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1.
J Consult Clin Psychol ; 89(10): 869-884, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34807661

RESUMO

Objective: High dropout rates are common in randomized clinical trials (RCTs) for comorbid posttraumatic stress disorder and substance use disorders (PTSD + SUD). Optimizing attendance is a priority for PTSD + SUD treatment development, yet research has found few consistent associations to guide responsive strategies. In this study, we employed a data-driven pipeline for identifying salient and reliable predictors of attendance. Method: In a novel application of the iterative Random Forest algorithm (iRF), we investigated the association of individual level characteristics and session attendance in a completed RCT for PTSD + SUD (n = 70; women = 22 [31.4%]). iRF identified a group of potential predictor candidates for the total trial sessions attended; then, a Poisson regression model assessed the association between the iRF-identified factors and attendance. As a validation set, a parallel regression of significant predictors was conducted on a second, independent RCT for PTSD + SUD (n = 60; women = 48 [80%]). Results: Two testable hypotheses were derived from iRF's variable importance measures. Faster within-treatment improvement of PTSD symptoms was associated with greater session attendance with age moderating this relationship (p = .01): faster PTSD symptom improvement predicted fewer sessions attended among younger patients and more sessions among older patients. Full-time employment was also associated with fewer sessions attended (p = .02). In the validation set, the interaction between age and speed of PTSD improvement was significant (p = .05) and the employment association was not. Conclusions: Results demonstrate the potential of data-driven methods to identifying meaningful predictors as well as the dynamic contribution of symptom change during treatment to understanding RCT attendance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Comorbidade , Feminino , Humanos , Aprendizado de Máquina , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia
2.
Int J Dent Hyg ; 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758187

RESUMO

INTRODUCTION: The Supplemental Nutrition Assistance Programme (SNAP) is a federal programme aimed to alleviate hunger and improve food insecurity. The impact of SNAP participation on overall health has been studied. However, little is known about the effects of SNAP participation on oral health. We aimed to investigate the association between participating in SNAP and dental caries and to explore the role of food insecurity as a moderator in this relationship. METHODS: We obtained data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 and 2013-2014.The primary outcome was untreated dental caries (none vs. one or more). Self-reported SNAP participation status in the past 12 months was the predictor, and food security was the moderator. Food security was measured as overall food security status (full food secure/ food insecure) and household-level food security (full, marginal, low and very low). Bivariate and multiple logistic regression analyses were conducted to evaluate the relationship between SNAP and dental caries, and whether food insecurity moderates this relationship. Statistical analysis was carried out in September 2020. RESULTS: Our results suggested that after adjusting for potential confounders, SNAP participants were more likely to have untreated dental caries than non-SNAP participants (odds ratio: 1.6; 95% CI: 1.2-2.0). Food security status did not alter the relationship between SNAP participation and untreated dental caries. CONCLUSIONS: Food security status did not alter the relationship between SNAP participation and untreated dental caries. SNAP participation was associated with untreated dental caries among U.S. adults, and this was not affected by their food security status.

3.
Ann Behav Med ; 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34453512

RESUMO

BACKGROUND: In the general population, quitting smoking is associated with improved health-related quality of life (QoL), but this association has not been examined in smokers with chronic mobility impairments (MIs). PURPOSE: We examined associations between smoking status and health-related QoL over 6 months, and whether relationships are moderated by depression and MI severity. METHODS: This is a secondary analysis of a smoking cessation induction trial among smokers with MIs (n = 241, 56% female, 36% Black) assessed at baseline, and 4 and 6 months after. Participants were grouped into "Smokers" (smoking at 4 and 6 months), "Abstainers" (quit at 4 and 6 months), "Relapsers" (relapsed at 6 months), and "Late-quitters" (quit at 6 months). Physical and mental health-related QoL was assessed with the Short-Form Health Survey. Depression was defined as scores ≥10 on the Patient Health Questionnaire, and MI severity by the use of skilled care for personal needs. Data were analyzed with linear mixed models. RESULTS: Aggregating across time, among nondepressed participants, compared with "Smokers," the "Abstainer," and "Late-quitter" groups improved their physical health scores. "Late-quitters" also improved compared with "Relapsers." Among the total sample, compared with "Smokers," "Abstainers" showed improvements in mental health scores overtime, whereas "Relapsers" improved their score at 4 months, and "Late-quitters" improved at 6 months. CONCLUSIONS: Quitting smoking is associated with improvements in physical health-related QoL regardless of the severity of MI but only among those without depression at baseline. For mental health-related QoL, associations with quitting smoking were independent of baseline depression and severity of MI.

4.
BMC Oral Health ; 21(1): 332, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225707

RESUMO

BACKGROUND: Vitamin D is critical for bone physiology. In this study, we quantified Vitamin D Binding Protein (VitDBP) levels in saliva as a measure of Vitamin D during orthodontic tooth movement. METHODS: In this longitudinal study, saliva samples were collected from 73 orthodontic patients for 4 timepoints for the first six months of orthodontic treatment, along with dental casts at the beginning and the end of the study period. The saliva was measured for VitDBP as a biological marker for bone apposition and clinical tooth movement. We used the absolute change in Little's Irregularity Index as a quantitative measure for alignment. In addition, we measured the levels of alkaline phosphatase (ALP) in saliva as a marker of bone turnover. RESULTS: Both low (< 2.75 ng/ml) and high (> 6.48 ng/ml) VitDBP levels were associated with reduced tooth movement. Significant (p < 0.05) seasonal changes in VitDBP using a two-season year model were found with lower levels observed in the summer (Apr-Sept) than in the winter (Oct-Mar). CONCLUSIONS: Clinically significant orthodontic tooth movement is associated with an optimal range of VitDBP in saliva. Normal levels of VitDBP correlated with more orthodontic tooth movement, suggesting a "normal" range of salivary content of VitDBP. Given the strong trend that is independent of the confounding factors (ex. age, race or gender), the predictive value or salivary VitDBP for tooth movement should be studied in larger cohorts in future studies.


Assuntos
Técnicas de Movimentação Dentária , Proteína de Ligação a Vitamina D , Remodelação Óssea , Humanos , Estudos Longitudinais , Saliva
5.
J Am Dent Assoc ; 152(8): 613-621, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34147241

RESUMO

BACKGROUND: The aim of this study was to examine the association between food insecurity and untreated caries among US children and the potential role of diet quality as a mediator in this relationship. METHODS: The authors analyzed data for 4,822 children aged 5 through 17 years from the National Health and Nutrition Examination Survey cycles from 2011 through 2014. The authors measured food security as household-level food security status (full, marginal, low, very low) and overall food security status (full food secure, food insecure). They measured diet quality using the Healthy Eating Index. The primary outcome measure was untreated caries (none, ≥ 1). The authors used multiple logistic regression analysis to evaluate the relationships among food insecurity, diet quality, and untreated caries. They conducted mediation analysis using the Baron and Kenny approach. RESULTS: Food-insecure children were more likely to have untreated caries compared with their fully food-secure counterparts, after controlling for confounding variables (odds ratio [OR], 1.38; 95% [CI, 1.11 to 1.72). Specifically, children from marginal and very low food-secure households had significantly higher odds of untreated caries (OR, 1.48; 95% CI, 1.10 to 2.01) compared with children from fully food-secure households (OR, 1.59; 95% CI, 1.12 to 2.26). Diet quality was not significantly associated with untreated caries. CONCLUSIONS: Food insecurity was negatively associated with untreated caries among US children. Diet quality was not associated with untreated caries. PRACTICAL IMPLICATIONS: Social factors such as food insecurity should be taken into consideration when dental clinicians perform caries risk assessment because caries risk is shown to be associated with overall health and dental health.


Assuntos
Suscetibilidade à Cárie Dentária , Insegurança Alimentar , Criança , Estudos Transversais , Dieta , Abastecimento de Alimentos , Humanos , Inquéritos Nutricionais , Fatores Socioeconômicos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33799795

RESUMO

Previous studies investigating the effect of excessive weight on the foot have commonly been cross-sectional; therefore, it is still unclear how the foot function gradually changes with the increased body mass that is physiologically gained over time. This study aimed to use a load transfer method to identify the mechanism of how the foot function changed with the increased excessive body mass over two years. Taking normal weight as the baseline, fifteen children became overweight or obese (group 1), and fifteen counterparts maintained normal weight (group 0) over the two years. Barefoot walking was assessed using a Footscan® plate system. A load transfer method was used based upon the relative force-time integral (FTI) to provide an insight into plantar load transference as children increased in weight. Significantly increased FTIs were found at the big toe (BT), medial metatarsal (MM), lateral metatarsal (LM), and lateral heel (HL) in group 1, while at BT, MM, medial heel (HM), and HL in group 0. Foot load showed a posterior to anterior transferal from midfoot (2.5%) and heel (7.0%) to metatarsal and big toe in group 1. The control group, however, shifted the loading within the metatarsal level from LM to HM (4.1%), and equally relieved weight from around the midfoot (MF) (3.0%) to BT, MM, HM and HL. Earlier weight loss intervention is required to prevent further adverse effects on foot functions caused by excessive weight-bearing.


Assuntos
, Caminhada , Criança , Estudos Transversais , Humanos , Estudos Longitudinais , Pressão
7.
Biosci Trends ; 15(2): 129-131, 2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-33776019

RESUMO

During the COVID-19 pandemic, frontline nurses have faced extraordinary personal and professional challenges. These challenges have had mental health consequences, and concerning reports of burnout have emerged globally. We conducted a cross-sectional survey at a designated COVID-19 hospital in Shanghai at the peak of the pandemic, i.e. about 2 months after the onset of the outbreak from February to April 2020. Findings revealed burnout in 6.85% of nurses. Of 336 respondents, 87 (25.89%) had a high level of emotional exhaustion, 61 (18.15%) had a high level of depersonalization, and 100 (29.76%) had a low level of personal accomplishment. Burnout can be prevented by offering more support from families and supervisors, paying attention to health monitoring and personal protection, and creating a rational human resource allocation and shift management system. Specific training on infection control and self-protection, mental health guidance, and stress coping techniques must be implemented. As the current health crisis ultimately abates, moving the focus from mental health issues to public health issues, more attention and support at the national and organizational levels are needed to reduce occupational discrimination, nurse autonomy and status need to be promoted, and public health emergency teams need to be created. A positive and fair working environment is essential to effective healthcare delivery.


Assuntos
Esgotamento Profissional/enfermagem , COVID-19/tratamento farmacológico , COVID-19/enfermagem , Recursos Humanos de Enfermagem/psicologia , Pandemias , SARS-CoV-2 , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/prevenção & controle , COVID-19/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Saúde Pública , Inquéritos e Questionários
8.
ACS Appl Mater Interfaces ; 13(8): 10349-10358, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33600166

RESUMO

Design of the crowding of chains tethered at the faces of ß-sheet nanocrystals self-assembled from ß-alanine trimers grafted on polyisobutylene (PIB) rubber tailors nanocrystal size and thus the elastic matrix morphology, thereby altering the material's macroscopic elastic properties. Results from transmission electron microscopy, small-angle X-ray scattering, and small-angle neutron scattering characterizations of the morphology demonstrate that increasing the density of chain tethering at the crystalline nanodomain/matrix interface can sharply limit the nanodomain growth in the direction of hydrogen bonding in the crystals. The nanocrystal size, in turn, impacts the gradient in chain stretching away from the crystal surface and the macroscopic volume fraction of unperturbed chains. Nanocomposite mechanical and dynamic mechanical properties at low degrees of deformation are related to the structural hierarchy resulting from the control of interfacial tethering density.


Assuntos
Proteínas Imobilizadas/química , Nanopartículas/química , Oligopeptídeos/química , Polienos/química , Polímeros/química , Propriedades de Superfície
9.
Community Dent Oral Epidemiol ; 49(5): 464-470, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33486800

RESUMO

OBJECTIVES: The purpose of this study was to examine the association between food insecurity and untreated dental caries using a nationally representative sample of US adults. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 and 2013-2014 on adults aged 18 years and older were analysed (n = 10 723). Primary predictors were overall food security (food-secure/ food-insecure) and household food security (full, marginal, low and very low). The main outcome was any untreated dental caries (none/ ≥ one). Multiple logistic regression analyses were done to estimate the adjusted odds ratio after controlling for confounders. RESULTS: Food-insecure adults were more likely to have untreated dental caries than food-secure adults after adjusting for potential confounders (OR: 1.2; 95% CI: 0.9-1.5). Adults from households with marginal (OR:1.4; 95% CI:1.5-2.2), low (OR:1.3, 95% CI:1.3-2.0) and very low food security (OR:1.3; 95% CI:0.9-1.5) had higher odds of untreated caries than adults from households with full food security. Following age stratification, marginal, low and very low food-secure adults had higher prevalence of untreated dental caries than full food-secure adults across all age groups. CONCLUSIONS: Our findings suggest that food-insecure adults had higher odds of untreated dental caries than food-secure adults. These findings highlight the importance of assessing food insecurity as a risk factor for dental caries. Longitudinal cohort studies are recommended to determine causal mechanisms.


Assuntos
Cárie Dentária , Insegurança Alimentar , Adulto , Estudos Transversais , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Abastecimento de Alimentos , Humanos , Estudos Longitudinais , Inquéritos Nutricionais
10.
Neuroimage Clin ; 29: 102529, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33321271

RESUMO

Binge drinking and age at first full drink (AFD) of alcohol prior to 21 years (AFD < 21) have been linked to neuroanatomical differences in cortical and subcortical grey matter (GM) volume, cortical thickness, and surface area. Despite the importance of understanding network-level relationships, structural covariation patterns among these morphological measures have yet to be examined in relation to binge drinking and AFD < 21. Here, we used the Joint and Individual Variance Explained (JIVE) method to characterize structural covariation patterns common across and specific to morphological measures in 293 participants (149 individuals with past-12-month binge drinking and 144 healthy controls) from the Human Connectome Project (HCP). An independent dataset (Nathan Kline Institute Rockland Sample; NKI-RS) was used to examine reproducibility/generalizability. We identified a reproducible joint component dominated by structural covariation between GM volume in the brainstem and thalamus proper, and GM volume and surface area in prefrontal cortical regions. Using linear mixed regression models, we found that participants with AFD < 21 showed lower joint component scores in both the HCP (beta = 0.059, p-value = 0.016; Cohen's d = 0.441) and NKI-RS (beta = 0.023, p-value = 0.040, Cohen's d = 0.216) datasets, whereas the individual thickness component associated with binge drinking (p-value = 0.02) and AFD < 21 (p-value < 0.001) in the HCP dataset was not statistically significant in the NKI-RS sample. Our findings were also generalizable to the HCP full sample (n = 880 participants). Taken together, our results show that use of JIVE analysis in high-dimensional, large-scale, psychiatry-related datasets led to discovery of a reproducible cortical and subcortical structural covariation pattern involving brain regions relevant to thalamic-PFC-brainstem neural circuitry which is related to AFD < 21 and suggests a possible extension of existing addiction neurocircuitry in humans.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Consumo de Bebidas Alcoólicas , Encéfalo/diagnóstico por imagem , Etanol , Substância Cinzenta/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes
11.
J Clin Periodontol ; 48(1): 51-60, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33031608

RESUMO

AIM: To investigate unmeasured confounding in bidirectional associations between periodontitis and diabetes using quantitative bias analysis. METHODS: Subsamples from the Veterans Affairs Dental Longitudinal Study were selected. Adjusted for known confounders, we used Cox proportional hazards models to estimate associations between pre-existing clinical periodontitis and incident Type II Diabetes (n = 672), and between pre-existing diabetes and incident severe periodontitis (n = 521), respectively. Hypothetical confounders were simulated into the dataset using Bernoulli trials based on pre-specified distributions of confounders within categories of each exposure and outcome. We calculated corrected hazard ratios (HR) over 10,000 bootstrapped samples. RESULTS: In models using periodontitis as the exposure and incident diabetes as the outcome, adjusted HR = 1.21 (95% CI: 0.64-2.30). Further adjustment for simulated confounders positively associated with periodontitis and diabetes greatly attenuated the association or explained it away entirely (HR = 1). In models using diabetes as the exposure and incident periodontitis as the outcome, adjusted HR = 1.35 (95% CI: 0.79-2.32). After further adjustment for simulated confounders, the lower bound of the simulation interval never reached the null value (HR ≥ 1.03). CONCLUSIONS: Presence of unmeasured confounding does not explain observed associations between pre-existing diabetes and incident periodontitis. However, presence of weak unmeasured confounding eliminated observed associations between pre-existing periodontitis and incident diabetes. These results clarify the bidirectional periodontitis-diabetes association.


Assuntos
Diabetes Mellitus Tipo 2 , Periodontite , Viés , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Estudos Longitudinais , Periodontite/complicações , Periodontite/epidemiologia , Modelos de Riscos Proporcionais
12.
Artigo em Inglês | MEDLINE | ID: mdl-33316964

RESUMO

With the outbreak of novel coronavirus in 2019, most universities changed from traditional offline teaching to online teaching, which brought about a large amount of problems, including teachers' physical and mental problems. Because of teaching on the computer screen for a long period of time, the teacher lacks communication and can act casually. With long-term accumulation, the problem of teachers' job burnout has become increasingly serious. The main purpose of this study was to examine the influence of professional identity on job burnout during the period of the novel coronavirus. At the same time, this study also discussed the moderating effect of job satisfaction on professional identity and job burnout, and its relationship between job satisfaction and job burnout. During the peak period of the COVID-19 epidemic, we conducted an online survey-483 Chinese university teachers with online teaching experience completed the Teacher Professional Identity Scale, Job Satisfaction Scale, and Job Burnout Scale. The results of this study found professional identity and job satisfaction of university teachers to be significantly negative predictors of job burnout, with job satisfaction playing a moderating role between professional identity and job burnout. This study also confirmed that professional identity and job satisfaction are important factors affecting job burnout of university teachers. Therefore, this study proposed that schools should adopt more effective strategies to improve university teachers' professional identity and job satisfaction in order to reduce the practical problems of job burnout, ensure the effectiveness of online teaching, and maintain the sustainable development during the epidemic.


Assuntos
Esgotamento Profissional , COVID-19 , Docentes , Satisfação no Emprego , Pandemias , Esgotamento Profissional/epidemiologia , China , Humanos , Inquéritos e Questionários , Universidades
13.
Sci Adv ; 6(48)2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33239291

RESUMO

Current homogeneous bioscaffolds could hardly recapture the regenerative microenvironment of extracellular matrix. Inspired by the peculiar nature of dura matter, we developed an extracellular matrix-mimicking scaffold with biomimetic heterogeneous features so as to fit the multiple needs in dura mater repairing. The inner surface endowed with anisotropic topology and optimized chemical cues could orchestrate the elongation and bipolarization of fibroblasts and preserve the quiescent phenotype of fibroblasts indicated by down-regulated α-smooth muscle actin expression. The outer surface could suppress the fibrotic activity of myofibroblasts via increased microfiber density. Furthermore, integrin ß1 and Yes-associated protein molecule signaling activities triggered by topological and chemical cues were verified, providing evidence for a potential mechanism. The capability of the scaffold in simultaneously promoting dura regeneration and inhibiting epidural fibrosis was further verified in a rabbit laminectomy model. Hence, the so-produced heterogeneous fibrous scaffold could reproduce the microstructure and function of natural dura.

14.
Sensors (Basel) ; 20(19)2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32992886

RESUMO

Recent developments in the area of condition monitoring research have been targeted towards predicting machinery health condition for the purpose of preventative maintenance. Typically, published research uses data collected from rotating components (bearings, cutting tools, etc.) working in an idealized lab environment as the case study for prognosis algorithm validations. However, the operational implementation in industry is still very sporadic, mainly owing to the lack of proper data allowing sufficiently mature development of comprehensive methodologies. The prognosis methodology presented herein bridges the gap between academic research and industrial implementations by employing a novel time period for prognosis and implementing random coefficients regression models. The definition of the remaining maintenance-free operating period (RMFOP) is proposed first, which helps to transform the usefulness of the degradation data that is readily available from data short of failure. Degradation patterns are subsequently extracted from the original degradation data, before fitting into either of two regression models (linear or exponential). The system residual life distributions are then computed and updated by estimating the parameter statistics within the model. This RMFOP-based methodology is validated using real-world degradation data collected from multiple operational railway switch systems across Great Britain. The results indicate that both the linear model and the exponential model can produce residual life distributions with a sufficient prediction accuracy for this specific application. The exponential model gives better predictions, the accuracy of which also improves as more of system life percentage has elapsed. By using the RMFOP methodology, switch system health condition affected by an incipient overdriving fault is recognized and predicted.

15.
J Clin Periodontol ; 47(12): 1457-1465, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32990981

RESUMO

AIM: To quantify exposure misclassification bias arising from use of partial-mouth protocols in studies of periodontitis-systemic disease associations. MATERIALS AND METHODS: Using data from 10,134 adults participating in the National Health and Nutrition Examination Survey, we classified periodontal status based on full-mouth clinical examinations and three commonly used partial-mouth protocols. Associations between periodontitis and self-reported diabetes and cardiovascular disease were evaluated under each protocol using adjusted logistic regression. Percent relative bias was calculated to evaluate magnitude and direction of bias. RESULTS: Misclassification primarily resulted in underestimation of associations, the extent of which depended on both the outcome under study and exposure severity. Bias due to misclassification of severe periodontitis was negligible for cardiovascular disease (0%-4.1%) compared to diabetes (177.7%-234.1%). In contrast, bias in moderate periodontitis associations was comparable across each outcome-diabetes (28.4%-39.5%) and cardiovascular disease (8.9%-46.7%). Results did not meaningfully change based on the partial-mouth protocol implemented. Stratified analyses showed increased bias among those with ≤15 teeth. Use of mean attachment loss as a continuous exposure resulted in minimal-to-no bias. CONCLUSIONS: Exposure misclassification bias due to use of partial-mouth protocols can yield inaccurate conclusions about periodontitis-systemic disease associations, the extent of which may depend on periodontitis classification and the association under study.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Periodontite , Adulto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Humanos , Inquéritos Nutricionais , Índice Periodontal , Periodontite/complicações , Periodontite/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-32927864

RESUMO

Age is a key factor in plantar pressure distributions during the development of obese children. However, the existing evidence for age-related plantar pressures of obese children is not sufficient to make clear how the plantar pressures would change with the increasing age. This study aimed to evaluate the plantar pressure redistributions of obese children after a three-year follow-up and to further compare these changes with normal-weighted children. Ten obese children and eleven normal-weighted counterparts were involved in this study. Plantar pressure measurements were undertaken using a Footscan® plantar pressure plate on two test sessions three years apart. Peak pressure, pressure-time integral, standard maximum force, and z-scores of these variables were analyzed. Loading transference analyses were applied to detect the different loading transferring mechanisms between obese and normal-weighted children. Significantly increased plantar pressures were observed at the lateral forefoot and midfoot for obese children, which gradually deviated from those of normal-weighted children over the 3 years. With the increasing age, obese children displayed a lateral loading shift at the forefoot in contrast to the normal-weighted. Early interventions are cautiously recommended for obese children before the plantar loading deviation gets worse as they grow older.


Assuntos
Pé/anatomia & histologia , Pé/patologia , Obesidade/complicações , Pressão , Fenômenos Biomecânicos , Índice de Massa Corporal , Peso Corporal/fisiologia , Criança , China , Seguimentos , Humanos
17.
EClinicalMedicine ; 27: 100547, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32984784

RESUMO

Background: Epidemic outbreaks caused by SARS-CoV-2 are worsening around the world, and there are no target drugs to treat COVID-19. IFN-κ inhibits the replication of SARS-CoV-2; and TFF2 is a small secreted polypeptide that promotes the repair of mucosal injury and reduces the inflammatory responses. We used the synergistic effect of both proteins to treat COVID-19. Methods: We conducted an open-label, randomized, clinical trial involving patients with moderate COVID-19. Patients were assigned in a 1:1 ratio to receive either aerosol inhalation treatment with IFN-κ and TFF2 every 24 h for six consecutive dosages in addition to standard care (experimental group) or standard care alone (control group). The primary endpoint was the time until a viral RNA negative conversion for SARS-CoV-2 in all clinical samples. The secondary clinical endpoint was the time of CT imaging improvement. Data analysis was performed per protocol. This study was registered with chictr.org.cn, ChiCTR2000030262. Findings: Between March 23 and May 23 of 2020, 86 COVID-19 patients with symptoms of moderate illness were recruited, and 6 patients were excluded due to not matching the inclusion criteria (patients with pneumonia through chest radiography). Among the remaining 80 patients, 40 patients were assigned to experimental group, and the others were assigned to control group to only receive standard care. Efficacy and safety were evaluated for both groups. The time of viral RNA negative conversion in experimental group (Mean, 3·80 days, 95% CI 2·07-5·53), was significantly shorter than that in control group (7·40 days, 95% CI 4·57 to 10·23) (p = 0.031), and difference between means was 3·60 days. The percentage of patients in experimental group with reversion to negative viral RNA was significantly increased compared with control group on all sampling days (every day during the 12-day observation period) (p = 0·037). For the secondary endpoint, the experimental group had a significantly shorter time until improvement was seen by CT (Mean 6·21 days, N = 38/40, 95% CI 5·11-7·31) than that in control group (8·76 days, N = 34/40, 95% CI 7·57-9·96) (p = 0.002), and difference between means was 2·55 days. No discomfort or complications during aerosol inhalation were reported to the nurses by any experimental patients. Interpretation: In conclusion, we found that aerosol inhalation of IFN-κ plus TFF2 in combination with standard care is safe and superior to standard care alone in shortening the time up to viral RNA negative conversion in all clinical samples. In addition, the patients in experimental group had a significantly shortened CT imaging improvement time than those in control group. This study suggested that this combination treatment is able to facilitate clinical improvement (negative for virus, improvement by CT, reduced hospitalization stay) and thereby result in an early release from the hospital. These data support the need for exploration with a large-scale trial of IFN-κ plus TFF2 to treat COVID-19. Funding: Funding was provided by the National Natural Science Foundation of China, National Major Project for Control and Prevention of Infectious Disease in China, Shanghai Science and Technology Commission, Shanghai Municipal Health Commission.

18.
Public Health Rep ; 135(5): 587-598, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687737

RESUMO

OBJECTIVE: Hospital discharge data are a means of monitoring infectious diseases in a population. We investigated rates of infectious disease hospitalizations in New York City. METHODS: We analyzed data for residents discharged from New York State hospitals with a principal diagnosis of an infectious disease during 2001-2014 by using the Statewide Planning and Research Cooperative System. We calculated annual age-adjusted hospitalization rates and the percentage of hospitalizations in which in-hospital death occurred. We examined diagnoses by site of infection or sepsis and by pathogen type. RESULTS: During 2001-2014, the mean annual age-adjusted rate of infectious disease hospitalizations in New York City was 1661.6 (95% CI, 1659.2-1663.9) per 100 000 population; the mean annual age-adjusted hospitalization rate decreased from 2001-2003 to 2012-2014 (rate ratio = 0.9; 95% CI, 0.9-0.9). The percentage of in-hospital death during 2001-2014 was 5.9%. The diagnoses with the highest mean annual age-adjusted hospitalization rates among all sites of infection and sepsis diagnoses were the lower respiratory tract, followed by sepsis. From 2001-2003 to 2012-2014, the mean annual age-adjusted hospitalization rate per 100 000 population for HIV decreased from 123.1 (95% CI, 121.7-124.5) to 40.0 (95% CI, 39.2-40.7) and for tuberculosis decreased from 10.2 (95% CI, 9.8-10.6) to 4.6 (95% CI, 4.4-4.9). CONCLUSIONS: Although hospital discharge data are subject to limitations, particularly for tracking sepsis, lower respiratory tract infections and sepsis are important causes of infectious disease hospitalizations in New York City. Hospitalizations for HIV infection and tuberculosis appear to be declining.


Assuntos
Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/terapia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Vigilância da População , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Adulto Jovem
19.
J Oral Maxillofac Surg ; 78(7): 1078-1087, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32275900

RESUMO

PURPOSE: We sought to obtain baseline statistics regarding the amount of opioid tablets prescribed by oral and maxillofacial surgeons (OMSs) in the New England area after office-based procedures and to identify factors that might be predictors of their prescription patterns. MATERIALS AND METHODS: An anonymous online survey was e-mailed to practicing OMSs in the New England area. The survey explored the quantity of opioid medications prescribed for various procedures, how opioid precautions were given, practitioners' attitude toward opioid dependency, and whether certain surgeon- or patient-related factors influenced prescription behavior. Statistical analyses were used to categorize the OMSs according to their prescription patterns and to identify the most common factors affecting their decision to prescribe opioids. RESULTS: Of 315 OMSs, 151 (43%) responded to the survey. Our analyses were of complete data obtained from 118 respondents. For procedures, such as extraction of 7 or more teeth, the placement of 4 or more implants, office-based sinus surgery, cortical block grafts, and removal of third molar teeth, respondents indicated they typically prescribed 8 to 12 opioid tablets. For all other procedures, they typically never or rarely prescribed opioid tablets. The respondents were grouped into low-, medium-, and high-quantity opioid prescribers. Regardless of their grouping status, the respondents showed general agreement regarding their roles in reducing opioid prescription-related issues. No group differences were found in terms of the demographic variables. Relative to the factors predicting increased prescribing habits, the results suggested that OMSs working either exclusively or primarily in academic settings tended to prescribe fewer opioid tablets than those working primarily in the private setting (ß = -2.73; P < .001). Additionally, 109 respondents (92.4%) reported that OMSs could play a role in decreasing opioid dependency. CONCLUSIONS: Most practicing OMSs in the New England area prescribed opioids after office-based surgery and are cognizant of the risks of opioid medications.


Assuntos
Analgésicos Opioides , Cirurgiões Bucomaxilofaciais , Humanos , Dente Serotino , Dor Pós-Operatória , Padrões de Prática Odontológica , Padrões de Prática Médica , Inquéritos e Questionários
20.
Cells ; 9(3)2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32143485

RESUMO

Rho GTPases, including Rho, Cdc42, Rac and ROP subfamilies, are key signaling molecules in RNA polymerase II (Pol II) transcriptional control. Our prior work has shown that plant ROP and yeast Cdc42 GTPases similarly modulate Ser2 and Ser5 phosphorylation status of the C-terminal domain (CTD) of the Pol II largest subunit by regulating CTD phosphatase degradation. Here, we present genetic and pharmacological evidence showing that Cdc42 and Rac1 GTPase signaling modulates a similar CTD Ser2 and Ser5 phosphorylation code in cultured human cancer cells. While siRNA knockdown of Cdc42 and Rac1, respectively, in HeLa cells increased the level of CTD Ser phosphatases RPAP2 and FCP1, they both decreased the level of CTD kinases CDK7 and CDK13. In addition, the protein degradation inhibitor MG132 reversed the effect of THZ1, a CDK7 inhibitor which could decrease the cell number and amount of CDK7 and CDK13, accompanied by a reduction in the level of CTD Ser2 and Ser5 phosphorylation and DOCK4 and DOCK9 (the activators for Rac1 and Cdc42, respectively). Conversely, treatments of Torin1 or serum deprivation, both of which promote protein degradation, could enhance the effect of THZ1, indicating the involvement of protein degradation in controlling CDK7 and CDK13. Our results support an evolutionarily conserved signaling shortcut model linking Rho GTPases to Pol II transcription across three kingdoms, Fungi, Plantae and Animalia, and could lead to the development of a potential synthetic-lethal strategy in controlling cancer cell proliferation or death.


Assuntos
Proteínas de Transporte/metabolismo , Proteínas Monoméricas de Ligação ao GTP/metabolismo , Proteína cdc42 de Ligação ao GTP/metabolismo , Proteínas rac1 de Ligação ao GTP/metabolismo , Humanos , Neoplasias/tratamento farmacológico , RNA Polimerase II/metabolismo , Saccharomyces cerevisiae/metabolismo , Transdução de Sinais/fisiologia , Proteínas rho de Ligação ao GTP/metabolismo
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