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1.
Artigo em Inglês | MEDLINE | ID: mdl-32086872

RESUMO

To show the synthetic utility of the catalytic C-C activation of less strained substrates, here we describe collective and concise syntheses of natural products (-)-microthecaline A, (-)-leubehanol, (+)-pseudopteroxazole, (+)- seco -pseudopteroxazole, pseudopterosin A-F and G-J aglycones, and (+)-heritonin. The key step in these syntheses involve a Rh-catalyzed C-C/C-H activation cascade of 3-arylcyclopentanones, which provides a rapid and enantioselective route to access the polysubstituted tetrahydronaphthalene cores presented in these natural products. Other important features include (i) the direct C-H amination of the tetralone substrate in the synthesis of (-)-microthecaline A, (ii) the use of phosphoric acids to enhance efficiency and regioselectivity for problematic cyclopentanone substrates in the C-C activation reactions, and (iii) the direct conversion of serrulatane to amphilectane diterpenes via an allylic cyclodehydrogenation coupling.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32088846

RESUMO

Poor mental health remains a significant source of morbidity and mortality in the Bhutanese refugee community. Mental Health First Aid (MHFA) is a promising intervention that has been used in other immigrant communities to prepare individuals to recognize and respond to mental health warning signs. This was a non-randomized program evaluation. Using pre- and post-training questionnaires developed for prior evaluations of MHFA, we examined the effectiveness of training offered with and without culturally-appropriate orientation to mental health terminology and concepts (N = 458). Pre- to post-training improvement in ability to recognize schizophrenia, ability to respond to schizophrenia and depression, and the overall mental health literacy was greater for Bhutanese refugees who attended orientation relative to other participants (P < 0.05). In scaling up MHFA training for other immigrant communities, we recommend developing and systematically evaluating culturally-appropriate orientation materials that introduce mental health vocabulary and contextualize mental health concepts.

3.
Nat Commun ; 11(1): 792, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32034155

RESUMO

Acyclic contiguous stereocenters are frequently seen in biologically active natural and synthetic molecules. Although various synthetic methods have been reported, predictable and unified approaches to all possible stereoisomers are rare, particularly for those containing non-reactive hydrocarbon substituents. Herein, a ß-boronyl group is employed as a readily accessible handle for predictable α-functionalization of enolates with either syn or anti selectivity depending on reaction conditions. Contiguous tertiary-tertiary and tertiary-quaternary stereocenters are thus accessed in generally good yields and diastereoselectivity. Based on experimental and computational studies, mechanism for syn selective alkylation is proposed, and Bpin (pinacolatoboronyl) behaves as a smaller group than most carbon-centered groups. The synthetic utility of this methodology is demonstrated by preparation of several key intermediates for bioactive molecules.

4.
Front Oncol ; 9: 1180, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31788447

RESUMO

Gallbladder carcinoma (GBC) is a relatively rare and aggressive malignant tumor with a poor prognosis. A systematic review of current clinical studies illustrates an extreme paucity of second-line therapeutic options following the failure of standard-of-care cisplatin-gemcitabine chemotherapy. The efficacy of apatinib, an highly potent and selective oral inhibitor of VEGFR-2 tyrosine kinase, for refractory advanced GBC has not yet been clarified. Herein, we report a case of advanced GBC that presented a durable partial response to apatinib used as monotherapy after the failure of multiline chemotherapies including S-1 monotherapy, capecitabine monotherapy, gemcitabine plus capecitabine, and irinotecan plus oxaliplatin. The patient achieved an efficacy of partial response within 2 months. By September 23, 2019, the duration of treatment had extended for almost 1 year with a satisfactory quality of life, and the administration of apatinib was continued. Dose reduction of apatinib occurred at week four due to grade 2 hypertension and hand-foot skin reaction (HFSR). No fatigue, proteinuria, mucositis, or thrombocytopenia occurred. To the best of our knowledge, this is the first case of a successful use of apatinib monotherapy for heavily pretreated GBC. Further prospective studies are warranted to confirm the efficacy and safety of apatinib in GBC.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31849167

RESUMO

Commercial ultrafiltration membranes have proliferated globally for water treatment. However, their pore sizes are too large to sieve gases. Conjugated microporous polymers (CMPs) feature well-developed microporosity yet are difficult to be fabricated into membranes. Herein, we report a strategy to prepare molecular-sieving membranes by partitioning the mesoscopic channels in water ultrafiltration membrane (PSU) into ultra-micropores by space-confined polymerization of multi-functionalized rigid building units. Nine CMP@PSU membranes were obtained, and their separation performance for H2 /CO2 , H2 /N2 , and H2 /CH4 pairs surpass the Robeson upper bound and rival against the best of those reported membranes. Furthermore, highly crosslinked skeletons inside the channels result in the structural robustness and transfer into the excellent aging resistance of the CMP@PSU. This strategy may shed light on the design and fabrication of high-performance polymeric gas separation membranes.

6.
J Xray Sci Technol ; 27(5): 949-963, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31381539

RESUMO

PURPOSE: To reduce the cost of positron emission tomography (PET) scanning systems, image reconstruction algorithms for low-sampled data have been extensively studied. However, the current method based on total variation (TV) minimization regularization nested in the maximum likelihood-expectation maximization (MLEM) algorithm cannot distinguish true structures from noise resulting losing some fine features in the images. Thus, this work aims to recover fine features lost in the MLEM-TV algorithm from low-sampled data. METHOD: A feature refinement (FR) approach previously developed for statistical interior computed tomography (CT) reconstruction is applied to PET imaging to recover fine features in this study. The proposed method starts with a constant initial image and the FR step is performed after each MLEM-TV iteration to extract the desired structural information lost during TV minimization. A feature descriptor is specifically designed to distinguish structure from noise and artifacts. A modified steepest descent method is adopted to minimize the objective function. After evaluating the impacts of different patch sizes on the outcome of the presented method, an optimal patch size of 7×7 is selected in this study to balance structure-detection ability and computational efficiency. RESULTS: Applying MLEM-TV-FR algorithm to the simulated brain PET imaging using an emission activity phantom, a standard Shepp-Logan phantom, and mouse results in the increased peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) as comparing to using the conventional MLEM-TV algorithm, as well as the substantial reduction of the used sampling numbers, which improves the computational efficiency. CONCLUSIONS: The presented algorithm can achieve image quality superior to that of the MLEM and MLEM-TV approaches in terms of the preservation of fine structure and the suppression of undesired artifacts and noise, indicating its useful potential for low-sampled data in PET imaging.

7.
Am J Physiol Renal Physiol ; 317(5): F1311-F1317, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31339772

RESUMO

Ischemia-reperfusion (I/R)-induced acute kidney injury (I/R-AKI) favors mitochondrial permeability transition pore (mPTP) opening and subsequent cell death. Cyclophilin D (CypD) is an essential component of the mPTP, and recent findings have implicated the p53-CypD complex in cell death. To evaluate the role of p53-CypD after I/R-AKI, we tested the hypothesis that the p53-CypD complex mediates renal tubular cell apoptosis in I/R-AKI via mPTP opening. Expression of p53 and cleaved caspase-3 was significantly increased in rats subjected to I/R-AKI compared with normal controls and sham-operated controls. The underlying mechanisms were determined using an in vitro model of ATP depletion. Inhibition of mPTP opening using the CypD inhibitor cyclosporin A or siRNA for p53 in ATP-depleted HK-2 cells prevented mitochondrial membrane depolarization and reduced apoptosis. Furthermore, p53 bound to CypD in ATP-depleted HK-2 cells. These results suggest that the p53-CypD complex mediates renal tubular cell apoptosis in I/R-AKI via mPTP opening.

8.
Mol Med Rep ; 20(2): 1613-1620, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257491

RESUMO

Renal tubular epithelial cell apoptosis is an important pathological mechanism of septic acute kidney injury (AKI). Endotoxin, also known as lipopolysaccharide (LPS), has a key role in septic AKI and can directly induce tubular epithelial cell apoptosis. The upregulation of receptor­interacting protein kinase 3 (RIPK3) in tubular epithelial cells has been reported in septic AKI, with RIPK3 mediating apoptosis in several cell types. In the present study, the effect of RIPK3 on endotoxin­induced AKI was investigated in mouse tubular epithelial cell apoptosis in vitro and in vivo. It was found that the expression of RIPK3 was markedly increased in endotoxin­induced AKI. Endotoxin­induced AKI and tubular epithelial cell apoptosis could be attenuated by GSK'872, a RIPK3 inhibitor. LPS stimulation also upregulated RIPK3 expression in tubular epithelial cells in a time­dependent manner. Both RIPK3 inhibitor and small interfering RNA (siRNA) targeting RIPK3 reduced LPS­induced tubular epithelial cell apoptosis in vitro. The expression of the proapoptotic protein Bax was induced by LPS and reversed by GSK'872 or RIPK3­siRNA. The present study revealed that RIPK3 mediated renal tubular cell apoptosis in endotoxin­induced AKI. RIPK3 may be a potential target for the prevention of renal tubular cell apoptosis in endotoxin­induced AKI.


Assuntos
Lesão Renal Aguda/metabolismo , Células Epiteliais/patologia , Túbulos Renais/patologia , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismo , Lesão Renal Aguda/induzido quimicamente , Lesão Renal Aguda/patologia , Animais , Apoptose , Células Cultivadas , Modelos Animais de Doenças , Endotoxinas/efeitos adversos , Células Epiteliais/metabolismo , Túbulos Renais/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Proteína Serina-Treonina Quinases de Interação com Receptores/análise
9.
J Xray Sci Technol ; 27(4): 739-753, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31227684

RESUMO

X-ray radiation is harmful to human health. Thus, obtaining a better reconstructed image with few projection view constraints is a major challenge in the computed tomography (CT) field to reduce radiation dose. In this study, we proposed and tested a new algorithm that combines penalized weighted least-squares using total generalized variation (PWLS-TGV) and dictionary learning (DL), named PWLS-TGV-DL to address this challenge. We first presented and tested this new algorithm and evaluated it through both data simulation and physical experiments. We then analyzed experimental data in terms of image qualitative and quantitative measures, such as the structural similarity index (SSIM) and the root mean square error (RMSE). The experiments and data analysis indicated that applying the new algorithm to CT data recovered images more efficiently and yielded better results than the traditional CT image reconstruction approaches.

10.
Angew Chem Int Ed Engl ; 58(26): 8768-8772, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31050847

RESUMO

Membrane technologies that do not rely on heat for industrial gas separation would lower global energy cost. While polymeric, inorganic, and mixed-matrix separation membranes have been rapidly developed, the bottleneck is balancing the processability, selectivity, and permeability. Reported here is a softness adjustment of rigid networks (SARs) strategy to produce flexible, stand-alone, and molecular-sieving membranes by electropolymerization. Here, 14 membranes were rationally designed and synthesized and their gas separation ability and mechanical performance were studied. The separation performance of the membranes for H2 /CO2 , H2 /N2 , and H2 /CH4 can exceed the Robeson upper bound, among which, H2 /CO2 separation selectivity reaches 50 with 626 Barrer of H2 permeability. The long-term and chemical stability tests demonstrate their potential for industrial applications. This simple, scalable, and cost-effective strategy holds promise for the design other polymers for key energy-intensive separations.

11.
Cureus ; 10(9): e3328, 2018 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-30473961

RESUMO

We assessed the association between different levels of needle exchange program (NEP) use and human immunodeficiency virus (HIV) seroconversion in the injecting drug user (IDU) population using meta-analysis to aggregate risk estimates from any reported cohort studies or randomized controlled trials (RCTs) in the literature. We searched the literature for articles published from January 1990 to August 2014 using Medical Subject Headings and other terms from MEDLINE® (using Ovid), Embase, ProQuest, the International Aids Society Abstract database, and the European AIDS clinical society database, and the European Conferences Abstract Archive. Articles were included if data were reported from an original study; the study was a prospective cohort or RCT design; estimates for seroconversion (hazard ratios [HRs]) for drug-users with different levels of NEP-use, as well as variance data, or the information to calculate these were reported; risk estimates were adjusted for unstable housing, risky sexual behaviors, frequency of injections, cocaine use, and risky needle sharing practices; and the study was published between January 1990 and August 2014. Information abstracted was general study information (i.e., study name, authors, publication year, study site, sample size, length of follow-up, and follow-up intervals, incentives to IDUs for improving compliance/enrollment), outcomes variable measures (seroconversion HR estimates, variance figures, and factors adjusted for), description of the study population (inclusion and exclusion criteria and definitions of comparison groups), type of intervention (NEP program), statistical methods used, and sub-group information. Two prospective cohort studies with a total of 3,172 IDUs were eligible for inclusion. Comparison groups had different levels of NEP-use (e.g., daily use vs. non-daily use and NEP-users vs. non-users) from fixed-site NEPs. Our Q-statistic was insignificant with a p-value of 0.401 while the I2 value was 0.0%. A random-effects model was used to aggregate the estimates, and we found an overall significant positive association between NEP-use and HIV seroconversion with an HR estimate of 1.59 (95% confidence interval [CI]: 1.2 to 2.1). According to our results, higher usage of NEPs is associated with a higher risk of HIV seroconversion in the IDU population. The observed association aligns with previous findings of NEP programs being inadequate for HIV control in IDUs. Further research on the topic needs to be done including studies on different NEP designs and how they can be made more effective by combining with other strategies, including the study of IDU characteristics which make them more likely to use safe syringes when they inject.

12.
Cancer Manag Res ; 10: 4065-4072, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30323662

RESUMO

Background: The effectiveness of gemcitabine plus capecitabine compared with gemcitabine monotherapy for resected pancreatic cancer has been evaluated in the ESPAC-4 trial. We aimed to assess the cost-effectiveness of these adjuvant regimens on resected pancreatic cancer. Methods: A Markov model was established to simulate the disease process of resected pancreatic cancer (relapse-free survival, progressive disease, and death). The efficacy and toxicity profiles were collected from the ESPAC-4 trial. Transition probabilities were calculated based on survival in each group. Cost data were calculated from the perspective of the Chinese health-care payer. The primary endpoint in the analysis was the incremental cost-effectiveness ratio (ICER), and model uncertainties were explored by one-way sensitivity analysis and probabilistic sensitivity analysis. Results: Our results demonstrated that gemcitabine monotherapy cost $36,028.45 and yielded a survival of 1.02 quality-adjusted life year (QALY), while gemcitabine plus capecitabine cost $46,095.05 and yielded a survival of 1.23 QALY. Therefore, the incremental cost-effectiveness ratio of gemcitabine plus capecitabine vs gemcitabine monotherapy was $45,191.23 which surpassed the willingness-to-pay threshold of $29,291.42 per QALY in China. Conclusion: The gemcitabine monotherapy regimen is more cost-effective compared with gemcitabine plus capecitabine regimen for the patients with postoperative pancreatic cancer from the Chinese societal perspective.

13.
Angew Chem Int Ed Engl ; 57(50): 16501-16505, 2018 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-30334322

RESUMO

Covalent organic framework (COF) films combine the processability of polymers with the porosity and atomic precision of crystalline porous materials, properties that are long-sought-after in electronics yet hard to realize. Herein, we prepared four flexible COF films with different alkoxy side chains via interfacial polymerization. The COF films exhibit an ultralow dielectric constant (κ=1.19±0.04 at 105  Hz), small dielectric loss (<0.02, 103 -106  Hz), high breakdown voltage (>63 kV cm-1 ) and low leakage current (10-10  A cm-2 at 1 kV cm-1 ). They have considerable mechanical strength, and ability to withstand high humidity (RH 70 % for 10 days) and repeated bending (1000 times) without losing their dielectric properties. Extension of the alkoxy chains reduces the film's κ and enhances its moisture resistance, while incorporation of guest molecules further increase the κ value up to 43 times.

14.
Br J Psychiatry ; 213(4): 579-586, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30160644

RESUMO

BACKGROUND: The Chinese Great Famine caused widespread starvation in 1959-1961. Its long-term association with depressive symptoms has not been studied.AimsTo estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms. METHOD: The China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression. RESULTS: The prevalence of depressive symptoms was 26.2% (95% CI 25.1-27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1-13.1%) of this population experienced severe famine. When compared with participants who did not experience starvation, those who had experienced severe famine during fetal, mid-childhood, young-teenage and early-adulthood stages had 1.87 (95% CI 1.36-2.55), 1.54 (95% CI 1.23-1.94), 1.47 (95% CI 1.09-2.00) and 1.77 (95% CI 1.42-2.21) times higher odds of having depressive symptoms in late adulthood, respectively. The first two trimesters of pregnancy were a critical time window during the fetal stage when severe famine had a stronger association with depressive symptoms. Famine during infant, toddler, preschool or teenage stages was not associated with depressive symptoms. Overall, famine contributed to 13.6% of the depressive symptom burden in this population. CONCLUSIONS: The Chinese Great Famine contributed substantially to the burden of depressive symptoms in China.Declaration of interestNone.


Assuntos
Depressão/epidemiologia , Inanição/epidemiologia , Inanição/psicologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Depressão/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Prevalência , Pontuação de Propensão , Aposentadoria , Adulto Jovem
15.
ACS Appl Mater Interfaces ; 10(4): 3160-3163, 2018 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-29322772

RESUMO

Three new Al-MOFs in the formation of [Al4(OH)2(OCH3)4(OH-BDC)3]·xH2O (BIT-72), [Al4(OH)2(OCH3)4(CH3-BDC)3]·xH2O (BIT-73) and {Al4(OH)2(OCH3)4[(CH3)2-BDC]3}·xH2O (BIT-74) have been synthesized by assembling Al3+ ion with terephthalic acid ions decorated with monohydroxyl, monomethyl or dimethyl groups, respectively. All of these three MOFs exhibit high stability in boiling water and acidic conditions. Among them, BIT-72 shows the highest surface area of 1618 m2·g-1 and IAST CO2/N2 selectivity of 48, while BIT-73 and BIT-74 present moderate IAST CO2/N2 selectivity and much lower H2O capacity below P/P0 = 0.3. The high CO2/N2 selectivity together with alleviative H2O sorption at low water relative pressure may provide promising potential in postcombustion CO2 capture.

16.
Phys Med Biol ; 62(12): 5114-5130, 2017 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-28402287

RESUMO

Penalized likelihood (PL) reconstruction has demonstrated potential to improve image quality of positron emission tomography (PET) over unregularized ordered-subsets expectation-maximization (OSEM) algorithm. However, selecting proper regularization parameters in PL reconstruction has been challenging due to the lack of ground truth and variation of penalty functions. Here we present a method to choose regularization parameters using a cross-validation log-likelihood (CVLL) function. This new method does not require any knowledge of the true image and is directly applicable to list-mode PET data. We performed statistical analysis of the mean and variance of the CVLL. The results show that the CVLL provides an unbiased estimate of the log-likelihood function calculated using the noise free data. The predicted variance can be used to verify the statistical significance of the difference between CVLL values. The proposed method was validated using simulation studies and also applied to real patient data. The reconstructed images using optimum parameters selected by the proposed method show good image quality visually.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Tomografia por Emissão de Pósitrons , Algoritmos , Humanos , Funções Verossimilhança , Imagens de Fantasmas
17.
J Nutr Sci Vitaminol (Tokyo) ; 62(4): 213-219, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27725405

RESUMO

Vitamin D deficiency is highly prevalent all over the world and dietary intakes of vitamin D are very low in China. In this study we aimed to determine whether vitamin D deficiency is associated with increased risk of metabolic syndrome (MetS) among Chinese type 2 diabetes mellitus (T2DM) patients aged over 50 y. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured in a cross-sectional sample of 270 T2DM patients aged over 50 y from Zhejiang. Data on demographic characteristics, anthropometry and other variables were collected. The mean of serum 25(OH)D was 22.93 ng/mL, and percentages of vitamin D deficiency and insufficiency were 43.71% and 39.63%, respectively. Serum 25(OH)D concentrations were significantly lower in subjects with MetS than in those without MetS (21.74 vs 24.96 ng/mL, p=0.001), and the prevalence of MetS significantly increased according to tertiles of serum 25(OH)D concentrations. After adjusting for multivariate factors, the adverse effect of lower serum 25(OH)D concentrations was significant (OR: 3.26, 95% CI: 1.03-7.34; p=0.044) in the group with BMI≥24 kg/m2 while the change in OR of MetS for each 10 ng/mL decrease in the serum 25(OH)D concentrations was 2.03 (95% CI: 1.10-3.79). These results suggest that serum 25(OH)D deficiency may be a risk factor of MetS among Chinese type 2 diabetic patients, especially in the T2DM with BMI≥24 kg/m2. The challenge is determining the mechanisms of vitamin D action for recommendation of vitamin D supplementation that reduces the risks of MetS and progression to T2DM.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Síndrome Metabólica/epidemiologia , Deficiência de Vitamina D/sangue , Idoso , Grupo com Ancestrais do Continente Asiático , Biomarcadores/sangue , Glicemia/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , China/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Insulina/sangue , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Triglicerídeos/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Circunferência da Cintura
18.
Curr Med Res Opin ; 32(8): 1399-407, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27052817

RESUMO

PURPOSE: The objective of the study is to evaluate the effect of antiviral treatment, pre-existing diseases, and sociodemographic factors on the risk of influenza-related complications and healthcare utilization. METHODS: Case data was obtained from U.S. MarketScan Research Databases. Cases had a clinical diagnosis of influenza between 2006 and 2010 and continuous healthcare insurance from 90 days before to 30 days after diagnosis. Logistic regression models were applied to explore the impact of antiviral treatment on complications and healthcare utilization. Modified generalized estimating equation regression models in propensity score matched samples were used to address the robustness of the study. RESULTS: Analyses included 1,557,437 cases from four influenza seasons. In each season, 34.82%-43.42% of patients received antiviral treatment, mostly oseltamivir. On average, 1.86% of patients were hospitalized, 9.56% visited the emergency room and 41.14% made ≥2 outpatient visits. The incidence of complications ranged from 17.62 to 19.67 per 100 patient-months. The relative risk of complications was increased in patients aged 0-4 years and those with pre-existing diseases, including asthma, Parkinson's disease, and cystic fibrosis. Overall, patients receiving antiviral treatment had an 11% reduction in the risk of complications. Among oseltamivir-treated patients, the risk of complications was significantly reduced by 81% in those treated ≤2 days after diagnosis compared with later. Antiviral treatment significantly reduced the risk of hospitalization, emergency room visits and need for ≥2 outpatient visits by 29%, 24% and 11%, respectively. The propensity score matching method improved the strength of the study. CONCLUSIONS: Early treatment with antivirals, and specifically oseltamivir, significantly reduced the risk of influenza-related complications and healthcare utilization. However, lacking information about disease severity and the time from onset of symptoms to fulfillment of a prescription may bias the outcomes.


Assuntos
Antivirais/uso terapêutico , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêutico , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/complicações , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
19.
J Nucl Med ; 57(7): 1130-5, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27013696

RESUMO

UNLABELLED: We developed a prototype small-animal PET scanner based on depth-encoding detectors using dual-ended readout of small scintillator elements to produce high and uniform spatial resolution suitable for imaging the mouse brain. METHODS: The scanner consists of 16 tapered dual-ended-readout detectors arranged in a 61-mm-diameter ring. The axial field of view (FOV) is 7 mm, and the transaxial FOV is 30 mm. The scintillator arrays consist of 14 × 14 lutetium oxyorthosilicate elements, with a crystal size of 0.43 × 0.43 mm at the front end and 0.80 × 0.43 mm at the back end, and the crystal elements are 13 mm long. The arrays are read out by 8 × 8 mm and 13 × 8 mm position-sensitive avalanche photodiodes (PSAPDs) placed at opposite ends of the array. Standard nuclear-instrumentation-module electronics and a custom-designed multiplexer are used for signal processing. RESULTS: The detector performance was measured, and all but the crystals at the very edge could be clearly resolved. The average intrinsic spatial resolution in the axial direction was 0.61 mm. A depth-of-interaction resolution of 1.7 mm was achieved. The sensitivity of the scanner at the center of the FOV was 1.02% for a lower energy threshold of 150 keV and 0.68% for a lower energy threshold of 250 keV. The spatial resolution within a FOV that can accommodate the entire mouse brain was approximately 0.6 mm using a 3-dimensional maximum-likelihood expectation maximization reconstruction. Images of a hot-rod microphantom showed that rods with a diameter of as low as 0.5 mm could be resolved. The first in vivo studies were performed using (18)F-fluoride and confirmed that a 0.6-mm resolution can be achieved in the mouse head in vivo. Brain imaging studies with (18)F-FDG were also performed. CONCLUSION: We developed a prototype PET scanner that can achieve a spatial resolution approaching the physical limits of a small-bore PET scanner set by positron range and detector interaction. We plan to add more detector rings to extend the axial FOV of the scanner and increase sensitivity.


Assuntos
Encéfalo/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/instrumentação , Animais , Eletrônica , Desenho de Equipamento , Fluordesoxiglucose F18 , Processamento de Imagem Assistida por Computador , Lutécio , Camundongos , Imagens de Fantasmas , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Silicatos
20.
Infect Agent Cancer ; 11: 3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26788120

RESUMO

BACKGROUND: Mounting evidence suggests a causal relationship between specific bacterial infections and the development of certain malignancies. However, the possible role of the keystone periodontal pathogen, Porphyromonas gingivalis, in esophageal squamous cell carcinoma (ESCC) remains unknown. Therefore, we examined the presence of P. gingivalis in esophageal mucosa, and the relationship between P. gingivalis infection and the diagnosis and prognosis of ESCC. METHODS: The presence of P. gingivalis in the esophageal tissues from ESCC patients and normal controls was examined by immunohistochemistry using antibodies targeting whole bacteria and its unique secreted protease, the gingipain Kgp. qRT-PCR was used as a confirmatory approach to detect P. gingivalis 16S rDNA. Clinicopathologic characteristics were collected to analyze the relationship between P. gingivalis infection and development of ESCC. RESULTS: P. gingivalis was detected immunohistochemically in 61 % of cancerous tissues, 12 % of adjacent tissues and was undetected in normal esophageal mucosa. A similar distribution of lysine-specific gingipain, a catalytic endoprotease uniquely secreted by P. gingivalis, and P. gingivalis 16S rDNA was also observed. Moreover, statistic correlations showed P. gingivalis infection was positively associated with multiple clinicopathologic characteristics, including differentiation status, metastasis, and overall survival rate. CONCLUSION: These findings demonstrate for the first time that P. gingivalis infects the epithelium of the esophagus of ESCC patients, establish an association between infection with P. gingivalis and the progression of ESCC, and suggest P. gingivalis infection could be a biomarker for this disease. More importantly, these data, if confirmed, indicate that eradication of a common oral pathogen could potentially contribute to a reduction in the overall ESCC burden.

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