Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.699
Filtrar
1.
Front Chem ; 10: 902487, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35665066

RESUMO

Dielectrics with improved energy density have long-standing demand for miniature and lightweight energy storage capacitors for electrical and electronic systems. Recently, polyvinylidene fluoride (PVDF)-based ferroelectric polymers have shown attractive energy storage performance, such as high dielectric permittivity and high breakdown strength, and are regarded as one of the most promising candidates. However, the non-negligible energy loss and inferior temperature stability of PVDF-based polymers deteriorated the energy storage performance or even the thermal runaway, which could be ascribed to vulnerable amorphous regions at elevated temperatures. Herein, a new strategy was proposed to achieve high energy density and high temperature stability simultaneously of PVDF/PMMA blends by in situ polymerization. The rigidity of the amorphous region was ideally strengthened by in situ polymerization of methyl methacrylate (MMA) monomers in a PVDF matrix to obtain PVDF/PMMA blends. The atomic force microscopic study of the microstructure of etched films showed the ultra-homogenous distribution of PMMA with high glass transition temperature in the PVDF matrix. Consequently, the temperature variation was remarkably decreased, while the high polarization response was maintained. Accordingly, the high energy density of ∼8 J/cm3 with ∼80% efficiency was achieved between 30 and 90 °C in PVDF/PMMA films with 39-62% PMMA content, outperforming most of the dielectric polymers. Our work could provide a general solution to substantially optimize the temperature stability of dielectric polymers for energy storage applications and other associated functions.

2.
Clin Nutr ; 41(7): 1491-1500, 2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35667265

RESUMO

BACKGROUND AND AIMS: Despite animal studies revealing a causal link between the gut microbiota and skeletal muscle mass, the role of the gut microbiome and its metabolites in humans having low muscle mass remains unclear. METHODS: Eighty-eight subjects older than 65 years were measured for sarcopenia-related parameters, including body composition, grip strength, gait speed and flexibility. Participants were divided into normal muscle mass group (NM, n = 52) and low muscle mass group (LM, n = 36) and fresh fecal samples were collected for metagenome and short chain fatty acids (SCFAs) analysis. RESULTS: The richness and evenness of gut microbiota diversity were significantly decreased in the subjects with low muscle mass, including observed ASVs, Shannon and Chao 1 index. A significant difference of gut microbiota profile was noted between NM group and LM group. The Firmicutes/Bacteroidetes ratio was significantly reduced in the LM group. A significant decrease in the abundance of a SCFA-producer, Marvinbryantia spp., whereas a remarkable enrichment of a flavonoid degrader, Flavonifractor spp., was observed in the LM elders. Comparing with the NM group, the fecal butyrate significantly diminished in the LM group and correlated with skeletal muscle mass index. CONCLUSIONS: This is the first study that demonstrates the reduced fecal butyrate in elders with low muscle mass and highlights the associated gut microbiome changes. The identified gut microbial features and fecal butyrate level may serve as potential biomarkers for early detection of sarcopenic patients.

3.
Front Surg ; 9: 877929, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35693316

RESUMO

Background: To investigate the effect of posterior atlantoaxial screw fixation for the treatment of atlantoaxial dislocation in children with Down syndrome (DS). Methods: Children diagnosed with DS who underwent posterior atlantoaxial screw fixation or occipitocervical fusion from January 2017 to January 2020 in Hebei Children's Hospital were retrospectively included. Preoperative CT and MRI were performed to check the os odontoideum (OsO) and spinal cord compression, signal changes and spinal cord injury grade (ASIA grade). Results: All 5 children have atlantoaxial dislocation and OsO. Among which 60% (3/5) of children had changes in spinal cord signals and 40% (2/5) had dural sac compression. Every child underwent posterior atlantoaxial screw fixation (3.5-mm diameter), and the average fusion level was 1.8 (1-2). All 5 cases wore the head-neck-chest brace for 3-6 months after the operation. 1 case had dural tear and recovered well after timely suturing. 1 case had internal fixation breakage of the prosthetic joint and underwent revision surgery. At the last follow-up, all cases were fused and the neurological function were all ASIA grade E. Conclusion: After posterior atlantoaxial screw fixation, fusion and nerve recovery were achieved in all children with atlantoaxial dislocation and OsO. Postoperative head-neck-chest braces are necessary for children, especially those with occipitocervical fusion.

4.
Front Cardiovasc Med ; 9: 879812, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35694666

RESUMO

Background: In updated international guidelines, combined albumin resuscitation is recommended for septic shock patients who receive large volumes of crystalloids, but minimal data exist on albumin use and the optimal timing in those with cardiogenic shock (CS). The objective of this study was to evaluate the relationship between resuscitation with a combination of albumin within 24 h and 30-day mortality in CS patients. Methods: We screened patients with CS from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Multivariable Cox proportional hazards models and propensity score matching (PSM) were employed to explore associations between combined albumin resuscitation within 24 h and 30-day mortality in CS. Models adjusted for CS considered potential confounders. E-value analysis suggested for unmeasured confounding. Results: We categorized 1,332 and 254 patients into crystalloid-only and early albumin combination groups, respectively. Patients who received the albumin combination had decreased 30-day and 60-day mortality (21.7 vs. 32.4% and 25.2 vs. 34.2%, respectively, P < 0.001), and the results were robust after PSM (21.3 vs. 44.7% and 24.9 vs. 47.0%, respectively, P < 0.001) and following E-value. Stratified analysis showed that only ≥ 60 years old patients benefited from administration early albumin. In the early albumin combination group, the hazard ratios (HRs) of different adjusted covariates remained significant (HRs of 0.45-0.64, P < 0.05). Subgroup analysis showed that resuscitation with combination albumin was significantly associated with reduced 30-day mortality in patients with maximum sequential organ failure assessment score≥10, with acute myocardial infarction, without an Impella or intra-aortic balloon pump, and with or without furosemide and mechanical ventilation (HRs of 0.49, 0.58, 0.65, 0.40, 0.65 and 0.48, respectively; P < 0.001). Conclusion: This study found, compared with those given crystalloid-only, resuscitation with combination albumin within 24 h is associated with lower 30-day mortality of CS patients aged≥60. The results should be conducted to further assess in randomized controlled trials.

5.
Artigo em Inglês | MEDLINE | ID: mdl-35682025

RESUMO

OBJECTIVES: This study aimed to visualize the evidence in the global research on health education to better improve the nation's health literacy and to guide future research. METHOD: We searched the Web of Science (Core Collection) electronic databases. The search strategies: topic: ("Health Education" OR "Education, Health" OR "Community Health Education" OR "Education, Community Health" OR "Health Education, Community") AND document: (Article) AND language:(English). Articles of evidence from January 2011 to December 2021 with those words in the title or abstract or keywords will be included in this review. We used the Citespace 5.6.R5 (64-bit) to investigate and determine the thematic patterns, and emerging trends of the knowledge domain, and presented a narrative account of the findings. RESULT: We analyzed 10,273 eligible articles. It showed that BMC Public Health displays the most prolific journals. Author MARCO PAHOR is highlighted in health education. The University of Sydney has published the most studies about health education. The USA plays an important role in these studies. Specifically, the visualization shows several hotspots: disease prevalence surveys and a specific population of knowledge, attitude and practice surveys, health intervention, chronic and non-communicable management, youth-health action, sexual and reproductive health, and physical activity promotion. Furthermore, document co-citation analysis indicated that there are 10 main clusters, which means the research front in health education. Meanwhile, by the citation detected, COVID-19, has achieved universal health coverage in related studies, however, public health education and the health workforce might be more popular in the coming years. CONCLUSION: Health education is an effective measure to shift the concept of public health and improve healthy living standards. The present study facilitates an extensive understanding of the basic knowledge and research frontiers that are pivotal for the developmental process of health education and allows scholars to visualize the identification modes and tendencies.


Assuntos
COVID-19 , Adolescente , Previsões , Educação em Saúde , Humanos , Conhecimento , Publicações
6.
Microsyst Nanoeng ; 8: 58, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35655900

RESUMO

An electret-based mechanical antenna (EBMA), which can transmit extremely low frequency (ELF) electromagnetic signals, has the advantages of miniaturization and high transmitting efficiency, with great potential applications in air, underwater, and underground communications. To improve the charge density of the electret, which is a key factor in determining the radiation performance of an EBMA, this work proposes a fluorinated ethylene propylene/terpolymer of tetrafluoroethylene, hexafluoropropylene and vinylidene fluoride (FEP/THV) unipolar electret exhibiting negative polarity, reaching a total charge density up to -0.46 mC/m2 for each layer of electret. Long transmission distances can be achieved in sea water, soil, and air using a 3-layer-FEP/THV-based EBMA with a compact volume of 5 × 10-4 m3. As an application demonstration, binary ASCII-coded ELF information of "BUAA" is successfully transmitted with a power consumption < 5 W.

7.
Metallomics ; 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35657662

RESUMO

Zn2+ dyshomeostasis is an intriguing phenomenon in breast and prostate cancers, with breast cancer cells exhibiting higher intracellular Zn2+ level compared to their corresponding normal epithelial cells, in contrast to the low Zn2+ level in prostate cancer cells. In order to gain molecular insights into the zinc homeostasis of breast and prostate cancer cells, this study profiled the expression of 28 genes, including 14 zinc importer genes (SLC39A1-14) which encode ZIP1-14 to transport Zn2+ into the cytoplasm, 10 zinc exporter genes (SLC30A1-10) which encode ZnT1-10 to transport Zn2+ out of the cytoplasm and 4 metallothionein genes (MT1B, MT1F, MT1X, MT2A) in breast (MCF10A, MCF-7, MDA-MB-231) and prostate (RWPE-1, PC3, DU145) cell lines in response to extracellular zinc exposures at a mild cytotoxic dosage and a benign dosage. The RNA samples were prepared at 0 min (T0), 30 min (T30) and 120 min (T120) in a time course with or without zinc exposure, which were used for profiling the baseline and dynamic gene expression. The up-regulation of MT genes was observed across the breast and prostate cancer cell lines. The expression landscape of SLC39A and SLC30A was revealed by the qRT-PCR data of this study, which sheds light on the divergence of intracellular Zn2+ levels for breast and prostate cancer cells. Taken together, the findings are valuable in unravelling the molecular intricacy of zinc homeostasis in breast and prostate cancer cells.

8.
World J Surg Oncol ; 20(1): 181, 2022 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-35659244

RESUMO

BACKGROUND: The purpose of this retrospective study was to demonstrate the safety and feasibility of three-port single-intercostal video-assisted thoracoscopic surgery (SIC-VATS) segmentectomy compared to uniportal video-assisted thoracoscopic surgery (UVATS) segmentectomy. METHODS: We included 544 patients diagnosed with cT1N0M0 non-small-cell lung cancer (NSCLC) who underwent thoracoscopic segmentectomy between January 2020 and August 2021, including 147 and 397 patients who underwent three-port SIC-VATS and UVATS, respectively. After incorporating preoperative clinical variables, we compared surgical outcomes and perioperative indicators between the two groups by propensity score matching analysis. RESULTS: After 1:1 propensity score matching, each group comprised 143 patients with no significant differences in baseline demographics and characteristics. There was no significant difference in operative time (p = 0.469), blood loss (p = 0.501), number of dissected lymph nodes (p = 0.228), dwell time of the main chest drain (p = 0.065), hospital stay (p = 0.243), or major complication rate (p = 0.295) between the three-port SIC-VATS and UVATS groups. CONCLUSIONS: The three-port SIC-VATS was as safe and feasible as UVATS for patients who are diagnosed with early-stage NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Pontuação de Propensão , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/efeitos adversos
9.
Dalton Trans ; 51(24): 9397-9403, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35674199

RESUMO

Luminescent metal-organic frameworks (MOFs) have garnered considerable attention in various fields. Herein, we proposed a hierarchical confinement strategy based on MOF-on-MOF to tune luminescence emission ranging from blue to red including white light in a flexible way. The easily available ZIF-8 MOF was used as a host for the confinement of two kinds of size-matching dyes (perylene and rhodamine B) to obtain a layered ZIF-8@dye@ZIF-8@dye via in situ encapsulation and seed-mediated synthesis. ZIF-8@dye@ZIF-8@dye materials with different fluorescence emission in dispersed and solid states were both obtained by tuning the initial encapsulation concentration of dye and changing the structure of the inner and outer ZIF-8@dye layers. To our delight, ZIF-8@0.125perylene@ZIF-8@25RhB with white light emission in the dispersed state was obtained; meanwhile, ZIF-8@0.125perylene + 25RhB and mechanically mixed ZIF-8@0.125perylene + ZIF-8@25RhB could not realize white light emission under the same conditions, indicating that the proposed hierarchical confinement strategy facilitated white light regulation. Similarly, the emission of ZIF-8@dye@ZIF-8@dye in the solid state has also been investigated; ZIF-8@perylene@ZIF-8@3RhB with white light emission was obtained, while white light emission could not be achieved in ZIF-8@perylene + 3RhB and ZIF-8@perylene + ZIF-8@3RhB, which further indicated the importance of the hierarchical confinement strategy based on MOF-on-MOF. The proposed hierarchical confinement strategy may also inspire the development of other functional optical MOF materials.

10.
ACS Appl Mater Interfaces ; 14(24): 27979-27993, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35674395

RESUMO

Rational construction of inexpensive, highly efficient, and stable catalysts for ammonia borane (AB) methanolysis is in high demand but still remains a great challenge. In this work, we have successfully fabricated uniform Mox-Ni0.8Cu0.2O nanowires using a simple hydrothermal method followed by a post-calcination treatment and flexibly modulated the acidity of their surface by changing the amount of Mo introduced into Ni0.8Cu0.2O. The Mo0.1-Ni0.8Cu0.2O catalyst displayed strong catalytic activity toward AB methanolysis with an ultrahigh turnover frequency of 46.9 molH2 molcat.-1 min-1, which is even higher than some noble metal catalysts. In this work, an equation regarding the relationship between the quantity of moderated acid sites of catalysts and its corresponding activity toward AB methanolysis was first determined. A plausible mechanism for AB methanolysis catalyzed by Mox-Ni0.8Cu0.2O was proposed, and the benefits of the introduction of MoO3 to Ni0.8Cu0.2O for enhancing the catalytic performance were also discussed. These findings can form a basis for the rational construction of inexpensive catalysts with robust performance toward AB methanolysis for hydrogen production.

11.
Pain Res Manag ; 2022: 3458056, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35711611

RESUMO

Background: The enhanced recovery after surgery (ERAS) program is aimed to shorten patients' recovery process and improve clinical outcomes. This study aimed to compare the outcomes between the ERAS program and the traditional pathway among patients with ankle fracture and distal radius fracture. Methods: This is a multicenter prospective clinical controlled study consisting of 323 consecutive adults with ankle fracture from 12 centers and 323 consecutive adults with distal radial fracture from 13 centers scheduled for open reduction and internal fixation between January 2017 and December 2018. According to the perioperative protocol, patients were divided into two groups: the ERAS group and the traditional group. The primary outcome was the patients' satisfaction of the whole treatment on discharge and at 6 months postoperatively. The secondary outcomes include delapsed time between admission and surgery, length of hospital stay, postoperative complications, functional score, and the MOS item short form health survey-36. Results: Data describing 772 patients with ankle fracture and 658 patients with distal radius fracture were collected, of which 323 patients with ankle fracture and 323 patients with distal radial fracture were included for analysis. The patients in the ERAS group showed higher satisfaction levels on discharge and at 6 months postoperatively than in the traditional group (P < 0.001). In the subgroup analysis, patients with distal radial fracture in the ERAS group were more satisfied with the treatment (P=0.001). Furthermore, patients with ankle fracture had less time in bed (P < 0.001) and shorter hospital stay (P < 0.001) and patients with distal radial fracture received surgery quickly after being admitted into the ward in the ERAS group than in the traditional group (P=0.001). Conclusions: Perioperative protocol based on the ERAS program was associated with high satisfaction levels, less time in bed, and short hospital stay without increased complication rate and decreased functional outcomes.


Assuntos
Fraturas do Tornozelo , Recuperação Pós-Cirúrgica Melhorada , Fraturas do Rádio , Adulto , Fraturas do Tornozelo/cirurgia , Humanos , Tempo de Internação , Estudos Prospectivos , Fraturas do Rádio/cirurgia , Resultado do Tratamento
12.
Sci Rep ; 12(1): 10147, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35710921

RESUMO

Sodium-glucose cotransporter 2 inhibitor (SGLT2i) potentially decrease all-cause and cardiovascular death, however, associations with non-cardiovascular death remain unclear. Therefore, we investigated SGLT2i associations with death and the cause of death. We used the Taiwanese National Health Institutes Research database linked to the National Register of Deaths (NRD). Incident type 2 diabetes mellitus (T2DM) patients and propensity score matched T2DM SGLT2i and Dipeptidyl peptidase 4 inhibitor (DPP4i) users were investigated. The index year was the SGLT2i or DPP4i prescription date from May 2016. Patients were followed-up until death or December 2018. Deaths verified by the NRD and grouped accordingly. Multiple Cox proportional hazards models were used. In total, 261,211 patients were included in the population; 47% of the patients were female and the average age was 62 years. The overall incidence of all-cause death was 8.67/1000 patient-years for SGLT2i and 12.41 for DPP4i users during follow-up. After adjusting for potential risk factors in the propensity score matched population, SGLT2i users were associated with lower risks of all-cause death, cardiovascular death, cancer death, and non-cancer, non-vascular death compared with DPP4i-users. For specific death causes, significantly lower death risks from heart disease, cerebrovascular disease, and accidents were associated with SGLT2i-use. SGLT2i benefits for T2DM patients were not different across subgroups. Compared with DPP4i-use, SGLT2i-use for T2DM was associated with lower disease and death risk.


Assuntos
Diabetes Mellitus Tipo 2 , Inibidores da Dipeptidil Peptidase IV , Inibidores do Transportador 2 de Sódio-Glicose , Causas de Morte , Diabetes Mellitus Tipo 2/complicações , Inibidores da Dipeptidil Peptidase IV/farmacologia , Feminino , Humanos , Hipoglicemiantes/efeitos adversos , Incidência , Masculino , Pessoa de Meia-Idade , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia
13.
Front Bioeng Biotechnol ; 10: 860515, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35721857

RESUMO

Taxifolin (TAX) is a hepatoprotective flavanol compound, which is severely limited by poor solubility and low bioavailability. Liposomes (Lips) are used as well-recognized drug carrier systems that improve the water solubility and bioavailability of drugs, but are easily damaged by gastric juice after oral administration, resulting in the release of drugs in the gastric juice. Therefore, it is important to find materials that modify liposomes and avoid the destruction of the liposomal phospholipid bilayer structure by the gastrointestinal environment. Taxifolin liposomes (TAX-Lips) were modified by polyvinylpyrrolidone-k30 (PVP-TAX-Lips) and manufactured using a thin-film hydration technique. Particle size (109.27 ± 0.50 nm), zeta potential (-51.12 ± 3.79 mV), polydispersity coefficient (PDI) (0.189 ± 0.007), and EE (84.7 ± 0.2%) of PVP-TAX-Lips were studied. In addition, the results of in vitro release experiments indicated that the cumulative release rates of TAX-Lips and PVP-TAX-Lips were 89.73 ± 5.18% and 65.66 ± 4.86% in the simulated gastric fluid after 24 h, respectively, while the cumulative release rates were 68.20 ± 4.98% and 55.66 ± 3.92% in the simulated intestinal fluid after 24 h, respectively. Moreover, PVP-TAX-Lips were able to reverse lipopolysaccharide and D-galactosamine (LPS/D-GalN)-induced acute liver injury (ALI) by inducing autophagy to inhibit the expression levels of the TLR4/NF-κB signaling pathway and inflammatory factors, which suggested that PVP-TAX-Lips played an important role in the prevention of ALI and also provided a promising drug delivery system for the application of TAX.

14.
Front Cardiovasc Med ; 9: 768904, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35722090

RESUMO

Aims: The study explores the leading causes of postoperative extubation difficulties in pediatric patients (neonates and toddlers) with congenital heart diseases and establishes individualized treatment for different reasons. Method: We retrospectively analyzed medical records of 4,971 pediatric patients with congenital heart defects treated in three tertiary Congenital Heart Disease Centres in China from January 2005 to December 2020, from whom we selected those with difficulty extubation but successful weaning during the postoperative period. Next, we performed an analysis of risk factors and reported the combined experience of individualized treatment for successful extubation. Results: Seventy-five pediatric patients were identified in our database, among whom 23 had airway stenosis, 17 had diaphragmatic dysfunction, and 35 had pulmonary infection. The patients were all successfully weaned from the ventilator after an individualized treatment plan. In addition, the intubation time in the airway stenosis group was 17.7 ± 9.0, 33.6 ± 13.9 days in the diaphragmatic dysfunction group, and 11.9 ± 3.8 days in the pulmonary infection group. Conclusion: Given the primary reasons for difficult weaning following open-heart surgery in pediatric patients with congenital heart diseases, an individualized treatment scheme can achieve the ideal therapeutic effect where patients can be weaned faster with a shorter intubation period.

15.
J Investig Med ; 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725020

RESUMO

This is a secondary analysis of a randomized controlled trial (RCT) on the effects of the glucagon-like peptide-1 receptor agonists exenatide and insulin aspartate 30 injection on carotid intima-media thickness. Here, we report the renal outcomes of the intervention in patients with type 2 diabetes mellitus (T2DM). Data from the RCT study was used to evaluate the effect of exenatide or insulin given for 52 weeks on estimated glomerular filtration rate (eGFR) in patients with T2DM. The primary end point was the change in the eGFR from baseline between the exenatide and insulin groups in normal versus overweight patients and patients with obesity. The secondary end point was the correlation between change in eGFR and oxidative stress, glycemic control, and dyslipidemia. There was a significant difference in eGFR between the insulin and exenatide groups at 52 weeks (p=0.0135). Within the insulin group, the eGFR remained below baseline at 52 weeks in all patients, and there was an increase in body weight in the normal group compared with the overweight patients and patients with obesity. The opposite was observed in the exenatide group. A decrease in body weight was prominent in the exenatide group at 52 weeks (p<0.05), the eGFR was below baseline in overweight patients and patients with obesity and significantly above baseline in the normal group (p<0.05). The eGFR was positively correlated to 8-oxo-7,8-dihydroguanosine in the insulin group (p<0.05) but not the exenatide group. It can be concluded that compared with insulin, exenatide may improve renal function in overweight patients and patients with obesity more than in normal-weight patients with T2DM, but a further RCT is needed to confirm this effect.

16.
Gut ; 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725291

RESUMO

OBJECTIVE: An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ. DESIGN: Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised. RESULTS: Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO). CONCLUSIONS: This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.

17.
J Formos Med Assoc ; 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35725679

RESUMO

BACKGROUND/PURPOSE: The Accreditation Council for Graduate Medical Education (ACGME) milestones have been implemented in residency training worldwide. We investigated the development of individual competency in first-year residents (R1) and second-year postgraduate students (PGY2) who received internal medicine training in Taiwan. METHODS: A multicenter observational cohort study was conducted to evaluate the competency-based milestone evaluation designed by the Taiwan Society of Internal Medicine in 2019. The evaluation was based on the ACGME-accredited milestone ratings. Periodic evaluation of milestone achievements of R1 and PGY2, who entered the internal medicine residency training at six medical centers, was performed. Each resident was evaluated every 3 months. RESULTS: Among the 98 R1 enrolled in 2019, substantial improvement in sub-competencies, including skill in performing procedures (Patient Care 4), clinical knowledge (Medical Knowledge 1), knowledge of diagnostic testing and procedures (Medical Knowledge 2), and identify impact the cost of health care and practices cost-effective care (Systems Based Practice 3) during the two years of training. Among the 107 R1 and 46 PGY2 enrolled in 2020, no significant difference in baseline milestone ratings was observed. However, the milestone assessments of R1 in 2020 showed improvement in nearly all sub-competencies compared with the stationary status of PGY2 in 2020. CONCLUSION: We demonstrate the application of ACGME-based accredited milestone ratings to target the educational goals of internal medicine residency training in Taiwan. Differences in milestone ratings between different PGY training systems exist. The long-term impact of performance among different PGY training systems requires further investigation.

18.
Sci Rep ; 12(1): 10209, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715696

RESUMO

In the present paper, we report two studies examining the relationships among renunciation of desires, death anxiety, and mental health. In the first study, we constructed the Desire Questionnaire (DQ), which measures success in renouncing certain desire. The DQ has satisfactory psychometric properties. In the second study, 501 adults from a Chinese society ranging in age from 17 to 84 years (M = 35.58, SD = 14.76) completed the DQ, the Death Anxiety Scale (DAS), and the Chinese Health Questionnaire (CHQ), which measures mental health and the presence of psychiatric symptoms. As predicted, DQ had significant negative correlations with both DAS (p < 0.05) and CHQ (p < 0.01). DAS had a significant positive correlation with CHQ (p < 0.01). In the linear mediation model, DAS was found to partially mediate the relationship between DQ and CHQ (ß = - 0.18, p < 0.001). These results suggest that the negative effect of poor control of desires on mental health can be partially accounted for by death anxiety. These findings imply that training in eliminating desires can be a successful strategy to improve mental health. These results also support the Nonself Theory as a theory of death anxiety and show its relevance to the relationship between nonself and mental health.


Assuntos
Transtornos Mentais , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Humanos , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Psicometria , Inquéritos e Questionários , Adulto Jovem
19.
Carbohydr Polym ; 291: 119549, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35698379

RESUMO

A variety of cellulose-based polymer composite materials has been developed and show different impacts on the morphologies and properties of composites. Herein, we report the morphologies and properties of composites by blending polyurethane (PU) with either ethyl cellulose (EC) or cellulose nanofiber (CNF) through either drop-casting or electrospinning process. EC is homogenously mixed with PU without microphase separation and enhanced Young's modulus of composites from 0.04 to 6.94 MPa. The CNF is heterogeneously distributed in PU/CNF composites without interference on the PU microstructure and slightly increased modulus to 0.24 MPa. While the shearing force of the electrospinning process slightly affects the PU/EC composites, it drastically enhances PU crystallinity and Young's modulus to 54.95 MPa in PU/CNF composites. A model is established to summarize the effect of cellulose additives, compositions, and processes on PU/cellulose composites, providing a comprehensive understanding for designing future cellulose composites.


Assuntos
Nanofibras , Poliuretanos , Celulose/química , Módulo de Elasticidade , Nanofibras/química , Polímeros/química , Poliuretanos/química
20.
mSystems ; : e0017222, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35670534

RESUMO

Antibiotics used as growth promoters in livestock and animal husbandry can be detected in animal-derived food. Epidemiological studies have indicated that exposure to these antibiotic residues in food may be associated with childhood obesity. Herein, the effect of exposure to a residual dose of tylosin-an antibiotic growth promoter-on host metabolism and gut microbiota was explored in vivo. Theoretical maximal daily intake (TMDI) doses of tylosin were found to facilitate high-fat-diet-induced obesity, induce insulin resistance, and perturb gut microbiota composition in mice. The obesity-related phenotypes were transferrable to germfree recipient mice, indicating that the effects of a TMDI dose of tylosin on obesity and insulin resistance occurred mainly via alteration of the gut microbiota. Tylosin TMDI exposure restricted to early life, the critical period of gut microbiota development, altered the abundance of specific bacteria related to host metabolic homeostasis later in life. Moreover, early-life exposure to tylosin TMDI doses was sufficient to modify the ratio of primary to secondary bile acids, thereby inducing lasting metabolic consequences via the downstream FGF15 signaling pathway. Altogether, these findings demonstrate that exposure to very low doses of antibiotic residues, whether continuously or in early life, could exert long-lasting effects on host metabolism by altering the gut microbiota and its metabolites. IMPORTANCE This study demonstrates that even with limited exposure in early life, a residual dose of tylosin might cause long-lasting metabolic disturbances by altering the gut microbiota and its metabolites. Our findings reveal that the gut microbiota is susceptible to previously ignored environmental factors.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...