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1.
Chem Commun (Camb) ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32003396

RESUMO

Construction of large multi-component coordination cages becomes much more challenging as the number of building blocks increases. A giant hexameric calix[4]resorcinarene-based coordination cage (cage-1) was successfully designed through the precise tuning of ancillary rigid tetracarboxylic acid. Significantly, cage-1 exhibited reversible uptake of volatile iodine, suggesting that it could serve as a porous material for efficient capture and separation of radioactive iodine.

2.
J Oral Pathol Med ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32004389

RESUMO

BACKGROUND: Oral squamous cell carcinoma (OSCC) ranks as the fifth most frequent cancer worldwide, and the recurrence and migration of OSCC still pose large threats to patients. Long noncoding RNAs (lncRNAs) have recently emerged as crucial players in cancer development, and it is of great significance to understand the regulatory nexus of lncRNAs in OSCC. METHODS: Here, we identified a novel lncRNA, RP11-874J12.4, which is ectopically expressed in OSCC and facilitates OSCC. RESULTS: RP11-874J12.4 directly binds to and regulates miR-19a-5p. Interestingly, RP11-874J12.4 and miR-19a-5p form a negative regulatory loop that inhibits the expression of miR-19a-5p in OSCC. The expression of an oncogenic transcription factor, EBF1, is unleashed in OSCC due to the low expression of miR-19a-5p, which promotes the growth and migration of OSCC. CONCLUSION: our data illustrate a regulatory axis of RP11-874J12.4/miR-19a-5P/EBF1 and an inhibitory loop with RP11-874J12.4 and miR-19a-5p. These data provide insights into the tumorigenesis of OSCC and the novel drug targets for OSCC.

3.
Water Res ; 172: 115538, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-32007675

RESUMO

In nature, many microorganisms show resistance to toxic selenite by reducing selenite to non-soluble and low toxic elemental selenium. Extracellular polymeric substances (EPS), a high-molecular-weight biopolymers originated from microbial metabolism, contain many reducing groups and can induce reductive transformation of pollutants. However, the roles of EPS and its redox state in reductive detoxification or reduction removal of selenite, respectively, remain unknown yet. Herein, the reduction of selenite by different sources of EPS was investigated. Selenite was proved to be reduced by EPS and partly transformed to elemental selenium. The formed elemental selenium was mainly selenium nanoparticles confirmed by transmission electron microscopy coupled with energy dispersive spectroscopy. The redox state of EPS governed selenite reduction and elemental selenium formation, and the reduced state of EPS was in favor of selenite reduction. Dissolved oxygen concentration in water regulated EPS redox state and influenced selenite reduction. The thiols, aldehyde and phenolic groups in EPS were responsible for selenite reduction. Under selenite stress, EPS was capable of increasing cell survivability by enhancing microorganisms-mediated selenite reduction. This work revealed the previously undiscovered roles of EPS in selenite reduction and elemental selenium formation in aquatic environments and also suggested a possible crucial role of EPS in selenium biogeochemical cycle.

4.
Aging (Albany NY) ; 12(2): 1104-1113, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31945744

RESUMO

Elderly long-term care facility residents typically have musculoskeletal conditions that may lead to long-term disability and increased mortality. Our main objective was to explore the relationship between body mass index (BMI), albumin levels, and mortality in elderly individuals with limited performance status. Among 182 participants (mean age, 78.8 years; 57% women), 11%, 64%, and 25% had serum albumin levels of <2.8, 2.8-3.5, and >3.5 g/dL, respectively. After multivariate adjustments, diastolic blood pressure >90 mmHg was associated with all-cause mortality [hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.13-3.82; P = 0.018]. In addition, BMI <18.5 kg/m2 and albumin level <2.8 g/dL associated with higher mortality than BMI = 18.5-24 kg/m2 and albumin level > 3.5 g/dL (HR = 1.80, 95% CI = 1.11-2.94 and HR = 2.54, 95% CI 1.22-5.30, respectively; P = 0.018 and 0.013, respectively). Highest mortality was noted in participants with albumin levels <2.8 g/dL and BMIs <18.5 kg/m2 (HR = 6.12, 95% CI = 1.85-20.21, P = 0.003). Combined hypoalbuminemia (albumin level < 2.8 g/dL) and low BMI (<18.5 kg/m2) may be a useful prognostic indicator of high mortality risk in elderly individuals with limited performance status.

5.
Environ Sci Technol ; 54(3): 1614-1622, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-31976657

RESUMO

Extracellular DNA (eDNA), which is derived from lysis or secretion of cells, is ubiquitous in various environments and crucial for gene dissemination, bacterial metabolism, biofilm integrity, and aquatic monitoring. However, these processes are largely influenced by damage to eDNA. Photodamage to eDNA, one of the most important types of DNA damage in natural waters, thus far remains unclear. In particular, the roles of the ubiquitous dissolved organic matter (DOM) in this process have yet to be determined. In this study, eDNA photodamage, including both deoxynucleoside damage and strand breaks, proved to be significantly influenced by DOM. DOM competed with eDNA for photons to inhibit the direct photodamage of eDNA. Nevertheless, DOM was photosensitized to produce reactive oxygen species (ROS) (i.e., hydroxyl radicals (·OH) and singlet oxygen (1O2)) to enhance the indirect photodamage of eDNA. The ·OH induced damage to four deoxynucleosides and strand breaks, and the 1O2 substantially enhanced deoxyguanosine damage. The presence of DOM changed the main photodamage products of deoxynucleosides, additional oxidation products induced by ROS formed besides pyrimidine dimers caused by UV. Results indicate that DOM-mediated indirect photodamage contributed significantly to eDNA photodamage in most water bodies. This study revealed the previously unrecognized crucial role of DOM in the decay of eDNA in waters.

6.
J Mass Spectrom ; : e4497, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31918453

RESUMO

A multiclass and multiresidue method for screening veterinary drugs and pesticides in infant formula was developed and validated using ultrahigh-performance liquid chromatography coupled to Quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-HRMS). A total of 49 veterinary drugs and pesticides investigated belong to 11 classes including antivirals, anticoccidials, macrolides, pyrethroids, insecticides, sulfonamides, beta-agonists, sedatives, thyreostats, nonsteroidal anti-inflammatory drugs, and other pharmacologically active substances. A generic sample preparation and highly selective acquisition mode of parallel reaction monitoring (PRM) were deliberately incorporated to perform efficient screening analysis. As a result, the screening target concentrations of the analytes varied from 1 to 500 µg/kg with ≤5% of false compliant rate as specified in Decision 2002/657/EC for screening analysis. The average recoveries ranged from 40.7 to 124.9% as well as the relative standard deviations from 4.2 to 26.6%, respectively. The matrix effects and interferences were effectively controlled by integrated application of dispersive solid phase extraction, PRM scan mode, and matrix-matched standard calibration. The proposed method will be helpful to provide applicable strategy for screening residues in infant formula with surveillance purpose.

7.
J Agric Food Chem ; 68(5): 1436-1446, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-31927917

RESUMO

High fructose intake promotes hepatic lipid accumulation. Pterostilbene, a natural analogue of resveratrol found in diet berries, exhibits a hepatoprotective property. Here, we studied the protection by pterostilbene against fructose-induced hepatic lipid accumulation and explored its possible mechanism. We observed a high expression of microRNA-34a (miR-34a, P < 0.05) and a low expression of its target, sirtuin1 (Sirt1, mRNA: P < 0.01; protein: P < 0.001), with the overactivation of downstream sterol regulatory element-binding protein-1 (SREBP-1) lipogenic pathway (nuclear SREBP-1 protein: P < 0.05; FAS and SCD1 mRNA: P < 0.01), in rat livers, as well as BRL-3A and HepG2 cells, stimulated by fructose. More interestingly, pterostilbene recovered the fructose-disturbed miR-34a expression (0.3-0.5-fold vs fructose control, P < 0.05), Sirt1 protein level (1.2- to 1.5-fold vs fructose control, P < 0.05), and SREBP-1 lipogenic pathway, resulting in significant amelioration of hepatocyte lipid accumulation in animal [hepatic triglyceride and total cholesterol (TG&TC) mg/g·wet tissue: 4.90 ± 0.19, 5.23 ± 0.16, 5.20 ± 0.29 vs fructose control 9.73 ± 1.06, P < 0.001; 3.18 ± 0.30, 3.31 ± 0.39, 3.37 ± 0.47 vs 5.67 ± 0.28, P < 0.001] and cell models (BRL-3A TG&TC mmol/g·protein: 0.123 ± 0.011 vs 0.177 ± 0.004, P < 0.001; 0.169 ± 0.011 vs 0.202 ± 0.008, P < 0.05; HepG2: 0.257 ± 0.005 vs 0.303 ± 0.016, P < 0.05; 0.143 ± 0.004 vs 0.201 ± 0.008, P < 0.001). These results provide the experimental evidence supporting the anti-lipogenic effect of pterostilbene against fructose-induced hepatic lipid accumulation via modulating the miR-34a/Sirt1/SREBP-1 pathway.

8.
Epidemiol Infect ; 148: e1, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31910921

RESUMO

Chlamydia spp. are a group of obligate intracellular pathogens causing a number of diseases in animals and humans. Avian chlamydiosis (AC), caused by Chlamydia psittaci (C. psittaci) as well as new emerging C. avium, C. gallinacea and C. ibidis, have been described in nearly 500 avian species worldwidely. The Crested Ibis (Nipponia nippon) is a world endangered avian species with limited population and vulnerable for various infections. To get a better understanding of the prevalence of Chlamydia spp. in the endangered Crested Ibis, faecal samples were collected and analysed. The results confirmed that 20.20% (20/99) of the faecal samples were positive for Chlamydiaceae and were identified as C. ibidis with co-existence of C. psittaci in one of the 20 positive samples. In addition, ompA sequence of C. psittaci obtained in this study was classified into the provisional genotype Matt116, while that of C. ibidis showed high genetic diversity, sharing only 77% identity with C. ibidis reference strain 10-1398/6. We report for the first time the presence of C. ibidis and C. psittaci in the Crested Ibis, which may indicate a potential threat to the endangered birds and should be aware of the future protection practice.

9.
Phytochemistry ; 170: 112198, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31765875

RESUMO

Fungal endophytes from plants are an important source for discovery of novel bioactive natural products. In this study, five undescribed harziane diterpenoids with a 4/7/5/6 tetracyclic scaffold, harzianols F‒J and three known derivatives, were obtained from the liquid fermentation of an endophytic fungus Trichoderma atroviride B7, which was isolated from the healthy flower of a Lamiaceae plant Colquhounia coccinea var. mollis. Their structures were elucidated by comprehensive spectroscopic analyses and X-ray crystallographic diffraction in the case of harzianol F. Harzianol I exhibited significant antibacterial effect against the growth of Staphylococcus aureus (EC50 = 7.7 ± 0.8 µg/mL), Bacillus subtilis (EC50 = 7.7 ± 1.0 µg/mL), and Micrococcus luteus (EC50 = 9.9 ± 1.5 µg/mL). Meanwhile, cytotoxic activity of harzianol I against three cancer cell lines was also observed. A plausible biosynthetic pathway for harziane diterpenoids was proposed.

10.
World Neurosurg ; 133: 275-277, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31629145

RESUMO

We report a rare case of cervicothoracic intramedullary and extramedullary lipoma. Complete resection of the extramedullary lipoma and almost complete resection of the intramedullary lipoma were performed using a microscope, followed by posterior fusion and internal fixation from C4-T2 to maintain the stability of the cervicothoracic junction. Despite the high risk, it was still necessary to perform the decompression surgery and the surgical results were favorable.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Neoplasias da Medula Espinal/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Adulto , Vértebras Cervicais/cirurgia , Humanos , Laminectomia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Neoplasias da Medula Espinal/cirurgia , Fusão Vertebral , Vértebras Torácicas/cirurgia , Resultado do Tratamento
12.
Angiology ; 71(2): 183-188, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30987432

RESUMO

We investigated the preventive effect of nicorandil on contrast-induced nephropathy (CIN) in patients with moderate renal insufficiency undergoing percutaneous coronary intervention (PCI). A total of 250 patients with a creatinine clearance (crCl) ≤60 mL/min undergoing PCI were randomly assigned to either a nicorandil group (nicorandil 10 mg 3 times/d and hydration; n = 125) or a control group (hydration only; n = 125). The first end point was the incidence of CIN defined as an increase in serum creatinine (Scr) levels by ≥0.5 mg/dL or ≥25% within 72 hours after exposure to the contrast medium. The secondary end points were (1) changes in Scr, blood urea nitrogen, and crCl and (2) the incidence of major adverse events during hospitalization. The incidence of CIN was 1.6% (2/125) in the nicorandil group and 9.6% (12/125) in the control group (P = .011). There was no obvious difference in the incidence of major adverse events during hospitalization between the nicorandil and the control group (4.0% vs 4.8%, P = 1.000). Multivariate logistic regression analysis showed that nicorandil was a protective factor for CIN (odds ratios = 0.126, 95% confidence interval: -19.996 to -0.932, P = .012). Prophylactic administration of nicorandil may prevent against CIN in patients with moderate renal insufficiency undergoing PCI.


Assuntos
Nefropatias/induzido quimicamente , Nefropatias/prevenção & controle , Nicorandil/uso terapêutico , Intervenção Coronária Percutânea , Insuficiência Renal/complicações , Idoso , Meios de Contraste/efeitos adversos , Feminino , Humanos , Masculino , Índice de Gravidade de Doença
13.
Org Lett ; 22(1): 126-129, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31829019

RESUMO

Leaves of Leucosceptrum canum harbor abundant toxic aromatic abietanoids, and they are rarely attacked by insect herbivores, except for the larvae of Nacna malachitis. The excrements of the insect that fed on L. canum leaves were investigated, leading to the isolation and identification of two unprecedented 11,12-seco-abietane diterpene polyenes: nacnabietanins A (1) and B (2). This discovery heralds a unique detoxification mechanism of plant aromatic abietanoids by insects through enzymatic cleavage of stable benzene rings into more easily degraded polyenes.

14.
J Ethnopharmacol ; 248: 112204, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31669442

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Ficus hispida L.f. (Moraceae) has long been used as a traditional medicine in India, China, Sri Lanka, Australia, and Myanmar in the treatment of diarrhea, ulcer, anemia, diabetes, inflammation, and cancer. AIM OF THE REVIEW: This review provides a systematic comment on the botany, traditional uses, and phytochemical and pharmacological studies of F. hispida, with an aim to make critical update of the current knowledge and obtain opportunities for further therapeutic potential. MATERIALS AND METHODS: The information was derived from scientific literature databases including PubMed, Baidu Scholar, Google Scholar, Web of Science, and Science Direct. Additional information was gathered from books, Ph.D. and M.Sc. dissertations, and unpublished materials. RESULTS AND DISCUSSION: F. hispida is used especially in Chinese and Indian traditional medical systems as a remedy for skin disorders, respiratory diseases, and urinary diseases. Wound healing, anti-inflammatory, antinociceptive, sedative, antidiarrheal, antiulcer, antimicrobial, antioxidant, hepatoprotective, antineoplastic, and antidiabetic activities have been reported for crude extracts and isolated metabolites, but the methodologies in these studies often have inadequate design and low technical quality. More than 76 compounds have been isolated from F.hispida, including sesquiterpenoids and triterpenoids, flavonoids, coumarins, phenylpropionic acids, benzoic acid derivatives, alkaloids, steroids, other glycosides, and alkanes, but the method of bioassay-guided fractionation is seldom applied in the isolation from F. hispida. CONCLUSION: F. hispida is used widely in traditional medicines and has multiple pharmacological effects that could support traditional uses. However, pharmacological studies should be viewed with caution because of the inappropriate experimental design. More in vitro and in vivo research is urgently needed to study the molecular mechanisms and assess the effective and safe dose of F. hispida.

15.
Diabetologia ; 63(1): 194-205, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31686118

RESUMO

AIMS/HYPOTHESIS: Elevated glucose level is one of the risk factors for lower extremity amputation (LEA), but whether glycaemic variability confers independent risks of LEA remains to be elucidated. This study aimed to investigate the association between visit-to-visit glycaemic variability and minor and major LEA risks during 8 years of follow-up in type 2 diabetic individuals aged 50 years and older. METHODS: This retrospective cohort study included 27,574 ethnic Chinese type 2 diabetic individuals aged ≥50 years from the National Diabetes Care Management Program in Taiwan. Glycaemic variability measures were presented as the CVs of fasting plasma glucose (FPG-CV) and of HbA1c (A1c-CV). The effect of glycaemic variability on the incidence of LEA events was analysed using Cox proportional hazards models. RESULTS: After a median follow-up of 8.9 years, 541 incident cases of LEA with a crude incidence density rate of 2.4 per 1000 person-years were observed. After multivariate adjustment, FPG-CV and A1c-CV were found to be significantly associated with minor LEA, with corresponding HRs of 1.53 (95% CI 1.15, 2.04) and 1.34 (95% CI 1.02, 1.77) for the third tertiles of FPG-CV and A1c-CV, respectively. In addition, these associations were stronger amongst older adults with longer diabetes duration (≥3 years) than amongst those with shorter duration (<3 years) (pinteraction < 0.01). CONCLUSIONS/INTERPRETATION: Our study suggests that visit-to-visit variations in HbA1c and FPG are important predictors of minor LEA amongst older adults with type 2 diabetes, particularly for those with more than 3 years of diabetes duration.

17.
J Orthop Surg Res ; 14(1): 429, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829200

RESUMO

BACKGROUND: Cervical sagittal parameters were closely related with clinical outcomes after multi-level ACDF. Our purpose was to evaluate the clinical outcomes and cervical sagittal parameters in patients with MCSM after ACDF and to identify the risk factors of poor clinical outcomes. MATERIAL AND METHODS: ACDF was performed in 89 patients with MCSM. Based on average JOA recovery rate, patients were divided good-outcome group (group GO) and poor-outcome group (group PO). The cervical sagittal parameters including Cobb angle, SVA, T1S, cranial tilt and cervical tilt were measured. Multivariate logistic regression was used to identify risk factors. RESULTS: Fifty-four patients (60.67%) were divided into group GO, while 35 patients (39.33%) were divided into group PO. Cobb angle, SVA and T1S was corrected from preoperative average 11.80° ± 9.63°, 23.69 mm ± 11.69 mm and 24.43° ± 11.78° to postoperative average 15.08° ± 9.05°, 18.79 mm ± 10.78 mm and 26.92° ± 11.94° respectively (p < 0.001). △Cobb angle (p = 0.008) and △SVA (p = 0.009) showed significantly statistical differences between two groups. Longer symptom duration, lower preoperative JOA score, smaller △Cobb angle and larger △SVA were identified as risk factors of poor clinical outcomes. CONCLUSION: Multi-level ACDF is an effective surgical method to treat patients with MCSM. However, long duration of preoperative symptoms, lower preoperative JOA score, smaller △Cobb angle and larger △SVA are risk factors for poor outcomes in patients with MCSM after ACDF. Sagittal parameters should be paid attention to in surgery.

18.
Artigo em Inglês | MEDLINE | ID: mdl-31830335

RESUMO

BACKGROUND AND AIMS: Fecal microbiota transplantation (FMT) is used in recurrent Clostridioides difficile infections. However, protocols are facility dependent, and one variable is whether pre-procedural proton pump inhibitors (PPIs) are given. In theory, PPIs reduce acidity and protect the transplanted microbiome for the most potent dose. We conducted a systematic review to study the effect of PPIs on FMT delivered by upper gastrointestinal (GI) routes. METHODS: We searched Pubmed/Medline, Cochrane Library, Embase, Scopus, and Web of Science through December 16, 2018 using variations of keywords "fecal microbiota transplant" and "Clostridium difficile infection." Two authors independently reviewed 4210 results and found 11 qualifying studies with data on upper GI FMT, use of PPIs, and the rate of treatment failure at follow-up. RESULTS: Of 233 included patients, treatment failure occurred in 20.6% of those with use of PPIs versus 22.6% in the group without (relative risk 0.91; confidence interval 0.56-1.50). Limitations include the lack of studies directly comparing outcomes based on use of PPIs and inability to control for possible confounders such as chronic PPI use, amount of stool transplanted, and pre-FMT antibiotics. CONCLUSIONS: We did not find evidence supporting a clinically significant benefit from routine use of PPIs in FMT protocol. It is possible that the theoretical benefit from improved survival of transplanted microbiota is offset by negative effects on the microbiome. We suggest that routine use of PPIs in upper GI FMT be reconsidered. Further investigation is needed to optimize protocols for safety and efficacy.

19.
Sci Total Environ ; : 135130, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31837865

RESUMO

Drainage and cultivation have turned peatlands from carbon (C) sinks into hotspots for greenhouse gas (GHG) emissions. Raising the water table and planting of winter cover crops are potential strategies to help reduce peat oxidation and re-initiate net C accumulation during the non-cropping period. However, the effects of these practices as well as their interactions on GHG emissions remain unclear. Here, we carried out an outdoor mesocosm experiment to elucidate the effect of water table levels (-30 cm and -50 cm) and winter cover crop cultivation (vetch, rye, no plant) on carbon dioxide (CO2), nitrous oxide (N2O) and methane (CH4) fluxes during the winter period (November-April). Soil-atmosphere GHG exchange, GHG concentrations within the peat profile and soil water solute concentrations were monitored. Our results showed that high water table significantly reduced ecosystem respiration, while it had no net effect on N2O and CH4 fluxes. Uptake of available N by the cover crop significantly reduced nitrate in soil solution, thereby lowering the potential for leaching and both direct and indirect N2O emissions. No interactive effects between water table levels and cover crops were detected for any of the measured GHG fluxes. Seasonal variations of GHG fluxes were positively correlated with soil air concentrations at -15 cm and -40 cm depths, which were further regulated by dissolved organic C, nitrate concentration, and anaerobic conditions in the soil. This study suggests that there is great potential to raise water table levels and introduce green cover crops to reduce GHG emissions. Further studies are needed to achieve a complete evaluation of these strategies outside of the growing season, which may provide a significant mitigation benefit in C-rich cultivated peatlands.

20.
Sci Rep ; 9(1): 19897, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31882689

RESUMO

We evaluated whether genetic information could offer improvement on risk prediction of diabetic nephropathy (DN) while adding susceptibility variants into a risk prediction model with conventional risk factors in Han Chinese type 2 diabetes patients. A total of 995 (including 246 DN cases) and 519 (including 179 DN cases) type 2 diabetes patients were included in derivation and validation sets, respectively. A genetic risk score (GRS) was constructed with DN susceptibility variants based on findings of our previous genome-wide association study. In derivation set, areas under the receiver operating characteristics (AUROC) curve (95% CI) for model with clinical risk factors only, model with GRS only, and model with clinical risk factors and GRS were 0.75 (0.72-0.78), 0.64 (0.60-0.68), and 0.78 (0.75-0.81), respectively. In external validation sample, AUROC for model combining conventional risk factors and GRS was 0.70 (0.65-0.74). Additionally, the net reclassification improvement was 9.98% (P = 0.001) when the GRS was added to the prediction model of a set of clinical risk factors. This prediction model enabled us to confirm the importance of GRS combined with clinical factors in predicting the risk of DN and enhanced identification of high-risk individuals for appropriate management of DN for intervention.

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