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1.
Nature ; 630(8015): 84-90, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38840015

RESUMO

Direct and precise monitoring of intracranial physiology holds immense importance in delineating injuries, prognostication and averting disease1. Wired clinical instruments that use percutaneous leads are accurate but are susceptible to infection, patient mobility constraints and potential surgical complications during removal2. Wireless implantable devices provide greater operational freedom but include issues such as limited detection range, poor degradation and difficulty in size reduction in the human body3. Here we present an injectable, bioresorbable and wireless metastructured hydrogel (metagel) sensor for ultrasonic monitoring of intracranial signals. The metagel sensors are cubes 2 × 2 × 2 mm3 in size that encompass both biodegradable and stimulus-responsive hydrogels and periodically aligned air columns with a specific acoustic reflection spectrum. Implanted into intracranial space with a puncture needle, the metagel deforms in response to physiological environmental changes, causing peak frequency shifts of reflected ultrasound waves that can be wirelessly measured by an external ultrasound probe. The metagel sensor can independently detect intracranial pressure, temperature, pH and flow rate, realize a detection depth of 10 cm and almost fully degrade within 18 weeks. Animal experiments on rats and pigs indicate promising multiparametric sensing performances on a par with conventional non-resorbable wired clinical benchmarks.


Assuntos
Implantes Absorvíveis , Encéfalo , Hidrogéis , Monitorização Fisiológica , Ondas Ultrassônicas , Tecnologia sem Fio , Animais , Masculino , Ratos , Encéfalo/fisiologia , Hidrogéis/química , Concentração de Íons de Hidrogênio , Injeções/instrumentação , Pressão Intracraniana , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Ratos Sprague-Dawley , Porco Miniatura , Temperatura , Fatores de Tempo , Tecnologia sem Fio/instrumentação
2.
Nature ; 614(7948): 456-462, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36792740

RESUMO

Stretchable hybrid devices have enabled high-fidelity implantable1-3 and on-skin4-6 monitoring of physiological signals. These devices typically contain soft modules that match the mechanical requirements in humans7,8 and soft robots9,10, rigid modules containing Si-based microelectronics11,12 and protective encapsulation modules13,14. To make such a system mechanically compliant, the interconnects between the modules need to tolerate stress concentration that may limit their stretching and ultimately cause debonding failure15-17. Here, we report a universal interface that can reliably connect soft, rigid and encapsulation modules together to form robust and highly stretchable devices in a plug-and-play manner. The interface, consisting of interpenetrating polymer and metal nanostructures, connects modules by simply pressing without using pastes. Its formation is depicted by a biphasic network growth model. Soft-soft modules joined by this interface achieved 600% and 180% mechanical and electrical stretchability, respectively. Soft and rigid modules can also be electrically connected using the above interface. Encapsulation on soft modules with this interface is strongly adhesive with an interfacial toughness of 0.24 N mm-1. As a proof of concept, we use this interface to assemble stretchable devices for in vivo neuromodulation and on-skin electromyography, with high signal quality and mechanical resistance. We expect such a plug-and-play interface to simplify and accelerate the development of on-skin and implantable stretchable devices.


Assuntos
Eletromiografia , Eletrônica Médica , Nanoestruturas , Maleabilidade , Polímeros , Próteses e Implantes , Dispositivos Eletrônicos Vestíveis , Humanos , Nanoestruturas/química , Polímeros/química , Pele , Monitorização Fisiológica , Eletrônica Médica/instrumentação , Eletrônica Médica/métodos , Eletromiografia/instrumentação
3.
Nature ; 624(7991): 295-302, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38092907

RESUMO

Connecting different electronic devices is usually straightforward because they have paired, standardized interfaces, in which the shapes and sizes match each other perfectly. Tissue-electronics interfaces, however, cannot be standardized, because tissues are soft1-3 and have arbitrary shapes and sizes4-6. Shape-adaptive wrapping and covering around irregularly sized and shaped objects have been achieved using heat-shrink films because they can contract largely and rapidly when heated7. However, these materials are unsuitable for biological applications because they are usually much harder than tissues and contract at temperatures higher than 90 °C (refs. 8,9). Therefore, it is challenging to prepare stimuli-responsive films with large and rapid contractions for which the stimuli and mechanical properties are compatible with vulnerable tissues and electronic integration processes. Here, inspired by spider silk10-12, we designed water-responsive supercontractile polymer films composed of poly(ethylene oxide) and poly(ethylene glycol)-α-cyclodextrin inclusion complex, which are initially dry, flexible and stable under ambient conditions, contract by more than 50% of their original length within seconds (about 30% per second) after wetting and become soft (about 100 kPa) and stretchable (around 600%) hydrogel thin films thereafter. This supercontraction is attributed to the aligned microporous hierarchical structures of the films, which also facilitate electronic integration. We used this film to fabricate shape-adaptive electrode arrays that simplify the implantation procedure through supercontraction and conformally wrap around nerves, muscles and hearts of different sizes when wetted for in vivo nerve stimulation and electrophysiological signal recording. This study demonstrates that this water-responsive material can play an important part in shaping the next-generation tissue-electronics interfaces as well as broadening the biomedical application of shape-adaptive materials.


Assuntos
Eletrofisiologia , Polímeros , Água , Animais , alfa-Ciclodextrinas/química , Eletrodos , Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Eletrofisiologia/tendências , Coração , Músculos , Polietilenoglicóis/química , Polímeros/química , Seda/química , Aranhas , Água/química , Hidrogéis/química , Eletrônica/instrumentação , Eletrônica/métodos , Eletrônica/tendências
4.
Nature ; 600(7888): 246-252, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34880427

RESUMO

Skin-like intrinsically stretchable soft electronic devices are essential to realize next-generation remote and preventative medicine for advanced personal healthcare1-4. The recent development of intrinsically stretchable conductors and semiconductors has enabled highly mechanically robust and skin-conformable electronic circuits or optoelectronic devices2,5-10. However, their operating frequencies have been limited to less than 100 hertz, which is much lower than that required for many applications. Here we report intrinsically stretchable diodes-based on stretchable organic and nanomaterials-capable of operating at a frequency as high as 13.56 megahertz. This operating frequency is high enough for the wireless operation of soft sensors and electrochromic display pixels using radiofrequency identification in which the base-carrier frequency is 6.78 megahertz or 13.56 megahertz. This was achieved through a combination of rational material design and device engineering. Specifically, we developed a stretchable anode, cathode, semiconductor and current collector that can satisfy the strict requirements for high-frequency operation. Finally, we show the operational feasibility of our diode by integrating it with a stretchable sensor, electrochromic display pixel and antenna to realize a stretchable wireless tag. This work is an important step towards enabling enhanced functionalities and capabilities for skin-like wearable electronics.


Assuntos
Eletrodos , Polímeros/química , Dispositivos Eletrônicos Vestíveis , Eletrônica/instrumentação , Humanos , Nanofios/química , Semicondutores , Prata/química , Pele , Tecnologia sem Fio/instrumentação
5.
Nat Immunol ; 15(11): 1009-16, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25329189

RESUMO

Mesenchymal stem cells (MSCs) are multipotent stromal cells that exist in many tissues and are capable of differentiating into several different cell types. Exogenously administered MSCs migrate to damaged tissue sites, where they participate in tissue repair. Their communication with the inflammatory microenvironment is an essential part of this process. In recent years, much has been learned about the cellular and molecular mechanisms of the interaction between MSCs and various participants in inflammation. Depending on their type and intensity, inflammatory stimuli confer on MSCs the ability to suppress the immune response in some cases or to enhance it in others. Here we review the current findings on the immunoregulatory plasticity of MSCs in disease pathogenesis and therapy.


Assuntos
Terapia de Imunossupressão , Inflamação/imunologia , Células-Tronco Mesenquimais/imunologia , Regeneração/imunologia , Cicatrização/imunologia , Diferenciação Celular/imunologia , Proliferação de Células , Humanos , Regeneração/fisiologia , Linfócitos T/imunologia
6.
Nat Mater ; 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867019

RESUMO

Continuous and in situ detection of biomarkers in biofluids (for example, sweat) can provide critical health data but is limited by biofluid accessibility. Here we report a sensor design that enables in situ detection of solid-state biomarkers ubiquitously present on human skin. We deploy an ionic-electronic bilayer hydrogel to facilitate the sequential dissolution, diffusion and electrochemical reaction of solid-state analytes. We demonstrate continuous monitoring of water-soluble analytes (for example, solid lactate) and water-insoluble analytes (for example, solid cholesterol) with ultralow detection limits of 0.51 and 0.26 nmol cm-2, respectively. Additionally, the bilayer hydrogel electrochemical interface reduces motion artefacts by a factor of three compared with conventional liquid-sensing electrochemical interfaces. In a clinical study, solid-state epidermal biomarkers measured by our stretchable wearable sensors showed a high correlation with biomarkers in human blood and dynamically correlated with physiological activities. These results present routes to universal platforms for biomarker monitoring without the need for biofluid acquisition.

7.
Chem Rev ; 123(23): 13796-13865, 2023 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-37976052

RESUMO

Efforts to design devices emulating complex cognitive abilities and response processes of biological systems have long been a coveted goal. Recent advancements in flexible electronics, mirroring human tissue's mechanical properties, hold significant promise. Artificial neuron devices, hinging on flexible artificial synapses, bioinspired sensors, and actuators, are meticulously engineered to mimic the biological systems. However, this field is in its infancy, requiring substantial groundwork to achieve autonomous systems with intelligent feedback, adaptability, and tangible problem-solving capabilities. This review provides a comprehensive overview of recent advancements in artificial neuron devices. It starts with fundamental principles of artificial synaptic devices and explores artificial sensory systems, integrating artificial synapses and bioinspired sensors to replicate all five human senses. A systematic presentation of artificial nervous systems follows, designed to emulate fundamental human nervous system functions. The review also discusses potential applications and outlines existing challenges, offering insights into future prospects. We aim for this review to illuminate the burgeoning field of artificial neuron devices, inspiring further innovation in this captivating area of research.


Assuntos
Eletrônica , Sinapses , Humanos , Sinapses/fisiologia , Neurônios
8.
Nano Lett ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38838340

RESUMO

Cancer immunotherapies based on cytotoxic CD8+ T lymphocytes (CTLs) are highly promising for cancer treatment. The specific interaction between T-cell receptors and peptide-MHC-I complexes (pMHC-I) on cancer cell membranes critically determines their therapeutic outcomes. However, the lack of appropriate endogenous antigens for MHC-I presentation disables tumor recognition by CTLs. By devising three antigen-loaded self-assembling peptides of pY-K(Ag)-ERGD, pY-K(Ag)-E, and Y-K(Ag)-ERGD to noncovalently generate light-activatable supramolecular antigens at tumor sites in different manners, we report pY-K(Ag)-ERGD as a promising candidate to endow tumor cells with pMHC-I targets on demand. Specifically, pY-K(Ag)-ERGD first generates low-antigenic supramolecular antigens on cancer cell membranes, and a successive light pulse allows antigen payloads to efficiently release from the supramolecular scaffold, directly producing antigenic pMHC-I. Intravenous administration of pY-K(Ag)-ERGD enables light-controlled tumor inhibition when combined with adoptively transferred antigen-specific CTLs. Our strategy is feasible for broadening tumor antigen repertoires for T-cell immunotherapies and advancing precision-controlled T-cell immunotherapies.

9.
Nano Lett ; 24(5): 1635-1641, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38277778

RESUMO

We present an on-chip filter with a broad tailorable working wavelength and a single-mode operation. This is realized through the application of topological photonic crystal nanobeam filters employing synthesis parameter dimensions. By introducing the translation of air holes as a new synthetic parameter dimension, we obtained nanobeams with tunable Zak phases. Leveraging the bulk-edge correspondence, we identify the existence of topological cavity modes and establish a correlation between the cavity's interface morphology and working wavelength. Through experiments, we demonstrate filters with adjustable filtering wavelengths ranging from 1301 to 1570 nm. Our work illustrates the use of the synthetic translation dimension in the design of on-chip filters, and it holds potential for applications in other devices such as microcavities.

10.
Ann Surg ; 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38814074

RESUMO

OBJECTIVE: An expert panel made recommendations to optimize surgical education and training based on the effects of contemporary challenges. BACKGROUND: The inaugural Blue Ribbon Committee (BRC I) proposed sweeping recommendations for surgical education and training in 2004. In light of those findings, a second BRC (BRC II) was convened to make recommendations to optimize surgical training considering the current landscape in medical education. METHODS: BRC II was a panel of 67 experts selected on the basis of experience and leadership in surgical education and training. It was organized into subcommittees which met virtually over the course of a year. They developed recommendations, along with the Steering Committee, based on areas of focus and then presented them to the entire BRC II. The Delphi Method was chosen to obtain consensus, defined as>80% agreement amongst the panel. Cronbach alpha was computed to assess the internal consistency of three Delphi rounds. RESULTS: Of 50 recommendations, 31 obtained consensus in the following aspects of surgical training (# consensus recommendation /# proposed): Workforce (1/5), Medical Student Education (3/8), Work Life Integration (4/6), Resident Education (5/7), Goals, Structure and Financing of Training (5/8), Education Support and Faculty Development (5/6), Research Training (7/9), and Educational Technology and Assessment (1/1). The internal consistency was good in Rounds 1 and 2 and acceptable in Round 3. CONCLUSIONS: BRC II used the Delphi approach to identify and recommend 31 priorities for surgical education in 2024. We advise establishing a multidisciplinary surgical educational group to oversee, monitor and facilitate implementation of these recommendations.

11.
Environ Microbiol ; 26(3): e16600, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38482770

RESUMO

Microbial community structure and function were assessed in the organic and upper mineral soil across a ~4000-year dune-based chronosequence at Big Bay, New Zealand, where total P declined and the proportional contribution of organic soil in the profile increased with time. We hypothesized that the organic and mineral soils would show divergent community evolution over time with a greater dependency on the functionality of phosphatase genes in the organic soil layer as it developed. The structure of bacterial, fungal, and phosphatase-harbouring communities was examined in both horizons across 3 dunes using amplicon sequencing, network analysis, and qPCR. The soils showed a decline in pH and total phosphorus (P) over time with an increase in phosphatase activity. The organic horizon had a wider diversity of Class A (phoN/phoC) and phoD-harbouring communities and a more complex microbiome, with hub taxa that correlated with P. Bacterial diversity declined in both horizons over time, with enrichment of Planctomycetes and Acidobacteria. More complex fungal communities were evident in the youngest dune, transitioning to a dominance of Ascomycota in both soil horizons. Higher phosphatase activity in older dunes was driven by less diverse P-mineralizing communities, especially in the organic horizon.


Assuntos
Microbiota , Solo , Solo/química , Fósforo/análise , Floresta Úmida , Bactérias/genética , Microbiota/genética , Minerais , Monoéster Fosfórico Hidrolases/genética , Microbiologia do Solo
12.
Anal Chem ; 96(22): 9192-9199, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38758357

RESUMO

Singlet oxygen (1O2) plays imperative roles in a variety of biotic or abiotic stresses in crops. The change of its concentration within a crop is closely related to the crop growth and development. Accordingly, there is an urgent need to develop an efficient analytical method for on-site quantitative detection of 1O2 in crops. Here, we judiciously constructed a novel ratiometric fluorescent probe, SX-2, for the detection of 1O2 in crops. Upon treating with 1O2, probe SX-2 displayed highly selective ratiometric fluorescence response, which is favorable for the quantitative detection of 1O2. Concurrently, the fluorescence solution color of probe SX-2 was varied, obviously from blue to yellow, indicating that the probe is beneficial for on-site detection by the naked eye. Sensing reaction mechanism studies showed that the 2,3-diphenyl imidazole group in SX-2 could function as a new selective recognition group for 1O2. Probe SX-2 was utilized for the detection of photoirradiation-induced 1O2 and endogenous 1O2 in living cells. The changes in the 1O2 level in zebrafish were also tracked by fluorescence imaging. In addition, the production of 1O2 in crop leaves under a light source of different wavelengths was studied. The results demonstrated more 1O2 were produced under a light source of 365 nm. Furthermore, to achieve on-site quantitative detection, a mobile fluorescence analysis device has been made. Probe SX-2 and mobile fluorescence analysis device were capable of on-site quantitative detecting of 1O2 in crops. The method developed herein will be convenient for the on-site quantitative measurement of 1O2 in distinct crops.


Assuntos
Produtos Agrícolas , Corantes Fluorescentes , Oxigênio Singlete , Peixe-Zebra , Corantes Fluorescentes/química , Oxigênio Singlete/metabolismo , Oxigênio Singlete/química , Produtos Agrícolas/química , Produtos Agrícolas/metabolismo , Animais , Imagem Óptica , Humanos
13.
J Transl Med ; 22(1): 316, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38549133

RESUMO

BACKGROUND: Propofol is a widely used anesthetic and sedative, which has been reported to exert an anti-inflammatory effect. TLR4 plays a critical role in coordinating the immuno-inflammatory response during sepsis. Whether propofol can act as an immunomodulator through regulating TLR4 is still unclear. Given its potential as a sepsis therapy, we investigated the mechanisms underlying the immunomodulatory activity of propofol. METHODS: The effects of propofol on TLR4 and Rab5a (a master regulator involved in intracellular trafficking of immune factors) were investigated in macrophage (from Rab5a-/- and WT mice) following treatment with lipopolysaccharide (LPS) or cecal ligation and puncture (CLP) in vitro and in vivo, and peripheral blood monocyte from sepsis patients and healthy volunteers. RESULTS: We showed that propofol reduced membrane TLR4 expression on macrophages in vitro and in vivo. Rab5a participated in TLR4 intracellular trafficking and both Rab5a expression and the interaction between Rab5a and TLR4 were inhibited by propofol. We also showed Rab5a upregulation in peripheral blood monocytes of septic patients, accompanied by increased TLR4 expression on the cell surface. Propofol downregulated the expression of Rab5a and TLR4 in these cells. CONCLUSIONS: We demonstrated that Rab5a regulates intracellular trafficking of TLR4 and that propofol reduces membrane TLR4 expression on macrophages by targeting Rab5a. Our study not only reveals a novel mechanism for the immunomodulatory effect of propofol but also indicates that Rab5a may be a potential therapeutic target against sepsis.


Assuntos
Propofol , Sepse , Camundongos , Humanos , Animais , Propofol/farmacologia , Propofol/uso terapêutico , Propofol/metabolismo , Receptor 4 Toll-Like/metabolismo , Modelos Animais de Doenças , Macrófagos/metabolismo , Sepse/complicações , Lipopolissacarídeos/farmacologia , Lipopolissacarídeos/metabolismo
14.
J Vasc Surg ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38906429

RESUMO

OBJECTIVE: Although multidisciplinary clinics improve outcomes in chronic limb-threatening ischemia (CLTI), their role in addressing socioeconomic disparities is unknown. Our institution treats patients with CLTI at both traditional general vascular clinics and a multidisciplinary Limb Preservation Program (LPP). The LPP is in a minority community, providing expedited care at a single facility by a consistent team. We compared outcomes within the LPP with our institution's traditional clinics and explored patients' perspectives on barriers to care to evaluate if the LPP might address them. METHODS: All patients undergoing index revascularization for CLTI from 2014 to 2023 at our institution were stratified by clinic type (LPP or traditional). We collected clinical and socioeconomic variables, including Area Deprivation Index (ADI). Patient characteristics were compared using χ2, Student t, or Mood median tests. Outcomes were compared using log-rank and multivariable Cox analysis. We also conducted semi-structured interviews to understand patient-perceived barriers. RESULTS: From 2014 to 2023, 983 limbs from 871 patients were revascularized; 19.5% of limbs were treated within the LPP. Compared with traditional clinic patients, more LPP patients were non-White (43.75% vs 27.43%; P < .0001), diabetic (82.29% vs 61.19%; P < .0001), dialysis-dependent (29.17% vs 13.40%; P < .0001), had ADI in the most deprived decile (29.38% vs 19.54%; P = .0061), resided closer to clinic (median 6.73 vs 28.84 miles; P = .0120), and had worse Wound, Ischemia, and foot Infection (WIfI) stage (P < .001). There were no differences in freedom from death, major adverse limb event (MALE), or patency loss. Within the most deprived subgroup (ADI >90), traditional clinic patients had earlier patency loss (P = .0108) compared with LPP patients. Multivariable analysis of the entire cohort demonstrated that increasing age, heart failure, dialysis, chronic obstructive pulmonary disease, and increasing WIfI stage were independently associated with earlier death, and male sex was associated with earlier MALE. Ten traditional clinic patients were interviewed via convenience sampling. Emerging themes included difficulty understanding their disease, high visit frequency, transportation barriers, distrust of the health care system, and patient-physician racial discordance. CONCLUSIONS: LPP patients had worse comorbidities and socioeconomic deprivation yet had similar outcomes to healthier, less deprived non-LPP patients. The multidisciplinary clinic's structure addresses several patient-perceived barriers. Its proximity to disadvantaged patients and ability to conduct multiple appointments at a single visit may address transportation and visit frequency barriers, and the consistent team may facilitate patient education and improve trust. Including these elements in a multidisciplinary clinic and locating it in an area of need may mitigate some negative impacts of socioeconomic deprivation on CLTI outcomes.

15.
Phys Rev Lett ; 132(11): 113801, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38563935

RESUMO

Manipulating radiation asymmetry of photonic structures is of particular interest in many photonic applications such as directional optical antenna, high efficiency on-chip lasers, and coherent light control. Here, we proposed a term of pseudopolarization to reveal the topological nature of radiation asymmetry in bilayer metagratings. Robust pseudopolarization vortex with an integer topological charge exists in P-symmetry metagrating, allowing for tunable directionality ranging from -1 to 1 in synthetic parameter space. When P-symmetry breaking, such vortex becomes pairs of C points due to the conservation law of charge, leading to the phase difference of radiation asymmetry from π/2 to 3π/2. Furthermore, topologically enabled coherent perfect absorption is robust with customized phase difference at will between two counterpropagating external light sources. This Letter can not only enrich the understanding of two particular topological photonic behaviors, i.e., bound state in the continuum and unidirectional guided resonance, but also provide a topological view on radiation asymmetry, opening an unexplored avenue for asymmetric light manipulation in on-chip laser, light-light switch, and quantum emitters.

16.
Chemistry ; 30(23): e202304266, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38369590

RESUMO

The exploration of stable, efficient, and low-cost catalysts toward ammonia borane hydrolysis is of vital significance for the practical implementation of this hydrogen production technology. Integrating interface engineering and nano-architecture engineering is a favorable strategy to elevate catalytic performance, as it can modify the electronic structure and provide sufficient active sites simultaneously. In this work, urchin-like NiCoP/CoP heterostructures are prepared via a three-step hydrothermal-oxidation-phosphorization synthesis route. It is demonstrated that the original Ni/Co molar ratio and the amount of phosphorus are crucial for adjusting the morphology, enhancing the exposed surface area, facilitating charge transfer, and modulating the adsorption and activation of H2O molecules. Consequently, the optimal Ni1Co2P heterostructure displays remarkable catalytic properties in the hydrolysis of ammonia borane with a turnover frequency (TOF) value of 30.3 molH2 ⋅ min-1 ⋅ molmetal -1, a low apparent activation energy of 25.89 kJ ⋅ mol-1, and good stability. Furthermore, by combining infrared spectroscopy and isotope kinetics experiments, a possible mechanism for the hydrolysis of ammonia borane was proposed.

17.
Calcif Tissue Int ; 115(1): 41-52, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38743269

RESUMO

Previous observational studies have suggested that anti-Müllerian hormone (AMH) and reproductive factors are linked to reduced bone mineral density (BMD) and an increased risk of osteoporosis (OP) in women. However, related studies are limited, and these traditional observational studies may be subject to residual confounders and reverse causation, while also lacking a more comprehensive observation of various reproductive factors. Univariate and multivariate two-sample Mendelian randomization analyses were conducted to determine the causal associations of AMH levels and six reproductive factors with BMD and OP, using the random-effects inverse-variance weighted method. Heterogeneity was assessed using Cochran's Q-statistic, and sensitivity analyses were performed to identify causal correlations. Age at menarche (AAM) was negatively associated with total body BMD (TB-BMD) in females aged 45-60 and over 60 years, as well as with heel bone mineral density (eBMD). Conversely, age at natural menopause (ANM) was positively associated with TB-BMD in the same age ranges and with eBMD. ANM was only causally associated with self-reported OP and showed no significant correlation with definitively diagnosed OP. Neither AMH level nor other reproductive factors were significantly associated with a genetic predisposition to BMD at any age and OP. Later AAM and earlier ANM are significantly genetically causally associated with decreased BMD but not with OP. AMH levels, length of menstrual cycle, age at first birth, age at last birth, and number of live births, in terms of genetic backgrounds, are not causally related to BMD or OP.


Assuntos
Hormônio Antimülleriano , Densidade Óssea , Análise da Randomização Mendeliana , Osteoporose , Humanos , Hormônio Antimülleriano/sangue , Feminino , Densidade Óssea/genética , Densidade Óssea/fisiologia , Pessoa de Meia-Idade , Osteoporose/genética , Menopausa/genética , Menopausa/sangue , Predisposição Genética para Doença , Menarca/genética , Adulto , Fatores de Risco
18.
BMC Neurol ; 24(1): 34, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38243162

RESUMO

BACKGROUND: Neuroleptospirosis and anti-dipeptidyl-peptidase-like protein 6 (DPPX) encephalitis are both very rare and have only been reported in the form of respective case reports. There are no reports of anti-DPPX encephalitis combined with neuroleptospirosis in the literature. We reported the first case of neuroleptospirosis combined with elevated DPPX antibodies in serum and cerebrospinal fluid (CSF). CASE PRESENTATION: A previously healthy 53-year-old Chinese male farmer with a history of drinking raw stream water and flood sewage exposure was brought to the hospital due to an acute onset of neuropsychiatric symptoms. No fever or meningeal irritation signs were detected on physical examination. Routine laboratory investigations, including infection indicators, leukocyte and protein in CSF, electroencephalogram and gadolinium-enhanced magnetic resonance imaging of the brain, all revealed normal. While metagenomic next-generation sequencing (mNGS) identified the DNA genome of Leptospira interrogans in the CSF. Anti-DPPX antibody was detected both in blood and in CSF. A diagnosis of neuroleptospirosis combined with autoimmune encephalitis associated with DPPX-Ab was eventually made. He resolved completely after adequate amount of penicillin combined with immunotherapy. CONCLUSION: We highlight that in patients with acute or subacute behavioral changes, even in the absence of fever, if the most recent freshwater exposure is clear, physicians should pay attention to leptospirosis. Due to the low sensitivity of routine microscopy, culture, polymerase chain reaction and antibody testing, mNGS may have more advantages in diagnosing neuroleptospirosis. As autoimmune encephalitis can be triggered by various infections, neuroleptospirosis may be one of the causes of autoimmune encephalitis. Since neuronal antibody measurements themselves are not that common in neuroleptospirosis, future studies are needed to determine whether the detection of anti-DPPX antibodies is a rare event in leptospirosis. Early identification of autoimmune encephalitis and timely administration of immunotherapy may lead to a better outcome.


Assuntos
Doenças Autoimunes do Sistema Nervoso , Encefalite , Doença de Hashimoto , Leptospirose , Masculino , Humanos , Pessoa de Meia-Idade , Encefalite/diagnóstico , Encéfalo , Leptospirose/complicações , Leptospirose/diagnóstico
19.
Cereb Cortex ; 33(11): 6772-6784, 2023 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-36734278

RESUMO

Gaze change can misalign spatial reference frames encoding visual and vestibular signals in cortex, which may affect the heading discrimination. Here, by systematically manipulating the eye-in-head and head-on-body positions to change the gaze direction of subjects, the performance of heading discrimination was tested with visual, vestibular, and combined stimuli in a reaction-time task in which the reaction time is under the control of subjects. We found the gaze change induced substantial biases in perceived heading, increased the threshold of discrimination and reaction time of subjects in all stimulus conditions. For the visual stimulus, the gaze effects were induced by changing the eye-in-world position, and the perceived heading was biased in the opposite direction of gaze. In contrast, the vestibular gaze effects were induced by changing the eye-in-head position, and the perceived heading was biased in the same direction of gaze. Although the bias was reduced when the visual and vestibular stimuli were combined, integration of the 2 signals substantially deviated from predictions of an extended diffusion model that accumulates evidence optimally over time and across sensory modalities. These findings reveal diverse gaze effects on the heading discrimination and emphasize that the transformation of spatial reference frames may underlie the effects.


Assuntos
Percepção de Movimento , Vestíbulo do Labirinto , Humanos , Tempo de Reação , Córtex Cerebral , Viés , Percepção Visual , Estimulação Luminosa
20.
Environ Res ; 243: 117880, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38070858

RESUMO

Antibiotic resistant genes (ARGs) present significant risks to environments and public health. In particular, there is increasing awareness of the role of soil nitrogen in ARG dissemination. Here, we investigated the connections between antibiotic resistome and nitrogen-cycling microbes in paddy soil by performing five-year field experiments with the treatments of no nitrogen fertilization (CK), reduced chemical nitrogen fertilization (LN), conventional chemical nitrogen fertilization (CN) and plant-derived organic nitrogen fertilization (ON). Compared with CK treatment, CN and ON treatments significantly increased soil NH4+ and TN concentrations by 25.4%-56.5% and 10.4%-20.1%, respectively. Redundancy analysis revealed significantly positive correlation of NH4+ with most ARGs, including tetA, macB and barA. Correspondingly, CN and ON treatments enhanced ARG abundances by 21.9%-23.2%. Moreover, CN and ON treatments promoted nitrate/nitrite-reducing bacteria and linked the corresponding N-cycling functional genes (narG, narH, nirK and nrfA) with most ARGs. Metagenomic binning was performed and identified Gemmatimonadaceae, Caulobacteraceae, Ilumatobacteraceae and Anaerolineaceae as hosts for both ARGs and nitrate/nitrite reduction genes that were enriched by CN and ON treatments. Soil resistome risk score analysis indicated that, although there was increased relation of ARG to nitrogen-cycling microorganisms with nitrogen fertilizer application, the environmental risk of ARGs was not increased due to the lower distribution of ARGs in pathogens. This study contributed to a deeper understanding of the role of soil nitrogen in shaping ARG profiles and controlling soil resistome risk.


Assuntos
Antibacterianos , Solo , Solo/química , Antibacterianos/farmacologia , Antibacterianos/análise , Fertilizantes/análise , Nitratos/análise , Nitritos/análise , Esterco/análise , Esterco/microbiologia , Bactérias/genética , Nitrogênio/análise , Microbiologia do Solo , Genes Bacterianos
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