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1.
J Formos Med Assoc ; 120(1 Pt 1): 234-241, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32414667

RESUMO

BACKGROUND/PURPOSE: Metabolites in blood have been found associated with the occurrence of vascular diseases, but its role in the functional recovery of stroke is unclear. The aim of this study is to investigate whether the untargeted metabolomics at the acute stage of ischemic stroke is able to predict functional recovery. METHODS: One hundred and fifty patients with acute ischemic stroke were recruited and followed up for 3 months. Fasting blood samples within 7 days of stroke were obtained, liquid chromatography and mass spectrometry were applied to identify outcome-associated metabolites. The patients' clinical characteristics and identified metabolites were included for constructing the outcome prediction model using machine learning approaches. RESULTS: By using multivariate analysis, 220 differentially expressed metabolites (DEMs) were discovered between patients with favorable outcomes (modified Rankin Scale, mRS ≤ 2 at 3 months, n = 77) and unfavorable outcomes (mRS ≥ 3 at 3 months, n = 73). After feature selection, 63 DEMs were chosen for constructing the outcome prediction model. The predictive accuracy was below 0.65 when including patients' clinical characteristics, and could reach 0.80 when including patients' clinical characteristics and 63 selected DEMs. The functional enrichment analysis identified platelet activating factor (PAF) as the strongest outcome-associated metabolite, which involved in proinflammatory mediators release, arachidonic acid metabolism, eosinophil degranulation, and production of reactive oxygen species. CONCLUSION: Metabolomics is a potential method to explore the blood biomarkers of acute ischemic stroke. The patients with unfavorable outcomes had a lower PAF level compared to those with favorable outcomes.

2.
Sci Total Environ ; 753: 141809, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33207450

RESUMO

In recent years, the safety and ecology threat of cyanobacterial burst has drawn wide concern, especially the release of toxic microcystin-LR (MC-LR). To break through the bottleneck of uncomplete MC-LR degradation by conventional physical-chemistry methods, Fenton-based advanced oxidation processes (AOPs) developed rapidly due to striking degradation efficiency through the potent hydroxyl radicals (HO·) oxidation. Herein, a comprehensive overview is presented on the recent achievements of the various Fenton-based technologies (including conventional Fenton, photo-Fenton, electro-Fenton, ozone-Fenton and sono-Fenton) for MC-LR degradation. In particular, the comparisons between various Fenton-based technologies about advantages and drawbacks are discussed. Based on analyzing the degradation intermediates and pathways, the destruction of Adda chain via hydroxylation was confirmed to be essential for detoxification of MC-LR. Roles of influencing factors such as MC-LR initial concentration, dosages of the catalyst and oxidant, environment alkalinity, natural organic matters (NOMs) as well as other inorganic ions are specifically summarized. This Review also gave special emphasis on technique optimization trends for Fenton application of MC-LR degradation, as well as key challenges and future opportunities in this fast developing field.


Assuntos
Ozônio , Purificação da Água , Microcistinas , Oxirredução
3.
Microorganisms ; 8(11)2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33158259

RESUMO

Cryptococcus neoformans is a basidiomycete human fungal pathogen causing lethal meningoencephalitis, mainly in immunocompromised patients. Oxidoreductases are a class of enzymes that catalyze redox, playing a crucial role in biochemical reactions. In this study, we identified one Cryptococcus oxidoreductase-like protein-encoding gene OLP1 and investigated its role in the sexual reproduction and virulence of C. neoformans. Gene expression patterns analysis showed that the OLP1 gene was expressed in each developmental stage of Cryptococcus, and the Olp1 protein was located in the cytoplasm of Cryptococcus cells. Although it produced normal major virulence factors such as melanin and capsule, the olp1Δ mutants showed growth defects on the yeast extract peptone dextrose (YPD) medium supplemented with lithium chloride (LiCl) and 5-fluorocytosine (5-FC). The fungal mating analysis showed that Olp1 is also essential for fungal sexual reproduction, as olp1Δ mutants show significant defects in hyphae growth and basidiospores production during bisexual reproduction. The fungal nuclei imaging showed that during the bilateral mating of olp1Δ mutants, the nuclei failed to undergo meiosis after fusion in the basidia, indicating that Olp1 is crucial for regulating meiosis during mating. Moreover, Olp1 was also found to be required for fungal virulence in C. neoformans, as the olp1Δ mutants showed significant virulence attenuation in a murine inhalation model. In conclusion, our results showed that the oxidoreductase-like protein Olp1 is required for both fungal sexual reproduction and virulence in C. neoformans.

4.
Trends Biotechnol ; 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33160678

RESUMO

There is much interest in the use of extracellular vesicles (EVs) as a subcellular therapy for regenerative medicine and drug delivery. Blood-borne platelets represent a source of therapeutic EVs that is so far largely unexplored. Advantages of platelets as a cellular source of EVs include their established clinical value, regulated collection procedures, availability in a concentrated form, propensity to generate EVs, and unique composition and tissue-targeting capacity. This review analyzes the unique potential of platelet-derived (p-) EVs as therapeutic modalities and presents their inherent translational advantages for hemostasis, for regenerative medicine, and as drug-delivery vehicles.

5.
J Atheroscler Thromb ; 2020 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-33162430

RESUMO

AIMS: Type 2 diabetes mellitus (T2DM) is no longer regarded as a coronary risk equivalent, and heterogeneity of cardiovascular risk exists, suggesting that further risk stratification should be mandatory. This study aimed to determine the prevalence and clinical predictors of coronary artery calcium (CAC) score, and evaluate the CAC score as a predictor of cardiovascular outcome in a large asymptomatic T2DM cohort. METHODS: A total of 2,162 T2DM patients were recruited from a Diabetes Shared Care Network and the CAC score was measured. Cardiovascular outcomes were obtained for 1,928 patients after a follow-up of 8.4 years. Multiple regression analysis and Cox proportional hazard regression were applied to identify clinical predictors of CAC and calculate the incidence and hazard ratios (HRs) for all-cause mortality and cardiovascular events by CAC category. RESULTS: Of the recruited patients, 96.8% had one or more risk factors. The distribution of CAC scores was as follows: CAC=0 in 24.2% of the patients, 0 <CAC ≤ 100 in 41.5%, 100 <CAC ≤ 400 in 20.3%, CAC >400 in 14.7%. The multivariable predictor of increased CAC included age (years) (odds ratio, 1.07; 95% confidence interval, 1.06-1.08), male sex (1.82; 1.54-2.17), duration (years) of T2DM (1.07; 1.05-1.09), and multiple risk factors (1.94; 1.28-2.95). Increasing severity of CAC was associated with higher all-cause or cardiac mortality and higher incident cardiovascular events. The HRs for cardiac death or major cardiac events in CAC >400 vs CAC=0 were 8.67 and 10.52, respectively (p<0.001) Conclusion: CAC scoring provides better prognostication of cardiovascular outcome than traditional risk factors in asymptomatic T2DM patients, and may allow identifying a high-risk subset for enhancing primary prevention.

7.
World J Gastroenterol ; 26(38): 5863-5873, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33132640

RESUMO

BACKGROUND: People with achalasia typically have a thick lower esophageal muscularis propria (LEMP), and peroral endoscopic myotomy (POEM) has been effective in treating most patients. LEMP thickness may be associated with the outcomes and prognosis after POEM. However, more evidence is needed regarding the relationship between LEMP thickness and patient prognosis after POEM. AIM: To assess the association between LEMP thickness, measured using endoscopic ultrasound (EUS), and long-term prognosis, especially relapse, after POEM for achalasia. METHODS: All medical records, including EUS data, of patients who underwent POEM to treat achalasia at Shengjing Hospital of China Medical University from January 2012 to September 2018 were retrospectively reviewed. LEMP thickness was measured by EUS, and a thickness of ≥ 3 mm was defined as thickened. The severity of patient symptoms was evaluated using the Eckardt score. Relapse was defined as a 3-point rise in the Eckardt score after a period of clinical remission. The relationship between patient characteristics, muscle thickness, and recurrence was analyzed. RESULTS: Eighty-two patients (32 males and 50 females, aged 17-78 years) and 85 POEM procedures were included. In total, 76.8% (63/82 patients) of patients had a thickened muscularis propria. Older age and longer disease course were associated with muscularis propria thickening (P < 0.05). The mean postoperative follow-up time was 35.4 ± 17.2 mo (range, 8-87.5 mo) in 60 patients. Five patients with Eckardt scores > 3 refused further management after their symptoms were relieved. The relapse rate was 12.73% (7/55 cases). Five patients, four of whom had muscularis propria thickening, had disease recurrence within 12 mo after the procedure. Achalasia relapsed in one patient who had a thickened muscularis propria after 24 mo and in another patient who did not have a thickened muscularis propria after 30 mo. Patients with recurrence were typically younger and had a shorter disease course (P < 0.05). The relapse rate in patients with a non-thickened muscularis propria tended to be higher (18.2%, 2/11 patients) than that in patients with a thickened muscularis propria (11.4%, 5/44 patients), although no significant difference was found. Age (hazard ratio = 0.92; 95% confidence interval: 0.865-0.979; P < 0.05) and being male (hazard ratio = 7.173; 95% confidence interval: 1.277-40.286; P < 0.05) were identified as risk factors for symptomatic recurrence by multivariable analysis using the Cox model. CONCLUSION: Patients with a thickened muscularis are typically older and have a longer disease course. Younger age and the male sex are associated with increased recurrence. Patients with a thin muscularis propria may be prone to relapse, although further validation is needed.

8.
J Craniofac Surg ; 31(8): e802-e805, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33136917

RESUMO

OBJECTIVE: The surgical treatment of myogenic ptosis accompanying extraocular muscle paralysis is an intractable problem in the field of oculoplastic surgery due to the severe complications such as exposure keratopathy. It is promising to find an appropriate procedure to treat this kind of patients, which is able to ensure the safety and efficacy. METHODS: The authors retrospectively reviewed 12 eyes of 6 patients who underwent the under-corrected "double V-Loop" frontalis suspension sling procedure for myogenic ptosis accompanying extraocular muscle paralysis and access the safety and efficacy of this kind of surgery. All the patients underwent corneal fluorescein staining and confocal microscopy before and after the surgery to inspect the corneal condition. The density of central corneal epithelial cells and endothelial cells were observed. RESULTS: After the surgery, the eyelids contour was natural, and the symmetry was achieved in these cases. The average palpebral fissures height changed from 2.75 ±â€Š1.41 mm to 4.50 ±â€Š0.35 mm (P = 0.0007) and margin reflex distance 1 changed from -1.25 ±â€Š1.22 mm to +0.50 ±â€Š0.35 mm (P = 0.0002). Out of 12 operated eyes, mild postoperative lagophthalmos was present in 4 cases but without exposure keratopathy during the follow-up, the confocal microscopy showed that there were no significant differences in central corneal superficial epithelial cells (P = 0.93) and endothelial cells (P = 0.90) before and after the surgery. CONCLUSION: The under-corrected "double V-Loop" frontalis suspension sling is a proper surgery in myogenic ptosis accompanying extraocular muscle paralysis, which leads to a low occurrence of exposure keratopathy, maintains the integrity of the cornea, and remains the patients' vision function.

9.
Sensors (Basel) ; 20(21)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33138234

RESUMO

In this study, an impact-driven piezoelectric energy harvester (PEH) in magnetic field is presented. The PEH consists of a piezoelectric cantilever beam and plural magnets. At its initial status, the beam tip magnet is attracted by a second magnet. The second magnet is moved away by hand and then the beam tip magnet moves to a third magnet by the guidance of the magnetic fields. The impact occurs when the beam motion is stopped by the third magnet. The impact between magnets produces an impact energy and causes a transient beam vibration. The electric energy is generated by the piezoelectric effect. Based on the energy principle, a multi-DOF (multi-degree of freedom) mathematical model was developed to calculate the displacements, velocities, and voltage outputs of the PEH. A prototype of the PEH was fabricated. The voltages outputs of the beam were monitored by an oscilloscope. The maximum generated energy was about 0.4045 mJ for a single impact. A comparison between numerical and experimental results was presented in detail. It showed that the predictions based on the model agree with the experimental measurements. The PEH was connected to a diode bridge rectifier and a storage capacitor. The charges generated by the piezoelectric beam were stored in the capacitor by ten impacts. The experiments showed that the energy stored in the capacitor can light up the LED.

10.
Inflammation ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33174138

RESUMO

The regulatory role of toll-like receptor 4 (TLR4) in the inactivate staphylococcus epidermidis (ISE)-induced cornea inflammation is not well investigated. Here, TLR4 silence could decrease inflammatory cytokines in corneal epithelial cells treated with ISE. The mouse corneal epithelial cells were exposed to ISE for 24 h, either alone or with the NF-κB inhibitor, TLR4 lentivirus to bilaterally (knock-down or and overexpression). The expression of TLR4 in mouse corneal epithelial cells was investigated using western blot and qRT-PCR assay. The inflammatory cytokine levels were evaluated by qRT-PCR and ELISA, respectively. The relative impact factors of TLR4-mediated NF-κB signaling detected using western blot assay. Results show the expression levels of TLR4 and some inflammatory cytokines were significantly increased in corneal epithelial cells treated with ISE. TLR4 Silence markedly decreased ISE-induced production of IL12, TNF-α, CCL5, and CCL9 in corneal epithelial cells. Furthermore, the nuclear translocation of NF-κB p65 and myeloid differentiation protein 88 (MyD88) in the cells treated with ISE were further reduced by silencing TLR4. Inhibition of TLR4-mediated NF-κB signaling by using BAY11-7082 also alleviated ISE-induced inflammation. In the rescue experiment, transfected the stable TLR4 silenced corneal epithelial cells with TLR4 overexpression lentivirus, we found that TLR4 overexpression can restore the down-regulation of TLR4 and inflammatory cytokines (IL12, TNF-α, CCL9) caused by TLR4 knocked down. Therefore, ISE-induced cornea inflammation was due to the activation of the TLR4/MyD88/NF-κB signaling pathway, and dramatically stimulated IL12, TNF-α, CCL9 secretion. TLR4 silence presented mitigates damage in corneal epithelial cells treated with ISE.

11.
Metab Brain Dis ; 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33180213

RESUMO

The enhanced release of inflammatory cytokines mediated by high mobility group box1 (HMGB1) leads to pain sensation, and has been implicated in the etiology of inflammatory pain. Paeonol (PAE), a major active phenolic component in Cortex Moutan, provides neuroprotective efficacy via exerting anti-inflammatory effect. However, the role and mechanism of PAE in inflammatory pain remain to be fully clarified. In this study, we showed that PAE treatment significantly ameliorated mechanical and thermal hyperalgesia of mice induced by complete Freund's adjuvant (CFA). The analgesic effect of PAE administration was associated with suppressing the enhanced expression of HMGB1 as well as the downstream signaling molecules including toll-like receptor 4 (TLR4), the nuclear NF-κB p65, TNF-α and IL-1ß after CFA insult in the anterior cingulate cortex (ACC), a key brain region responsible for pain processing. Furthermore, inhibition of HMGB1 activity by glycyrrhizin (GLY), an HMGB1 inhibitor, alleviated CFA-induced pain and also facilitated PAE-mediated analgesic effect in mice along with the decreased expression of TLR4, NF-κB p65, TNF-α and IL-1ß upon CFA injury. Collectively, we showed PAE exerted analgesic effect through inhibiting the HMGB1/TLR4/NF-κB p65 pathway and subsequent generation of cytokines TNF-α and IL-1ß in the ACC.

12.
Phys Chem Chem Phys ; 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33226052

RESUMO

ABO3-δ perovskites are utilized in many applications including optical gas sensing for energy systems. Understanding the opto-electronic properties allows rational selection of the perovskite-based sensors from a diverse family of ABO3-δ perovskites, associated with the choices of A and B cations and range of oxygen concentrations. Herein, we assess the impact of oxygen vacancies on the electronic structure and optical response of pristine and oxygen-vacant ABO3-δ (A = La, Sr; B = Cr, Mn) perovskites via first-principles calculations. The endothermic formation energy for oxygen vacancies shows that the generation of ABO3-δ defect structures is thermodynamically possible. LaCrO3 and LaMnO3 have direct and indirect ground-state band gaps, respectively, whereas SrCrO3 and SrMnO3 are metallic. In the presence of an oxygen mono-vacancy, however, the band gap decreases in LaCrO3-δ and vanishes in LaMnO3-δ. In contrast to the decrease in the band gaps, the oxygen vacancies in ABO3-δ are found to increase optical absorption in the visible to near-infrared wavelength regime, and thus lower the onset energy of absorption compared with the pristine materials. Our assessments emphasize the role of the oxygen vacancy, or other possible oxygen non-stoichiometry defects, in perovskite oxides with respect to the opto-electronic performance parameters that are of interest for optical gas sensors for energy generation process environments.

13.
Insights Imaging ; 11(1): 119, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33226480

RESUMO

BACKGROUND: With recent transformations in medical education, the integration of technology to improve medical students' abilities has become feasible. Artificial intelligence (AI) has impacted several aspects of healthcare. However, few studies have focused on medical education. We performed an AI-assisted education study and confirmed that AI can accelerate trainees' medical image learning. MATERIALS: We developed an AI-based medical image learning system to highlight hip fracture on a plain pelvic film. Thirty medical students were divided into a conventional (CL) group and an AI-assisted learning (AIL) group. In the CL group, the participants received a prelearning test and a postlearning test. In the AIL group, the participants received another test with AI-assisted education before the postlearning test. Then, we analyzed changes in diagnostic accuracy. RESULTS: The prelearning performance was comparable in both groups. In the CL group, postlearning accuracy (78.66 ± 14.53) was higher than prelearning accuracy (75.86 ± 11.36) with no significant difference (p = .264). The AIL group showed remarkable improvement. The WithAI score (88.87 ± 5.51) was significantly higher than the prelearning score (75.73 ± 10.58, p < 0.01). Moreover, the postlearning score (84.93 ± 14.53) was better than the prelearning score (p < 0.01). The increase in accuracy was significantly higher in the AIL group than in the CL group. CONCLUSION: The study demonstrated the viability of AI for augmenting medical education. Integrating AI into medical education requires dynamic collaboration from research, clinical, and educational perspectives.

14.
Artigo em Inglês | MEDLINE | ID: mdl-33219825

RESUMO

BACKGROUND: Laparoscopic repair is a well-accepted treatment modality for perforated peptic ulcer (PPU). However, intraoperative conversion to laparotomy is still not uncommon. We aimed to identify preoperative factors strongly associated with conversion. METHODS: A retrospective review of records of all PPU patients treated between January 2011 and July 2019 was performed. Patients were divided into three groups: laparoscopic repair (LR), conversion to laparotomy (CL), and primary laparotomy (PL). Patient demographics, operative findings, and outcomes were compared between the groups. Logistic regression analyses were performed, taking conversion as the outcome. RESULTS: Of 822 patients, there were 236, 45, and 541 in the LR, CL, and PL groups, respectively. The conversion rate was 16%. Compared with those in the LR group, patients in the CL group were older (p < 0.001), had higher PULP scores (p < 0.001), had higher ASA scores (p < 0.001) and had hypertension (p = 0.003). PULP score was the only independent risk factor for conversion. The area under the curve (AUC) for the PULP score to predict conversion was 75.3%, with a best cut-off value of ≥ 4. The operative time was shorter for PL group patients than for CL group patients with PULP scores ≥ 4. For patients with PULP scores < 4, LR group patients had a shorter length of stay than PL group patients. CONCLUSION: The PULP score may have utility in predicting and minimizing conversion for laparoscopic PPU repair. Laparoscopic repair is the procedure of choice for PPU patients with PULP scores < 4, while open surgery is recommended for those with PULP scores ≥ 4.

15.
Microbiome ; 8(1): 162, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33213511

RESUMO

The capability of gut microbiota in degrading foods and drugs administered orally can result in diversified efficacies and toxicity interpersonally and cause significant impact on human health. Production of atherogenic trimethylamine N-oxide (TMAO) from carnitine is a gut microbiota-directed pathway and varies widely among individuals. Here, we demonstrated a personalized TMAO formation and carnitine bioavailability from carnitine supplements by differentiating individual TMAO productivities with a recently developed oral carnitine challenge test (OCCT). By exploring gut microbiome in subjects characterized by TMAO producer phenotypes, we identified 39 operational taxonomy units that were highly correlated to TMAO productivity, including Emergencia timonensis, which has been recently discovered to convert γ-butyrobetaine to TMA in vitro. A microbiome-based random forest classifier was therefore constructed to predict the TMAO producer phenotype (AUROC = 0.81) which was then validated with an external cohort (AUROC = 0.80). A novel bacterium called Ihubacter massiliensis was also discovered to be a key microbe for TMA/TMAO production by using an OCCT-based humanized gnotobiotic mice model. Simply combining the presence of E. timonensis and I. massiliensis could account for 43% of high TMAO producers with 97% specificity. Collectively, this human gut microbiota phenotype-directed approach offers potential for developing precision medicine and provides insights into translational research. Video Abstract.

16.
J Am Acad Audiol ; 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157559

RESUMO

BACKGROUND: Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in situ data that describe respondents' current or recent experiences and related contexts in their natural environments. Audiology literature investigating the test-retest reliability of EMA is scarce. PURPOSE: This article examines the test-retest reliability of EMA in measuring the characteristics of listening contexts and listening experiences. RESEARCH DESIGN: An observational study. STUDY SAMPLE: Fifty-one older adults with hearing loss. DATA COLLECTION AND ANALYSIS: The study was part of a larger study that examined the effect of hearing aid technologies. The larger study had four trial conditions and outcome was measured using a smartphone-based EMA system. After completing the four trial conditions, participants repeated one of the conditions to examine the EMA test-retest reliability. The EMA surveys contained questions that assessed listening context characteristics including talker familiarity, talker location, and noise location, as well as listening experiences including speech understanding, listening effort, loudness satisfaction, and hearing aid satisfaction. The data from multiple EMA surveys collected by each participant were aggregated in each of the test and retest conditions. Test-retest correlation on the aggregated data was then calculated for each EMA survey question to determine the reliability of EMA. RESULTS: At the group level, listening context characteristics and listening experience did not change between the test and retest conditions. The test-retest correlation varied across the EMA questions, with the highest being the questions that assessed talker location (median r = 1.0), reverberation (r = 0.89), and speech understanding (r = 0.85), and the lowest being the items that quantified noise location (median r = 0.63), talker familiarity (r = 0.46), listening effort (r = 0.61), loudness satisfaction (r = 0.60), and hearing aid satisfaction (r = 0.61). CONCLUSION: Several EMA questions yielded appropriate test-retest reliability results. The lower test-retest correlations for some EMA survey questions were likely due to fewer surveys completed by participants and poorly designed questions. Therefore, the present study stresses the importance of using validated questions in EMA. With sufficient numbers of surveys completed by respondents and with appropriately designed survey questions, EMA could have reasonable test-retest reliability in audiology research.

17.
Sci Rep ; 10(1): 19523, 2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177603

RESUMO

Clinical and pathological predictors have proved to be insufficient in identifying high-risk patients who develop cancer recurrence after tumour resection. We aimed to compare the prognostic ability of various inflammation markers in patients undergoing surgical resection of lung cancer. We consecutively included 2,066 patients with stage I-III non-small-cell lung cancer undergoing surgical resection at the center between 2005 and 2015. We evaluated prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio along with their perioperative changes. We conducted stepwise backward variable elimination and internal validation to compare the selected markers' predictive performance for postoperative recurrence-free survival and overall survival. Preoperative neutrophil-to-lymphocyte ratio independently predicts recurrence-free survival (HR: 1.267, 95% CI 1.064-1.509, p = 0.0079, on base-2 logarithmic scale) and overall survival (HR: 1.357, 95% CI 1.070-1.721, p = 0.0117, on base-2 logarithmic scale). The cut-off value is 2.3 for predicting both recurrence (sensitivity: 46.1% and specificity: 66.7%) and mortality (sensitivity: 84.2% and specificity: 40.4%). Advanced cancer stage, poor tumour differentiation, and presence of perineural infiltration were significantly correlated with higher preoperative neutrophil-to-lymphocyte ratio. We concluded that preoperative neutrophil-to-lymphocyte ratio is superior to prognostic nutritional index and platelet-to-lymphocyte ratio in predicting postoperative recurrence and mortality of patients undergoing surgical resection of non-small-cell lung cancer.

18.
Sci Total Environ ; : 143291, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33199007

RESUMO

Biochar addition can enhance plant growth and change soil physicochemical properties in saline soil. However, it is unclear whether the positioning of biochar additions (e.g., rhizosphere addition and surface addition) alters such impacts and whether such positioning effects interact with salinity levels. In the Yellow River Delta, China, we carried out a field experiment in which biochar was not added (control) or was added to the soil surface (surface addition) or to the soil at the rhizosphere position (rhizosphere addition) of Phragmites australis in three sites with different salt levels (1‰ - low, 5‰ - medium and 10‰ - high). Rhizosphere addition of biochar significantly improved the growth of P. australis, especially its fine root mass. Both rhizosphere addition and surface addition of biochar significantly decreased nitrate nitrogen content and electrical conductivity, and the inhibitory effects were more effective at the sites with medium and high salt levels in 2018. Structural equation modeling showed that biochar addition could directly increase the fine root mass of P. australis by decreasing the soil electrical conductivity, further improving the total mass of P. australis. Overall, rhizosphere addition of biochar is a better choice for improving the productivity of P. australis in saline soil and is beneficial to P. australis wetland restoration in the Yellow River Delta. Long-term field research is needed to better understand the effect and mechanism of biochar application.

19.
JMIR Med Inform ; 8(11): e16503, 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33200995

RESUMO

BACKGROUND: Predictions in pregnancy care are complex because of interactions among multiple factors. Hence, pregnancy outcomes are not easily predicted by a single predictor using only one algorithm or modeling method. OBJECTIVE: This study aims to review and compare the predictive performances between logistic regression (LR) and other machine learning algorithms for developing or validating a multivariable prognostic prediction model for pregnancy care to inform clinicians' decision making. METHODS: Research articles from MEDLINE, Scopus, Web of Science, and Google Scholar were reviewed following several guidelines for a prognostic prediction study, including a risk of bias (ROB) assessment. We report the results based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were primarily framed as PICOTS (population, index, comparator, outcomes, timing, and setting): Population: men or women in procreative management, pregnant women, and fetuses or newborns; Index: multivariable prognostic prediction models using non-LR algorithms for risk classification to inform clinicians' decision making; Comparator: the models applying an LR; Outcomes: pregnancy-related outcomes of procreation or pregnancy outcomes for pregnant women and fetuses or newborns; Timing: pre-, inter-, and peripregnancy periods (predictors), at the pregnancy, delivery, and either puerperal or neonatal period (outcome), and either short- or long-term prognoses (time interval); and Setting: primary care or hospital. The results were synthesized by reporting study characteristics and ROBs and by random effects modeling of the difference of the logit area under the receiver operating characteristic curve of each non-LR model compared with the LR model for the same pregnancy outcomes. We also reported between-study heterogeneity by using τ2 and I2. RESULTS: Of the 2093 records, we included 142 studies for the systematic review and 62 studies for a meta-analysis. Most prediction models used LR (92/142, 64.8%) and artificial neural networks (20/142, 14.1%) among non-LR algorithms. Only 16.9% (24/142) of studies had a low ROB. A total of 2 non-LR algorithms from low ROB studies significantly outperformed LR. The first algorithm was a random forest for preterm delivery (logit AUROC 2.51, 95% CI 1.49-3.53; I2=86%; τ2=0.77) and pre-eclampsia (logit AUROC 1.2, 95% CI 0.72-1.67; I2=75%; τ2=0.09). The second algorithm was gradient boosting for cesarean section (logit AUROC 2.26, 95% CI 1.39-3.13; I2=75%; τ2=0.43) and gestational diabetes (logit AUROC 1.03, 95% CI 0.69-1.37; I2=83%; τ2=0.07). CONCLUSIONS: Prediction models with the best performances across studies were not necessarily those that used LR but also used random forest and gradient boosting that also performed well. We recommend a reanalysis of existing LR models for several pregnancy outcomes by comparing them with those algorithms that apply standard guidelines. TRIAL REGISTRATION: PROSPERO (International Prospective Register of Systematic Reviews) CRD42019136106; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136106.

20.
Sci Rep ; 10(1): 20085, 2020 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208827

RESUMO

The COVID-19 pandemic is a worldwide health emergency which calls for an unprecedented race for vaccines and treatment. In developing a COVID-19 vaccine, we applied technology previously used for MERS-CoV to produce a prefusion-stabilized SARS-CoV-2 spike protein, S-2P. To enhance immunogenicity and mitigate the potential vaccine-induced immunopathology, CpG 1018, a Th1-biasing synthetic toll-like receptor 9 (TLR9) agonist was selected as an adjuvant candidate. S-2P in combination with CpG 1018 and aluminum hydroxide (alum) was found to be the most potent immunogen and induced high titer of neutralizing antibodies in sera of immunized mice against pseudotyped lentivirus reporter or live wild-type SARS-CoV-2. In addition, the antibodies elicited were able to cross-neutralize pseudovirus containing the spike protein of the D614G variant, indicating the potential for broad spectrum protection. A marked Th1 dominant response was noted from cytokines secreted by splenocytes of mice immunized with CpG 1018 and alum. No vaccine-related serious adverse effects were found in the dose-ranging study in rats administered single- or two-dose regimens of S-2P combined with CpG 1018 alone or CpG 1018 with alum. These data support continued development of CHO-derived S-2P formulated with CpG 1018 and alum as a candidate vaccine to prevent COVID-19 disease.

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