Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 488
Filtrar
1.
J Hazard Mater ; 401: 123438, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-32763717

RESUMO

Cadmium (Cd), a well-known environmental pollutant, can lead to placental insufficiency and fetal growth restriction. However, the underlying mechanism is unknown. The purpose of our study is to explore the effect of Cd on placental angiogenesis and its mechanism using in vitro and in vivo models. Results found that gestational Cd exposure obviously decreased placental weight and impaired placental vascular development in mice. Correspondingly, Cd exposure evidently downregulated the expression of VEGF-A protein (a key indicator of angiogenesis) and progesterone receptor (PR) in placental trophoblasts. Further experiment showed that lentivirus PR overexpression reversed Cd-caused the reduction of VEGF-A level in human placental trophoblasts. In addition, Cd significantly reduced progesterone level, down-regulated the expression of key progesterone synthase (StAR, CYP11A1), and activated mitochondrial stress response and GCN-2/p-eIF2α signaling in placental trophoblasts. Additional experiment showed that GCN-2 siRNA pretreatment markedly alleviated Cd-activated mitochondrial stress response, restored Cd-downregulated the expression of CYP11A1, reversed Cd-reduced the level of progesterone and VEGF-A in human placental trophoblasts. Finally, our case-control study confirmed that impaired placental angiogenesis and reduced progesterone level occurred in all-cause small for gestational age placenta. Taken together, environmental exposure to Cd impairs fetal growth and placental angiogenesis via GCN-2-mediated mitochondrial stress.

2.
Nanotechnology ; 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33152726

RESUMO

Exosomal microRNAs (miRNAs) have attracted great attention as predictive and prognostic biomarkers of cancer. Profiling of miRNAs plays a key role in the effective diagnosis of cancers. However, simultaneous quantification of multiple miRNAs is challenging due to their homology and low abundance especially in exosomes. Here, we developed a sensitive detection method for multiple exosomal miRNAs with the help of rolling circle amplification (RCA). In contrast of the traditional ways, this method takes the advantages of both the multiplex sensing ability and the simplicity of RCA. Specifically, multiple exosomal miRNAs from different cell lines were replicated simultaneously through RCA and detected using designed molecular beacons (MBs). miRNA-21, miRNA-122 and miRNA-155 were chosen as the targets, which are overexpressed in cancers. Normalized fluorescence intensities of MB were used to imply the relative concentrations of these miRNAs. The obtained relative miRNAs expression levels could be used to distinguish the breast cancer exosome from normal one. If the varieties of the detected exosomal miRNAs are abundant enough, the concentration ratios of miRNAs could basically indicate the corresponding exosome and exosome screening could be realized. Such exosomal miRNA profiling and exosome screening can assist cancer diagnosis, which is promising in clinical application.

3.
J Clin Neurosci ; 81: 462-468, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33222963

RESUMO

OBJECTIVE: To evaluate the long-term efficacy of Coflex dynamic stabilization device in the treatment of lumbar spinal stenosis. METHODS: The clinical and imaging data of 73 patients undergoing Coflex dynamic stabilization surgery from July 2008 to June 2012 were retrospectively analyzed. All patients had a minimum of 8 years of follow-up. Clinical data were used to assess the clinical efficacy, and radiographic parameters were measured for evaluation of ASD. RESULTS: 56 Patients were followed up for 107.6 ± 13.3 months. The visual analogue scale of pain (VAS), Owestry disability index (ODI) and Japanese Orthopedic Association Scores (JOA) improved significantly after surgery. At 6 months after surgery and the last follow-up, lumbar range of motion (ROM) was significantly lower than that before surgery (P < 0.001). ROM was slightly increased at the last follow-up compared with that 6 months after operation (P > 0.05). ROM of adjacent segments increased at 6 months and at the last follow-up compared with that before surgery (P > 0.05). At 6 months after surgery, intervertebral space height (ISH) and intervertebral foramen height (IFH) of implanted segment was significantly higher than that before surgery (P < 0.05). At the last follow-up, there was a decrease in ISH and IFH (P > 0.05). During the follow-up period, a total of 11 patients (19.6%) experienced complications and 6 patients (10.7%) underwent secondary surgery. CONCLUSION: Coflex interspinous process dynamic stabilization is effective in the long-term treatment of lumbar spinal stenosis, the ISH and IFH of implanted segment could be increased in a short period of time.

4.
Org Lett ; 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33215922

RESUMO

We report an efficient method for the preparation of various 2,2'-dihalobiaryls from cyclic diaryliodonium salts. With cheap halogen sources as starting materials, a broad range of 2,2'-diiodobiaryls, 2-bromo-2'-iodobiaryls, and 2-chloro-2'-iodobiaryls were obtained under mild reaction conditions. More importantly, a chiral copper-bisoxazoline catalyst system was further developed for the preparation of axially chiral 2,2'-dihalobiaryls in excellent yields and enantioselectivities, which can serve as versatile precursors for the synthesis of various chiral ligands.

5.
J Hazard Mater ; : 124426, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33158654

RESUMO

A peroxidase-like MOF coated magnetic surface-enhanced Raman scattering (SERS) probe as Ni@Mil-100(Fe)@Ag nanowires (NMAs) was developed, which can detect multiple cationic dyes with a good recyclability and a high sensitivity. Specifically, Mil-100(Fe) with peroxidase-like activity was fabricated on the magnetic prickly Ni nanowires through layer-by-layer (LBL) method. With the presence of 10 mM H2O2, hydroxyl radical (•OH) produced by peroxidase-like catalytic reaction of Mil-100(Fe) layer can easily eliminate the pollution molecules within 1 min without any requirement for expensive equipment or complicated process. The magnetic NMAs can provide a rapid refreshment for at least 10 times. In addition, carboxyl-functionalized Mil-100(Fe) can not only increase the decoration efficiency of Tollens but also promote the selective enrichment of the cationic dyes, which endows the probe with a greatly improved sensitivity with a limit of detection (LOD) as low as 10-10 M for crystal violet (CV). Following the erasure by H2O2, multiple cationic fishery drugs in pond water can be sequentially detected. Such a recyclable SERS probe holds a great potential in various applications as aquaculture, biomedicine and chemical analysis.

6.
J Cell Physiol ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33174204

RESUMO

Arsenic is an environmental toxicant. Its overdose can cause liver damage. Autophagy has been reported to be involved in arsenite (iAs3+ ) cytotoxicity and plays a dual role in cell proliferation and cell death. However, the effect and molecular regulative mechanisms of iAs3+ on autophagy in hepatocytes remains largely unknown. Here, we found that iAs3+ exposure lead to hepatotoxicity by inducing autophagosome and autolysosome accumulation. On the one hand, iAs3+ promoted autophagosome synthesis by inhibiting E2F1/mTOR pathway in L-02 human hepatocytes. On the other, iAs3+ blocked autophagosome degradation partially via suppressing the expression of INPP5E and Rab7 as well as impairing lysosomal activity. More importantly, autophagosome and autolysosome accumulation induced by iAs3+ increased the protein level of E2F7a, which could further inhibit cell viability and induce apoptosis of L-02 cells. The treatment of Ginkgo biloba extract (GBE) effectively reduced autophagosome and autolysosome accumulation and thus alleviated iAs3+ -induced hepatotoxicity. Moreover, GBE could also protect lysosomal activity, promote the phosphorylation level of E2F1 (Ser364 and Thr433) and Rb (Ser780) as well as suppress the protein level of E2F7a in iAs3+ -treated L-02 cells. Taken together, our data suggested that autophagosome and autophagolysosome accumulation play a critical role for iAs3+ -induced hepatotoxicity, and GBE is a promising candidate for intervening iAs3+ induced liver damage by regulating E2F1-autophagy-E2F7a pathway and restoring lysosomal activity.

7.
Adv Mater ; : e2003312, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33175442

RESUMO

Metal halide perovskites (MHPs) have transfixed the photovoltaic (PV) community due to their outstanding and tunable optoelectronic properties coupled to demonstrations of high-power conversion efficiencies (PCE) at a range of bandgaps. This has motivated the field to push perovskites to reach the highest possible performance. One way to increase the efficiency is by fabricating multijunction solar cells, which can split the solar spectrum, reducing thermalization loss. Low-cost all-perovskite tandems have a real chance to soon exceed 30% PCE, which could transform the PV industry. Achieving this goal requires the identification of perovskite sub-cells that are both highly efficient and can be effectively integrated. Herein, it is discussed how to navigate the multiple-choice adventure in choosing between the myriad of options and considerations present when deciding what perovskite materials, contact layers, and processing tools to use. Some of the potential fabrication pitfalls often encountered in MHP based tandem PVs are highlighted, so that they can hopefully be avoided in the future.

8.
Biosens Bioelectron ; 172: 112769, 2020 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-33166801

RESUMO

Nanostructure with precisely controllable narrow gap width remains a great challenge, especially at the sub-nanoscale level. Here, a versatile strategy named as DNA-assisted synthesis of ortho-nanodimer (DaSON) is proposed to fabricate Ag (Au) nanodimers with a uniform gap width from nanometers to angstroms. In such a strategy, two nanoparticles are constrained by the equilibrium state of the DNA hybridization and electrostatic repulsion to form zipper-like ortho-nanostructures with an extremely uniform gap whose width can be finely adjusted at nanoscale or sub-nanoscale by changing the DNA sequence and the surface charge of nanoparticles. The inherent strong electromagnetic coupling in the uniform sub-nanometer gap can generates an unparalleled SERS enhancement together with an extraordinary reproducibility. Compared with conventional DNA-based nano-gap fabrication strategy, the DaSON strategy enhances the SERS intensity for more than two orders of magnitude with a detection limit of 100 aM for DNA, and significantly improves the reproducibility in both labeled and label-free SERS sensing applications. Moreover, the DaSON strategy holds wide applicability for arbitrary kinds of DNA-modifiable nanoparticles. Therefore, we believe that the DaSON strategy provides an innovative method for the synthesis of nanostructures with controllable nanogaps and has a promising future in multiple fields including nanotechnology, catalysis and photonics.

9.
Sci Rep ; 10(1): 20355, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33230215

RESUMO

Partial photooxidation of micropollutants may lead to various degradation intermediates, obviously affecting disinfection byproducts (DBPs) formation during the post-chlorination process. The photooxidation of atrazine (ATZ) in aqueous solutions with low-pressure mercury UV lamps in UV, UV/H2O2 and UV/TiO2 treatment system and the formation of chlorinated disinfection byproducts (DBPs) during subsequent chlorination processes including dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), 1,1,1-trichloro-2-propanone (TCP), trichloromethane (TCM) and chloropicrin (CHP) were investigated in this study. The effect of solution pH on the oxidation pathway of ATZ in three UV photooxidation treatment process and the impact of photooxidation on the DBPs formations were assessed. Based on UPLC-ESI-MS/MS analyses, identification of main oxidation intermediates was performed and the plausible degradation pathways of ATZ in photooxidation system were proposed, indicating that photooxidation of ATZ in UV/H2O2 and UV/TiO2 process system was significantly pH-dependent processes. Dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), 1,1,1-trichloro-2-propanone (TCP), trichloromethane (TCM) and chloropicrin (CHP) were detected in photooxidized ATZ solutions. Compared to the other three DBPs, TCM and TCP were the main DBPs formed. The DBPs formations were greatly promoted in oxidized ATZ solutions. Solution pH and UV irradiation time exhibited obvious impact on the DBPs formation on the basis of DBP species. The variation tendency of DBPs observed relates to the combustion of ATZ in photooxidation system and the production oxidation intermediates.

10.
BMJ Open ; 10(11): e036915, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177133

RESUMO

INTRODUCTION: Early non-pharmacological interventions can prevent cognitive decline in older adults with mild cognitive impairment (MCI). Creative expression (CrExp) can potentially mitigate cognitive decline and enhance the physical and mental health of older people. However, it is unclear whether activities involving CrExp can improve cognitive function and other health-related outcomes in older adults with MCI. The aim of the present study is to develop a Creative Expressive Arts-based Storytelling (CrEAS) programme that integrates verbal and non-verbal expressive activities and evaluate its effectiveness in improving cognitive function and other outcome indicators so as to explore its possible mechanism from the perspective of neuroimaging. METHODS AND ANALYSIS: This parallel randomised controlled trial with three arms (one intervention and two control arms) will be conducted over a 24-week period. A total of 111 participants will be enrolled and randomised to the CrEAS, recreation and usual activity groups. The CrEAS programme combines visual arts therapy and storytelling (TimeSlips) under the Expressive Therapy Continuum theoretical framework and provides an opportunity for people with MCI to actively engage in activities to improve cognitive function through verbal and nonverbal CrExp. Global cognitive function, specific domains of cognition (memory, executive function, language and attention) and other health-related outcomes (anxiety, depression and quality of life) will be measured at baseline, at the end of the intervention, and at the 24-week follow-up. Structural/functional brain MRI data will be collected at baseline and immediately after the intervention. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Ethics Committee of Fujian Provincial Hospital (K2018-03-061). The study results will be disseminated through peer-reviewed journals and at academic conferences. TRIAL REGISTRATION NUMBER: ChiCTR1900021526.

11.
J Pediatr Surg ; 2020 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-33189302

RESUMO

INTRODUCTION: Neuroblastoma (NB) is the most common solid tumor in children. Studies showed that long-chain noncoding RNA (lncRNA) HCP5 played an important role in tumorigenesis, but its role in NB remained unclear. This study aims to determine the role of HCP5 in NB and its possible molecular mechanism. METHODS: We analyzed the expression levels of miRNA-186-5p and HCP5 in neuroblastoma and neuroblastoma cell lines SHSY-5Y, Kelly, NBL-S and SK-N-AS, and explored their roles. RESULTS: We found that the HCP5 expression was up-regulated in NB tissues and cells. The higher the HCP5 expression in NB cells, the stronger the ability of clone formation. Down regulation of the HCP5 expression inhibited the proliferation of NB cells and the growth of subcutaneous transplanted tumor in nude mice. HCP5 could competitively bind miR-186-5p, while miR-186-5p could target the 3'-UTR of MAP3K2. The expression level of miR-186-5p was down regulated while the expression level of MAP3K2 was up-regulated in NB tissues. The expression level of HCP5 and miR-186-5p, the expression level of miR-186-5p and MAP3K2 were negatively correlated. The decreased proliferation of NB cells induced by down-regulation of HCP5 expression can be counteracted by miR-186-5p inhibitor or MAP3K2, and vice versa. CONCLUSION: This study showed that lncRNA HCP5, as ceRNA, regulated MAP3K2 to promote NB progression through competitive binding of miR-186-5p. We revealed a new signaling pathway that mediates NB, which provided a new target for the diagnosis and treatment of NB.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33179450

RESUMO

Induced pluripotent stem cells (iPSCs) offer an effective platform for studies of human physiology and have revealed new possibilities for disease modeling at the cellular level. These cells also have the potential to be leveraged in the practice of precision medicine, including personalized drug testing. Aortic diseases result in significant morbidity and mortality and pose a global burden to healthcare. Their pathogenesis is mostly associated with functional alterations of vascular components, such as endothelial cells and vascular smooth muscle cells. Drugs that have been proven to be effective in animal models often fail to protect patients from adverse aortic events in clinical studies, provoking researchers to develop reliable in vitro models using human cells. In this review, we summarize the patient iPSC-derived aortic cells that have been utilized to model aortic diseases in vitro. In advanced models, hemodynamic factors, such as blood flow-induced shear stress and cyclic strain, have been added to the systems to replicate cellular microenvironments in the aortic wall. Examples of the utility of such factors in modeling various aortopathies, such as Marfan syndrome, Loeys-Dietz syndrome, and bicuspid aortic valve-related aortopathy, are also described. Overall, the iPSC-based in vitro cell models have shown the potential to promote the development and practice of precision medicine in the treatment of aortic diseases.

13.
J Surg Res ; 258: 179-186, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33011449

RESUMO

BACKGROUND: In the context of shifting population demographics in the United States, a diverse workforce in health care can lead to improved patient outcomes and enhance access to culturally competent care for minorities. The objective of this study was to analyze and quantify the relationship of gender, race, and academic rank, tenure status, and degree in American academic surgical faculty. MATERIALS AND METHODS: A 12-y retrospective cross-sectional analysis of the data from the Association of American Medical Colleges was performed. The distribution of race and gender across academic ranks, tenure, and degree types were recorded from 2007-2018. Simple descriptive statistics and chi-square analysis was used to analyze the time trends and association between gender and race across academic rank, tenure status, and degree types. RESULTS: When averaged over the 12 y of this study, there were significantly more whites (69.8%) and males (74.5%) among the academic surgery faculty compared with other races and females, respectively (P value <0.05). Asians and females experienced the greatest increase in proportional representation across all academic ranks with an absolute increase of 7% and 5% in full professor, 5% and 6% in associate professor, and 7% and 3% in chairperson (P value <0.05), respectively. No significant association was observed between gender and race with tenure status or degree type. CONCLUSIONS: Female and Asians are increasing in proportional representation; however, racial and gender disparities remain prevalent at higher academic ranks and positions of leadership, especially among black and Hispanic academic surgeons.

14.
Headache ; 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33078413

RESUMO

PURPOSE: The purpose of this paper is to review some of the causes of secondary headache particularly focusing on the subcategories of secondary headache in the International Classification of Headache Disorders, 3rd edition, the clinical features of these headaches, and their associated features and management. OVERVIEW: Headache attributed to trauma or injury to the head and/or neck, headache attributed to cranial or cervical vascular disorder, headache attributed to non-vascular intracranial disorder, headache attributed to a substance or its withdrawal, headache attributed to infection, headache attributed to disorder of homeostasis, and headache or facial pain attributed to disorder of the cranium, neck, eye, ears, nose, sinuses, teeth, mouth, or other facial or cervical structure are discussed in this paper. DISCUSSION: Headache is a common symptom of multiple medical conditions. Although a minority of headache patients have a secondary basis for their headaches, it is important to identify clinical features of secondary headache disorders including both the headache and non-headache features of the condition, diagnose the secondary etiology correctly, and treat them appropriately.

15.
Biofabrication ; 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059333

RESUMO

A crucial step in creating reliable in vitro platforms for neural development and disorder studies is the reproduction of the multicellular three-dimensional (3D) brain microenvironment and the capturing of cell-cell interactions within the model. The power of self-organization of diverse cell types into brain spheroids could be harnessed to study mechanisms underlying brain development trajectory and diseases. A challenge of current 3D organoid and spheroid models grown in petri-dishes is the lack of control over cellular localization and diversity. To overcome this limitation, neural spheroids can be patterned into customizable 3D structures using microfabrication. We developed a 3D brain-like co-culture construct using embedded 3D bioprinting as a flexible solution for composing heterogenous neural populations with neurospheroids and glia. Specifically, neurospheroid-laden free-standing 3D structures were fabricated in an engineered astrocyte-laden support bath resembling a neural stem cell niche environment. A photo-crosslinkable bioink and a thermal-healing supporting bath were engineered to mimic the mechanical modulus of soft tissue while supporting the formation of self-organizing neurospheroids within elaborate 3D networks. Moreover, bioprinted neurospheroid-laden structures exhibited the capability to differentiate into neuronal cells. These brain-like co-cultures could provide a reproducible platform for modeling neurological diseases, neural regeneration, and drug development and repurposing.

16.
Cell Cycle ; : 1-11, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33064974

RESUMO

MiR-34a is associated with diabetic retinopathy (DR). This article aims to demystify the role of miR-34a in DR. We established a DR model by streptozocin injection. Rat retinal vascular endothelial cells (RVECs) were treated with high glucose (HG) to induce DR. The pathological changes of retinal tissues and blood-retinal vascular barrier permeability of DR rats were assessed by HE staining and Evans-Blue leak test. The expression of gene and protein was evaluated by quantitative real-time PCR or western blot. MTT assay and flow cytometry were performed to detect proliferation and apoptosis. The relationship between miR-34a and SIRT1 was evaluated using luciferase reporter assay. MiR-34a was up-regulated and SIRT1 was down-regulated in retinal tissues of DR rats and HG-induced RVECs. MiR-34a silencing improved DR by regulating apoptosis and VEGF expression in DR rats. Furthermore, miR-34a interacted with SIRT1 and suppressed SIRT1 expression. MiR-34a overexpression inhibited proliferation and promoted apoptosis of RVECs, which was effectively abolished by SIRT1 up-regulation. In summary, our data demonstrate that miR-34a promotes apoptosis of RVECs by targeting SIRT1 in DR rats. Our findings suggest that miR-34a/SIRT1 axis could be a valuable target for DR therapies.

17.
J Colloid Interface Sci ; 583: 652-660, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-33039862

RESUMO

Binary metal niobium oxides can offer a higher specific capacity compared to niobium pentoxide (Nb2O5) and thus are ideal anode candidates for lithium ion capacitors (LICs). However, their lower electronic conductivity limits their ability to achieve high energy and power densities. In this paper, one-dimensional (1D) copper niobate (CuNb2O6) nanowires are successfully prepared by electrospinning technology and then immobilized on two-dimensional (2D) reduced graphene oxide (rGO) nanosheets to form a unique 1D nanowire/2D nanosheet CuNb2O6/rGO structure. The 1D/2D CuNb2O6/rGO electrode exhibits a high specific capacity of 312.2 mAh g-1 at 100 mA g-1 as the anode of LICs. The proposed Li+ storage mechanism of the CuNb2O6 anode involves CuNb2O6 decomposition into lithium niobate (Li3NbO4) and copper (Cu) during the initial lithium insertion process. The intercalation-type Li3NbO4 will further serve as the host to Li+ and the inactive Cu phase will act as a conductive network for electron transportation. Furthermore, the energy density of the assembled CuNb2O6/rGO//activated carbon (CuNb2O6/rGO//AC) device could achieve a value as high as 92.1 Wh kg-1 and could thus be considered as a possible alternative electrode material for high energy and power LICs.

18.
J Cardiothorac Surg ; 15(1): 284, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004041

RESUMO

BACKGROUND: This study aims to evaluate the early and mid-term outcomes of mitral valve repair for degenerative mitral regurgitation (MR) in patients with left ventricular systolic dysfunction. METHODS: From January 2005 to December 2016, the profiles of patients with degenerative MR who underwent mitral valve repair at our institution were analyzed. Left ventricular systolic dysfunction was defined as an ejection fraction < 60% or left ventricular end-systolic dimension > 40 mm. Finally, 322 patients with left ventricular systolic dysfunction were included in this study. The prognosis of left ventricular function during follow-up was evaluated and preoperative factors associated with deteriorated left ventricular systolic function during follow-up were analyzed. RESULTS: The in-hospital mortality rate was 1.6%. The rate of eight-year overall survival, freedom from reoperation for mitral valve and freedom from recurrent MR were 96.9, 91.2 and 73.4%, respectively. Intraoperative residual mild MR (hazard ratio 4.82) and an isolated anterior leaflet lesion (hazard ratio 2.48) were independent predictive factors for recurrent MR. During follow-up, 212 patients underwent echocardiography examinations at our institution. Among them, 132 patients had improved left ventricular systolic function, and 80 patients had deteriorated left ventricular systolic. Freedom from recurrent MR was found in 75.9% of the improved left ventricular systolic function group and 56.2% of the deteriorated left ventricular systolic function group (P = 0.047). An age > 50 years (odds ratio 2.40), ejection fraction≤52% (odds ratio 2.79) and left ventricular end-systolic dimension≥45 mm (odds ratio 2.31) were independent risk factors for deteriorated left ventricular systolic function during follow-up. CONCLUSIONS: Mitral valve repair could be safely performed for degenerative MR in patients with left ventricular systolic dysfunction. Intraoperative residual mild MR and an isolated anterior leaflet lesion were independent predictive factors for recurrent MR. An age > 50 years, ejection fraction≤52% and left ventricular end-systolic dimension≥45 mm were independent risk factors for deteriorated left ventricular systolic function during follow-up.

19.
Trends Ecol Evol ; 35(12): 1090-1099, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32933777

RESUMO

Understanding ecological processes and predicting long-term dynamics are ongoing challenges in ecology. To address these challenges, we suggest an approach combining mathematical analyses and Bayesian hierarchical statistical modeling with diverse data sources. Novel mathematical analysis of ecological dynamics permits a process-based understanding of conditions under which systems approach equilibrium, experience large oscillations, or persist in transient states. This understanding is improved by combining ecological models with empirical observations from a variety of sources. Bayesian hierarchical models explicitly couple process-based models and data, yielding probabilistic quantification of model parameters, system characteristics, and associated uncertainties. We outline relevant tools from dynamical analysis and hierarchical modeling and argue for their integration, demonstrating the value of this synthetic approach through a simple predator-prey example.

20.
Asian Cardiovasc Thorac Ann ; 28(7): 390-397, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32938206

RESUMO

BACKGROUND: Emergency or urgent surgery is often required in patients with papillary muscle rupture and active mitral valve infective endocarditis. The aim of this study was to analyze the outcomes of patients with active endocarditis who underwent emergency or urgent mitral valve repair. METHODS: From 2005 to 2014, 154 ischemic mitral regurgitation patients and 41 infective endocarditis patients underwent mitral valve repair in our institution; 23 had emergency operations due to papillary muscle rupture, and 18 with active infective endocarditis underwent urgent surgery. RESULTS: Cardiopulmonary bypass time (141.4 ± 43.3 versus 145.3 ± 46.5 min) and crossclamp time (77.7 ± 34.1 versus 79.2 ± 33.0 min) were similar in the papillary muscle rupture and elective ischemic mitral regurgitation subgroups, and major postoperative complications were comparable. Hospital mortality was 17.4% in the papillary muscle rupture subgroup and 8.4% in the elective ischemic mitral regurgitation subgroup. Cardiopulmonary bypass time (103.6 ± 37.0 versus 75.5 ± 20.8 min) and crossclamp time (61.7 ± 21.2 versus 45.3 ± 18.0 min) were significantly longer in infective endocarditis patients. There were no major complications or hospital deaths. Eight years postoperatively, overall survival was 94.4% and 86.5% in the papillary muscle rupture and elective ischemic mitral regurgitation subgroups, respectively (p = 0.730). Overall survival was 100% in both infective endocarditis subgroups. CONCLUSION: The feasibility and effectiveness of emergency or urgent mitral valve repair in patients with papillary muscle rupture and active infective endocarditis are satisfactory. Early and mid-term outcomes are comparable to those of elective operations.


Assuntos
Endocardite/cirurgia , Ruptura Cardíaca/cirurgia , Implante de Prótese de Valva Cardíaca , Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Músculos Papilares/cirurgia , Idoso , Procedimentos Cirúrgicos Eletivos , Emergências , Endocardite/diagnóstico por imagem , Endocardite/mortalidade , Endocardite/fisiopatologia , Feminino , Ruptura Cardíaca/diagnóstico por imagem , Ruptura Cardíaca/mortalidade , Ruptura Cardíaca/fisiopatologia , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Anuloplastia da Valva Mitral/efeitos adversos , Anuloplastia da Valva Mitral/instrumentação , Anuloplastia da Valva Mitral/mortalidade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/mortalidade , Insuficiência da Valva Mitral/fisiopatologia , Duração da Cirurgia , Músculos Papilares/diagnóstico por imagem , Músculos Papilares/fisiopatologia , Complicações Pós-Operatórias/mortalidade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA