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2.
Nano Converg ; 8(1): 28, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34542727

RESUMO

Transition metal dichalcogenides (TMDs), transition metal carbides (TMCs), and transition metal oxides (TMOs) have been widely investigated for electrocatalytic applications owing to their abundant active sites, high stability, good conductivity, and various other fascinating properties. Therefore, the synthesis of composites of TMDs, TMCs, and TMOs is a new avenue for the preparation of efficient electrocatalysts. Herein, we propose a novel low-cost and facile method to prepare TMD-TMC-TMO nano-hollow spheres (WS2-WC-WO3 NH) as an efficient catalyst for the hydrogen evolution reaction (HER). The crystallinity, morphology, chemical bonding, and composition of the composite material were comprehensively investigated using X-ray diffraction, Raman spectroscopy, field emission scanning electron microscopy, and X-ray photoelectron spectroscopy. The results confirmed the successful synthesis of the WS2-WC-WO3 NH spheres. Interestingly, the presence of nitrogen significantly enhanced the electrical conductivity of the hybrid material, facilitating electron transfer during the catalytic process. As a result, the WS2-WC-WO3 NH hybrid exhibited better HER performance than the pure WS2 nanoflowers, which can be attributed to the synergistic effect of the W-S, W-C, and W-O bonding in the composite. Remarkably, the Tafel slope of the WS2-WC-WO3 NH spheres was 59 mV dec-1, which is significantly lower than that of the pure WS2 NFs (82 mV dec-1). The results also confirmed the unprecedented stability and superior electrocatalytic performance of the WS2-WC-WO3 NH spheres toward the HER, which opens new avenues for the preparation of low-cost and highly effective materials for energy conversion and storage applications.

3.
Sensors (Basel) ; 21(12)2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34205721

RESUMO

Gait analysis has historically been implemented in laboratory settings only with expensive instruments; yet, recently, efforts to develop and integrate wearable sensors into clinical applications have been made. A limited number of previous studies have been conducted to validate inertial measurement units (IMUs) for measuring ankle joint kinematics, especially with small movement ranges. Therefore, the purpose of this study was to validate the ability of available IMUs to accurately measure the ankle joint angles by comparing the ankle joint angles measured using a wearable device with those obtained using a motion capture system during running. Ten healthy subjects participated in the study. The intraclass correlation coefficient (ICC) and standard error of measurement were calculated for reliability, whereas the Pearson coefficient correlation was performed for validity. The results showed that the day-to-day reliability was excellent (0.974 and 0.900 for sagittal and frontal plane, respectively), and the validity was good in both sagittal (r = 0.821, p < 0.001) and frontal (r = 0.835, p < 0.001) planes for ankle joints. In conclusion, we suggest that the developed device could be used as an alternative tool for the 3D motion capture system for assessing ankle joint kinematics.


Assuntos
Articulação do Tornozelo , Corrida , Tornozelo , Fenômenos Biomecânicos , Marcha , Humanos , Reprodutibilidade dos Testes
4.
Front Plant Sci ; 12: 678111, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194454

RESUMO

Ascorbate peroxidase (APX) is an important reactive oxygen species (ROS)-scavenging enzyme, which catalyzes the removal of hydrogen peroxide (H2O2) to prevent oxidative damage. The peroxidase activity of APX is regulated by posttranslational modifications (PTMs), such as S-nitrosylation, tyrosine nitration, and S-sulfhydration. In addition, it has been recently reported that APX functions as a molecular chaperone, protecting rice against heat stress. In this study, we attempted to identify the various functions of APX in Arabidopsis and the effects of PTMs on these functions. Cytosol type APX1 from Arabidopsis thaliana (AtAPX1) exists in multimeric forms ranging from dimeric to high-molecular-weight (HMW) complexes. Similar to the rice APX2, AtAPX1 plays a dual role behaving both as a regular peroxidase and a chaperone molecule. The dual activity of AtAPX1 was strongly related to its structural status. The main dimeric form of the AtAPX1 protein showed the highest peroxidase activity, whereas the HMW form exhibited the highest chaperone activity. Moreover, in vivo studies indicated that the structure of AtAPX1 was regulated by heat and salt stresses, with both involved in the association and dissociation of complexes, respectively. Additionally, we investigated the effects of S-nitrosylation, S-sulfhydration, and tyrosine nitration on the protein structure and functions using gel analysis and enzymatic activity assays. S-nitrosylation and S-sulfhydration positively regulated the peroxidase activity, whereas tyrosine nitration had a negative impact. However, no effects were observed on the chaperone function and the oligomeric status of AtAPX1. Our results will facilitate the understanding of the role and regulation of APX under abiotic stress and posttranslational modifications.

5.
J Allergy Clin Immunol Pract ; 9(5): 1939-1947.e7, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33307277

RESUMO

BACKGROUND: Tiotropium has the potential to alleviate asthmatic symptoms caused by the aging of lungs. However, few studies have focused on specific treatments for elderly patients with asthma. OBJECTIVES: To estimate the cost-effectiveness of adding tiotropium to inhaled corticosteroids and long-acting beta-agonists in elderly patients with severe asthma using real-world data. METHODS: Phase I was a retrospective cohort study using the National Health Insurance claims data to measure clinical and economic outcomes. In phase II, a Markov model was constructed to evaluate cost-effectiveness from Korean health care system perspective, based on phase I, including 2 health states, and an asthma exacerbation event. We estimated cost given in 2018 US dollars, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Subgroup analyses for patients with poorly controlled symptoms (frequent short-acting beta-agonist users; frequent exacerbators) were performed. RESULTS: In elderly patients with severe asthma, the incremental cost and effectiveness in the tiotropium group compared with the inhaled corticosteroid and long-acting beta-agonist group were $2281 and 0.038 QALYs, respectively. The incremental cost-effectiveness ratio was $60,074/QALY, indicating that the addition of tiotropium is not a cost-effective alternative. Meanwhile, 2 subgroups with poorly controlled symptoms showed that adding tiotropium is a cost-effective alternative (frequent short-acting beta-agonist users $4078/QALY; frequent exacerbators $8332/QALY). CONCLUSIONS: Tiotropium shows a higher cost-effectiveness profile when applied to elderly patients with uncontrolled symptoms. These results using real-world evidence provide information beyond the clinical outcomes reported by randomized controlled trials, providing a complementary ground in establishing the reimbursement criteria of tiotropium for elderly patients with severe asthma.


Assuntos
Asma , Corticosteroides/uso terapêutico , Idoso , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Análise Custo-Benefício , Humanos , Estudos Retrospectivos , Brometo de Tiotrópio/uso terapêutico
6.
Sensors (Basel) ; 20(23)2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33271990

RESUMO

The purpose of our study was to validate a newly developed breath acetone (BrAce) analyzer, and to explore if BrAce could predict aerobic exercise-related substrate use. Six healthy men ran on a treadmill at 70% of maximal oxygen consumption (VO2max) for 1 h after two days of a low-carbohydrate diet. BrAce and blood ketone (acetoacetate (ACAC), beta-hydroxybutyrate (BOHB)) levels were measured at baseline and at different time points of post-exercise. BrAce values were validated against blood ketones and respiratory exchange ratio (RER). Our results showed that BrAce was moderately correlated with BOHB (r = 0.68, p < 0.01), ACAC (r = 0.37, p < 0.01) and blood ketone (r = 0.60, p < 0.01), suggesting that BrAce reflect blood ketone levels, which increase when fat is oxidized. Furthermore, BrAce also negatively correlated with RER (r = 0.67, p < 0.01). In our multiple regression analyses, we found that when BMI and VO2max were added to the prediction model in addition to BrAce, R2 values increased up to 0.972 at rest and 0.917 at 1 h after exercise. In conclusion, BrAce level measurements of our BrAce analyzer reflect blood ketone levels and the device could potentially predict fat oxidation.


Assuntos
Acetona , Testes Respiratórios , Gastos em Saúde , Ácido 3-Hidroxibutírico , Metabolismo Energético , Exercício Físico , Humanos , Masculino , Oxirredução , Consumo de Oxigênio
7.
Arch Osteoporos ; 15(1): 180, 2020 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-33188505

RESUMO

This study analyzed the incidence and risk factors of subsequent osteoporotic fractures in South Korea. The results showed that the incidence rate of subsequent fractures within 24 months was 10.23 per 100 person-years. Additionally, the index hip fracture site was a significant risk factor for a subsequent fracture. PURPOSE: To identify and analyze the incidence and risk factors of subsequent osteoporotic fractures in South Korea. METHODS: This retrospective cohort study analyzed data from the National Health Insurance Review and Assessment claims database from 2012 to 2017. Men and women with osteoporosis, aged ≥50 years, with index fractures between July 1, 2014, and July 1, 2015, were included. The incidence rate of subsequent fractures was calculated by determining the number of second event within 2 years from the index fracture. To identify the risk factors for subsequent fractures, we applied the Cox proportional hazard model to estimate the hazard ratios (HRs). RESULTS: Of the 73,717 patients with osteoporotic fractures, 13,203 (17.91%) had a subsequent fracture. The incidence rate of subsequent fractures within 24 months was 10.23/100 person-years. The index fracture site was a significant risk factor for a subsequent fracture, with the hip showing the highest risk (HR, 7.51; 95% confidence interval [CI], 6.77-8.34), followed by the vertebra (HR, 1.99; 95% CI, 1.91-2.06). The risk of subsequent fractures increased with a higher Charlson Comorbidity Index (CCI) score (CCI score ≥ 5: HR, 1.79; 95% CI, 1.67-1.92). CONCLUSION: The incidence rate of subsequent osteoporotic fractures in South Korea is similar or higher than that reported in the USA and Europe. A hip fracture within the prior 2 years, relative to other fracture sites, significantly increased the risk of subsequent fractures in osteoporosis patients. Patients who have these risk factors need closer disease management to prevent subsequent fractures.


Assuntos
Fraturas do Quadril , Fraturas por Osteoporose , Estudos de Coortes , Europa (Continente) , Feminino , Fraturas do Quadril/epidemiologia , Humanos , Incidência , Masculino , Fraturas por Osteoporose/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
8.
J Med Econ ; 23(12): 1598-1605, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33001716

RESUMO

OBJECTIVES: This study aimed to assess the economic burden of subsequent fracture in osteoporosis patients with incident fracture. METHODS: The authors conducted a retrospective cohort analysis of the South Korean national health insurance claims data. Study subjects included osteoporosis patients aged ≥50 with incident fracture (July 1, 2014-June 30, 2015). Fracture-related 1-year healthcare cost was evaluated after incident fracture for patients with and without subsequent fracture, defined as a fracture occurring within 2 years from incident fracture at a different site or at the same site after 6-months washout period. Per-patient-per-month (PPPM) cost was calculated by dividing each patient's cumulative healthcare cost until subsequent fracture with time-to-subsequent-fracture. For the patients without subsequent fracture, PPPM cost equaled 1-year monthly cost. A generalized linear model (GLM) was used to estimate the ratio of increase in healthcare cost to assess the economic impact of subsequent fracture. RESULTS: A total of 73,717 osteoporosis patients with incident fracture were identified, consisting of 52.1% vertebral, 1.9% hip, and 46.0% non-vertebral-non-hip fractures. Subsequent fracture occurred in 17.9% of patients with average time-to-subsequent-fracture of 256 days. Patients with subsequent fracture had significantly higher 1-year healthcare cost after incident fracture than those without subsequent fracture ($4,307 vs $1,721) and the difference was greater in PPPM cost ($930 vs $141). GLM analysis showed that having subsequent fracture increased both 1-year healthcare cost and PPPM cost by 1.91-fold (95% CI = 1.87-1.95) and 6.14-fold (95% CI = 5.99-6.28), respectively. CONCLUSIONS: Subsequent fracture imposes a substantial burden on osteoporosis patients and, therefore, more efforts are needed for preventing subsequent fracture among osteoporosis patients.


Assuntos
Fraturas do Quadril , Osteoporose , Fraturas por Osteoporose , Efeitos Psicossociais da Doença , Humanos , Osteoporose/complicações , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos
9.
Nanomaterials (Basel) ; 10(2)2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32079261

RESUMO

Diatomite (DE) has attracted considerable attention owing to its abundance, low cost, and potential for a wide variety of applications. This work reports the development of mesoporous wool-ball-like (WBL) microspheres from natural DE through a simple hydrothermal treatment. We discovered that the presence of cetyltrimethylammonium bromide is a prerequisite for generating monodispersed WBL microspheres. The mechanism for the transformation of pristine DE into mesoporous microspheres through dissolution-recrystallization was clearly investigated. Interestingly, the microspheres exhibited a specific surface area 25-60 times larger than that of the pristine DE. The application of WBL microsphere DE as an effective support for metallic catalysts in the toluene total oxidation reaction was demonstrated.

10.
Protoplasma ; 257(3): 807-817, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31909437

RESUMO

Alkyl hydroperoxide reductase subunit F (AhpF) is a well-known flavoprotein that transfers electrons from pyridine nucleotides to the peroxidase protein AhpC via redox-active disulfide centers to detoxify hydrogen peroxide. However, study of AhpF has historically been limited to particular eubacteria, and the connection between the functional and structural properties of AhpF remains unknown. The present study demonstrates the dual function of Pseudomonas aeruginosa AhpF (PaAhpF) as a reductase and a molecular chaperone. It was observed that the functions of PaAhpF are closely linked with its structural status. The reductase and foldase chaperone function of PaAhpF predominated for its low-molecular-weight (LMW) form, whereas the holdase chaperone function of PaAhpF was found associated with its high-molecular-weight (HMW) complex. Further, the present study also demonstrates the multiple function of PaAhpF in controlling oxidative and heat stresses in P. aeruginosa resistance to oxidative and heat stress.


Assuntos
Proteínas de Bactérias/metabolismo , Chaperonas Moleculares/química , Peroxirredoxinas/química , Pseudomonas aeruginosa/metabolismo , Sequência de Aminoácidos , Oxirredução
11.
ACS Omega ; 5(51): 33387-33394, 2020 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-33403301

RESUMO

This study aims at producing exopolysaccharides (EPS) from a lactic acid bacterial strain. The soybean whey-isolated Lactobacillus plantarum W1 (EPS-W1), which belongs to genus Lactobacillus, is identified using the phenylalanyl-tRNA sequencing method. Of all the examined strains, R-49778 (as numbered by BCCM/LMG Bacteria Collection, Ghent University, Belgium) showed the highest capability of producing exopolysaccharides. Structural characterization revealed a novel exopolysaccharide consisting of repeating units of →6)-d-Glcp-(1→; →3)-d-Manp-(1→; →3)-d-Glcp-(1→ and a branch of →6)-d-Manp-(1→; →2)-d-Glcp-(1→. This discovery opens up avenues for the production of EPS for food industries, functional foods, and biomedical applications.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31816834

RESUMO

Background: This study aimed to test the validity of three different submaximal tests (i.e., 3-min step test with 20.3-cm step box height (3MST20), 3-min step test with 30-cm step box height (3MST30), and 6-min walk test (6MWT)) in estimating maximal oxygen consumption (VO2max) in young and healthy individuals. Methods: The 3MST20, 3MST30, 6MWT, as well as the cardiopulmonary exercise test (CPET) were performed in 73 participants (37 men and 36 women; mean age: 30.8 ± 9.3 years). All participants visited the clinic three times in a random order for anthropometric measurements, three submaximal tests, and the VO2max test. Multiple linear regression analyses were conducted to construct the VO2max prediction equations for each submaximal test. Results: The prediction equations developed based on multiple regression analyses for each submaximal tests were as follows: 3MST20: VO2max = 86.0 - 10.9 × sex (male = 1, female = 2) - 0.4 × age - 0.1 × weight - 0.1 × heart rate recovery at 30 s (HRR30s); 3MST30: VO2max = 84.5 - 10.2 × sex (male = 1, female = 2) - 0.4 × age - 0.1 × weight - 0.1 × HRR30s; and 6MWT: VO2max = 61.1 - 11.1 × sex (male = 1, female = 2) - 0.4 × age - 0.2 × weight - 0.2 × (distance walked·10-1). The estimated VO2max values based on formulated equations were 37.0 ± 7.9, 37.3 ± 7.6, and 36.9 ± 7.9 mL∙kg-1∙min-1 derived from the 3MST20, 3MST30, and 6MWT, respectively. These estimated VO2max values were not significantly different from the measured VO2max value, 37.3 mL∙kg-1∙min-1. The estimated VO2max based on the 3MST20, 3MST30, and 6MWT results explained 73.4%, 72.2%, and 74.4% of the variances in the measured VO2max (p < 0.001), respectively. Conclusions: The 3MST20, 3MST30, and 6MWT were valid in estimating VO2max in relatively young and healthy Asian individuals.


Assuntos
Teste de Esforço/métodos , Voluntários Saudáveis/estatística & dados numéricos , Consumo de Oxigênio , Caminhada , Adulto , Teste de Esforço/instrumentação , Feminino , Humanos , Masculino , República da Coreia , Fatores de Tempo , Teste de Caminhada/métodos , Adulto Jovem
13.
J Microbiol Biotechnol ; 29(7): 1165-1176, 2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31280529

RESUMO

Botulinum neurotoxins (BoNTs), produced by Clostridium botulinum, are the most toxic substances known. However, the number of currently approved medical countermeasures for these toxins is very limited. Therefore, studies on therapeutic antitoxins are essential to prepare for toxin-related emergencies. Currently, more than 10,000 Halla horses, a crossbreed between the native Jeju and Thoroughbred horses, are being raised in Jeju Island of Korea. They can be used for equine antitoxin experiments and production of hyperimmune serum against BoNT/A1. Instead of the inactivated BoNT/A1 toxoid, Halla horse was immunized with the receptor-binding domain present in the C-terminus of heavy chain of BoNT/A1 (BoNT/A1-HCR) expressed in Escherichia coli. The anti-BoNT/A1-HCR antibody titer increased rapidly by week 4, and this level was maintained for several weeks after boosting immunization. Notably, 20 µL of the week 24 BoNT/A1-HCR(-immunized) equine serum showed an in vitro neutralizing activity of over 8 international unit (IU) of a reference equine antitoxin. Furthermore, 20 µL of equine serum and 100 µg of purified equine F(ab')2 showed 100% neutralization of 10,000 LD50 in vivo. The results of this study shall contribute towards optimizing antitoxin production for BoNT/A1, which is essential for emergency preparedness and response.


Assuntos
Anticorpos Antibacterianos/imunologia , Vacinas Bacterianas/imunologia , Antitoxina Botulínica/imunologia , Toxinas Botulínicas Tipo A/imunologia , Clostridium botulinum/imunologia , Fragmentos de Peptídeos/imunologia , Animais , Anticorpos Antibacterianos/sangue , Vacinas Bacterianas/química , Antitoxina Botulínica/sangue , Toxinas Botulínicas Tipo A/química , Feminino , Cavalos , Imunização/veterinária , Camundongos Endogâmicos BALB C , Testes de Neutralização/veterinária , Fragmentos de Peptídeos/química , Coelhos
14.
Respir Res ; 20(1): 80, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31039780

RESUMO

BACKGROUND: Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), little is known about the estimates of their incidence in patients with asthma-COPD overlap (ACO), which has been described and acknowledged as a distinct clinical entity. We aimed to estimate the risk of depression and anxiety among patients with ACO and compare it with the risk among those with COPD alone in the general population. METHODS: We conducted a nationwide population-based retrospective cohort study using the Korean National Sample Cohort database between 1 January, 2002, and 31 December, 2013. Patients who were diagnosed with COPD (International Classification of Diseases, 10th revision [ICD-10] codes J42-J44) at least twice and prescribed COPD medications at least once between 2003 and 2011 were classified into two categories: patients who were diagnosed with asthma (ICD-10 codes J45-J46) more than twice and at least once prescribed asthma medications comprised the ACO group, and the remaining COPD patients comprised the COPD alone group. Patients who had been diagnosed with depression or anxiety within a year before the index date were excluded. We defined the outcome as time to first diagnosis with depression and anxiety. Matched Cox regression models were used to compare the risk of depression and anxiety among patients with ACO and patients with COPD alone after propensity score matching with a 1:1 ratio. RESULTS: After propensity score estimation and matching in a 1:1 ratio, the cohort used in the analysis included 15,644 patients. The risk of depression during the entire study period was higher for patients with ACO than for patients with COPD alone (adjusted hazard ratio, 1.10; 95% confidence interval, 1.03-1.18; P value = 0.0039), with an elevated risk in patients aged 40-64 years (1.21; 1.10-1.34; 0.0001) and in women (1.18; 1.07-1.29; 0.0005). The risk of anxiety was higher for patients with ACO than for patients with COPD alone (1.06; 1.01-1.12; 0.0272), with a higher risk in patients aged 40-64 years (1.08; 1.00-1.17; 0.0392); however, the risk was not significant when stratified by sex. CONCLUSIONS: This population-based study revealed a higher incidence of depression and anxiety in patients with ACO than in patients with COPD alone.


Assuntos
Asma/epidemiologia , Transtornos do Humor/epidemiologia , Vigilância da População , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Asma/psicologia , Estudos de Coortes , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Doença Pulmonar Obstrutiva Crônica/psicologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
15.
J Allergy Clin Immunol Pract ; 7(8): 2642-2652.e3, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31108218

RESUMO

BACKGROUND: Although elderly patients with asthma have clinical characteristics different from those of young adults, few studies or guidelines have focused on specific treatments for this population. OBJECTIVE: This study compared the effectiveness of leukotriene receptor antagonists (LTRAs) versus inhaled corticosteroids (ICSs) in elderly patients with asthma in real-world settings. METHODS: We extracted records for elderly patients with asthma who were newly prescribed LTRAs or low-dose ICSs from January 2003 to December 2010 from National Sample Cohort data of Korea. We defined the first prescription date for each medication as the index date. We compared the risks of asthma exacerbation between the 2 groups using Cox proportional-hazard regression after propensity score-based inverse probability of treatment weighting to balance covariates between treatment groups. We also compared asthma-related health care resource utilization and medication compliance in both groups using chi-square test and t test. RESULTS: The number of identified patients newly treated with LTRAs and low-dose ICSs was 1571 and 121, respectively. The risks of asthma exacerbation in the LTRA and low-dose ICS groups after weighting were not significantly different (hazard ratio, 0.98; 95% CI, 0.65-1.54). The proportion with high compliance (medication possession ratio ≥ 80%) in the LTRA group was higher than that in the low-dose ICS group. CONCLUSIONS: The effectiveness of LTRAs was not different from that of low-dose ICSs regarding the risk of asthma exacerbation in elderly patients with asthma in real-world settings. Given the practical benefits gained from convenient administration, LTRAs can be considered a reasonable alternative first-line therapy for elderly patients with mild asthma.


Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Antagonistas de Leucotrienos/uso terapêutico , Grupos Populacionais , Administração por Inalação , Idoso , Asma/epidemiologia , Estudos de Coortes , Humanos , Coreia (Geográfico)/epidemiologia , Adesão à Medicação/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
16.
Clin Ther ; 41(6): 1066-1079, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31101372

RESUMO

PURPOSE: Sacubitril/valsartan, the first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is a possible treatment option for chronic heart failure patients with reduced ejection fraction (HFrEF). The aim of this study was to estimate the cost-effectiveness of sacubitril/valsartan use in South Korea for treating patients with HFrEF compared with that of enalapril, an angiotensin-converting enzyme inhibitor, and with angiotensin receptor blockers (ARBs). METHODS: A Markov model was designed to estimate the lifetime cost-effectiveness of treatment for patients with HFrEF. Cohorts in the alive-state incurred a monthly risk of hospitalization because of deteriorated HF, adverse events (AEs), or death. Transition probabilities of sacubitril/valsartan and enalapril were estimated by using data from the PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial. The effectiveness of ARBs (eg, reduction in mortality and hospitalization rates) was assumed to be identical to that of enalapril, according to the results of the meta-analysis. However, there was no comparative evidence for AEs. We therefore conducted a Bayesian network meta-analysis and adjusted the incidence rate of AEs for ARBs. The utility for estimating quality-adjusted life years (QALYs) was elicited by the survey of the general South Korean population by using EuroQol-5 dimensions. We calculated the medical costs, including medication, monitoring, hospitalization, AEs, and terminal care, from the health care sector perspective. Costs and effectiveness were discounted by 5%. One-way sensitivity analyses and a probabilistic sensitivity analysis were conducted to determine the model robustness. FINDINGS: The total cost per patient for sacubitril/valsartan and enalapril was $25,832 and $18,295, respectively. Sacubitril/valsartan was associated with an ∼8- month longer life expectancy compared with enalapril and a QALY gain of 0.59. As a result, the incremental cost-effectiveness ratio for sacubitril/valsartan versus enalapril was $12,722 per QALY. The incremental cost-effectiveness ratio of sacubitril/valsartan versus ARB was $11,970 with an incurred cost of $18,741 for the ARB group. The main results and those of various sensitivity analyses were lower than a threshold of $20,000. IMPLICATIONS: From a health care sector perspective, sacubitril/valsartan is a cost-effective treatment for HFrEF compared with enalapril and ARBs. This finding could be helpful for cardiologists or decision makers in reaching cost-effective choices regarding the treatment selection process.


Assuntos
Aminobutiratos , Antagonistas de Receptores de Angiotensina , Insuficiência Cardíaca , Tetrazóis , Aminobutiratos/economia , Aminobutiratos/uso terapêutico , Antagonistas de Receptores de Angiotensina/economia , Antagonistas de Receptores de Angiotensina/uso terapêutico , Doença Crônica , Análise Custo-Benefício , Combinação de Medicamentos , Custos de Cuidados de Saúde , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/economia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/fisiopatologia , Humanos , Modelos Estatísticos , República da Coreia , Tetrazóis/economia , Tetrazóis/uso terapêutico , Disfunção Ventricular Esquerda
17.
Polymers (Basel) ; 11(2)2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30960305

RESUMO

Water-based drilling mud (WBM) is a non-Newtonian fluid that has a variety of applications such as in transporting cuttings during drilling, protecting the borehole, and cooling the drill bit. With the development of nano-technology, various nanoparticles have been synthesized and have been added to WBM to improve its performance. Shear thinning is the most important factor in drilling mud and this attribute can be improved when two-dimensional particles are added. MoS2 nanoparticles, which represent a typical two-dimensional material, are easy to synthesize in large quantities and have a high thermal conductivity and low coefficient of friction. Since the two-dimensional structure, thermal conductivity, and low coefficient of friction of MoS2 would improve the performance of WBM, we experimented with MoS2 nanosheets as an additive, under optimal conditions, using various samples each with uniform sizes and thicknesses of nanosheets. A large amount of MoS2 nanosheets was synthesized, sorted by thickness and diameter, and added to drilling mud. The diameter of MoS2 was divided into a small diameter group (about 100⁻400 nm) and a big diameter group (about 300⁻650 nm), and the thickness was divided into 1⁻2 nm and 5⁻10 nm groups. Experimental results showed that when MoS2 is added to WBM, shear thinning occurs more strongly. In addition, the addition of MoS2 with a thickness of 1⁻2 nm and a diameter of 300⁻650 nm resulted in the highest increase in viscosity and thermal conductivity of WBM. As a result, we experimentally confirmed that MoS2 can be used as an additive to increase the thermal conductivity and viscosity of WBM and to make shear thinning phenomenon more.

18.
Pharmacoepidemiol Drug Saf ; 28(4): 479-488, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30848536

RESUMO

PURPOSE: Given the severity and high-costs demand of Clostridium difficile-associated diarrhea (CDAD), management of risk factors is very important. Although the association between proton-pump inhibitors (PPIs) and CDAD has been established, little is known among high-risk antibiotics users. This study aimed to identify the association between PPIs and CDAD in high-risk antibiotics users by using a case-crossover design. METHODS: We conducted a case-crossover study using a nationwide population-based cohort in South Korea. Participants who developed CDAD from 1 January 2003 to 31 December 2013 and had prior prescription records of both PPIs and high-risk antibiotics were included. The hazard period was 49 days, and the three prior control periods had the same duration as the hazard period. The status of exposure to PPIs was assessed during the hazard and control periods in each patient and discordant pairs of exposure were used to estimate the matched odds ratio (OR). RESULTS: In total, 200 participants with CDAD who had histories of both PPIs and high-risk antibiotics use were included. A twofold increased risk for CDAD due to PPI use was observed (OR = 2.0; 95% confidence interval, 1.2-3.2). The time-invariant variables including age group, sex, and comorbidities were proven not to modify the association between PPIs and CDAD. CONCLUSIONS: Our study suggested that PPIs increase the risk of developing CDAD in high-risk antibiotics users. Thus, PPIs should be used cautiously in patients requiring high-risk antibiotics in the situation of medical treatment to prevent further incidence of CDAD.


Assuntos
Antibacterianos/efeitos adversos , Clostridioides difficile/isolamento & purificação , Diarreia/epidemiologia , Enterocolite Pseudomembranosa/epidemiologia , Inibidores da Bomba de Prótons/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Comorbidade , Estudos Cross-Over , Diarreia/microbiologia , Enterocolite Pseudomembranosa/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , República da Coreia/epidemiologia , Fatores de Risco
19.
ACS Appl Mater Interfaces ; 10(50): 43785-43791, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30474953

RESUMO

Nanocrystal quantum dots (QDs) provide tunable optoelectronic properties on the basis of their dimension. CdSe QDs, which are size-dependent colloidal nanocrystals, are used for efficient electrochromic devices owing to their unique properties in modulating quantum confinement, resulting in enhanced electron insertion during the electrochromic process. Incorporating a well-known metal oxide electrochromic material such as WO3 into CdSe QDs enhances the redox process. Herein, we propose a facile method for producing and optimizing CdSe QDs doped in WO3. The fabrication of the electrochromic film involves a solution and annealing process. Moreover, the effect of the QD size to optimize the electrochromic layer is studied. As a result, the coloration efficiency of WO3 and optimized CdSe QD-WO3 are obtained as 68.6 and 112.3 cm2/C, respectively. Thus, size-tunable nanocrystal QDs combined with a metal oxide yield high-performance electrochromic devices and are promising candidates for producing smart windows.

20.
Korean Circ J ; 48(7): 637-651, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29968437

RESUMO

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (-5.2 mmHg; 95% CI, -8.3 to -2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, -2.5 to 3.3). CONCLUSIONS: In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.

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