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1.
Neuroimage ; 297: 120690, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38880309

RESUMO

A fundamental question in the study of happiness is whether there is neural evidence to support a well-known hypothesis that happy people are always similar while unfortunate people have their own misfortunes. To investigate this, we employed several happiness-related questionnaires to identify potential components of happiness, and further investigated and confirmed their associations with personality, mood, aggressive behaviors, and amygdala reactivity to fearful faces within a substantial sample size of college students (n = 570). Additionally, we examined the functional and morphological similarities and differences among happy individuals using the inter-subject representational similarity analysis (IS-RSA). IS-RSA emphasizes the geometric properties in a high-dimensional space constructed by brain or behavioral patterns and focuses on individual subjects. Our behavioral findings unveiled two factors of happiness: individual and social, both of which mediated the effect of personality traits on individual aggression. Subsequently, mood mediated the impact of happiness on aggressive behaviors across two subgroup splits. Functional imaging data revealed that individuals with higher levels of happiness exhibited reduced amygdala reactivity to fearful faces, as evidenced by a conventional face-matching task (n = 104). Moreover, IS-RSA demonstrated that these participants manifested similar neural activation patterns when processing fearful faces within the visual pathway, but not within the emotional network (e.g., amygdala). Morphological observations (n = 425) indicated that individuals with similar high happiness levels exhibited comparable gray matter volume patterns within several networks, including the default mode network, fronto-parietal network, visual network, and attention network. Collectively, these findings offer early neural evidence supporting the proposition that happy individuals may share common neural characteristics.

2.
Opt Express ; 32(5): 7633-7639, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38439440

RESUMO

We present an optical parametric chirped-pulse amplification (OPCPA) based on mixed cascaded crystals, taking advantage of the unique parametric phase-matching of lithium triborate (LiB3O5, LBO) and yttrium calcium oxyborate ((YCa4O(BO3)3, YCOB) crystals. The OPCPA properties of LBO at 880 nm and YCOB at 750 nm are studied respectively. After amplification by two LBO and two YCOB crystals, a total signal gain of 108 and spectral bandwidth close to 400 nm is obtained. After accurate dispersion compensation with a grating-pair compressor and chirped mirror compensator, a pulse duration of 9.4 fs is obtained by a SHG-frequency-resolved optical grating (FROG). This approach will be of great significance in high energy amplifier for high peak power few-cycle laser sources.

3.
Sensors (Basel) ; 24(9)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38732796

RESUMO

Gait speed and timed-up-and-go (TUG) predict cognitive decline, falls, and mortality. Dual-tasks may be useful in cognitive screening among people living with dementia (PWD), but more evidence is needed. This cross-sectional study aimed to compare single- and dual-task performance and determine the influence of dementia severity on dual-task performance and interference. Thirty PWD in two residential care facilities (Age: 81.3 ± 7.1 years; Montreal Cognitive Assessment: 10.4 ± 6.0 points) completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backward), single- (walk 4 m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)), and dual-task functional mobility (TUG while completing a category task) with APDM inertial sensors. Dual-tasks resulted in greater sway frequency, jerk, and sway area; slower gait speed; greater double limb support; shorter stride length; reduced mid-swing elevation; longer TUG duration; reduced turn angle; and slower turn velocity than single-tasks (ps < 0.05). Dual-task performance was impacted (reduced double limb support, greater mid-swing elevation), and dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild PWD. Moderate-to-severe PWD had poorer dynamic stability and a reduced ability to appropriately select a cautious gait during dual-tasks than those with mild PWD, indicating the usefulness of dual-tasks for cognitive screening.


Assuntos
Demência , Marcha , Postura , Humanos , Masculino , Demência/fisiopatologia , Projetos Piloto , Marcha/fisiologia , Feminino , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Postura/fisiologia , Análise e Desempenho de Tarefas , Instituições Residenciais , Equilíbrio Postural/fisiologia , Índice de Gravidade de Doença , Acidentes por Quedas/prevenção & controle
4.
Eur Radiol ; 33(12): 8669-8681, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37368105

RESUMO

OBJECTIVES: This study aimed to investigate the efficacy and safety of transarterial chemoembolization (TACE) plus camrelizumab, a monoclonal antibody targeting programmed death-1, and apatinib for patients with intermediate and advanced hepatocellular carcinoma (HCC) in a real-world setting. METHODS: A total of 586 HCC patients treated with either TACE plus camrelizumab and apatinib (combination group, n = 107) or TACE monotherapy (monotherapy group, n = 479) were included retrospectively. Propensity score matching analysis was used to match patients. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and safety in the combination group were described in comparison to monotherapy. RESULTS: After propensity score matching (1:2), 84 patients in the combination group were matched to 147 patients in the monotherapy group. The median age was 57 years and 71/84 (84.5%) patients were male in the combination group, while the median age was 57 years with 127/147 (86.4%) male in the monotherapy group. The median OS, PFS, and ORR in the combination group were significantly higher than those in the monotherapy group (median OS, 24.1 vs. 15.7 months, p = 0.008; median PFS, 13.5 vs. 7.7 months, p = 0.003; ORR, 59.5% [50/84] vs. 37.4% [55/147], p = 0.002). On multivariable Cox regression, combination therapy was associated with significantly better OS (adjusted hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.26-0.64; p < 0.001) and PFS (adjusted HR, 0.52; 95% CI, 0.37-0.74; p < 0.001). Grade 3 or 4 adverse events occurred in 14/84 (16.7%) and 12/147 (8.2%) in the combination and monotherapy groups, respectively. CONCLUSIONS: TACE plus camrelizumab and apatinib showed significantly better OS, PFS, and ORR versus TACE monotherapy for predominantly advanced HCC. CLINICAL RELEVANCE STATEMENT: Compared with TACE monotherapy, TACE plus immunotherapy and molecular targeted therapy showed better clinical efficacy for predominantly advanced HCC patients, with a higher incidence of adverse events. KEY POINTS: • This propensity score-matched study demonstrates that TACE plus immunotherapy and molecular targeted therapy have a longer OS, PFS, and ORR compared with TACE monotherapy in HCC. • Grade 3 or 4 adverse events occurred in 14/84 (16.7%) patients treated with TACE plus immunotherapy and molecular targeted therapy compared with 12/147 (8.2%) patients in the monotherapy group, while no grade 5 adverse events were observed in all cohorts.


Assuntos
Antineoplásicos , Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Antineoplásicos/uso terapêutico , Quimioembolização Terapêutica/efeitos adversos , Pontuação de Propensão , Estudos Retrospectivos
5.
Eur Radiol ; 32(11): 7335-7343, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35776182

RESUMO

OBJECTIVES: To investigate the efficacy and safety of dicycloplatin as chemotherapeutic regimen in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). METHODS: In this randomized, open-label, phase II trial, patients with unresectable HCC who were TACE treatment-naïve or experienced recurrence after surgical resection or ablation were enrolled at 7 centers in China from March 2019 to November 2019. Participants were randomly assigned (1:1:1) to receive TACE with chemotherapeutic regimen of dicycloplatin alone (group A1), dicycloplatin plus epirubicin (group A2), or epirubicin alone (group B). The primary endpoint was objective response rate (ORR). The secondary endpoints included disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), and safety. RESULTS: The ORR at 6 months in group A1 (n = 22) was significantly better than that in group B (p = 0.093; 90% confidence interval [CI], 1.03-9.45). The DCR in group A1 was significantly higher than that in group B (p = 0.045; 90% CI, 1.29-12.88). There was no significant difference in DOR among the groups (p = 0.271). The median PFS were 6.00 and 3.05 months in groups A2 (n = 25) and B (n = 24), respectively (p = 0.061). Grade 3 or worse adverse events were similar among groups in the safety population (p = 0.173). CONCLUSION: TACE with dicycloplatin was comparably safe and well tolerable as epirubicin alone in patients with unresectable HCC. Compared with epirubicin alone, significant improvement in ORR and DCR when dicycloplatin was applied, as well as prolonged PFS when dicycloplatin plus epirubicin was applied, was generated. KEY POINTS: • To our knowledge, this is the first multicenter randomized trial to assess the efficacy and safety of TACE with dicycloplatin in patients with unresectable HCC. • This phase II trial showed that TACE with dicycloplatin alone or plus epirubicin was comparably safe and well tolerable as epirubicin alone. • Significant improvements in ORR, DCR when dicycloplatin was applied, and prolonged PFS when dicycloplatin plus epirubicin was applied were recorded compared with epirubicin alone.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Epirubicina/uso terapêutico , Resultado do Tratamento
6.
J Vasc Interv Radiol ; 32(7): 974-982, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33862196

RESUMO

PURPOSE: To evaluate the current status of women interventional radiologists in China and discuss possible measures to boost their representation in this male-dominated field for a more diverse workplace environment in the future. MATERIALS AND METHODS: The list of Chinese interventional radiologists obtained from the Chinese College of Interventionalists was retrospectively reviewed. Key information was extracted from the database, including sex, chronologic trends of representation of women interventional radiologists, position, education level, geographic distribution, interventional radiology (IR) practice time, departmental affiliation, and hospital classification. RESULTS: Of the 13,855 entries, 7,324 (52.9%) were interventional radiologists having valid information. Among them, 684 (9.3%) were identified as women. The number of women interventional radiologists has continued to increase since the first woman registered in 1992. The average age of women interventional radiologists was 39.1 years ± 5.7 (range, 26-50). The majority of them were attending physicians (n = 280; 40.9%) with a bachelor's degree (n = 363; 53.1%). Most women interventional radiologists (n = 215, 31.4%) joined this specialty 5-9 years after becoming physicians, whereas 128 (18.7%) started practicing IR from the very beginning. A total of 42.4% of women interventional radiologists were from the departments of IR and cardiology. CONCLUSIONS: Although the total number shows an upward trend, women interventional radiologists are still underrepresented. Education level, geographic areas, and other socioeconomic factors may simultaneously influence the population size of women interventional radiologists in China.


Assuntos
Benchmarking , Radiologistas , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiologia Intervencionista , Estudos Retrospectivos
7.
Arterioscler Thromb Vasc Biol ; 40(11): 2776-2784, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32814439

RESUMO

OBJECTIVE: We aimed to characterize circulating HMGB1 (high-mobility group box-1) levels, one of the better-characterized damage-associated molecular patterns, with respect to age, sex, and race in the general population, and investigate the longitudinal associations of HMGB1 with inflammatory markers, obesity, and preclinical markers of cardiovascular disease. Approach and Results: The analyses included 489 participants (50% Blacks, aged 24.6±3.3 years at the first visit) with up to 4 follow-up visits (1149 samples) over a maximum of 8.5 years. Systolic blood pressure, diastolic blood pressure, carotid-femoral pulse wave velocity, and carotid intima-media thickness together with plasma HMGB1, hs-CRP (high-sensitivity C-reactive protein), IFN-γ (interferon-γ), IL-6 (interleukin-6), IL-10 (interleukin-10), and TNF-α (tumor necrosis factor-α) were measured at each visit. At baseline, plasma HMGB1 concentrations were higher in Blacks compared with Whites (3.86 versus 3.20 ng/mL, P<0.001), and in females compared with males (3.75 versus 3.30 ng/mL, P=0.005). HMGB1 concentrations increased with age (P=0.007), and higher levels of obesity measures (P<0.001). Without adjustment for age, sex, race, and body mass index, HMGB1 concentrations were positively associated with hs-CRP, IL-6, TNF-α, systolic blood pressure, diastolic blood pressure, and carotid-femoral pulse wave velocity (P<0.05) but not IL-10, IFN-γ or carotid intima-media thickness. After covariate adjustments, the associations of HMGB1 with hs-CRP, and carotid-femoral pulse wave velocity remained statistically significant (P<0.05). CONCLUSIONS: This study demonstrates the age, sex, and race differences in circulating HMGB1. The increasing circulating concentrations of HMGB1 with age suggest a potential role of HMGB1 in the pathogenesis of chronic low-grade inflammation, obesity, and subclinical cardiovascular disease risk.


Assuntos
Doenças Cardiovasculares/sangue , Proteína HMGB1/sangue , Inflamação/sangue , Obesidade/sangue , Adulto , Negro ou Afro-Americano , Fatores Etários , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Feminino , Georgia/epidemiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Inflamação/diagnóstico , Inflamação/etnologia , Estudos Longitudinais , Masculino , Obesidade/diagnóstico , Obesidade/etnologia , Prognóstico , Fatores Raciais , Medição de Risco , Fatores Sexuais , Fatores de Tempo , Regulação para Cima , População Branca , Adulto Jovem
8.
J Thromb Thrombolysis ; 52(4): 1094-1100, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33988823

RESUMO

Impact of pandemic on the incidence of venous thromboembolism (VTE) in non-COVID-19 patients is undetermined. Thus, a nationwide multicenter retrospective survey was conducted to evaluate the disease burden in non-COVID-19 population. This multi-center survey involved 94 hospitals from 24 provinces in the mainland of China, and collected data on non-COVID-19 patients admitted to the radiology departments due to VTE between January 24 and April 16, 2020. Baseline characteristics, VTE risk factors, clinical manifestations and the treatments were compared with those in the same period of 2019. 3,358 patients with VTE from 74 hospitals were included in this study (1,458 in 2020, 1,900 in 2019). Most aged ≥ 50 years (80.6% in the pandemic, 81.2% in 2019). The number of patients aged 30-39 years increased from 3.9% in 2019 period to 5.8% in the pandemic (p = 0.009). Among the VTE risk factors, the rate of decreased activity increased significantly in the pandemic, and was much higher than that in 2019 (30.7% vs 22.6%, p < 0.0001). Under the risk of decreased activity, patients with comorbidities chronic diseases, especially diabetes, showed significantly a higher incidence of VTE (30.4% vs 22.0%, p < 0.0001). In the pandemic period, fewer patients were treated with anticoagulation alone (33.5% vs 36.7%, p = 0.05), and more underwent inferior vena cava filter (IVCF) implantation, compared with those in 2019 (66.5% vs 63.2%, p = 0.046). The pandemic increased the VTE risk of decreased activity among the non-COVID-19 population. Patients with comorbidities, especially diabetes, have a significant higher risk of VTE during the pandemic.


Assuntos
Pandemias , Filtros de Veia Cava , Tromboembolia Venosa , Adulto , COVID-19 , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Tromboembolia Venosa/epidemiologia
9.
Appl Opt ; 60(7): 2056-2061, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33690298

RESUMO

The temporal contrast of ultrashort and ultraintense laser pulses can significantly influence the laser-plasma interactions. As the optical parametric chirped pulse amplification (OPCPA) has been widely adopted in these laser facilities, the inherent optical parametric fluorescence, exhibiting a pedestal in the time window of the pump pulse, has become a significant problem. In this paper, we investigated experimentally its influence on the contrast of the compressed pulses at 808 nm using a multistage OPCPA amplifier. Compared to the highest value of 108 ever reported in the literature for such a type of regime, by adjusting the pump energy allocation between OPCPA stages and controlling the gain of small signal regime, we for the first time, to the best of our knowledge, realized a 1011 temporal contrast in a pure nanosecond OPCPA design at a gain exceeding 7×108, without adopting any other noise cleaning methods, such as picosecond OPCPA, cross-polarized wave generation, etc. This indicates that the OPCPA has a very significant potential for contrast improvement and to become a candidate for the future high-energy amplifiers in ultrashort high-power laser facilities.

10.
Perception ; 50(10): 842-860, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34623190

RESUMO

It is well known that adults spontaneously classify people into social categories and this categorization in turn guides their cognition and behavior. A wealth of research has examined how people perceive race and investigated the effect of race on social behavior. But what about race encoding? Although considerable behavioral research has investigated the encoding of race, that is, the social categorization by race, the neural underpinning of it is largely underexplored. To investigate the time course of race encoding, the current study employed a modified category verification task and a multivariate analyzing approach. We found that racial information became decodable from event-related potential topographies as early as about 200 ms after stimulus onset. At this stage, the brain can differentiate different races in a task-relevant manner. Nonetheless, it is not until 100 ms later that racial information is encoded in a socially relevant manner (own- versus other-race). Importantly, perceptual differentiation not only occurs before the encoding of the race but actually influences it: the faces that are more easily perceptually categorized are actually encoded more readily. Together, we posit that the detection and the encoding of race are decoupled although they are not completely independent. Our results provide powerful constraints toward the theory-building of race.


Assuntos
Reconhecimento Facial , Encéfalo , Potenciais Evocados , Humanos , Reconhecimento Visual de Modelos , Grupos Raciais
11.
Int J Obes (Lond) ; 44(5): 1152-1163, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31754238

RESUMO

INTRODUCTION: Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children. METHODS: One hundred and seventy-five inactive children with overweight or obesity (8-11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day, n = 90) or a sedentary control condition (n = 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8-12 months later. Intent-to-treat analyses were conducted using mixed models. RESULTS: The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VÈ®2 peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (-1.8 (-2.4, -1.1) vs. -0.8 (-1.5, -0.1)%), each p = 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. -0.028 (-0.083, 0.023) mmol/L, p < 0.0001). There was no group × time effect on other outcomes at 8 months, or on any outcomes at follow-up. The change in PWV at 8 months correlated with changes in insulin and insulin resistance (both r = 0.32), diastolic BP (r = 0.24), BMI (r = 0.22), and adiposity (r = 0.18). CONCLUSIONS: Eight months of aerobic exercise training improved fitness, adiposity, and HDL-cholesterol levels, but did not reduce arterial stiffness in children with excess weight. PWV improved as a function of insulin resistance, BP, BMI, and adiposity. Weight loss may be required to improve arterial stiffness. Exercise benefits waned after discontinuing the program.


Assuntos
Exercício Físico/fisiologia , Obesidade Infantil , Rigidez Vascular/fisiologia , Pressão Sanguínea/fisiologia , Criança , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Sobrepeso/fisiopatologia , Sobrepeso/terapia , Obesidade Infantil/fisiopatologia , Obesidade Infantil/terapia , Análise de Onda de Pulso
12.
Opt Lett ; 45(8): 2279-2282, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32287213

RESUMO

The spatiotemporal plasma-lens filter proposed here enhances the temporal contrast of the ultrashort pulse laser by combining plasma optics and spatial filtering. Experimentally, the spatiotemporal plasma-lens filter has improved the temporal contrast by 2 orders of magnitude with 80% laser transmission efficiency under a 1 Hz repetitive laser operation. Not only were the pre-pulse and the pedestal cleaned out, but also the rising edge of the main pulse was sharpened.

13.
Pediatr Res ; 87(3): 602-607, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31574531

RESUMO

BACKGROUND: Chocolate intake has shown cardiometabolic health benefits. Whether chocolate has any effect on cellular aging remains unknown. We aimed to test the hypothesis that higher chocolate intake is associated with longer leukocyte telomere length (LTL) in adolescents. METHODS: A total of 660 adolescents (aged 14-18 years) were included in the analysis. The chocolate intake was assessed by 7-day, 24-h dietary recalls and split into three groups, which were none, <2 servings/week, and 2 servings/week or more. LTL (T/S ratio) was determined by a modified quantitative polymerase chain reaction-based assay. RESULTS: Among the 660 adolescents, 58% did not take any chocolate, 25% consumed <2 servings/week, and 17% consumed ≥2 servings/week. Compared to non-consumers, adolescents who consumed chocolate of ≥2 servings/week had 0.27 standard deviation (SD) longer LTL (p = 0.014). Higher chocolate consumption was associated with increased apolipoprotein A1 (ApoA1) (p = 0.038) and ApoA1/high-density lipoprotein (HDL) (p = 0.046). Moreover, higher ApoA1/HDL levels were correlated with longer LTL (p = 0.026). CONCLUSION: Adolescents who consume 2 servings/week or more of chocolate candy have longer LTL compared with non-consumers, and ApoA1/HDL pathway may be involved in this relationship.


Assuntos
Comportamento do Adolescente , Chocolate , Comportamento Alimentar , Homeostase do Telômero , Adolescente , Fatores Etários , Apolipoproteína A-I/sangue , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Lipoproteínas HDL/sangue , Masculino , Tamanho da Porção de Referência
14.
J Vasc Interv Radiol ; 31(6): 876-881, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32340864

RESUMO

The outbreak of coronavirus disease 2019 (COVID-19) in late December 2019 in Wuhan, China, has been characterized as a "pandemic" by the World Health Organization and has resulted in 81,603 confirmed cases in China, among the 334,981 cases confirmed in 189 countries as of 09:00 am, March 24, 2020 (China central standard time). During the past 3 months, hundreds of thousands of Chinese health care workers, including interventional radiologists (IRs), have been fighting this battle against the horrifying COVID-19 disease. As IRs, what should we know and what can we do when facing this challenge? This paper shares the experience we have gone through.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Radiologia Intervencionista/métodos , COVID-19 , Humanos , Radiologistas
15.
Dysphagia ; 35(4): 725-732, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31773333

RESUMO

Currently, there are no recommendations or guidelines concerning the preferred diameter of esophageal stents for palliative treatment, owing to the lack of adequate evidence. We therefore conducted a retrospective cohort study to evaluate whether 18 mm stents would achieve a similar function of dysphagia relief with fewer complications and longer survival compared to 20 mm stents. Esophageal cancer patients who underwent 125 iodine seed-loaded stent placement with a diameter of either 18 mm (n = 103) or 20 mm (n = 54) were included at five hospitals in China. The stabilized inverse probability of treatment weighting (IPTW) was used to control potential confounding factors and bias that are inherent in a retrospective study. The primary endpoint was dysphagia relief. Stent-related complications and overall survival were assessed as the secondary endpoints. In the IPTW-adjusted analysis, no significant difference was found in the dysphagia score between the two groups either at 1 week after stent placement or at the last week before death. Despite a comparable rate of overall complications, there was a significantly lower incidence of severe retrosternal pain (15.4% vs. 32.7%, p = 0.013) and a trend toward longer survival (median survival, 176 days [95% confidence interval (CI) 144 to 209] vs. 109 days [92 to 126], p = 0.057) in the 18 mm group. An irradiated stent with a diameter of 18 mm showed a similar outcome of dysphagia relief to that achieved with a 20 mm diameter stent, but halved the incidence of retrosternal pain after stent placement.


Assuntos
Transtornos de Deglutição/tratamento farmacológico , Stents Farmacológicos , Desenho de Equipamento , Neoplasias Esofágicas/complicações , Radioisótopos do Iodo/administração & dosagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Estudos Retrospectivos , Resultado do Tratamento
16.
J Trauma Nurs ; 27(3): 131-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32371728

RESUMO

Chronic stress and accelerated aging have been shown to impact the inflammatory response and related outcomes like sepsis and organ failure, but data are lacking in the trauma literature. The purpose of this study was to investigate potential relationships between pretrauma stress and posttrauma outcomes. The hypothesis was that pretrauma chronic stress accelerates aging, which increases susceptibility to posttrauma sepsis and organ failure. In this prospective, correlational study, chronic stress and accelerated biologic aging were compared to the occurrence of systemic inflammatory response syndrome, sepsis, and organ failure in trauma patients aged 18-44 years. Results supported the hypothesis with significant overall associations between susceptibility to sepsis and accelerated biologic aging (n = 142). There were also significant negative associations between mean cytokine levels and chronic stress. The strongest association was found between mean interleukin-1ß (IL-1ß) and human telomerase reverse transcriptase (hTERT), r(101) = -0.28), p = .004. Significant negative associations were found between mean cytokine levels, IL-12p70, r(108) = -0.20, p = .034; and tumor necrosis factor-α (TNF-α), r(108) = -0.20, p = .033, and positive life events via the behavioral measure of chronic stress. Results may help identify individuals at increased risk for poor outcomes of trauma and inform interventions that may reduce the risk for sepsis and organ failure.


Assuntos
Envelhecimento/fisiologia , Insuficiência de Múltiplos Órgãos/fisiopatologia , Sepse/fisiopatologia , Estresse Psicológico/fisiopatologia , Ferimentos e Lesões/complicações , Ferimentos e Lesões/fisiopatologia , Adolescente , Adulto , Fatores Etários , Doença Crônica , Currículo , Educação Médica Continuada , Feminino , Humanos , Interleucina-1beta/sangue , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Sepse/etiologia , Estresse Psicológico/etiologia , Telomerase/sangue , Fatores de Tempo , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem
17.
Opt Express ; 27(12): 16812-16822, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31252901

RESUMO

A novel chromatic aberration pre-compensation scheme for ultrashort petawatt laser systems was proposed. The pre-compensation scheme consists of a convex lens, group of concave lenses, and a spherical reflector combined with a conventional vacuum chamber. It provides a versatile method to accurately compensate the chromatic aberration of an entire laser system via controlling the amount of propagation time delay (PTD) induced by the compensator without changing the input and output beam size. A compensator, tailored based on the proposed scheme, was designed and experimentally evaluated for the Shen-Guang-II 5PW (SG-II 5PW) laser system at Shanghai Institute of Optics and Fine Mechanics (SIOM). The experimental results verified that chromatic aberration in the laser system was almost fully compensated: the size of laser beam focused by an f/2.42 off-axis parabolic mirror (OAP) was reduced tremendously from 32×18µm2to about 4×4µm2at full width at half maximum (FWHM). The proposed scheme provides the flexibility to accurately correct chromatic aberration in high-power laser systems within a wide dynamic range.

18.
J Vasc Interv Radiol ; 30(8): 1233-1241.e1, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31208946

RESUMO

PURPOSE: To establish a nomogram for predicting the occurrence of early biliary infection (EBI) after percutaneous transhepatic biliary stent (PTBS) placement in malignant biliary obstruction (MBO). MATERIALS AND METHODS: In this multicenter study, patients treated with PTBS for MBO were allocated to a training cohort or a validation cohort. The independent risk factors for EBI selected by multivariate analyses in the training cohort were used to develop a predictive nomogram. An artificial neural network was applied to assess the importance of these factors in predicting EBI. The predictive accuracy of this nomogram was determined by concordance index (c-index) and a calibration plot, both internally and externally. RESULTS: A total of 243 patients (training cohort: n = 182; validation cohort: n = 61) were included in this study. The independent risk factors were length of obstruction (odds ratio [OR], 1.061; 95% confidence interval [CI], 1.013-1.111; P = .012), diabetes (OR, 5.070; 95% CI, 1.917-13.412; P = .001), location of obstruction (OR, 2.283; 95% CI, 1.012-5.149; P = .047), and previous surgical or endoscopic intervention (OR, 3.968; 95% CI, 1.709-9.217; P = .001), which were selected into the nomogram. The c-index values showed good predictive performance in the training and validation cohorts (0.792 and 0.802, respectively). The optimum cutoff value of risk was 0.25. CONCLUSIONS: The nomogram can facilitate the early and accurate prediction of EBI in patients with MBO who underwent PTBS. Patients with high risk (> 0.25) should be administered more effective prophylactic antibiotics and undergo closer monitoring.


Assuntos
Colestase/terapia , Técnicas de Apoio para a Decisão , Neoplasias do Sistema Digestório/complicações , Drenagem/efeitos adversos , Nomogramas , Infecções Relacionadas à Prótese/etiologia , Stents/efeitos adversos , Idoso , Antibioticoprofilaxia , China , Colestase/diagnóstico por imagem , Colestase/etiologia , Tomada de Decisão Clínica , Neoplasias do Sistema Digestório/diagnóstico por imagem , Drenagem/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Seleção de Pacientes , Valor Preditivo dos Testes , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/prevenção & controle , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
19.
J Vasc Interv Radiol ; 30(3): 330-338, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30819473

RESUMO

PURPOSE: To construct the albumin-bilirubin (ALBI) grade and the Child-Turcotte-Pugh (CTP) score based on nomograms, as well as to develop an artificial neural network (ANN) to compare the prognostic performance of the 2 scores for hepatocellular carcinoma (HCC) that has undergone transarterial chemoembolization. MATERIALS AND METHODS: This multicentric retrospective study included patients with HCC who underwent transarterial chemoembolization monotherapy as an initial treatment at 4 institutions between January 2008 and December 2016. In the training cohort, significant risk factors associated with overall survival (OS) were identified by univariate and multivariate analyses. The prognostic nomograms and ANN were established and then validated in 2 validation cohorts. RESULTS: A total of 838 patients (548, 115, and 175 in the training cohort and validation cohorts 1 and 2, respectively) were included. The median OS was 10.4, 15.7, and 9.2 months in the training cohort and validation cohorts 1 and 2, respectively. In the training cohort, both ALBI grade and CTP score were identified as significant risk factors. The ALBI grade and CTP score based on nomograms were established separately and showed similar prognostic performance when assessed externally in validation cohorts (C-index in validation cohort 1: 0.823 vs 0.802, P = .417; in validation cohort 2: 0.716 vs 0.729, P = .793). ANN showed that ALBI grade had higher importance on survival prediction than CTP score. CONCLUSIONS: ALBI grade performs at least no worse than CTP score regarding survival prediction for HCC receiving transarterial chemoembolization. Considering the easy application, ALBI grade has the potential to be regarded as an alternative to CTP score.


Assuntos
Bilirrubina/sangue , Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Técnicas de Apoio para a Decisão , Neoplasias Hepáticas/terapia , Redes Neurais de Computação , Nomogramas , Albumina Sérica Humana/metabolismo , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/mortalidade , China , Feminino , Humanos , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
20.
Oral Dis ; 25(5): 1403-1413, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30912231

RESUMO

OBJECTIVES: Vitamin D deficiency/insufficiency is a worldwide public health issue that has been linked to numerous inflammatory disorders, including periodontitis. There is increasing support for a role for adequate vitamin D levels in overall health. Populations with darker skin color have a higher prevalence of vitamin D deficiency/insufficiency and periodontitis. The purpose of this small pilot study was to investigate the influence of 12 weeks of 25(OH)D vitamin D supplementation (VDS) on mediators of systemic inflammation in dark-skinned, periodontitis patients. MATERIALS AND METHODS: A total of 23 patients with moderate to severe periodontitis were randomly assigned to the vitamin D group or placebo group and received intensive single visit scaling and root planning to elicit a systemic inflammatory response. RESULTS: Vitamin D supplementation increased serum 25(OH)D levels approximately 2-fold over baseline levels; moreover, VDS group had reduced peripheral blood CD3 and CD3+CD8+ cytotoxic T lymphocyte (CTLs) counts and reduced pro-inflammatory salivary cytokines. In contrast, VDS group had higher levels of the autophagy-related proteins and other proteins crucial for anti-microbial autophagy in whole blood PBMCs. CONCLUSION: In conclusion, VDS has multiple benefits for reducing systemic inflammation and promoting induction of autophagy-related proteins related to anti-microbial functions.


Assuntos
Mediadores da Inflamação/sangue , Inflamação/etiologia , Periodontite , Deficiência de Vitamina D , Vitamina D/administração & dosagem , Suplementos Nutricionais , Humanos , Inflamação/sangue , Projetos Piloto , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/imunologia , Vitaminas/uso terapêutico
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