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1.
JMIR Med Inform ; 10(8): e36199, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35943793

RESUMO

BACKGROUND: Artificial intelligence (AI) has shown promising results in various fields of medicine. It has the potential to facilitate shared decision making (SDM). However, there is no comprehensive mapping of how AI may be used for SDM. OBJECTIVE: We aimed to identify and evaluate published studies that have tested or implemented AI to facilitate SDM. METHODS: We performed a scoping review informed by the methodological framework proposed by Levac et al, modifications to the original Arksey and O'Malley framework of a scoping review, and the Joanna Briggs Institute scoping review framework. We reported our results based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guideline. At the identification stage, an information specialist performed a comprehensive search of 6 electronic databases from their inception to May 2021. The inclusion criteria were: all populations; all AI interventions that were used to facilitate SDM, and if the AI intervention was not used for the decision-making point in SDM, it was excluded; any outcome related to patients, health care providers, or health care systems; studies in any health care setting, only studies published in the English language, and all study types. Overall, 2 reviewers independently performed the study selection process and extracted data. Any disagreements were resolved by a third reviewer. A descriptive analysis was performed. RESULTS: The search process yielded 1445 records. After removing duplicates, 894 documents were screened, and 6 peer-reviewed publications met our inclusion criteria. Overall, 2 of them were conducted in North America, 2 in Europe, 1 in Australia, and 1 in Asia. Most articles were published after 2017. Overall, 3 articles focused on primary care, and 3 articles focused on secondary care. All studies used machine learning methods. Moreover, 3 articles included health care providers in the validation stage of the AI intervention, and 1 article included both health care providers and patients in clinical validation, but none of the articles included health care providers or patients in the design and development of the AI intervention. All used AI to support SDM by providing clinical recommendations or predictions. CONCLUSIONS: Evidence of the use of AI in SDM is in its infancy. We found AI supporting SDM in similar ways across the included articles. We observed a lack of emphasis on patients' values and preferences, as well as poor reporting of AI interventions, resulting in a lack of clarity about different aspects. Little effort was made to address the topics of explainability of AI interventions and to include end-users in the design and development of the interventions. Further efforts are required to strengthen and standardize the use of AI in different steps of SDM and to evaluate its impact on various decisions, populations, and settings.

2.
Small Methods ; : e2200486, 2022 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-35900067

RESUMO

The exotic topological phase is attracting considerable attention in condensed matter physics and materials science over the past few decades due to intriguing physical insights. As a combination of "topology" and "ferroelectricity," the ferroelectric (polar) topological structures are a fertile playground for emergent phenomena and functionalities with various potential applications. Herein, the review starts with the universal concept of the polar topological phase and goes on to briefly discuss the important role of computational tools such as phase-field simulations in designing polar topological phases in oxide heterostructures. In particular, the history of the development of phase-field simulations for ferroelectric oxide heterostructures is highlighted. Then, the current research progress of polar topological phases and their emergent phenomena in ferroelectric functional oxide heterostructures is reviewed from a theoretical perspective, including the topological polar structures, the establishment of phase diagrams, their switching kinetics and interconnections, phonon dynamics, and various macroscopic properties. Finally, this review offers a perspective on the future directions for the discovery of novel topological phases in other ferroelectric systems and device design for next-generation electronic device applications.

3.
Clin Biochem ; 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35843269

RESUMO

BACKGROUND: Sjogren's syndrome (SS) is a systemic autoimmune disease featured with a dry mouth and dry eyes. Several autoantibodies, including anti-SSA, anti-SSB, antinuclear antibodies can be detected in patients with SS. Oxidation-specific epitopes (OSEs) can be formed from malondialdehyde (MDA)-modified protein adducts and trigger chronic inflammation. In this study, our purposes were used serum levels of anti-MDA-modified peptide adducts autoantibodies to evaluate predictive performance by machine learning algorithms in primary Sjögren's syndrome (pSS) and assess the association between pSS and healthy controls. METHODS: Three novel MDA-modified peptide adducts, including immunoglobulin (Ig) gamma heavy chain 1 (IGHG1)102-131, complement factor H (CFAH)1045-1062, and Ig heavy constant alpha 1 (IGHA1)307-327 were identified and validated. Serum levels of protein, MDA-modified protein adducts, MDA, and autoantibodies recognizing unmodified peptides and MDA-modified peptide adducts were measured. Statistically significance in correlations and odds ratios (ORs) were estimated. RESULTS: The random forest classifier utilized autoantibodies combination composed of IgM anti-IGHG1102-131, IgM anti-IGHG1102-131 MDA and IgM anti-IGHA1307-327 achieved predictive performance as an accuracy of 88.0%, a sensitivity of 93.7%, and a specificity of 84.4% which may be as potential diagnostic biomarkers to differentiate patients with pSS from rheumatoid arthritis (RA), and secondary SS in RA and HCs. CONCLUSIONS: Our findings imply that low levels of IgA anti-IGHG1102-131 MDA (OR = 2.646), IgA anti-IGHG1102-131 (OR = 2.408), IgA anti-CFAH1045-1062 (OR = 2.571), and IgA anti-IGHA1307-327 (OR = 2.905) may denote developing risks of pSS, respectively.

4.
PLoS Med ; 19(7): e1004034, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35788767

RESUMO

BACKGROUND: Rapid intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) is crucial for improving outcomes. However, few randomized trials of interventions aimed at reducing in-hospital delay have been carried out in China. We aimed to evaluate the effect of a multicomponent intervention on thrombolytic door-to-needle time (DNT) of AIS patients via video teleconference based on the Behavior Change Wheel (BCW) method. METHODS AND FINDINGS: This cluster-randomized trial, conducted between January 1, 2019 and December 31, 2019, randomly allocated 22 hospitals equally to PEITEM (Persuasion Environment reconstruction Incentivization Training Education Modeling) intervention or routine care plus stroke registry and subsequently enrolled 1,634 AIS patients receiving IVT within 4.5 hours upon stroke onset from participant hospitals. The PEITEM group received a 1-year PEITEM 6-component intervention based on the behavioral theory monthly via video teleconference. The primary outcome was the proportion of patients with a DNT of 60 minutes or less. A total of 987 patients participated in the PEITEM group (mean age, 69 years; female, 411 [41.6%]) and 647 patients in the control group (mean age, 70 years; female, 238 [36.8%]). Of all participants, the proportion of DNT ≤60 minutes in the PEITEM group was higher than in the control group (82.0% versus 73.3%; adjusted odds ratio, 1.77; 95% confidence interval (CI), 1.17 to 2.70; ICC, 0.04; P = 0.007). Among secondary outcomes, the average DNT was 43 minutes in the PEITEM group and 50 minutes in the control group (adjusted mean difference: -8.83; 95% CI, -14.03 to -3.64; ICC, 0.12; P = 0.001). Favorable functional outcome (score of 0 to 1 on the modified Rankin scale (mRS)) was achieved in 55.6% patients of the PEITEM group and 50.4% of the control group (adjusted odds ratio, 1.38; 95% CI, 1.00 to 1.90; ICC, 0.01; P = 0.049). Main study limitations include non-blinding of clinicians, and that specific interventions component responsible for the observed changes could not be determined. CONCLUSIONS: The teleconference-delivered PEITEM intervention resulted in a moderate but clinically relevant shorter DNT and better functional outcome in AIS patients receiving IVT. TRIAL REGISTRATION: Clinicaltrials.gov NCT03317639.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Administração Intravenosa , Idoso , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos
5.
ACS Omega ; 7(28): 24851-24857, 2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35874193

RESUMO

Li(Ni0.8, Co0.1, Mn0.1)O2 (NCM-811) cathode materials have been commercialized recently, aiming to increase the specific capacity and specific energy of the lithium-ion battery for practical applications in electric vehicles. The surface coating has been proved to be an effective approach for the stabilization of NCM-based cathodes, which could reduce the structural instability and prevent surface reactions between the cathode materials and electrolytes. Herein, we demonstrate the facile synthesis of graphitic carbon nitride (g-C3N4)-coated NCM cathodes with both the sonication-assisted liquid exfoliation method (g-C3N4NS@NCM-811) and chemical vapor-assisted coating method (g-C3N4@NCM-811). It is discovered that coating with a thin g-C3N4 layer could reduce the impedance of the NCM-811 cathode material, as well as increase the cycle stability of the cathode material, leading to increased capacity retention from 130 mA h/g (for the pristine sample) to 140 mA h/g after 225 cycles. While the coating of thick g-C3N4 nanosheets could hinder the lithium intercalation, resulting in significant loss of specific capacity. This study paves the way toward practical applications of the g-C3N4-coated NCM-811 cathode materials.

6.
3D Print Med ; 8(1): 17, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35678954

RESUMO

BACKGROUND: Advanced diagnostic imaging is an essential part of preoperative planning for oral and maxillofacial surgery in veterinary patients. 3-dimensional (3D) printed models and surgical guides generated from diagnostic imaging can provide a deeper understanding of the complex maxillofacial anatomy, including relevant spatial relationships. Additionally, patient-specific 3D printed models allow surgeons and trainees to better examine anatomical features through tactile and visuospatial feedback allowing for improved preoperative planning, intraoperative guidance, and enhanced trainee education. Furthermore, these models facilitate discussions with pet owners, allowing for improved owner understanding of pathology, and educated decision-making regarding treatment. CASE PRESENTATION: Our case series consists of three 3D printed models segmented from computed tomography (CT) and cone beam CT (CBCT) and fabricated via desktop vat polymerization for preoperative planning and intraoperative guidance for resection of maxillary osteosarcoma, mandibular reconstruction after mandibulectomy, and gap arthroplasty for temporomandibular joint ankylosis in dogs. CONCLUSIONS: We illustrate multiple benefits and indications for 3D printing in veterinary oral and maxillofacial surgery. 3D printed models facilitate the understanding of complex surgical anatomy, creating an opportunity to assess the spatial relationship of the relevant structures. It facilitates individualized surgical planning by allowing surgeons to tailor and augment the surgical plan by examining patient-specific anatomy and pathology. Surgical steps may also be simulated in advance, including planning of osteotomy lines, and pre-contouring of titanium plates for reconstruction. Additionally, a 3D printed model and surgical guide also serve as invaluable intraoperative reference and guidance. Furthermore, 3D printed models have the potential to improve veterinary resident and student training as well as pet owner understanding and communication regarding the condition of their pets, treatment plan and intended outcomes.

7.
Eur J Nutr ; 61(5): 2837-2845, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35303753

RESUMO

PURPOSE: Lower plasma level of folate has been associated with an increased risk of age-related cognitive impairment. However, studies that examined this relation have yielded mixed results. We aimed to examine the prospective association of plasma folate level with risk of cognitive impairment in a community-based prospective cohort of older adults in China. METHODS: This study included 615 participants (mean age: 76.3 years) without baseline cognitive impairment from the Rugao Longevity and Ageing Study (RuLAS). We used logistic regression to examine the prospective association between baseline plasma folate and risk of cognitive impairment in the next two years. Fasting blood samples were collected and assayed for plasma folate level at baseline. Cognitive impairment was defined as Hasegawa Dementia Scale (HDS) score ≤ 21.5 points. RESULTS: During two years' follow-up, 20.7% of the participants developed cognitive impairment. After controlled for age, gender, and plasma homocysteine, a higher level of plasma folate was associated with lower odds of cognitive impairment. The corresponding odds ratio (OR) with 95% confidence interval was 0.41 (0.19-0.89) comparing participants at extreme quintiles of plasma folate (median level 17.2 vs. 6.3 nmol/L). The associations were similar after further adjustment for major demographic and lifestyle factors (OR = 0.42, 0.18-0.98). Moreover, the inverse association was particularly stronger among males (OR = 0.12, 0.03-0.52) but was non-significant among females. CONCLUSION: Our findings support a potential beneficial role of higher plasma folate levels in cognitive function in older Chinese adults, particularly among males. Future studies with larger sample size and longer follow-up are warranted to confirm these findings and to identify the optimal plasma folate level for cognitive function.


Assuntos
Disfunção Cognitiva , Deficiência de Ácido Fólico , Idoso , China/epidemiologia , Disfunção Cognitiva/epidemiologia , Estudos de Coortes , Feminino , Ácido Fólico , Deficiência de Ácido Fólico/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vitamina B 12
8.
Adv Sci (Weinh) ; 9(13): e2105550, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35277947

RESUMO

Piezoelectric nanocomposites with oxide fillers in a polymer matrix combine the merit of high piezoelectric response of the oxides and flexibility as well as biocompatibility of the polymers. Understanding the role of the choice of materials and the filler-matrix architecture is critical to achieving desired functionality of a composite towards applications in flexible electronics and energy harvest devices. Herein, a high-throughput phase-field simulation is conducted to systematically reveal the influence of morphology and spatial orientation of an oxide filler on the piezoelectric, mechanical, and dielectric properties of the piezoelectric nanocomposites. It is discovered that with a constant filler volume fraction, a composite composed of vertical pillars exhibits superior piezoelectric response and electromechanical coupling coefficient as compared to the other geometric configurations. An analytical regression is established from a linear regression-based machine learning model, which can be employed to predict the performance of nanocomposites filled with oxides with a given set of piezoelectric coefficient, dielectric permittivity, and stiffness. This work not only sheds light on the fundamental mechanism of piezoelectric nanocomposites, but also offers a promising material design strategy for developing high-performance polymer/inorganic oxide composite-based wearable electronics.


Assuntos
Nanocompostos , Eletrônica , Aprendizado de Máquina , Óxidos , Polímeros
9.
J Rehabil Med ; 54: jrm00264, 2022 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-35174865

RESUMO

OBJECTIVE: To investigate the effects of concomitant injections of botulinum toxin-A (BoNT-A) into the detrusor and external urethral sphincter muscles in suprasacral spinal cord injured patients with detrusor overactivity and detrusor sphincter dyssynergia. DESIGN: An open treatment trial with pre- and posttreatment evaluations. SUBJECTS: Male suprasacral spinal cord injury patients (n = 20) with neurogenic detrusor overactivity and detrusor sphincter dyssynergia who emptied their bladder by reflex voiding and were unwilling to increase the frequency of intermittent catheterization. METHODS: Cystoscopic guidance of 200 U BoNT-A injections into the detrusor muscle and 100 U into external urethral sphincter muscles were applied. The urodynamic parameters, voiding diaries and quality of life scores using Urinary Distress Inventory, Short Form (UDI-6) and Incontinence Impact Questionnaire, Short Form (IIQ-7) were compared. RESULTS: All participants experienced a significant mean reduction in maximal detrusor pressure and maximal urethral pressure profile, and a mean significant increase in maximal cystometric bladder capacity 12 weeks after concomitant injections. Bladder diaries demonstrated persistently increased spontaneous voided volume, but no increase in post-void residual ratio, daily clean intermittent catheterization (CIC) frequency and diaper pad use from baseline to 24 weeks. UDI-6 scores were significantly improved at 4 and 12 weeks and IIQ-7 scores improved only at 12 weeks. CONCLUSION: Concomitant detrusor and external urethral sphincter BoNT-A injections may decrease detrusor and urethral pressure without increasing postvoid residual ratio and diaper pad use. For spinal cord injury patients with neurogenic detrusor overactivity and detrusor sphincter dyssynergia who are unwilling, or for whom it is inconvenient, to increase CIC frequency and who want to preserve spontaneous voiding, this treatment may provide an optional alternative.


Assuntos
Toxinas Botulínicas Tipo A , Traumatismos da Medula Espinal , Ataxia/complicações , Toxinas Botulínicas Tipo A/uso terapêutico , Humanos , Masculino , Qualidade de Vida , Traumatismos da Medula Espinal/complicações , Resultado do Tratamento , Uretra
10.
Bioengineered ; 13(3): 4810-4820, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35188436

RESUMO

Acute lung injury (ALI) is a common complication of sepsis. Mitochondrial aldehyde dehydrogenase 2 (ALDH2), an enzyme involved in aldehyde metabolism, exerts a protective effect against sepsis. This study investigated the possible mechanisms underlying the roles of ALDH2, pyroptosis, and ferroptosis in sepsis-induced lung injury. A mouse model of sepsis-induced lung injury was established by cecal ligation and puncture (CLP); lung morphology was evaluated by calculation of lung coefficient, hematoxylin-eosin staining, and electron microscopy. Malondialdehyde (MDA), reactive oxygen species (ROS), and 4-hydroxy-2-nonenal (4-HNE) protein expression levels were used to detect the level of lipid oxidative stress. In addition, total iron was detected using an iron detection kit, and the expression of ferroptosis-related proteins (PTGS2, GPX4), pyroptosis-related proteins, and ALDH2 was examined using western blotting. To further examine the likely mechanisms, the ferroptosis inhibitor ferrostatin 1 (Fer-1), NLRP3 inflammasome inhibitor MCC950, and ALDH2 activator Alda-1 were added. CLP-treated mice exhibited destruction of lung tissue morphology, lipid peroxidation injury, iron content, and increased lung PTGS2 protein expression, accompanied by a decrease in GPX4 protein expression. CLP also downregulated ALDH2 expression and increased the expression of the NLRP3 inflammasome and pyroptosis-related proteins. These adverse effects of CLP were relieved by Alda-1, Fer-1, and MCC950 treatment. In conclusion, both pyroptosis and ferroptosis participate in CLP-induced ALI, and ALDH2 plays a protective role by reducing pyroptosis and ferroptosis. This study provides a scientific basis for the treatment of lung injury in sepsis.


Assuntos
Lesão Pulmonar Aguda , Aldeído-Desidrogenase Mitocondrial/metabolismo , Ferroptose , Sepse , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/metabolismo , Aldeído-Desidrogenase Mitocondrial/genética , Animais , Ciclo-Oxigenase 2 , Modelos Animais de Doenças , Inflamassomos/metabolismo , Inflamassomos/farmacologia , Ferro , Camundongos , Camundongos Endogâmicos C57BL , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Piroptose , Sepse/complicações , Sepse/metabolismo
11.
Clin Nutr ; 41(3): 645-652, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35131717

RESUMO

BACKGROUND & AIMS: The neuroprotective roles of uric acid are still controversial. One possible explanation is that previous studies included participants with hyperuricemia, which might interfere with clarifying the association. Therefore, this study aimed to investigate the prospective association between plasma uric acid levels and cognitive function among non-hyperuricemia adults. METHODS: A total of 7828 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were free from hyperuricemia, brain damage, mental retardation, or memory-related diseases at baseline were included. According to the baseline plasma uric acid levels, participants were classified into low (<3.5 mg/dL for men and <2.5 mg/dL for women), low-normal (3.5-4.9 mg/dL for men and 2.5-3.9 mg/dL for women), and high-normal groups (4.9-7.0 mg/dL for men and 3.9-6.0 mg/dL for women). Cognitive function tests covered the domains of executive function (time orientation, numerical ability, and drawing) and episodic memory (immediate and delayed word recall). We used generalized estimating equation models to evaluate the average difference in cognitive function within 4-years' follow-up across different uric acid groups. RESULTS: Compared with the high-normal group, participants with lower uric acid levels were associated with poorer cognitive performance during 4-years' follow-up. The corresponding level of difference was -0.24 (95% CI: -0.47, -0.01) for low group, and -0.13 (95% CI: -0.26, -0.01) for low-normal group. The associations were significant and similar for the specific domain of executive function (P < 0.001). In addition, a stronger association was observed among participants with baseline age ≥60 years (P < 0.05 for interaction). CONCLUSIONS: Our study supports a potential detrimental role of low levels of plasma uric acid on cognitive function among Chinese adults without hyperuricemia. More research is warranted to confirm this finding and identify the optimal plasma uric acid level for cognitive benefits.


Assuntos
Hiperuricemia , Ácido Úrico , Adulto , Cognição , Feminino , Humanos , Hiperuricemia/complicações , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
12.
Food Funct ; 13(5): 2857-2864, 2022 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-35179535

RESUMO

Two undescribed phenolic glycosides, trochinenols B and C (1 and2), together with four known analogues (3-6), were isolated from the functional tea Trollius chinensis Bunge and their α-glucosidase inhibitory kinetics and mechanisms were investigated. It was found that 1 inhibited α-glucosidase in a noncompetitive manner with an IC50 value of 25.96 µM, while 3 showed a notable inhibitory effect against α-glucosidase in an uncompetitive manner with an IC50 value of 3.14 µM. Analysis of synchronous fluorescence and circular dichroism spectroscopy indicated that the binding of 1 to α-glucosidase led to the rearrangement and conformational alteration of the α-glucosidase enzyme. Furthermore, molecular docking indicated that 1 had a high affinity close to the active site pocket of α-glucosidase and indirectly inhibited the catalytic activity of the enzyme. However, 3 was bound to the entrance part of the active center of α-glucosidase and could hinder the release of the substrate as well as the catalytic reaction product, eventually suppressing the catalytic activity of α-glucosidase.


Assuntos
Inibidores de Glicosídeo Hidrolases/farmacologia , Glicosídeos/farmacologia , Fenóis/farmacologia , Extratos Vegetais/farmacologia , Ranunculaceae , alfa-Glucosidases/efeitos dos fármacos , Flores , Inibidores de Glicosídeo Hidrolases/química , Glicosídeos/química , Glicosídeos/farmacocinética , Humanos , Concentração Inibidora 50 , Simulação de Acoplamento Molecular , Fenóis/química , Fenóis/farmacocinética , Extratos Vegetais/química , Extratos Vegetais/farmacocinética , alfa-Glucosidases/química
13.
Reprod Biol ; 22(1): 100607, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35085910

RESUMO

This study embarked on the assessment regarding the function and mechanism of miR-520h/IL6R axis in polycystic ovary syndrome (PCOS). Specifically, we analyzed the differential expression of IL6R in PCOS samples and normal samples based on the GEO database, and then verified IL6R expression in KGN cells (Human granulosa-like tumor cell line) using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and western blot. MiRNA targeting IL6R was predicted by bioinformatics analysis and verified by luciferase reporter assay, qRT-PCR and western blot. KGN cells were transfected with miR-520h inhibitor and si-IL6R, and then the cell viability and apoptosis were detected by cell counting kit-8 (CCK-8) and flow cytometry assays. Additionally, western blot was applied to examine the expressions of cell cycle-, apoptosis-, and JAK / STAT pathway-related proteins. IL6R was highly expressed in PCOS and KGN cells, and IL6R silencing inhibited the viability, while promoting the apoptosis of KGN cells. Importantly, miR-520h directly targeted IL6R and inhibited IL6R expression. Moreover, downregulation of miR-520h enhanced the cell viability, impeded the cell apoptosis, upregulated the expressions of CDK2, CCNB1, Bcl-2, activated JAK/STAT pathway and downregulated Bax expression in KGN cells. Of note, knockdown of IL6R can reverse the biological functions of miR-520h in KGN cells. Collectively, miR-520h hindered the proliferation and promoted the apoptosis of KGN cells via targeting IL6R to inhibit the development of PCOS, and these effects were possibly realized by JAK/STAT pathway. However, the effect of miR-520h in the progression of PCOS need to further study in the GCs.


Assuntos
Apoptose , MicroRNAs , Síndrome do Ovário Policístico , Apoptose/fisiologia , Linhagem Celular Tumoral , Proliferação de Células/fisiologia , Feminino , Células da Granulosa/metabolismo , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Síndrome do Ovário Policístico/metabolismo , Receptores de Interleucina-6/genética , Receptores de Interleucina-6/metabolismo , Transdução de Sinais
14.
Arch Phys Med Rehabil ; 103(8): 1574-1581, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34979129

RESUMO

OBJECTIVE: This study aimed to develop and validate a machine learning-based short measure to assess 5 functions (the ML-5F) (activities of daily living [ADL], balance, upper extremity [UE] and lower extremity [LE] motor function, and mobility) in patients with stroke. DESIGN: Secondary data from a previous study. A follow-up study assessed patients with stroke using the Barthel Index (BI), Postural Assessment Scale for Stroke (PASS), and Stroke Rehabilitation Assessment of Movement (STREAM) at hospital admission and discharge. SETTING: A rehabilitation unit in a medical center. PARTICIPANTS: Patients (N=307) with stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The BI, PASS, and STREAM. RESULTS: A machine learning algorithm, Extreme Gradient Boosting, was used to select 15 items from the BI, PASS, and STREAM, and transformed the raw scores of the selected items into the scores of the ML-5F. The ML-5F demonstrated good concurrent validity (Pearson's r, 0.88-0.98) and responsiveness (standardized response mean, 0.28-1.01). CONCLUSIONS: The ML-5F comprises only 15 items but demonstrates sufficient concurrent validity and responsiveness to assess ADL, balance, UE and LE functions, and mobility in patients with stroke. The ML-5F shows great potential as an efficient outcome measure in clinical settings.


Assuntos
Atividades Cotidianas , Aprendizado de Máquina , Acidente Vascular Cerebral , Seguimentos , Humanos , Reprodutibilidade dos Testes , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral
15.
J Urol ; 207(6): 1207-1213, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35080472

RESUMO

PURPOSE: We evaluated the association between intravesical prostate protrusion (IPP) and the detection rate of clinically significant prostate cancer (csPCa) on magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion targeted biopsy (TB). MATERIALS AND METHODS: A total of 538 consecutive men who underwent MRI-TRUS fusion TB and concomitant systematic biopsy were evaluated. IPP on MRI was independently measured by 4 blinded reviewers. The primary outcome was per-lesion detection of csPCa on TB. We assessed the association between IPP and csPCa detection on TB, controlling for age, prostate specific antigen, Prostate Imaging Reporting and Data System® (PI-RADS®) score, prostate volume, targeted cores sampled and previous biopsy experience. RESULTS: A total of 847 PI-RADS 3 or greater lesions were targeted across 570 biopsies. Intra- and interrater reliability for measuring IPP was strong. A total of 81 (14.2%), 127 (22.3%), 237 (41.6%) and 125 (21.9%) men had 0, small, medium and large IPP, respectively. A total of 230, 392 and 196 lesions were PI-RADS 3, 4 and 5, respectively. Of the lesions 198 (34.7%) had csPCa on TB. The overall relationship between IPP size and csPCa found on TB was not significant; however, large IPP is associated with a significantly lower rate of csPCa detection than 0 IPP (p=0.007). Every mm increase in IPP is associated with a 5.6% decrease in the odds of csPCa detection on TB (p=0.004) and a 66.5% decrease in odds of detection in large IPP compared to 0 IPP (p=0.003). CONCLUSIONS: As the size of the IPP and volume increase, there is a decrease in the detection rate of csPCa on MRI-guided TB. These findings may be driven by poor MRI-TRUS co-registration and prostate asymmetry.


Assuntos
Próstata , Neoplasias da Próstata , Humanos , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Próstata/diagnóstico por imagem , Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Reprodutibilidade dos Testes
16.
Artigo em Inglês | MEDLINE | ID: mdl-35010842

RESUMO

Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76-103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Atividades Cotidianas , Idoso , Transtornos Cognitivos/epidemiologia , Disfunção Cognitiva/epidemiologia , Hospitalização , Humanos , Pacientes Internados
17.
Arch Gynecol Obstet ; 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35061066

RESUMO

PURPOSE: To explore the possible factors that contributed to the poor performance of minimally invasive surgery (MIS) versus abdominal surgery regarding progression-free survival (PFS) and overall survival (OS) in cervical cancer. METHODS: MEDLINE, EMBASE, Cochrane Library and Web of Science were searched (January 2000 to April 2021). Study selection was performed by two researchers to include studies reported oncological safety. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were combined using random-effect model. Subgroup analyses were stratified by characteristics of disease, publication, study design and treatment center. RESULTS: Sixty-one studies with 63,369 patients (MIS 26956 and ARH 36,049) were included. The overall-analysis revealed a higher risk of recurrence (HR 1.209; 95% CI 1.102-1.327) and death (HR 1.124; 95% CI 1.013-1.248) after MIS versus ARH expect in FIGO IB1 (FIGO 2009 staging) patients with tumor size less than 2 cm. However, subgroup analyses showed comparable PFS/DFS and OS in studies published before the Laparoscopic Approach to Cervical Cancer (LACC) trial, published in European journals, conducted in a single center, performed in centers in Europe and in centers with high sample volume or high MIS sample volume. CONCLUSION: Our findings highlight possible factors that associated with inferior survival after MIS in cervical cancer including publication characteristics, center-geography and sample volume. Center associated factors were needed to be taken into consideration when evaluating complex surgical procedures like radical hysterectomy.

18.
Curr Med Sci ; 42(1): 185-191, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34669113

RESUMO

OBJECTIVE: The present study was designed to evaluate the effects of adjuvant chemotherapy (CT) vs. radiotherapy (RT, alone or combined with CT) on the prognosis of patients with high-risk, early-stage (stage I and stage II) endometrioid endometrial carcinoma. METHODS: This single-center retrospective clinical study was conducted in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between 2010 and 2019. In the present study, endometrioid endometrial carcinoma patients, who underwent total hysterectomy and bilateral salpingo-oophorectomy followed by postoperative adjuvant CT or RT (alone or combined with CT), and were diagnosed with stage IA grade 2/3 with lymph-vascular space invasion (LVSI), and stage IB with two or more uterine risks, including old age, histological grade 2 or 3, LVSI and stage II, were included. According to the postoperative adjuvant therapy, all eligible patients were divided into two groups: CT group and RT (RT±CT) group. The primary objective was to investigate overall survival (OS) and disease-free survival (DFS) between the CT and RT groups. Grade 3 or worse adverse events were also presented in the present study. RESULTS: A total of 145 eligible patients were included. Among these patients, 97 patients underwent adjuvant CT and 48 patients underwent adjuvant RT (RT±CT). The median follow-up was 47.2 months, and the five-year OS rate was 92.7% in the CT group and 88.6 % in the RT group [hazard ratio (HR): 0.81, 95% confidence interval (CI): 0.22-2.99). The 5-year DFS rate for the two groups was 85.7% and 80.2%, respectively (HR: 0.82, 95% CI: 0.33-2.05). The cumulative incidence of local-regional disease recurrence at 60 months of follow-up was 6.2% in the CT group and 6.3% in the RT group (HR=1.11; 95%CI: 0.28-4.35). The cumulative incidence of distant recurrence at 60 months of follow-up was 5.2% in the CT group and 10.4% in the RT group (HR=0.65; 95%CI: 0.19-2.24). Both groups of patients were well-tolerant, and the only grade 3 or worse adverse events were neutropenia and thrombocytopenia. CONCLUSION: There was no difference in efficacy for adjuvant CT or adjuvant RT (RT±CT) in high-risk, early-stage endometrioid endometrial carcinoma. CT exhibited a trend of reducing the distant relapse, although there was no significant difference, when compared with adjuvant RT (RT±CT).


Assuntos
Carcinoma Endometrioide/tratamento farmacológico , Carcinoma Endometrioide/radioterapia , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/radioterapia , Estadiamento de Neoplasias , Avaliação de Resultados em Cuidados de Saúde , Adulto , Idoso , Carcinoma Endometrioide/mortalidade , Carcinoma Endometrioide/cirurgia , Quimiorradioterapia , Quimioterapia Adjuvante , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/cirurgia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Risco
19.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(11): 1276-1284, 2021 Nov 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34911863

RESUMO

As a form of new programmed cell death, pyroptosis is divided into a canonical pyroptosis pathway and a non-canonical pyroptosis pathway. In recent years, it is reported that non-canonical pyroptosis is closely related to inflammatory reactions, which directly affects the occurrence, development, and outcome of sepsis, inflammatory bowel disease, respiratory disease, nerve system inflammatory disease, and other inflammatory diseases. When the cells were infected with Gram-negative bacteria or lipopolysaccharide (LPS), it can induce the activation of cysteinyl aspartate specific proteinase(caspase)-4/5/11 and directly bind to the cells to cleave gasdermin D (GSDM-D) into the active amino-terminus of GSDM-D. The amino-terminus of GSDM-D with membrane punching activity migrates to the cell membrane, triggering the rupture of the cell membrane, and the cell contents discharge, leading to the occurrence of non-canonical pyroptosis. After activation of caspase-11, it also promotes the canonical pyroptosis, activates and releases interleukin-1ß and interleukin-18, which aggravated inflammation. Caspase-4/5/11, GSDM-D, Toll-like receptor 4 and high mobility group protein B1 are the key molecules of the non-canonical pyroptosis. Exploring the mechanisms of non-canonical pyroptosis and the related research progresses in inflammatory diseases intensively is of great significance for clinical prevention and treatment of the relevant diseases.


Assuntos
Piroptose , Sepse , Caspases , Humanos , Inflamassomos , Inflamação , Lipopolissacarídeos
20.
Ecol Evol ; 11(23): 16693-16703, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34938466

RESUMO

Understanding the shifts in competitive ability and its driving forces is key to predict the future of plant invasion. Changes in the competition environment and soil biota are two selective forces that impose remarkable influences on competitive ability. By far, evidence of the interactive effects of competition environment and soil biota on competitive ability of invasive species is rare. Here, we investigated their interactive effects using an invasive perennial vine, Mikania micrantha. The competitive performance of seven M. micrantha populations varying in their conspecific and heterospecific abundance were monitored in a greenhouse experiment, by manipulating soil biota (live and sterilized) and competition conditions (competition-free, intraspecific, and interspecific competition). Our results showed that with increasing conspecific abundance and decreasing heterospecific abundance, (1) M. micrantha increased intraspecific competition tolerance and intra- vs. interspecific competitive ability but decreased interspecific competition tolerance; (2) M. micrantha increased tolerance of the negative soil biota effect; and (3) interspecific competition tolerance of M. micrantha was increasingly suppressed by the presence of soil biota, but intraspecific competition tolerance was less affected. These results highlight the importance of the soil biota effect on the evolution of competitive ability during the invasion process. To better control M. micrantha invasion, our results imply that introduction of competition-tolerant native plants that align with conservation priorities may be effective where M. micrantha populations are long-established and inferior in inter- vs. intraspecific competitive ability, whereas eradication may be effective where populations are newly invaded and fast-growing.

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