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1.
IEEE Trans Biomed Eng ; PP2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33798063

RESUMO

Electrophysiological signals are recorded generally by metal electrodes placed on body surface. For long term use, the signal quality may decay with the change of interface impedance between electrodes and skin due to the conductive hydrogel dehydration. Besides, electrodes may shift during body movements, which causes unstable signal recordings. To improve the quality of electrophysiological signal recordings on human body surface, in this work, a type of microneedle electrode array (MEA) with microneedles around 550 m in length was fabricated with a magnetization-induce self-assembly method. The experiments showed that compared with the commonly used dry electrode array, the MEA has lower and more stable interface impedance, especially when the electrode-skin interface is under unstable pressures. For electrophysiological signal recording, the MEA can acquire electromyography (EMG) with significantly lower noise energy, higher signal-to-noise ratio, and higher motion-classification accuracy based on the EMG pattern-recognition method. Additionally, high quality electrocardiography (ECG) can be recorded by using the MEA, where more accurate R-peaks are extracted in different scenarios. Besides, there was no report about any discomfort like bleeding or inflammation by all the subjects. These findings suggest that the microneedles on the MEA can penetrate through the corneum and reach the epidermis of the subjects, which could avoid the influence of corneum and fix the electrode on the body surface for high-quality signal recording especially during body movements. Furthermore, the microneedles would not touch the dermis, enabling a painless signal acquisition, which is beneficial to the applications of wearable human-machine interface technology.

2.
Cell Death Dis ; 12(3): 231, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658491

RESUMO

Acute myeloid leukemia (AML) is a hematological malignancy with high incidence and recurrence rates. Gene expression profiling has revealed that transcriptional overexpression of glioma-associated oncogene 1 (GLI1), a vital gene in the Hedgehog (Hh) signaling pathway, occurs in poor-prognosis AML, and high levels of phosphoinositide-3-kinase, regulatory subunit 1 (PIK3R1) and AKT3 predict shorter overall survival in AML patients. In this study, we discovered that GLI1 overexpression promotes cell proliferation and reduces chemotherapy sensitivity in AML cells while knocking down GLI1 has the opposite effect. Moreover, GLI1 promoted cell cycle progression and led to elevated protein levels of cyclins and cyclin-dependent kinases (CDKs) in AML cells. By luciferase assays and co-immunoprecipitation, we demonstrated that the PI3K/AKT pathway is directly activated by GLI1. GLI1 overexpression significantly accelerates tumor growth and upregulated p-AKT, CDK4, and cyclinD3 in vivo. Notably, the GLI1 inhibitor GANT61 and the CDK4/6 inhibitor PD 0332991 had synergistic effects in promoting Ara-c sensitivity in AML cell lines and patient samples. Collectively, our data demonstrate that GLI1 reduces drug sensitivity by regulating cell cycle through the PI3K/AKT/GSK3/CDK pathway, providing a new perspective for involving GLI1 and CDK4/6 inhibitors in relapsed/refractory (RR) patient treatment.

3.
J Clin Apher ; 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33587767

RESUMO

BACKGROUND: Since early 2020, convalescent plasma has been widely used for treating coronavirus disease 2019 (COVID-19). There is limited information regarding donor tolerability of convalescent plasma donation. In this study, we evaluated the short-term donor tolerability of convalescent plasma donation. METHODS: A prospective study of 309 convalescent plasma donation related adverse events were conducted at Wuhan Blood Center of China, from February 12 to April 1, 2020. Additionally, up to 28-day post-donation follow-ups were performed on the donors. RESULTS: Sixteen (5.2%) adverse events were reported in 309 donations. All of these were mild vasovagal without loss of consciousness. The frequency of adverse reactions was higher in donors with a per donation volume of >8 mL/kg body weight or ≥ 600 mL, <100 mm Hg in pre-donation systolic blood pressure, or less than 28 days from the onset of COVID-19 symptoms. There was no correlation to donation history, weight, sex, ABO blood type, pre-donation diastolic blood pressure, pulse, or hemoglobin. CONCLUSION: The donation of convalescent plasma is generally safe. Mitigation of risk factors associated with adverse events can further enhance donor tolerability of convalescent plasma donation.

4.
Cell Death Dis ; 12(2): 138, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33542227

RESUMO

The interaction between LncRNA and RNA-binding protein (RBPs) plays an essential role in the regulation over the malignant progression of tumors. Previous studies on the mechanism of SNHG1, an emerging lncRNA, have primarily focused on the competing endogenous RNA (ceRNA) mechanism. Nevertheless, the underlying mechanism between SNHG1 and RBPs in tumors remains to be explored, especially in prostate cancer (PCa). SNHG1 expression profiles in PCa were determined through the analysis of TCGA data and tissue microarray at the RNA level. Gain- and loss-of-function experiments were performed to investigate the biological role of SNHG1 in PCa initiation and progression. RNA-seq, immunoblotting, RNA pull-down and RNA immunoprecipitation analyses were utilized to clarify potential pathways with which SNHG1 might be involved. Finally, rescue experiments were carried out to further confirm this mechanism. We found that SNHG1 was dominantly expressed in the nuclei of PCa cells and significantly upregulated in PCa patients. The higher expression level of SNHG1 was dramatically correlated with tumor metastasis and patient survival. Functionally, overexpression of SNHG1 in PCa cells induced epithelial-mesenchymal transition (EMT), accompanied by down-regulation of the epithelial marker, E-cadherin, and up-regulation of the mesenchymal marker, vimentin. Increased proliferation and migration, as well as accelerated xenograft tumor growth, were observed in SNHG1-overexpressing PCa cells, while opposite effects were achieved in SNHG1-silenced cells. Mechanistically, SNHG1 competitively interacted with hnRNPL to impair the translation of protein E-cadherin, thus activating the effect of SNHG1 on the EMT pathway, eventually promoting the metastasis of PCa. Our findings demonstrate that SNHG1 is a positive regulator of EMT activation through the SNHG1-hnRNPL-CDH1 axis. SNHG1 may serve as a novel potential therapeutic target for PCa.

5.
Biomed Pharmacother ; 137: 111378, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33601148

RESUMO

Hydroxy-3-methylglutaryl-CoA synthase 1 (HMGCS1) is a key enzyme in the mevalonate pathway of cholesterol synthesis. Dysregulation of HMGCS1 expression is a common occurrence in many solid tumors. It was also found to be overexpressed in newly diagnosed (ND) and relapsed/refractory (RR) acute myeloid leukemia (AML) patients. Previous study proved that HMGCS1 could induce drug-resistance in AML cells. However, the underlying mechanism how HMGCS1 contributed to chemoresistance remains elusive. Here, we confirmed that HMGCS1 inhibitor Hymeglusin enhanced cytarabine/Adriamycin (Ara-c/ADR) chemo-sensitivity in AML cells lines. Moreover, Ara-c-resistant HL-60 cells (HL-60/Ara-c) and ADR-resistant HL-60 cells (HL-60/ADR) were more sensitive to HMGCS1 inhibition than HL-60 cells. In addition, we demonstrated that the transcription factor GATA1 was the upstream regulator of HMGCS1 and could directly bind to the HMGCS1 promoter. After treatment of Tunicamycin (Tm), the number of mitochondria was increased and the damage of endoplasmic reticulum (ER) was reduced in bone marrow cells from AML-RR patients, compared to cells from AML-CR group. HMGCS1 protected mitochondria and ER under ER stress and up-regulated unfold protein response (UPR) downstream molecules in AML cells. In summary, we proved that HMGCS1 could upregulate UPR downstream components, protect mitochondria and ER from damage in AML cells under stress, therefore conferring drug resistance. Therefore, HMGCS1 could serve as a novel target for treatment of patients with intolerant chemotherapy and AML-RR patients.

6.
BMC Infect Dis ; 21(1): 104, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33482756

RESUMO

BACKGROUND: Dengue virus (DENV) infection is increasingly common in southern China and can be transmitted through blood transfusion but is not currently part of donor screening throughout the region. We assessed DENV prevalence among donors at the Xishuangbanna Blood Center, Yunnan, to support development of DENV screening strategies. METHODS: Blood samples were collected randomly between June 2019 and August 2019. These were screened for anti-DENV IgG and IgM using enzyme-linked immunosorbent assay (ELISA). Then, all reactive samples and some randomly-chosen non-reactive samples were used to detect DENV RNAs using real-time polymerase-chain-reaction (RT-PCR) assays. After RT-PCR, samples were further tested for soluble nonstructural protein 1 (NS1) using the colloidal gold method. Donors demographics were also collected and assessed. RESULTS: Over the study period, 2254 donor samples were collected and tested for anti-DENV IgG and IgM by ELISA. This revealed 598 anti-DENV IgG and/or IgM reactive samples, a serological prevalence of 26.53%. Of these, 26 were RT-PCR positive and/or NS1 positive. Significant differences in DENV prevalence were noted by occupation (P = 0.001), education (P < 0.001), and ethnicity (P = 0.026). CONCLUSION: The prevalence of DENV in Xishuangbanna Blood Center was higher than most other blood centers that have implemented DENV donor screening. Our study provides first-hand data about the prevalence of DENV and allows the development of a screening strategy for clinical use.


Assuntos
Doadores de Sangue , Vírus da Dengue/isolamento & purificação , Dengue/diagnóstico , Dengue/epidemiologia , Programas de Rastreamento/métodos , Adulto , Anticorpos Antivirais/sangue , China/epidemiologia , Dengue/sangue , Vírus da Dengue/genética , Vírus da Dengue/imunologia , Feminino , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , RNA Viral/genética , Proteínas não Estruturais Virais/genética , Adulto Jovem
7.
Front Psychol ; 11: 563023, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33041927

RESUMO

Decision-making competence refers to the ability to make better decisions, as defined by decision-making principles posited by models of rational choice. The adult decision-making competence (A-DMC) scale is a relatively mature evaluation tool used for decision-making competence. However, the A-DMC is yet far from other mature psychological evaluation tools, and especially the structure of A-DMC remains unclear. In the current study, we estimated a regularized partial correlation network of decision-making competence in a Chinese sample consisting of 339 adults who were evaluated by the A-DMC, and then the centrality indicators were calculated. The results revealed that all nodes of the decision-making competence networks are positively associated, except for the association of resistance to framing (RF) and resistance to sunk costs (SC). The strongest edge was between RF and applying decision rules (DR; regularized partial correlation = 0.37). The centrality indicators of RF and applying DR were highest, revealing that these two variables may play important roles in the decision-making competence network. Our study conceptualizes the decision-making competence from network perspectives, so as to provide some insights for future researches.

8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 519-522, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018041

RESUMO

Recently, there is an increasing recognition that sensory feedback is critical for proper motor control. With the help of BCI, people with motor disabilities can communicate with their environments or control things around them by using signals extracted directly from the brain. The widely used non-invasive EEG based BCI system require that the brain signals are first preprocessed, and then translated into significant features that could be converted into commands for external control. To determine the appropriate information from the acquired brain signals is a major challenge for a reliable classification accuracy due to high data dimensions. The feature selection approach is a feasible technique to solving this problem, however, an effective selection method for determining the best set of features that would yield a significant classification performance has not yet been established for motor imagery (MI) based BCI. This paper explored the effectiveness of bio-inspired algorithms (BIA) such as Ant Colony Optimization (ACO), Genetic Algorithm (GA), Cuckoo Search Algorithm (CSA), and Modified Particle Swarm Optimization (M-PSO) on EEG and ECoG data. The performance of SVM classifier showed that M-PSO is highly efficacious with the least selected feature (SF), and converges at an acceptable speed in low iterations.


Assuntos
Interfaces Cérebro-Computador , Algoritmos , Eletroencefalografia , Humanos , Imagens, Psicoterapia , Imaginação
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3831-3834, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018836

RESUMO

Upper extremity motor function loss severely affects stroke survivors during daily life activities. Different rehabilitation robotic systems have been developed to allow stroke survivors regain their motor function. Meanwhile, most of the robots only operate in a passive mode and restrict the users to navigate predefined trajectories which may not align with their motion intent, thus limiting motor recovery. One way to resolve this issue would be to utilize a decoded movement intent to trigger intuitively active motor training for patients. In this direction, this study proposed and investigated the use of spatial-temporal neuromuscular descriptor (STD) for optimal decoding of multiple patterns of movement intents in patient to provide inputs for active motor training in the rehabilitation robotic systems. The STD performance was validated using High-Density surface electromyogram recordings from five stroke survivors who performed 21 limb movements. Experimental results show that the STD achieved a significant reduction in limb movement classification error (13.36%) even in the presence of the inevitable White Gaussian Noise compared to other methods (p<0.05). The STD also showed obvious class separability for individual movement. Findings from this study suggest that the STD may provide potential inputs for intuitively active motor training in stroke rehabilitation robotic systems.Clinical Relevance- This study showed that spatial-temporal neuromuscular information could aid adequate decoding of movement intents upon which intuitively active motor training could be achieved in stroke rehabilitation robotic systems.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Intenção , Sobreviventes , Extremidade Superior
10.
Medicine (Baltimore) ; 99(43): e22832, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120810

RESUMO

BACKGROUND: Anterior cruciate ligament rupture is a common motor system injury, and the most effective treatment is anterior cruciate ligament reconstruction (ACLR). Choosing the right graft is an important factor to ensure the success of the surgery. Current research shows that the clinical effect of autologous ligaments is better than that of allogeneic ligaments and artificial ligaments. However, there are differences between the autogenous ligaments, and how to choose them is still controversial. This study evaluated the published systematic reviews on the efficacy of different autologous ligament grafts in ACLR, and based on this, conducted a network meta-analysis of related randomized controlled trials. METHODS: We searched 8 international and Chinese databases including PubMed, Embase, Web of Science, and Cochrane Library. The methodological quality of systematic reviews will be evaluated by Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR2) measurement tool. Cochrane's risk of bias tool will be used to assess the risk of bias of included randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be used to evaluate the evidence quality. Network meta-analysis will be applied to evaluate the therapeutic effect of different autologous grafts. The main outcome measures are IKDC score, clinical failure rate, Lachman test, Lysholm score, and the incidence of complications. Odds ratio and its 95% confidence interval will be used to synthesize the dichotomy results, while the mean difference and 95% confidence interval of continuous variables will be used for continuous variables. RESULTS: This study will provide comprehensive evidence for the application of autologous grafts in ACLR. CONCLUSION: The results of this study will help clinicians make appropriate decisions. PROTOCOL REGISTRATION NUMBER: INPLASY202090061.

11.
Science ; 370(6516): 605-608, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33122385

RESUMO

Contemporary earthquake hazard models hinge on an understanding of how strain is distributed in the crust and the ability to precisely detect millimeter-scale deformation over broad regions of active faulting. Satellite radar observations revealed hundreds of previously unmapped linear strain concentrations (or fractures) surrounding the 2019 Ridgecrest earthquake sequence. We documented and analyzed displacements and widths of 169 of these fractures. Although most fractures are displaced in the direction of the prevailing tectonic stress (prograde), a large number of them are displaced in the opposite (retrograde) direction. We developed a model to explain the existence and behavior of these displacements. A major implication is that much of the prograde tectonic strain is accommodated by frictional slip on many preexisting faults.

12.
Cogn Neurodyn ; 14(5): 591-607, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33014175

RESUMO

Current prostheses are limited in their ability to provide direct sensory feedback to users with missing limb. Several efforts have been made to restore tactile sensation to amputees but the somatotopic tactile feedback often results in unnatural sensations, and it is yet unclear how and what information the somatosensory system receives during voluntary movement. The present study proposes an efficient model of stacked sparse autoencoder and back propagation neural network for detecting sensory events from a highly flexible electrocorticography (ECoG) electrode. During the mechanical stimulation with Von Frey (VF) filament on the plantar surface of rats' foot, simultaneous recordings of tactile afferent signals were obtained from primary somatosensory cortex (S1) in the brain. In order to achieve a model with optimal performance, Particle Swarm Optimization and Adaptive Moment Estimation (Adam) were adopted to select the appropriate number of neurons, hidden layers and learning rate of each sparse auto-encoder. We evaluated the stimulus-evoked sensation by using an automated up-down (UD) method otherwise called UDReader. The assessment of tactile thresholds with VF shows that the right side of the hind-paw was significantly more sensitive at the tibia-(p = 6.50 × 10-4), followed by the saphenous-(p = 7.84 × 10-4), and sural-(p = 8.24 × 10-4). We then validated our proposed model by comparing with the state-of-the-art methods, and recorded accuracy of 98.8%, sensitivity of 96.8%, and specificity of 99.1%. Hence, we demonstrated the effectiveness of our algorithms in detecting sensory events through flexible ECoG recordings which could be a viable option in restoring somatosensory feedback.

13.
Orphanet J Rare Dis ; 15(1): 239, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32900391

RESUMO

An amendment to this paper has been published and can be accessed via the original article.

14.
Medicine (Baltimore) ; 99(33): e21811, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872082

RESUMO

BACKGROUND: Osteoporosis is a disease with a high prevalence and low treatment rate, which poses a serious threat to the lives of patients and brings a heavy economic burden. Clinical practice guidelines (CPGs) provide vital guidance for disease management. Up to now, different countries, regions, and organizations have issued a certain number of CPGs for osteoporosis, but the recommendations in different guidelines are inconsistent. This protocol plans to evaluate the quality of the CPGs for osteoporosis and then make a comparative analysis of the recommendations in the CPGs. METHODS: Several databases including PubMed, Web of Science, Embase, and Cochrane Library, as well as the official website of relevant organizations will be searched. Screen and data extraction will be performed by two reviewers independently, and the third reviewer help to resolve the divergence between them. Using the AGREE II instrument and RIGHT checklist to assess the methodological and reporting quality of the CPGs. The extracted recommendations, including but not limited to screening, diagnosis, evaluation and treatment, will be summarized and analyzed, and the results will be presented in tabular form. Bubble charts will be used to show quality differences between CPGs and to describe the correlation between methodological and reporting quality through regression analysis. Excel, EndnoteX9 and SPSS 25.0 will be used. RESULT: To evaluate the advantages and disadvantages of the existing CPGs of osteoporosis and analyze the similarities and differences between the recommendations, the results will be published in a peer-reviewed journal. CONCLUSION: This study will provide systematic evidence for existing CPGs of osteoporosis and to provide a reference for CPGs users. PROTOCOL REGISTRATION: INPLASY 202070031.


Assuntos
Osteoporose , Guias de Prática Clínica como Assunto , Humanos , Revisões Sistemáticas como Assunto
15.
J Proteomics ; 228: 103924, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32736140

RESUMO

Tissues hypoxia caused by hemorrhage is a common complication in many clinical diseases. However, its pathological mechanism remains largely unknown. To partly address this issue, an ischemic-hypoxic rat model was established and the plasma proteomic and metabolic profiles were quantified and analyzed using TMT-based quantitative proteomics and metabolomics. The analysis revealed a total of 177 differentially expressed proteins and 32 metabolites that were uniquely altered in the hypoxic rat plasma, compared to the control. Bioinformatics analysis showed that these altered proteins and metabolites were involved in a wide range of biological processes. Twelve of the 177 differentially expressed proteins were involved in PI3K-Akt signaling, a pathway that has been reported to be strongly associated with tissue hypoxia. Other signaling pathways such as complement and coagulation cascades, GnRH signaling, relaxin signaling, protein processing in endoplasmic reticulum, as well as AGE-RAGE signaling were markedly altered in the ischemic-hypoxic response, implying their potential roles in tissue hypoxia. A joint analysis of proteome and metabolome showed that the significantly altered metabolites such as guanine, tryptamine, dopamine, hexadecenoic, l-methionine, and fumarate may have participated in the pathogenesis of tissue hypoxia. Further, we found that changes in the levels of metabolites matched the changes in protein abundance within the same pathway. Overall, this study presents an overview of the molecular networks in ischemic-hypoxic pathology and offers biochemical basis for further study on the mechanism of tissue hypoxia. SIGNIFICANCE: We employed an integrated metabonomic-proteomic method to systematically analyze the profiles of metabolites and proteins in an ischemic-hypoxic rat model. Bioinformatics and enrichment analysis showed that the differentially expressed proteins were mainly involved in complement and coagulation cascades, PI3K-Akt signaling, GnRH signaling, relaxin signaling, protein processing in endoplasmic reticulum, and AGE-RAGE signaling. Moreover, a panel of 12 candidate proteins involved in PI3K-Akt signaling (i.e., Vtn, Hsp90b1, Ywhae, Tnc, Ywhaz, Thbs4, Lamc1, Col1a1, Il2rg, Egfr, Newgene 621,351, and Tfrc) may serve as the potential biomarkers to predict tissue hypoxia.

16.
Gac. sanit. (Barc., Ed. impr.) ; 34(4): 370-376, jul.-ago. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-198708

RESUMO

OBJECTIVE: China launched an innovative program of catastrophic medical insurance (CMI) to protect households from catastrophic health expenditure (CHE) and impoverishment. This article assesses the effect of CMI on relieving CHE and impoverishment from catastrophic illnesses in urban and rural China. METHOD: In total, 8378 cases are included in the analysis. We employed descriptive statistical analysis to compare the incidence and intensity of CHE at five health expenditure levels, from 1 June 2014 to 31 May 2015. To illustrate the different protection of the policy, we analyzed the data in two lines, the covered medical expenses and the total medical expenses. RESULTS: CMI drop down CHE incidence from 4.8% to 0.1% and the mean catastrophic payment gap from 7.9% to zero when only considering covered medical expenses. CMI drop down CHE incidence from 15.5% to 7.9% and the mean catastrophic payment gap from 31.2% to 14.7% when considering total medical expenses. If CMI reimburse uncovered medical expenses at 30%, the mean catastrophic payment gap could be 7.9% and insured person's annual premium will increase US$2.19. CONCLUSIONS: China CMI perfectly meet the pursued policy objectives when only considering the covered medical expenses. However, when considering the total medical expenses, the CMI is only partially effective in protecting households from CHE. The considerable gap is the result of the limitation of CMI list


OBJETIVO: China lanzó un innovador programa de Seguro Catastrófico de Salud (SCS) para proteger a los hogares del gasto sanitario catastrófico (GSC) y el empobrecimiento. Este artículo evalúa el efecto del SCS para aliviar el GSC y el empobrecimiento a causa de las enfermedades catastróficas en zonas urbanas y rurales de China. MÉTODO: En total, se incluyen 8378 casos en el análisis. Se emplearon análisis estadísticos descriptivos para comparar la incidencia y la intensidad del GSC en cinco niveles de gastos de salud, del 1 de junio de 2014 al 31 de mayo de 2015. Para ilustrar la diferente protección de la política se analizaron los datos en dos líneas: los gastos sanitarios cubiertos por el seguro y los gastos sanitarios totales. RESULTADOS: Considerando los gastos cubiertos por el seguro, se redujeron los hogares con gastos catastróficos del 4,8% al 0,1%, y la brecha de pago catastrófico media cayó del 7,9% al 0,0% en promedio. Cuando consideramos el gasto sanitario total, los hogares con gasto catastrófico se redujeron del 15,5% al 7,9%, y la brecha de pago catastrófico media cayó del 31,2% al 14,7% en promedio. Esta cantidad podría reducirse al 7,9% si se reembolsara el 30% a los gastos no cubiertos por el SCS, lo que supondría un aumento de la prima del seguro por persona de US$ 2,19. CONCLUSIONES: El SCS de China cumple perfectamente los objetivos de la política perseguida cuando solo se consideran los gastos cubiertos por el seguro. Si se consideran los gastos totales, el SCS solo es parcialmente efectivo para proteger a los hogares del gasto sanitario catastrófico. El motivo de este desfase es la limitación existente en la lista de servicios cubiertos por el SCS


Assuntos
Humanos , Doença Catastrófica/epidemiologia , Seguro Médico Ampliado/estatística & dados numéricos , Gasto Catastrófico , Gastos em Saúde/estatística & dados numéricos , China/epidemiologia , Efeitos Psicossociais da Doença , Análise de Impacto Orçamentário/métodos , Custos e Análise de Custo/métodos
17.
Artigo em Inglês | MEDLINE | ID: mdl-32610591

RESUMO

The current study aims to explore how coach-athlete attachment affects the subjective well-being (SWB) of athletes and is primarily focused on the confirmation of the mediating roles of athletes' perceived coach support and self-esteem in the relationship between them. A total of 179 Chinese athletes participated in this study, in which they responded to questions comprising a coach-athlete attachment scale, a perceived coach support measurement, the Rosenberg self-esteem scale, and SWB measures. The results suggest that both attachment anxiety and attachment avoidance significantly predict SWB in athletes. The effects of attachment anxiety on SWB are partially mediated by perceived coach support and self-esteem, and the effects of attachment avoidance on SWB are completely mediated by perceived coach support and self-esteem. Moreover, a chain mediating effect was found: coach-athlete attachment → perceived coach support → self-esteem → SWB. These findings extend the conclusions of prior reports and shed light on how coach-athlete attachment influences the athlete's well-being.


Assuntos
Atletas , Relações Interpessoais , Tutoria , Transtornos de Ansiedade , Humanos
18.
Transfusion ; 60(8): 1773-1777, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32491199

RESUMO

BACKGROUND: A novel coronavirus has caused an international outbreak. Currently, there are no specific therapeutic agents for coronavirus infections. Convalescent plasma (CP) therapy is a potentially effective treatment option. METHODS: Patients who had recovered from COVID-19 and had been discharged from the hospital for more than 2 weeks were recruited. COVID-19 convalescent plasma (CCP)-specific donor screening and selection were performed based on the following criteria: 1) aged 18-55 years; 2) eligible for blood donation; 3) diagnosed with COVID-19; 4) had two consecutive negative COVID-19 nasopharyngeal swab tests based on PCR (at least 24 hr apart) prior to hospital discharge; 5) had been discharged from the hospital for more than 2 weeks; and 6) had no COVID-19 symptoms prior to convalescent plasma donation. In addition, preference was given to CCP donors who had a fever lasting more than 3 days or a body temperature exceeding 38.5°C (101.3°F), and who donated 4 weeks after the onset of symptoms. CCP collection was performed using routine plasma collection procedures via plasmapheresis. In addition to routine donor testing, the CCP donors' plasma was also tested for SARS-CoV-2 nucleic acid and S-RBD-specific IgG antibody. RESULTS: Of the 81 potential CCP donors, 64 (79%) plasma products were collected. There were 18 female donors and 46 male donors. There were 34 first-time blood donors and 30 repeat donors. The average time between CCP collection and initial symptom onset was 49.1 days, and the average time between CCP collection and hospital discharge was 38.7 days. The average volume of CCP collected was 327.7 mL. All Alanine transaminase (ALT) testing results met blood donation requirements. HIV Ag/Ab, anti-HCV, anti-syphilis, and HBsAg were all negative; NAT for HIV, HBV, and HCV were also negative. In addition, all of the CCP donors' plasma units were negative for SARS-CoV-2 RNA. Of the total 64 CCP donors tested, only one had an S-RBD-specific IgG titer of 1:160, all others had a titer of ≥1:320. CONCLUSION: Based on a feasibility study of a pilot CCP program in Wuhan, China, we demonstrated the success and feasibility of CCP collection. In addition, all of the CCP units collected had a titer of ≥1:160 for S-RBD-specific IgG antibody, which met the CCP quality control requirements based on the Chinese national guidelines for CCP.


Assuntos
Infecções por Coronavirus/patologia , Seleção do Doador/normas , Plasmaferese/métodos , Pneumonia Viral/patologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Doadores de Sangue , Coleta de Amostras Sanguíneas , China , Convalescença , Infecções por Coronavirus/sangue , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Estudos de Viabilidade , Feminino , Humanos , Imunização Passiva/métodos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Pandemias , Projetos Piloto , Pneumonia Viral/sangue , Pneumonia Viral/imunologia , Glicoproteína da Espícula de Coronavírus/imunologia , Fatores de Tempo , Adulto Jovem
19.
Orphanet J Rare Dis ; 15(1): 137, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503636

RESUMO

BACKGROUND: Hemophilia, a high-cost disease, is the only rare disease covered by basic medical insurance in all province of China. However, very few studies have estimated the medical expenditure of patients with this rare disease Therefore, this study is aimed at evaluating the medical expenditure of patients with hemophilia and identifying its determinants. METHODS: The study population included 450 patients with hemophilia who were extracted from the national insurance database between 2014 and 2016. An independent-sample Kolmogorov-Smirnov test was performed to compare the medical expenditure of patients with hemophilia covered under urban employee basic medical insurance (UEBMI) and urban residence basic medical insurance (URBMI). Quantile regression analysis was conducted to explore the factors that affect the medical expenditure of patients with hemophilia. RESULTS: The total annual medical expenditure of patients with hemophilia in 2013, 2014, and 2015 had median of ¥7167 (US$ 1156), ¥3522 (US$ 577), and ¥4197 (US$ 677), respectively. The median medical expenditures of patients with hemophilia covered by UEBMI were ¥10,991 (US$ 1773), ¥2301 (US$ 377) and ¥8074 (US$ 1302), those of patients covered by URBMI were ¥4000 (US$ 645), ¥5717 (US$ 937) and ¥3141 (US$ 507) from 2013 to 2015. The differences in the medical expenditure of patients with hemophilia between UEBMI and URBMI from 2013 to 2015 were statistically significant. The number of admissions and the number of hospital days were statistically significant and positive for all quantiles. The types of medical service were statistically significant and negative for 50th quantile, and the reimbursement ratio was statistically significant and positive for 50th and 75th quantiles. (p < 0.05). CONCLUSION: The medical expenditure of patients with hemophilia was lower than that of patients with other common rare diseases that were not included in the scope of basic medical insurance reimbursement. It was also observed that the medical expenditure was mainly influenced by the severity of disease, and partly affected by the reimbursement rate.

20.
Transfusion ; 60(7): 1434-1442, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32452053

RESUMO

BACKGROUND: Transfusion-related acute lung injury (TRALI) is an important cause of death associated with transfusion, and no specific clinical treatments are available. Endothelial cells are believed to play an important role in the development of TRALI. This study investigated whether IL-35, an endothelial stabilizing cytokine could regulate the severity of antibody-mediated TRALI in vivo. STUDY DESIGN AND METHODS: Human microvascular endothelial cells (HMVECs) were cultured in vitro, rIL-35(2 µg/mL) was added before HMVECs activation, and HMVECs were fully activated by LPS (0.5 µg/mL). Then cells were collected for flow cytometry analysis. We used a previously established "two-event" mouse model of TRALI with naive and lipopolysaccharide (LPS)-injected mice as controls. rIL-35(100 µg/kg) was injected into the tail vein for 3 consecutive days before the induction of the TRALI model. Samples were collected 2 hours after TRALI induction and tested for lung tissue myeloperoxidase activity, total protein levels, lung tissue histology, endothelial cell activation assay, and cytokine assay. RESULTS: In vitro culture of HMVECs with rIL-35 verified that rIL-35 inhibited endothelial cells. In a mouse model, prophylactic administration of rIL-35 prevented pulmonary edema, increased lung protein levels, and reduced polymorphonuclear neutrophil accumulation in the lung. CONCLUSIONS: This work suggests that antibody-mediated murine TRALI can be prevented by rIL-35, and that rIL-35 appears to work by inhibiting the activation of lung endothelial cells.

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