Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 726
Filtrar
1.
Neurochem Res ; 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34623561

RESUMO

Vincristine is a common chemotherapeutic agent in cancer treatment, while it often causes chemotherapy-induced peripheral neuropathy(CIPN), which brings patients a great disease burden and associated economic pressure. The mechanism under CIPN remains mostly unknown. The previous study has shown that cell-type-specific spinal synaptic plasticity in the dorsal horn plays a pivotal role in neuropathic pain. Downregulation of GABA transmission, which mainly acts as an inhibitory pathway, has been reported in the growing number of research. Our present study found that GAD67, responsible for > 90% of basal GABA synthesis, is down-regulated, while its relative mRNA remains unchanged in vincristine-induced neuropathy. Considering microRNAs (miRNAs) as a post-transcription modifier by degrading targeted mRNA or repressing mRNA translation, we performed genome-wide miRNA screening and revealed that miR-30d might contribute to GAD67 down-regulation. Further investigation confirmed that miR-30d could affect the fluorescence activity of GAD67 by binding to the 3 'UTR of the GAD67 gene, and intrathecal injection of miR-30d antagomir increased the expression of GAD67, partially rescued vincristine-induced thermal hyperalgesia and mechanical allodynia. In summary, our study revealed the molecule interactions of GAD67 and miR-30d in CIPN, which has not previously been discussed in the literature. The results give more profound insight into understanding the CIPN mechanism and hopefully helps pain control.

2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(5): 1528-1532, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34627435

RESUMO

OBJECTIVE: To investigate the clinical characteristics of myelodysplastic syndrome (MDS) patients with chromosome 21 karyotype abnormality. METHODS: The clinical data of 155 patients with MDS were retrospectively analyzed, the clinical characteristics, survival and factors affecting prognosis of chromosome 21 karyotype abnormality patients were analyzed. RESULTS: Among 155 MDS patients, 4 were 5q- syndrome, 41 were MDS-EB-I, 35 were MDS-EB-II, 27 were MDS-SLD, 46 were MDS-MLD, 1 was MDS-RS-SLD, and 1 was MDS-U. The median follow-up time was 11.0(0.1-120.9) months. Among 155 MDS patients, 13 (9.0%) showed chromosome 21 abnormalities. Among the 13 patients with chromosome 21 karyotype abnormalities, there were 5 cases with simple +21 karyotype, 1 case with del (21q12), 1 case with +8, +21, 1 case with i(21q), 1 case with 20q-, +21, and 4 cases with complex karyotype involving chromosome 21; including 2 cases of MDS-SLD, 4 cases of MDS-MLD, 5 cases of MDS-EB-I and 2 cases of MDS-EB-II. The median survival time of the patients was 3.1 (0.1-6.7) months. CONCLUSION: Chromosome 21 karyotype abnormality is rare in MDS, and the prognosis is worse than the patients without chromosome 21 abnormalities.


Assuntos
Cromossomos Humanos Par 21 , Síndromes Mielodisplásicas , Humanos , Cariótipo , Cariotipagem , Síndromes Mielodisplásicas/genética , Estudos Retrospectivos
3.
Front Public Health ; 9: 691554, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631641

RESUMO

Objective: This paper aimed to systematically review the application methods and components of step counter-based physical activity (PA) promotion programs in patients with chronic obstructive pulmonary disease (COPD). The effects of longer-duration (≥12 weeks) programs on PA, exercise capacity, quality of life, and dyspnea were discussed. Methods: This review was performed in accordance with the preferred reporting items for systematic reviews and meta-analysis. Online data resources PubMed, Web of Science, Embase, and EBSCO were searched. The publication year was limited between January 2000 to August 2020. All randomized controlled trials with ≥12-week duration of step counter-based PA promotion programs of COPD were included. Two researchers independently assessed the quality of the included studies and extracted their characteristics. Results: Nine studies involving 1,450 participants were included. Step counters, counseling, exercise goals, diaries, and tele-communicational approaches were common components of these programs. The PA feedback tools were mostly pedometers (n = 8), whereas accelerometers were often used as assessment tools of PA (n = 5). All studies implemented counseling: five applied behavioral change theories, and three reported motivational interview techniques simultaneously. Six studies reported detailed exercise goals. The usual exercise goal was to reach a total of 8,000-10,000 steps/day. Three research studies used diaries, and five applied tele-communication approaches to deliver interventions. The programs could be implemented alone (n = 4), in combination with exercise training (n = 2), or with pulmonary rehabilitation (n = 2). All studies showed a significant increase in the PA (≥793 steps/day). Three studies observed a significant improvement in exercise capacity (≥13.4 m), and two reported a significant increase in the quality of life (p < 0.05). No study showed significant between-group differences in dyspnea. Conclusion: There are a few studies assessing the impact of long-duration (≥12 weeks) step counter-based interventions in COPD, with different methodologies, although all studies included counseling and exercise goal setting. These interventions seem to have a positive effect on PA. A few studies also showed benefit on exercise capacity and quality of life.

4.
Nano Lett ; 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34591476

RESUMO

Disordered carbons can be considered under the modeling framework of disordered graphene networks (DGNs) due to the continuous three-dimensional connectivity and high graphitization. Correlating microstructures and mechanical behaviors of DGNs to their topology is pivotal to revealing more intrinsic features hidden by disorder. Herein, starting from basic deformations and topology, we investigate DGNs with various densities to explore their micromechanical landscape. Both the tension and shear of DGNs exhibit prolonged plastic platforms through local tearing of microstructures. However, compression displays special plastic damages of forming kinklike puckers and sp3-bonded carbon, resulting in a tension-compression asymmetry of DGNs. Out-of-plane topological defects contribute to the main negative-curvature topology in deformed DGNs. Moreover, there are novel scaling laws where both the Young's modulus and strength (logarithms) follow an inversely proportional scaling with respect to average angular defects. Ashby charts demonstrate that the mechanical properties of DGNs can reach the theoretical limit region, surpassing those of most conventional materials.

5.
Bioresour Technol ; : 126030, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34592455

RESUMO

High organic loading (HOL) could reduce substrate degradation and methane production. The objective of this study was to investigate the promotion mechanism of iron-modified biochar in HOL co-digestion. The results showed that the specific surface area of iron-modified biochar prepared at 500 °C (500Fe@BC) was 131.7 m2/g. In 12% (w/w) of HOL co-digestion, 500Fe@BC addition enhanced methanogenesis by both aceticlastic and hydrogenotrophic pathways and showed the best methane yield performance. Compared with the non-biochar addition group, an increase of 56.6% and 11% in average methane content and cumulative methane yield was observed in the presence of 500Fe@BC during 25 days of hydraulic retention time. Furthermore, the buffer capacity of HOL co-digestion has been intensified, which attributed to the 500Fe@BC accelerated the hydrolysis of substrates and promoted the consumption of the volatile fatty acids. Moreover, 500Fe@BC promoted the enrichment of iron-reducing bacteria (Clostridium_sensu_stricto_1, Romboutsia) and methanogens (Methanosarcina, Methanobacterium).

6.
Huan Jing Ke Xue ; 42(10): 4708-4716, 2021 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-34581113

RESUMO

Environmental DNA(eDNA), a new tool for monitoring the biodiversity of aquatic ecosystems, is able to analyze characteristics of biodiversity from a microscopic perspective. Based on eDNA data collected from the Weihe River, diversity indexes, non-metric multidimensional scaling, cluster analysis, and correlation network analysis were employed to explore the diversity and community structure of zooplankton focusing on the niche differentiation of keystone species and environmental adaptability. The eDNA approach identified three types of zooplankton including Rotifera, Cladocera, and Copepoda, among which the dominant species was Brachionus calyciflorus. The zooplankton community shows significant differences in species composition, abundance, diversity and spatial distribution characteristics(P<0.01). The average values of the Chao1 index, ACE index, Shannon index, and Simpson index were 22.25, 22.38, 2.32, and 0.68, respectively. The downstream biodiversity is significantly higher than in the upstream area. Non-metric multidimensional scale analysis and hierarchical cluster analysis further showed that the zooplankton community structure shows distinct regional differences. The keystone species in the community have a high degree of connection with other species, with a high node degree, centrality, and modularity. The niche breadth(Bi) of the operational taxonomic units(OTUs) of the keystone species varied from 0.38 to 0.80. The medium niche species accounted for 63% of all keystone species. The average niche overlap index(Qik) was 0.72, and the degree of overlap was generally high. RDA analysis further identified that water environmental variables were closely related to changes in the zooplankton community structure and niche differentiation. For example, total nitrogen and water temperature were the main limiting factors, which play important roles in shaping the zooplankton community structure.


Assuntos
Cladóceros , Zooplâncton , Animais , Biodiversidade , Ecossistema , Rios , Estações do Ano , Zooplâncton/genética
7.
ACS Nano ; 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34516074

RESUMO

The increasing demand for wearable electronic devices necessitates flexible batteries with high stability and desirable energy density. Flexible lithium-sulfur batteries (FLSBs) have been increasingly studied due to their high theoretical energy density through the multielectron chemistry of low-cost sulfur. However, the implementation of FLSBs is challenged by several obstacles, including their low practical energy density, short life, and poor flexibility. Various graphene-based materials have been applied to address these issues. Graphene, with good conductivity and flexibility, exhibits synergistic effects with other active/catalytic/flexible materials to form multifunctional graphene-based materials, which play a pivotal role in FLSBs. This review summarizes the recent progress of graphene-based materials that have been used as various FLSB components, including cathodes, interlayers, and anodes. Particular attention is focused on the precise nanostructures, graphene efficacy, interfacial effects, and battery layout for realizing FLSBs with good flexibility, energy density, and cycling stability.

8.
BMC Musculoskelet Disord ; 22(1): 778, 2021 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-34511076

RESUMO

BACKGROUND: Postoperative delirium (PD), as an acute brain failure, is widely reported as a very common postoperative complication, and it is closely associated with increased morbidity and mortality. Recently, malnutrition is reported as one of the risk factors for PD. The prognostic nutritional index (PNI) is a simple method for nutritional evaluation. However, few studies have discussed the effectiveness of PNI as a nutritional assessment in predicting PD after primary total joint arthroplasty (TJA). The aim of this study is to investigate potential risk factors including PNI for PD following primary TJA. METHODS: A retrospective analysis of 994 patients was performed to identify risk factors associated with PD after primary TJA by using univariate and multivariate analyses. A receiver operating characteristic curve and the area under the curve were applied to evaluate the significant results of the multivariate analysis and the optimal cutoff value (CV). RESULTS: Postoperatively, sixty-seven patients (67/994, 6.7 %) experienced PD. Univariate analysis demonstrated that operative time, duration of anesthesia, age, hypertension, serum albumin, and PNI differed between the PD and non-PD groups (P < 0.05). Multivariate logistic regression analysis showed that the preoperative PNI (odds ratio [OR]: 0.908; 95 % confidence interval [CI]: 0.840-0.983; CV: 47.05), age of patients (OR: 1.055; 95 % CI: 1.024-1.087; CV: 73.5 years), and hypertension (OR: 1.798; 95 % CI: 1.047-3.086), were independently associated with PD (P < 0.05). CONCLUSIONS: A low preoperative PNI associated with malnutrition was demonstrated to be an independent risk factor for PD following primary TJA. Patients with preoperative low PNI should be cautioned and provided with adequate nutritional intervention to reduce postoperative PD.


Assuntos
Delírio , Avaliação Nutricional , Idoso , Artroplastia , Delírio/diagnóstico , Delírio/epidemiologia , Delírio/etiologia , Humanos , Prognóstico , Estudos Retrospectivos
9.
Phys Chem Chem Phys ; 23(35): 19590-19601, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34524285

RESUMO

The mechanism of how a soot nucleus is impacted by polycyclic aromatic hydrocarbons (PAHs) and then grows through PAH condensation remains unclear. Using steered molecular dynamics (SMD), the non-bonding interaction between PAHs and soot was quantitatively studied using the free energy distribution during the dimerisation and condensation. The results showed that only two dimers (A7-A10 and 2 A10) remained stable at 1000 K. The simulations showed that PAH condensation on a fullerene should not be ignored in soot mass growth. For fullerenes with a diameter not less than 1.8 nm (C540), even A4 condenses at temperatures of 1500 K, and A10 condenses stably on the surface of fullerenes even at 2000 K. The effects of multilayers and hydrogenated fullerenes on the free energy of PAH condensation are different. The stability of PAH dimers and PAH condensation pairs was discussed through free energy and chemical equilibrium. The results show that larger dimers are more stable than small ones at flame temperatures. Condensation is far more important than nucleation in mass growth at flame temperatures. Furthermore, the larger the PAH is, the higher the transformation ratio of the PAH in condensation on soot and thus the more stable the condensation product is. Finally, both the stability analysis of an upper temperature limit for condensation and simulation results of ReaxFF-MD cross-confirm that pyrene stably condensates on a simplified nascent soot (C540) and a simulated soot (C658H319O9), respectively, at 1500 K, but not at higher temperatures over 1800 K.

10.
Math Biosci Eng ; 18(5): 5978-5994, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34517519

RESUMO

OBJECTIVE: To calculate fractional flow reserve (FFR) based on computed tomography angiography (i.e., FFRCT) by considering the branch flow distribution in the coronary arteries. BACKGROUND: FFR is the gold standard to diagnose myocardial ischemia caused by coronary stenosis. An accurate and noninvasive method for obtaining total coronary blood flow is needed for the calculation of FFRCT. METHODS: A mathematical model for estimating the coronary blood flow rate and two approaches for setting the patient-specific flow boundary condition were proposed. Coronary branch flow distribution methods based on a volume-flow approach and a diameter-flow approach were employed for the numerical simulation of FFRCT. The values of simulated FFRCT for 16 patients were compared with their clinically measured FFR. RESULTS: The ratio of total coronary blood flow to cardiac output and the myocardial blood flow under the condition of hyperemia were 16.97% and 4.07 mL/min/g, respectively. The errors of FFRCT compared with clinical data under the volume-flow approach and diameter-flow approach were 10.47% and 11.76%, respectively, the diagnostic accuracies of FFRCT were 65% and 85%, and the consistencies were 95% and 90%. CONCLUSIONS: The mathematical model for estimating the coronary blood flow rate and the coronary branch flow distribution method can be applied to calculate the value of clinical noninvasive FFRCT.


Assuntos
Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Humanos
11.
Sci Rep ; 11(1): 17536, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475446

RESUMO

Capitalizing on the photoacoustic effect, we developed a new fingerprint sensing system that can reveal both fingerprints and underlying vascular structures at a high spatial resolution. Our system is built on a 15 MHz linear transducer array, a research ultrasound system, and a 532-nm pulsed laser. A 3D image was obtained by scanning the linear array over the fingertip. The acquired fingerprint images strongly agreed with the images acquired from ultrasound. Additional experiments were also conducted to investigate the effect of acoustic coupling. We discovered that high-quality fingerprint and vessel images can be acquired from both wet and dry fingers using our photoacoustic system. The reduced subdermal features in dry coupling can be enhanced through post-processing. Compared to existing fingerprint scanners, the photoacoustic approach provides a higher quality 3D image of the fingerprint, as well as unique subdermal vasculature structures, making the system almost impossible to counterfeit.

12.
Cell Death Dis ; 12(9): 839, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497268

RESUMO

Ferroptosis, a new form of programmed cell death, not only promotes the pathological process of various human diseases, but also regulates cancer progression. Current perspectives on the underlying mechanisms remain largely unknown. Herein, we report a member of the NEET protein family, CISD3, exerts a regulatory role in cancer progression and ferroptosis both in vivo and in vitro. Pan-cancer analysis from TCGA reveals that expression of CISD3 is generally elevated in various human cancers which are consequently associated with a higher hazard ratio and poorer overall survival. Moreover, knockdown of CISD3 significantly accelerates lipid peroxidation and accentuates free iron accumulation triggered by Xc- inhibition or cystine-deprivation, thus causing ferroptotic cell death. Conversely, ectopic expression of the shRNA-resistant form of CISD3 (CISD3res) efficiently ameliorates the ferroptotic cell death. Mechanistically, CISD3 depletion presents a metabolic reprogramming toward glutaminolysis, which is required for the fuel of mitochondrial oxidative phosphorylation. Both the inhibitors of glutaminolysis and the ETC process were capable of blocking the lipid peroxidation and ferroptotic cell death in the shCISD3 cells. Besides, genetic and pharmacological activation of mitophagy can rescue the CISD3 knockdown-induced ferroptosis by eliminating the damaged mitochondria. Noteworthily, GPX4 acts downstream of CISD3 mediated ferroptosis, which fails to reverse the homeostasis of mitochondria. Collectively, the present work provides novel insights into the regulatory role of CISD3 in ferroptotic cell death and presents a potential target for advanced antitumor activity through ferroptosis.

13.
Front Public Health ; 9: 640205, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485211

RESUMO

The rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergency involved Italy as the first European country. Meanwhile, China was the only other country to experience the emergency scenario, implementing public health recommendations and raising concerns about the mental health of the population. The Italian National Institute of Health [Istituto Superiore di Sanità (ISS)] reviewed relevant scientific literature in mental health to evaluate the best clinical practices and established the collaboration with the WHO, World Psychiatry Association, and China to support the public health system in a phase of acute emergency. This process permitted the definition of organizational and practical-operational Italian guidelines for the protection of the well-being of healthcare workers. These guidelines have been extensively disseminated within the Italian territory for maximum stakeholder utilization.


Assuntos
COVID-19 , Pandemias , Humanos , Itália/epidemiologia , Saúde Mental , Saúde Pública , SARS-CoV-2
14.
Sci Total Environ ; 805: 150232, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34534869

RESUMO

With the rapid development of urban agglomerations, urban water use and wastewater environments have gradually constrained sustainable development and caused increasing concern. In this paper, we selected the urban agglomeration on the middle reaches of the Yangtze River (UAMRYZ) as a typical area. We proposed an integrated urban water use and wastewater treatment (UWUWT) system and its urban water use (UWU) subsystem and urban wastewater treatment (UWT) subsystem. Moreover, an integrated two-stage slacks-based measure (SBM) data envelopment analysis (DEA) model was used to evaluate the efficiency of the UWUWT system and its subsystem during 2010 to 2017. Additionally, the multiscale geographically weighted regression (MGWR) model was adopted to analyze the influence mechanism of each factor on the defined system. The results indicated that the tendency of UWU efficiency and UWUWT efficiency were similar and mainly showed the same trend with an 'N' shape in a time-dependent manner for the UAMRYZ and provinces, respectively. Furthermore, the UWU efficiency and UWUWT efficiency of each city showed strong spatiotemporal heterogeneity. The UWT efficiency of the UAMRYZ and its representative cities was stable in the region and always had a higher value. With continuous economic development and increased interregional foreign trade, the UWU subsystem efficiency and the UWUWT system efficiency had a significant increase for cities along the entire river in the Yangtze Basin. The regional differences of the overall UWU efficiency, UWT efficiency and UWUWT efficiency gradually decreased and the efficiency has gradually improved from 2010 to 2017. Attribution analysis showed that the secondary industry was the main constraining factor, while the water resource was the most acceleration factor for the UWUWT system in most areas and the UWT subsystem for all cities. Our study evaluated the specific insufficiencies of the defined system and supported regulatory policies.

15.
J Integr Med ; 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34544670

RESUMO

BACKGROUND: Influenza places a heavy public health burden in numerous countries every year. In addition to vaccines, there are some interventions that are effective in preventing influenza. OBJECTIVE: This overview of systematic reviews (SRs) aimed to evaluate the efficacy and safety of interventions for influenza prevention. SEARCH STRATEGY: We searched the Cochrane Database of Systematic Reviews, 2020, Issue 1 for relevant Cochrane SRs using the keywords "common cold," "influenza," and "flu." INCLUSION CRITERIA: Cochrane SRs that investigated the prevention of influenza were included. Participants included the general population without influenza or influenza-like symptoms, who were treated with preventative interventions and compared to individuals receiving no treatment or placebo. DATA EXTRACTION AND ANALYSIS: Two reviewers independently screened citations against pre-defined inclusion criteria and extracted data. The methodological quality of these SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-II (AMSTAR-II) guidelines. The primary outcome of our analysis was the incidence of influenza, and the secondary outcomes were the incidence of influenza-like illness and hospitalization. In addition to the narrative summary of SR findings, we also pooled data from homogeneous trials among these SRs and produced evidence mapping. We conducted a network meta-analysis to compare the effect across interventions and used the Cochrane approach to grading of recommendations, assessment, development, and evaluation (GRADE) to assess the quality of evidence. RESULTS: Eleven Cochrane SRs were included, covering five medications, eleven vaccinations and four complementary therapies. Among these SRs, 73% scored "high" quality on AMSTAR-II rating. We found that eight interventions, including amantadine, garlic, and six different vaccines, were beneficial for reducing the incidence of influenza compared to placebo, while oseltamivir, zanamivir, Ganmao capsule, Echinacea, and another three types of vaccine were probably beneficial. Ganmao capsule ranked highest for influenza prevention in the network meta-analysis, followed by amantadine, garlic, and vaccines of all types. Monovalent inactivated parenteral vaccine was found to be beneficial in reducing the incidence of influenza-like illness. None of the interventions reduced the hospitalization rate. CONCLUSION: High-quality evidence showed that garlic or vaccine had advantages in preventing influenza, and that vitamin C is not effective. The effect of other interventions needs to be further verified with high-quality evidence.

16.
Appl Environ Microbiol ; : AEM0116021, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34469192

RESUMO

Nordic Seas are the subarctic seas connecting the Arctic Ocean and North Atlantic Ocean with complex water masses, experiencing an abrupt climate change. Though the knowledge of the marine virosphere has been expanded rapidly, the diversity of viruses and their relationships with host cells and water masses in the Nordic Seas remains to be fully revealed. Here we establish the Nordic Seas DNA viromes (NSVs) dataset of 55,315 viral contigs including 1,478 unique viral populations from seven stations influenced by both the warm Atlantic and cold Arctic water masses. Caudovirales dominated in the seven NSVs, especially in the warm Atlantic waters. The major giant nucleocytoplasmic large DNA viruses (NCLDVs) contributed a significant proportion of the classified viral contigs in the NSVs (32.2%), especially in the cold Arctic waters (44.9%). The distribution patterns of Caudovirales and NCLDVs were a reflection of the community structure of their hosts in the corresponding water masses and currents. Latitude, pH, and flow speed were found to be key factors influencing the microbial communities and co-influencing the variation of viral communities. Network analysis illustrated the tight coupling between the variation of viral communities and microbial communities in the Nordic Seas. This study suggests a probable linkage between the viromes, host cells and the surface water masses from both the cool Arctic and warm Atlantic Oceans. Importance: This is a systematic study of Nordic Seas Viromes using metagenomic analysis. The viral diversity, community structure, and their relationships with host cells and the complex water masses from both the cool Arctic and warm Atlantic Oceans were illustrated. The NCLDVs and Caudovirales are proposed as the viral characteristics of the cold Arctic and the warm Atlantic waters, respectively. This study provided an important background for the viromes in the subarctic seas connecting the Arctic Ocean and North Atlantic Ocean, and will shed a light on their responses to the abrupt climate change in the future.

17.
Adv Mater ; 33(39): e2102724, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34387379

RESUMO

Porous carbon materials demonstrate extensive applications for their attractive characteristics. Mechanical flexibility is an essential property guaranteeing their durability. After decades of research efforts, compressive brittleness of porous carbon materials is well resolved. However, reversible stretchability remains challenging to achieve due to the intrinsically weak connections and fragile joints of the porous carbon networks. Herein, it is presented that a porous all-carbon material achieving both elastic compressibility and stretchability at large strain from -80% to 80% can be obtained when a unique long-range lamellar multi-arch microstructure is introduced. Impressively, the porous all-carbon material can maintain reliable structural robustness and durability under loading condition of cyclic compressing-stretching process, similar to a real metallic spring. The unique performance renders it as a promising platform for making smart vibration and magnetism sensors, even capable of operating at extreme temperatures. Furthermore, this study provides valuable insights for creating highly stretchable and compressible porous materials from other neat inorganic components for diverse applications in future.

19.
Cochrane Database Syst Rev ; 8: CD014698, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34438475

RESUMO

BACKGROUND: Ultrasound examination of pregnancy before 24 weeks gestation may lead to more accurate dating and earlier diagnosis of pathology, but may also give false reassurance. It can be used to monitor development or diagnose conditions of an unborn baby. This review compares the effect of routine or universal, ultrasound examination, performed before 24 completed weeks' gestation, with selective or no ultrasound examination.  OBJECTIVES: To assess the effect of routine pregnancy ultrasound before 24 weeks as part of a screening programme, compared to selective ultrasound or no ultrasound, on the early diagnosis of abnormal pregnancy location, termination for fetal congenital abnormality, multiple pregnancy, maternal outcomes and later fetal compromise. To assess the effect of first trimester (before 14 weeks) and second trimester (14 to 24 weeks) ultrasound, separately. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) on 11 August 2020. We also examined the reference lists of retrieved studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs, cluster-RCTs and RCTs published in abstract form. We included all trials with pregnant women who had routine or revealed ultrasound versus selective ultrasound, no ultrasound, or concealed ultrasound, before 24 weeks' gestation. All eligible studies were screened for scientific integrity and trustworthiness. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for eligibility and risk of bias, extracted data and checked extracted data for accuracy. Two review authors independently used the GRADE approach to assess the certainty of evidence for each outcome MAIN RESULTS: Our review included data from 13 RCTs including 85,265 women. The review included four comparisons. Four trials were assessed to be at low risk of bias for both sequence generation and allocation concealment and two as high risk. The nature of the intervention made it impossible to blind women and staff providing care to treatment allocation.  Sample attrition was low in the majority of trials and outcome data were available for most women. Many trials were conducted before it was customary for trials to be registered and protocols published. First trimester routine versus selective ultrasound: four studies, 1791 women, from Australia, Canada, the United Kingdom (UK) and the United States (US). First trimester scans probably reduce short-term maternal anxiety about pregnancy (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.65 to 0.99; moderate-certainty evidence). We do not have information on whether the reduction was sustained.  The evidence is very uncertain about the effect of first trimester scans on perinatal loss (RR 0.97, 95% CI 0.55 to 1.73; 648 participants; one study; low-certainty evidence) or induction of labour for post-maturity (RR 0.83, 95% CI 0.50 to 1.37; 1474 participants; three studies; low-certainty evidence). The effect of routine first trimester ultrasound on birth before 34 weeks or termination of pregnancy for fetal abnormality was not reported. Second trimester routine versus selective ultrasound: seven studies, 36,053 women, from Finland, Norway, South Africa, Sweden and the US. Second trimester scans probably make little difference to perinatal loss (RR 0.98, 95% CI 0.81 to 1.20; 17,918 participants, three studies; moderate-certainty evidence) or intrauterine fetal death (RR 0.97, 95% CI 0.66 to 1.42; 29,584 participants, three studies; low-certainty evidence). Second trimester scans may reduce induction of labour for post-maturity (RR 0.48, 95% CI 0.31 to 0.73; 24,174 participants, six studies; low-certainty evidence), presumably by more accurate dating. Routine second trimester ultrasound may improve detection of multiple pregnancy (RR 0.05, 95% CI 0.02 to 0.16; 274 participants, five studies; low-certainty evidence). Routine second trimester ultrasound may increase detection of major fetal abnormality before 24 weeks (RR 3.45, 95% CI 1.67 to 7.12; 387 participants, two studies; low-certainty evidence) and probably increases the number of women terminating pregnancy for major anomaly (RR 2.36, 95% CI 1.13 to 4.93; 26,893 participants, four studies; moderate-certainty evidence). Long-term follow-up of children exposed to scans before birth did not indicate harm to children's physical or intellectual development (RR 0.77, 95% CI 0.44 to 1.34; 603 participants, one study; low-certainty evidence). The effect of routine second trimester ultrasound on birth before 34 weeks or maternal anxiety was not reported. Standard care plus two ultrasounds and referral for complications versus standard care: one cluster-RCT, 47,431 women, from Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia. This trial included a co-intervention, training of healthcare workers and referral for complications and was, therefore, assessed separately. Standard pregnancy care plus two scans, and training and referral for complications, versus standard care probably makes little difference to whether women with complications give birth in a risk appropriate setting with facilities for caesarean section (RR 1.03, 95% CI 0.89 to 1.19; 11,680 participants; moderate-certainty evidence).  The intervention also probably makes little to no difference to low birthweight (< 2500 g) (RR 1.01, 95% CI 0.90 to 1.13; 47,312 participants; moderate-certainty evidence). The evidence is very uncertain about whether the community intervention (including ultrasound) makes any difference to maternal mortality (RR 0.92, 95% CI 0.55 to 1.55; 46,768 participants; low-certainty evidence). Revealed ultrasound results (communicated to both patient and doctor) versus concealed ultrasound results (blinded to both patient and doctor at any time before 24 weeks): one study, 1095 women, from the UK. The evidence was very uncertain for all results relating to revealed versus concealed ultrasound scan (very low-certainty evidence). AUTHORS' CONCLUSIONS: Early scans probably reduce short term maternal anxiety.  Later scans may reduce labour induction for post-maturity. They may improve detection of major fetal abnormalities and increase the number of women who choose termination of pregnancy for this reason. They may also reduce the number of undetected twin pregnancies. All these findings accord with observational data.  Neither type of scan appears to alter other important maternal or fetal outcomes, but our review may underestimate the effect in modern practice because trials were mostly  from relatively early in the development of the technology, and many control participants also had scans. The trials were also underpowered to show an effect on other important maternal or fetal outcomes.

20.
Cochrane Database Syst Rev ; 8: CD011108, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34350974

RESUMO

BACKGROUND: This is an update of the original Cochrane Review first published in Issue 10, 2016. For people with advanced cancer, the prevalence of pain can be as high as 90%. Cancer pain is a distressing symptom that tends to worsen as the disease progresses. Evidence suggests that opioid pharmacotherapy is the most effective of these therapies. Hydromorphone appears to be an alternative opioid analgesic which may help relieve these symptoms. OBJECTIVES: To determine the analgesic efficacy of hydromorphone in relieving cancer pain, as well as the incidence and severity of any adverse events. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and clinical trials registers in November 2020. We applied no language, document type or publication status limitations to the search. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared hydromorphone with placebo, an alternative opioid or another active control, for cancer pain in adults and children. Primary outcomes were participant-reported pain intensity and pain relief; secondary outcomes were specific adverse events, serious adverse events, quality of life, leaving the study early and death. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data. We calculated risk ratio (RR) and 95% confidence intervals (CI) for binary outcomes on an intention-to-treat (ITT) basis. We estimated mean difference (MD) between groups and 95% CI for continuous data. We used a random-effects model and assessed risk of bias for all included studies. We assessed the evidence using GRADE and created three summary of findings tables. MAIN RESULTS: With four new identified studies, the review includes a total of eight studies (1283 participants, with data for 1181 participants available for analysis), which compared hydromorphone with oxycodone (four studies), morphine (three studies) or fentanyl (one study). All studies included adults with cancer pain, mean age ranged around 53 to 59 years and the proportion of men ranged from 42% to 67.4%. We judged all the studies at high risk of bias overall because they had at least one domain with high risk of bias. We found no studies including children. We did not complete a meta-analysis for the primary outcome of pain intensity due to skewed data and different comparators investigated across the studies (oxycodone, morphine and fentanyl). Comparison 1: hydromorphone compared with placebo We identified no studies comparing hydromorphone with placebo. Comparison 2: hydromorphone compared with oxycodone Participant-reported pain intensity We found no clear evidence of a difference in pain intensity (measured using a visual analogue scale (VAS)) in people treated with hydromorphone compared with those treated with oxycodone, but the evidence is very uncertain (3 RCTs, 381 participants, very low-certainty evidence). Participant-reported pain relief We found no studies reporting participant-reported pain relief. Specific adverse events We found no clear evidence of a difference in nausea (RR 1.13 95% CI 0.74 to 1.73; 3 RCTs, 622 participants), vomiting (RR 1.18, 95% CI 0.72 to 1.94; 3 RCTs, 622 participants), dizziness (RR 0.91, 95% CI 0.58 to 1.44; 2 RCTs, 441 participants) and constipation (RR 0.92, 95% CI 0.72 to 1.19; 622 participants) (all very low-certainty evidence) in people treated with hydromorphone compared with those treated with oxycodone, but the evidence is very uncertain. Quality of life We found no studies reporting quality of life. Comparison 3: hydromorphone compared with morphine Participant-reported pain intensity We found no clear evidence of a difference in pain intensity (measured using the Brief Pain Inventory (BPI) or VAS)) in people treated with hydromorphone compared with those treated with morphine, but the evidence is very uncertain (2 RCTs, 433 participants; very low-certainty evidence). Participant-reported pain relief We found no clear evidence of a difference in the number of clinically improved participants, defined by 50% or greater pain relief rate, in the hydromorphone group compared with the morphine group, but the evidence is very uncertain (RR 0.99, 95% CI 0.84 to 1.18; 1 RCT, 233 participants; very low-certainty evidence). Specific adverse events At 24 days of treatment, morphine may reduce constipation compared with hydromorphone, but the evidence is very uncertain (RR 1.56, 95% CI 1.12 to 2.17; 1 RCT, 200 participants; very low-certainty evidence). We found no clear evidence of a difference in nausea (RR 0.94, 95% CI 0.66 to 1.30; 1 RCT, 200 participants), vomiting (RR 0.87, 95% CI 0.58 to 1.31; 1 RCT, 200 participants) and dizziness (RR 1.15, 95% CI 0.71 to 1.88; 1 RCT, 200 participants) (all very low-certainty evidence) in people treated with hydromorphone compared with those treated with morphine, but the evidence is very uncertain. Quality of life We found no studies reporting quality of life. Comparison 4: hydromorphone compared with fentanyl Participant-reported pain intensity We found no clear evidence of a difference in pain intensity (measured by numerical rating scale (NRS)) at 60 minutes in people treated with hydromorphone compared with those treated with fentanyl, but the evidence is very uncertain (1 RCT, 82 participants; very low-certainty evidence). Participant-reported pain relief We found no studies reporting participant-reported pain relief. Specific adverse events We found no studies reporting specific adverse events. Quality of life We found no studies reporting quality of life. AUTHORS' CONCLUSIONS: The evidence of the benefits and harms of hydromorphone compared with other analgesics is very uncertain. The studies reported some adverse events, such as nausea, vomiting, dizziness and constipation, but generally there was no clear evidence of a difference between hydromorphone and morphine, oxycodone or fentanyl for this outcome. There is insufficient evidence to support or refute the use of hydromorphone for cancer pain in comparison with other analgesics on the reported outcomes. Further research with larger sample sizes and more comprehensive outcome data collection is required.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...