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1.
Clin Toxicol (Phila) ; 62(10): 625-635, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39291923

RESUMO

INTRODUCTION: Poisons information centres provide phone-based risk assessment and management advice on poisonings. Unintentional poisonings are a common reason for consulting a poisons information centre, and older adults are at increased risk of unintentional poisoning and adverse outcomes. We describe patterns of unintentional poisoning in older adults reported to a regional poisons information centre. METHODS: We conducted a retrospective audit of poisons information centre call records and identified unintentional poisonings involving older adults (≥75 years) over a 12-month period to determine patient demographics and poisoning circumstances (substances, contributing factors, and disposition recommendation). Univariate analyses identified variables associated with hospital referral and multivariate models to identify independent risk factors in home-dwelling older adults. RESULTS: We identified 2,757 calls. More exposures occurred in women (62%) and involved therapeutic errors (70.8%). Paracetamol was the most common drug involved (11%), and cardiovascular drugs were the most common drug class (36%). Only 14.3% of the study population was referred to hospital. Independent risk factors for hospital referral in home-dwelling older adults were exposure to cardiovascular, centrally acting and antihyperglycaemics, non-oral route of administration and symptoms at the time of the call. DISCUSSION: Unintentional poisoning is not uncommon, and our findings are similar to those in other countries over recent decades. These findings suggest that unintentional poisoning in older adults is inadequately addressed by current medication safety strategies. Our findings indicate the value of timely advice by poisons information centres for preventing potentially unnecessary hospitalizations. CONCLUSION: Further research is needed to identify more effective approaches to medication safety strategies for older adults. Poisons information centre data contribute to pharmacovigilance activities and could inform patient care.


Assuntos
Centros de Controle de Intoxicações , Intoxicação , Humanos , Estudos Retrospectivos , Feminino , Idoso , Masculino , Centros de Controle de Intoxicações/estatística & dados numéricos , Idoso de 80 Anos ou mais , Intoxicação/epidemiologia , Intoxicação/terapia , Fatores de Risco , New South Wales/epidemiologia , Erros de Medicação/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , População Australasiana
2.
Small ; : e2406912, 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-39324225

RESUMO

This article aims to develop CeO2 nanocontainer-constructed coating with a synergistic self-healing and protective nature through a simple mechanical blending technique to manage metal corrosion. The proposed coating exhibits excellent corrosion resistance, which is primarily attributed to the combination of thermal-driven healing and active corrosion inhibition. Paraffin wax and 2-polybenzothiazole-loaded CeO2 nanotubes (CeO2-MBT) are directly doped into epoxy coating to perform such a multifunctional role. CeO2 nanocontainers and encapsulated corrosion inhibitor MBT can be released by pH triggers to achieve instant corrosion inhibition upon the surface of metal substrate. In addition, any physical defects in the coating are responsively repaired by heating incorporated paraffin wax to regain structural integrity and consequent barrier function. Corrosion protection efficiency remains sufficient even after ten cycles of damage and healing. Such a multiple-functional coating strategy provides an alternative pathway toward efficient and sustainable performance to tackle corrosion-related challenges of metal components in both short-term and long-term services.

3.
HPB (Oxford) ; 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39271376

RESUMO

BACKGROUND: When considering hepatectomy for elderly HCC patients, it's essential to assess surgical safety and survival benefits. This study investigated the impact of preoperative frailty, assessed with the Clinical Frailty Scale (CFS), on outcomes for octogenarians undergoing HCC hepatectomy. METHODS: A retrospective cohort study of octogenarians who had hepatectomy for HCC between 2010 and 2022 at 16 hepatobiliary centers was conducted. Patients were categorized as frail or non-frail based on preoperative CFS, with frailty defined as CFS ≥5. The primary endpoints were overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS), with perioperative outcomes as secondary endpoints. RESULTS: Among 240 octogenarians, 105 were characterized as being frail. Frail patients had a higher incidence of postoperative 30-day morbidity and postoperative 30-day and 90-day mortality versus non-frail patients. Meanwhile, 5-year OS, RFS and CSS among frail patients were lower compared with non-frail patients. Univariable and multivariable analysis revealed that preoperative frailty was an independent risk factor of postoperative 30-day morbidity (OR: 2.060), OS (HR: 2.384), RFS (HR: 2.190) and CSS (HR: 2.203). CONCLUSION: Preoperative frailty, as assessed by the CFS, was strongly associated with both short-term outcomes and long-term survival among octogenarians undergoing hepatectomy for HCC. Incorporating frailty assessment into the preoperative evaluation may help optimize patient selection and perioperative care.

4.
J Stroke Cerebrovasc Dis ; 33(11): 107960, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39222699

RESUMO

INTRODUCTION: Lipoprotein(a) [Lp(a)] is an established independent causal risk factor for cardiovascular disease and atherosclerosis. However, its association with young-onset ischemic stroke is not well-established. A systematic review and meta-analysis was performed to investigate the association of elevated Lp(a) with young ischemic stroke. METHODS: Four electronic databases: PubMed (MEDLINE), EMBASE, Scopus and Cochrane Library were systematically searched, profiling studies from inception till 6 Mar 2024. We included studies investigating the relationship between stratified Lp(a) levels and young ischemic stroke. We compared the odds of young stroke patients (age <65 years) having elevated Lp(a) compared to age-matched controls without stroke or transient ischemic attack. RESULTS: Five case-control studies comprising a total of 1345 patients were included; 57.7 % (776/1345) were females, with a mean age of 41.5 years. Among them, 22.5 % (264/1171) were smokers. Additionally, 16.8 % (197/1171) had hypertension, 5.9 % (69/1171) had diabetes, and 29.2 % (284/971) had hyperlipidemia. Young stroke patients were more likely to have high Lp(a) level than age-matched controls (OR 1.61, 95 %CI 1.24-2.10). Four studies defined a high Lp(a) level as ≥30mg/dL, whilst one study used a Lp(a) level of >23.2mg/dL as the cut-off. A sensitivity analysis excluding this study showed that young stroke patients were still more likely to have Lp(a) ≥30mg/dL than controls (OR 1.43, 95 %CI 1.08-1.88). CONCLUSION: Young stroke patients are more likely to have elevated Lp(a) compared to age-matched controls, suggesting an association between elevated Lp(a) and young stroke. Further research is warranted to evaluate the causal relationships between Lp(a) and young-onset ischemic stroke, as well as to conduct a cost-benefit analysis of Lp(a) screening in young adults as part of a primary prevention strategy.

5.
NPJ Breast Cancer ; 10(1): 72, 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39112498

RESUMO

Breast cancer diagnosis and treatment have been revolutionized by multiparametric Magnetic Resonance Imaging (mpMRI), encompassing T2-weighted imaging (T2WI), Diffusion-weighted imaging (DWI), and Dynamic Contrast-Enhanced MRI (DCE-MRI). We conducted a retrospective analysis of mpMRI data from 194 breast cancer patients (September 2019 to October 2023). Using 'pyradiomics' for radiomics feature extraction and MOVICS for unsupervised clustering. Interestingly, we identified two distinct patient clusters associated with significant differences in molecular subtypes, particularly in Luminal A subtype distribution (p = 0.03), estrogen receptor (ER) (p = 0.01), progesterone receptor (PR) (p = 0.04), mean tumor size (p < 0.01), lymph node metastasis (LNM) (p = 0.01), and edema (p < 0.01). Our study emphasizes mpMRI's potential in breast cancer by using radiomics-based cluster analysis to categorize tumors, uncovering heterogeneity, and aiding in personalized treatment strategies.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39168760

RESUMO

BACKGROUND: While transcatheter edge-to-edge repair (TEER) with MitraClip is increasingly used, data on the risk stratification for assessing early mortality after this procedure are scarce. OBJECTIVE: This study aimed to assess early mortality and analyze the risk factors of early mortality among patients who underwent TEER. METHODS: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the risk factors associated with early mortality. RESULTS: A total of 15,931 patients who had TEER were included; 292 (1.8 %) with early mortality and 15,639 (98.2 %) without. There was a decreasing trend in early mortality from 2.8 % in the first quarter of 2017 to 1.2 % in the fourth quarter of 2020, but it was not statistically significant (p = 0.18). In multivariable analysis, the independent risk factors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95 % confidence interval [CI]: 1.11-2.22, p = 0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p < 0.01), chronic liver disease (aOR: 4.90; CI: 3.29-7.29, p < 0.01), coagulation disorder (aOR: 3.42; CI: 2.35-5.03, p < 0.01), systolic heart failure (aOR: 2.81; CI: 1.34-5.90, p < 0.01), diastolic heart failure (aOR: 2.69; CI: 1.24-5.84, p = 0.01) and unspecified heart failure (aOR: 3.23; CI: 1.49-7.01, p < 0.01). Among those who died during 30-day readmission following TEER, the most common cardiac cause and non-cardiac-cause of readmission were heart failure (18.2 %) and infection (26.6 %), respectively. CONCLUSION: The early mortality following TEER was low at 1.8 %. The independent risk factors associated with early mortality were chronic kidney disease (including end-stage renal disease), chronic liver disease, coagulation disorder, and heart failure (both systolic and diastolic).

7.
J Arrhythm ; 40(4): 1001-1004, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39139881

RESUMO

Background: The impact of atrial fibrillation (AF) among patients with amyloidosis on in-hospital outcomes is not well-established. We aimed to examine in-hospital outcomes among patients admitted with a primary diagnosis of AF with and without amyloidosis. Methods and Results: We queried the Nationwide Readmissions Database to compare the in-hospital outcomes among AF patients with and without amyloidosis. Our study demonstrated that in-hospital all-cause mortality, adverse events, and 30-day readmission were comparable between the two groups. Conclusions: Patients with AF and concurrent amyloidosis did not have worse in-hospital outcomes than those with AF alone.

8.
J Soc Cardiovasc Angiogr Interv ; 3(3Part A): 101231, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-39131780

RESUMO

Background: While patients with spontaneous coronary artery dissection (SCAD) occasionally present with concurrent ventricular arrhythmias (VA), the impact of VA on in-hospital outcomes in the United States (US) is not well-established. This study aims to analyze in-hospital outcomes of patients with SCAD and concurrent VA and to determine the factors associated with VA occurrence in this high-risk population in the US. Methods: Using the Nationwide Readmissions Database, our study included patients age 18 years or older who had SCAD between 2017 and 2020. We categorized the cohort into 2 groups depending on the presence of VA during hospitalization. In-hospital outcomes were assessed between SCAD patients with VA and those without. Weighted analysis was performed. We analyzed the independent factors associated with VA occurring among SCAD patients through univariable and multivariable analyses. Results: Eight hundred seventy-seven SCAD patients were included in the study: 118 (13.5%) with VA and 759 (86.6%) without. SCAD patients with concurrent VA were associated with higher rates of early mortality (10.2% vs 2.0%; P < .01), prolonged index hospital stay (≥7 days) (33.1% vs 11.7%; P < .01), and non-home discharge (21.2% vs 5.9%; P < .01). The length of hospital stay was longer in the SCAD with concurrent VA group (7.39 days vs 3.58 days; P < .01), and the median cumulative cost of hospitalization was also higher in this group ($31,451 vs $13,802; P < .01). SCAD patients with concurrent VA had increased in-hospital adverse events: acute heart failure, cardiac arrest, cardiogenic shock, cerebral infarction, pulmonary edema, and acute kidney injury. In multivariable analysis, the independent factors associated with VA occurrence among SCAD patients were chronic liver disease (aOR, 3.42; 95% CI, 1.43-8.20; P < .01) and heart failure (aOR, 5.63; 95% CI, 3.36-9.42; P < .01). Conclusions: Concurrence of VA among SCAD patients was associated with poorer in-hospital outcomes. Heart failure and chronic liver disease were the independent factors associated with VA occurrence in SCAD patients.

9.
Transl Oncol ; 49: 102068, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39121828

RESUMO

OBJECTIVE: Nucleotide metabolic reprogramming as a hallmark of cancer is closely related to the occurrence and progression of cancer. We aimed to comprehensively analyze the nucleotide metabolism-related gene set and clinical significance in gliomas. METHODS: The RNA sequencing data of 702 gliomas from the Cancer Genome Atlas (TCGA) dataset were included as the training set, and the RNA sequencing data from the other three datasets (CGGA, GSE16011, and Rembrandt) were used as independent validation sets. Survival curve, Cox regression analysis, time-dependent ROC curve and nomogram model were performed to evaluate prognostic power of signature. R language was the main tool for bioinformatic analysis and graphical work. RESULTS: Based on the expression profiles of nucleotide metabolism-related genes, consensus clustering identified two robust clusters with different prognosis. We then developed a nucleotide metabolism-related signature that was closely related to clinical, pathological, and genomic characteristics of gliomas. And ROC curve showed that our signature was a potential biomarker for mesenchymal subtype. Survival curve and Cox regression analysis revealed signature as an independent prognostic factor for gliomas. In addition, we constructed a nomogram model to predict individual survival. Finally, functional analysis showed that nucleotide metabolism not only affected cell division and cell cycle, but also was associated with immune response in gliomas. CONCLUSION: We developed a nucleotide metabolism-related signature to predict prognosis and provided new insights into the role of nucleotide metabolism in gliomas.

10.
J Innov Card Rhythm Manag ; 15(6): 5894-5901, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38948660

RESUMO

Knowledge of the impact of paroxysmal and persistent atrial fibrillation (AF) after catheter ablation on in-hospital outcomes and 30-day readmission remains limited. This study aimed to evaluate the procedural outcomes and 30-day readmission rates among patients with paroxysmal or persistent AF who were hospitalized for AF ablation. Using the Nationwide Readmissions Database, our study included patients aged ≥18 years with AF who were hospitalized and underwent catheter ablation during 2017-2020. Then, we compared the in-hospital procedural outcomes and 30-day readmission rates between patients with paroxysmal and persistent AF, respectively. Our study included 7310 index admissions for paroxysmal AF ablation and 9179 index admissions for persistent AF ablation. According to our analysis, there was no significant difference in procedural complications-namely, cerebrovascular accident, vascular complications, major bleeding requiring blood transfusion, phrenic nerve palsy, pericardial complications, and systemic embolization-between the persistent and paroxysmal AF groups. There was also no significant difference in early mortality between these groups (0.5% vs. 0.7%; P = .22). Persistent AF patients had significantly higher rates of prolonged index hospitalization (9.9% vs. 7.2%; P < .01) and non-home discharge (4.8% vs. 3.1%; P < .01). The 30-day readmission rates were comparable in both groups (10.0% vs. 9.5%; P = .34), with recurrent AF and heart failure being two of the most common causes of cardiac-related readmissions. Catheter ablation among hospitalized patients with paroxysmal or persistent AF resulted in no significant difference in procedural complications, early mortality, or 30-day readmission. This suggests that catheter ablation of AF can be performed with a relatively similar safety profile for both paroxysmal and persistent AF.

11.
Eur J Surg Oncol ; 50(9): 108477, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38954879

RESUMO

BACKGROUND AND AIMS: The concept of textbook outcomes (TOs) has gained increased attention as a critical metric to assess the quality and success of outcomes following complex surgery. A simple yet effective scoring system was developed and validated to predict risk of not achieving textbook outcomes (non-TOs) following hepatectomy for hepatocellular carcinoma (HCC). METHODS: Using a multicenter prospectively collected database, risk factors associated with non-TO among patients who underwent hepatectomy for HCC were identified. A predictive scoring system based on factors identified from multivariate regression analysis was used to risk stratify patients relative to non-TO. The score was developed using 70 % of the overall cohort and validated in the remaining 30 %. RESULTS: Among 3681 patients, 1458 (39.6 %) failied to experience a TO. Based on the derivation cohort, obesity, American Society of Anaesthesiologists score(ASA score), Child-Pugh grade, tumor size, and extent of hepatectomy were identified as independent predictors of non-TO. The scoring system ranged from 0 to 10 points. Patients were categorized into low (0-3 points), intermediate (4-6 points), and high risk (7-10 points) of non-TO. In the validation cohort, the predicted risk of developing non-TOs was 39.0 %, which closely matched the observed risk of 39.9 %. There were no differences among the predicted and observed risks within the different risk categories. CONCLUSIONS: A novel scoring system was able to predict risk of non-TO accurately following hepatectomy for HCC. The score may enable early identification of individuals at risk of adverse outcomes and inform surgical decision-making, and quality improvement initiatives.


Assuntos
Carcinoma Hepatocelular , Hepatectomia , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/cirurgia , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Idoso , Fatores de Risco , Carga Tumoral
12.
J Exp Clin Cancer Res ; 43(1): 208, 2024 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-39061061

RESUMO

BACKGROUND: Colorectal cancer (CRC) metachronous liver metastasis is a significant clinical challenge, largely attributable to the late detection and the intricate molecular mechanisms that remain poorly understood. This study aims to elucidate the role of Solute Carrier Family 14 Member 1 (SLC14A1) in the pathogenesis and progression of CRC metachronous liver metastasis. METHODS: We conducted a comprehensive analysis of CRC patient data from The Cancer Genome Atlas and GSE40967 databases, focusing on the differential expression of genes associated with non-metachronous liver metastasis and metachronous liver metastasis. Functional assays, both in vitro and in vivo, were performed to assess the biological impact of SLC14A1 modulation in CRC cells. Gene set enrichment analysis, molecular assays and immunohistochemical analyses on clinical specimens were employed to unravel the underlying mechanisms through which SLC14A1 exerts its effects. RESULTS: SLC14A1 was identified as a differentially expressed gene, with its overexpression significantly correlating with poor relapse-free and overall survival. Mechanistically, elevated SLC14A1 levels enhanced CRC cell invasiveness and migratory abilities, corroborated by upregulated TGF-ß/Smad signaling and Epithelial-Mesenchymal Transition. SLC14A1 interacted with TßRII and stabilized TßRII protein, impeding its Smurf1-mediated K48-linked ubiquitination and degradation, amplifying TGF-ß/Smad signaling. Furthermore, TGF-ß1 reciprocally elevated SLC14A1 mRNA expression, with Snail identified as a transcriptional regulator, binding downstream of SLC14A1's transcription start site, establishing a positive feedback loop. Clinically, SLC14A1, phosphorylated Smad2, and Snail were markedly upregulated in CRC patients with metachronous liver metastasis, underscoring their potential as prognostic markers. CONCLUSIONS: Our findings unveil SLC14A1 as a critical regulator in CRC metachronous liver metastasis, providing novel insights into the molecular crosstalk between SLC14A1 and TGF-ß/Smad signaling. These discoveries not only enhance our understanding of CRC metachronous liver metastasis pathogenesis, but also highlight SLC14A1 as a promising target for therapeutic intervention and predictive marker.


Assuntos
Neoplasias Colorretais , Transição Epitelial-Mesenquimal , Neoplasias Hepáticas , Transdução de Sinais , Fator de Crescimento Transformador beta , Animais , Feminino , Humanos , Masculino , Camundongos , Linhagem Celular Tumoral , Neoplasias Colorretais/patologia , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Prognóstico , Fator de Crescimento Transformador beta/metabolismo
14.
Ying Yong Sheng Tai Xue Bao ; 35(4): 1073-1082, 2024 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-38884242

RESUMO

Understanding the spatiotemporal variations and driving factors of regional vegetation coverage is crucial for developing scientific plans for ecological environment protection and maintaining regional ecological balance. Based on the Google Earth Engine (GEE) platform and using Landsat Collection 2 data, we investigated the spatiotemporal variation and driving factors of vegetation coverage in Shanxi Province, China, from 1990 to 2020, by employing methods such as pixel-based binary model, trend analysis, zonal statistics, and geodetector. The results showed that vegetation coverage in Shanxi Province showed a fluctuating upward trend from 1990 to 2020. Vegetation coverage in 44.4% of this region had been significantly improved, and the area with significant degradation accounted for 7.4%. Vegetation coverage in Shanxi Province was positively correlated with elevation, slope, and mountain terrain relief. The area proportion of vegetation coverage growth was the highest in the plateau and hilly regions. Factor detection results showed that land use type, landform type, annual average precipitation, and soil type were the main influencing factors of the spatial differentiation of vegetation coverage in Shanxi Province. Results of the interaction detection showed that the interaction between driving factors all showed enhancement. The interaction between natural factors showed a downward trend, while the interaction results of social factors showed an upward trend, reflecting that the impacts of human activities on vegetation coverage in Shanxi Province were gradually increasing.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Monitoramento Ambiental , China , Monitoramento Ambiental/métodos , Análise Espaço-Temporal , Árvores/crescimento & desenvolvimento , Tecnologia de Sensoriamento Remoto , Imagens de Satélites
15.
J Arrhythm ; 40(3): 434-439, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38939760

RESUMO

Background: The transdermal patch of bisoprolol available in Japan has been reported to demonstrate superior efficacy in preventing postoperative atrial fibrillation, possibly surpassing its oral counterpart. However, there has been no systematic review and meta-analysis assessing the efficacy of transdermal bisoprolol. Methods: A comprehensive systematic literature search was conducted on PubMed, Embase, and Cochrane to identify all relevant studies assessing the efficacy of transdermal bisoprolol in preventing postoperative atrial fibrillation. The search covered studies from inception up to December 4, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random-effects model to calculate risk ratios (RR) and 95% confidence intervals (CI). Results: Three studies, comprising a total of 551 patients (transdermal bisoprolol 228 and control 323), were included. There was a decreased risk of postoperative atrial fibrillation or atrial tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43, 95% CI 0.27-0.67, p = .0002, I 2 = 0%). Conclusion: Transdermal administration of bisoprolol has consistently shown efficacy, and this pooled analysis supports its effectiveness. The heterogeneity of the included studies limits certain interpretations. Future randomized clinical trials may elucidate the superiority of transdermal administration over oral administration.

16.
J Med Internet Res ; 26: e48572, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38700923

RESUMO

BACKGROUND: Adverse drug reactions (ADRs), which are the phenotypic manifestations of clinical drug toxicity in humans, are a major concern in precision clinical medicine. A comprehensive evaluation of ADRs is helpful for unbiased supervision of marketed drugs and for discovering new drugs with high success rates. OBJECTIVE: In current practice, drug safety evaluation is often oversimplified to the occurrence or nonoccurrence of ADRs. Given the limitations of current qualitative methods, there is an urgent need for a quantitative evaluation model to improve pharmacovigilance and the accurate assessment of drug safety. METHODS: In this study, we developed a mathematical model, namely the Adverse Drug Reaction Classification System (ADReCS) severity-grading model, for the quantitative characterization of ADR severity, a crucial feature for evaluating the impact of ADRs on human health. The model was constructed by mining millions of real-world historical adverse drug event reports. A new parameter called Severity_score was introduced to measure the severity of ADRs, and upper and lower score boundaries were determined for 5 severity grades. RESULTS: The ADReCS severity-grading model exhibited excellent consistency (99.22%) with the expert-grading system, the Common Terminology Criteria for Adverse Events. Hence, we graded the severity of 6277 standard ADRs for 129,407 drug-ADR pairs. Moreover, we calculated the occurrence rates of 6272 distinct ADRs for 127,763 drug-ADR pairs in large patient populations by mining real-world medication prescriptions. With the quantitative features, we demonstrated example applications in systematically elucidating ADR mechanisms and thereby discovered a list of drugs with improper dosages. CONCLUSIONS: In summary, this study represents the first comprehensive determination of both ADR severity grades and ADR frequencies. This endeavor establishes a strong foundation for future artificial intelligence applications in discovering new drugs with high efficacy and low toxicity. It also heralds a paradigm shift in clinical toxicity research, moving from qualitative description to quantitative evaluation.


Assuntos
Big Data , Mineração de Dados , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Mineração de Dados/métodos , Farmacovigilância , Modelos Teóricos , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos
17.
APMIS ; 132(8): 571-580, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38798084

RESUMO

The clinical data from 118 CTD patients with bronchiectasis were collected and categorized into two groups: pulmonary infection present (n = 67) and absent (n = 51), for comparative analysis of characteristics and risk factors. Then, we analyzed and compared their demographics, disease characteristics, and risk factors for infection. Among the whole cohort (n = 118), the incidence of pulmonary infections was 56.78%. The occurrence of rheumatoid arthritis, systemic lupus erythematosus, and vasculitis was found to be associated with an increased risk of pulmonary infection. Sputum culture identified Pseudomonas aeruginosa and Klebsiella pneumoniae as the predominant pathogens in the infected group. Notably, symptoms such as joint pains (p = 0.018) and morning stiffness (p = 0.017) were significantly more common in the infected group compared to the noninfected group. Moreover, our findings revealed that elevated levels of C-reactive protein and complement C3, along with bronchial expansion observed on high-resolution computed tomography (HRCT), were significant independent factors in the infection group. Conversely, pulmonary interstitial changes identified through HRCT (OR: 0.135, 95% CI: 0.030-0.612, p = 0.009) were significantly associated with the non-infection group. Overall, this study provides valuable insights into managing CTD patients with bronchiectasis, emphasizing early detection and tailored approaches to prevent and treat pulmonary infections for better outcomes.


Assuntos
Bronquiectasia , Doenças do Tecido Conjuntivo , Humanos , Bronquiectasia/complicações , Masculino , Feminino , Fatores de Risco , Pessoa de Meia-Idade , Doenças do Tecido Conjuntivo/complicações , Adulto , Idoso , Tomografia Computadorizada por Raios X , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Pseudomonas aeruginosa/isolamento & purificação , Incidência , Escarro/microbiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/complicações , Estudos Retrospectivos , Complemento C3/análise , Complemento C3/metabolismo
18.
ACS Omega ; 9(14): 15854-15860, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38617703

RESUMO

The porous skeleton structure of oxidizers can effectively enlarge the contact area with fuels and boost the reactivity of thermites, but the overly complex preparation processes tend to limit their use to some extent. To overcome this issue, water-soluble starch and copper nitrate were used as a template to form a carbon skeleton copper oxide (C-CuO) after spray drying and calcination. By adding nanoaluminum into the spray drying process, the n-Al@C-CuO was prepared and compared with the physically mixed n-Al/C-CuO in the context. Scanning electron microscopy and differential scanning calorimetry were used to observe the morphology and analyze the thermal process. The pressure-time test and the electrostatic sensitivity test were used to measure the energy release properties and the safety of the thermites. Results indicated that the n-Al@C-CuO had 60.97 °C earlier initial exothermic temperature and 1.74 times higher peak pressure than that of the physically mixed sample. The n-Al@C-CuO was not ignited under 25 kV in the electrostatic sensitivity test, showing the great electrostatic safety of the sample. These findings are expected to facilitate the development of spray drying and promote energy release of traditional thermites.

19.
Ying Yong Sheng Tai Xue Bao ; 35(3): 705-712, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38646758

RESUMO

The composition and stability of soil aggregates are important indicators for measuring soil quality, which would be affected by land use changes. Taking wetlands with different returning years (2 and 15 years) in the Yellow River Delta as the research object, paddy fields and natural wetlands as control, we analyzed the changes in soil physicochemical properties and soil aggregate composition. The results showed that soil water content, total organic carbon, dissolved organic carbon and total phosphorus of the returning soil (0-40 cm) showed an overall increasing trend with returning period, while soil pH and bulk density was in adverse. There was no significant change in clay content, electrical conductivity, and total nitrogen content. The contents of macro-aggregates and micro-aggregates showed overall increasing and decreasing trend with returning period, respectively. The stability of aggregates in the topsoil (0-10 cm) increased with returning years. Geometric mean diameter and mean weight diameter increased by 8.9% and 40.4% in the 15th year of returning, respectively, while the mass proportion of >2.5 mm fraction decreased by 10.5%. There was no effect of returning on aggregates in subsoil (10-40 cm). Our results indicated that returning paddy field to wetland in the Yellow River Delta would play a positive role in improving soil structure and aggregate stability.


Assuntos
Oryza , Rios , Solo , Áreas Alagadas , Solo/química , China , Rios/química , Oryza/crescimento & desenvolvimento , Oryza/química , Monitoramento Ambiental , Agricultura/métodos , Fósforo/análise , Fósforo/química , Carbono/análise , Carbono/química
20.
Food Chem ; 451: 139467, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38678661

RESUMO

Betacyanins have garnered escalating research interest for their promising bioactivities. However, substantial challenges in purification and separation have impeded a holistic comprehension of the distinct bioactivities of individual betacyanins and their underlying mechanisms. Herein, betanin and phyllocactin monomers with purity exceeding 95% were successfully obtained from Hylocereus polyrhizus peel using a feasible protocol. These monomers were subsequently employed for comparative bioactivity assessments to uncover underlying mechanisms and illuminate structure-activity relationships. Interestingly, phyllocactin exhibited superior antioxidant activities and 36.1% stronger inhibitory activity on α-glucosidase compared to betanin. Mechanistic studies have revealed that they function as mixed-type inhibitors of α-amylase and competitive inhibitors of α-glucosidase, with interactions predominantly driven by hydrogen bonding. Notably, phyllocactin demonstrated a greater binding affinity with enzymes than betanin, thereby substantiating its heightened inhibitory activity. Overall, our results highlight novel bioactivities of betacyanin monomers and provide profound insights into the intricate interplay between structures and properties.


Assuntos
Antioxidantes , Betacianinas , Cactaceae , Hipoglicemiantes , Extratos Vegetais , Antioxidantes/química , Antioxidantes/farmacologia , Antioxidantes/isolamento & purificação , Betacianinas/química , Betacianinas/farmacologia , Betacianinas/isolamento & purificação , Hipoglicemiantes/química , Hipoglicemiantes/farmacologia , Hipoglicemiantes/isolamento & purificação , Cactaceae/química , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Extratos Vegetais/isolamento & purificação , alfa-Glucosidases/química , alfa-Glucosidases/metabolismo , alfa-Amilases/antagonistas & inibidores , alfa-Amilases/química , Relação Estrutura-Atividade
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