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1.
Anal Chim Acta ; 1312: 342742, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38834261

ABSTRACT

Hyperuricemia (HUA) has gradually become a public health burden as an independent risk factor for a variety of chronic diseases. Herein, a user-friendly point-of-care (POC) detection system (namely "Smart-HUA-Monitor") based on smartphone-assisted paper-based microfluidic is proposed for colorimetric quantification of HUA urinary markers, including uric acid (UA), creatinine (CR) and pH. The detection limits of UA and CR were 0.0178 and 0.5983 mM, respectively, and the sensitivity of pH were 0.1. The method was successfully validated in artificial urine samples and 100 clinical samples. Bland-Altman plots showed a high consistency between µPAD and the testing instruments (HITACHI 7600 Automatic Analyzer, URIT-500B Urine Analyzer and AU5800B automatic biochemical analyzer) in hospital. Smart-HUA-Monitor provides an accurate quantitative, rapid, low-cost and reliable tool for the monitoring and early diagnosis of HUA urine indicators.


Subject(s)
Colorimetry , Hyperuricemia , Paper , Polymers , Uric Acid , Humans , Hyperuricemia/diagnosis , Hyperuricemia/urine , Polymers/chemistry , Uric Acid/urine , Colorimetry/instrumentation , Lab-On-A-Chip Devices , Smartphone , Creatinine/urine , Microfluidic Analytical Techniques/instrumentation , Limit of Detection , Biomarkers/urine , Hydrogen-Ion Concentration
2.
Nat Commun ; 15(1): 4386, 2024 May 23.
Article in English | MEDLINE | ID: mdl-38782953

ABSTRACT

Sialin, a member of the solute carrier 17 (SLC17) transporter family, is unique in its ability to transport not only sialic acid using a pH-driven mechanism, but also transport mono and diacidic neurotransmitters, such as glutamate and N-acetylaspartylglutamate (NAAG), into synaptic vesicles via a membrane potential-driven mechanism. While most transporters utilize one of these mechanisms, the structural basis of how Sialin transports substrates using both remains unclear. Here, we present the cryogenic electron-microscopy structures of human Sialin: apo cytosol-open, apo lumen-open, NAAG-bound, and inhibitor-bound. Our structures show that a positively charged cytosol-open vestibule accommodates either NAAG or the Sialin inhibitor Fmoc-Leu-OH, while its luminal cavity potentially binds sialic acid. Moreover, functional analyses along with molecular dynamics simulations identify key residues in binding sialic acid and NAAG. Thus, our findings uncover the essential conformational states in NAAG and sialic acid transport, demonstrating a working model of SLC17 transporters.


Subject(s)
Cryoelectron Microscopy , Molecular Dynamics Simulation , Humans , N-Acetylneuraminic Acid/metabolism , N-Acetylneuraminic Acid/chemistry , Lysosomes/metabolism , HEK293 Cells , Protein Conformation , Organic Anion Transporters/metabolism , Organic Anion Transporters/chemistry , Organic Anion Transporters/antagonists & inhibitors , Dipeptides/chemistry , Dipeptides/metabolism , Dipeptides/pharmacology , Symporters
3.
ACS Appl Mater Interfaces ; 16(20): 26943-26953, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38718354

ABSTRACT

The continuous, noninvasive monitoring of human blood pressure (BP) through the accurate detection of pulse waves has extremely stringent requirements on the sensitivity and stability of flexible strain sensors. In this study, a new ultrasensitive flexible strain sensor based on the interlayer synergistic effect was fabricated through drop-casting and drying silver nanowires and graphene films on polydimethylsiloxane substrates and was further successfully applied for continuous monitoring of BP. This strain sensor exhibited ultrahigh sensitivity with a maximum gauge factor of 34357.2 (∼700% sensitivity enhancement over other major sensors), satisfactory response time (∼85 ms), wide strange range (12%), and excellent stability. An interlayer fracture mechanism was proposed to elucidate the working principle of the strain sensor. The real-time BP values can be obtained by analyzing the relationship between the BP and the pulse transit time. To verify our strain sensor for real-time BP monitoring, our strain sensor was compared with a conventional electrocardiogram-photoplethysmograph method and a commercial cuff-based device and showed similar measurement results to BP values from both methods, with only minor differences of 0.693, 0.073, and 0.566 mmHg in the systolic BP, diastolic BP, and mean arterial pressure, respectively. Furthermore, the reliability of the strain sensors was validated by testing 20 human subjects for more than 50 min. This ultrasensitive strain sensor provides a new pathway for continuous and noninvasive BP monitoring.


Subject(s)
Nanowires , Silver , Humans , Nanowires/chemistry , Silver/chemistry , Blood Pressure/physiology , Graphite/chemistry , Blood Pressure Determination/instrumentation , Blood Pressure Determination/methods , Male , Dimethylpolysiloxanes/chemistry , Nanostructures/chemistry , Adult
4.
Heart Rhythm ; 2024 May 16.
Article in English | MEDLINE | ID: mdl-38762134

ABSTRACT

BACKGROUND: Autonomic nerve activity is important in the mechanisms of paroxysmal atrial fibrillation (PAF). OBJECTIVE: To test the hypothesis that a single burst of skin sympathetic nerve activity (SKNA) can toggle on and off PAF or premature atrial contraction (PAC) clusters. METHODS: We performed neuECG recording over 7 days in patients with PAF. RESULTS: In Study 1, we found 8 patients (7 men, 1 woman, 62±8 years) had 124 episodes of PAF. An SKNA burst toggled both on and off PAF in 8 (6.5%) episodes (Type 1), toggled on but not off in 12 (9.7%) episodes (Type 2), and toggled on a PAC cluster, followed by PAF in 4 (3.2%) episodes (Type 3). The duration of these PAF episodes was < 10 min. The remaining 100 (80.6%) episodes were associated with active SKNA bursts throughout PAF (Type 4) and lasted longer than Type 1 (p=0.0185) and Type 2 (p=0.0027) PAF. There were 47 PAC clusters. Among them, 24 (51.1%) were toggled on and off, and 23 (48.9%) were toggled on but not off by an SKNA burst. In Study 2, we found 17 patients (9 men, 8 women, 58±12 years) with < 10 min PAF (4, 8, 0, and 31 of Types 1-4, respectively). There were significant circadian variations of all types of PAF. CONCLUSIONS: A single SKNA burst can toggle short-duration PAF and PAC cluster episodes on and off. The absence of continued SKNA after the onset might have affected the maintenance of these arrhythmias.

5.
3D Print Addit Manuf ; 11(2): e529-e536, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38689923

ABSTRACT

With high strength and good fatigue resistance, Al-Cu alloys such as AA2024 are widely used in the aerospace and automotive industries. However, the system's susceptibility to hot cracking and other solidification defects hinders its development in metal additive manufacturing (AM). A nano-treated AA2024 deposition, with the addition of TiC nanoparticles, is successfully additively manufactured without cracks. Microstructural analysis suggests nanoparticles not only mitigate the hot cracking sensitivity but also significantly refine and homogenize grains, resulting in an average size of 23.2 ± 0.4 µm. Microhardness profiles show consistent mechanical performance along the build direction, regardless of cyclic thermal exposure. Finally, excellent tensile strength and elongation up to 428 MPa and 7.4% were achieved after heat treatment. The combined results show a great promise of nano-treating in high-strength aluminum AM.

6.
Ann Emerg Med ; 2024 May 01.
Article in English | MEDLINE | ID: mdl-38691067

ABSTRACT

OBJECTIVE: We assessed the concordance of patient-reported race and ethnicity for emergency department (ED) patients compared with what was recorded in the electronic health record. METHODS: We conducted a single-center, prospective, observational study of 744 ED patients (English- and/or Spanish-speaking), asking them to describe their race and ethnicity. We compared the distributions of ethnicity and race between patient-reported and electronic health record data using McNemar's test. We calculated percent agreement and Cohen's kappa, with 95% confidence intervals (CI), for the concordance of patient-reported race and ethnicity with electronic health record data. RESULTS: Of 744 ED patients, 731 participants who completed the survey reported their ethnicity, resulting in 98.2% of electronic health records obtained ethnicities matched self-reported data (kappa = 0.95; 95% CI: 0.92 to 0.98). For those who self-reported as Hispanic, only 92.3% agreement was observed between the self-reported and electronic health record values. For all patients who had race recorded, 85.4% agreement was observed (kappa = 0.75; 95% CI 0.71 to 0.79). High rates of agreement were observed for Black or African American patients (98.7%) and White patients (96.6%), with low rates for those who identified as "More than one race" (22.9%) or "Other" race (1.8%). In the subset of Hispanic patients, low rates of agreement (25.0%) were observed for race (kappa = 0.10; 95% CI 0.01 to 0.19). CONCLUSIONS: Documentation discordance regarding race and ethnicity exists between electronic health records and self-reported data for our ED patients, particularly for ethnically Hispanic and Latino/a patients. Future efforts should focus on ensuring that demographic information in the electronic health record is accurately collected.

7.
ACS Biomater Sci Eng ; 10(5): 3438-3453, 2024 05 13.
Article in English | MEDLINE | ID: mdl-38564666

ABSTRACT

Despite being a weaker metal, zinc has become an increasingly popular candidate for biodegradable implant applications due to its suitable corrosion rate and biocompatibility. Previous studies have experimented with various alloy elements to improve the overall mechanical performance of pure Zn without compromising the corrosion performance and biocompatibility; however, the thermal stability of biodegradable Zn alloys has not been widely studied. In this study, TiC nanoparticles were introduced for the first time to a Zn-Al-Cu system. After hot rolling, TiC nanoparticles were uniformly distributed in the Zn matrix and effectively enabled phase control during solidification. The Zn-Cu phase, which was elongated and sharp in the reference alloy, became globular in the nanocomposite. The strength of the alloy, after introducing TiC nanoparticles, increased by 31% from 259.7 to 340.3 MPa, while its ductility remained high at 49.2% elongation to failure. Fatigue performance also improved greatly by adding TiC nanoparticles, increasing the fatigue limit by 47.6% from 44.7 to 66 MPa. Furthermore, TiC nanoparticles displayed excellent phase control capability during body-temperature aging. Without TiC restriction, Zn-Cu phases evolved into dendritic morphologies, and the Al-rich eutectic grew thicker at grain boundaries. However, both Zn-Cu and Al-rich eutectic phases remained relatively unchanged in shape and size in the nanocomposite. A combination of exceptional tensile properties, improved fatigue performance, better long-term stability with a suitable corrosion rate, and excellent biocompatibility makes this new Zn-Al-Cu-TiC material a promising candidate for biodegradable stents and other biodegradable applications.


Subject(s)
Absorbable Implants , Copper , Stents , Zinc , Zinc/chemistry , Zinc/pharmacology , Copper/chemistry , Copper/pharmacology , Alloys/chemistry , Humans , Titanium/chemistry , Titanium/pharmacology , Aluminum/chemistry , Aluminum/pharmacology , Materials Testing , Corrosion , Biocompatible Materials/chemistry , Biocompatible Materials/pharmacology , Metal Nanoparticles/chemistry , Metal Nanoparticles/therapeutic use , Nanoparticles/chemistry , Nanocomposites/chemistry
8.
Stat Methods Med Res ; 33(6): 966-980, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38592341

ABSTRACT

The Fellegi-Sunter model is a latent class model widely used in probabilistic linkage to identify records that belong to the same entity. Record linkage practitioners typically employ all available matching fields in the model with the premise that more fields convey greater information about the true match status and hence result in improved match performance. In the context of model-based clustering, it is well known that such a premise is incorrect and the inclusion of noisy variables could compromise the clustering. Variable selection procedures have therefore been developed to remove noisy variables. Although these procedures have the potential to improve record matching, they cannot be applied directly due to the ubiquity of the missing data in record linkage applications. In this paper, we modify the stepwise variable selection procedure proposed by Fop, Smart, and Murphy and extend it to account for missing data common in record linkage. Through simulation studies, our proposed method is shown to select the correct set of matching fields across various settings, leading to better-performing algorithms. The improved match performance is also seen in a real-world application. We therefore recommend the use of our proposed selection procedure to identify informative matching fields for probabilistic record linkage algorithms.


Subject(s)
Algorithms , Latent Class Analysis , Medical Record Linkage , Humans , Medical Record Linkage/methods , Models, Statistical , Cluster Analysis , Computer Simulation
9.
Sci Rep ; 14(1): 6072, 2024 03 13.
Article in English | MEDLINE | ID: mdl-38480826

ABSTRACT

Blood transfusions from convalescent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected patients could be used to treat patients with severe infections or immunocompromised patients. However, it is necessary to select the optimal donors to maximize the utilization of resources. In this study, we investigated the associations among body mass index (BMI), tobacco smoking, exercise frequency and duration, and alcohol consumption with the SARS-CoV-2 immunoglobulin-G (IgG) antibody titer levels with in the Chinese convalescent blood donor population. Here we show that BMI, smoking habits, and exercise frequency appear to be predictive factors for IgG levels in convalescent male blood donors. However, these variables were not observed as predictive of IgG levels in female convalescent blood donors. The findings could be used to optimize the screening for potential blood donors to treat immunocompromised or severely ill COVID-19 patients.


Subject(s)
COVID-19 , Humans , Male , Female , SARS-CoV-2 , Blood Donors , Cross-Sectional Studies , Immunization, Passive , COVID-19 Serotherapy , Antibodies, Viral , Immunoglobulin G , China
10.
Appl Clin Inform ; 2024 Mar 20.
Article in English | MEDLINE | ID: mdl-38508580

ABSTRACT

BACKGROUND: Patient data is fragmented across multiple repositories, yielding suboptimal and costly care. Record linkage algorithms are widely accepted solutions for improving completeness of patient records. However, studies often fail to fully describe their linkage techniques. Further, while many frameworks evaluate record linkage methods, few focus on producing gold standard datasets. This highlights a need to assess these frameworks and their real-world performance. OBJECTIVE: We use real-world datasets and expand upon previous frameworks to evaluate a consistent approach to the manual review of gold standard datasets and measure its impact on algorithm performance. METHODS: We applied the framework, which includes elements for data description, reviewer training and adjudication, and software and reviewer descriptions, to four datasets. Record-pairs were formed and 15,000 records were randomly sampled from these pairs. After training, two reviewers determined match status for each record-pair. If reviewers disagreed, a third reviewer was used for final adjudication. RESULTS: Between the four datasets, the percent discordant rate ranged from 1.8-13.6%. While reviewers' discordance rate typically ranged between 1% and 5%, one exhibited a 59% discordance rate, showing the importance of the third reviewer. The original analysis was compared to three sensitivity analyses. The original analysis most often exhibited the highest predictive values compared to the sensitivity analyses. CONCLUSION: Reviewers vary in their assessment of a gold standard, which can lead to variances in estimates for matching performance. Our analysis demonstrates how a multi-reviewer process can be applied to create gold standards, identify reviewer discrepancies, and evaluate algorithm performance.

11.
ACS Appl Mater Interfaces ; 16(7): 9532-9543, 2024 Feb 21.
Article in English | MEDLINE | ID: mdl-38345942

ABSTRACT

Flexible piezoresistive sensors with a porous structure that are used in the field of speech recognition are seldom characterized by both high sensitivity and ease of preparation. In this study, a piezoresistive sensor with a porous structure that is both highly sensitive and can be prepared by using a simple method is proposed for speech recognition. The preparation process utilizes the interaction of bubbles generated by ethanol evaporation and active agents with polydimethylsiloxane to produce a porous flexible substrate. This preparation process requires neither templates nor harsh experimental conditions such as a low temperature and a low pressure. Furthermore, the prepared piezoresistive sensor has excellent properties, such as a high sensitivity (27.6 kPa-1), a satisfactory response time (800 µs), and a good stability (10,000 cycles). When used for speech recognition, more than 1500 vocalizations and silent speech signals obtained from subjects saying numbers from "0" to "9" were collected by the sensor for training a convolutional neural network model. The average accuracy of the recognition reached 94.8%. The simple preparation process and the excellent performance of the prepared flexible piezoresistive sensor endow it with a wide application prospect in the field of speech recognition.


Subject(s)
Speech Perception , Speech , Humans , Porosity , Cold Temperature , Ethanol
12.
J Inflamm Res ; 17: 91-100, 2024.
Article in English | MEDLINE | ID: mdl-38204989

ABSTRACT

Intervertebral disc degeneration is a chronic degenerative disease caused by the interaction of genetic and environmental factors, mainly manifested as lower back pain. At present, the diagnosis of intervertebral disc degeneration mainly relies on imaging. However, early intervertebral disc degeneration is usually insidious, and there is currently a lack of relevant clinical biomarkers that can reliably reflect early disease progression. Pyroptosis is a regulatory form of cell death triggered by the activation of inflammatory bodies and caspase, which can induce the formation of plasma membrane pores and cell swelling or lysis. Previous studies have shown that during the progression of intervertebral disc degeneration, sustained activation of inflammasomes leads to nuclear cell pyroptosis, which can occur in the early stages of intervertebral disc degeneration. Moreover, intervertebral disc nucleus pulposus cells adapt to the external environment through autophagy and maintain cellular homeostasis and studying the mechanism of autophagy in IDD and intervening in its pathological and physiological processes can provide new ideas for the clinical treatment of IDD. This review analyzes the effects of pyroptosis and autophagy on IDD by reviewing relevant literature in recent years, in order to explore the relationship between pyroptosis, autophagy and IDD.

13.
JAMA Netw Open ; 7(1): e2350511, 2024 Jan 02.
Article in English | MEDLINE | ID: mdl-38198141

ABSTRACT

Importance: More than 80% of patients who present to the emergency department (ED) with acute heart failure (AHF) are hospitalized. With more than 1 million annual hospitalizations for AHF in the US, safe and effective alternatives are needed. Care for AHF in short-stay units (SSUs) may be safe and more efficient than hospitalization, especially for lower-risk patients, but randomized clinical trial data are lacking. Objective: To compare the effectiveness of SSU care vs hospitalization in lower-risk patients with AHF. Design, Setting, and Participants: This multicenter randomized clinical trial randomly assigned low-risk patients with AHF 1:1 to SSU or hospital admission from the ED. Patients received follow-up at 30 and 90 days post discharge. The study began December 6, 2017, and was completed on July 22, 2021. The data were analyzed between March 27, 2020, and November 11, 2023. Intervention: Randomized post-ED disposition to less than 24 hours of SSU care vs hospitalization. Main Outcomes and Measures: The study was designed to detect at least 1-day superiority for a primary outcome of days alive and out of hospital (DAOOH) at 30-day follow-up for 534 participants, with an allowance of 10% participant attrition. Due to the COVID-19 pandemic, enrollment was truncated at 194 participants. Before unmasking, the primary outcome was changed from DAOOH to an outcome with adequate statistical power: quality of life as measured by the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). The KCCQ-12 scores range from 0 to 100, with higher scores indicating better quality of life. Results: Of the 193 patients enrolled (1 was found ineligible after randomization), the mean (SD) age was 64.8 (14.8) years, 79 (40.9%) were women, and 114 (59.1%) were men. Baseline characteristics were balanced between arms. The mean (SD) KCCQ-12 summary score between the SSU and hospitalization arms at 30 days was 51.3 (25.7) vs 45.8 (23.8) points, respectively (P = .19). Participants in the SSU arm had 1.6 more DAOOH at 30-day follow-up than those in the hospitalization arm (median [IQR], 26.9 [24.4-28.8] vs 25.4 [22.0-27.7] days; P = .02). Adverse events were uncommon and similar in both arms. Conclusions and Relevance: The findings show that the SSU strategy was no different than hospitalization with regard to KCCQ-12 score, superior for more DAOOH, and safe for lower-risk patients with AHF. These findings of lower health care utilization with the SSU strategy need to be definitively tested in an adequately powered study. Trial Registration: ClinicalTrials.gov Identifier: NCT03302910.


Subject(s)
Heart Failure , Patient Discharge , Female , Humans , Male , Middle Aged , Aftercare , Emergency Service, Hospital , Heart Failure/therapy , Hospitalization , Pandemics , Quality of Life , Aged
14.
Clin Genitourin Cancer ; 22(1): e31-e37.e1, 2024 02.
Article in English | MEDLINE | ID: mdl-37482523

ABSTRACT

INTRODUCTION: Somatic mutations in the Wnt signaling gene Adenomatous Polyposis Coli (APC) promote metastatic prostate cancer (PCa) progression. Less is known regarding the impact of germline APC mutations on PCa outcomes. We sought to investigate the prevalence of aggressive variant PCa (AVPC) and treatment-emergent neuroendocrine PCa (t-NEPC) in patients with the germline APC I1307K variant, an alteration found in 7% of Ashkenazi Jewish men. MATERIALS AND METHODS: We report a retrospective cohort study comparing patients with PCa and either APC I1307K germline mutation, APC somatic mutations, or unselected patients. Proportions of patients with AVPC among all the cases were estimated along with 95% Clopper-Pearson exact confidence intervals (CI). Odds ratios with 95% CI were provided for the prevalence of t-NEPC and AVPC in patients with germline APC I1307K compared to patients with frameshift alterations in APC. RESULTS: From 2016-2022, 18 patients with PCa at 3 institutions with the germline APC (I1307K) mutation were identified. Clinically-defined AVPC was found in 8 of the 15 cases with metastatic disease (53%; 95% CI: 26%-79%). Combined somatic alterations in two or more of RB1, TP53 or PTEN (molecularly-defined AVPC) were found in 5/18 cases (28%; 95% CI: 10%-54%). When compared to 20 patients with APC somatic frameshift mutations, patients with the germline APC I1307K variant had a significantly increased risk of AVPC (OR 7.2; 95% CI 1.27, 40.68). CONCLUSION: PCa that develops in the presence of the germline APC I1307K mutation appear to be enriched for clinically-defined and molecularly-defined AVPC and in particular, for t-NEPC.


Subject(s)
Adenomatous Polyposis Coli , Colorectal Neoplasms , Prostatic Neoplasms , Male , Humans , Germ-Line Mutation , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/genetics , Retrospective Studies , Adenomatous Polyposis Coli/genetics , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology , Germ Cells/pathology
15.
Nephrol Dial Transplant ; 39(2): 264-276, 2024 Jan 31.
Article in English | MEDLINE | ID: mdl-37468453

ABSTRACT

BACKGROUND: 25-hydroxyvitamin D can undergo C-3 epimerization to produce 3-epi-25(OH)D3. 3-epi-25(OH)D3 levels decline in chronic kidney disease (CKD), but its role in regulating the cardiovascular system is unknown. Herein, we examined the relationship between 3-epi-25(OH)D3, and cardiovascular functional and structural endpoints in patients with CKD. METHODS: We examined n = 165 patients with advanced CKD from the Cardiopulmonary Exercise Testing in Renal Failure and After Kidney Transplantation (CAPER) study cohort, including those who underwent kidney transplant (KTR, n = 76) and waitlisted patients who did not (NTWC, n = 89). All patients underwent cardiopulmonary exercise testing and echocardiography at baseline, 2 months and 12 months. Serum 3-epi-25(OH)D3 was analyzed by liquid chromatography-tandem mass spectrometry. RESULTS: Patients were stratified into quartiles of baseline 3-epi-25(OH)D3 (Q1: <0.4 ng/mL, n = 51; Q2: 0.4 ng/mL, n = 26; Q3: 0.5-0.7 ng/mL, n = 47; Q4: ≥0.8 ng/mL, n = 41). Patients in Q1 exhibited lower peak oxygen uptake [VO2Peak = 18.4 (16.2-20.8) mL/min/kg] compared with Q4 [20.8 (18.6-23.2) mL/min/kg; P = .009]. Linear mixed regression model showed that 3-epi-25(OH)D3 levels increased in KTR [from 0.47 (0.30) ng/mL to 0.90 (0.45) ng/mL] and declined in NTWC [from 0.61 (0.32) ng/mL to 0.45 (0.29) ng/mL; P < .001]. Serum 3-epi-25(OH)D3 was associated with VO2Peak longitudinally in both groups [KTR: ß (standard error) = 2.53 (0.56), P < .001; NTWC: 2.73 (0.70), P < .001], but was not with left ventricular mass or arterial stiffness. Non-epimeric 25(OH)D3, 24,25(OH)2D3 and the 25(OH)D3:24,25(OH)2D3 ratio were not associated with any cardiovascular outcome (all P > .05). CONCLUSIONS: Changes in 3-epi-25(OH)D3 levels may regulate cardiovascular functional capacity in patients with advanced CKD.


Subject(s)
Cardiovascular System , Kidney Transplantation , Renal Insufficiency, Chronic , Humans , Vitamin D , Vitamins , Renal Insufficiency, Chronic/surgery
16.
J Cardiol ; 83(2): 121-129, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37579872

ABSTRACT

BACKGROUND: Lung ultrasound congestion scoring (LUS-CS) is a congestion severity biomarker. The BLUSHED-AHF trial demonstrated feasibility for LUS-CS-guided therapy in acute heart failure (AHF). We investigated two questions: 1) does change (∆) in LUS-CS from emergency department (ED) to hospital-discharge predict patient outcomes, and 2) is the relationship between in-hospital decongestion and adverse events moderated by baseline risk-factors at admission? METHODS: We performed a secondary analysis of 933 observations/128 patients from 5 hospitals in the BLUSHED-AHF trial receiving daily LUS. ∆LUS-CS from ED arrival to inpatient discharge (scale -160 to +160, where negative = improving congestion) was compared to a primary outcome of 30-day death/AHF-rehospitalization. Cox regression was used to adjust for mortality risk at admission [Get-With-The-Guidelines HF risk score (GWTG-RS)] and the discharge LUS-CS. An interaction between ∆LUS-CS and GWTG-RS was included, under the hypothesis that the association between decongestion intensity (by ∆LUS-CS) and adverse outcomes would be stronger in admitted patients with low-mortality risk but high baseline congestion. RESULTS: Median age was 65 years, GWTG-RS 36, left ventricular ejection fraction 36 %, and ∆LUS-CS -20. In the multivariable analysis ∆LUS-CS was associated with event-free survival (HR = 0.61; 95 % CI: 0.38-0.97), while discharge LUS-CS (HR = 1.00; 95%CI: 0.54-1.84) did not add incremental prognostic value to ∆LUS-CS alone. As GWTG-RS rose, benefits of LUS-CS reduction attenuated (interaction p < 0.05). ∆LUS-CS and event-free survival were most strongly correlated in patients without tachycardia, tachypnea, hypotension, hyponatremia, uremia, advanced age, or history of myocardial infarction at ED/baseline, and those with low daily loop diuretic requirements. CONCLUSIONS: Reduction in ∆LUS-CS during AHF treatment was most associated with improved readmission-free survival in heavily congested patients with otherwise reassuring features at admission. ∆LUS-CS may be most useful as a measure to ensure adequate decongestion prior to discharge, to prevent early readmission, rather than modify survival.


Subject(s)
Heart Failure , Pulmonary Edema , Aged , Humans , Lung/diagnostic imaging , Prognosis , Stroke Volume , Ventricular Function, Left
17.
J Neurotrauma ; 2024 Apr 04.
Article in English | MEDLINE | ID: mdl-37265124

ABSTRACT

The early stages of brain injury can induce acute liver injury, which can be recovered in the short term. Continued medication treatment during hospitalization for brain injury alleviates the prognosis and contributes to a high incidence of drug-induced liver injury (DILI). We hypothesize that there is an interaction between changes in the hepatic environment after brain injury and liver injury produced by intensive drug administration, leading to an upregulation of the organism's sensitivity to DILI. In this study, mice models of TBI were established by controlled cortical impact (CCI) and models of DILI were constructed by acetaminophen (APAP). All mice were divided into four groups: Sham, TBI, APAP, and TBI+APAP, and related liver injury indicators in liver and serum were detected by Western blot, Quantitative real-time PCR (qRT-PCR), and immunohistochemical staining. The results suggested that liver injury induced in the early stages of brain injury recovered in 3 days, but this state could still significantly aggravate DILI, represented by higher liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), oxidative stress (increase in malondialdehyde [MDA] concentration and deregulation of glutathione [GSH] and superoxide dismutase [SOD] activities), inflammatory response (activation of the HMGB1/TLR4/NF-κB signaling pathway, and increased messenger RNA [mRNA] and protein levels of pro-inflammatory cytokines including tumor necrosis factor alpha [TNF-α], interleukin [IL]-6, and IL-1ß), and apoptosis (TUNEL assay, upregulation of Bax protein and deregulation of Bcl-2 protein). In summary, our results suggested that TBI is a potential susceptibility factor for DILI and exacerbates DILI.

18.
Dalton Trans ; 53(4): 1449-1459, 2024 Jan 23.
Article in English | MEDLINE | ID: mdl-37909312

ABSTRACT

Discrete spin crossover (SCO) tetranuclear cages are a unique class of materials that have potential use in next-generation molecular recognition and sensing. In this work, two new edge-bridged SCO FeII4L6 (L = 2,7-bis(((E)-pyridin-2-ylmethylene)amino)benzo[lmn] [3,8]phenanthroline-1,3,6,8(2H,7H)-tetraone) supramolecular cages with different counter anions: ClO4- (2) and CF3SO3- (3) were constructed via subcomponent self-assembly to investigate both solvent and anion influences on their magnetic properties and compare them to cage 1 with a BF4- anion. Pyridyl-hydrazone bidentate ligand scaffolds were employed to replace the 'classical' imidazole/thiazolyl-imine coordination units to induce SCO behaviour in these cages. 2 and 3 were structurally characterized by single-crystal X-ray diffraction analysis and electrospray ionization time-of-flight mass spectrometry. Magnetic susceptibilities of 1-3 and 1-3·desolvated indicate that the solvents' presence is in favor of the low-spin (LS) state. While different counter anions in 1-3·desolvated affect the spin-state configurations of the four FeII metal centers. According to the 57Fe Mössbauer spectral analysis, the spin-state distributions in 1-3 at 80 K are [2 high-spin (HS)-2LS], [1HS-3LS] and [2HS-2LS], respectively and density functional theory calculations were employed to investigate the reasons. These findings provide insights to regulate the spin-state versatility of SCO FeII cage systems in the solid state.

19.
Photodiagnosis Photodyn Ther ; 45: 103939, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38161035

ABSTRACT

OBJECTIVE: To investigate macula structure thickness and volume changes in patients with moyamoya disease (MMD). METHOD: In this cross-sectional study, we used artificial intelligence (AI) -assisted optical coherence tomography (OCT) to analyze the thickness and volume of macula in Moyamoya patients. ETDRS zoning divides the macula into nine different regions. In 15 patients with radial scanning OCT, the average thickness and volume of retina, RNFL, GCL, and choroid in these regions were measured. In 30 patients with radial or horizontal scanning OCT, based on the anatomical structure, the macula is divided into seven segments. Mean Sattler layer-choriocapillaris complex thickness (SLCCT), Haller layer thickness, and total choroidal thickness were measured for each segment using AI-assisted OCT. RESULTS: We recruited 30 patients (59 eyes) with MMD. In the 15 patients (29 eyes) who underwent radial scanning OCT, no significant change in retina, RNFL, GCL, and choroidal thickness was identified between the two groups (p > 0.05). There was no significant change in retina, RNFL, or choroidal volume between the two groups in different ETDRS macula regions (p > 0.05). The GCL volume in the macula's inner ring nasal portion (IN) was significantly lower. SLCCTs were considerably reduced in six macula regions in moyamoya groups (p < 0.05). There was no statistically significant change in Haller layer thickness. Only the nasal perifovea (PE_N) exhibited a significant variation in choroidal thickness. The Moyamoya group showed reduced choroidal thickness in PE_N segment. CONCLUSION: In patients with MMD, there is thinning of the Sattler layer-choriocapillaris complex in the choroid.


Subject(s)
Moyamoya Disease , Photochemotherapy , Humans , Artificial Intelligence , Tomography, Optical Coherence/methods , Moyamoya Disease/diagnostic imaging , Cross-Sectional Studies , Photochemotherapy/methods , Photosensitizing Agents
20.
ACS Omega ; 8(48): 46127-46143, 2023 Dec 05.
Article in English | MEDLINE | ID: mdl-38075791

ABSTRACT

The Qingshui Basin in China is a hotspot for coalbed methane exploration, and the selection and arrangement of the surface well are crucial engineering issues for the drainage process. To address this, the present study establishes several novel coal permeability models based on the strain relationship of representative elementary volumes (REV) and discusses the evolution mechanism of permeability. Moreover, the spatiotemporal evolution patterns of permeability during the drainage process are analyzed, and a methodology is presented for the selection and arrangement of a surface well based on the predrainage time at the working face. The results indicate that in the permeability model, the volumetric strain of REV is linearly correlated with the volumetric strain of their respective fractures, with the correlation coefficient representing the initial fracture porosity. The variation pattern of coal permeability near surface wells during the drainage process is closely aligned with the trend of the adsorption strain. Additionally, the selection and arrangement of surface wells are correlated with the predrainage time at the working face, including the minimum number and location of vertical wells, as well as the optimal length of horizontal wells. The research findings provide valuable insights into enhancing the efficiency of coalbed methane drainage.

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