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1.
J Hazard Mater ; 421: 126696, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34332490

RESUMO

Graphitic carbon nitride (g-C3N4) has been proved to be a potential photocatalyst for environment purification, but the high recombination rate of photogenerated carriers leads to the low photocatalytic efficiency. Herein, we report the enhanced degradation of chlorophenols by 2D ultrathin g-C3N4 nanosheets with intrinsic piezoelectricity through photopiezocatalysis strategy. Under the simultaneous visible-light irradiation and ultrasonic vibration, the 2D g-C3N4 presented improved removal efficiency for elimination of 2,4-dichlorophenol (2,4-DCP) with an apparent rate constant of 6.65 × 10-2 min-1, which was 6.7 and 2.2 times of the photocatalysis and piezocatalysis, respectively. The improved removal efficiency was attributed to the sufficient separation of free charges driven by the ultrasound-induced piezoelectric field in the 2D g-C3N4, which was demonstrated by the enhanced current response under photopiezocatalysis mode. Additionally, the photopiezocatalysis of 2D g-C3N4 was proved to possess well universality for removing different chlorophenols, as well as high durability and dechlorination efficiency. Finally, a possible photopiezocatalytic mechanism for removal of 2,4-DCP was proposed based on the electron paramagnetic resonance (EPR) technique and the determination of intermediates through liquid chromatography-mass spectrometry (LC-MS) analysis. This work provides a promising strategy for the design of energy-conversion materials towards capturing solar and mechanical energy in ambient environment.

2.
Inflammopharmacology ; 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34643849

RESUMO

BACKGROUND: Thalamic pain, a neuropathic pain syndrome, frequently occurs after stroke. This research aimed to investigate the effect of dexmedetomidine (DEX) on thalamic pain. METHODS: The cellular localization of the TLR4 protein was determined by immunostaining. The expression of Iba1, GFAP and protein associated with the TLR4/NF-κB/ERK1/2 pathway was measured by Western blotting. Continuous pain hypersensitivity was evaluated by behavioural tests. The results were analysed by one-way ANOVA, two-way ANOVA and Tukey's post hoc test. RESULTS: The results demonstrated that DEX obviously alleviated thalamic pain induced by haemorrhage on the ipsilateral side and delayed the development of pain hypersensitivity. Furthermore, the expression levels of Iba1, GFAP and proteins associated with the TLR4/NF-κB/ERK1/2 signalling pathway were greatly increased in mice with thalamic pain, but these effects were reversed by DEX. CONCLUSION: Our findings suggest that DEX alleviates the inflammatory response during thalamic pain through the TLR4/NF-κB/ERK1/2 signalling pathway and might be a potential therapeutic agent for thalamic pain.

3.
Cancer Biol Med ; 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34633775

RESUMO

OBJECTIVE: Neoadjuvant chemotherapy (NAC) is currently used in both early stage and locally advanced breast cancers. The survival benefits of standard vs. non-standard NAC cycles are still unclear. This study aimed to investigate the relationship between NAC cycles and survival based on real world data. METHODS: We identified patients diagnosed with invasive primary breast cancers who underwent NAC followed by surgery. Patients who received at least 4 NAC cycles were defined as having received standard cycles, while patients who received less than 4 NAC cycles were defined as having received non-standard cycles. Kaplan-Meier curves and Cox proportional hazard models were used to estimate the disease-free survival (DFS) and overall survival (OS). RESULTS: Of the 1,024 included patients, 700 patients received standard NAC cycles and 324 patients received non-standard NAC cycles. The DFS estimates were 87.1% and 81.0% (P = 0.007) and the OS estimates were 90.0% and 82.6% (P = 0.001) in the standard and non-standard groups, respectively. Using multivariate analyses, patients treated with standard NAC cycles showed significant survival benefits in both DFS [hazard ratio (HR): 0.62, 95% confidence interval (CI): 0.44-0.88] and OS (HR: 0.54, 95% CI: 0.37-0.79). Using stratified analyses, standard NAC cycles were associated with improved DFS (HR: 0.59, 95% CI: 0.36-0.96) and OS (HR: 0.49, 95% CI: 0.28-0.86) in the HER2 positive group. Similar DFS (HR: 0.50, 95% CI: 0.25-0.98) and OS (HR: 0.45, 95% CI: 0.22-0.91) benefits were shown for the triple negative group. CONCLUSIONS: Standard NAC cycles were associated with a significant survival benefit, especially in patients with HER2 positive or triple negative breast cancer.

4.
JCI Insight ; 6(19)2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622799

RESUMO

A population genetic study identified that the asialoglycoprotein receptor 1 (ASGR1) mutation carriers had substantially lower non-HDL-cholesterol (non-HDL-c) levels and reduced risks of cardiovascular diseases. However, the mechanism behind this phenomenon remained unclear. Here, we established Asgr1-knockout mice that represented a plasma lipid profile with significantly lower non-HDL-c and triglyceride (TG) caused by decreased secretion and increased uptake of VLDL/LDL. These 2 phenotypes were linked with the decreased expression of microsomal triglyceride transfer protein and proprotein convertase subtilisin/kexin type 9, 2 key targeted genes of sterol regulatory element-binding proteins (SREBPs). Furthermore, there were fewer nuclear SREBPs (nSREBPs) on account of more SREBPs being trapped in endoplasmic reticulum, which was caused by an increased expression of insulin-induced gene 1 (INSIG1), an anchor of SREBPs. Overexpression and gene knockdown interventions, in different models, were conducted to rescue the ASGR1-deficient phenotypes, and we found that INSIG1 knockdown independently reversed the ASGR1-mutated phenotypes with increased serum total cholesterol, LDL-c, TG, and liver cholesterol content accompanied by restored SREBP signaling. ASGR1 rescue experiments reduced INSIG1 and restored the SREBP network defect as manifested by improved apolipoprotein B secretion and reduced LDL uptake. Our observation demonstrated that increased INSIG1 is a critical factor responsible for ASGR1 deficiency-associated lipid profile changes and nSREBP suppression. This finding of an ASGR1/INSIG1/SREBP axis regulating lipid hemostasis may provide multiple potential targets for lipid-lowering drug development.

5.
Bioengineered ; 12(1): 7882-7892, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34612767

RESUMO

Chitinase-3 like-protein-1 (CHI3L1) has been found to be overexpressed in many cancers and increased CHI3L1 level in serum seems to correlate with a poor prognosis in patients with metastatic cancer. However, the expression of CHI3L1 and its potential role in esophageal cancer remains unclear. We retrieved publicly available RNA-seq datasets of esophageal cancer tissues and normal esophageal tissues. We analyzed the correlation between CHI3L1 expression with different clinical parameters (such as T stages, N stage, response to treatment and tumor residues after treatment), the relationship between CHI3L1 expression level and prognosis, and the relationship between CHI3L1 expression and different immune cell signatures in esophageal cancer tissues. A transgenic mouse model of esophageal carcinoma was used to validate CHI3L1 expression and its association with macrophage signature gene expression. The effect of recombinant CHI3L1 on macrophage polarization was assessed in cell model. We showed the upregulation of CHI3L1 in esophageal cancer tissues in comparison to normal esophageal tissues, and its upregulation was positively associated with tumor size. The analysis of immunological signatures and CHI3L1 expression indicated that CHI3L1 level was highly correlated with increased expression of macrophage signature genes in esophageal tumor tissues. CHI3L1 was also upregulated in the esophagus dysplasia tissues in a transgenic mouse model. Recombinant CHI3L1 treatment favored M2 gene expression in LPS-stimulated RAW 264.7 macrophage cell line. CHI3L1 overexpression may favor macrophage recruitment in esophageal tumor tissues. Future studies are needed to delineate the mechanisms of CHI3L1-mediated macrophage recruitment and polarization in tumor tissues.

6.
Proteins ; 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34546597

RESUMO

Analysis of protein subcellular localization is a critical part of proteomics. In recent years, as both the number and quality of microscopic images are increasing rapidly, many automated methods, especially convolutional neural networks (CNN), have been developed to predict protein subcellular location(s) based on bioimages, but their performance always suffers from some inherent properties of the problem. First, many microscopic images have non-informative or noisy sections, like unstained stroma and unspecific background, which affect the extraction of protein expression information. Second, the patterns of protein subcellular localization are very complex, as a lot of proteins locate in more than one compartment. In this study, we propose a new label-correlation enhanced deep neural network, laceDNN, to classify the subcellular locations of multi-label proteins from immunohistochemistry images. The model uses small representative patches as input to alleviate the image noise issue, and its backbone is a hybrid architecture of CNN and recurrent neural network, where the former network extracts representative image features and the latter learns the organelle dependency relationships. Our experimental results indicate that the proposed model can improve the performance of multi-label protein subcellular classification.

7.
Neurotoxicology ; 87: 149-155, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34582899

RESUMO

Many environmental chemicals are being identified as suspected neurotoxicants based on the findings of both experimental and epidemiological studies. Organophosphate esters (OPEs), which are among the chemicals that have replaced neurotoxic polybrominated diphenyl ethers (PBDEs) after 2004, have also become an important public health topic as evidence regarding their potential for early-life neurotoxicity is growing. In 233 mother child pairs from Cincinnati, OH, we measured concentrations of the OPE metabolites bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), bis-2-chloroethyl phosphate (BCEP), diphenyl phosphate (DPHP), and di-n-butyl phosphate (DNBP) in the urine of pregnant women at 16 and 26 weeks gestation and at delivery. At age 8 years, we assessed children's cognition using the Wechsler Intelligence Scale for Children-IV. In models adjusted for maternal race, income, body mass index, and IQ, maternal urinary BCEP was associated with a modest increase in child full-scale IQ (ß: 0.81 per a ln-unit BCEP increase; 95 % CI: 0.00, 1.61) while other OPEs were not associated with changes in full-scale IQ or any IQ subscales. Maternal serum PBDE concentrations did not confound the relationships between urinary OPE metabolites and child IQ. Using Bayesian kernel machine regression, we did not find that concentrations of a mixture of OPE metabolites during gestation was associated with any child cognition measures. The results of this study are not consistent with other published work, and a larger sample size would be beneficial to explore potential associations more fully. Therefore, additional studies are necessary to continue studying prenatal OPE exposure and child neurodevelopment and behavior.

8.
Environ Health Perspect ; 129(9): 97011, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34585601

RESUMO

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) may impair bone accrual and strength via endocrine disruption and nuclear receptor agonism, but human studies are primarily of adults or cross-sectional. OBJECTIVES: We assessed associations of individual PFAS and their mixture during pregnancy with child bone mineral content (BMC) and areal bone mineral density (aBMD) at age 12 y. METHODS: Among 206 mother-child pairs enrolled in a prospective cohort (2003-2006), we quantified perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) in maternal serum collected during gestation or delivery. When children were age 12 y, we performed dual energy X-ray absorptiometry and calculated BMC, aBMD, and bone mineral apparent density (BMAD) z-scores for six skeletal sites. We estimated covariate-adjusted z-score differences per doubling of individual PFAS using linear regression and assessed the PFAS mixture using quantile g-computation and Bayesian kernel machine regression. We explored whether associations were modified by child's sex or mediated by whole-body lean mass. RESULTS: In covariate-adjusted models, we found that higher maternal serum concentrations of PFOA, PFNA, and the PFAS mixture were associated with lower total hip and forearm (one-third distal radius) BMC z-scores in children. Differences in forearm BMC z-scores were -0.17 [95% confidence interval (CI): -0.35, 0.01] and -0.24 (95% CI: -0.44, -0.05) per doubling of PFOA and PFNA, respectively, and -0.18 (95% CI: -0.34, -0.02) per quartile increase in the PFAS mixture. Child's sex modified PFOA associations for some skeletal sites; for example, differences in spine BMAD z-score per doubling were -0.31 (95% CI: -0.58, -0.03) among males and 0.07 (95% CI: -0.16, 0.30) among females (modification p=0.04). Except for PFNA among females, these associations were not mediated by whole-body lean mass. DISCUSSION: Maternal PFAS concentrations during pregnancy may be associated with lower bone mineral accrual and strength in early adolescence. https://doi.org/10.1289/EHP9424.

9.
World J Surg Oncol ; 19(1): 227, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344373

RESUMO

BACKGROUND: Immunoinflammatory and nutritional markers, such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Onodera's prognostic nutritional index (OPNI), have gained considerable attention and have been preliminarily revealed as prognostic markers of gastrointestinal stromal tumors (GISTs). METHODS: In this study, we first investigated the prognostic value of OPNI in GISTs treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, and data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: The patients were divided into groups treated and not treated with TKIs, and we used the propensity score matching method to homogenize their baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen, and 280 of them were included for analysis under the inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI as an independent prognostic marker that was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.409; P < 0.001) was associated with worse RFS. CONCLUSIONS: Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated and not treated with TKIs. Higher NLR and PLR have negative effects on RFS.


Assuntos
Tumores do Estroma Gastrointestinal , Avaliação Nutricional , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Humanos , Prognóstico , Inibidores de Proteínas Quinases , Estudos Retrospectivos
10.
PLoS One ; 16(8): e0254868, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34358255

RESUMO

BACKGROUND: Papillary renal cell carcinoma (PRCC) is the most common type of renal cell carcinoma after clear cell renal cell carcinoma (ccRCC). Its pathological classification is controversial, and its molecular mechanism is poorly understood. Therefore, the identification of key genes and their biological pathways is of great significance to elucidate the molecular mechanisms of PRCC occurrence and progression. METHODS: The PRCC-related datasets GSE7023, GSE48352 and GSE15641 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified, and gene ontology (GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed. Cytoscape and STRING were used to construct the protein-protein interaction network (PPI) and perform module analysis to identify hub genes and key pathways. A heatmap of hub genes was constructed using the UCSC cancer genomics browser. Overall survival and recurrence-free survival of patients stratified by the expression levels of hub genes were analysed using Kaplan-Meier Plotter. The online database UALCAN was applied to analyse gene expression based on tissue type, stage, subtype and race. RESULTS: A total of 214 DEGs, specifically, 205 downregulated genes and 9 upregulated genes, were identified. The DEGs were mainly enriched in angiogenesis, kidney development, oxidation-reduction process, metabolic pathways, etc. The 17 hub genes identified were mainly enriched in the biological processes of angiogenesis, cell adhesion, platelet degranulation, and leukocyte transendothelial migration. Survival analysis showed that EGF, KDR, CXCL12, REN, PECAM1, CDH5, THY1, WT1, PLAU and DCN might be related to the carcinogenesis, metastasis or recurrence of PRCC. UALCAN analysis showed that low expression of PECAM1 and PLAU in PRCC tissues was related to stage, subtype and race. CONCLUSIONS: The DEGs and hub genes identified in the present study provide insight into the specific molecular mechanisms of PRCC occurrence and development and may be potential molecular markers and therapeutic targets for the accurate classification and efficient diagnosis and treatment of PRCC.

11.
Brain Behav ; 11(9): e2333, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34423572

RESUMO

OBJECTIVES: Effective strategy for the treatment of depression is limited. This study was to evaluate the safety and efficacy of botulinum toxin A (BoNT/A) in the treatment of depression. METHODS: Seventy-six patients were assigned to the BoNT/A group (n = 52) and sertraline control group (n = 24). For the BoNT/A group, BoNT/A was injected into the frowning muscle, depressor muscle, occipital frontalis muscle, lateral canthus, and bilateral temporal region at 20 sites. Five units per site and a total of 100 units of BoNT/A were given. Patients in the sertraline control group were medicated with sertraline 50-200 mg (114.58 ± 52.08 mg) per day. Depression was assessed by the 17-item Hamilton Depression Scale (HAMD-17), 14-item Hamilton Anxiety Scale (HAMA-14), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). All participants were followed up for 12 weeks. RESULTS: Scores of HAMD, HAMA, SDS, and SAS decreased significantly in both BoNT/A and sertraline groups after treatment for 12 weeks. Overall, there were no differences in decreased magnitude between the two groups (p > .05). The HAMA, SDS, and SAS results showed that the onset time of BoNT/A was earlier than that of sertraline. Side effects rates were 15.38% for BoNT/A and 33.33% for sertraline. CONCLUSION: This study demonstrated significant antidepressant effects of BoNT/A. The efficacy of BoNT/A was comparable with established antidepressant sertraline. The onset time of BoNT/A was earlier than sertraline, and the proportion of side effects was less than sertraline. Therefore, BoNT/A could be a safe and effective option for the treatment of depression.

12.
Front Public Health ; 9: 704900, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34386475

RESUMO

The Bitcoin market has become a research hotspot after the outbreak of Covid-19. In this paper, we focus on the relationships between the Bitcoin spot and futures. Specifically, we adopt the vector autoregression-dynamic correlation coefficient-generalized autoregressive conditional heteroskedasticity (VAR-DCC-GARCH) model and vector autoregression-Baba, Engle, Kraft, and Kroner-generalized autoregressive conditional heteroskedasticity (VAR-BEKK-GARCH) models and calculate the hedging effectiveness (HE) value to investigate the dynamic correlation and volatility spillover and assess the risk reduction of the Bitcoin futures to spot. The empirical results show that the Bitcoin spot and futures markets are highly connected; second, there exists a bi-directional volatility spillover between the spot and futures market; third, the HE value is equal to 0.6446, which indicates that Bitcoin futures can indeed hedge the risks in the Bitcoin spot market. Furthermore, we update the data to the post-Covid-19 period to do the robustness checks. The results do not change our conclusion that Bitcoin futures can hedge the risks in the Bitcoin spot market, and besides, the post-Covid-19 results indicate that the hedging ability of Bitcoin futures increased. Finally, we test whether the gold futures can be used as a Bitcoin spot market hedge, and we further control other cryptocurrencies to illustrate the hedging ability of the Bitcoin futures to the Bitcoin spot. Overall, the empirical results in this paper will surely benefit the related investors in the Bitcoin market.


Assuntos
COVID-19 , Previsões , Humanos , SARS-CoV-2
13.
Eur J Med Chem ; 223: 113735, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34371367

RESUMO

Cannabidiol (CBD) and rivastigmine have been launched as drugs for treating dementia and cholinesterases (ChEs) are ideal drug targets. This study focused on developing novel ChE inhibitors as drug leads against dementia through molecular modeling and fragment reassembly approaches. A potent carbamate fragment binding to active site gorge of BuChE was found via a docking-based structural splicing approach, thus, 17 novel compounds were designed by structural reassembly. Compound C16 was identified as a highly selective potent BuChE inhibitor (IC50 = 5.3 nM, SI > 4000), superior to CBD (IC50 = 0.67 µM). C16 possessed BBB penetrating ability, benign safety, neuroprotection, antioxidant and pseudo-irreversible BuChE inhibition (Kd = 13 nM, k2 = 0.26 min-1), showing good drug-like properties. In vivo studies confirmed that C16 significantly ameliorated the scopolamine-induced cognition impairment, almost entirely recovered the Aß1-42 (icv)-impaired cognitive function to the normal level, showed better behavioral performance than donepezil and good anti-amyloidogenic effect. Hence, the potential BuChE inhibitor C16 can be developed as a promising disease-modifying treatment of AD.


Assuntos
Butirilcolinesterase/química , Canabidiol/química , Carbamatos/química , Inibidores da Colinesterase/química , Fármacos Neuroprotetores/química , Acetilcolinesterase/química , Acetilcolinesterase/metabolismo , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/patologia , Animais , Sítios de Ligação , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Butirilcolinesterase/metabolismo , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Inibidores da Colinesterase/metabolismo , Inibidores da Colinesterase/uso terapêutico , Desenho de Fármacos , Humanos , Cinética , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos ICR , Simulação de Acoplamento Molecular , Fármacos Neuroprotetores/metabolismo , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Relação Estrutura-Atividade
14.
Acad Pediatr ; 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34461345

RESUMO

OBJECTIVE: Primary care centers are trialing open access scheduling models to expand access. Given evidence linking irregular caregiver work schedules with adverse child developmental outcomes, we hypothesized that children presenting for unscheduled "walk-in" visits would have higher odds of developmental concerns than those presenting for scheduled visits. METHODS: We conducted a retrospective review of electronic health record data for children aged 6 to 66 months visiting an academic pediatric primary care center between July 1, 2013 and February 1, 2019. Our primary outcome was presence of developmental concerns, defined by results below cutoff on a child's Ages & Stages Questionnaire, Third Edition (ASQ-3). We examined associations between visit stream (unscheduled vs scheduled; time of day) and ASQ-3 using multivariable logistic regression, adjusting for child demographics, visit type (well-child vs ill), and responses to a standardized social history questionnaire. RESULTS: Of 11,169 eligible total encounters each for a unique child, 8% were unscheduled (n = 848); 19% had developmental concerns in at least one domain (n = 2100). Twenty-eight percent of children presenting for unscheduled visits had developmental concerns compared to 18% of those presenting for scheduled visits (P < .0001). Compared to those presenting for scheduled well-child visits, children presenting for unscheduled ill visits had a higher odds of an ASQ-3 score below cutoff (adjusted odds ratio 2.02; 95% confidence interval, 1.54-2.65). CONCLUSIONS: As pediatric primary care centers implement open access scheduling models, they should be prepared to identify and respond to developmental concerns at a rate that may be higher than what is typically seen during scheduled visits.

15.
Clin Pediatr (Phila) ; 60(11-12): 452-458, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34382880

RESUMO

Telemedicine, more novel in provision of pediatric care, rapidly expanded due to the recent coronavirus disease 2019 pandemic. This study aimed to determine the feasibility of telemedicine for acute and chronic care provision in an underserved pediatric primary care center. Items assessed included patient demographic data, chief complaint, and alternative care locations if telemedicine was not available. In our setting, 62% of telemedicine visits were for acute concerns and 38% for chronic concerns. Of acute telemedicine visits, 16.5% of families would have sought care in the Emergency Department/Urgent Care, and 11.3% would have opted for no care had telemedicine not been offered. The most common chronic issues addressed were attention deficit hyperactivity disorder (80.3%) and asthma (16.9%). Racial disparities existed among our telemedicine visits with Black patients utilizing telemedicine services less frequently than non-Black patients. Telemedicine is feasible for pediatric acute and chronic care, but systems must be designed to mitigate widening racial disparities.


Assuntos
Área Carente de Assistência Médica , Pediatria/métodos , Atenção Primária à Saúde/métodos , Telemedicina/métodos , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34432968

RESUMO

OBJECTIVES: Physical examinations to characterize pubertal maturation may be unacceptable for children enrolled in research studies. Studies confirm the utility of pubertal self staging for research, but there has been limited comparison of self examination with hormone biomarkers. Our objective was to assess concordance of pubertal self staging with hormone biomarkers of puberty. METHODS: Participants were enrolled in the Health Outcomes and Measures of the Environment Study, a longitudinal pregnancy and birth cohort study. At age 12 years, 139 females and 112 males completed pubertal self staging including breast and pubic hair development in females and pubic hair development in males. No clinical physical examination was performed. Hormone concentrations were measured in 102 females and 96 males including serum dehydroepiandrosterone sulfate, luteinizing hormone, and follicle-stimulating hormone in all; estradiol in females; and testosterone in males. RESULTS: Estradiol was significantly associated with female breast stage, even when adjusted for BMI, with geometric least squares means (95%CI) of 13.2 (8.7, 20.2), 38.3 (29.9, 49.1), 59.4 (39.8, 88.6), and 81.2 (45.6, 144) pg/mL for breast stage 1-2, 3, 4, and 5, respectively. Testosterone was significantly associated with male pubic hair stage, with adjusted geometric least squares means (95%CI) of 37.6 (19.9, 71.1), 43.4 (27.7, 68.3), 126 (78.4, 203), 275 (146, 521), and 559 (237, 1319) ng/dL for pubic hair stage 1, 2, 3, 4, and 5, respectively. CONCLUSIONS: Self assessed pubertal development was positively associated with hormonal biomarkers of puberty.

17.
Bioorg Chem ; 114: 105140, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34229200

RESUMO

Twenty seven dihydro-ß-agarofuran sesquiterpenoids, including fifteen new congeners, wilforsinines I-W (1-9, 12-13, 24-27), and twelve known compounds were isolated from the dried root of Tripterygium wilfordii. The structures of the new sesquiterpenoids, wilforsinines I-W, were elucidated by extensive spectroscopic data analysis. The anti-inflammatory activity of isolates 1-27 were evaluated by examining their inhibitory effects on nitric oxide (NO) production in LPS-induced RAW 264.7 macrophage cells. Among them, wilforsinine K (3) and angulatin M (16) exerted optimal inhibitory effects on the production of NO in LPS-induced RAW 264.7 cells. Moreover, Western blot results revealed that their anti-inflammatory activities were correlated with the suppression of the expression of nitric oxide synthase (iNOS) and down-regulation of the level of NF-κB p65 phosphorylation.

19.
Artigo em Inglês | MEDLINE | ID: mdl-34238698

RESUMO

The aim of this study is to investigate the efficacy of treatment-combined electrocauterization after removal of apocrine sweat glands with ultrasound-guided (BOTOX) injection for adolescents with axillary bromhidrosis. From January 2015 to January 2018, 90 adolescents with axillary bromhidrosis were recruited and randomly divided into three groups (group A, B, and C). Patients in group A underwent electrocauterization after removal of apocrine sweat glands, patients in group B received ultrasound-guided BOTOX injection, and patients in group C had electrocauterization after the removal of apocrine sweat glands followed by ultrasound-guided BOTOX administration after two weeks. All patients were followed up for one year. The percentages of axillary malodor score at twelve months after treatments compared with pre-operation for group A, group B, and group C were 20.2%, 27.5%, and 12.5%, respectively. Significant statistical differences were observed in changes of axillary malodor score among the three groups at three, six, nine and twelve months postoperatively. Satisfaction rates of group A, group B, and group C were 90.0%, 93.3%, and 96.7%, respectively. The side effects after surgery in group A were similar to group C, and no side effect was observed in group B. One-year postoperative scar formation rate of group A was 16.7%, which was significantly higher than that of group B (0) and group C (6.66%). Combination of electrocauterization after removal of apocrine sweat glands with ultrasound-guided BOTOX injection showed better treatment effects.

20.
Nurs Ethics ; : 9697330211015284, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34254552

RESUMO

BACKGROUND: In 2019, an outbreak of COVID-19 broke out in Hubei, China. Medical workers from all over the country rushed to Hubei and participated in the treatment and care of COVID-19 patients. These nurses, dedicated to their professional practice, volunteered to provide compassion and expert clinical care during the pandemic. As with other acts of heroism, the ethical dilemmas associated with working on the front line must be considered for future practice. PURPOSE: To explore the ethical dilemmas of frontline nurses of Jiangsu Province in China during deployment to Wuhan to fight the novel coronavirus pneumonia, and to provide a basis for developing strategies to help nursing staff address personal and practice concerns in order to work more effectively during this pandemic and other disasters in the future. RESEARCH DESIGN AND METHOD: Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 10 nurses, post-deployment to Wuhan, who had worked on the front line to fight the novel coronavirus. ETHICAL CONSIDERATIONS: The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. FINDINGS: From the analysis of the interviews of the 10 participants, three main themes were identified: ethical dilemmas in clinical nursing, ethical dilemmas in interpersonal relationships, and ethical dilemmas in nursing management. CONCLUSION: During a quick response to public health emergencies, where nurses are deployed immediately as a call to action, the issues surrounding ethical dilemmas from several perspectives must be considered. This research suggests that a team approach to proactive planning and open communication during the emergency is an efficient and productive strategy to improve the nurses' experience and sense of well-being.

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