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1.
ACS Appl Mater Interfaces ; 13(42): 50236-50245, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34636532

RESUMO

Catalytic cascades have drawn much attention by avoiding the isolation of intermediates and due to high atom economy. Yet, developing an efficient, one-pot biocatalytic cascade remains challenging. Combined with the selectivity of biological enzymes and tunable activity of nanozymes, we herein demonstrate an effective bio-nanozyme cascade formed by glucose oxidase (GOx) and in situ-generated nanoceria. The prepared H2O2-nanoceria complex shows strong oxidative activity for common chromogenic substrates under physiological conditions, which are the optimal reaction conditions for most biological enzymes. Interestingly, GOx not only provides H2O2 for the second step reaction but also simultaneously leads to 7.4-fold enhancement of activity. We characterized the process of in situ generation of nanoceria at pH 7.0 and how proteins boost the activity by enhancing product desorption. In addition, the proposed one-pot bio-nanozyme cascade shows high stability and analytical performance for serum glucose with a detection limit of 5 µM.

2.
Res Synth Methods ; 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34709718

RESUMO

We sought to apply natural language processing to the task of automatic risk of bias assessment in preclinical literature, which could speed the process of systematic review, provide information to guide research improvement activity, and support translation from preclinical to clinical research. We use 7840 full-text publications describing animal experiments with yes/no annotations for five risk of bias items. We implement a series of models including baselines (support vector machine, logistic regression, random forest), neural models (convolutional neural network, recurrent neural network with attention, hierarchical neural network) and models using BERT with two strategies (document chunk pooling and sentence extraction). We tune hyperparameters to obtain the highest F1 scores for each risk of bias item on the validation set and compare evaluation results on the test set to our previous regular expression approach. The F1 scores of best models on test set are 82.0% for random allocation, 81.6% for blinded assessment of outcome, 82.6% for conflict of interests, 91.4% for compliance with animal welfare regulations and 46.6% for reporting animals excluded from analysis. Our models significantly outperform regular expressions for four risk of bias items. For random allocation, blinded assessment of outcome, conflict of interests and animal exclusions, neural models achieve good performance; for animal welfare regulations, BERT model with a sentence extraction strategy works better. Convolutional neural networks are the overall best models. The tool is publicly available which may contribute to the future monitoring of risk of bias reporting for research improvement activities.

3.
Front Physiol ; 12: 731762, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630148

RESUMO

Objectives: To evaluate the effect of extreme weight loss programs on circulating metabolites and their relationship with cardiometabolic health in children with metabolic syndrome. Methods: This study was a quasi-experimental design with a pretest and post-test. Thirty children with metabolic syndrome and aged 10-17years were recruited to an extreme weight loss program (i.e., exercise combined with diet control). The primary outcomes included plasma metabolites, body composition, and cardiometabolic risk factors. A total of 324 metabolites were quantitatively detected by an ultra-performance liquid chromatography coupled to tandem mass spectrometry system, and the variable importance in the projection (VIP) value of each metabolite was calculated by the orthogonal projection to latent structures discriminant analysis. The fold change (FC) and p value of each metabolite were used to screen differential metabolites with the following values: VIP>1, p value<0.05, and |log2FC|>0.25. Pathway enrichment and correlation analyses between metabolites and cardiometabolic risk factors were also performed. Result: A large effect size was observed, presenting a weight loss of -8.9kg (Cohen's d=1.00, p<0.001), body mass index reduction of -3.3kg/m2 (Cohen's d=1.47, p<0.001), and body fat percent reduction of -4.1 (%) (Cohen's d=1.22, p<0.001) after the intervention. Similar improvements were found in total cholesterol (Cohen's d=2.65, p<0.001), triglycerides (Cohen's d=2.59, p<0.001), low-density lipoprotein cholesterol (Cohen's d=2.81, p<0.001), glucose metabolism, and blood pressure. A total of 59 metabolites were changed after the intervention (e.g., aminoacyl-tRNA biosynthesis, glycine, serine, and threonine metabolism; nitrogen metabolism, tricarboxylic acid cycle, and phenylalanine, tyrosine, and tryptophan biosynthesis). The changes in metabolites (e.g., amino acids, fatty acids, organic acids, and carnitine) were related to lipid metabolism improvement (p<0.05). Organic acids and carnitines were associated with changes in the body composition (p<0.05). Conclusion: Exercise combined with dietary control improved the body composition and cardiometabolic health in children with metabolic syndrome, and these changes may be related to plasma metabolites.

4.
Exp Cell Res ; 408(1): 112813, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34492266

RESUMO

Keloids are benign skin tumors characterized by aggressive growth. To date, there is no exact treatment because little is known about its pathological mechanism. Therefore, it is important to investigate the mechanism of its occurrence and development to identify therapeutic targets. In this study, the expression of Kindlin-2 was higher in keloid fibroblasts (KFs) than in normal skin fibroblasts (NFs). In vitro experiments showed that knocking down Kindlin-2 in KFs could promote cell apoptosis and inhibit cell proliferation, cell migration and invasion, and contractile capability. Western blot results showed that the phosphorylation of Smad3 in KFs was inhibited after knocking down Kindlin-2, inhibiting the activation of the Smad pathway. Moreover, knocking down Kindlin-2 increased the expression of Fas and FasL in KFs, which demonstrated that knocking down Kindlin-2 promoted the activation of the exogenous apoptotic pathway of KFs and then facilitated apoptosis. The above results revealed that knocking down Kindlin-2 in KFs can inhibit the activation of the Smad pathway and promote the activation of the Fas/FasL exogenous apoptosis pathway, thereby altering the cytological function of KFs. Therefore, Kindlin-2 might play an important role in the occurrence and development of keloids and could become a new target to treat keloids.


Assuntos
Movimento Celular/fisiologia , Fibroblastos/metabolismo , Queloide/metabolismo , Proteínas de Membrana/metabolismo , Proteínas de Neoplasias/metabolismo , Adulto , Proliferação de Células/fisiologia , Células Cultivadas , Matriz Extracelular/metabolismo , Proteína Ligante Fas/metabolismo , Feminino , Fibroblastos/patologia , Humanos , Queloide/patologia , Masculino , Transdução de Sinais/fisiologia , Fator de Crescimento Transformador beta1/metabolismo
5.
Zhongguo Zhong Yao Za Zhi ; 46(17): 4403-4409, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34581043

RESUMO

This study aims to explore the pharmacodynamic differences of Puerariae Lobatae Radix(PLR), Puerariae Thomsonii Radix(PTR) and their different processed products and the influences of these medical materials on the diversity of intestinal flora. The Sennae Folium-induced diarrhea model, streptozotocin(STZ)-induced diabetes model and L-nitro-arginine methyl ester(L-NAME)-induced hypertension model were used to compare the pharmacodynamic differences in anti-diarrhea, blood glucose reduction and blood pressure lowering among raw, roasted and vinegar-processed PLR and PTR. The effects of raw and processed PLR and PTR on intestinal flora diversity of rats were evaluated by 16 S rDNA high-throughput sequencing. The roasted PLR and PTR performed better in anti-diarrhea, especially the former. PLR and its processed products all presented the efficacy of reducing blood glucose, and the vinegar-processed PLR was the most outstanding. The raw PTR was not that effective in reducing blood glucose, whereas its efficacy was improved after roasting and vinegar processing. Both PLR and PTR were capable of lowering blood pressure to a certain extent, and PLR is superior to PTR in this aspect. Further, the vinegar-processed PLR showed the best effect. The diversity of intestinal flora was different among rats to which different products of PLR and PTR were administered. The roasted PLR led to the highest abundance of Lactobacillus, which was closely related to its best antidiarrheal effect. The highest abilities of vinegar-processed PLR to lower blood glucose and blood pressure were associated with the high abundance of Blautia and Prevotella_9. This study lays a foundation for elucidating the processing mechanisms of PLR and PTR and provides a basis for their further development and application.


Assuntos
Medicamentos de Ervas Chinesas , Microbioma Gastrointestinal , Pueraria , Animais , Raízes de Plantas , Ratos
6.
Front Microbiol ; 12: 626920, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34539588

RESUMO

Non-Saccharomyces yeast with ß-glucosidase activity might positively contribute to the flavor and quality of wines. The contribution of four non-Saccharomyces yeast strains Issatchenkia terricola SLY-4, Pichia kudriavzevii F2-24, P. kudriavzevii F2-16, and Metschnikowia pulcherrima HX-13 with ß-glucosidase activity to the flavor and quality of wine making was studied. Compared with those of S. cerevisiae single fermentation, the four non-Saccharomyces yeast strains could grow and consume sugar completely with longer fermentation periods, and with no significantly negative effect on chemical characteristics of wines. Moreover, they produced lower content of C6 compounds, benzene derivative, and fatty acid ethyl ester compounds and higher content of terpene, ß-ionone, higher alcohol, and acetate compounds. Different yeast strains produced different aroma compounds profiles. In general, the sensory evaluation score of adding non-Saccharomyces yeast-fermented wine was better than that of S. cerevisiae, and I. terricola SLY-4 fermentation received the highest one, followed by P. kudriavzevii F2-24, P. kudriavzevii F2-16, and M. pulcherrima HX-13 from high to low. The research results provide a theoretical basis for the breeding of non-Saccharomyces yeast and its application in wine making.

7.
Acta Pharm Sin B ; 11(9): 2819-2834, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34589399

RESUMO

Resistance to breast cancer (BCa) chemotherapy severely hampers the patient's prognosis. MicroRNAs provide a potential therapeutic prospect for BCa. In this study, the reversal function of microRNA34a (miR34a) on doxorubicin (Dox) resistance of BCa and the possible mechanism was investigated. We found that the relative level of miR34a was significantly decreased in Dox-resistant breast cancer cell MCF-7 (MCF-7/A) compared with Dox-sensitive MCF-7 cells. Transfection with miR34a significantly suppressed the invasion, migration, adhesion of MCF-7/A cells without inhibiting their growth obviously. The combination of miR34a and Dox could significantly inhibit the proliferation, migration, invasion and induce the apoptosis of MCF-7/A cells. The synergistic effect of this combination on resistant MCF-7/A cells has no obvious relation with the expressions of classical drug-resistant proteins P-GP, MRP and GST-π, while closely related with the down-regulation on TOP2A and BCRP. Moreover, we found both protein and mRNA expression of Snail were significantly up-regulated in MCF-7/A cells in comparison with MCF-7 cells. Transfection with small interfering RNA (siRNA) of Snail could inhibit the invasion, migration and adhesion of drug-resistant MCF-7/A cells, while high-expression of Snail could remarkably promote the invasion, migration and adhesion of MCF-7 cells, which might be related with regulation of N-cadherin and E-cadherin. Transfection with miR34a in MCF-7/A cells induced a decrease of Snail expression. The potential binding sites of miR34a with 3' UTR of Snail were predicted by miRDB target prediction software, which was confirmed by luciferase reporter gene method. Results showed that the relative activity of luciferase was reduced in MCF-7/A cells after co-transfection of miR34a and wild type (wt)-Snail, while did not change by co-transfection with miR34a and 3' UTR mutant type (mut) Snail. Combination of miR34a and Dox induced a stronger decrease of Snail in MCF-7/A cells in comparison to miR34a or Dox treatment alone. What' more, for the first time, we also found miR34a combined with Dox could obviously inhibit the expression of Snail through suppressing Notch/NF-κB and RAS/RAF/MEK/ERK pathway in MCF-7/A cells. In vivo study indicated that combination of miR34a and Dox significantly slowed down tumor growth in MCF-7/A nude mouse xenograft model compared with Dox alone, which was manifested by the down-regulation of Snail and pro-apoptosis effect in tumor xenografts. These results together underline the relevance of miR34a-driven regulation of Snail in drug resistance and co-administration of miR34a and Dox may produce an effective therapy outcome in the future in clinic.

8.
Artigo em Inglês | MEDLINE | ID: mdl-34559656

RESUMO

Exemplar-based portrait stylization is widely attractive and highly desired. Despite recent successes, it remains challenging, especially when considering both texture and geometric styles. In this paper, we present the first framework for one-shot 3D portrait style transfer, which can generate 3D face models with both the geometry exaggerated and the texture stylized while preserving the identity from the original content. It requires only one arbitrary style image instead of a large set of training examples for a particular style, provides geometry and texture outputs that are fully parameterized and disentangled, and enables further graphics applications with the 3D representations. The framework consists of two stages. In the first geometric style transfer stage, we use facial landmark translation to capture the coarse geometry style and guide the deformation of the dense 3D face geometry. In the second texture style transfer stage, we focus on performing style transfer on the canonical texture by adopting a differentiable renderer to optimize the texture in a multi-view framework. Experiments show that our method achieves robustly good results on different artistic styles and outperforms existing methods. We also demonstrate the advantages of our method via various 2D and 3D graphics applications.

9.
Mol Ther ; 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34563673

RESUMO

Macrophages constitute a major component in human hepatocellular carcinoma (HCC) and perform various functions to facilitate disease progression. Reprogramming or reconstituting the tumor surveillance phenotypes of macrophages represents an attractive immunotherapeutic strategy in cancer treatments. The current study identified CD169 as a potential target for macrophage repolarization since it signified a population of macrophages positively correlated with an activated immune signature and better prognosis of patients with HCC. In vitro experiments revealed that a low dose of type I interferon (IFN) could effectively reprogram human monocyte-derived macrophages to upregulate CD169 expression, and such induced CD169+ macrophages exhibited significantly enhanced phagocytotic and CD8+ T cell-activating capacities compared to controls. A low dose of IFNα also inhibited hepatoma growth in mice in vivo, presumably through polarizing the CD169+ macrophage population and enhancing CD8+ T cell activities. Notably, IFNα also induced substantial PD-L1 expression on macrophages in vivo, and thus blockade of PD-L1 could further increase the anti-tumor efficacy of IFNα in the treatment of HCC. We propose a low dose of IFNα in combination with a PD-L1 blocking agent as a potential anti-tumor therapeutic strategy via its effects on macrophage polarization.

10.
Fam Pract ; 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34423363

RESUMO

BACKGROUND: Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients' health. However, these studies are heterogeneous and the evidence is inconclusive. OBJECTIVE: To synthesize evidence from published randomized controlled trials: the interventional effects and the quality of study performance, also to identify the research gap and the directions for future studies. METHODS: We performed the scoping review by following the PRISMA-ScR guidance. We searched and examined the reports from MEDLINE, EMBASE, PsychInfo, CINAHL Plus by the pre-specified criteria. Key characteristics and information of eligible reports were extracted, analysed and synthesized comprehensively, and the results were presented in the form of words and diagrams. RESULTS: We identified 5 reports from 4 studies out of 3479 records included. Qualified studies indicated a positive effect of couple-based interventions on couples' distress. Insufficient evidence on physiological health or health behaviours was identified owing to the small number of included studies and inconsistent assessment outcomes. The methodological quality across these studies was generally low due to inadequate reporting of study process and substantial biases. CONCLUSIONS: Couple-based interventions for patients with T2DM showed small effects on the couple's distress while the effects of other outcomes were inconclusive. Future studies should strengthen methodologies by using standard measures of core diabetic outcomes, including detailed assessments of implementation process, and taking a dyadic approach to systematically examine the effects.

11.
BMC Public Health ; 21(1): 1545, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384378

RESUMO

BACKGROUNDS: This study examined the dynamic association between risk communication and the public's risk perception and action across the COVID-19 outbreak timeline in China. METHODS: This study collected publicly available information on COVID-19 released on official channels (e.g., government websites and official media) by the Parehub tool. Also, the study used the Zhongyun Big Data Platform to search public datasets about released COVID-19 information on Chinese social media, such as TikTok and Weibo. An online survey was conducted via WeChat to Chinese citizens using a snowball sampling method. The questionnaire assessed changes in participants' risk perception and action against COVID-19. The data analysis examined information content and release-time trajectories against the public's risk perception and actions over time. RESULTS: Altogether, the collected data includes 1477 pieces of authorized information and 297,000 short videos on COVID-19. Of 1362 participants recruited from 33 provinces and municipalities of China, 1311 respondents (25-60 years, 42% male) were valid for future analysis. The study indicated that 85.7% of participants mainly relied on official channels to obtain information. Alongside the outbreak's progress, there was a gradual rise in information quantity, publishing frequency, and content variation. Correspondingly, the public's risk perception that "take it seriously" rose from 13 to 80%, 87.1% of those who took "multiple actions" compared to 25.9% initially. CONCLUSIONS: Our findings indicated that insufficient information freely-accessible at the early stages of the outbreak might lead to the lack of risk awareness and the public's inadequate protective actions. Given the current global situation of COVID-19, the study highlights authorized, transparent, and timely two-way risk communication is vital to guide public perception and actions. Furthermore, our study provides risk communication recommendations and may contribute to developing full measures to address future crises.


Assuntos
COVID-19 , Mídias Sociais , China/epidemiologia , Comunicação , Feminino , Humanos , Masculino , Opinião Pública , SARS-CoV-2
12.
Lab Med ; 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34415345

RESUMO

OBJECTIVE: To reveal the relationship between anti-Golgi antibody (AGA) and clinical diseases through retrospective analysis. METHODS: The clinical data of 584 cases testing positive for AGA in the past 11 years were collected and retrospectively analyzed. RESULTS: AGA pattern accounted for .2% of positive ANA results. In total, 35.0% of diagnosed patients had autoimmune diseases (AID), mainly rheumatoid arthritis (RA). High-titer AGA (≧1:1000) was common in AID. In nondiagnosed patients with clinical symptoms, joint pain/muscle pain was the most common. CONCLUSIONS: Positive AGA with high titer was closely related to RA. Joint pain/muscle pain was the most common symptom in patients who tested AGA positive. Therefore, AGA may be a key indicator of RA in the Chinese population.

13.
BMJ Open ; 11(8): e048449, 2021 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433597

RESUMO

INTRODUCTION: In the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas. The Healthy China 2030 highlights the gate-keeping role of primary healthcare (PHC). However, the impact of PHC reforms on the future TB burden is unclear. We propose to use mathematical models to project and evaluate the impacts of different gate-keeping policies. METHODS AND ANALYSIS: We will develop a deterministic, population-level, compartmental model to capture the dynamics of TB transmission within adult rural population. The model will incorporate seven main TB statuses, and each compartment will be subdivided by service providers. The parameters involving preference for healthcare seeking will be collected using discrete choice experiment (DCE) method. We will solve the deterministic model numerically over a 20-year (2021-2040) timeframe and predict the TB prevalence, incidence and cumulative new infections under the status quo or various policy scenarios. We will also conduct an analysis following standard protocols to calculate the average cost-effectiveness for each policy scenario relative to the status quo. A numerical calibration analysis against the available published TB prevalence data will be performed using a Bayesian approach. ETHICS AND DISSEMINATION: Most of the data or parameters in the model will be obtained based on secondary data (eg, published literature and an open-access data set). The DCE survey has been reviewed and approved by the Ethics Committee of the School of Public Health, Sun Yat-sen University. The approval number is SYSU [2019]140. Results of the study will be disseminated through peer-reviewed journals, media and conference presentations.


Assuntos
Tuberculose , Adulto , Teorema de Bayes , China/epidemiologia , Reforma dos Serviços de Saúde , Humanos , Modelos Teóricos , Atenção Primária à Saúde , Tuberculose/epidemiologia , Tuberculose/prevenção & controle
14.
Nanotechnology ; 32(49)2021 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-34450604

RESUMO

Pineapple, as a world-famous tropical fruit, is also prone to produce by-products rich in cellulose. In this study, different sections of pineapple, including pineapple core (PC), pineapple pulp (PPu), pineapple leaf (PL) and pineapple peel (PPe) were used for production of pineapple cellulose nanocrystals (PCNCs) by sulfuric acid hydrolysis. The crystallinity of PCNCs from PC, PPu, PL and PPe were 57.81%, 55.68%, 59.19% and 53.58%, respectively, and the thermal stability of PCNCs in order was PC > PL > PPe > PPu. The prepared PCNCs from PC, PPu, PL and PPe were needle like structure at the average aspect ratios of 14.2, 5.6, 5.5, and 14.8, respectively. Additionally, the differences in the structure and properties of PCNCs affected the stability of the prepared Pickering emulsions, which ranked as PPu > PPe > PL > PC. The Pickering emulsions stabilized by PCNCs prepared from PPu could be stored stably for more than 50 d. These results show the differences of PCNCs from four sections of pineapple, and provide isolated raw material selection for the further application of PCNCs.

15.
Biochem Pharmacol ; 192: 114671, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246626

RESUMO

Sepsis-induced disseminated intravascular coagulation (DIC) is a common life-threatening terminal-stage disease with high mortality. This study aimed to identify effective miRNAs as therapeutic targets for DIC. Bioinformatics and luciferase reporter gene analyses were performed to predict miR-19a-3p and validate that it targets tissue factor (TF). Quantitative real-time PCR was used to detect the expression of miR-19a-3p and TF, and TF procoagulant activity was determined using the chromogenic substrate method. Western blotting was used to detect the protein levels of TF, AKT serine/threonine kinase (AKT), extracellular regulated protein kinases (ERK), nuclear factor kappa B (NF-κB) P65, NFKB inhibitor alpha (IκB-a) and their phosphorylated counterparts in cell experiments. Furthermore, a rat model was established to explore the potential of miR-19a-3p in DIC treatment. As a result, a human clinical study revealed that miR-19a-3p was downregulated and that TF was upregulated in neonates with sepsis-induced DIC compared with those in the control group. The luciferase reporter assay showed that TF was a direct target of miR-19a-3p. Cell experiments verified that the mRNA and protein levels of TF, and the p-AKT/AKT, p-Erk/Erk, p-P65/P65, p-IκB-a/IκB-a ratios, and TF procoagulant activity were significantly decreased in lipopolysaccharide (LPS) -induced human peripheral blood mononuclear cells (PBMCs) and human umbilical vein endothelial cells (HUVECs) inhibited by overexpression of miR-19a-3p, and that miR-19a-3p regulating TF was dependent on the NF-kB and AKT pathways. In vivo, miR-19a-3p injection into DIC rats suppressed the mRNA expression of TF; more importantly, significant improvements in coagulation function indicators and in histopathologies of lung and kidney were observed. In conclusion, miR-19a-3p may suppress DIC by targeting TF and might be a potential therapeutic target in treating sepsis-induced DIC.


Assuntos
Coagulação Intravascular Disseminada/metabolismo , Regulação para Baixo/fisiologia , Células Endoteliais da Veia Umbilical Humana/metabolismo , MicroRNAs/biossíntese , Sepse/metabolismo , Tromboplastina/metabolismo , Animais , Células Cultivadas , Coagulação Intravascular Disseminada/induzido quimicamente , Regulação para Baixo/efeitos dos fármacos , Feminino , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Recém-Nascido , Lipopolissacarídeos/toxicidade , Masculino , Ratos , Ratos Sprague-Dawley , Sepse/induzido quimicamente , Tromboplastina/antagonistas & inibidores
16.
Ann Palliat Med ; 10(7): 8232-8241, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34263643

RESUMO

BACKGROUND: The aim of this review was to explore the quality assessment checklists development methods in previous researches using standardized patients (SPs), as well as to propose an evidence-based checklist development procedure for quality assessment of common conditions in primary health care (PHC) settings. METHODS: We conducted a systematic review of studies that described checklist development method and extracted the methodology in terms of the developer, the basis and processes. Based on that, we formulated the development procedure according to the recommendations of the WHO Handbook for Guideline Development. RESULTS: We identified a total of 13 articles, and proposed the following five key steps: (I) forming a multidisciplinary team; (II) selecting and evaluating relevant references; (III) extracting medical information and forming the basic items; (IV) clinical expert consensus on the items; and (V) pre-testing the item pool and determining final items. DISCUSSION: SP has been proven to be an effective method to assess performance in practice. There are still some deficiencies in the developing of case-specific checklists using SPs. To ensure the validity and reliability of checklists, the development processes need to be more standardized and procedural.


Assuntos
Lista de Checagem , Atenção Primária à Saúde , Humanos , Reprodutibilidade dos Testes
17.
BMC Geriatr ; 21(1): 438, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301190

RESUMO

BACKGROUND: Family-centered care, as a contemporary model of health service delivery, involves a mutually beneficial partnership between healthcare providers, patients and their families. Although evidence on the positive effects of family-centered care on older adults and their families is accumulating, less is known about the providers' beliefs, attitudes and practices related to family-centeredness, especially regarding community-based primary healthcare services for the rapidly-ageing Chinese population. METHODS: This study investigated Chinese primary care providers' perceptions and experiences of family-centered care for older adults, using community-based diabetes management services as an example. Ten focus-group interviews involving 48 community health professionals were conducted. Major themes were identified using thematic analysis. RESULTS: The interviews revealed that the providers acknowledged the importance of the family in older patients' diabetes management, while their current scope of practice with the patients' families was limited and informal. The barriers to implementing family-centered care were attributed to structural and environmental obstacles associated with the patients' families and the community healthcare context and culture. To engage patients' families more effectively, the providers suggested that family-centered values endorsed by their healthcare organizations and reinforced by policies, a trained interdisciplinary team of health professionals and community social workers, and also that the utilization of technology would be beneficial. CONCLUSIONS: Our study extends the evidence of family-centered care for older adults in Chinese community-based healthcare settings, contributing to the design of a tailored healthcare delivery model embodying ageing in place.


Assuntos
Diabetes Mellitus , Vida Independente , Idoso , China/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Pessoal de Saúde , Humanos , Assistência Centrada no Paciente , Percepção , Atenção Primária à Saúde , Pesquisa Qualitativa
18.
Int J Gen Med ; 14: 3109-3118, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34234539

RESUMO

Purpose: Examining whether modulation of right orbitofrontal cortex (OFC) activity by continuous theta-burst stimulation (cTBS) affects obsessive-compulsive disorder (OCD) symptoms. Patients and Methods: A total of 28 treatment-resistant OCD participants were treated with either active or sham cTBS of the OFC twice per day, for five days a week, for 2 weeks, in a double-blinded manner. Clinical response to treatment was determined using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Results: There were no statistically significant differences between the 2 groups after two weeks of treatment in the Yale-Brown Obsessive-Compulsive Scale score (group*time interaction, F2,20=0.996, p=0.387) and other secondary outcome measures, including anxiety symptoms and responder rates. Depressive symptoms improved significantly in the active group (p=0.027), but the significant difference disappeared at 6 weeks (p=0.089). Conclusion: This is the first randomized controlled study using cTBS in the right OFC to observe the improvement of treatment-resistant OCD symptoms. It is safe to use cTBS, but 2 weeks of treatment is not enough to achieve a curative effect. Future studies are needed to explore more advanced stimulation parameters suitable for the treatment of OCD. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR2000034814.

19.
Front Public Health ; 9: 686282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34327187

RESUMO

Background: To mobilize family's positive involvement in improving and sustaining self-management activities of older adults with diabetes, we developed a couple-based collaborative management model (CCMM) for community-dwelling older Chinese. Methods: The model was developed stepwise through applying theoretical models, interviewing older couples and community healthcare workers, as well as incorporating expert reviews. A 3-month pilot study was conducted to test the model's feasibility and its treatment effects by linear regression on 18 pairs of older couples aged 60 years+, who were equally divided into a couple-based intervention arm and a patient-only control arm. Results: The developed CCMM covered four theory-driven intervention modules: dyadic assessment, dyadic education, dyadic behavior-change training, and dyadic monitoring. Each module was delivered by community healthcare workers and targeted at older couples as the management units. Based on interviews with older couples and healthcare workers, 4 weekly education and training group sessions and 2-month weekly behavior change booster calls were designed to address older adults' main management barriers. These modules and session contents were evaluated as essential and relevant by the expert panel. Furthermore, the CCMM showed good feasibility and acceptability in the pilot, with non-significant yet more positive changes in physiological outcomes of diabetic participants and couples' well-being and exercise levels of these in the intervention arm than their controlled counterparts. Conclusion: We systematically developed a couple-based collaborative management model of diabetes, which was well-received by healthcare practitioners and highly feasible among older Chinese couples living in the community. The model's treatment effects need to be verified in fully powered randomized controlled trials. Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=42964, identifier: ChiCTR1900027137.


Assuntos
Diabetes Mellitus Tipo 2 , Vida Independente , Idoso , China , Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Humanos , Projetos Piloto
20.
Artigo em Inglês | MEDLINE | ID: mdl-34319483

RESUMO

PURPOSE: Basaloid squamous cell carcinoma (BSCC) is a rare aggressive variant of squamous cell carcinoma (SCC) with a poor prognosis. No large series of exclusively hypopharyngeal BSCC patients have been previously reported. Therefore, this retrospective population-based study aims to explain the patient demographics, clinicopathologic characteristics, incidence, and survival outcomes of hypopharyngeal BSCC and how it relates to conventional-type SCC. METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results database registry was queried for patients diagnosed with hypopharyngeal BSCC and conventional-type SCC between 2001 and 2016. RESULTS: The incidence of hypopharyngeal BSCC from 2001 to 2016 was 0.0161 per 100,000 individuals. The BSCC group comprised 213 patients, and the SCC group 7958 patients. The majority of BSCCs were considered high grade (Grade III/IV, 89.58%). Most BSCC patients were diagnosed at an advanced stage (American Joint Committee on Cancer [AJCC] stage IV, 65.38%). The 1-, 5-, and 10-year disease-specific survival (DSS) rates for hypopharyngeal BSCC were 84.10%, 57.40%, and 46.20%, respectively. Multivariate analysis, after adjustment for sex, age, race, tumor location, grade, and AJCC stage, showed that patients with BSCC had significantly better DSS than those with conventional-type SCC. Surgery with radiation contributed to a favorable DSS for BSCC patients in comparison with other treatments. CONCLUSION: This analysis of the largest hypopharyngeal BSCC series indicates a better prognosis for this pathologic type compared with conventional-type hypopharyngeal SCC. Multimodality treatment with surgery and radiation may result in a favorable prognosis for hypopharyngeal BSCC patients.

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