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2.
J Affect Disord ; 296: 189-197, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34607060

RESUMO

BACKGROUND: The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. METHODS: Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. RESULTS: Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%-1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%-57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. LIMITATIONS: The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. CONCLUSIONS: Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

4.
BMC Psychiatry ; 21(1): 427, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465307

RESUMO

BACKGROUND: This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China. METHODS: Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng. RESULTS: The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were "failure to quit/cutdown" and "drinking more or for longer than intended." Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11). CONCLUSION: AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , China/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Masculino , Prevalência , Fatores de Risco
5.
Hum Gene Ther ; 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34555961

RESUMO

Hemophilia A (HA) is a monogenic disease characterized by plasma clotting factor 8 (F8) deficiency due to F8 mutation. We have been attempting to cure HA permanently using a CRISPR-Cas9 gene-editing strategy. Here, we induced targeted integration of BDDF8 (B-domain-deleted F8) gene into the albumin locus of HA mice by hydrodynamic tail vein injection of editing plasmid vectors. One week after treatment, a high F8 activity ranging from 70% to 280% of normal serum levels was observed in all treated HA mice but dropped to background levels 3-5 weeks later. We found that the humoral immune reaction targeting F8 is the predominant cause of the decreased F8 activity. We hypothesized that hydrodynamic injection-induced liver damage triggered the release of large quantities of inflammatory cytokines. However, co-injection of plasmids expressing a dozen immunomodulatory factors failed to curtail the immune reaction and stabilize F8 activity. The spCas9 plasmid carrying a miR-142-3p target sequence alleviated the cellular immune response but was unable to deliver therapeutic efficacy. Strikingly, immunosuppressant cyclo-phosphamide virtually abolished the immune response, leading to a year-long stable F8 level. Our findings should have important implications in developing therapies in mouse models using the hydrodynamic gene delivery approach, highlighting the ne-cessity of modulating the innate immune response triggered by liver damage.

6.
Lancet Psychiatry ; 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34559991

RESUMO

BACKGROUND: In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012-15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China. METHODS: The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age-sex-residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution. FINDINGS: 28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20-1·72] and 12-month prevalence OR 1·41 [1·12-1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68-3·38] and 12-month OR 2·80 [95% CI 1·88-4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39-2·51] and 12-month OR 1·85 [95% CI 1·40-2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately. INTERPRETATION: Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China. FUNDING: National Health Commission and Ministry of Science and Technology of People's Republic of China. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

7.
Genome Biol ; 22(1): 236, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416913

RESUMO

BACKGROUND: After repairing double-strand breaks (DSBs) caused by CRISPR-Cas9 cleavage, genomic damage, such as large deletions, may have pathogenic consequences. RESULTS: We show that large deletions are ubiquitous but are dependent on editing sites and cell types. Human primary T cells display more significant deletions than hematopoietic stem and progenitor cells (HSPCs), whereas we observe low levels in induced pluripotent stem cells (iPSCs). We find that the homology-directed repair (HDR) with single-stranded oligodeoxynucleotides (ssODNs) carrying short homology reduces the deletion damage by almost half, while adeno-associated virus (AAV) donors with long homology reduce large deletions by approximately 80%. In the absence of HDR, the insertion of a short double-stranded ODN by NHEJ reduces deletion indexes by about 60%. CONCLUSIONS: Timely bridging of broken ends by HDR and NHEJ vastly decreases the unintended consequences of dsDNA cleavage. These strategies can be harnessed in gene editing applications to attenuate unintended outcomes.

8.
Pathogens ; 10(7)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34357979

RESUMO

Noroviruses (NoVs) are a leading cause of acute gastroenteritis worldwide. P particles are a potential vaccine candidate against NoV. Simvastatin is a cholesterol-reducing drug that is known to increase NoV infectivity. In this study, we examined simvastatin's effects on P particle-induced protective efficacy and T-cell immunogenicity using the gnotobiotic pig model of human NoV infection and diarrhea. Pigs were intranasally inoculated with three doses (100 µg/dose) of GII.4/VA387-derived P particles together with monophosphoryl lipid A and chitosan adjuvants. Simvastatin-fed pigs received 8 mg/day orally for 11 days prior to challenge. A subset of pigs was orally challenged with 10 ID50 of a NoV GII.4/2006b variant at post-inoculation day (PID) 28 and monitored for 7 days post-challenge. Intestinal and systemic T cell responses were determined pre- and postchallenge. Simvastatin abolished the P particle's protection and significantly increased diarrhea severity after NoV infection. Simvastatin decreased proliferation of virus-specific and non-specific CD8 T cells in duodenum and virus-specific CD4 and CD8 T cells in spleen and significantly reduced numbers of intestinal mononuclear cells in vaccinated pigs. Furthermore, simvastatin significantly decreased numbers of duodenal CD4+IFN-γ+, CD8+IFN-γ+ and regulatory T cells and total duodenal activated CD4+ and CD8+ T cells in vaccinated pigs pre-challenge at PID 28. Following challenge, simvastatin prevented the IFN-γ+ T cell response in spleen of vaccinated pigs. These results indicate that simvastatin abolished P particle vaccine-induced partial protection through, at least in part, impairing T cell immunity. The findings have specific implications for the development of preventive and therapeutic strategies against NoV gastroenteritis, especially for the elderly population who takes statin-type drugs.

9.
Aging (Albany NY) ; 13(14): 18442-18463, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34260414

RESUMO

Although novel drugs and treatments have been developed and improved, multiple myeloma (MM) is still recurrent and difficult to cure. In the present study, the magenta module containing 400 hub genes was determined from the training dataset of GSE24080 through weighted gene co-expression network analysis (WGCNA). Then, using the least absolute shrinkage and selection operator (Lasso) analysis, a fifteen-gene signature was firstly selected and the predictive performance for overall survival (OS) was favorable, which was identified by Receiver Operating Characteristic (ROC) curves. The risk score model was constructed based on survival-associated fifteen genes from the Lasso model, which classified MM patients into high-risk and low-risk groups. Areas under the curve (AUC) of ROC curve and log-rank test showed that the high-risk group was correlated to the dismal survival outcome of MM patients, which was also identified in testing dataset of GSE9782. The calibration plot, the AUC value of the ROC curve and Concordance-index showed that the interactive nomogram with risk score could favorably predict the probability of multi-year OS of MM patients. Therefore, it may help clinicians make a precise therapeutic decision based on the easy-to-use tool of the nomogram.

10.
Anesth Analg ; 133(2): 340-348, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34257195

RESUMO

BACKGROUND: Medicaid expansions under the Affordable Care Act have increased insurance coverage and prenatal care utilization in low-income women. However, it is not clear whether they are associated with any measurable improvement in maternal health outcomes. In this study, we compared the changes in the incidence of severe maternal morbidity (SMM) during delivery hospitalizations between low- and high-income women associated with the 2014 Medicaid expansion in New York State. METHODS: Data for this retrospective cohort study came from the 2006-2016 New York State Inpatient Database, a census of discharge records from community hospitals. The outcome was SMM during delivery hospitalizations, as defined by the Centers for Disease Control and Prevention. We used regression coefficients (ß) from multivariable logistic models: (1) to compare independently in low-income women and in high-income women the changes in slopes in the incidence of SMM before (2006-2013) and after (2014-2016) the expansion, and (2) to compare low- and high-income women for the changes in slopes in the incidence of SMM before and after the expansion. RESULTS: A total of 2,286,975 delivery hospitalizations were analyzed. The proportion of Medicaid beneficiaries in parturients increased a relative 12.1% (95% confidence interval [CI], 11.8-12.4), from 42.9% in the preexpansion period to 48.1% in the postexpansion period, whereas the proportion of the uninsured decreased a relative 4.8% (95% CI, 2.8-6.8). Multivariable logistic modeling revealed that implementation of the 2014 Medicaid expansion was associated with a decreased slope during the postexpansion period both in low-income women (ß = -0.0161 or 1.6% decrease; 95% CI, -0.0190 to -0.0132) and in high-income women (ß = -0.0111 or 1.1% decrease; 95% CI, -0.0130 to -0.0091). The decrease in slope during the postexpansion period was greater in low- than in high-income women (ß = -0.0042 or 0.42% difference; 95% CI, -0.0076 to -0.0007). CONCLUSIONS: Implementation of the Medicaid expansion in 2014 in New York State is associated with a small but statistically significant reduction in the incidence of SMM in low-income women compared with high-income women.


Assuntos
Parto Obstétrico/efeitos adversos , Hospitalização , Serviços de Saúde Materna , Medicaid , Patient Protection and Affordable Care Act , Complicações na Gravidez/epidemiologia , Parto Obstétrico/mortalidade , Feminino , Humanos , Incidência , Renda , New York/epidemiologia , Gravidez , Complicações na Gravidez/mortalidade , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/terapia , Fatores Raciais , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologia
11.
Viruses ; 13(7)2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209472

RESUMO

West Nile virus disease (WND) is an arthropod-borne zoonosis responsible for nonspecific fever or severe encephalitis. The pathogen is West Nile virus belonging to the genus Flavivirus, family Flaviviridae. Every year, thousands of cases were reported, which poses significant public health risk. Here, we constructed a West Nile virus chimera, ChiVax-WN01, by replacing the prMΔE gene of JEV SA14-14-2 with that of the West Nile virus NY99. The ChiVax-WN01 chimera showed clear, different characters compared with that of JEV SA14-14-2 and WNV NY99 strain. An animal study indicated that the ChiVax-WN01 chimera presented moderate safety and immunogenicity for 4-week female BALB/c mice.

12.
Disaster Med Public Health Prep ; : 1-8, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34096486

RESUMO

OBJECTIVE: The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions. METHODS: An online survey was administered to physicians licensed in New York State. RESULTS: Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87). CONCLUSION: Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.

13.
Bull Entomol Res ; 111(5): 579-584, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33998423

RESUMO

Temperature is one of the main factors affecting insect growth, development and reproduction. The effects of temperatures (10, 15, 20, 25 and 30°C) on the development and reproduction of Cinara cedri Mimeur (Hemiptera: Aphidoidea: Lachnidae) fed on Cedrus deodara (Roxb.) G. Don were evaluated in this study. With the increase of temperature from 10 to 30°C, the development duration at different development stages gradually shortened. There was a significant positive correlation between the developmental rates and temperature, following a quadratic regression model. The lower developmental threshold temperature (C) and effective accumulated temperatures (K) for completing a generation were 4.13°C and 263.4 degree-days, respectively. The highest fecundity was observed at 20°C with 25.74 first-instar nymphs/female. Both the highest intrinsic rate of increase (r, 0.11 ± 0.03) and net reproduction rate (R0, 19.06 ± 2.05) were observed at 20°C, whereas the lowest values of r (0.05 ± 0.01) at 10°C and R0 (5.78 ± 0.88) at 30°C were observed. The results suggest that temperature significantly affects the biology of C. cedri and the optimal temperature for its development is 20°C.


Assuntos
Hemípteros/crescimento & desenvolvimento , Temperatura , Animais , Cedrus , Fertilidade/fisiologia , Hemípteros/fisiologia , Estágios do Ciclo de Vida
14.
J Autism Dev Disord ; 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33983521

RESUMO

Recent research indicates that children with autism are at increased risk of maltreatment. We examined news media reports on homicide incidents involving children with autism as victims in the United States between 2000 and 2019. Of the 52 victims studied, 47 (90.4%) were male. Age of victims ranged from 2 to 20 years (mean = 10.4 ± 5.3 years). Parents and other caregivers accounted for 63.5% and 13.5% of the perpetrators, respectively. The leading injury mechanism was gunshot wounds (23.1%), followed by drowning (19.2%), and suffocation, strangulation, or asphyxiation (19.2%). The most commonly cited contributing factor (47.1%) was overwhelming stress from caring for the autistic child. These results underscore the importance of supporting services for caregivers of children with autism.

15.
J Exp Clin Cancer Res ; 40(1): 174, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34011395

RESUMO

Although new developments of surgery, chemotherapy, radiotherapy, and immunotherapy treatments for cancer have improved patient survival, the emergence of chemoresistance in cancer has significant impacts on treatment effects. The development of chemoresistance involves several polygenic, progressive mechanisms at the molecular and cellular levels, as well as both genetic and epigenetic heterogeneities. Chemotherapeutics induce epigenetic reprogramming in cancer cells, converting a transient transcriptional state into a stably resistant one. Super-enhancers (SEs) are central to the maintenance of identity of cancer cells and promote SE-driven-oncogenic transcriptions to which cancer cells become highly addicted. This dependence on SE-driven transcription to maintain chemoresistance offers an Achilles' heel for chemoresistance. Indeed, the inhibition of SE components dampens oncogenic transcription and inhibits tumor growth to ultimately achieve combined sensitization and reverse the effects of drug resistance. No reviews have been published on SE-related mechanisms in the cancer chemoresistance. In this review, we investigated the structure, function, and regulation of chemoresistance-related SEs and their contributions to the chemotherapy via regulation of the formation of cancer stem cells, cellular plasticity, the microenvironment, genes associated with chemoresistance, noncoding RNAs, and tumor immunity. The discovery of these mechanisms may aid in the development of new drugs to improve the sensitivity and specificity of cancer cells to chemotherapy drugs.

16.
Am J Prev Med ; 61(1): 105-114, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34020849

RESUMO

INTRODUCTION: Fall fatality rates among U.S. older adults increased 30% from 2007 to 2016. In response, the Centers for Disease Control and Prevention developed the Stopping Elderly Accidents, Deaths, and Injuries algorithm for fall risk screening, assessment, and intervention. The current Stopping Elderly Accidents, Deaths, and Injuries algorithm with 2 levels (at risk and not at risk) was adapted to an existing cohort of older adult drivers. METHODS: A U.S. multisite prospective cohort (N=2,990) of drivers (aged 65-79 years), from 2015 to 2017, was used for these analyses completed in January 2020-October 2020. To measure the adapted Stopping Elderly Accidents, Deaths, and Injuries key questions for fall risk screening performance in predicting future falls, adjusted logistic regression determined the area of the receiver operating characteristic curve. An adjusted mixed logistic regression modeled the association between the adapted Stopping Elderly Accidents, Deaths, and Injuries key questions and future falls. RESULTS: The adapted Stopping Elderly Accidents, Deaths, and Injuries key questions yielded an area under the curve of 0.65 in determining any fall over 2 years. The adjusted mixed logistic regression model suggests that those at risk for falls at baseline were associated with 2.37 times higher odds of any fall (95% CI=2.00, 2.80) and 3.60 times higher odds of multiple falls (95% CI=2.88, 4.51) over 2 years. CONCLUSIONS: The adapted Stopping Elderly Accidents, Deaths, and Injuries key questions for fall risk screening yielded fair predictive ability for falls over 2 years and were strongly associated with future falls for older adult drivers. The adapted Stopping Elderly Accidents, Deaths, and Injuries key questions can be applied to existing data in nonclinical settings to strengthen fall screening and prevention at a population level.


Assuntos
Acidentes por Quedas , Programas de Rastreamento , Acidentes por Quedas/prevenção & controle , Idoso , Algoritmos , Humanos , Modelos Logísticos , Estudos Prospectivos , Medição de Risco , Fatores de Risco
17.
Clin Lab ; 67(5)2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33978379

RESUMO

BACKGROUND: Respiratory syncytial virus and adenovirus are seasonal diseases that cause an enormous burden on health systems. Previously, our lab uses DHI D3-Ultra DFA for detecting antigen of respiratory syncytial virus (RSV) and adenovirus (ADV). This article will evaluate the performance of AutoLumo RSV-IgM and ADV-IgM assays compared to D3-Ultra DFA method. METHODS: We used quality control specimens to evaluate precision, cross-reactivity specimen to evaluate the specificity, exogenous interferent: Hb (1,000 mg/dL); total bilirubin (50 mg/dL), ANA titer (1:10,000), RF (500 IU/mL) to evaluate interference, and paired, nasopharyngeal swab and sera specimens to evaluate clinical sensitivity and specificity. RESULTS: AutoLumo RSV-IgM and ADV-IgM assay show good precision and no cross-reactivity with other pathogen-specific IgM antibodies; no hook effect; exogenous interferent substance: Hb < 1,000 mg/dL; total bilirubin < 50 mg/dL, ANA titer < 1:10,000, and RF < 500 IU/mL showed no interference to RSV-IgM and ADV-IgM antibodies. The paired comparison test showed that RSV-IgM and ADV-IgM appear partly on the fifth day of the disease and peaked on days six to fourteen. CONCLUSIONS: AutoLumo RSV-IgM and ADV-IgM have good performance, but their sensitivities await further improvements.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Adenoviridae , Humanos , Imunoensaio , Imunoglobulina M , Lactente , Infecções por Vírus Respiratório Sincicial/diagnóstico , Sensibilidade e Especificidade
18.
J Ethnopharmacol ; 277: 114245, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34052351

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: "Mutong" ( in Chinese, and generally known as Akebiae Caulis), which refers to a group of herbal medicines with different biological origins along history, has been used in traditional Chinese medicine for over 2000 years; it is still being frequently used in medicine. In recent decades, Akebiae Caulis has been reported to exhibit apparent toxicity. AIM OF THIS STUDY: To clarify the plant species used as Akebiae Caulis and its synonyms, and to summarize their phytochemistry, pharmacology, and toxicology. METHODS: Academic search engines (Google Scholar, Baidu Scholar, CNKI, Science Direct, Springer Link, SciFinder, PubMed, Web of Science, and EBSCO), ancient Chinese herbals, and modern medical monographs were used to obtain phytochemical, pharmacological, toxicological, and quality control information. Furthermore, a field survey was conducted to clarify the associated species. RESULTS: Akebiae Caulis is derived from eight species belonging to two families. In the 2005 Pharmacopoeia of The People's Republic of China, it has been separated into two categories: Akebiae Caulis and Clematidis Armandii Caulis. Traditionally, Akebiae Caulis has been used to treat conditions such as gonorrhea, edema, and tongue sores. Pharmacological studies have demonstrated the anti-inflammatory, antitumor, antihypertensive, antibacterial, analgesic, and other properties of Akebiae Caulis. Among the species used, Aristolochiae manshuriensis Kom. (Aristolochiaceae) contains aristolochic acid that has raised concerns globally because of its nephrotoxicity. CONCLUSIONS: Clarifying the biological origin of traditional herbal medicines is critical for their safe and effective use. The present review revealed that the biological origin of Akebiae Caulis is diverse. The traditional uses, phytochemistry, and pharmacology of Akebiae Caulis indicate that it is a useful medical resource. The diversity of its biological and pharmacological activities is associated with the presence of a large number of chemical substances, among which terpenoids are predominant. Systematic reviews on Akebiae Caulis such as this one would provide solid references for its safe use, as well as drug discovery studies in the future.

19.
Eur Heart J ; 42(34): 3349-3357, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-33822910

RESUMO

AIMS: Observational studies have suggested strong associations between sleep duration and many cardiovascular diseases (CVDs), but causal inferences have not been confirmed. We aimed to determine the causal associations between genetically predicted sleep duration and 12 CVDs using both linear and nonlinear Mendelian randomization (MR) designs. METHODS AND RESULTS: Genetic variants associated with continuous, short (≤6 h) and long (≥9 h) sleep durations were used to examine the causal associations with 12 CVDs among 404 044 UK Biobank participants of White British ancestry. Linear MR analyses showed that genetically predicted sleep duration was negatively associated with arterial hypertension, atrial fibrillation, pulmonary embolism, and chronic ischaemic heart disease after correcting for multiple tests (P < 0.001). Nonlinear MR analyses demonstrated nonlinearity (L-shaped associations) between genetically predicted sleep duration and four CVDs, including arterial hypertension, chronic ischaemic heart disease, coronary artery disease, and myocardial infarction. Complementary analyses provided confirmative evidence of the adverse effects of genetically predicted short sleep duration on the risks of 5 out of the 12 CVDs, including arterial hypertension, pulmonary embolism, coronary artery disease, myocardial infarction, and chronic ischaemic heart disease (P < 0.001), and suggestive evidence for atrial fibrillation (P < 0.05). However, genetically predicted long sleep duration was not associated with any CVD. CONCLUSION: This study suggests that genetically predicted short sleep duration is a potential causal risk factor of several CVDs, while genetically predicted long sleep duration is unlikely to be a causal risk factor for most CVDs.


Assuntos
Doenças Cardiovasculares , Análise da Randomização Mendeliana , Bancos de Espécimes Biológicos , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/genética , Estudo de Associação Genômica Ampla , Humanos , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco , Sono , Reino Unido/epidemiologia
20.
Obstet Gynecol ; 137(5): 791-800, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33831938

RESUMO

OBJECTIVE: To analyze racial and ethnic disparities in failure to rescue (ie, death) associated with severe maternal morbidity and describe temporal trends. METHODS: This was a retrospective cohort study using administrative data. Data for delivery hospitalizations with severe maternal morbidity, as defined by the Centers for Disease Control and Prevention, were abstracted from the 1999-2017 National Inpatient Sample. Race and ethnicity were categorized into non-Hispanic White (reference), non-Hispanic Black, Hispanic, other, and missing. The outcome was failure to rescue from severe maternal morbidity. Disparities were assessed using the failure-to-rescue rate ratio (ratio of the failure-to-rescue rate in the racial and minority group to the failure-to-rescue rate in White women), adjusted for patient and hospital characteristics. Temporal trends in severe maternal morbidity and failure to rescue were assessed. RESULTS: During the study period, 73,934,559 delivery hospitalizations were identified, including 993,864 with severe maternal morbidity (13.4/1,000; 95% CI 13.3-13.5). Among women with severe maternal morbidity, 4,328 died (4.3/1,000; 95% CI 4.2-4.5). The adjusted failure-to-rescue rate ratio was 1.79 (95% CI 1.77-1.81) for Black women, 1.39 (95% CI 1.37-1.41) for women of other race and ethnicity, 1.43 (95% CI 1.42-1.45) for women with missing race and ethnicity data, and 1.08 (95% CI 1.06-1.09) for Hispanic women. During the study period, the severe maternal morbidity rate increased significantly in each of the five racial and ethnic groups but started declining in 2012. Meanwhile, the failure-to-rescue rate decreased significantly during the entire study period. CONCLUSION: Despite improvement over time, failure to rescue from severe maternal morbidity remains a major contributing factor to excess maternal mortality in racial and ethnic minority women.


Assuntos
Disparidades em Assistência à Saúde , Morte Materna/estatística & dados numéricos , Complicações na Gravidez/mortalidade , Adulto , Estudos de Coortes , Grupos Étnicos , Feminino , Humanos , Morte Materna/etnologia , Serviços de Saúde Materna , Gravidez , Complicações na Gravidez/etnologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
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