Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 79.609
Filtrar
1.
Anticancer Res ; 40(1): 557-564, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892612

RESUMO

BACKGROUND/AIM: Ultraviolet radiation (UVR) causes solar lentigines (SL) and skin cancer (SC) in humans. The association between measured lifetime UVR dose and SC has not been investigated. This study investigated this relation through their common relationship to SL. MATERIALS AND METHODS: First we investigated the association between lifetime UVR dose and SL for 16,897 days in 38 healthy participants, and secondly, the relation between SL and SC was investigated in 2,898 participants, including 149 with SC. By combining both studies, SC risk related to lifetime UVR dose and skin phototype was estimated. RESULTS: A positive association was found between SL and lifetime UVR dose (p=0.060). Skin phototype (p=0.001) and SL (p<0.001) were associated with SC. Combined SC risk increased 1.23 by doubling the average lifetime UVR dose and was 34.9 times higher for those with very fair skin compared to dark Mediterranean skin. CONCLUSION: The estimate of SC risk shows that skin phototype is of greater relative importance than lifetime UVR dose.


Assuntos
Lentigo/epidemiologia , Neoplasias Cutâneas/epidemiologia , Raios Ultravioleta , Adulto , Idoso , Relação Dose-Resposta à Radiação , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
2.
Food Chem ; 307: 125527, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31648179

RESUMO

We report on a sensitive and fast quantitative MALDI-MS/MS method used to assess saffron authenticity by direct analysis through the determination of picrocrocin as the saffron authenticity marker, and using curcumin as the non-isotopic isobaric internal standard. The internal standard curcumin yielded good linearity (R2 = 0.994), and with confidence intervals at 95% for intercept. The detectable maximum adulteration percentage (99.0%) was estimated interpolating the limit of detection (LOD) for the isobaric internal standard in linear regression. The LOD was 47.63 ppm, and LOQ was 56.53 ppm. Good accuracy and precision were obtained for all concentrations. The capability of the MS approach to monitor analytes in a specific, selective fashion was used to obtain a semi-quantitative adulteration percentage and to establish the adulterant by additional experiments. The detection of gardecin and its derivatives in commercial samples indicated that Gardenia jasminoides Ellis was used as the adulterant.


Assuntos
Crocus/química , Cicloexenos/análise , Glucosídeos/análise , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Terpenos/análise , Calibragem , Curcumina/química , Cicloexenos/normas , Glucosídeos/normas , Limite de Detecção , Modelos Lineares , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/normas , Terpenos/normas
3.
Chemosphere ; 238: 124604, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31450113

RESUMO

Accurate in silico predictions of chemical substance ecotoxicity has become an important issue in recent years. Most conventional methods, such as the Ecological Structure-Activity Relationship (ECOSAR) model, cluster chemical substances empirically based on structural information and then predict toxicity by employing a log P linear regression model. Due to empirical classification, the prediction accuracy does not improve even if new ecotoxicity test data are added. In addition, most of the conventional methods are not appropriate for predicting the ecotoxicity on inorganic and/or ionized compounds. Furthermore, a user faces difficulty in handling multiple Quantitative Structure-Activity Relationship (QSAR) formulas with one chemical substance. To overcome the flaws of the conventional methods, in this study a new method was developed that applied unsupervised machine learning and graph theory to predict acute ecotoxicity. The proposed machine learning technique is based on the large AIST-MeRAM ecotoxicity test dataset, a software program developed by the National Institute of Advanced Industry Science and Technology for Multi-purpose Ecological Risk Assessment and Management, and the Molecular ACCess System (MACCS) keys that vectorize a chemical structure to 166-bit binary information. The acute toxicity of fish, daphnids, and algae can be predicted with good accuracy, without requiring log P and linear regression models in existing methods. Results from the new method were cross-validated and compared with ECOSAR predictions and show that the new method provides better accuracy for a wider range of chemical substances, including inorganic and ionized compounds.


Assuntos
Ecotoxicologia/métodos , Aprendizado de Máquina , Poluentes Químicos da Água/toxicidade , Poluição Química da Água/análise , Animais , Simulação por Computador , Daphnia/efeitos dos fármacos , Peixes , Modelos Lineares , Modelos Teóricos , Relação Quantitativa Estrutura-Atividade , Medição de Risco/métodos , Software , Poluentes Químicos da Água/química
4.
Chemosphere ; 240: 124898, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31557644

RESUMO

Urinary polycyclic aromatic hydrocarbon (PAH) metabolites, biomarkers of internal PAH exposure, are commonly used to explore the effects of PAH on human health. However, the correlation between environmental PAH exposure and the species or levels of urinary PAH metabolites remains unclear. We collected detailed information on PAH exposure sources, including cigarette smoking, cooking, traffic and diet habits via structured questionnaires, and determined 12 urinary monohydroxylated PAH metabolites (OH-PAHs) among 4092 participants from the Wuhan-Zhuhai cohort. Linear mixed models and generalized linear models were conducted to explore the associations of urinary metabolite levels with single or multiple PAH exposure sources. We also calculated the standardized regression coefficients to further compare the contributions of different sources to urinary OH-PAH levels. Our results showed that increasing levels of urinary 1-, 2-hydroxynaphthalene (1-, 2- OHNa) and 2-hydroxyfluorene (2-OHFlu) were significantly correlated with tobacco smoking (all P < 0.01). The concentrations of 1-, 2- OHNa and 9-hydroxyfluorene (9-OHFlu) were positively correlated with dietary intake (all P < 0.05). Individuals who spent a long time in traffic showed elevated levels of 9-OHFlu and 1-hydroxyphenanthrene (1-OHPh) compared with individuals who spent a short time in traffic (all P < 0.05). Self-cooking was associated only with elevated 1-hydroxypyrene (1-OHP) levels. Moreover, good kitchen ventilation resulted in significantly decreased urinary low-molecular-weight OH-PAH levels. These findings suggested that cigarette smoking, self-cooking, high dietary PAH intake and a long time spent in traffic were associated with increased levels of specific urinary PAH metabolites, and good kitchen ventilation effectively reduced the exposure to low-molecular-weight PAHs in self-cooking participants.


Assuntos
Exposição Ambiental/análise , Poluentes Ambientais/urina , Hidrocarbonetos Policíclicos Aromáticos/urina , Adulto , Biomarcadores/urina , China , Estudos de Coortes , Estudos Transversais , Exposição Ambiental/estatística & dados numéricos , Feminino , Fluorenos , Humanos , Estilo de Vida , Modelos Lineares , Pulmão/metabolismo , Masculino , Naftóis , Fenantrenos
5.
Adv Exp Med Biol ; 1192: 139-158, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705494

RESUMO

Neuroimaging-based personalized medicine is emerging to characterize brain disorders and their evolution at the patient level. In this chapter, we present the most classic methods used to infer large-scale brain connectivity based on functional MRI. We adopt a modeling perspective where every connectivity measure is linked to a specific model that allows to interpret the connectivity estimate. This perspective allows to analyze the quality of retrieved connectivity profiles in terms of modeling error and estimation error. In the first part of the chapter, we present undirected functional connectivity (Pearson's correlation and MI) and effective connectivity (partial correlation), as well as directed effective connectivity (VAR, MOU, Granger causality, DCM). In addition, some of these measures correspond to fully connected graphs (Pearson's correlation) while others to sparse ones (MOU, DCM), where the sparsity can come from the integration of functional and structural data. In the second part, we claim that machine learning tools are better suited than null-hypothesis testing to link the estimated connectomes with diagnosis and prognosis of neuropsychiatric diseases. Finally, we propose that linear models and features selection are preferable to more complex and nonlinear tools (when prediction performance is on a par) for building interpretable algorithms to predict clinical variables.


Assuntos
Encefalopatias , Conectoma , Encéfalo , Humanos , Modelos Lineares , Imagem por Ressonância Magnética
6.
Am J Forensic Med Pathol ; 40(4): 329-335, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31688050

RESUMO

Forensic pathologists are requested to select matrices alternative to blood in cases of toxicological interest in which blood is not available for different reasons. We evaluated morphine concentrations in blood, bile, and liver samples in 52 cases of heroin overdoses, relating them to each other, to understand the information that could be derived from their analysis. Gas chromatography/mass spectrometry analysis was performed for all the samples positive on screening for opiates. Shapiro-Wilk test, nonparametric Mann-Whitney test, linear regression analysis, and Bland-Altman test were used for analysis. Linear regression demonstrated that there was not a statistically significant association in morphine concentrations between blood and bile and blood and liver. Mean liver/blood ratio was 2.76, varying from 0.131 to 13.379, and bile/blood ratio was 28.79, varying from 0.28 to 559.16. According to these results, bile analysis is a "screening test"; biliary or hepatic concentration of morphine cannot provide information on hematic concentration at the time of death, having no forensic value taken individually.


Assuntos
Bile/química , Overdose de Drogas , Heroína/envenenamento , Fígado/química , Morfina/análise , Adolescente , Adulto , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Dependência de Heroína , Humanos , Modelos Lineares , Masculino , Detecção do Abuso de Substâncias , Adulto Jovem
7.
Nurs Res ; 68(6): 445-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693550

RESUMO

BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/psicologia , Estresse Psicológico/epidemiologia , Adulto , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato
8.
Medicine (Baltimore) ; 98(45): e17747, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702625

RESUMO

BACKGROUND AND OBJECTIVE: Colonoscopy is the most important method for the diagnosis and treatment of intestinal diseases, and there are many factors affecting the quality of examination. Although the assistant is one of the factors influencing the quality of colonoscopy, there are few studies on the effect of different assistants with different experiences on the quality of colonoscopy. Therefore, the study was aimed to research the correlation between different assistants with different experiences and the quality of water-injection colonoscopy. METHOD: In this study, a single-center randomized controlled trial was conducted to analyze the key quality indicators (the rate to arrive cecum, time to arrive cecum, total operation time, detection rate of polyps, detection rate of adenoma, pain score, operation satisfaction, and the pressure on abdomen) of patients who underwent water-injection colonoscopy under non-sedation from January 2018 to June 2018 in the center. Patients were randomly assigned to different assistant groups based on the actual working period of 6 months (0∼6 months inexperienced assistant group and assistant group with more than 6 months of experience). Through fitting the bivariate and multivariate logistic regression models, the differences between the two groups and the effects on the key quality indicators of colon examination were analyzed. RESULTS: A total of 331 patients who were eligible for non-sedation colonoscopy were randomly assigned to the experienced assistant group (n = 179) and the inexperienced assistant group (n = 152). Among them, 103 cases of polyp and 70 cases of adenoma were detected. The rate to arrive cecum, polyp detection rate and adenoma detection rate were compared between the two groups during operation (P > 0.05). However, there were significant differences in the time to arrive cecum, patients' satisfaction with operation, pain score and abdominal pressure (P < .05). In the inexperienced assistant group, 20% of the operation time was one standard deviation higher than the mean value, while the experienced assistant group was 12% (339 s vs 405s, OR 0.541, 95% 0.295-0.990). Compared with the inexperienced assistant group, patients in the experienced assistant group had higher operational satisfaction (98.32% vs 92.11%, OR 0.199, 95% 0.055-0.718) and lower pain score (0.3 vs 0.49, OR 1.993, 95% 1.52-3.775). All relations remained unchanged after adjusting for potential confounders. CONCLUSION: The assistant is a key factor in the quality of colonoscopy, especially in the case of non-sedating colonoscopy. The experience of the assistant is related to the time to arrive cecum, the degree of pain and the overall satisfaction of patient with the operation. The assistant should be subject to the quality supervision of the endoscopic inspector. Proof of human Clinical Trial Registration: The institutional review board of Fifth Affiliated Hospital of Wenzhou Medical College, Zhejiang Province, China approved the study. The study is registered on. Chinese Clinical Trial Registry (ChiCTR1800015650).


Assuntos
Competência Clínica , Colonoscopia/métodos , Enteropatias/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Colonoscopia/efeitos adversos , Feminino , Humanos , Enteropatias/cirurgia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Medição da Dor , Assistentes Médicos , Projetos Piloto , Adulto Jovem
9.
Braz J Cardiovasc Surg ; 34(5): 572-580, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719008

RESUMO

OBJECTIVE: To characterize the behavior of cardiac autonomic modulation in individuals with different times after orthotopic heart transplantation (HTx) using symbolic dynamics analysis. METHODS: Sixty patients were evaluated after HTx. We recorded their instantaneous R-R intervals (RRi) by cardiac monitor Polar® RS800CX™ (Polar Electro Oy, Kempele, Finland) for 10 minutes. The same sequence of RRi with 256 consecutive beats was used to perform spectral analysis and symbolic dynamics analysis. We used hierarchical clustering to form groups. One-way analysis of variance (ANOVA) (with Holm-Sidak method) or one-way Kruskal-Wallis test (with Dunn´s post-hoc test) was used to analyze the difference between groups. Linear correlation analysis between variables was performed using Pearson's or Spearman's tests. P-value < 0.05 was considered statistically significant. RESULTS: The 0V% index increased, the 2UV% index and the normalized complexity index decreased with an increase of HTx postoperative time. There were a negative correlation between complexity indexes and 0V% and a positive correlation between complexity indexes and 2UV%. CONCLUSION: Symbolic dynamics indexes were able to show a specific cardiac autonomic modulation pattern for HTx recipients with different postoperative times.


Assuntos
Transplante de Coração/reabilitação , Coração/fisiopatologia , Dinâmica não Linear , Sistema Nervoso Parassimpático/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adulto , Análise de Variância , Estudos Transversais , Entropia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo
10.
Medicine (Baltimore) ; 98(41): e17400, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593091

RESUMO

INTRODUCTION: Cardiac autonomic modulation is an important marker of cardiovascular health and the practice of physical activity is a fundamental tool for good maintenance or increments in this marker. However, it is not clear in the literature whether different intensities and different domains of physical activity are related in the same way to cardiac autonomic modulation. OBJECTIVES: This randomized epidemiologic study will examine the relationship between cardiac autonomic modulation and different intensities and domains of physical activity in a representative sample of adults. METHODS: The sample of study will consist of 252 subjects aged from 18 years and above. The sample will be randomized through census sectors in which the neighborhoods, streets, and houses will also be randomized. Cardiac autonomic modulation will be assessed by heart rate variability and the intensity (mild, moderate, intense) of physical activity will be evaluated by means of accelerometers, while the different domains of physical activity (physical activity at work, occupational activities) will be evaluated through a questionnaire. The relationship between cardiac autonomic modulation and different physical activity intensities, as well as the different domains will be analyzed by linear regression, considering a statistical significance of 5% and a 95% confidence interval. This research protocol is registered in ClinicalTrials.gov at number NCT03986879.


Assuntos
Acelerometria/estatística & dados numéricos , Sistema Nervoso Autônomo/fisiologia , Exercício/fisiologia , Coração/fisiologia , Esforço Físico/fisiologia , Adolescente , Adulto , Feminino , Frequência Cardíaca/fisiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Inquéritos e Questionários , Adulto Jovem
11.
Medicine (Baltimore) ; 98(42): e17530, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626114

RESUMO

Serious bacterial infection (SBI) is a major cause of morbidity and mortality in children. Distinguishing SBI from self-limiting viral infections is a very important task in the emergency department (ED), especially in the children with fever without source (FWS). The aim of this study was to analyze whether parents' statements about clinical manifestations, which were categorized according to grades, are related to the actual diagnosis of SBI in children with FWS.Retrospective analysis was conducted using prospectively acquired cohort data for all febrile children in the pediatric ED of Seoul National University Hospital from August 2016 to August 2017. The association of clinical manifestations and SBI was the main outcome of this study. The SBIs included diagnoses such as bacteremia, bacterial meningitis, urinary tract infection, and pneumonia. Clinical manifestations including activity, urination, and feeding were categorized into 3 or 4 grades according to the parents' statements. The linear-by-linear association test was used to examine linear associations between the severity of clinical manifestations and SBI. Receiver operating characteristic curves for clinical manifestations were constructed for patients with SBI. Area under the curve (AUC) statistics and 95% confidence intervals (CIs) were obtained to evaluate the predictive performance of clinical manifestations.There was no linear association between SBI and non-SBI when compared by severity of the clinical manifestations, such as duration of fever (P = .299), activity (P = .781), feeding (P = .161), and urination (P = .834). The AUC was 0.54 (95% CI 0.41-0.67) for duration of fever, 0.52 for activity (95% CI 0.40-0.64), 0.42 for feeding (95% CI 0.32-0.53), and 0.51 for urination (95% CI 0.39-0.62).There was no evidence that the test performance of the clinical manifestations is valid for predicting SBIs, even considering the severity of manifestations. For optimal evaluation of the children with FWS, more comprehensive approach including laboratory tests, are needed.


Assuntos
Infecções Bacterianas/diagnóstico , Febre de Causa Desconhecida/diagnóstico , Pais , Avaliação de Sintomas/estatística & dados numéricos , Pré-Escolar , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Seul , Avaliação de Sintomas/métodos
13.
JAMA ; 322(15): 1486-1499, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31613346

RESUMO

Importance: High-quality dietary patterns may help prevent chronic disease, but limited data exist from randomized trials about the effects of nutritional and behavioral interventions on dietary changes. Objective: To assess the effect of a nutritional and physical activity education program on dietary quality. Design, Setting, and Participants: Preliminary exploratory interim analysis of an ongoing randomized trial. In 23 research centers in Spain, 6874 men and women aged 55 to 75 years with metabolic syndrome and no cardiovascular disease were enrolled in the trial between September 2013 and December 2016, with final data collection in March 2019. Interventions: Participants were randomized to an intervention group that encouraged an energy-reduced Mediterranean diet, promoted physical activity, and provided behavioral support (n = 3406) or to a control group that encouraged an energy-unrestricted Mediterranean diet (n = 3468). All participants received allotments of extra-virgin olive oil (1 L/mo) and nuts (125 g/mo) for free. Main Outcomes and Measures: The primary outcome was 12-month change in adherence based on the energy-reduced Mediterranean diet (er-MedDiet) score (range, 0-17; higher scores indicate greater adherence; minimal clinically important difference, 1 point). Results: Among 6874 randomized participants (mean [SD] age, 65.0 [4.9] years; 3406 [52%] men), 6583 (96%) completed the 12-month follow-up and were included in the main analysis. The mean (SD) er-MedDiet score was 8.5 (2.6) at baseline and 13.2 (2.7) at 12 months in the intervention group (increase, 4.7 [95% CI, 4.6-4.8]) and 8.6 (2.7) at baseline and 11.1 (2.8) at 12 months in the control group (increase, 2.5 [95% CI, 2.3-2.6]) (between-group difference, 2.2 [95% CI, 2.1-2.4]; P < .001). Conclusions and Relevance: In this preliminary analysis of an ongoing trial, an intervention that encouraged an energy-reduced Mediterranean diet and physical activity, compared with advice to follow an energy-unrestricted Mediterranean diet, resulted in a significantly greater increase in diet adherence after 12 months. Further evaluation of long-term cardiovascular effects is needed. Trial Registration: isrctn.com Identifier: ISRCTN89898870.


Assuntos
Restrição Calórica , Dieta Mediterrânea , Exercício , Síndrome Metabólica/dietoterapia , Cooperação do Paciente , Idoso , Doenças Cardiovasculares/prevenção & controle , Inquéritos sobre Dietas , Feminino , Educação em Saúde , Humanos , Modelos Lineares , Lipídeos/sangue , Masculino , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Obesidade/dietoterapia , Fatores de Risco , Espanha
14.
Am Surg ; 85(9): 992-997, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638512

RESUMO

Ventilator-associated pneumonia (VAP) affects up to 30 per cent of ICU patients and has been associated with increased morbidity and mortality. We identified factors associated with prolonged latency of VAP and evaluated its effects on survival and additional outcomes. We also determined the sensitivity of various clinical definitions of VAP, including the Centers for Disease Control and Prevention (CDC) 2013 criteria. We hypothesized that the CDC 2013 criteria would have poor sensitivity. We collected data on 102 subjects who developed VAP between 2012 and 2017. We conducted a Kaplan-Meier survival analysis with Cox proportional hazards regression and generalized linear models/ANOVA to look at predictor variables along with multivariate models for each outcome. White patients, nonsurgical patients, patients with renal failure, altered mental status, increased FiO2, and increased positive end-expiratory pressure had worse survival. Trauma patients, patients with positive sputum cultures, and patients with suspected pneumonia had better survival. Sensitivity of the CDC 2013 criteria was only 44.1 per cent. Our results emphasize the importance of having a high index of suspicion for VAP in ventilator-dependent patients. The 2013 CDC criteria failed to detect 55.9 per cent of confirmed VAP cases. These results are concerning because undetected VAP can have devastating consequences for patients.


Assuntos
Pneumonia Associada à Ventilação Mecânica/diagnóstico , Pneumonia Associada à Ventilação Mecânica/mortalidade , Adulto , Idoso , Cuidados Críticos , Feminino , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Fatores de Tempo
15.
Water Sci Technol ; 80(4): 695-706, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31661449

RESUMO

Soft-sensor applications for wastewater management can provide valuable information for intelligent monitoring and process control above and beyond what is available from conventional hard sensors and laboratory measurements. To realize these benefits, it is important to know how to manage gaps in the data time series, which could result from the failure of hard sensors, errors in laboratory measurements, or low-frequency monitoring schedules. A robust soft-sensor system needs to include a plan to address missing data and efficiently select variable(s) to make the most use of the available information. In this study, we developed and applied an enhanced iterated stepwise multiple linear regression (ISMLR) method through a MATLAB-based package to predict the next day's influent flowrate at the Kirie water reclamation plant (WRP). The method increased the data retention from 77% to 93% and achieved an adjusted R2 up to 0.83 by integrating with a typical artificial neural network.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Modelos Lineares , Águas Residuárias , Água
16.
Medicine (Baltimore) ; 98(43): e17507, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651854

RESUMO

This study aimed to investigate measles antibody level and its associated factors in a healthy Chinese population, so as to provide evidence to measles prevention and control measures in the future.We conducted a cross-sectional survey by using probability proportionate to size sampling (PPS) among a healthy population aged 8 months to 45 years. Information on measles vaccination status was obtained from the vaccination certificates. Serum measles IgG antibody was detected by enzyme-linked immunosorbent assay. Multivariate logistic and linear regression models were used to analysis the associated factors of measles antibody.Of the 663 study subjects, the positive rate, protective rate, and geometric mean concentration (GMC) of measles antibodies were 92.76%, 77.53%, 1612.55 mIU/ml, respectively. The antibody concentration was higher in Han ethnical majority than in Hui minority. The positive rate, protective rate and concentration of antibodies in different age groups and regions were clearly disparate. Age, area, and measles-containing vaccine (MCV) immunization history were the prominent influencing factors of antibody positive rate and protective rate. Ethnicity, age, area, and MVC immunization history were the influencing factors of antibody concentration.Our major findings suggest that, children in rural China, especially in impoverished mountainous regions, were more likely to suffer from delays in measles vaccination. Various measures in optimizing vaccination practices should be implemented in order to prevent possible measles epidemic, even outbreak in these regions.


Assuntos
Anticorpos Antivirais/sangue , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Sarampo/imunologia , Morbillivirus/imunologia , Saúde da População/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Criança , Pré-Escolar , China , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/imunologia , Lactente , Modelos Lineares , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Pessoa de Meia-Idade , Análise Multivariada , Vacinação/estatística & dados numéricos , Adulto Jovem
17.
Medicine (Baltimore) ; 98(43): e17578, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651862

RESUMO

BACKGROUND: To evaluate the methylation levels of human telomerase reverse transcriptase (hTERT) promoter three CpG island (CGIs) regions and its prognostic impact in Chinese patients with acral and mucosal melanoma. METHODS: Bioinformatics software was used to analyze hTERT gene promoter. Fresh frozen tissues were taken from 14 patients with melanoma (6 acral melanoma and 8 mucosal melanoma) and 14 pigmented nevus as control subjects (14 acral pigmented nevus). Bisulfite sequencing PCR (BSP) combined TA clone sequencing was used to assess the methylation levels of hTERT promoter CGIs regions. The relative expression level of hTERT mRNA was measured by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: CGIs-1 (-1392--1098 bp), CGIs-2 (-945--669 bp), and CGIs-3 (-445--48 bp) were selected for our study. Our results indicated that the methylation levels of hTERT promotor CGIs regions in melanoma were greater than pigmented nevus (CGIs-1: 69.3 ±â€Š18.7% vs 46.8 ±â€Š20.4%, t = 3.048 P = .005; CGIs-2: 73.8 ±â€Š14.7% vs 55.6 ±â€Š16.0%, t = 3.120 P = .004; CGIs-3: 5.8 ±â€Š2.2% vs 2.2 ±â€Š1.3%, t = 5.164 P < .001). The relative expression level of hTERT in melanoma was greater than in pigmented nevus (50.39 ±â€Š9.16 vs 26.10 ±â€Š7.25, t = 7.778, P < .001). Linear regression analysis showed that the methylation level of CGIs-2 in melanoma was positively correlated with the relative expression level of hTERT mRNA (R = .490, F = 13.478, P = .003). Combined with the analysis of clinicopathological features, the methylation level of CGIs-2 in melanoma with lymph node metastasis was greater than in melanoma without lymph node metastasis, and the methylation level of CGIs-2 increased with TNM staging. CONCLUSION: CGIs-2 methylation level was associated with the relative expression level of hTERT mRNA, lymph node metastasis and TNM staging, suggesting that CGIs-2 hypermethylation might be used to evaluate the prognosis in Chinese patients with acral and mucosal melanoma.


Assuntos
Ilhas de CpG/genética , Metilação de DNA/genética , Melanoma/genética , Proteína 2 de Ligação a Metil-CpG/metabolismo , Telomerase/metabolismo , Idoso , Grupo com Ancestrais do Continente Asiático/genética , China , Biologia Computacional , Feminino , Humanos , Modelos Lineares , Metástase Linfática , Masculino , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Reação em Cadeia da Polimerase , Prognóstico , RNA Mensageiro/metabolismo
18.
Bone Joint J ; 101-B(10): 1218-1229, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564157

RESUMO

AIMS: Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. PATIENTS AND METHODS: A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. RESULTS: We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. CONCLUSION: In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218-1229.


Assuntos
Artroscopia/métodos , Impacto Femoroacetabular/cirurgia , Imagem Tridimensional , Metatarso Valgo/diagnóstico por imagem , Metatarso Varo/diagnóstico por imagem , Osteotomia/efeitos adversos , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Fêmur/fisiopatologia , Seguimentos , Humanos , Modelos Lineares , Imagem por Ressonância Magnética/métodos , Masculino , Metatarso Valgo/epidemiologia , Metatarso Varo/epidemiologia , Pessoa de Meia-Idade , Osteotomia/métodos , Prevalência , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Anormalidade Torcional/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
19.
Medicine (Baltimore) ; 98(40): e17361, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577733

RESUMO

Limbs muscle wasting is a common disorder in patients with chronic obstructive pulmonary disease (COPD) that limits daily activities and exercise intolerance, especially in males. The present study aimed to estimate the prevalence of appendicular skeletal muscle mass (ASM) in male patients with stable COPD. In addition, factors associated with parameters of ASM were also investigated.We recruited 116 male patients with stable COPD from the outpatient clinic between September 2016 and December 2017. For each patient, we obtained demographic characteristics and measured post-bronchodilator forced expiratory volume in 1 second, symptoms, exacerbations history, and ASM. ASM was defined as the sum of the muscle masses of the 4 limbs.Appendicular skeletal muscle mass index (ASMI) in male patients with stable COPD was 8.2 ±â€Š0.9 kg/m, and the prevalence of low skeletal muscle mass was 7.8% (9 of 116 patients). Multiple linear-regression analysis showed that body mass index, occupation, fat-free mass index, and the modified medical research council scale were significantly correlated with ASMI. Compared with nonexercise group, lower limb muscle mass and ASM were significantly improved in physical exercise group.Underweight, retirement, fat-free mass depletion, and severe dyspnea are all risk factors for ASM in male patients with stable COPD. Our findings also justify the importance of exercise training in improving ASM.


Assuntos
Músculo Esquelético/patologia , Doença Pulmonar Obstrutiva Crônica/patologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Pesos e Medidas Corporais , Estudos Transversais , Exercício , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Testes de Função Respiratória , Índice de Gravidade de Doença , Fatores Socioeconômicos
20.
Rev Lat Am Enfermagem ; 27: e3207, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31664414

RESUMO

OBJECTIVE: To identify the level of interpersonal communication competence among nursing students and to correlate its domains with sociodemographic and academic variables. METHOD: This is a correlational study, developed through a multicenter research project in six federal universities in Brazil. Data from 1,079 nursing students were collected through a questionnaire with sociodemographic and academic variables and the Interpersonal Communication Competence Scale. Data were analyzed using descriptive and inferential statistics. RESULTS: The mean of the sum of the Interpersonal Communication Competence Scale was 63.74 (± 7.6). The domains "availability" and "environment control" had, respectively, the highest and lowest averages. There was a statistically significant difference between the sum of the Interpersonal Communication Competence Scale and the variables age, marital status, participation in a research/extension group, and paid professional activity. CONCLUSION: This study contributed to identify the level of interpersonal communication competence of nursing students in the Brazilian reality, providing useful information for education in the area.


Assuntos
Competência Clínica , Comunicação , Relações Interpessoais , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Bacharelado em Enfermagem , Feminino , Humanos , Modelos Lineares , Masculino , Fatores Socioeconômicos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA