; 293: 118487, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34774674

RESUMO

Coastal acidification is often much more intense than ocean acidification due to eutrophication. To better understand the relationship between long-term coastal acidification (CA) and coastal eutrophication (CE), in-situ monthly data over the past three decades (1986-2017) were analyzed from Hong Kong Coast (HKC). The coastwide annual mean pH change (ΔpHmean) was estimated at -0.0085 ± 0.0069 unit·yr-1 in last decades, which was over four times stronger than current estimation on open ocean acidification rate (∼-0.0019 unit·yr-1). According to the CA spatial pattern, greater pH decline (ΔpHmean = -0.017 ± 0.009 unit·yr-1) occurred in northwest, central south and central east HKC areas, much higher than the less acidified (ΔpHmean = -0.004 ± 0.002 unit·yr-1) southwest and northeast HKC areas. The spatiotemporal CA variations were associated with water discharges, atmospheric CO2 increase and respiration/production that was indicated by DIN:DIP structure changes. The annual mean DIN:DIP ratio increased progressively from initial ∼16 in 1986 to ∼37 in 2017, revealing excess nitrogen load from rapid urbanization in this region. Such discharge-induced acidification was estimated as the major contributor for the total CA in HKC over the last three decades. In addition, our simulation results indicated that a potential CA rate at ∼0.0035 unit·yr-1 could be reached if reducing mean DIN:DIP from discharged water to ∼23 from HKC. This study revealed a previously not recognized relationship between coastal acidification and changing coastal nutrient stoichiometry, and proposed possible management approaches.

5.
Am J Nephrol ; 52(10-11): 788-797, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34749369

RESUMO

INTRODUCTION: Transplant glomerulopathy (TG) is a morphological lesion resulting from chronic glomerular endothelium injury, and it is strongly associated with poor graft survival. TG coexisting with focal segmental glomerulosclerosis (FSGS) can be found in renal allograft biopsies, but few related studies are available. METHODS: Consecutive kidney transplant recipients with biopsy-proven TG were studied retrospectively. Patients concomitant with FSGS were identified and compared with those without FSGS. The influence of FSGS on allograft outcomes was assessed using univariate and multivariate Cox regression models. RESULTS: Of the 66 patients with TG, 40 (60.6%) had concomitant FSGS. TG patients with FSGS had higher proteinuria (median, 2.6 vs. 0.8 g/24 h, p < 0.001) and serum creatinine levels (median, 2.5 vs. 2.1 mg/dL, p = 0.04), lower serum albumin levels, higher chronic glomerulopathy (cg) score, larger glomerular tuft area, lower number of podocytes, and higher incidences of podocyte hyperplasia, pseudotubule formation, and diffuse foot process effacement than those without FSGS (all p < 0.05). The kidney allograft loss rate of patients with FSGS was higher than that of patients without FSGS (65.7% vs. 37.5%, p = 0.03). The presence of FSGS was independently associated with allograft loss in TG (hazard ratio (HR) = 3.42, 95% confidence interval (CI): 1.30-8.98, p = 0.01). Other independent predictors were proteinuria (HR = 1.18, 95% CI: 1.02-1.37, p = 0.02), estimated glomerular filtration rate (HR = 0.94, 95% CI: 0.91-0.97, p < 0.001), and panel reactive antibody (HR = 3.99, 95% CI: 1.14-13.99, p = 0.03). Moreover, FSGS (odds ratio (OR) = 4.39, 95% CI: 1.29-14.92, p = 0.02) and cg (OR = 5.36, 95% CI: 1.56-18.40, p = 0.01) were independent risk factors for proteinuria. CONCLUSION: In this cohort of patients with TG, the presence of FSGS was strongly associated with more severe clinicopathological features and worse allograft survival.

6.
BMC Nephrol ; 22(1): 328, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600511

RESUMO

BACKGROUND: Some studies have suggested mizoribine (MZR) could inhibit the replication of BK polyomavirus (BKPyV). The purpose of this study was to explore whether conversion from mycophenolate mofetil (MMF) to MZR in the early stages of BKPyV infection can improve kidney allograft prognosis. METHODS: Twenty-one kidney transplant recipients with BKPyV viruria/viremia and ten with BK polyomavirus-associated allograft nephropathy (BKPyVAN) received MZR conversion therapy were retrospectively identified. The clearance rate of urine and blood BKPyV DNA, change of serum creatinine (SCr), uric acid (UA), hemoglobin (HB), white blood cell (WBC), lymphocyte ratio, platelet (PLT), routine urinalysis, panel reactive antibody (PRA), and gastrointestinal disorders during follow-up of the 2 groups were evaluated and compared. RESULTS: After MZR conversion therapy, the clearance rate of urine and blood viral load in BKPyV viruria/viremia group were 85.7 and 100 %, while that in BKPyVAN were 40 and 87.5 %, respectively. Stable SCr were observed in all cases of BKPyV viruria/viremia group, while that of BKPyVAN was only 40 % (P < 0.001) and one even progressed to end-stage renal disease. The results of routine urinalysis in the two groups showed no significant changes before and after MZR conversion therapy. However, in BKPyV viruria/viremia group, four cases developed acute rejection and one had positive PRA-II but no donor specific antibody, requiring conversion back to MMF. Hyperuricemia was the common adverse effect of MZR. CONCLUSIONS: Conversion from MMF to MZR could help clear BKPyV infection. As compared to BKPyVAN, patients who underwent initiation of MZR conversion therapy in the early stages of BKPyV infection maintained stable allograft function. Prospective studies with larger sample size are needed to ascertain this preliminary finding.

7.
PLoS One ; 16(10): e0258253, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34634063

RESUMO

Current knowledge on responses of aquatic clonal plants to resource availability is largely based on studies manipulating limited resource levels, which may have failed to capture the "big picture" for aquatic clonal plants in response to resource availability. In a greenhouse experiment, we grew the floating clonal plant Spirodela polyrhiza under ten nutrient levels (i.e., 1/64×, 1/32×, 1/16×, 1/8×, 1/4×, 1/2×, 1×, 2×, 4× and 8×full-strength Hoagland solution) and examined their responses in terms of clonal growth, morphology and biomass allocations. The responses of total biomass and number of ramets to nutrient availability were unimodal. A similar pattern was found for frond mass, frond length and frond width, even though area per frond and specific frond area fluctuated greatly in response to nutrient availability. In contrast, the responses of root mass and root length to nutrient availability were U-shaped. Moreover, S. polyrhiza invested more to roots under lower nutrient concentrations. These results suggest that nutrient availability may have distinct influences on roots and fronds of the aquatic clonal plant S. polyrhiza, resulting in a great influence on the whole S. polyrhiza population.


Assuntos
Araceae/fisiologia , Nutrientes/farmacologia , Folhas de Planta/fisiologia , Raízes de Plantas/fisiologia , Araceae/anatomia & histologia , Araceae/efeitos dos fármacos , Araceae/crescimento & desenvolvimento , Biomassa , Células Clonais , Folhas de Planta/anatomia & histologia , Folhas de Planta/efeitos dos fármacos , Raízes de Plantas/anatomia & histologia , Raízes de Plantas/efeitos dos fármacos , Brotos de Planta/anatomia & histologia , Brotos de Planta/efeitos dos fármacos , Brotos de Planta/fisiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34491497

RESUMO

Abscisic acid (ABA) may play an important role in alleviating negative effects of heavy metal stress on growth performance of plants. A pot experiment was conducted to investigate differential effects of exogenous ABA with different concentrations (0, 20, 40, and 60 µmol/L) on heavy metal accumulation and physiological response of Cd/Zn hyperaccumulator Sedum alfredii Hance and non-hyperaccumulator Hylotelephium spectabile (Boreau) H. Ohba grown in co-contaminated soil. In the experiment, Cd, Zn, or Pb concentration in stem and leaf of H. spectabile was significantly increased by exogenous ABA application than control. However, the opposite pattern was observed for S. alfredii. With decrease of Cd concentration, Zn or Pb concentration in root of H. spectabile grown in co-contaminated soil was significantly increased by exogenous ABA application than control. Cd, Zn, or Pb concentration in root of S. alfredii was significantly increased by exogenous ABA application than control. Compared with S. alfredii, BCF and TF of Cd, Zn, or Pb for H. spectabile were significantly increased by exogenous ABA application. With negative effect on root growth, total biomass of the two species, especially H. spectabile, was significantly increased by exogenous ABA application than control. With increase of their total chlorophyll content, antioxidant capacity of the two species subjected to heavy metal stress was improved by exogenous ABA application than control. Heavy metal-induced growth inhibition was significantly alleviated by exogenous ABA application when the two species were grown in co-contaminated soil. We tentatively concluded that differential effects of exogenous ABA application on transport pathway of ions incurred different patterns of heavy metal accumulation between Cd/Zn hyperaccumulator S. alfredii and non-hyperaccumulator H. spectabile. It is suggested that compared with Cd/Zn hyperaccumulator S. alfredii, exogenous ABA application may improve heavy metal uptake in root and transport of heavy metal ions between different organs for non-hyperaccumulator H. spectabile grown in co-contaminated soil. Our results provide insight into effects of exogenous ABA application on phytoremediation of Cd-, Pb-, and Zn-co-contaminated soil.

9.
J Am Heart Assoc ; 10(16): e012704, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34378404

RESUMO

Background Evidence suggests that subjective (perceived) social status (SSS) may predict health outcomes more strongly than objective social status, but little is known about the relationship between SSS and cardiovascular health (CVH). This study focuses on this relationship among diverse Hispanic/Latino adults because while poor CVH profiles are prevalent in this population, immigration complicates attempts to measure their social status. Methods and Results We analyzed baseline HCHS/SOL (Hispanic Community Health Study/Study of Latinos) data on 15 374 Hispanic/Latino adults aged 18 to 74 years in 2008 to 2011. SSS was assessed using the McArthur Scale, a 10-rung "social ladder." CVH was based on levels of 7 metrics defined by the American Heart Association. Linear and logistic regressions were used to examine cross-sectional associations of SSS with CVH (overall and single metrics) after adjusting for objective social status, demographic, and health factors. Less than half of the population (46%) had Ideal scores in ≥4 metrics of CVH. In multivariable-adjusted models, an increase in SSS was associated with a higher overall CVH score (ß=0.04; 95% CI, 0.01-0.06) and greater likelihood of Ideal levels of body mass index, physical activity, and fasting blood glucose levels. Nativity and time in the United States modified the association between SSS and Ideal smoking. Conclusions Subjective measures of social status can enhance an understanding of CVH among Hispanic/Latino people. Future studies should explore the stability of SSS over time in comparison with objective social status and the mechanisms through which SSS may influence CVH.


Assuntos
Doenças Cardiovasculares/etnologia , Indicadores Básicos de Saúde , Nível de Saúde , Estilo de Vida Saudável , Distância Psicológica , Determinantes Sociais da Saúde/etnologia , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Proteção , Medição de Risco , Estados Unidos/epidemiologia , Adulto Jovem
10.
Kidney Med ; 3(4): 528-535.e1, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34401720

RESUMO

Rationale & Objective: Recent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented. Study Design: Observational cohort. Setting & Participants: We analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline. Predictors: Predictors included ≥30% of sites with clinical attachment loss ≥3 mm, ≥30% of sites with probing depth ≥4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present). Outcomes: Outcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m2 and decline in eGFR ≥1 mL/min/year); incident albuminuria (urine albumin:creatinine ratio [ACR] ≥30 mg/g); and change in eGFR and ACR. Analytic Approach: Poisson and linear regression. Results: For the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had ≥30% of sites with clinical attachment loss ≥3 mm, 5.1% had ≥30% of sites with probing depth ≥4 mm, 30.7% had ≥50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of ≥30% of sites with probing depth ≥4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes. Limitations: Only a single kidney function follow-up measure. Conclusions: In this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.

11.
Nano Lett ; 21(15): 6480-6486, 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34324350

RESUMO

Lower coercivity (HC) and magnetic anisotropy (K1) coupled with high mechanical strength are essential properties for Co-based soft magnetic thin films; however, the strength-coercivity trade-off limits their development. Co with face centered cubic structure (fcc) exhibits lower HC and K1 than its grand hexagonal close packed structure (hcp); however, metastable fcc-phase Co is hard to stabilize. Here, by using Cu (100) seed layer, we synthesized micron-thick fcc Co films with self-formed three-dimensional nanoscale stacking faults (3D-nSFs) that could achieve high strengths without sacrificing soft magnetic properties. The 3D-nSFs, induced by the Co/Cu interface, could not only stabilize the metastable fcc Co to yield lower HC but also impede dislocation motion to strengthen Co films. More importantly, we successfully tailored the density of 3D-nSFs and confirmed a large variation in magnetic coercivity (by 100%) and indentation hardness (by 25%). This work provides a new strategy for integrated performance optimization by interface design and strain engineering.

12.
Zhongguo Zhong Yao Za Zhi ; 46(7): 1769-1782, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-33982481

RESUMO

NAC(NAM/ATAF/CUC) protein plays an important role in plant growth and development, secondary cell wall formation and stress response. In this study, based on the sequencing data of Angelica dahurica, the NAC family was systematically analyzed using bioinformatics methods and its expression pattern was analyzed. Studies showed that 75 candidate genes had been selected from the NAC transcription factor family of A. dahurica, with the protein size of 148-641, all of which were unstable hydrophilic proteins. Most NAC proteins were localized in the nucleus, and had complete NAC domain. Phylogenetic analysis of NAC family proteins of A.dahurica and Arabidopsis thaliana showed that among the 17 subfamilies, NAC members were unevenly distributed in each subfamily, indicating that the evolution of species is developing in multiple directions. Among them, ANAC063 subfamily contained no NAC sequence of A. dahurica, which might be due to the functional evolution of the species. Analysis of protein transmembrane structure and signal peptide showed that NAC transcription factor could carry out transmembrane transportation, but its signal peptide function had not been found. Expression analysis showed that most transcription factors responded to abiotic stress and hormones to varying degrees, and the effects of hormones were obvious, especially ABA and IAA. In different organs of A. dahurica, most members of the NAC family had higher expression in root phloem, followed by root xylem. This study lays a foundation for further research on the function of A. dahurica NAC transcription factor and for solving the biological problems of A. dahurica.


Assuntos
Angelica , Biologia Computacional , Regulação da Expressão Gênica de Plantas , Filogenia , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Estresse Fisiológico , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo
13.
Transpl Immunol ; 69: 101404, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33971294

RESUMO

INTRODUCTION: Antibody-mediated rejection (ABMR) is a major cause of kidney transplant failure which requires donor-specific antibodies (DSA) for a definitive diagnosis. Donor-derived cell-free DNA (ddcfDNA) is an emerging biomarker used to assess kidney allograft injury. However, current data is limited to predict the accuracy of ddcfDNA in ABMR diagnosis. This study was conducted to compare the performance of DSA with plasma ddcfDNA for the diagnosis of ABMR. METHODS: In this retrospective single-center observational study, we enrolled 50 kidney transplant recipients who were diagnosed with the suspicion of rejection between June 2018 and May 2019 at the Jinling Hospital. Plasma ddcfDNA was measured by using a novel target region capture sequencing methodology. A total of 37 patients who were tested with DSA and biopsy were divided into four subgroups (ABMR+/DSA+, ABMR+/DSA-, ABMR-/DSA+, ABMR-/DSA-) for the distribution of ddcfDNA (%) by ABMR and DSA. RESULTS: The median level of ddcfDNA in biopsy showed that the ABMR group (1.66%, IQR 1.34-3.76%) was significantly higher than the median level (0.63%, IQR 0.43-0.74%) in non-ABMR (p < 0.001). With a ddcfDNA cutoff of 0.96%, the AUC was 0.90 (95%CI, 0.86-0.95), which was associated with a sensitivity of 90.5% (95%CI, 69.6-98.8%) and specificity of 96.6% (95%CI, 82.2-100%), a PPV of 95% (95%CI, 73.4-99.2%) and NPV of 93.3% (95%CI, 78.9-98.1%) were also observed. Among the four subgroups, ddcfDNA had no significant difference in both DSA+ group and DSA-group (p > 0.05). In the diagnosis of ABMR, the specificity, sensitivity, PPV and NPV of DSA were 50%, 74.1%, 41.7%, 80%, respectively. CONCLUSIONS: ddcfDNA levels in the blood could highly distinguish (biopsy-supported) ABMR occurrence, irrespective of whether this method is accompanied by DSA or not.

14.
Contemp Clin Trials ; 106: 106433, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33991686

RESUMO

This randomized controlled trial aims to determine the feasibility and preliminary efficacy of a patient-centered, mobile health technology intervention (iCardia4HF) in patients with chronic Heart Failure (HF). Participants (n = 92) are recruited and randomized 1:1 to the intervention or control group. The intervention group receives a commercial HF self-care app (Heart Failure Storylines), three connected health devices that interface with the app (Withings weight scale and blood pressure monitor, and Fitbit activity tracker), and a program of individually tailored text-messages targeting health beliefs, self-care self-efficacy, HF-knowledge, and physical activity. The control group receives the same connected health devices, but without the HF self-care app and text messages. Follow-up assessments occur at 30 days and 12 weeks. The main outcome of interest is adherence to HF self-care assessed objectively through time-stamped data from the electronic devices and also via patient self-reports. Primary measures of HF self-care include medication adherence and adherence to daily weight monitoring. Secondary measures of HF self-care include adherence to daily self-monitoring of HF symptoms and blood pressure, adherence to low-sodium diet, and engagement in physical activity. Self-reported HF self-care and health-related quality of life are assessed with the Self-care Heart Failure Index and the Kansas City Cardiomyopathy Questionnaire, respectively. Hospitalizations and emergency room visits are tracked in both groups over 12 weeks as part of our safety protocol. This study represents an important step in testing a scalable mHealth solution that has the potential to bring about a new paradigm in self-management of HF.


Assuntos
Insuficiência Cardíaca , Telemedicina , Tecnologia Biomédica , Estudos de Viabilidade , Insuficiência Cardíaca/terapia , Humanos , Assistência Centrada no Paciente , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Autocuidado
15.
Multivariate Behav Res ; : 1-16, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34003705

RESUMO

This research extends the partially confirmatory approach to accommodate mixed types of data and missingness in a unified framework that can address a wide range of the confirmatory-exploratory continuum in factor analysis. A mix of Bayesian adaptive and covariance Lasso procedures was developed to estimate model parameters and regularize the loading structure and local dependence simultaneously. Several model variants were offered with different constraints for identification. The less-constrained variant can achieve sufficient condition for the more-powerful variant, although loading estimates associated with local dependence can be inflated. Parameter recovery was satisfactory, but the information on local dependence was partially lost with categorical data or missingness. A real-life example illustrated how the models can be used to obtain a more discernible loading pattern and to identify items that do not measure what they are supposed to measure. The proposed methodology has been implemented in the R package LAWBL.

16.
PeerJ ; 9: e10753, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33552737

RESUMO

Background: The present study aimed to investigate longitudinal associations between bone mineral densities (BMDs) and appendicular skeletal muscle (ASM) mass in different regions of the body using three different indicators, in Chinese community-dwelling middle-aged and elderly men. Methods: A total of 1,343 men aged ≥ 40 years from a Chinese community were assessed at baseline (2014-2016), one-year follow-up (2016-2017; n = 648), two-year follow-up (2017-2018; n = 407), and three-year follow up (2018-2019; n = 208). At all the four time-points, measurements included ASM mass and BMDs for all regions of the body using dual-energy X-ray absorptiometry. A questionnaire was completed by patients and biochemical markers were assessed. We applied three different indicators to define ASM mass or lean mass respectively, including the appendicular skeletal muscle index (ASM adjusted by height, ASMI, according to the Asian Working Group for Sarcopenia), skeletal muscle index (ASM adjusted by weight, SMI, according to the International Working Group on Sarcopenia), and the appendicular skeletal muscle/body mass index (ratio of ASM and Body mass index (BMI), ASM/BMI, according to the Foundation for the National Institutes of Health). After adjusting for potential confounders, the generalized additive mixed model (GAMM) was used to analyze the trend in ASM mass over time, and to test the association between ASM mass and regional and whole-body BMDs. Results: The incidence of low lean mass was 8.2% defined by ASMI, 16.3% defined by SMI, and 8.3% defined by ASM/BMI. There was a linear relationship between BMDs and ASM mass, and ASMI, ASM/BMI, and SMI gradually decreased with time. After adjusting for covariances, GAMM analysis determined longitudinal associations between BMDs and ASM mass by three indicators respectively: the skull BMD was negatively associated with ASM mass. For each unit increase in skull BMD, ASMI decreased by 0.28 kg/m2 (95% confidence interval (CI) [-0.39 to -0.16]), ASM/BMI decreased by 0.02 m2 (95% CI [-0.03 to -0.00]), and SMI decreased by 0.01% (95% CI[-0.01 to -0.00]). The remaining parameters (including whole-body mean BMD, thoracic spinal BMD, lumbar spinal BMD, hip BMD, femoral neck BMD, pelvic BMD, left arm BMD, right arm BMD, left leg BMD, right leg BMD) were positively correlated with ASM mass. The ASMI increased by 3.07 kg/m2for each unit increase in the femoral neck BMD (95% CI [2.31-3.84]). The ASM/BMI increased by 0.22 m2for each unit increase in the left arm BMD (95% CI [0.12-0.33]), and the SMI increased by 0.05% per unit increase in the left arm BMD (95% CI [0.02-0.08]). Conclusions: Compared to ASMI and ASM/BMI, SMI was more sensitive to screen for the low lean mass. Skull BMD was negatively associated with ASM mass, while BMDs throughout the rest of the body were positively correlated with ASM mass among the middle-aged and elderly Chinese men.

17.
J Agric Food Chem ; 69(6): 1852-1863, 2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33550805

RESUMO

Stevia (Stevia rebaudiana Bertoni) possesses substantial value for its unique sweet compounds-steviol glycosides (SGs). In the metabolic glycosylation grid of SGs, SrUGT91D2 has been shown to catalyze formation of 1,2-ß-d-glucoside linkages at the C13- and C19-positions and play a crucial role in the synthesis of SGs, including the formation of stevioside (ST), rebaudioside E (RE), and rebaudioside D (RD). However, the key residues of the SrUGT91D2 enzyme and how SrUGT91D2 affects the accumulation of SGs in S. rebaudiana remain unclear. In the present study, cloning and functional analysis of full-length SrUGT91D2 gene sequences were performed in 10 different S. rebaudiana genotypes with divergent SG compositions. After sequence analysis, it was found that most of the sequences of this gene (more than 50%) in each genotype were consistent with the UGT91D2e_No.5 allele, which has been reported to exert catalytic activity on 1,2-ß-d-glucoside. Moreover, six variants (UGT91D2e_No.5, SrUGT91D2-11-14, SrUGT91D2-110, SrUGT91D2-023, SrUGT91D2-N01, and SrUGT91D2-N04) of this gene were obtained, and their activities were identified. Although there were some differences among these variants, the only type of mutation was partial base substitution at a very low level. In addition, the expression analysis of SrUGT91D2 in each genotype showed that the expression level of the gene was significantly different among genotypes, and a significant positive correlation was found between the content of RD (which was closely influenced by SrUGT91D2) and the expression level of SrUGT91D2 in each genotype (correlation coefficient = 0.91). Thus, it was indicated that SrUGT91D2 was relatively conserved in S. rebaudiana, and the differential effect of SrUGT91D2 on the accumulation of related SGs mainly derived from its expression level. Furthermore, based on homologous modeling and molecular docking analysis, T84, T144, A194, S284, E285, V286, G365, E369, R404, and G409 were predicted to be key residues in the glucosylation of SGs by SrUGT91D2. After site-mutation and enzyme assays, it was confirmed that T84, T144, R404, A194, and G409 are the key residues in the SrUGT91D2 protein, especially T144 and G409. This work provided valuable information for understanding the structure-activity relationship of the SrUGT91D2 protein and the molecular mechanism of SG accumulation in stevia.


Assuntos
Diterpenos do Tipo Caurano , Stevia , Glucosídeos , Glicosídeos , Glicosiltransferases/genética , Simulação de Acoplamento Molecular , Folhas de Planta , Stevia/genética , Difosfato de Uridina
18.
Eur Radiol ; 31(5): 2687-2695, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33151395

RESUMO

OBJECTIVES: To evaluate the utility of arterial spin labeling (ASL) for the identification of kidney allografts with underlying pathologies, particularly those with stable graft function. METHODS: A total of 75 patients, including 18 stable grafts with normal histology (normal group), 21 stable grafts with biopsy-proven pathology (subclinical pathology group), and 36 with unstable graft function (unstable graft group), were prospectively examined by ASL magnetic resonance imaging. Receiver operating characteristic curves were generated to calculate the area under the curve (AUC), sensitivity, and specificity. RESULTS: Patient demographics among the 3 groups were comparable. Compared with the normal group, kidney allograft cortical ASL values decreased in the subclinical pathology group and the unstable graft group (204.7 ± 44.9 ml/min/100 g vs 152.5 ± 38.9 ml/min/100 g vs 92.3 ± 37.4 ml/min/100 g, p < 0.001). The AUC, sensitivity, and specificity for discriminating allografts with pathologic changes from normal allografts were 0.92 (95% CI, 0.83-0.97), 71.9%, and 100% respectively by cortical ASL and 0.82 (95% CI, 0.72-0.90), 54.4%, and 100% respectively by serum creatinine. The cortical ASL identified allografts with subclinical pathology among patients with stable graft function with an AUC of 0.80 (95% CI, 0.64-0.91), sensitivity of 57.1%, and specificity of 88.9%. Combined use of proteinuria and cortical ASL could improve the sensitivity and specificity to 76.2% and 100% respectively for distinguishing the subclinical pathology group from the normal group. CONCLUSIONS: Cortical ASL is useful for the identification of allografts with underlying pathologies. More importantly, ASL showed promise as a non-invasive tool for the clinical translation of identifying kidney allografts with subclinical pathology. KEY POINTS: • Cortical ASL values were decreased in kidney allografts with subclinical pathologic changes as compared with normal allografts (152.5 ± 38.9 ml/min/100 g vs 204.7 ± 44.9 ml/min/100 g, p < 0.001). • Cortical ASL differentiated allografts with pathologic changes and subclinical pathology group from normal group with an AUC of 0.92 (95% CI, 0.83-0.97) and 0.80 (95% CI, 0.64-0.91) respectively. • Cortical ASL discriminated allografts with underlying pathologic changes from normal allografts with a specificity of 100%, and combined use of proteinuria and cortical ASL values could also achieve 100% specificity for discriminating allografts with subclinical pathology from normal allografts.


Assuntos
Transplante de Rim , Humanos , Rim/diagnóstico por imagem , Imageamento por Ressonância Magnética , Circulação Renal , Marcadores de Spin
19.
Tob Control ; 30(5): 498-504, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-32675250

RESUMO

OBJECTIVES: To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers. METHODS: A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising. RESULTS: 42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation. CONCLUSION: The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.


Assuntos
Abandono do Hábito de Fumar , Poluição por Fumaça de Tabaco , Adulto , China/epidemiologia , Estudos Transversais , Humanos , Masculino , Fumantes , Fumar/epidemiologia , Inquéritos e Questionários
20.
Ann Transl Med ; 8(21): 1453, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33313198

RESUMO

Background: To explore the performance status of Chinese postgraduate medical students in literature searching. Methods: A self-designed online questionnaire was used to assess the literature search performance of postgraduate students (PGSs) from the classes of 2016, 2017, 2018, and 2019 from two medical colleges. The items of the questionnaire mainly included: the demographic characteristics of the PGSs, methods of literature review, literature reading habits, and use of literature. We also designed a self-assessed score that ranged from the lowest 1 point to the highest 5 points. Results: A total of 902 PGSs (482 male, average age: 29.4±5.8 years old, working time range: 0-10 years, average 3.7±2.4 years) completed the questionnaire. Most PGSs investigated literature only at the work tasks (632, 70.1%) and writing papers (571, 63.3%) stages. Of the PGSs, 542 (60.1%) PGSs searched literature frequency (≥1 paper/week), and 114 (12.6%) did not perform advanced searches, and some had no knowledge of advanced search techniques at all. Most PGSs had not read more than 100 Chinese articles or English articles before. Most PGSs were used to read articles from the most authoritative journals (665, 73.7%) or high impact factor (IF) (540, 59.9%). PGSs (845, 93.7%) only read the full text of articles they deemed important. Of the PGSs, 441 (48.9%) did not use literature management tools. For self-assessed score of literature searching and reading skills, the mean was 2.1 (standard deviation, 0.8). Reading literature efficiently (710, 78.7%) and tracking recent literatures (615, 68.2%) were the two needed literature skills reported. Conclusions: Chinese medical PGSs still have room for improvement in relation to literature investigation. Intensive training in literature searching should be given to improve their performance.

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