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BACKGROUND: The U.S. Food and Drug Administration is considering a policy to reduce nicotine in cigarettes to non-addictive levels. Although current evidence supports the public-health benefits of a reduced-nicotine policy, almost half of people who smoke (â¼ 40%) do not support the policy. This study estimates the factors most strongly associated with support or opposition toward the policy, including tobacco use status, perceived effects of a reduced nicotine policy, trust in the FDA, and psychological distress. The study aims to inform messaging campaigns and policy makers. METHODS: Data were collected in 2021 with nationally representative samples of U.S. adults (n = 1763). After receiving information about the reduced nicotine policy, participants indicated their beliefs and support for or opposition to the policy, along with other individual difference characteristics. Univariate population parameters and multinomial logistic regression coefficients were estimated. RESULTS: In adjusted models, people who formerly or never smoked were less likely to oppose the policy compared to those who currently smoke; people with higher psychological distress and those who believe the policy will promote switching to e-cigarettes were more likely to oppose the policy. In addition, people were more likely to support the policy if they believed it would make quitting easier or that the FDA is trustworthy. CONCLUSIONS: Educational campaigns about reduced nicotine policy should expect higher impact by targeting prevalent perceptions and those more strongly associated with policy sentiment. In anticipation of the policy rollout, there may be a critical window to shape public opinion.
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Nicotina , Humanos , Estados Unidos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Nicotina/administração & dosagem , Política de Saúde , United States Food and Drug Administration , Abandono do Hábito de Fumar/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Opinião Pública , AdolescenteRESUMO
BACKGROUND: USA is considering reducing nicotine in cigarettes to non-addictive levels, coupled with promoting alternative nicotine delivery products (eg, e-cigarettes). However, effective communication is needed to reduce misperceptions about very low nicotine cigarettes (VLNCs) being less harmful than regular cigarettes. METHODS: In 2022-2023, we conducted a four-group randomised clinical trial with a national probability sample from an online panel (971 adults who smoked cigarettes exclusively, 472 adults who dual used cigarettes and e-cigarettes and 458 adults aged 18-29 who had never smoked). Participants were randomised (parallel assignment) to one message condition: (1) VLNCs as harmful but easier to quit than regular cigarettes (n=468), (2) those who are not ready to quit should consider switching to e-cigarettes as less harmful alternatives (n=484), (3) combined (VLNC and e-cigarette messages; n=476) or (4) control condition (ie, water ads), n=473. The primary outcome was perceived absolute harm of VLNCs. RESULTS: Perceived harm of VLNCs was higher in the VLNC condition compared with the e-cigarette and control conditions, and higher in the combined condition compared with the e-cigarette condition (adjusted p<0.05). Among adults who dual used, intention to switch to e-cigarettes was higher in the VLNC condition than the e-cigarette, combined or control conditions (adjusted p<0.05). CONCLUSIONS: VLNC messages reduced the misperception that VLNCs are less harmful than cigarettes, but adding messages about e-cigarettes did not enhance desired outcomes. These VLNC messages can be considered during the rollout of a reduced nicotine policy. TRIAL REGISTRATION: NCT05506046.
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OBJECTIVE: The objective of the study was to investigate the relationship between types of disc displacement (DD) diagnosed by magnetic resonance imaging (MRI), and the risk (presence or absence) and severity of condylar erosion (CE) graded using cone-beam computed tomography (CBCT) in adult Temporomandibular disorders (TMD) patients. METHODS: A total of 353 TMD patients (283 females, 70 males) underwent MRI scans to categorise DD as normal (NA), anterior displacement with reduction (ADDR), or anterior displacement without reduction (ADDNR). CE severity was graded on a scale of 0-3 (absence, mild, moderate or severe) using CBCT. To establish the plausibility and cut-off points for CE diagnosis, the severity of CE was then further divided into three classifications: Grade 0 versus 1 + 2 + 3; Grades 0 + 1 versus 2 + 3; Grades 0 + 1 + 2 versus 3. Logistic regression analysis was performed, adjusting for age, gender and joint correlation. RESULTS: ADDNR significantly increased the risk of CE compared with NA (OR = 10.04, 95% CI: [6.41, 15.73]) and showed a significant increase in CE severity across all classifications (ORs = 10.04-18.95). The effects of ADDNR were significant in both genders (p < .001) and had a greater impact in females. ADDR was predominantly associated with mild CE. CONCLUSIONS: ADDNR significantly increased the risk and severity of CE independent of gender when compared to NA, whereas ADDR was mainly associated with mild CE. Slight cortical discontinuity may represent a subclinical diagnosis requiring further investigation.
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Tomografia Computadorizada de Feixe Cônico , Luxações Articulares , Imageamento por Ressonância Magnética , Côndilo Mandibular , Disco da Articulação Temporomandibular , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Masculino , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/patologia , Adulto , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/patologia , Disco da Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/patologia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto Jovem , Fatores de RiscoRESUMO
Vibration signal analysis is an important means for bearing fault diagnosis. Affected by the vibration of other machine parts, external noise and the vibration transmission path, the impulses induced by a bearing defect in the measured vibrations are very weak. Blind deconvolution (BD) methods can counteract the effect of the transmission path and enhance the fault impulses. Most BD methods highlight fault features of the filtered signals by impulse-featured objective functions (OFs). However, residual noise in the filtered signals has not been well tackled. To overcome this problem, a fuzzy entropy-assisted deconvolution (FEAD) method is proposed. First, FEAD takes advantage of the high noise sensitivity of fuzzy entropy (FuzzyEn) and constructs a weighted FuzzyEn-kurtosis OF to enhance the fault impulses while suppressing noise interference. Then, the PSO algorithm is used to iteratively solve the optimal inverse deconvolution filter. Finally, envelope spectrum analysis is performed on the filtered signal to realize bearing fault diagnosis. The feasibility of FEAD was first verified by the bearing fault simulation signals at constant and variable speeds. The bearing test signals from Case Western Reserve University (CWRU), the railway wheelset and the test bench validated the good performance of FEAD in fault feature enhancement. A comparison with and quantitative results for the other state-of-the-art BD methods indicated the superiority of the proposed method.
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Rolling element bearing (REB) vibration signals under variable speed (VS) have non-stationary characteristics. Order tracking (OT) and time-frequency analysis (TFA) are two widely used methods for REB fault diagnosis under VS. However, the effect of OT methods is affected by resampling errors and close-order harmonic interference, while the accuracy of TFA methods is mainly limited by time-frequency resolution and ridge extraction algorithms. To address this issue, a novel method based on envelope spectrum fault characteristic frequency band identification (FCFBI) is proposed. Firstly, the characteristics of the bearing fault vibration signal's envelope spectrum under VS are analyzed in detail and the fault characteristic frequency band (FCFB) is introduced as a new and effective representation of faults. Then, fault templates based on FCFB are constructed as reference for fault identification. Finally, based on the calculation of the correlation coefficients between the envelope spectrum and fault templates in the extended FCFB, the bearing fault can be diagnosed automatically according to the preset correlation coefficient criterion. Two bearing VS experiments indicate that the proposed method can achieve satisfactory diagnostic accuracy. The comparison of OT and TFA methods further demonstrates the comprehensive superiority of the proposed method in the overall consideration of accuracy, diagnostic time, tachometer dependency, and automatic degree.
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BACKGROUND: Degenerative joint disease (DJD) can be associated with disc displacement (DD) in temporomandibular disorder (TMD) patients. However, the relationship between different types of DDs and DJD remains unclear. OBJECTIVES: To investigate the odds ratios of different types of sagittal and coronal DDs confirmed by magnetic resonance imaging (MRI) and DJD confirmed by cone-beam computed tomography (CBCT) in TMD patients. METHODS: Radiographic data from 69 males and 232 females were collected for analysis. CBCT was used to diagnose DJD, with criteria including erosion, osteophytes, generalised sclerosis and cysts in the joint. Eight types of DDs were evaluated by sagittal and coronal MRIs: NA, no abnormality; SW, sideways; ADDR, anterior with reduction; ADDR+SW; ADDNR, anterior without reduction; ADDNR + SW; single SW; PDD, posterior; PDD + SW. The odds ratios of DJD in joints with different types of DDs were determined after joint correlation, age and gender adjustment. RESULTS: Compared with NA, the odds ratio of DJD in ADDR was 2.397 (95% CI [confidence interval]: 1.070-5.368), ADDR + SW was 4.808 (95% CI: 1.709-3.528), ADDNR was 29.982 (95% CI: 15.512-57.950) and ADDNR + SW was 25.974 (95% CI: 12.743-52.945). Erosion was significantly increased in ADDR, ADDR + SW, ADDNR and ADDNR + SW; osteophytes were significantly increased in ADDR + SW, ADDNR and ADDNR + SW; and generalised sclerosis and cysts were significantly increased in ADDNR and ADDNR + SW. There were no significant associations between single SW, PDD, PDD + SW and the DJD. CONCLUSIONS: ADDR, ADDR+SW, ADDNR and ADDNR+SW were associated with DJD. ADDNR had a significantly higher prevalence of DJD than ADDR. There were no significant relationships between single SW, PDD, PDD + SW and the DJD.
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Cistos , Luxações Articulares , Osteófito , Tomografia Computadorizada de Feixe Cônico Espiral , Transtornos da Articulação Temporomandibular , Masculino , Feminino , Humanos , Osteófito/diagnóstico por imagem , Osteófito/patologia , Esclerose/patologia , Transtornos da Articulação Temporomandibular/diagnóstico , Imageamento por Ressonância Magnética , Cistos/patologia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologia , Luxações Articulares/diagnósticoRESUMO
OBJECTIVES: To determine whether contrast-enhanced ultrasonography (CEUS) can be used for selecting lesions and assessing the ablative effects of MRgFUS ablation on uterus fibroids, compared with MR imaging. METHODS: This retrospective study was approved by the institutional review board of our hospital. From April 2018 to November 2019, a total of 44 symptomatic fibroids in 38 patients who underwent MRgFUS ablation were included. The association between pre-ablation characteristics on CEUS/MR imaging and the non-perfusion volume (NPV) after ablation was analyzed using multivariable linear regression analysis. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve values was compared between the CEUS and MR imaging regression models. NPV after ablation was compared between CEUS and enhanced MR imaging. RESULTS: On CEUS, entangled branch vessels, fast-in, and fast-out patterns were significantly associated with NPV, with an AUC of 0.95 (95% CI; 0.88, 1.00). On MR imaging, hyper-intensity on T2-weighted images (T2WI), hyper-intense ring-like signal on T2WI images, and hyper-enhancement on contrast-enhanced T1WI images were correlated with NPV, with an AUC of 0.86 (95% CI; 0.70, 1.00). After ablation, no differences in NPV were noted between contrast-enhanced T1WI (84.13 ± 75.42 cm3) and CEUS (80.22 ± 76.49 cm3). CONCLUSIONS: Some pre-ablation characteristics of uterine fibroids on CEUS were associated with NPV after MRgFUS. CEUS may contribute to the evaluation of ablative outcomes and patient selection, similar to MR imaging. KEY POINTS: ⢠Contrast-enhanced ultrasonography (CEUS) is effective for selecting the appropriate uterine fibroids before MR-guided focused ultrasound (MRgFUS) ablation and evaluating non-perfusion volumes (NPV) after ablation, as a potential alternative to MR imaging. ⢠Before ablation, entangled branch vessels, fast-in, and fast-out patterns on CEUS were significantly associated with NPV after MRgFUS. ⢠No significant differences in NPV were detected between contrast-enhanced T1WI and CEUS after ablation.
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Ablação por Ultrassom Focalizado de Alta Intensidade , Leiomioma , Neoplasias Uterinas , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgia , ÚteroRESUMO
Three new caffeoyl derivatives (1-3), together with two known ones (4-5), were isolated from the whole plant of Elephantopus scaber Linn. The structures of the new compounds were elucidated using detailed spectroscopic analysis. Compound 4 was obtained and its NMR data were given for the first time. All isolates were evaluated for their anti-inflammatory activity against lipopolysaccharide (LPS)-stimulated nitric oxide (NO) production and pro-inflammatory cytokines release in RAW 264.7 cells. Compounds 2-5 showed mild inhibitory activities with IC50 values ranging from 64.78 to 87.21 µM, and 3-4 could inhibit LPS-induced tumor necrosis factor-α (TNF-α) production.
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Asteraceae , Lipopolissacarídeos , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Asteraceae/química , Lipopolissacarídeos/farmacologia , Camundongos , Estrutura Molecular , Óxido Nítrico , Células RAW 264.7RESUMO
The complex and harsh working environment of rolling bearings cause the fault characteristics in vibration signal contaminated by the noise, which make fault diagnosis difficult. In this paper, a feature enhancement method of rolling bearing signal based on variational mode decomposition with K determined adaptively (K-adaptive VMD), and radial based function fuzzy entropy (RBF-FuzzyEn), is proposed. Firstly, a phenomenon called abnormal decline of center frequency (ADCF) is defined in order to determine the parameter K of VMD adaptively. Then, the raw signal is separated into K intrinsic mode functions (IMFs). A coefficient En for selecting optimal IMFs is calculated based on the center frequency bands (CFBs) of all IMFs and frequency spectrum for original signal autocorrelation operation. After that, the optimal IMFs of which En are bigger than the threshold are selected to reconstruct signal. Secondly, RBF is introduced as an innovative fuzzy function to enhance the feature discrimination of fuzzy entropy between bearings in different states. A specific way for determination of parameter r in fuzzy function is also presented. Finally, RBF-FuzzyEn is used to extract features of reconstructed signal. Simulation and experiment results show that K-adaptive VMD can effectively reduce the noise and enhance the fault characteristics; RBF-FuzzyEn has strong feature differentiation, superior noise robustness, and low dependence on data length.
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In this work, a naphthalene-based macrocycle prism[5]arene (NP5 OCH3 ) is developed as a novel kind of photoinitiator. When NP5 OCH3 is irradiated under light, the bond between methylene and naphthalene can be quickly broken owning to the existence of ring tension. The macrocycle is cleaved to linear oligomer biradicals, which can effectively initiate the free radical photopolymerization of acrylate monomers. Compared with conventional photoinitiators, NP5 OCH3 has strong light absorption in the wavelength range of 365-405 nm, so it can well match the environment-friendly light-emitting diodes (LEDs) light source to realize highly efficient initiation. In addition, there is no small molecule fragment generated during NP5 OCH3 fracture, and the resulted linear oligomer biradicals can be immobilized in the polymer after initiating polymerization, so NP5 OCH3 photoinitiators show much lower migration rate and cytotoxicity. Cleavable macrocycle prismarene may provide a new idea for the design of safe and efficient photoinitiators matching long wavelength light.
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Luz , Polímeros , Radicais Livres , PolimerizaçãoRESUMO
Olfactory receptors (OR), a group of classic membrane proteins, plays a vital role in insect reproduction and acclimatization. Deciphering the molecular mechanism of insect olfaction could enhance pest control and environmental protection. Studies on ORs have faced a major bottleneck due to the notoriously strong hydrophobicity of ORs, which results in difficult expression in heterologous cell systems. Here, we demonstrated that insect ORs could be functionally produced using the E. coli cell-free protein synthesis system (CFPS), in which the highest yield of total ORs is 350⯵g per 1â¯ml reaction. We tested the effects of detergent types and concentrations on soluble expression of ORs. The ORs showed a classic α-helical infrared spectrum. Quartz crystal microbalance (QCM) was used to demonstrate that ORs fold correctly and respond to their ligands. This is the first report that insect OR42a could be functionally produced in vitro. This approach may facilitate the development of biomimetic olfactory biosensors and may also be utilized for drug positioning and development, environmental protection and agriculture.
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Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Escherichia coli/metabolismo , Receptores Odorantes/genética , Animais , Técnicas Biossensoriais , Detergentes/metabolismo , Proteínas de Drosophila/química , Proteínas de Drosophila/metabolismo , Expressão Gênica , Ligantes , Conformação Proteica , Receptores Odorantes/química , Receptores Odorantes/metabolismo , SolubilidadeRESUMO
Mosquitoes transmit many harmful diseases that seriously threaten public health. The mosquito's olfactory system is of great significance for host selection. Inotropic receptors (IRs) and olfactory receptors (ORs) have been demonstrated to be capable of odorant molecular recognition. Analyzing the molecular principles of mosquito olfaction facilitates the development of prevention and therapy techniques. Advances in the understanding of IRs have been seriously inadequate compared to those of ORs. Here, we provide evidence that 35 Anopheles sinensis IR (AsIR) genes are expressed, 7 of which are in the antennae and 2 have expression levels that are upregulated with a blood meal. A homologous analysis of the sequences showed that AsIRs are a subfamily of ionotropic glutamate receptors (iGLURs). This is the first that time IRs have been identified in Anopheles sinensis in vitro. The ultrastructure of the antennae supports the theory that diverse sensilla are distributed in the antennae. The results here may facilitate the revelation of the regulation mechanism in AsIRs, which could mitigate the transmission of diseases by mosquitoes.
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Anopheles/genética , Anopheles/metabolismo , Antenas de Artrópodes/metabolismo , Proteínas de Insetos/genética , Receptores Ionotrópicos de Glutamato/genética , Sequência de Aminoácidos , Animais , Anopheles/ultraestrutura , Antenas de Artrópodes/ultraestrutura , Feminino , Regulação da Expressão Gênica , Genes de Insetos , Proteínas de Insetos/metabolismo , Microscopia Eletrônica de Varredura , Filogenia , Receptores Ionotrópicos de Glutamato/metabolismo , Receptores Odorantes/genética , Receptores Odorantes/metabolismo , Olfato/genéticaRESUMO
SIGNIFICANCE: For decades, tobacco advertisements and promotions have been common in mass media and public places in China. In 2015, China amended the Advertising Law to prohibit the distribution of tobacco advertising, while also initiating waves of tobacco control media campaigns. This study investigates the associations between exposure to anti- and pro-smoking messages, smoking status, and people's smoking-related beliefs and willingness to support tobacco control policies. METHODS: A secondary data analysis was performed with the 2018 Global Adult Tobacco Survey of 19,376 adults aged ≥15 years in China. Anti- and pro-smoking message exposures were measured as the sum of sources (media or places) where respondents have seen the messages. Multivariable logistic regression analyses were conducted to examine the relationships among smoking status, message exposure, and the outcome variables (health harm beliefs, support for increasing tax on cigarettes, support for using part of the increased tax on tobacco control) controlling for smoking status and demographic differences. RESULTS: Overall, 63.3% of the respondents reported being exposed to anti-smoking messages from at least 1 source, while 18.1% were exposed to pro-smoking messages from at least 1 source. Adults who currently, formerly, and never smoked differed in their beliefs about smoking and willingness to support tobacco control policies. Greater reported exposure to anti-smoking messages was positively associated with belief that smoking is harmful, support for increased cigarette tax, and support for using increased tax revenue for tobacco control measures. Meanwhile, greater reported exposure to pro-smoking messages was negatively related to willingness to support cigarette tax increases. CONCLUSIONS: While national and local tobacco control campaigns in China have reached a large proportion of the adult population, there is still room for improvement. China might consider expanding anti-tobacco campaigns, as reported exposure to these messages is associated with increased public awareness of the health hazards of smoking and support for increasing cigarette taxes.
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Fumar , Humanos , Adulto , China/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Inquéritos e Questionários , Fumar/psicologia , Fumar/epidemiologia , Publicidade , Produtos do Tabaco/economia , Produtos do Tabaco/legislação & jurisprudência , Idoso , Meios de Comunicação de Massa , Impostos , Prevenção do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologiaRESUMO
Purpose: This study aimed to investigate the relationship between temporomandibular joint (TMJ) effusion and TMJ pain, as well as jaw function limitation in patients via two-dimensional (2D) and three-dimensional (3D) magnetic resonance imaging (MRI) evaluation. Patients and Methods: 121 patients diagnosed with temporomandibular disorder (TMD) were included. TMJ effusion was assessed qualitatively using MRI and quantified with 3D Slicer software, then graded accordingly. In addition, a visual analogue scale (VAS) was employed for pain reporting and an 8-item Jaw Functional Limitations Scale (JFLS-8) was utilized to evaluate jaw function limitation. Statistical analyses were performed appropriately for group comparisons and association determination. A probability of p<0.05 was considered statistically significant. Results: 2D qualitative and 3D quantitative strategies were in high agreement for TMJ effusion grades (κ = 0.766). No significant associations were found between joint effusion and TMJ pain, nor with disc displacement and JLFS-8 scores. Moreover, the binary logistic regression analysis showed significant association between sex and the presence of TMJ effusion, exhibiting an Odds Ratio of 5.168 for females (p = 0.008). Conclusion: 2D qualitative evaluation was as effective as 3D quantitative assessment for TMJ effusion diagnosis. No significant associations were found between TMJ effusion and TMJ pain, disc displacement or jaw function limitation. However, it was suggested that female patients suffering from TMD may be at a risk for TMJ effusion. Further prospective research is needed for validation.
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Parents self-medicating their children with antibiotics (SMA) without consulting healthcare professionals is a common practice in China. Previous research has focused primarily on examining the socioeconomic factors that contribute to the prevalence of SMA. This study adopts and extends the theory of planned behavior to understand the cognitive and emotional factors that are associated with parental SMA in China. The responses to an online survey were collected from 961 parents of children aged 6-12 years old, primarily from Gansu, Shandong, and Shaanxi provinces. More than half of the participants (66.5%) engaged in parental SMA. Amoxicillin, Cephradine, and Azithromycin were the most frequently selected antibiotics used for children. Structural equation modeling showed that uncertainty was positively associated with negative emotions, which were in turn positively associated with attitude toward SMA. Uncertainty was also negatively associated with perceived behavioral control (PBC), but the association between PBC and SMA behavior was not significant. Attitude and subjective norm were both positively associated with SMA behavior. The relationship between subjective norm and attitude was also positive. Understanding the psychological factors driving parental SMA may inform tailored interventions to promote responsible antibiotic use among parents.
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Antibacterianos , População do Leste Asiático , Humanos , Criança , Antibacterianos/uso terapêutico , Incerteza , Amoxicilina , EmoçõesRESUMO
While the US Food and Drug Administration (FDA)'s proposal to reduce the nicotine content in cigarettes is gaining traction, it is still undetermined whether the policy will also include other combustible tobacco products, such as little cigars and cigarillos (LCCs), and how such a policy should be communicated given the patterns of use and perceptions around LCCs. This study examined perceptions of nicotine and addiction related to LCC use and involved data collection from eight semi-structured virtual focus groups conducted in Summer 2021 in the US. Participants were adults who reported past-30-day use of LCCs, consisting of African American males (n = 9), African American females (n = 9), white males (n = 14), and white females (n = 11). Participants discussed their perceptions of nicotine and addiction in general and in relation to LCC use. Inductive thematic analysis of transcripts was conducted. Differences across race and sex groups were examined. Participants did not consider nicotine to be a characterizing feature of LCCs; rather, they generally associated nicotine with cigarettes. Participants' views of nicotine and addiction related to LCCs were discussed along four dimensions: context of use, frequency of use, the presence of cravings, and whether a product is modified (e.g., by adding marijuana). Social and infrequent use, a lack of cravings, and the use of LCCs for marijuana were considered indicative of a lack of addiction and reasons not to be concerned about nicotine in LCCs. Because perceptions of nicotine and addiction related to LCCs differ from those of cigarettes, communications about a reduced nicotine policy that includes LCCs should consider these differences to ensure the policy is understood by people who currently use LCCs and to prevent people who use cigarettes from switching to LCCs.
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Cannabis , Fissura , Fumar , Produtos do Tabaco , Adulto , Feminino , Humanos , Masculino , Grupos Focais , NicotinaRESUMO
BACKGROUND: Early prediction of treatment response is crucial for the optimal treatment of advanced breast cancer. We aimed to explore whether monitoring early changes in plasma human epidermal growth factor receptor 2 (HER2) levels using digital PCR (dPCR) could predict the treatment response in advanced breast cancer. METHODS: This was a multicenter, prospective, noninterventional clinical study of patients with advanced breast cancer. All enrolled patients underwent blood testing to measure the HER2 levels by digital PCR before treatment initiation and once every 3 weeks during the study. The primary endpoints werea the diagnostic value of dPCR for detecting HER2 status in the blood andb the relevance of potential changes in the plasma HER2 level at 3 weeks from baseline for predicting treatment response. RESULTS: Overall, 85 patients were enrolled between October 9, 2018, and January 23, 2020. dPCR had a specificity of 91.67% (95% CI: 80.61% to 97.43%) for detecting HER2 amplification, and the area under the receiver operating characteristic (ROC) curve was 0.84 (p < 0.01). A clinically relevant specificity threshold of approximately 90%, which was equivalent to a ≥15% decrease in the plasma HER2 ratio at 3 weeks from baseline, showed a positive predictive value of 97.37% (95% CI: 77.11% to 98.65%) in terms of predicting clinical benefit. Patients whose plasma HER2 ratio was reduced by ≥15% had a longer median progression-free survival (PFS) than those whose ratio was reduced by <15% (9.20 months vs. 4.50 months, p < 0.01). CONCLUSIONS: Early changes in the plasma HER2 ratio may predict the treatment response in patients with advanced breast cancer and could facilitate optimal treatment selection.
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Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/tratamento farmacológico , Biomarcadores Tumorais/metabolismo , Estudos Prospectivos , Valor Preditivo dos Testes , Curva ROCRESUMO
Purpose: To evaluate head and cervical posture in individuals with or without temporomandibular disorders (TMDs) and to assess the correlations between pain, severity of symptoms, and posture. Methods: A total of 384 patients (129 males and 255 females) was included. The Fonseca Anamnestic Index (FAI) was used to assess the severity and prevalence of TMD and the presence of temporomandibular joint (TMJ) pain. Patients were divided into three groups: the TMD-free group, TMD without TMJ pain group, and TMD with TMJ pain group. Subsequently, the patients with TMJ pain were further divided into mild TMD and moderate/severe TMD groups. Nine parameters were traced on cephalograms to characterize the head and cervical posture. Results: TMD patients with TMJ pain showed increased forward head posture (FHP) than patients without TMJ pain and TMD-free subjects. No significant difference was observed between the TMD patients without TMJ pain and TMD-free subjects. In the TMD patients with the TMJ pain group, the moderate/severe TMD patients demonstrated increased FHP compared to mild TMD patients. TMD patients with joint pain had greater CVT/RL (B = 3.099), OPT/RL (B = 2.117), and NSL/C2' (B = 4.646) than the patients without joint pain after adjusting for confounding variables (P < 0.05). Conclusion: TMD patients with TMJ pain showed increased FHP compared to other groups, and FHP became more significant as TMD severity increased in male patients, indicating the FHP might play an important role in the development of TMJ pain. In the clinical assessment of TMD, the patients' abnormal head and cervical posture might be considered.
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Transtornos da Articulação Temporomandibular , Síndrome da Disfunção da Articulação Temporomandibular , Feminino , Humanos , Masculino , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Dor Facial , Artralgia/etiologia , PosturaRESUMO
Objective: This study aims to develop a new category scheme for the profile morphology of temporomandibular disorders (TMDs) based on lateral cephalometric morphology. Methods: Five hundred and one adult patients (91 males and 410 females) with TMD were enrolled in this study. Cluster tendency analysis, principal component analysis and cluster analysis were performed using 36 lateral cephalometric measurements. Classification and regression tree (CART) algorithm was used to construct a binary decision tree based on the clustering results. Results: Twelve principal components were discovered in the TMD patients and were responsible for 91.2% of the variability. Cluster tendency of cephalometric data from TMD patients were confirmed and three subgroups were revealed by cluster analysis: (a) cluster 1: skeletal class I malocclusion; (b) cluster 2: skeletal class I malocclusion with increased facial height; (c) cluster 3: skeletal class II malocclusion with clockwise rotation of the mandible. Besides, CART model was built and the eight key morphological indicators from the decision tree model were convenient for clinical application, with the prediction accuracy up to 85.4%. Conclusion: Our study proposed a novel category system for the profile morphology of TMDs with three subgroups according to the cephalometric morphology, which may supplement the morphological understanding of TMD and benefit the management of the categorical treatment of TMD.
Assuntos
Má Oclusão , Transtornos da Articulação Temporomandibular , Adulto , Feminino , Masculino , Humanos , Análise por Conglomerados , Análise de Componente Principal , AlgoritmosRESUMO
Purpose: To explore the relationship between craniomaxillofacial features and psychological distress among adult pretreatment orthodontic patients. Methods: A group of 190 patients (95 males and 95 females) was included. Questionnaires including the Kessler psychological distress scale (K10) were sent to patients, and cephalograms were collected. Patients were divided into two groups according to K10 score: psychological distress group (score ≥ 20) and no psychological distress group (score < 20). Nineteen hard tissue and thirteen soft tissue parameters were traced on cephalograms to characterize the craniomaxillofacial features. Results: There was no significant difference in gender or age distribution between the two groups. Male patients with psychological distress showed statistically significantly larger anterior facial height (AFH) (126.62 mm vs. 120.97 mm), upper lip length (25.11 mm vs. 23.26 mm), and smaller overbite (1.21 mm vs. 2.75 mm) than patients without psychological distress. Male patients with hyperdivergent pattern and open bite were more likely to have psychological distress. None of the parameters showed statistical differences across groups in females. Frankfort-mandibular plane angle (r = 0.235), Bjork's sum (r = 0.311), AFH (r = 0.322), overbite (r = -0.238), AFH/posterior facial height (r = 0.251), and upper anterior facial height (UAFH)/lower anterior facial height (LAFH) (r = -0.230) were correlated with K10 score in males. After adjusting gender and age, the AFH (B = 0.147) and UAFH/LAFH (B = -14.923) were significantly related with the K10 score. Conclusion: Psychological distress was mainly correlated with hyperdivergent pattern, open bite, and larger lower anterior facial height proportion in pretreatment orthodontic patients. Orthodontists should be aware of the possible underlying psychological distress in patients with specific craniomaxillofacial features. Clinical assessment of psychological distress may need to take into account gender differences in patients.