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1.
J Affect Disord ; 321: 126-133, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36280200

RESUMO

BACKGROUND: Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS: A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS: Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS: Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS: Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.


Assuntos
Esgotamento Profissional , COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Apoio Social , Esgotamento Psicológico , China/epidemiologia , Corpo Clínico
2.
BMC Nephrol ; 23(1): 372, 2022 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-36402958

RESUMO

BACKGROUND: A functioning vascular access (VA) is crucial to providing adequate hemodialysis (HD) and considered a critically important outcome by patients and healthcare professionals. A validated, patient-important outcome measure for VA function that can be easily measured in research and practice to harvest reliable and relevant evidence for informing patient-centered HD care is lacking. Vascular Access outcome measure for function: a vaLidation study In hemoDialysis (VALID) aims to assess the accuracy and feasibility of measuring a core outcome for VA function established by the international Standardized Outcomes in Nephrology (SONG) initiative. METHODS: VALID is a prospective, multi-center, multinational validation study that will assess the accuracy and feasibility of measuring VA function, defined as the need for interventions to enable and maintain the use of a VA for HD. The primary objective is to determine whether VA function can be measured accurately by clinical staff as part of routine clinical practice (Assessor 1) compared to the reference standard of documented VA procedures collected by a VA expert (Assessor 2) during a 6-month follow-up period. Secondary outcomes include feasibility and acceptability of measuring VA function and the time to, rate of, and type of VA interventions. An estimated 612 participants will be recruited from approximately 10 dialysis units of different size, type (home-, in-center and satellite), governance (private versus public), and location (rural versus urban) across Australia, Canada, Europe, and Malaysia. Validity will be measured by the sensitivity and specificity of the data acquisition process. The sensitivity corresponds to the proportion of correctly identified interventions by Assessor 1, among the interventions identified by Assessor 2 (reference standard). The feasibility of measuring VA function will be assessed by the average data collection time, data completeness, feasibility questionnaires and semi-structured interviews on key feasibility aspects with the assessors. DISCUSSION: Accuracy, acceptability, and feasibility of measuring VA function as part of routine clinical practice are required to facilitate global implementation of this core outcome across all HD trials. Global use of a standardized, patient-centered outcome measure for VA function in HD research will enhance the consistency and relevance of trial evidence to guide patient-centered care. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03969225. Registered on 31st May 2019.


Assuntos
Avaliação de Resultados em Cuidados de Saúde , Diálise Renal , Humanos , Diálise Renal/métodos , Estudos Prospectivos , Estudos de Viabilidade , Inquéritos e Questionários , Estudos Multicêntricos como Assunto
3.
Placenta ; 130: 25-33, 2022 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-36370492

RESUMO

INTRODUCTION: Vascular smooth muscle cells (VSMC) switched from a contractile phenotype to a synthetic phenotype during the decidual spiral artery (SPAs) remodeling process. The lncRNA plasmacytoma variant translocation 1 (PVT1) and glucose metabolism have been found to regulate the VSMC phenotype switch. This study aimed to analyze the dynamic expression of PVT1 and glycolytic key enzymes hexokinase2 (HK2) at different remodeling stages in early human pregnancy and elucidate the underlying mechanism of the PVT1/miR-145-5p/HK2 axis involved in the spiral artery remodeling. METHODS: qRT-PCR, Western blot (WB) analysis, Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) were used to detect the expression and localization of PVT1 and HK2 in decidual tissue. HA-VSMCs were transfected with specific siRNA, shRNA and plasmids to regulate corresponding genes. Extracellular lactate, cellular ATP, ROS, and intracellular NADPH levels were measured using the corresponding assay kits. Migration was measured by wound-healing and Transwell assays. Contractile phenotypic markers α-SMA, MYH11 with calponin and synthetic phenotypic markers OPN and vimentin were detected by WB. The PDC model was used to detect the degree of spiral arterial remodeling. RESULTS: PVT1 and HK2 were upregulated with gestational age (GA) increasing in decidual tissue during the early pregnancy. HK2 regulated the glycolytic activity and VSMC phenotype switch in vitro. PVT1 regulated the glycolytic activity and VSMC phenotype switch through HK2. PVT1 played a ceRNA role in regulating HK2 expression by sponging miR-145-5p. PVT1 and HK2 influenced spiral artery remodeling in the PDC model. DISCUSSION: PVT1 and HK2 were upregulated, and miR-145-5p was downregulated in decidua with the GA increasing. Meanwhile, the PVT1/miR-145-5p/HK2 axis may be involved in regulating the phenotypic switch and migratory capacity of VSMCs by affecting glycolysis in decidual SPAs remodeling.

4.
Bioengineering (Basel) ; 9(11)2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36354563

RESUMO

Placental angiogenesis disorder and placental dysplasia are important causes of many pregnancy complications. Due to safety and economic benefits, effective treatment strategies are currently limited. PFKFB3 is a key regulator of glycolysis that controls angiogenesis through a metabolic pathway independent of genetic signals. In this study, we constructed the nanodrug T-NPPFKFB3 and explored its feasibility to promote angiogenesis and enhance placental function. First, liposomes containing PFKFB3 overexpression plasmids modified by the placental homing peptide CGKRK were synthesized by the thin film method. In vivo experiments revealed that T-NPPFKFB3 injected intravenously specifically accumulated in the mouse placenta and therein upregulated the expression of PFKFB3 without affecting its expression in other important organs. In addition, T-NPPFKFB3 promoted placental angiogenesis and increased the fetal and placental weights of the mice. Finally, we evaluated the safety of T-NPPFKFB3. The expression levels of ALS/AST/BUN in the sera of pregnant mice were not significantly different from those in the sera of control group mice. However, T-NPPFKFB3 did not cause obvious fetal abnormalities or alter the average litter size. In conclusion, T-NPPFKFB3 can specifically target the placenta, promote angiogenesis, and enhance placental function without obvious side effects. Therefore, it has potential as a new strategy for the treatment of pregnancy complications.

5.
Seizure ; 103: 51-57, 2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36279597

RESUMO

OBJECTIVE: Infantile spasms (IS) is a common epilepsy syndrome in infancy. Genetically based birth defects are among the many causes of infantile spasms. Genetic diagnosis can reveal the etiology of IS and guide treatment strategies and genetic counseling, but significant challenges surround the choice of appropriate genetic diagnostic strategies to improve the diagnostic yield in IS. METHODS: For a cohort of Chinese patients with IS, appropriate genetic testing methods were selected according to etiological classification. Methods included karyotyping, copy number variation detection, single-gene sequencing, targeted sequencing panel, and whole-exome sequencing. RESULTS: A total of 728 children with IS from fifteen provinces and municipalities in China from June 2015 to October 2020 were recruited in the study. Among them, 436 were males (59.9%). The median age was 9.46 months. The diagnostic yield of our study was 31.5% (185/587). The top five causative genes were TSC2 (n = 91), STXBP1 (n = 21), TSC1 (n = 15), SCN2A (n = 6), and CDKL5 (n = 6). The genetic diagnostic yield was 100% in Down syndrome (n = 1), neurofibromatosis (n = 2), and methylmalonic acidemia (n = 2), 83.5% in tuberous sclerosis complex (n = 127), and 16.7% in unsolved infantile spasms (n = 442). Different genetic testing methods for different etiologies show large differences in diagnostic yields. CONCLUSION: This study demonstrates that appropriate genetic testing procedures for different phenotypes can ensure a high diagnostic yield.

6.
Brain Behav ; 12(11): e2785, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36259949

RESUMO

BACKGROUND: In December 2019, coronavirus disease (COVID-19) was first reported in Wuhan, China, and has had a negative psychological impact on the medical staff. However, the long-term psychological effects of COVID-19 were still unclear. We aimed to assess the posttraumatic stress disorder (PTSD) and depression among medical staff 2 years after COVID-19 pandemic in Wuhan, China. METHODS: We conducted a multicenter study in five general hospitals in Wuhan, China. PTSD was assessed using the PTSD Checklist-5. Depression was measured by the Center for Epidemiologic Studies Depression Scale. Multivariate adjusted logistic regression models were used to evaluate the association among demographic variables, depressive indicators, and PTSD. RESULTS: In a sample of 1795 medical staff, 295 (16.40%) participants reported PTSD and 329 (18.30%) reported depression. After multivariate adjusted logistic regression analyses, participants involved in COVID-19 clinical work, unsafe working environment, poor doctor-patient relationship, unhealth status, work dissatisfaction, and low family support were at a high risk for PTSD and depression 2 years after the outbreak of COVID-19 pandemic. CONCLUSIONS: Although it has been more than 2 years after the COVID-19 pandemic outbreak, the mental health of medical staff remains a concern. In particular, medical staff involved in the clinical care of COVID-19 patients showed a higher risk of PTSD and depression 2 years after the COVID-19 pandemic. This study may provide some useful suggestions for psychological interventions for medical staff.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , COVID-19/epidemiologia , Relações Médico-Paciente , Ansiedade/psicologia , Corpo Clínico , China/epidemiologia
7.
Biomolecules ; 12(10)2022 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-36291609

RESUMO

The usefulness of serum angiotensin-converting enzyme (sACE) for diagnosing sarcoidosis and determining the active status of sarcoidosis has been reported with varying outcomes. On the basis of the majority of published data, we conducted a meta-analysis to calculate the overall predictive accuracy of sACE in sarcoidosis disease and the active status of sarcoidosis. The inclusion of related research listed in Web of Science, PubMed, Scopus, and other literature databases was assessed. SROC curves were generated to characterize the overall test results after data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were combined. Publication bias was identified using Deeks' funnel plot. Thirty-five publications with 8645 subjects met the inclusion criteria. The following are summary estimates of sACE diagnostic performance for sarcoidosis: sensitivity, 60% (95% confidence interval (CI), 52-68%); specificity, 93% (95% CI, 88-96%); PLR, 8.4 (95% CI, 5.3-13.3); NLR, 0.43 (95% CI, 0.36-0.52); and DOR, 19 (95% CI, 12-31). The area under the SROC curve (AUC) was 0.84 (95% CI, 0.80-0.87). Summary estimates for predicting the active status of sarcoidosis were as follows: sensitivity, 0.76 (95% CI, 0.61-0.87); specificity, 0.80 (95% CI, 0.64-0.90); PLR, 3.9 (95% CI, 2.1-7.3); NLR, 0.29 (95% CI, 0.17-0.49); and DOR, 13 (95% CI, 6-31). The AUC was 0.85 (95% CI, 0.82-0.88). There was no evidence of publication bias. Our meta-analysis suggests that measuring the sACE may assist in the diagnosis of sarcoidosis and predicting the active status of sarcoidosis, but the interpretation of the sACE results should be with caution. Future studies should validate our results.


Assuntos
Peptidil Dipeptidase A , Sarcoidose , Humanos , Angiotensinas , Razão de Chances , Sarcoidose/sangue , Sarcoidose/diagnóstico , Peptidil Dipeptidase A/sangue
8.
Anal Chim Acta ; 1233: 340518, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36283791

RESUMO

Alkaline phosphatase (ALP) is regarded as an emerging biomarker and therapeutic target for various diseases. Herein, we developed a DNAzyme-regulated CRISPR/Cas12a cascade signal amplification strategy for sensitive and selective detection of ALP activity and inhibition. In this assay, the substrate strand of Cu2+-specific DNAzyme was designed as the DNA activator for Cas12a. The substrate strand would be cleaved into two fragments when ALP-catalyzed hydrolysis reaction disabled the complexation between Cu2+ and pyrophosphate (PPi). In this case, the cleaved sequences could not further bind to the Cas12a-crRNA complex to activate the trans-cleavage activity of CRISPR/Cas12a, which would hamper the cleavage of doubly labeled single-stranded DNA (ssDNA) fluorescence reporter, and thus a turn-off fluorescence signal. The cascade signal amplification strategy greatly improved the detection sensitivity for ALP activity, with a detection limit as low as 0.04 U/L. Moreover, the proposed method was successfully applied for ALP activity detection in serum samples and ALP inhibitory capability evaluation. This method overcomes the shortcoming of conventional methods that show unsatisfactory sensitivity and are susceptible to interfering substances, which might hold great promise in clinical diagnosis and biomedical research.


Assuntos
Técnicas Biossensoriais , DNA Catalítico , DNA Catalítico/química , Difosfatos/metabolismo , Fosfatase Alcalina/química , Sistemas CRISPR-Cas , DNA de Cadeia Simples , Espectrometria de Fluorescência/métodos , Técnicas Biossensoriais/métodos , DNA/química
9.
Front Neurol ; 13: 982050, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36237607

RESUMO

Objective: SCN1A, encoding the alpha 1 subunit of the sodium channel, is associated with a range of related epilepsy. This study aims to assess saliva and urine pH in children with SCN1A-related epilepsy. Methods: A prospective controlled observational study with a 1:1 ratio was conducted on seven patients with SCN1A-related epilepsy and seven healthy children of the same family, gender, and age but without a history of seizures. The pH of saliva and urine was measured by pH test paper. Parents of patients with epilepsy recorded seizures to compare the relationship between pH and seizures. Results: The fourteen participants were all males, aged 1 to 14 years. Seven patients had different pathogenic SCN1A variants. The pH of saliva and urine was monitored for 21-95 days. The pH of saliva and urine was higher in patients with SCN1A-related epilepsy than in the healthy group. The urine pH in Dravet syndrome patients was high compared with other epilepsy patients. The urine pH in patients with seizures was higher than that in patients without seizures, which occurred during the study. Conclusions: The pH of saliva and urine was chronically high in patients with SCN1A-related epilepsy, and urine pH was higher in patients with seizures and with Dravet syndrome.

10.
Front Neurol ; 13: 966022, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36203981

RESUMO

Background: Neutrophil-to-lymphocyte ratio (NLR) has been shown to be an important inflammatory maker. This study aims to investigate the association of NLR with intracranial and extracranial atherosclerotic stenosis. Methods: We retrospectively recruited patients who underwent digital subtraction angiography (DSA) for evaluating intracranial/extracranial stenosis in the Zhongnan Hospital of Wuhan University from January 2017 to October 2021. Clinical characteristics, DSA data, blood routine, and lipid profile were recorded. Logistic regression was used to evaluate the association of NLR and intercranial/extracranial atherosclerotic stenosis in three aspects: distribution of stenosis, whether the stenosis is symptomatic, and degree of stenosis. Results: A total of 1,129 patients were included in our analysis, with a median age of 62 y (interquartile range 55-68), and a median admission NLR of 2.39 (interquartile range 1.84-3.42). A total of 986 patients presented intracranial and/or extracranial atherosclerotic stenosis. Increased NLR were associated with intracranial stenosis [odds ratio (OR), 1.54; 95% CI, 1.27-1.85; p < 0.001], extracranial stenosis (OR, 1.56; 95% CI, 1.25-1.96; p < 0.001), and combined intracranial/extracranial stenosis (OR, 1.61; 95% CI, 1.28-2.03; p < 0.001). After adjustment of potential factors, higher NLR were independently associated with symptomatic stenosis (OR, 1.16; 95% CI, 1.05-1.27; p = 0.003) and degree of stenosis (OR, 1.32; 95% CI, 1.17-1.49; p < 0.001). Compared with the first quartile NLR, the second, third, and fourth quartiles NLR were independent risk factors for symptomatic stenosis and stenosis degree (both p for trend <0.001). Conclusion: Increased NLR is an important factor associated with both intracranial and extracranial atherosclerotic stenosis. Patients with symptomatic intracranial/extracranial atherosclerotic stenosis or a more severe degree of stenosis presented elevated NLR levels.

11.
Chem Biol Interact ; 368: 110197, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36174736

RESUMO

Carboxylesterases 1A (CES1A) is a key enzyme responsible for the hydrolytic metabolism of a great deal of endogenous and exogenous substrates bearing ester- or amide-bond(s). This study aimed to decipher the species difference in CES1A-mediated hydrolytic metabolism by using a newly developed bioluminescence CES1A sensor (termed NLMe) as the probe substrate, while the liver microsomes from six different mammalian species (human, cynomolgus monkey, dog, minipig, rat and mouse) were used as the enzyme sources. Metabolite profiling demonstrated that all tested liver microsomes from various species could catalyze NLMe hydrolysis, but significant difference in hydrolytic rate was observed. Kinetic plots of NLMe hydrolysis in liver microsomes from different species showed that the inherent clearance rates (Clint) of NLMe in human liver microsomes (HLM), cynomolgus monkey liver microsomes (CyLM), and pig liver microsome (PLM) were comparable, while the Clint values of NLMe in dog liver microsomes (DLM), mouse liver microsomes (MLM), and rat liver microsomes (RLM) were relatively small. Moreover, chemical inhibition assays showed that NLMe hydrolysis in all tested liver microsomes could be competently inhibited by BNPP (a potent broad-spectrum inhibitor of CES), but CUA (a selective inhibitor of human CES1A) only inhibited NLMe hydrolysis in human liver microsomes and dog liver microsomes. In summary, the species differences in CES1A-catalyzed NLMe hydrolysis were carefully investigated from the views of the similarities in metabolite profile, hydrolytic kinetics and inhibitor response. All these findings provide new insights into the species differences in CES1A-mediated hydrolytic metabolism and suggest that it is necessary for the pharmacologists to choose appropriate animal models to replace humans for evaluating the in vivo effects of CES1A inhibitors.

12.
J Fungi (Basel) ; 8(9)2022 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-36135614

RESUMO

Triterpenoids are secondary metabolites produced by the fungus Sanghuangporus&nbsp;baumii that have important pharmacological activities. However, the yield of triterpenoids is low and cannot meet market demand. Here, we treated S. baumii with several concentrations of MeJA (methyl jasmonate) and found that the total triterpenoid content was highest (23.31 mg/g) when the MeJA concentration was 250 µmol/L. qRT-PCR was used to quantify the transcription of five key genes involved in triterpenoid biosynthesis. The results showed that the relative transcription of most genes increased with increasing MeJA concentration, indicating that MeJA is a potent inducer of triterpenoid biosynthesis in S. baumii. To further explore whether other terpenoid biosynthesis pathways are also involved in the accumulation of triterpenoids induced by MeJA, we measured the contents of cis-Zeatin (cZ), gibberellins (GAs), and the transcript levels of related biosynthesis genes. We found that MeJA significantly inhibited the biosynthesis of cZ, GAs, and the transcription of related genes. The repressive effects of MeJA on cZ and GA accumulation were further confirmed by growth rate and biomass assays. In conclusion, our study provides an effective method to enhance the triterpenoid content of S. baumii, and also provides novel insights into the mechanism of MeJA-induced triterpenoid biosynthesis.

13.
J Plant Physiol ; 277: 153807, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36095952

RESUMO

Annual ryegrass is a widely cultivated forage grass with rapid growth and high productivity. However, drought is one of the abiotic stresses affecting ryegrass growth and quality. In this study, we compared the physiological and transcriptome responses of Chuansi No.1 (drought-tolerant, DT) and Double Barrel (drought-sensitive, DS) under drought stress simulated by PEG-6000 for 7 days. The results showed that Chuansi No. 1 had stronger physiological and biochemical parameters such as root properties, water content, osmotic adjustment ability and antioxidant ability. In addition, RNA-seq was used to elucidate the molecular mechanism of root drought resistance. We identified 8588 differentially expressed genes related to drought tolerance in root, which were mainly enriched in oxidation-reduction process, carbohydrate metabolic process, apoplast, arginine and proline metabolism, and phenylpropanoid biosynthesis pathways. The expression levels of DEGs were consistent with physiological changes of ryegrass under drought stress. We found that genes related to sucrose and starch synthesis, root development, osmotic adjustment, ABA signal regulation and specifically up-regulated transcription factors such as WRKY41, WRKY51, ERF7, ERF109, ERF110, NAC43, NAC68, bHLH162 and bHLH148 in Chuansi No. 1 may be the reason for its higher drought tolerance. This study revealed the underlying physiological and molecular mechanisms of root response to drought stress in ryegrass and provided some new candidate genes for breeding rye drought tolerant varieties.


Assuntos
Secas , Lolium , Antioxidantes , Arginina , Carboidratos , Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica de Plantas , Lolium/genética , Melhoramento Vegetal , Prolina/genética , Amido , Sacarose , Fatores de Transcrição/genética , Água
14.
Reprod Sci ; 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071344

RESUMO

Preeclampsia (PE) is a pregnancy complication with high maternal and fetal morbidity and mortality rates. During pregnancy, the concentration of exosomes in the maternal blood circulation would increase, establishing that plasma exosomes play a role in the development of pregnancy. Our previous study implied the important role of exosomal miR-199a-5p in preeclampsia with severe features (sPE). This study aims to reveal the role of exosomal miR-199a-5p in contribution to the development of sPE. The results showed that the expression of miR-199a-5p was significantly higher in plasma exosomes and placenta tissue from patients with sPE than that in normal pregnant women. Additionally, hydrogen peroxide (H2O2) could upregulate the expression of miR-199a-5p in BeWo cells and cell-derived exosomes. In terms of the regulatory effect, exosomal miR-199a-5p was observed to inhibit the expression of SIRT1 in human umbilical venous endothelial cells (HUVECs). Moreover, the treatment of both miR-199a-5p-overexpressed exosomes and SIRT1 inhibitor EX527 could decrease the nitric oxide production, elevate the intracellular reactive oxygen species level, and enhance the expressions of ICAM-1 and VCAM-1 of HUVECs. Thus, our findings suggest that the upregulated plasma exosomal miR-199a-5p in sPE might result from the trophoblast of the impaired placenta under oxidative stress. Furthermore, exosomal miR-199a-5p could impair the endothelial cell function via targeting SIRT1, contributing to the development of preeclampsia.

15.
Environ Res ; 215(Pt 1): 114249, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36058275

RESUMO

BACKGROUND AND AIMS: Noise exposure is a major public health challenge with important implications for cardiovascular health. However, the association between noise exposure and stroke risk remains controversial. Therefore, we aimed to evaluate the role of noise exposure on stroke incidence and mortality by conducting a dose-response meta-analysis of cohort studies. METHODS: The relevant publications were retrieved via PubMed, Embase, Web of Science, and Scopus up to June 26, 2022. The potential linear and curve relationship between noise and stroke were fitted using the generalized least squares method and restricted cubic spline. We estimated the pooled relative risk (RR) with 95% confidence interval (CI) by random-effect models. The Grading of Recommendations Assessment Development and Evaluation (GRADE) approach was used to evaluate the strength of the results. RESULTS: In total, 21 cohort studies with 16,075,204 participants and 311,878 cases were included in the analysis. The risk of stroke incidence increased up to 4% (95% CI:1.02-1.06) and stroke mortality increased up to 3% (95% CI:1.00-1.07), every 10 dB(A) increment in noise exposure. Moreover, each 10 dB(A) increment in noise exposure was associated with a 4% (95% CI:1.01-1.07) increase in ischemic stroke and a 2% (95% CI:1.00-1.04) increase in hemorrhagic stroke. According to GRADE criteria, the evidence level in this study was rated as moderate. CONCLUSIONS: The current findings provide further evidence of a dose-response relationship between exposure to noise and the risk of stroke incidence and mortality. Additionally, we update and fill a knowledge gap that the statistically significant increase in stroke incidence when noise decibels are >65 dB(A).


Assuntos
Acidente Vascular Cerebral , Estudos de Coortes , Humanos , Incidência , Mortalidade , Ruído , Ruído Ocupacional , Acidente Vascular Cerebral/epidemiologia
16.
Medicine (Baltimore) ; 101(33): e30055, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35984209

RESUMO

To determine the ultrasound imaging characteristics of patients with bronchial anthracofibrosis (BAF) and identify clinical markers for prevention and treatment. We randomly selected 1243 participants (113 with BAF) who underwent bronchoscopy and received treatment at our institution between April 2018 and October 2019. BAF was classified as flat, deep-seated retracted, or black mucosal protruding based on microscopic findings. Ultrasound probes were used to determine the maximum thickness of the tube walls and submucosa. The average values of the submucosal and bony tissue areas in the BAF subtypes were compared. The BAF group included 13 participants with a history of tuberculosis (11.5%) and 57 participants with biofuel exposure (50.4%). The average exposure time was 17.4 ± 6.2 years; BAF accounted for 10% of the bronchoscopies performed. The maximum tube-wall thicknesses of the deep-seated retracted (17.3 ± 5.7) and black mucosal protruding (19.3 ± 5.4) groups were significantly greater than those of the flat group (12.5 ± 5.0; P < .05). The maximum thicknesses of the submucosa in the deep-retracted (9.8 ± 3.0) and black mucosal protruding (14.5 ± 5.0) groups were significantly greater than that of the flat group (6.6 ± 3.5; P < .05). The ratios of bone tissue in the flat and black mucosal protruding groups were 33.3 ± 9.3% and 34.9% ± 12.1%, respectively. The ratio in the deep-seated retracted group (65.2% ± 8.7%) was significantly reduced (P < .05). The flat group showed no significant change (P > .05). Differences in BAF airway remodeling among different subtypes may lead to varying clinical symptoms. Analyzing the characteristics of BAF airway remodeling and the regulatory pathway may provide new clues for treatment.


Assuntos
Antracose , Broncopatias , Remodelação das Vias Aéreas , Antracose/diagnóstico por imagem , Broncopatias/diagnóstico por imagem , Broncoscopia/métodos , Estudos de Casos e Controles , Humanos , Ultrassonografia
17.
Hematology ; 27(1): 909-916, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35993333

RESUMO

Lymphoma-associated hemophagocytic syndrome (LAHS) is a rare and life-threatening clinical syndrome with rapidly deteriorating health and high mortality. We retrospectively analyzed clinical features and prognostic factors from 117 patients diagnosed with LAHS. The cumulative incidence rate of LAHS was 4.0% (117/2906). Patients were classified into B-cell LAHS (B-LAHS, n = 22) and T/natural killer (NK)-cell LAHS (T/NK-LAHS, n = 95) groups. Patients with T/NK-LAHS were younger and had lower neutrophil counts and fibrinogen values, higher LDH and transaminase levels, and were more likely to develop hemophagocytic syndrome (HPS) during the clinical course than those with B-LAHS. The median survival time for the entire cohort was 57 days, and for the T/NK-LAHS and B-LAHS groups, it was 52 and 154 days, respectively, after the diagnosis of LAHS. Patients with B-LAHS had superior 1-year OS (p = 0.003, 36.4% versus 14.5%) compared with those with T/NK-LAHS. Prognostic factor analysis revealed that elevated LDH levels (LDH > 1000 IU/L) (p = 0.004), T/NK-cell lineage (p < 0.001) and HPS onset at relapse (p = 0.001) were strongly associated with early death. For patients diagnosed with T/NK-LAHS, in addition to LDH levels and HPS onset status, high EBV-DNA copies (≥4,450 copies/mL) (p = 0.016) were also related to poor prognosis of T/NK-LAHS.


Assuntos
Linfo-Histiocitose Hemofagocítica , Linfoma , Humanos , Linfoma/diagnóstico , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
18.
Transp Policy (Oxf) ; 127: 22-30, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36035455

RESUMO

We investigate the impact of air travel mobility and global connectivity on viral transmission by tracing the announced arrival time of COVID-19 and its major variants in countries around the world. We find that air travel intensity to a country, "effective distance" as measured by international air traffic, is generally a significant predictor for the announced viral arrival time. The level of healthcare infrastructure in a country is less important at predicting the initial transmission and detection time of a virus. A policy variable, notably the percentage reduction of total inbound seats in response to a viral outbreak, is largely ineffective at delaying viral transmission and discovery time. These findings suggest that air network connectivity is a major contributor to the speed of viral transmission. However, government attempts to delay viral transmission by reducing air network connectivity after the virus is first discovered are largely ineffective.

19.
Stem Cell Res Ther ; 13(1): 391, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918720

RESUMO

BACKGROUND: Mesenchymal stem cells (MSCs) have a great potential ability for endothelial differentiation, contributing to an effective means of therapeutic angiogenesis. Placenta-derived mesenchymal stem cells (PMSCs) have gradually attracted attention, while the endothelial differentiation has not been fully evaluated in PMSCs. Metabolism homeostasis plays an important role in stem cell differentiation, but less is known about the glycometabolic reprogramming during the PMSCs endothelial differentiation. Hence, it is critical to investigate the potential role of glycometabolism reprogramming in mediating PMSCs endothelial differentiation. METHODS: Dil-Ac-LDL uptake assay, flow cytometry, and immunofluorescence were all to verify the endothelial differentiation in PMSCs. Seahorse XF Extracellular Flux Analyzers, Mito-tracker red staining, Mitochondrial membrane potential (MMP), lactate secretion assay, and transcriptome approach were to assess the variation of mitochondrial respiration and glycolysis during the PMSCs endothelial differentiation. Glycolysis enzyme 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) was considered a potential modulator for endothelial differentiation in PMSCs by small interfering RNA. Furthermore, transwell, in vitro Matrigel tube formation, and in vivo Matrigel plug assays were performed to evaluate the effect of PFKFB3-induced glycolysis on angiogenic capacities in this process. RESULTS: PMSCs possessed the superior potential of endothelial differentiation, in which the glycometabolic preference for glycolysis was confirmed. Moreover, PFKFB3-induced glycometabolism reprogramming could modulate the endothelial differentiation and angiogenic abilities of PMSCs. CONCLUSIONS: Our results revealed that PFKFB3-mediated glycolysis is important for endothelial differentiation and angiogenesis in PMSCs. Our understanding of cellular glycometabolism and its regulatory effects on endothelial differentiation may propose and improve PMSCs as a putative strategy for clinical therapeutic angiogenesis.


Assuntos
Células-Tronco Mesenquimais , Diferenciação Celular , Células Cultivadas , Glicólise , Humanos , Células-Tronco Mesenquimais/metabolismo , Neovascularização Patológica/metabolismo , Fosfofrutoquinase-2/genética , Fosfofrutoquinase-2/metabolismo
20.
World J Pediatr ; 18(11): 761-770, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35906344

RESUMO

BACKGROUND: Even though adrenocorticotropic hormone (ACTH) demonstrated powerful efficacy in the initially successful treatment of infantile spasms (IS), nearly half of patients have experienced a relapse. We sought to investigate whether features of electroencephalogram (EEG) predict relapse in those IS patients without structural brain abnormalities. METHODS: We retrospectively reviewed data from children with IS who achieved initial response after ACTH treatment, along with EEG recorded within the last two days of treatment. The recurrence of epileptic spasms following treatment was tracked for 12 months. Subjects were categorized as either non-relapse or relapse groups. General clinical and EEG recordings were collected, burden of amplitudes and epileptiform discharges (BASED) score and multiscale entropy (MSE) were carefully explored for cross-group comparisons. RESULTS: Forty-one patients were enrolled in the study, of which 26 (63.4%) experienced a relapse. The BASED score was significantly higher in the relapse group. MSE in the non-relapse group was significantly lower than the relapse group in the γ band but higher in the lower frequency range (δ, θ, α). Sensitivity and specificity were 85.71% and 92.31%, respectively, when combining MSE in the δ/γ frequency of the occipital region, plus BASED score were used to distinguish relapse from non-relapse groups. CONCLUSIONS: BASED score and MSE of EEG after ACTH treatment could be used to predict relapse for IS patients without brain structural abnormalities. Patients with BASED score ≥ 3, MSE increased in higher frequency, and decreased in lower frequency had a high risk of relapse.


Assuntos
Espasmos Infantis , Hormônio Adrenocorticotrópico/uso terapêutico , Criança , Eletroencefalografia , Entropia , Humanos , Lactente , Recidiva , Estudos Retrospectivos , Espasmo/tratamento farmacológico , Espasmos Infantis/diagnóstico , Espasmos Infantis/tratamento farmacológico , Resultado do Tratamento
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