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1.
Small Methods ; : e2400794, 2024 Sep 09.
Article in English | MEDLINE | ID: mdl-39246134

ABSTRACT

BiVO4 has garnered substantial interest as a promising photoanode material for photoelectrochemical water-splitting due to its narrow band gap and appropriate band edge positions for water oxidation. Nevertheless, its practical use has been impeded by poor charge transport and sluggish water oxidation kinetics. Here, a hybrid composite photoanode is fabricated by uniformly embedding SnS2 nanoparticles near the surface of a BiVO4 thin film, creating a type II heterostructure with strong interactions between the nanoparticles and the film for efficient charge separation. This structure forms via eutectic melting during atomic layer deposition of SnS2 with subsequent phase separation between SnS2 and BiVO4 at room temperature, offering greater advantages and flexibilities over conventional exsolution techniques. Furthermore, the SnS2/BiVO4 hybrid composite is coated with a thin amorphous ZnS passivation layer to accelerate charge transfer process and enhance long-term stability. The optimized BiVO4/SnS2/ZnS photoanode exhibits a photocurrent density of 5.44 mA cm-2 at 1.23 V versus RHE, which is 2.73 times higher than that of the BiVO4 photoanode, and a dramatic improvement in photostability retention at 1.23 V versus RHE, increasing from 55% to 91% over 24 hours. This method of anchoring nanoparticles onto host materials proves highly valuable for energy and environmental applications.

2.
Nat Mater ; 2024 Aug 28.
Article in English | MEDLINE | ID: mdl-39198713

ABSTRACT

Novel two-dimensional semiconductor crystals can exhibit diverse physical properties beyond their inherent semiconducting attributes, making their pursuit paramount. Memristive properties, as exemplars of these attributes, are predominantly manifested in wide-bandgap materials. However, simultaneously harnessing semiconductor properties alongside memristive characteristics to produce memtransistors is challenging. Herein we prepared a class of semiconducting III-V-derived van der Waals crystals, specifically the HxA1-xBX form, exhibiting memristive characteristics. To identify candidates for the material synthesis, we conducted a systematic high-throughput screening, leading us to 44 prospective III-V candidates; of these, we successfully synthesized ten, including nitrides, phosphides, arsenides and antimonides. These materials exhibited intriguing characteristics such as electrochemical polarization and memristive phenomena while retaining their semiconductive attributes. We demonstrated the gate-tunable synaptic and logic functions within single-gate memtransistors, capitalizing on the synergistic interplay between the semiconducting and memristive properties of our two-dimensional crystals. Our approach guides the discovery of van der Waals materials with unique properties from unconventional crystal symmetries.

3.
Food Sci Biotechnol ; 33(12): 2755-2760, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39184985

ABSTRACT

This study represents a visual detection for total biogenic monoamines with naked eye as a simple and rapid semi-quantitative method for biogenic amine monitoring. The equivalent reaction of H2O2 with ascorbic acid resulted in color development by an amine oxidase-peroxidase coupling reaction in the samples containing the biogenic monoamines higher than the subjected ascorbic acid by 10 µM. Upon employing the commercial doenjang extracts as a model food, an additional heating step was requested, and the expected ranges for the biogenic monoamines from 360 to 480 µM covered the real contents of the samples (360.2-407.3 µM). Therefore, this visual detection method makes it possible to decide with naked eye whether the sample contains the biogenic monoamines higher than the ascorbic acid supplemented as much as a control level on manufacturing sites without instrumental analysis.

4.
Microb Pathog ; 195: 106875, 2024 Aug 20.
Article in English | MEDLINE | ID: mdl-39173849

ABSTRACT

This study evaluated the probiotic properties, safety profile, and antioxidative and immune system-enhancing effects of Enterococcus faecium strains isolated from human infant feces. E. faecium KU22001, E. faecium KU22002, and E. faecium KU22005 exhibited potential probiotic properties; however, to eliminate concerns about toxin production and antibiotic resistance, the E. faecium strains were heat-treated prior to experimental usage. E. faecium KU22001 showed the highest antioxidant activity and lowest reactive oxygen species production among the three strains. The immune system-enhancing effects of heat-killed E. faecium strains were evaluated using a nitric oxide assay. E. faecium KU22001 induced an increase in the mRNA expression of inducible nitric oxide synthase, cyclooxygenase-2, and proinflammatory cytokines, including tumor necrosis factor-α, interleukin-1ß, and interleukin-6 in RAW 264.7 cells. Furthermore, E. faecium KU22001 activated the mitogen-activated protein kinase pathway, which was a key regulator of the immune system. These results demonstrate the potential use of E. faecium KU22001 as a multifunctional food material.

5.
Front Neurol ; 15: 1436127, 2024.
Article in English | MEDLINE | ID: mdl-39119559

ABSTRACT

Objective: In this study, we examined whether vestibular migraine, as a source of increased perceptual uncertainty due to the associated dizziness, interferes with adaptive learning. Methods: The IOWA gambling task (IGT) was used to assess adaptive learning in both healthy controls and patients with migraine-related dizziness. Participants were presented with four decks of cards (A, B, C, and D) and requested to select a card over 100 trials. Participants received a monetary reward or a penalty with equal probability when they selected a card. Card decks A and B (high-risk decks) involved high rewards (win £100) and high penalties (lose £250), whereas C and D (low-risk decks; favorable reward-to-punishment ratio) involved lower rewards (win £50) and penalties (lose £50). Task success required participants to decide (i.e., adaptively learn) through the feedback they received that C and D were the advantageous decks. Results: The study revealed that patients with vestibular migraine selected more high-risk cards than the control group. Chronic vestibular migraine patients showed delayed improvement in task performance than those with acute presentation. Only in acute vestibular migraine patients, we observed that impaired learning positively correlated with measures of dizzy symptoms. Conclusion: The findings of this study have clinical implications for how vestibular migraine can affect behavioural adaption in patients, either directly through altered perception or indirectly by impacting cognitive processes that can result in maladaptive behavior.

6.
Adv Sci (Weinh) ; 11(32): e2404035, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38899829

ABSTRACT

Threshold-switching devices based on amorphous chalcogenides are considered for use as selector devices in 3D crossbar memories. However, the fundamental understanding of amorphous chalcogenide is hindered owing to the complexity of the local structures and difficulties in the trap analysis of multinary compounds. Furthermore, after threshold switching, the local structures gradually evolve to more stable energy states owing to the unstable homopolar bonds. Herein, based on trap analysis, DFT simulations, and operando XPS analysis, it is determined that the threshold switching mechanism is deeply related to the charged state of Se-Se homopolar defects. A threshold switching device is demonstrated with an excellent performance through the modification of the local structure via the addition of alloying elements and investigating the time-dependent trap evolution. The results concerning the trap dynamics of local atomic structures in threshold switching phenomena may be used to improve the design of amorphous chalcogenides.

7.
Langmuir ; 40(23): 12200-12206, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38785373

ABSTRACT

Polyimide is commonly used as a substrate for flexible electronic devices because of its excellent thermal, physical, and electrical properties. To enhance the adhesion between substrates and electrodes, it is necessary to improve the hydrophilic properties of the polyimide. Various surface treatments, such as plasma treatment, laser ablation, and ultraviolet treatments, have been applied for this purpose. In this study, we demonstrated that Cu and Ti ion beam irradiation can temporarily create a superhydrophilic surface on polyimide after irradiation. When Cu or Ti ions bombarded the polyimide, the contact angle changed systematically with the beam current density and over time. We present atomic force microscopy (AFM) data for polyimide irradiated with Cu and Ti ions at different beam current densities and discuss the possible mechanisms behind the changes in the contact angle.

8.
World Neurosurg ; 188: e273-e277, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38777324

ABSTRACT

OBJECTIVE: Radiotherapy is one of the important treatment options for metastatic spinal tumors but is not the definite intervention in all cases, as there are patients who still require surgical treatment because of severe pain or neurologic events after this treatment. We evaluated the perioperative effects of preoperative radiotherapy in these cases as a future guide for surgeons on critical considerations in this period. METHODS: We included 328 patients in this study who had undergone decompression and fusion surgery for metastatic spinal tumors. Patients who underwent surgery with preoperative radiotherapy were designated as the radiotherapy group (group RT, n = 81), and cases of surgery without preoperative radiotherapy were assigned to the non-radiotherapy group (group nRT, n = 247). We compared the demographic, intraoperative, and postoperative factors between these 2 groups. RESULTS: In terms of intraoperative factors, statistically significant differences were evident in operation time, estimated blood loss, and transfusion (RT vs. nRT: 188.1 ± 80.7 minutes vs. 231.2 ± 106.1 minutes, 607.2 ± 532.7 mL vs. 830.1 ± 1324.7 mL, and 30.9% vs. 43.3%, P < 0.001, P < 0.031, and P < 0.048, respectively). With regard to postoperative factors, the incidence of infection, wound problems, and local recurrence were statistically higher in group RT (RT vs. nRT: 6.2% vs. 0.8%, 12.3% vs. 0.8%, 23.4% vs. 13.7%, P = 0.004, P < 0.001, and P = 0.038, respectively). CONCLUSIONS: Preoperative radiotherapy has the intraoperative advantages of reducing bleeding and shortening the operating time, but postoperative caution is needed because of the possibility of infection, wound problems, and local recurrence increases.


Subject(s)
Spinal Neoplasms , Humans , Female , Male , Middle Aged , Spinal Neoplasms/secondary , Spinal Neoplasms/radiotherapy , Spinal Neoplasms/surgery , Aged , Adult , Preoperative Care/methods , Spinal Fusion/methods , Postoperative Complications/epidemiology , Decompression, Surgical/methods , Retrospective Studies , Treatment Outcome , Blood Loss, Surgical , Operative Time , Neoplasm Recurrence, Local
9.
Discov Nano ; 19(1): 83, 2024 May 07.
Article in English | MEDLINE | ID: mdl-38714640

ABSTRACT

We present the first work of the synthesis mechanism from graphene quantum dots (GQDs) to carbon nanotubes (CNTs) by an ion-sputtering assisted chemical vapor deposition. During the annealing process, a Pt thin film deposited by the ion-sputtering was dewetted and agglomerated to form many nanometer-sized particles, leading to Pt nanoparticles (PtNPs) that can act as catalysts for creating carbon allotropes. The shape of the allotropes can be effectively tailored from GQDs to CNTs by controlling three key parameters such as the dose of catalytic ions (D), amounts of carbon source (S), and thermal energy (T). In our work, it was clearly proved that the growth control from GQDs to CNTs has a comparably proportional relationship with D and S, but has a reverse proportional relationship with T. Furthermore, high-purity GQDs without any other by-products and the CNTs with the cap of PtNPs were generated. Their shapes were appropriately controlled, respectively, based on the established synthesis mechanism.

10.
Adv Sci (Weinh) ; 11(25): e2401782, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38654698

ABSTRACT

Water electrolyzers powered by renewable energy are emerging as clean and sustainable technology for producing hydrogen without carbon emissions. Specifically, anion exchange membrane (AEM) electrolyzers utilizing non-platinum group metal (non-PGM) catalysts have garnered attention as a cost-effective method for hydrogen production, especially when integrated with solar cells. Nonetheless, the progress of such integrated systems is hindered by inadequate water electrolysis efficiency, primarily caused by poor oxygen evolution reaction (OER) electrodes. To address this issue, a NiFeCo─OOH has developed as an OER electrocatalyst and successfully demonstrated its efficacy in an AEM electrolyzer, which is powered by renewable electricity and integrated with a silicon solar cell.

11.
J Microbiol Biotechnol ; 34(4): 902-910, 2024 Apr 28.
Article in English | MEDLINE | ID: mdl-38494869

ABSTRACT

The anti-cancer effects of heat-killed Enterococcus faecium KU22001 (KU22001), KU22002, and KU22005 isolated from human infant feces were investigated. The anti-proliferative activity of these strains against various cancer cell lines was evaluated using the MTT assay. To determine the production of exopolysaccharides (EPS) with potential anti-cancer effect, ethanol precipitation and phenol-sulfuric acid method was used with the cell free supernatant of strains grown at 25°C or 37°C. The EPS yield of E. faecium strains was higher at 25°C than at 37°C. Among these E. faecium strains, KU22001 grown at 25°C was associated with the highest bax/bcl-2 ratio, effective apoptosis rate, cell cycle arrest in the G0/G1 phase, and condensation of the nucleus in the cervical cancer HeLa cell line. In conclusion, these results suggest that KU22001 can be beneficial owing to the anti-cancer effects and production of functional materials, such as EPS.


Subject(s)
Antineoplastic Agents , Apoptosis , Enterococcus faecium , Hot Temperature , Humans , HeLa Cells , Apoptosis/drug effects , Antineoplastic Agents/pharmacology , Cell Proliferation/drug effects , Feces/microbiology , Proto-Oncogene Proteins c-bcl-2/metabolism , bcl-2-Associated X Protein/metabolism , Cell Line, Tumor , Cell Cycle Checkpoints/drug effects , Temperature
12.
Sci Rep ; 14(1): 236, 2024 01 02.
Article in English | MEDLINE | ID: mdl-38168485

ABSTRACT

The optokinetic reflex (OKR) serves as a vital index for visual system development in early life, commonly observed within the first six months post-birth in humans. Zebrafish larvae offer a robust and convenient model for OKR studies due to their rapid development and manageable size. Existing OKR assays often involve cumbersome setups and offer limited portability. In this study, we present an innovative OKR assay that leverages the flexible screen of the Samsung Galaxy Z Flip to optimize setup and portability. We conducted paired slow-phase velocity measurements in 5-day post-fertilization (dpf) zebrafish larvae (n = 15), using both the novel flip-phone-based assay and a traditional liquid-crystal display (LCD) arena. Utilizing Bland-Altman plots, we assessed the agreement between the two methods. Both assays were efficacious in eliciting OKR, with eye movement analysis indicating high tracking precision in the flip-phone-based assay. No statistically significant difference was observed in slow-phase velocities between the two assays (p = 0.40). Our findings underscore the feasibility and non-inferiority of the flip-phone-based approach, offering streamlined assembly, enhanced portability, and the potential for cost-effective alternatives. This study contributes to the evolution of OKR assay methodologies, aligning them with emerging research paradigms.


Subject(s)
Nystagmus, Optokinetic , Zebrafish , Animals , Humans , Reflex
13.
Fish Shellfish Immunol ; 144: 109266, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38043872

ABSTRACT

Oncorhynchus mykiss, a significant aquaculture species, possesses compounds with numerous biological and pharmacological functions, including antioxidant, anticancer, anti-microbial, and anti-obesity effects. However, possible anti-inflammatory effects of lipids extracted from O. mykiss eggs on RAW264.7 cells induced by LPS have not been elucidated yet. The current study identified 13 fatty acids in lipids extracted from O. mykiss eggs that contained high amounts (51.92% of total fatty acids) of polyunsaturated fatty acids (PUFAs), especially DHA (33.66%) and EPA (7.77%). These O. mykiss lipids (100-400 µg/mL) showed significant anti-inflammatory effects by inhibiting NO and iNOS expression in LPS-stimulated RAW264.7 cells. They also inhibited expression of pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α, while upregulating anti-inflammatory cytokines IL-10, IL-11, and TGF-ß. These lipids from O. mykiss effectively inhibited LPS-induced expression CD86 as a surface biomarker on RAW264.7 cells. Additionally, O. mykiss lipids suppressed phosphorylation of p38, JNK, and ERK1/2 and the expression of phosphorylated NF-κB subunit p65. These findings indicate that O. mykiss lipids possess anti-inflammatory properties by inhibiting NF-κB and MAPK signaling pathways.


Subject(s)
Fatty Acids , Oncorhynchus mykiss , Animals , Mice , Anti-Inflammatory Agents/pharmacology , Cytokines/genetics , Cytokines/metabolism , Fatty Acids/pharmacology , Inflammation/drug therapy , Lipopolysaccharides , NF-kappa B/genetics , NF-kappa B/metabolism , Oncorhynchus mykiss/metabolism , RAW 264.7 Cells
14.
Small ; 20(18): e2308934, 2024 May.
Article in English | MEDLINE | ID: mdl-38161260

ABSTRACT

Exsolution generates metal nanoparticles anchored within crystalline oxide supports, ensuring efficient exposure, uniform dispersion, and strong nanoparticle-perovskite interactions. Increased doping level in the perovskite is essential for further enhancing performance in renewable energy applications; however, this is constrained by limited surface exsolution, structural instability, and sluggish charge transfer. Here, hybrid composites are fabricated by vacuum-annealing a solution containing SrTiO3 photoanode and Co cocatalyst precursors for photoelectrochemical water-splitting. In situ transmission electron microscopy identifies uniform, high-density Co particles exsolving from amorphous SrTiO3 films, followed by film-crystallization at elevated temperatures. This unique process extracts entire Co dopants with complete structural stability, even at Co doping levels exceeding 30%, and upon air exposure, the Co particles embedded in the film oxidize to CoO, forming a Schottky junction at the interface. These conditions maximize photoelectrochemical activity and stability, surpassing those achieved by Co post-deposition and Co exsolution from crystalline oxides. Theoretical calculations demonstrate in the amorphous state, dopant─O bonds become weaker while Ti─O bonds remain strong, promoting selective exsolution. As expected from the calculations, nearly all of the 30% Fe dopants exsolve from SrTiO3 in an H2 environment, despite the strong Fe─O bond's low exsolution tendency. These analyses unravel the mechanisms driving the amorphous exsolution.

15.
Molecules ; 28(21)2023 Oct 26.
Article in English | MEDLINE | ID: mdl-37959705

ABSTRACT

This study aims to compare the effects of three enzyme-rich foods, including one fermented (grain enzyme) and two non-fermented foods (enzyme foods 1 and 2), by investigating their antioxidant, anti-inflammatory, and anti-adipogenic properties. Grain enzyme exhibited the highest radical scavenging activity and was rich in antioxidant components, including total polyphenol and total flavonoid contents. Grain enzyme and enzyme foods 1 and 2 inhibited nitric oxide production by 27, 34, and 17%, respectively, at a concentration of 200 µg/mL in LPS-stimulated macrophages. Among the tested enzymes, grain enzyme demonstrated the strongest inhibition on the expression of inducible nitric oxide synthase (INOS), cyclooxygenase-2 (COX-2), and interleukin (IL)-1ß, while Enzyme Food 2 exhibited the most significant suppression of IL-6 mRNA levels. Furthermore, Grain Enzyme demonstrated a stronger inhibitory effect compared to Enzyme Food 1 and 2. Grain Enzyme decreased the mRNA expression of peroxisome proliferator-activated receptor (PPAR)γ, CCAAT/enhancer-binding protein (C/EBP)α, and fatty acid-binding protein (FABP)4 by 28, 21, and 30%, respectively, at a concentration of 400 µg/mL. In summary, fermented grain enzymes outperformed non-fermented enzymes in suppressing inflammation and adipogenesis. This study highlights the anti-inflammatory and anti-adipogenic effects of grain enzyme, suggesting its potential as a valuable dietary supplement for managing metabolic disorders.


Subject(s)
Antioxidants , Lipogenesis , Antioxidants/chemistry , Anti-Inflammatory Agents/chemistry , Macrophages , Nitric Oxide Synthase Type II/metabolism , Cyclooxygenase 2/metabolism , RNA, Messenger/metabolism , Nitric Oxide/metabolism , Lipopolysaccharides/pharmacology
16.
ACS Omega ; 8(36): 32794-32803, 2023 Sep 12.
Article in English | MEDLINE | ID: mdl-37720750

ABSTRACT

Copper oxide (Cu2O) has attracted significant interest as an efficient photocathode for photoelectrochemical (PEC) water splitting owing to its abundance, suitable band gap, and band-edge potential. Nevertheless, a high charge recombination rate restricts its practical photoconversion efficiency and reduces the PEC water-splitting performance. To address this challenge, we present the facile electrodeposition of graphene oxide (GO) on the Cu2O photocathode surface. To determine the effect of varying GO weight percentages on PEC performance, varying amounts of GO were deposited on the Cu2O photocathode surface. The optimally deposited GO-Cu2O photocathode exhibited a photocurrent density of -0.39 to -1.20 mA/cm2, which was three times that of a photocathode composed of pristine Cu2O. The surface decoration of Cu2O with GO reduced charge recombination and improved the PEC water-splitting performance. These composites can be utilized in strategies designed to address the challenges associated with low-efficiency Cu2O photocathodes. The physicochemical properties of the prepared samples were comprehensively characterized by field-emission scanning electron microscopy, energy-dispersive spectroscopy, X-ray diffraction, Raman spectroscopy, UV-visible spectroscopy, and X-ray photoelectron spectroscopy. We believe that this research will pave the way for developing efficient Cu2O-based photocathodes for PEC water splitting.

17.
ACS Appl Mater Interfaces ; 15(24): 29259-29266, 2023 Jun 21.
Article in English | MEDLINE | ID: mdl-37289727

ABSTRACT

Quantum dot light-emitting diodes (QLEDs) are promising devices for display applications. Polyethylenedioxythiophene:polystyrene sulfonate (PEDOT:PSS) is a common hole injection layer (HIL) material in optoelectronic devices because of its high conductivity and high work function. Nevertheless, PEDOT:PSS-based QLEDs have a high energy barrier for hole injection, which results in low device efficiency. Therefore, a new strategy is needed to improve the device efficiency. Herein, we have demonstrated a bilayer-HIL using VO2 and a PEDOT:PSS-based QLED that exhibits an 18% external quantum efficiency (EQE), 78 cd/A current efficiency (CE), and 25,771 cd/m2 maximum luminance. In contrast, the PEDOT:PSS-based QLED exhibits an EQE of 13%, CE of 54 cd/A, and maximum luminance of 14,817 cd/m2. An increase in EQE was attributed to a reduction in the energy barrier between indium tin oxide (ITO) and PEDOT:PSS, caused by the insertion of a VO2 HIL. Therefore, our results could demonstrate that using a bilayer-HIL is effective in increasing the EQE in QLEDs.

18.
PLoS One ; 18(4): e0284527, 2023.
Article in English | MEDLINE | ID: mdl-37058497

ABSTRACT

Recent advances in single-cell sequencing techniques have enabled gene expression profiling of individual cells in tissue samples so that it can accelerate biomedical research to develop novel therapeutic methods and effective drugs for complex disease. The typical first step in the downstream analysis pipeline is classifying cell types through accurate single-cell clustering algorithms. Here, we describe a novel single-cell clustering algorithm, called GRACE (GRaph Autoencoder based single-cell Clustering through Ensemble similarity larning), that can yield highly consistent groups of cells. We construct the cell-to-cell similarity network through the ensemble similarity learning framework, and employ a low-dimensional vector representation for each cell through a graph autoencoder. Through performance assessments using real-world single-cell sequencing datasets, we show that the proposed method can yield accurate single-cell clustering results by achieving higher assessment metric scores.


Subject(s)
Biomedical Research , Gene Expression Profiling , Gene Expression Profiling/methods , Algorithms , Cluster Analysis , Single-Cell Analysis
19.
Exp Brain Res ; 241(4): 1199-1206, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36892611

ABSTRACT

Environmental motion can induce physiological stress and trigger motion sickness. In these situations, lower-than-normal levels of adrenocorticotropic hormone (ACTH) have been linked with increased susceptibility to motion sickness in healthy individuals. However, whether patients with primary adrenal insufficiency, who typically have altered ACTH levels compared to the normal population, exhibit alterations in sickness susceptibility remains unknown. To address this, we recruited 78 patients with primary adrenal insufficiency and compared changes in the motion sickness susceptibility scores from 10 years prior to diagnosis (i.e. retrospective sickness rating) with the current sickness measures (post-diagnosis), using the validated motion sickness susceptibility questionnaire (MSSQ). Group analysis revealed that motion sickness susceptibility pre-diagnosis did not differ between controls and patients. We observed that following treatment, current measures of motion sickness were significantly increased in patients and subsequent analysis revealed that this increase was primarily in female patients with primary adrenal insufficiency. These observations corroborate the role of stress hormones in modulating sickness susceptibility and support the notion of a sexually dimorphic adrenal cortex as we only observed selective enhancement in females. A potential mechanism to account for our novel observation remains obscure, but we speculate that it may reflect a complex sex-disease-drug interaction.


Subject(s)
Addison Disease , Motion Sickness , Humans , Female , Sex Characteristics , Retrospective Studies , Motion Sickness/etiology , Adrenocorticotropic Hormone
20.
Medicine (Baltimore) ; 101(38): e30633, 2022 Sep 23.
Article in English | MEDLINE | ID: mdl-36197269

ABSTRACT

We examined the impact of COVID-19 pandemic on the emergency department length of stay (EDLOS) and clinical outcomes of patients with severe pneumonia admitted to the intensive care unit (ICU) through the emergency department (ED). This single-center retrospective observational study included adult patients with pneumonia admitted to the ICU through the ED between January and December 2019 (pre-pandemic) and between March 2020 and February 2021 (during-pandemic). We compared and analyzed the EDLOS by dividing it into pre-, mid-, and post-EDLOS and in-hospital mortality of patients with pneumonia admitted to the ICU according to the time of ED visits before and during the COVID-19 pandemic. Risk factors for in-hospital mortality according to the time of ED visits were analyzed using multiple logistic regression analysis. In total, 227 patients (73 patients pre-pandemic and 154 patients during the pandemic) with pneumonia admitted to the ICU through the ED were analyzed. During the COVID-19 pandemic, pre-, mid-, and post-EDLOS increased (P < .05), and the in-hospital mortality rate increased by 10.4%; however, this was not significant (P = .155). Multivariate logistic regression analysis revealed post-EDLOS (ED waiting time after making ICU admission decision) as an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU, pre-pandemic (odds ratio [OR] = 2.282, 95% confidence interval [CI]: 1.367-3.807, P = .002) and during the pandemic (OR = 1.126, 95% CI: 1.002-1.266, P = .047). Mid-EDLOS (ED time to assess, care, and ICU admission decision) was an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU during the COVID-19 pandemic (OR = 1.835, 95% CI: 1.089-3.092, P = .023). During the pandemic of emerging respiratory infectious diseases, to reduce in-hospital mortality of severe pneumonia patients, it is necessary to shorten the ED waiting time for admission by increasing the number of isolation ICU beds. It is also necessary to accelerate the assessment and care process in the ED, and make prompt decisions regarding admission to the ICU.


Subject(s)
COVID-19 , Pandemics , Adult , COVID-19/epidemiology , Emergency Service, Hospital , Hospital Mortality , Humans , Intensive Care Units , Length of Stay , Patient Admission , Retrospective Studies
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