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1.
Proc Biol Sci ; 288(1944): 20202631, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33563122

RESUMO

Ecologists have long theorized that apex predators stabilize trophic systems by exerting a net protective effect on the basal resource of a food web. Although experimental and observational studies have borne this out, it is not always clear what behavioural mechanisms among the trophically connected species are responsible for this stability. Fear of intraguild predation is commonly identified as one such mechanism in models and mesocosm studies, but empirical evidence in natural systems remains limited, as the complexity of many trophic systems renders detailed behavioural studies of species interactions challenging. Here, we combine long-term field observations of a trophic system in nature with experimental behavioural studies of how all the species in this system interact, in both pairs and groups. The results demonstrate how an abundant, sessile and palatable prey item (sea turtle eggs, Chelonia mydas) survives when faced by three potential predators that all readily eat eggs: an apex predator (the stink ratsnake, Elaphe carinata) and two mesopredators (the brown rat, Rattus norvegicus, and kukri snake, Oligodon formosanus). Our results detail how fear of intraguild predation, conspecific cannibalism, habitat structure and territorial behaviour among these species interact in a complex fashion that results in high egg survival.

2.
PLoS One ; 16(2): e0247009, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33577597

RESUMO

Dehydration and hypersalinity challenge non-marine organisms crossing the ocean. The rate of water loss and saltwater tolerance thus determine the ability to disperse over sea and further influence species distribution. Surprisingly, this association between physiology and ecology is rarely investigated in terrestrial vertebrates. Here we conducted immersion experiments to individuals and eggs of six lizard species differently distributed across Taiwan and the adjacent islands to understand if the physiological responses reflect the geographical distribution. We found that Plestiodon elegans had the highest rate of water loss and the lowest saltwater tolerance, whereas Eutropis longicaudata and E. multifasciata showed the lowest rate of water loss and the highest saltwater tolerance. Diploderma swinhonis, Hemidactylus frenatus, and Anolis sagrei had medium measurements. For the eggs, only the rigid-shelled eggs of H. frenatus were incubated successfully after treatments. While, the parchment-shelled eggs of E. longicaudata and D. swinhonis lost or gained water dramatically in the immersions without any successful incubation. Combined with the historical geology of the islands and the origin areas of each species, the inferences of the results largely explain the current distribution of these lizards across Taiwan and the adjacent islands, pioneerly showing the association between physiological capability and species distribution.

3.
Med Sci Monit ; 27: e927624, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33436534

RESUMO

BACKGROUND Traditional Chinese medicine has widely used Bolbostemma paniculatum to treat diseases, including cancer, but its underlying mechanisms remain unclear. The present study aimed to elucidate the potential pharmacological mechanisms of "Tu Bei Mu" (TBM), the Chinese name for Bolbostemmatis Rhizoma, the dry tuber of B. paniculatum, for the treatment of hepatocellular carcinoma (HCC). MATERIAL AND METHODS The active components and putative therapeutic targets of TBM were explored using SwissTargetPrediction, Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and Search Tool for Interactions of Chemicals (STITCH). The HCC-related target database was built using DrugBank, DisGeNet, Online Mendelian Inheritance in Man (OMIM), and Therapeutic Target Database (TTD). A protein-protein interaction network of the common targets was constructed, based on the matches between TBM potential targets and HCC-related targets, using Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of the cluster networks were used to elucidate the biological functions of TBM. RESULTS Pharmacological network diagrams of the TBM compound-target network and HCC-related target network were successfully constructed. A total of 22 active components, 191 predicted biological targets of TBM, and 3775 HCC-related targets were identified. Through construction of an HCC-related target database and a protein-protein interaction network of the common targets, TBM was predicted to be effective in treating HCC mainly through the PI3K-Akt, HIF-1, p53, and PPAR signaling pathways. CONCLUSIONS The PI3K/Akt, HIF1, p53, and PPAR pathways may play vital roles in TBM treatment of HCC. Also, the potential anti-cancer effect of TBM on HCC appears to stem from the synergetic effect of multiple targets and mechanisms.

4.
PLoS One ; 15(12): e0243159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33270706

RESUMO

A parental selection approach based on genomic prediction has been developed to help plant breeders identify a set of superior parental lines from a candidate population before conducting field trials. A classical parental selection approach based on genomic prediction usually involves truncation selection, i.e., selecting the top fraction of accessions on the basis of their genomic estimated breeding values (GEBVs). However, truncation selection inevitably results in the loss of genomic diversity during the breeding process. To preserve genomic diversity, the selection of closely related accessions should be avoided during parental selection. We thus propose a new index to quantify the genomic diversity for a set of candidate accessions, and analyze two real rice (Oryza sativa L.) genome datasets to compare several selection strategies. Our results showed that the pure truncation selection strategy produced the best starting breeding value but the least genomic diversity in the base population, leading to less genetic gain. On the other hand, strategies that considered only genomic diversity resulted in greater genomic diversity but less favorable starting breeding values, leading to more genetic gain but unsatisfactorily performing recombination inbred lines (RILs) in progeny populations. Among all strategies investigated in this study, compromised strategies, which considered both GEBVs and genomic diversity, produced the best or second-best performing RILs mainly because these strategies balance the starting breeding value with the maintenance of genomic diversity.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33307643

RESUMO

BACKGROUND: Whether sirolimus-eluting stents constituted with ultrathin-strut and biodegradable polymers (BP-SESs) can achieve a preferable effect over current drug-eluting stents with durable polymers (DP-DESs) remains highly controversial. The aim of this analysis based on randomized controlled trials (RCTs) was to detect the clinical and angiographic differences between ultrathin (defined as a strut thickness <70 µm) BP-SESs and DP-DESs. METHODS/MATERIALS: We searched seven databases to identify eligible articles. Late lumen loss (LLL) and target lesion failure (TLF) were assessed as the primary endpoints for angiographic and clinical outcomes, respectively. RESULTS: Nineteen articles containing thirteen RCTs with 14801 patients were analyzed. For the 9-month angiographic outcomes, similar results were discovered between BP-SESs and DP-DESs in terms of in-stent LLL (mean difference [MD]: -0.02[-0.05, 0.01], P=0.23), in-segment LLL (MD: -0.01[-0.04, 0.03], P=0.74), in-stent minimum lumen diameter (MLD) (MD: -0.01[-0.06, 0.04], P=0.72), in-segment MLD (MD: -0.01[-0.06, 0.05], P=0.75), in-stent diameter stenosis (DS) (MD: -1.10[-3.36, 1.15], P=0.34), in-segment DS (MD: -0.78[-1.97, 0.40], P=0.20), in-stent binary restenosis (BR) (risk ratio [RR]: 2.27[0.99, 5.21], P=0.05) and in-segment BR (RR: 1.46[0.78, 2.75], P=0.24). Regarding the 12-month clinical outcomes, there was a significant decrease in TLF and a trend of a lower incidence of target vessel failure (RR: 0.89[0.78,1.01], P=0.08), myocardial infarction (MI) and target vessel MI. CONCLUSIONS: With similar angiographic results, BP-SESs appeared to be superior to DP-DESs with better clinical prognoses, especially for female patients, patients with STEMI and ACS and patients without diabetes. More high-quality randomized controlled trials are needed to confirm these results.

6.
PLoS One ; 15(11): e0241829, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166360

RESUMO

The dragline silk of spiders is of particular interest to science due to its unique properties that make it an exceptional biomaterial that has both high tensile strength and elasticity. To improve these natural fibers, researchers have begun to try infusing metals and carbon nanomaterials to improve mechanical properties of spider silk. The objective of this study was to incorporate carbon nanomaterials into the silk of an orb-weaving spider, Nephila pilipes, by feeding them solutions containing graphene and carbon nanotubes. Spiders were collected from the field and in the lab were fed solutions by pipette containing either graphene sheets or nanotubes. Major ampullate silk was collected and a tensile tester was used to determine mechanical properties for pre- and post-treatment samples. Raman spectroscopy was then used to test for the presence of nanomaterials in silk samples. There was no apparent incorporation of carbon nanomaterials in the silk fibers that could be detected with Raman spectroscopy and there were no significant improvements in mechanical properties. This study represents an example for the importance of attempting to replicate previously published research. Researchers should be encouraged to continue to do these types of investigations in order to build a strong consensus and solid foundation for how to go forward with these new methods for creating novel biomaterials.

7.
J Mech Behav Biomed Mater ; : 104200, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33214109

RESUMO

The disruptive nature of water presents a significant challenge when designing synthetic adhesives that maintain functionality in wet conditions. However, many animal adhesives can withstand high humidity or underwater conditions, and some are even enhanced by them. An understudied mechanism in such systems is the influence of material plasticization by water to induce adhesive work through deformation. Cribellate silk is a dry adhesive used by particular spiders to capture moving prey. It presents as a candidate for testing the water plasticization model as it can remain functional at high humidity despite lacking an aqueous component. We performed herein tensile and adhesion tests on cribellate threads from the spider, Hickmania troglodytes; a spider that lives within wet cave environments. We found that the work of adhesion of its cribellate threads increased as the axial fibre deformed during pull-off experiments. This effect was enhanced when the silk was wetted and as spider body size increased. Dry threads on the other hand were stiff with low adhesion. We rationalized our experiments by a series of scaling law models. We concluded that these cribellate threads operate best when the nanofibrils and axial fibers both contribute to adhesion. Design of future synthetic materials could draw inspiration from how water facilitates, rather than diminishes, cribellate silk adhesion.

8.
Commun Biol ; 3(1): 658, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177645

RESUMO

Bats hibernate to survive stressful conditions. Examination of whole cell and mitochondrial proteomes of the liver of Myotis ricketti revealed that torpid bats had endoplasmic reticulum unfolded protein response (UPRER), global reduction in glycolysis, enhancement of lipolysis, and selective amino acid metabolism. Compared to active bats, torpid bats had higher amounts of phosphorylated serine/threonine kinase (p-Akt) and UPRER markers such as PKR-like endoplasmic reticulum kinase (PERK) and activating transcription factor 4 (ATF4). Torpid bats also had lower amounts of the complex of Kelch-like ECH-associated protein 1 (Keap1), nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) (p65)/I-κBα. Cellular redistribution of 78 kDa glucose-regulated protein (GRP78) and reduced binding between PERK and GRP78 were also seen in torpid bats. Evidence of such was not observed in fasted, cold-treated, or normal mice. These data indicated that bats activate Akt, Nrf2, and NF-κB via the PERK-ATF4 regulatory axis against endoplasmic reticulum stresses during hibernation.

9.
Sci Total Environ ; : 142760, 2020 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-33131841

RESUMO

Microbial pollution of beach water can expose swimmers to harmful pathogens. Predictive modeling provides an alternative method for beach management that addresses several limitations associated with traditional culture-based methods of assessing water quality. Widely-used machine learning methods often suffer from high variability in performance from one year or beach to another. Therefore, the best machine learning method varies between beaches and years, making method selection difficult. This study proposes an ensemble machine learning approach referred to as model stacking that has a two-layered learning structure, where the outputs of five widely-used individual machine learning models (multiple linear regression, partial least square, sparse partial least square, random forest, and Bayesian network) are taken as input features for another model that produces the final prediction. Applying this approach to three beaches along eastern Lake Erie, New York, USA, we show that generally the model stacking approach was able to generate reliably good predictions compared to all of the five base models. The accuracy rankings of the stacking model consistently stayed 1st or 2nd every year, with yearly-average accuracy of 78%, 81%, and 82.3% at the three studied beaches, respectively. This study highlights the value of the model stacking approach in predicting beach water quality and solving other pressing environmental problems.

10.
Antibiotics (Basel) ; 9(11)2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33143219

RESUMO

It is unknown whether neonatal ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) pathogens and inappropriate initial antibiotic treatment is associated with poor outcomes after adjusting for confounders. Methods: We prospectively observed all neonates with a definite diagnosis of VAP from a tertiary level neonatal intensive care unit (NICU) in Taiwan between October 2017 and March 2020. All clinical features, therapeutic interventions, and outcomes were compared between the MDR-VAP and non-MDR-VAP groups. Multivariate regression analyses were used to investigate independent risk factors for treatment failure. Results: Of 720 neonates who were intubated for more than 2 days, 184 had a total of 245 VAP episodes. The incidence rate of neonatal VAP was 10.1 episodes/per 1000 ventilator days. Ninety-six cases (39.2%) were caused by MDR pathogens. Neonates with MDR-VAP were more likely to receive inadequate initial antibiotic therapy (51.0% versus 4.7%; p < 0.001) and had delayed resolution of clinical symptoms (38.5% versus 25.5%; p = 0.034), although final treatment outcomes were comparable with the non-MDR-VAP group. Inappropriate initial antibiotic treatment was not significantly associated with worse outcomes. The VAP-attributable mortality rate and overall mortality rate of this cohort were 3.7% and 12.0%, respectively. Independent risk factors for treatment failure included presence of concurrent bacteremia (OR 4.83; 95% CI 2.03-11.51; p < 0.001), septic shock (OR 3.06; 95% CI 1.07-8.72; p = 0.037), neonates on high-frequency oscillatory ventilator (OR 4.10; 95% CI 1.70-9.88; p = 0.002), and underlying neurological sequelae (OR 3.35; 95% CI 1.47-7.67; p = 0.004). Conclusions: MDR-VAP accounted for 39.2% of all neonatal VAP in the neonatal intensive care unit (NICU), but neither inappropriate initial antibiotics nor MDR pathogens were associated with treatment failure. Neonatal VAP with concurrent bacteremia, septic shock, and underlying neurological sequelae were independently associated with final worse outcomes.

11.
Nanoscale ; 12(42): 21879-21884, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33107539

RESUMO

The development of colloidal near-infrared quantum dot (QD) lasers has been hindered by the high state degeneracy of lead salt QDs. Here, we show that this challenge can be addressed by utilizing orthorhombic Ag2Se QDs. We demonstrate that the lowest quantized states of Ag2Se QDs display a low, 2-fold degeneracy by employing femtosecond transient absorption (TA) spectroscopy. The optical gain threshold is evaluated to be 156 µJ cm-2, corresponding to ∼1.4 excitons per QD on average. Consequently, the amplified spontaneous emission (ASE) threshold of Ag2Se QD films is as low as 183 µJ cm-2. A large modal gain (∼470 cm-1) of the film is observed by variable stripe length (VSL) measurements. We leverage the low-threshold gain of the QDs to produce microlasers that exhibit single-mode near-infrared emission and a low threshold of 163 µJ cm-2 at room temperature. In addition, the cytotoxicity of Ag2Se QDs is remarkably negligible. Our work represents a significant step toward environmental-friendly near-infrared QD lasers.

12.
Cell Metab ; 32(3): 447-456.e6, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32877690

RESUMO

Metabolism and aging are tightly connected. Alpha-ketoglutarate is a key metabolite in the tricarboxylic acid (TCA) cycle, and its levels change upon fasting, exercise, and aging. Here, we investigate the effect of alpha-ketoglutarate (delivered in the form of a calcium salt, CaAKG) on healthspan and lifespan in C57BL/6 mice. To probe the relationship between healthspan and lifespan extension in mammals, we performed a series of longitudinal, clinically relevant measurements. We find that CaAKG promotes a longer, healthier life associated with a decrease in levels of systemic inflammatory cytokines. We propose that induction of IL-10 by dietary AKG suppresses chronic inflammation, leading to health benefits. By simultaneously reducing frailty and enhancing longevity, AKG, at least in the murine model, results in a compression of morbidity.

13.
Nanomaterials (Basel) ; 10(10)2020 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-32993122

RESUMO

We demonstrate the fabrication of free-standing inverse opals with gradient pores via a combination of electrophoresis and electroplating techniques. Our processing scheme starts with the preparation of multilayer colloidal crystals by conducting sequential electrophoresis with polystyrene (PS) microspheres in different sizes (300, 600, and 1000 nm). The critical factors affecting the stacking of individual colloidal crystals are discussed and relevant electrophoresis parameters are identified so the larger PS microspheres are assembled successively atop of smaller ones in an orderly manner. In total, we construct multilayer colloidal crystals with vertical stacking of microspheres in 300/600, 300/1000, and 300/600/1000 nm sequences. The inverse opals with gradient pores are produced by galvanostatic plating of Ni, followed by the selective removal of colloidal template. Images from scanning electron microscopy exhibit ideal multilayer close-packed structures with well-defined boundaries among different layers. Results from porometer analysis reveal the size of bottlenecks consistent with those of interconnected pore channels from inverse opals of smallest PS microspheres. Mechanical properties determined by nanoindentation tests indicate significant improvements for multilayer inverse opals as compared to those of conventional single-layer inverse opals.

14.
Ann Palliat Med ; 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32954751

RESUMO

BACKGROUND: Whether necitumumab combined with platinum-based chemotherapy (NC) for treating stage IV non-small cell lung cancer (NSCLC) as a first-line treatment could enhance antitumor effectiveness compared with platinum-based chemotherapy alone (CA) treatment is still controversial. The antitumor effectiveness and toxicity of the two treatments were compared in this meta-analysis. METHODS: We searched in PubMed, ScienceDirect, Scopus, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Google Scholar to acquire applicable articles. The outcome indicators mainly included progression-free survival (PFS), overall survival (OS) and adverse effects (AEs). RESULTS: Eight articles based on 4 randomized controlled trials were obtained. The NC group had a longer PFS [95% confidence interval (CI): 0.84-0.99, P=0.03] and a higher disease control rate (DCR, 95% CI: 1.01-1.10, P=0.03) than those of the CA group. OS (95% CI: 0.85-1.01, P=0.09) and the objective response rate (ORR, 95% CI: 0.93-1.71, P=0.14) were similar in the NC and CA groups. Nevertheless, in both quantity and extent, the NC treatment had more severe skin rash, hypomagnesemia, and venous thromboembolism than those of the CA treatment. Subanalysis suggested that the advantage of OS was more obvious in the NC group than that in the CA group in patients with high epidermal growth factor receptor (EGFR) expression. CONCLUSIONS: With a longer PFS and a higher DCR, NC treatment seemed to be more suitable for treating stage IV NSCLC as first-line therapy, especially for those with high EGFR expression, but its AEs could not be ignored.

15.
Artigo em Inglês | MEDLINE | ID: mdl-32733859

RESUMO

Type 2 diabetes mellitus (T2DM) is an important public health issue worldwide. T2DM correlates with cardiovascular disease. Arterial stiffness is also a key factor that can be thought of as a surrogate marker. Nevertheless, it was unclear which harmonic indexes of blood pressure waveforms (BPWs) from subjects' radial artery pulses would be affected by T2DM. Therefore, the objective of this study was to investigate whether and how harmonic indexes can be used to discriminate hemodynamic differences between patients with T2DM and non-T2DM. This helps us to build objective results no matter who conducts the examination instead of pulse diagnosis in traditional way. We enrolled T2DM and non-T2DM patients as experimental and control groups, respectively, from the Department of Family Medicine in the National Taiwan University Hospital and the Department of Internal Medicine in Taipei's Veterans General Hospital from December 2017 to January 2019. ANSWatch® Model TS-0411 was used to capture the BPWs. Amplitude proportions (Cn values) were calculated from harmonics 1-10 of the BPW using fast Fourier transform. Thirty-two T2DM and 15 non-T2DM patients were enrolled. T2DM patients had significant differences in C1 (p = 0.031) and C5 (p = 0.041). The study suggests that analyzing the harmonic characteristics of non-invasively measured BPW of radial artery may be a potential and easy-to-perform approach to discriminate T2DM-induced hemodynamic changes.

16.
Surg Today ; 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32833059

RESUMO

The complications caused by early closure (EC) or late closure (LC) after temporary ileostomy in rectal cancer patients have not been compared systematically. We conducted this meta-analysis to explore the details surrounding this issue, based on a search of PubMed, ScienceDirect, Scopus, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Google Scholar. The comparative indices included total complications, severe complications, and various individual complications before or after closure. Four randomized-controlled trials (RCTs), including the EASY trial, were analyzed, involving a collective total of 324 patients. EC tended to result in more postoperative complications than LC for rectal cancer patients with temporary ileostomy. This difference was mainly embodied in wound complications. Nevertheless, LC resulted in more complications than EC before closure, such as leakage outside the appliance bag and skin irritation. There was no obvious difference in severe postoperative complications or medical complications. With fewer overall and wound-related complications, LC tended to be more suitable than EC for rectal cancer patients with a temporary ileostomy; however, the complications before closure should also be considered.

17.
PLoS Comput Biol ; 16(8): e1008135, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810127

RESUMO

Social interaction between microbes can be described at many levels of details: from the biochemistry of cell-cell interactions to the ecological dynamics of populations. Choosing an appropriate level to model microbial communities without losing generality remains a challenge. Here we show that modeling cross-feeding interactions at an intermediate level between genome-scale metabolic models of individual species and consumer-resource models of ecosystems is suitable to experimental data. We applied our modeling framework to three published examples of multi-strain Escherichia coli communities with increasing complexity: uni-, bi-, and multi-directional cross-feeding of either substitutable metabolic byproducts or essential nutrients. The intermediate-scale model accurately fit empirical data and quantified metabolic exchange rates that are hard to measure experimentally, even for a complex community of 14 amino acid auxotrophies. By studying the conditions of species coexistence, the ecological outcomes of cross-feeding interactions, and each community's robustness to perturbations, we extracted new quantitative insights from these three published experimental datasets. Our analysis provides a foundation to quantify cross-feeding interactions from experimental data, and highlights the importance of metabolic exchanges in the dynamics and stability of microbial communities.


Assuntos
Microbiota , Bactérias/classificação , Bactérias/metabolismo , Modelos Biológicos
18.
Food Sci Nutr ; 8(7): 3525-3534, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32724615

RESUMO

Lactobacillus plantarum TWK10 (LP10) is a probiotic known to improve endurance exercise performance. Here, we analyze the proteomics and metagenomic changes in a LP10 supplemented mouse model. Male ICR mice were divided into two groups (n = 8) to receive by oral gavage either vehicle or of LP10 for 6 weeks. Proteins changes by LP10 treatment were subjected to the Ingenuity Pathway Analysis (IPA) to provide corroborative evidence for differential regulation of molecular and cellular functions affecting metabolic processes. Fecal samples were obtained from each mouse, and the microbial community profile analyzed by pyrosequencing of the 16S rRNA genes. Of the 880 identified proteins, 25 proteins were significantly downregulated and 44 proteins were significantly upregulated in the LP10 treated compared to vehicle group. LP10 supplementation shift in the gut microbiota to butyrate-producing members and provided from lipid oxidation since peroxisomal fatty acid oxidation in liver.

19.
Medicine (Baltimore) ; 99(28): e21057, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664119

RESUMO

Spontaneous subarachnoid hemorrhage (SAH) is a catastrophic event with high disability and fatality rates. Post-SAH survivors may require prolonged intubation with the assistance of mechanical ventilators, and some patients will undergo tracheostomy to facilitate their pulmonary hygiene and airway protection. The aim of this study is to identify the incidence and risk factors of the need for tracheostomy after spontaneous SAH. We used a retrospective approach and enrolled 838 adult patients with a primary diagnosis of spontaneous SAH who survived >7 days after hospitalization. Medical information was retrieved from the administrative database utilizing diagnostic and procedure codes by the International Classification of Diseases, Ninth Revision, Clinical Modification. Patients with first-ever SAH included 329 men and 509 women, and their average age was 56.9 ±â€Š14.4 years, ranging between 18 and 91 years. Fifty-eight of these 838 patients underwent tracheostomy procedures, and the overall incidence was 6.9%. In a multivariate logistic regression model, the independent risk factors of the need for tracheostomy were underlying diabetes mellitus (P = .02), hydrocephalus (P < .01), and pneumonia (P < .01). The mean duration of hospital stay was 26.0 ±â€Š15.3 and 16.8 ±â€Š12.2 days for patients with and without a tracheostomy, respectively (P < .01). In conclusion, a significant percentage of post-SAH survivors underwent tracheostomy during acute hospitalization. Attention to independent risk factors, including preexisting diabetes mellitus, concomitant hydrocephalus, and nosocomial pneumonia, is essential for timely patient selection for tracheostomy.


Assuntos
Hemorragia Subaracnóidea/cirurgia , Traqueostomia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
20.
ACS Appl Mater Interfaces ; 12(32): 36137-36147, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32667178

RESUMO

Developing next-generation battery chemistries that move beyond traditional Li-ion systems is critical to enabling transformative advances in electrified transportation and grid-level energy storage. In this work, we provide the first evidence for common descriptors for improved reversibility of metal plating/stripping in nonaqueous electrolytes for multivalent ion batteries. Focusing first on the specific role of chloride (Cl-) in promoting electrochemical reversibility in multivalent systems, rotating disk (RDE) and ring-disk electrode (RRDE) investigations were performed utilizing a variety of divalent cations (Mg2+, Zn2+, and Cu2+) and the bis-(trifluoromethane sulfonyl) imide (TFSI-) anion. By introducing varying concentrations of Cl-, a cooperative effect is observed between TFSI- and Cl- that yields the more reversible behavior of mixed electrolytes relative to electrolytes containing only TFSI-. This effect is shown to be general for Mg, Zn, and Cu electrodeposition, and mechanistic understanding of the role of Cl- in improving reversibility of TFSI-based electrolytes is obtained through the combination of R(R)DE experimental results and density functional theory (DFT) evaluation of the redox activity and thermodynamic stability of various TFSI- and Cl-based solution complexes of metal ions. The cooperative anion effect is further generalized to other mixed-anion systems, where systematic variations in anion association strength predicted from DFT (i.e., Cl- > OTf- ≈ TFSI- > BF4- > PF6-) yield corresponding trends in redox potentials and improvements of ≥200 mV in the reversibility of metal deposition/dissolution. These results identify anion association strength as a common descriptor for the reversibility of divalent metal anodes and suggest a set of general design principles for developing new electrolytes with improved activity and stability.

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