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1.
Artigo em Inglês | MEDLINE | ID: mdl-38972436

RESUMO

BACKGROUND: There are limited clinical data regarding the additional yields of random biopsies (RBs) during colorectal cancer surveillance in patients with inflammatory bowel disease. To assess the additional yield of RB, a systematic review and meta-analysis was conducted. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies investigating the preferred colonoscopy surveillance approach for inflammatory bowel disease patients. The additional yield, detection rate, procedure time, and withdrawal time were pooled. RESULTS: Thirty-seven studies (48 arms) were included in the meta-analysis with 9051 patients. The additional yields of RB were 10.34% in per-patient analysis and 16.20% in per-lesion analysis. The detection rates were 1.31% and 2.82% in per-patient and per-lesion analysis, respectively. Subgroup analysis showed a decline in additional yields from 14.43% to 0.42% in the per-patient analysis and from 19.20% to 5.32% in the per-lesion analysis for studies initiated before and after 2011. In per-patient analysis, the additional yields were 4.83%, 10.29%, and 56.05% for primary sclerosing cholangitis (PSC) proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 0.56%, 1.40%, and 19.45%. In the per-lesion analysis, additional yields were 11.23%, 21.06%, and 45.22% for PSC proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 2.09%, 3.58%, and 16.24%. CONCLUSIONS: The additional yields of RB were 10.34% and 16.20% for per-patient and per-lesion analyses, respectively. Considering the decreased additional yields in studies initiated after 2011, and the influence of PSC, endoscopy centers lacking full high-definition equipment should consider incorporating RB in the standard colonoscopy surveillance for inflammatory bowel disease patients, especially in those with PSC.

2.
Gastrointest Endosc ; 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39265743

RESUMO

BACKGROUND AND AIMS: Hemostatic powder (HP) is a novel hemostasis modality for nonvariceal GI bleeding. This meta-analysis was performed to evaluate the efficacy of HP monotherapy versus conventional endoscopic treatment (CET) for nonvariceal GI bleeding. METHODS: PubMed, EMBASE, and Cochrane Library databases were systematically searched from inception to October 16, 2023. The primary outcomes were the initial hemostatic rate and the 30-day recurrent bleeding rate. After the meta-analysis, a trial sequential analysis (TSA) was also conducted to decrease the risk of random errors and validate the result. RESULTS: The meta-analysis included 8 studies, incorporating 653 patients in total. Given significant heterogeneity, all analyses were segregated into malignancy-related and nonmalignancy-related GI bleeding lesions. For the former, HP monotherapy significantly improved the initial hemostasis rate and 30-day recurrent bleeding rate compared with CET (relative risk [RR], 1.50; 95% confidence interval [CI], 1.28-1.75; P < .001; RR, .32; 95% CI, .12-.86; P = .02, respectively), and TSA supported the results. For nonmalignancy-related GI bleeding, HP monotherapy and CET have similar initial hemostasis and 30-day recurrent bleeding rates (RR, 1.08; 95% CI, .98-1.19; P = .11; RR, 1.15; 95% CI, .46-2.90; P = .76, respectively), but the TSA failed to confirm the results. CONCLUSIONS: HP monotherapy surpassed CET in terms of the initial hemostasis rate and 30-day recurrent bleeding rate for patients with malignancy-related GI bleeding. However, their relative efficacy for nonmalignancy-related GI bleeding remains unresolved.

3.
Pediatr Res ; 96(3): 750-758, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38514860

RESUMO

BACKGROUND: Digital health technologies (DHTs) can collect gait and physical activity in adults, but limited studies have validated these in children. This study compared gait and physical activity metrics collected using DHTs to those collected by reference comparators during in-clinic sessions, to collect a normative accelerometry dataset, and to evaluate participants' comfort and their compliance in wearing the DHTs at-home. METHODS: The MAGIC (Monitoring Activity and Gait in Children) study was an analytical validation study which enrolled 40, generally healthy participants aged 3-17 years. Gait and physical activity were collected using DHTs in a clinical setting and continuously at-home. RESULTS: Overall good to excellent agreement was observed between gait metrics extracted with a gait algorithm from a lumbar-worn DHT compared to ground truth reference systems. Majority of participants either "agreed" or "strongly agreed" that wrist and lumbar DHTs were comfortable to wear at home, respectively, with 86% (wrist-worn DHT) and 68% (lumbar-worn DHT) wear-time compliance. Significant differences across age groups were observed in multiple gait and activity metrics obtained at home. CONCLUSIONS: Our findings suggest that gait and physical activity data can be collected from DHTs in pediatric populations with high reliability and wear compliance, in-clinic and in home environments. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04823650 IMPACT: Digital health technologies (DHTs) have been used to collect gait and physical activity in adult populations, but limited studies have validated these metrics in children. The MAGIC study comprehensively validates the performance and feasibility of DHT-measured gait and physical activity in the pediatric population. Our findings suggest that reliable gait and physical activity data can be collected from DHTs in pediatric populations, with both high accuracy and wear compliance both in-clinic and in home environments. The identified across-age-group differences in gait and activity measurements highlighted their potential clinical value.


Assuntos
Exercício Físico , Marcha , Humanos , Criança , Adolescente , Feminino , Masculino , Pré-Escolar , Acelerometria/instrumentação , Acelerometria/métodos , Reprodutibilidade dos Testes , Dispositivos Eletrônicos Vestíveis , Tecnologia Digital , Algoritmos , Saúde Digital
4.
Phys Chem Chem Phys ; 26(6): 5704-5712, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38289691

RESUMO

In Fischer-Tropsch synthesis (FTS), the cobalt catalyst has higher C5+ and lower CH4 selectivity in the hcp phase than in the fcc phase. However, a detailed explanation of the intrinsic mechanism is still missing. The underlying reason was explored combining density functional theory, Wulff construction, and a particle-level descriptor based on the slab model of surfaces that are prevalent in the Wulff shape to provide single-particle level understanding. Using a particle-level indicator of the reaction rates, we have shown that it is more difficult to form CH4 on hcp-Co than on fcc-Co, due to the larger effective barrier difference of CH4 formation and C-C coupling on hcp-Co particles, which leads to the lower CH4 selectivity of hcp-Co in FTS. Among the exposed facets of fcc-Co, the (311) surface plays a pivotal role in promoting CH4 formation. The reduction of CH4 selectivity in cobalt-based FTS is achievable through phase engineering of Co from fcc to hcp or by tuning the temperature and size of the particles.

5.
Surg Endosc ; 38(1): 148-157, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37945708

RESUMO

BACKGROUND: The pink-color sign (PCS) has been widely used for diagnosing esophageal squamous cell carcinoma (ESCC) during Lugol's iodine chromoendoscopy. However, the identification of the PCS only relies on the subjective assessments made by the endoscopist, which could lead to bias and disagreement. Previous research has indicated that the V' variable can, as an objective index, define the PCS in the LU'V' color space. We aimed to validate the diagnostic performance of the PCS defined by the V' variable alone and attempt to improve the diagnostic performance by combining the V' and U' variables. METHODS: We re-examined 231 subjects with Lugol's unstained lesions (LULs) from a previously reported prospective trial. The diagnostic performance of the method using V' variable alone (V' alone method), the combination method using V' and U' variables (V' + U' method), and the endoscopists were calculated and compared. RESULTS: A total of 236 LULs were included, among which 46 were histologically confirmed to be cancerous lesions. The sensitivity, specificity, and accuracy of the V' alone method were 73.91% (95% CI 58.87-85.73%), 79.47% (95% CI 73.03-84.98%), and 78.39% (95% CI 72.59-83.47%) in the external validation cohort, respectively. It is inferior to endoscopists in terms of specificity and accuracy. The V' + U' method demonstrated a diagnostic performance comparable to the experienced endoscopists, with sensitivity, specificity, and accuracy of 76.74% (95% CI 61.37-88.25%), 88.64% (95% CI 83.00-92.92%), and 86.30% (95% CI 81.03-90.56%), respectively. CONCLUSION: The V' alone method exhibited lower specificity and accuracy than the experienced endoscopist and the V' + U' method. However, the modified V' + U' method demonstrated a diagnostic performance comparable to experienced endoscopists. Utilizing the objective index of the PCS could provide valuable support in clinical decision-making.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Humanos , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Esofagoscopia/métodos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Estudos Prospectivos
6.
Sensors (Basel) ; 24(19)2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39409316

RESUMO

Cell-free millimeter wave (mmWave) multiple-input multiple-output (MIMO) can effectively overcome the shadow fading effect and provide macro gain to boost the throughput of communication networks. Nevertheless, the majority of the existing studies have overlooked the user-centric characteristics and practical fronthaul capacity limitations. To solve these practical problems, we introduce a resource allocation scheme using statistical channel state information (CSI) for uplink user-centric cell-free mmWave MIMO system. The hybrid beamforming (HBF) architecture is deployed at each access point (AP), while the central processing unit (CPU) only combines the received signals by the large-scale fading decoding (LSFD) method. We further frame the issue of maximizing sum-rate subject to the fronthaul capacity constraint and minimum rate constraint. Based on the alternating optimization (AO) and fractional programming method, we present an algorithm aimed at optimizing the users' transmit power for the power allocation (PA) subproblem. Then, an algorithm relying on the majorization-minimization (MM) method is given for the HBF subproblem, which jointly optimizes the HBF and the LSFD coefficients.

7.
Microb Pathog ; 174: 105939, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36521655

RESUMO

Biofilm formation is an important strategy for the colonization of Streptococcus pneumoniae, which can increase the capacity to evade antibiotic and host immune stress. Extracellular choline-binding proteins (CBPs) are required for successful biofilm formation, but the function of extracellular CBPs in the process of biofilm formation is not fully understood. In this study, we tend to analyze the functions of LytA, LytC and CbpD in biofilm formation by in vitro studies with their choline-binding domains (CBDs). Biofilm formation of S. pneumoniae was enhanced when cultured in medium supplemented with CBD-C and CBD-D. Parallel assays with ChBp-Is (choline binding repeats with different C-terminal tails) and character analysis of CBDs reveal a higher isoelectric point (pI) is related to promotion of biofilm formation. Phenotype characterization of biofilms revel CBD-C and CBD-D function differently, CBD-C promoting the formation of membrane-like structures and CBD-D promoting the formation of regular reticular structures. Gene expression analysis reveals membrane transport pathways are influenced with the binding of CBDs, among which the phosphate uptake and PTS of galactose pathways are both up-regulated under conditions with CBDs. Further, extracellular substances detection revealed that extracellular proteins increased with CBD-A and CBD-D, exhibiting as increase in extracellular high molecular weight proteins. Extracellular DNA increased under CBD-A but decreased under CBD-C and CBD-D; Extracellular phosphate increased under CBD-C. These support the alterations in membrane transport pathways, and reveal diverse reactions to extracellular protein, DNA and phosphate of these three CBDs. Overall, our results indicated extracellular CBP participate in biofilm formation by affecting surface charge and membrane transport pathways of pneumococcal cells, as well as promoting reactions to extracellular substances.


Assuntos
Proteínas de Bactérias , Streptococcus pneumoniae , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Biofilmes , Colina/metabolismo
8.
Am J Obstet Gynecol ; 228(4): 459.e1-459.e8, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36183777

RESUMO

BACKGROUND: Maternal sleep-disordered breathing is associated with adverse pregnancy outcomes and is considered to be deleterious to the developing fetus. Maternal obesity potentiates sleep-disordered breathing, which, in turn, may contribute to the effect of maternal obesity on adverse fetal outcomes. However, only a few empirical studies have evaluated the contemporaneous effects of maternal sleep-disordered breathing events on fetal well-being. These events include apnea and hypopnea with accompanying desaturations in oxyhemoglobin. OBJECTIVE: This study aimed to reconcile contradictory findings on the associations between maternal apnea or hypopnea events and clinical indicators of fetal compromise. It also sought to broaden the knowledge base by examining the fetal heart rate and heart rate variability before, during, and after episodes of maternal apnea or hypopnea. To accomplish this, we employed overnight polysomnography, the gold standard for ascertaining maternal sleep-disordered breathing, and synchronized it with continuous fetal electrocardiography. STUDY DESIGN: A total of 84 pregnant women with obesity (body mass index >30 kg/m2) participated in laboratory-based polysomnography with digitized fetal electrocardiography recordings during or near 36 weeks of gestation. Sleep was recorded, on average, for 7 hours. Decelerations in fetal heart rate were identified. Fetal heart rate and heart rate variability were quantified before, during, and after each apnea or hypopnea event. Event-level intensity (desaturation magnitude, duration, and nadir O2 saturation level) and person-level characteristics based on the full overnight recording (apnea-hypopnea index, mean O2 saturation, and O2 saturation variability) were analyzed as potential moderators using linear mixed effects models. RESULTS: A total of 2936 sleep-disordered breathing events were identified, distributed among all but 2 participants. On average, participants exhibited 8.7 episodes of apnea or hypopnea per hour (mean desaturation duration, 19.1 seconds; mean O2 saturation nadir, 86.6% per episode); nearly half (n=39) of the participants met the criteria for obstructive sleep apnea. Only 45 of 2936 apnea or hypopnea events were followed by decelerations (1.5%). Conversely, most (n=333, 88%) of the 378 observed decelerations, including the prolonged ones, did not follow an apnea or a hypopnea event. Maternal sleep-disordered breathing burden, body mass index, and fetal sex were unrelated to the number of decelerations. Fetal heart rate variability increased during events of maternal apnea or hypopnea but returned to initial levels soon thereafter. There was a dose-response association between the size of the increase in fetal heart rate variability and the maternal apnea-hypopnea index, event duration, and desaturation depth. Longer desaturations were associated with a decreased likelihood of the variability returning to baseline levels after the event. The mean fetal heart rate did not change during episodes of maternal apnea or hypopnea. CONCLUSION: Episodes of maternal sleep apnea and hypopnea did not evoke decelerations in the fetal heart rate despite the predisposing risk factors that accompany maternal obesity. The significance of the modest transitory increase in fetal heart rate variability in response to apnea and hypopnea episodes is not clear but may reflect compensatory, delimited autonomic responses to momentarily adverse conditions. This study found no evidence that episodes of maternal sleep-disordered breathing pose an immediate threat, as reflected in fetal heart rate responses, to the near-term fetus.


Assuntos
Obesidade Materna , Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Humanos , Feminino , Gravidez , Frequência Cardíaca Fetal , Sono
9.
J Phys Chem A ; 127(9): 2071-2080, 2023 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-36849363

RESUMO

Iron carbides have attracted increasing attention in recent years due to their enormous potential in catalytic fields, such as Fischer-Tropsch synthesis and the growth of carbon nanotubes. Theoretical calculations can provide a more thorough understanding of these reactions at the atomic scale. However, due to the extreme complexity of the active phases and surface structures of iron carbides at the operando conditions, calculations based on density functional theory (DFT) are too costly for realistically large models of iron carbide particles. Therefore, a cheap and efficient quantum mechanical simulation method with accuracy comparable to DFT is desired. In this work, we adopt the spin-polarized self-consistent charge density functional tight-binding (DFTB2) method for iron carbides by reparametrization of the repulsive part of the Fe-C interactions. To assess the performance of the improved parameters, the structural and electronic properties of iron carbide bulks and clusters obtained with DFTB2 method are compared with the previous experimental values and the results obtained with DFT approach. Calculated lattice parameters and density of states are close to DFT predictions. The benchmark results show that the proposed parametrization of Fe-C interactions provides transferable and balanced description of iron carbide systems. Therefore, spin-polarized DFTB2 is valued as an efficient and reliable method for the description of iron carbide systems.

10.
Surg Endosc ; 37(9): 6627-6639, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37430125

RESUMO

BACKGROUND: Endoscopic resection (ER) is widely applied to treat early colorectal cancer (CRC). Predicting the invasion depth of early CRC is critical in determining treatment strategies. The use of computer-aided diagnosis (CAD) algorithms could theoretically make accurate and objective predictions regarding the suitability of lesions for ER indication based on invasion depth. This study aimed to assess diagnostic test accuracy of CAD algorithms in predicting the invasion depth of early CRC and to compare the performance between the CAD algorithms and endoscopists. METHODS: Multiple databases were searched until June 30, 2022 for studies that evaluated the diagnostic performance of CAD algorithms for invasion depth of CRC. Meta-analysis of diagnostic test accuracy using a bivariate mixed-effects model was performed. RESULTS: Ten studies consisting of 13 arms (13,918 images from 1472 lesions) were included. Due to significant heterogeneity, studies were stratified into Japan/Korea-based or China-based studies. For the former, the area under the curve (AUC), sensitivity, and specificity of the CAD algorithms were 0.89 (95% CI 0.86-0.91), 62% (95% CI 50-72%), and 96% (95% CI 93-98%), respectively. For the latter, AUC, sensitivity, and specificity were 0.94 (95% CI 0.92-0.96), 88% (95% CI 78-94%), and 88% (95% CI 80-93%), respectively. The performance of the CAD algorithms in Japan/Korea-based studies was not significantly different from that of all endoscopists (0.88 vs. 0.91, P = 0.10) but was inferior to that of expert endoscopists (0.88 vs. 0.92, P = 0.03). The performance of the CAD algorithms in China-based studies was better than that of all endoscopists (0.94 vs. 0.90, P = 0.01). CONCLUSION: The CAD algorithms showed comparable accuracy for prediction of invasion depth of early CRC compared to all endoscopists, which was still lower than expert endoscopists in diagnostic accuracy; more improvements should be achieved before it can be extensively applied to clinical practice.


Assuntos
Neoplasias Colorretais , Diagnóstico por Computador , Humanos , Diagnóstico por Computador/métodos , Endoscopia/métodos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Testes Diagnósticos de Rotina , Computadores
11.
Arch Insect Biochem Physiol ; 112(1): e21978, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36377756

RESUMO

The Asian long-horned beetle, Anoplophora glabripennies (Motschulsky), is a destructive wood-boring pest that is capable of killing healthy trees. Gut bacteria in the larvae of the wood-boring pest is essential for the fitness of hosts. However, little is known about the structure of the intestinal microbiome of A. glabripennies during larval development. Here, we used Illumina MiSeq high-throughput sequencing technology to analyze the larval intestinal bacterial communities of A. glabripennies at the stages of newly hatched larvae, 1st instar larvae and 4th instar larvae. Significant differences were found in larval gut microbial community structure at different larvae developmental stages. Different dominant genus was detected during larval development. Acinetobacter were dominant in the newly hatched larvae, Enterobacter and Raoultella in the 1st instar larvae, and Enterococcus and Gibbsiella in the 4th instar larvae. The microbial richness in the newly hatched larvae was higher than those in the 1st and 4th instar larvae. Many important functions of the intestinal microbiome were predicted, for example, fermentation and chemoheterotrophy functions that may play an important role in insect growth and development was detected in the bacteria at all tested stages. However, some specific functions are found to be associated with different development stages. Our study provides a theoretical basis for investigating the function of the intestinal symbiosis bacteria of A. glabripennies.


Assuntos
Besouros , Microbioma Gastrointestinal , Animais , Larva , Trato Gastrointestinal/microbiologia , Bactérias
12.
Dig Endosc ; 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37767724

RESUMO

OBJECTIVES: Based on different physicochemical properties, common submucosal injection solutions could be classified into three categories: normal saline solution (NS), hypertonic solution (HS), and viscous solution (VS). We compared the efficacy and safety of various categories of solutions in this network meta-analysis of randomized controlled trials (RCTs) to identify the optimal submucosal injection fluid. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched for RCTs that compared the efficacy and safety of NS, HS, and VS during endoscopic resection for gastrointestinal (GI) mucosal lesions. Pairwise and network analyses were conducted to determine the ranking of different fluids. RESULTS: Thirteen RCTs were included in the final analysis with 1637 patients (1639 lesions). HS outperformed NS in rates of en bloc (pooled relative risk [RR] 1.50; 95% confidence interval [CI] 1.10-1.90), overall bleeding (pooled odds ratio [OR] 0.33; 95% CI 0.10-0.88; lesions >10 mm OR 4.65 × 10-2 ; 95% CI 1.10 × 10-3 -0.46), and intraoperative bleeding (lesions >10 mm OR 7.10 × 10-6 ; 95% CI 4.30 × 10-18 -0.26). HS showed the highest probability of ranking first in each outcome except for the volume of injection. Although VS was superior to NS in rates of en bloc, overall, and intraoperative bleeding in the lesions >10 mm subgroup, and required less fluid in pooled analysis, it ranked last in cost of submucosal injection solution. CONCLUSIONS: Both HS and VS were superior to NS in comparisons of efficacy and safety. Considering the better performance and potentially low cost, HS might be an optimal choice during gastrointestinal endoscopic resection, especially for colorectal endoscopic mucosal resection.

13.
Arch Insect Biochem Physiol ; 110(3): e21899, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35419869

RESUMO

Apriona germari is one of the most serious wood-boring pests that cause damage to economic and landscaping trees and has adapted to a wide range of plants as diet. Gut bacteria play an important role in biology and ecology of herbivores, especially in growth and adaptation. To investigate how plant hosts shape A. germari gut microbiota, A. germari larvae were collected from Populus tomentosa and Malus pumilal, and gut microbiomes were sequenced based on 16S rDNA high-throughput sequencing technology. A total of 853,424 high-quality reads were obtained and clustered into 196 operational taxonomic units under a 97% similarity cutoff, which were annotated into 8 phyla, 10 classes, 21 orders, 34 families, 59 genera, and 39 species. Gibbsiella was the most dominant genus of intestinal bacteria, followed by Enterobacter and Acinetobacter. No significant difference was observed in larvae gut bacterial richness and diversity of A. germari collected from two hosts, though alpha diversity showed that the richness of gut bacteria in A. germari larvae collected on P. tomentosa was slightly higher than that in A. germari on M. pumilal, and beta diversity showed little difference between two host plants. The functional abundance analysis of the detected bacteria revealed fermentation, chemoheterotrophy, symbionts, and nitrate relative functions that highly possibly support wood-boring beetles to feed on woody tissues. Our study provided a theoretical basis for investigating the function of intestinal symbiosis bacteria of A. germari.


Assuntos
Besouros , Microbioma Gastrointestinal , Animais , Bactérias/genética , Besouros/genética , Sequenciamento de Nucleotídeos em Larga Escala , Larva/microbiologia , RNA Ribossômico 16S/genética
14.
Microb Pathog ; 160: 105162, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34461245

RESUMO

Heteroresistance is a poorly understood mechanism of resistance which refers to a phenomenon where there are different subpopulations of seemingly isogenic bacteria which exhibit a range of susceptibilities to a particular antibiotic. In the current study, we identified a multidrug-resistant, carbapenemase-positive K. pneumoniae strain SWMUF35 which was classified as susceptible to amikacin and resistant to meropenem by clinical diagnostics yet harbored different subpopulations of phenotypically resistant cells, and has the ability to form biofilm. Population analysis profile (PAP) indicated that SWMUF35 showed heteroresistance towards amikacin and meropenem which was considered as co-heteroresistant K. pneumoniae strain. In vitro experiments such as dual PAP, dual Times-killing assays and checkerboard assay showed that antibiotic combination therapy (amikacin combined with meropenem) can effectively combat SWMUF35. Importantly, using an in vivo mouse model of peritonitis, we found that amikacin or meropenem monotherapy was unable to rescue mice infected with SWMUF35. Antibiotic combination therapy could be a rational strategy to use clinically approved antibiotics when monotherapy would fail. Furthermore, our data warn that antibiotic susceptibility testing results may be unreliable due to undetected heteroresistance which can lead to treatment failure and the detection of this phenotype is a prerequisite for a proper choice of antibiotic to support a successful treatment outcome.


Assuntos
Amicacina , Carbapenêmicos , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Modelos Animais de Doenças , Klebsiella pneumoniae , Meropeném/farmacologia , Camundongos , Testes de Sensibilidade Microbiana , Falha de Tratamento
15.
Dev Psychobiol ; 63(5): 945-959, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33764539

RESUMO

Despite prolonged and cumulative exposure during gestation, little is known about the fetal response to maternal sleep. Eighty-four pregnant women with obesity (based on pre-pregnancy BMI) participated in laboratory-based polysomnography (PSG) with continuous fetal electrocardiogram monitoring at 36 weeks gestation. Multilevel modeling revealed both correspondence and lack of it in maternal and fetal heart rate patterns. Fetal heart rate (fHR) and variability (fHRV), and maternal heart rate (mHR) and variability (mHRV), all declined during the night, with steeper rates of decline prior to 01:00. fHR declined upon maternal sleep onset but was not otherwise associated with maternal sleep stage; fHRV differed during maternal REM and NREM. There was frequent maternal waking after sleep onset (WASO) and fHRV and mHRV were elevated during these episodes. Cross-correlation analyses revealed little temporal coupling between maternal and fetal heart rate, except during WASO, suggesting that any observed associations in maternal and fetal heart rates during sleep are the result of other physiological processes. Implications of the maternal sleep context for the developing fetus are discussed, including the potential consequences of the typical sleep fragmentation that accompanies pregnancy.


Assuntos
Frequência Cardíaca Fetal , Sono , Eletrocardiografia , Feminino , Feto/fisiologia , Frequência Cardíaca/fisiologia , Frequência Cardíaca Fetal/fisiologia , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Sono/fisiologia
16.
Chin J Cancer Res ; 32(2): 242-251, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32410801

RESUMO

OBJECTIVE: Prevention and early detection of colorectal cancer (CRC) can increase the chances of successful treatment and reduce burden. Various data mining technologies have been utilized to strengthen the early detection of CRC in primary care. Evidence synthesis on the model's effectiveness is scant. This systematic review synthesizes studies that examine the effect of data mining on improving risk prediction of CRC. METHODS: The PRISMA framework guided the conduct of this study. We obtained papers via PubMed, Cochrane Library, EMBASE and Google Scholar. Quality appraisal was performed using Downs and Black's quality checklist. To evaluate the performance of included models, the values of specificity and sensitivity were comparted, the values of area under the curve (AUC) were plotted, and the median of overall AUC of included studies was computed. RESULTS: A total of 316 studies were reviewed for full text. Seven articles were included. Included studies implement techniques including artificial neural networks, Bayesian networks and decision trees. Six articles reported the overall model accuracy. Overall, the median AUC is 0.8243 [interquartile range (IQR): 0.8050-0.8886]. In the two articles that reported comparison results with traditional models, the data mining method performed better than the traditional models, with the best AUC improvement of 10.7%. CONCLUSIONS: The adoption of data mining technologies for CRC detection is at an early stage. Limited numbers of included articles and heterogeneity of those studies implied that more rigorous research is expected to further investigate the techniques' effects.

18.
Biometrics ; 74(2): 744-752, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29023644

RESUMO

Recent advances of wearable computing technology have allowed continuous health monitoring in large observational studies and clinical trials. Examples of data collected by wearable devices include minute-by-minute physical activity proxies measured by accelerometers or heart rate. The analysis of data generated by wearable devices has so far been quite limited to crude summaries, for example, the mean activity count over the day. To better utilize the full data and account for the dynamics of activity level in the time domain, we introduce a two-stage regression model for the minute-by-minute physical activity proxy data. The model allows for both time-varying parameters and time-invariant parameters, which helps capture both the transition dynamics between active/inactive periods (Stage 1) and the activity intensity dynamics during active periods (Stage 2). The approach extends methods developed for zero-inflated Poisson data to account for the high-dimensionality and time-dependence of the high density data generated by wearable devices. Methods are motivated by and applied to the Baltimore Longitudinal Study of Aging.


Assuntos
Interpretação Estatística de Dados , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos , Ciclos de Atividade , Envelhecimento , Humanos , Estudos Longitudinais , Modelos Estatísticos , Análise de Regressão , Fatores de Tempo
19.
Stat Probab Lett ; 136: 25-29, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29977100

RESUMO

Big Data is increasingly prevalent in science and data analysis. We provide a short tutorial for adapting to these changes and making the necessary adjustments to the academic culture to keep Biostatistics truly impactful in scientific research.

20.
Biostatistics ; 15(1): 102-16, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23999141

RESUMO

We introduce an explicit set of metrics for human activity based on high-density acceleration recordings from a hip-worn tri-axial accelerometer. These metrics are based on two concepts: (i) Time Active, a measure of the length of time when activity is distinguishable from rest and (ii) AI, a measure of the relative amplitude of activity relative to rest. All measurements are normalized (have the same interpretation across subjects and days), easy to explain and implement, and reproducible across platforms and software implementations. Metrics were validated by visual inspection of results and quantitative in-lab replication studies, and by an association study with health outcomes.


Assuntos
Interpretação Estatística de Dados , Atividade Motora/fisiologia , Aceleração , Idoso , Baltimore , Estudos de Coortes , Feminino , Humanos , Masculino
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