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1.
J Hepatol ; 2024 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-39368711

RESUMO

BACKGROUND & AIMS: Data are limited on the risk of de novo hepatocellular carcinoma (HCC) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) after achieving sustained virologic response (SVR12) using direct-acting antivirals (DAAs) for hepatitis C virus (HCV). METHODS: 1598 eligible patients received biannual alpha-fetoprotein (AFP) and liver imaging surveillance to detect de novo HCC beyond achieving SVR12. MASLD was defined as presence of controlled attenuation parameter (CAP) ≥ 248 dB/m and ≥ one cardiometabolic risk factor (CMRF). Cumulative HCC incidence was compared between patients with/without MASLD. We built univariable and multivariable Cox proportional hazards models to evaluate factors associated with HCC. Sensitivity analysis was performed using the Fine-Gray subdistribution hazards model. Additionally, we evaluated the mediation effect of MASLD on CMRFs and of CMRFs on MASLD for HCC using mediation analysis with bootstrapping. RESULTS: The incidence rate of HCC was 1.44 per 100 person-years of follow-up (PYFU) [95% confidence interval (CI): 1.19-1.74]. Patients with MASLD had a higher cumulative HCC incidence than those without MASLD (log-rank test, p < 0.001). Multivariable Cox regression analysis revealed that in addition to age, sex, LSM, platelet count, and AFP, MASLD (adjusted hazard ratio (aHR): 2.07 [95% CI:1.36-3.16], p < 0.001) was independently associated with HCC. This finding was confirmed by the Fine-Gray model, which showed a subdistribution HR (sHR) of 2.07 (95% CI: 1.34-3.19, p < 0.001) for MASLD. MASLD significantly mediated CMRFs for HCC development. CONCLUSION: After achieving SVR12, patients with MASLD exhibited an increased HCC risk compared to those without MASLD. Vigilant HCC surveillance and control of CMRFs to mitigate the effect MASLD on HCC remain crucial for this population. IMPACT AND IMPLICATIONS: The risk of de novo HCC among patients with MASLD, a novel nomenclature of steatotic liver disease (SLD), after the attaining of SVR12 using DAAs remains to be confirmed. In this study recruiting 1598 patients in Taiwan, individuals with MASLD exhibited approximately a two-fold increased risk of de novo HCC, compared to those without MASLD after achieving SVR12. MASLD significantly mediated CMRFs for HCC development. Our findings underscore the critical importance of pharmacological interventions and proactive lifestyle modifications to control CMRFs in patients with MASLD, as well as the need for vigilant HCC surveillance to ensure favorable outcomes following HCV eradication.

2.
Acta Cardiol Sin ; 40(5): 635-643, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39308657

RESUMO

Objectives: Cardiac amyloidosis (CA) is a type of systemic amyloidosis. Amyloid-targeting positron emission tomography (PET) has shown potential as an imaging method for CA. However, the optimal imaging protocol and role of 18F-florbetaben (FBB) PET in the diagnosis and subtyping of CA have yet to be determined. Methods: Patients with suspected CA who had positive or equivocal results of technetium-99m pyrophosphate (PYP) scintigraphy were enrolled for dynamic and late FBB PET imaging. In addition to visual assessment, a kinetic modeling-based approach including target-to-background ratio (TBR) and myocardial retention fraction (RF) of serial images reconstructed from a 20-min dynamic acquisition, and a late image at 110 min post-injection were performed. We compared FBB PET measures of four typical patients with light chain amyloidosis (AL), wild-type transthyretin amyloidosis (ATTRwt), variant transthyretin amyloidosis (ATTRv), and heart failure, respectively. We also reviewed the literature on the clinical use of amyloid PET in CA. Results: Myocardial tracer retention was only found in the AL patient on the late images. TBR and RF were highest in the AL patient followed by the ATTRwt patient, and lowest in the ATTRv and non-CA patients. Conclusions: FBB PET has potential in the detection and non-invasive subtyping of CA, especially in subjects with equivocal PYP findings or monoclonal gammopathy.

4.
J Chin Med Assoc ; 2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-39118204

RESUMO

BACKGROUND: TBK1 variants have been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia spectrum disorder. The current study elucidated the clinical and molecular genetic features of a novel TBK1 variant identified in a patient with young-onset, rapidly progressive ALS. METHODS: The coding regions of TBK1, SOD1, TARDBP, and FUS were genetically analyzed using Sanger sequencing. Repeat-primed PCR was used to survey the GGGGCC repeat in C9ORF72. The study participant underwent a comprehensive clinical evaluation. The functional effects of the TBK1 variant were analyzed through in vitro transfection studies. RESULTS: We identified a novel frameshift truncating TBK1 variant, c.456_457delGT (p.Y153Qfs*9), in a man with ALS. The disease initially manifested as right hand weakness at the age of 39 years but progressed rapidly, with the revised ALS Functional Rating Scale score declining at an average monthly rate of 1.92 points in the first year after diagnosis. The patient had no cognitive dysfunction. However, Technetium-99m single photon emission tomography indicated hypoperfusion in his bilateral superior and middle frontal cortices. In vitro studies revealed that the p.Y153Qfs*9 variant resulted in a truncated TBK1 protein product, reduced TBK1 protein expression, loss of kinase function, reduced interaction with optineurin, and impaired dimerization. CONCLUSION: The heterozygous TBK1 p.Y153Qfs*9 variant may be associated with young-onset, rapidly progressive ALS through a haploinsufficiency mechanism.

5.
BMC Nurs ; 23(1): 539, 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39112994

RESUMO

BACKGROUND: Patient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master's students in China. METHODS: A sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students' competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year. RESULTS: A total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members' authority and team dynamics, and dealing with inter-professional conflict. CONCLUSIONS: The quantitative and qualitative data align, supporting the enhancement of students' PS competence.

6.
J Hazard Mater ; 477: 135276, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39088953

RESUMO

Nitrate-containing wastewaters have been recognized as an important source for recovering valuable ammonia. This work targets integrating a series of transition metals (M = Fe, Co, Ni, and Zn) onto Cu crystallites through a layered-plating method. The strategy to promote the nitrate reduction reaction (NO3-RR) involves tuning M surfaces in specific ratios for the hydrogenation of nitrogenous species on MxCu1-x electrodes. Electrochemical analysis and operando Raman spectra identified that a solid-state Cu2O-to-Cu0 transition acted as the primary mediator, while its high corrosion resistance protected the M metals or metal oxides from inactivation in nitrate-to-ammonia pathways. Among bimetals, FeCu was the best combination, with the order of performance in constant potential electrolysis, Fe0.36Cu0.64 > Ni0.73Cu0.27 > Co0.34Cu0.66 > Zn0.64Cu0.36. The collaboration of Cu and M in deoxygenating nitrate and subsequently hydrogenating NOx at respective overpotentials is key to enhancing ammonia yield. Nitrate removal (96 %), NH3 selectivity (93 %), and Faradaic efficiency (92 %) were optimized on Fe0.36Cu0.64 electrode at -0.6 V (vs. RHE). A steady yield as high as 14,080 µg h-1 mg-1 was achieved at 30 mA cm-2 using a real water sample (NO3- ∼ 500 mg-N L-1, pH 4) as the input stream, continuously operated for 96 h.

7.
Sci Immunol ; 9(98): eadn2717, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39178275

RESUMO

The formation of memory T cells is a fundamental feature of adaptative immunity, allowing the establishment of long-term protection against pathogens. Although emerging evidence suggests that metabolic reprogramming is crucial for memory T cell differentiation and survival, the underlying mechanisms that drive metabolic rewiring in memory T cells remain unclear. Here, we found that up-regulation of the nuclear receptor peroxisome proliferator-activated receptor ß/δ (PPARß/δ) instructs the metabolic reprogramming that occurs during the establishment of central memory CD8+ T cells. PPARß/δ-regulated changes included suppression of aerobic glycolysis and enhancement of oxidative metabolism and fatty acid oxidation. Mechanistically, exposure to interleukin-15 and expression of T cell factor 1 facilitated activation of the PPARß/δ pathway, counteracting apoptosis induced by antigen clearance and metabolic stress. Together, our findings indicate that PPARß/δ is a master metabolic regulator orchestrating a metabolic switch that may be favorable for T cell longevity.


Assuntos
Linfócitos T CD8-Positivos , Camundongos Endogâmicos C57BL , PPAR delta , PPAR beta , Animais , PPAR beta/metabolismo , PPAR beta/imunologia , Linfócitos T CD8-Positivos/imunologia , PPAR delta/imunologia , PPAR delta/metabolismo , Camundongos , Memória Imunológica/imunologia , Células T de Memória/imunologia , Camundongos Knockout , Interleucina-15/imunologia , Interleucina-15/metabolismo , Camundongos Transgênicos , Reprogramação Metabólica , Receptores Citoplasmáticos e Nucleares
8.
Sci Rep ; 14(1): 17052, 2024 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-39048640

RESUMO

This study explores disparities and opportunities in healthcare information provided by AI chatbots. We focused on recommendations for adjuvant therapy in endometrial cancer, analyzing responses across four regions (Indonesia, Nigeria, Taiwan, USA) and three platforms (Bard, Bing, ChatGPT-3.5). Utilizing previously published cases, we asked identical questions to chatbots from each location within a 24-h window. Responses were evaluated in a double-blinded manner on relevance, clarity, depth, focus, and coherence by ten experts in endometrial cancer. Our analysis revealed significant variations across different countries/regions (p < 0.001). Interestingly, Bing's responses in Nigeria consistently outperformed others (p < 0.05), excelling in all evaluation criteria (p < 0.001). Bard also performed better in Nigeria compared to other regions (p < 0.05), consistently surpassing them across all categories (p < 0.001, with relevance reaching p < 0.01). Notably, Bard's overall scores were significantly higher than those of ChatGPT-3.5 and Bing in all locations (p < 0.001). These findings highlight disparities and opportunities in the quality of AI-powered healthcare information based on user location and platform. This emphasizes the necessity for more research and development to guarantee equal access to trustworthy medical information through AI technologies.


Assuntos
Inteligência Artificial , Humanos , Feminino , Nigéria , Taiwan , Estados Unidos
9.
Bioeng Transl Med ; 9(4): e10653, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39036090

RESUMO

Cervical cancer is a significant public health concern, particularly in low- and middle-income countries where resources for prevention and treatment are limited. Routine screening, such as the Papanicolaou test (Pap smears) and human papillomavirus (HPV) testing, plays a crucial role in the early detection and prevention of cervical cancer. However, the participation rate in cervical cancer screening programs remains below optimal levels due to various factors. This study aimed to evaluate the reliability and acceptability of the HygeiaTouch Self Sampling Kit for Women in collecting vaginal samples for HPV typing, comparing the results with samples collected by physicians. The study included 1210 women aged 21-65 from three medical centers in Taiwan. The findings indicated that the self-sampling kit was as effective as physician-collected specimens in terms of obtaining valid samples and identifying HPV. The agreement between the two methods was 88%, with a κ value of 0.75. Furthermore, the study assessed the mechanical characteristics of the self-sampling applicator through tensile, bending, and torque tests, and determined that it was safe for intravaginal use. Additionally, the study evaluated the safety and satisfaction of self-sampling and found a low rate of adverse events (0.7%) and high levels of satisfaction (over 90%) among participants. Overall, we demonstrated that the HygeiaTouch Self Sampling Kit for Women is a reliable and acceptable device for HPV testing and cervical screening, providing a convenient, safe, and effective alternative for women.

10.
Cureus ; 16(6): e62769, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39036279

RESUMO

Background In a population, when a disease is causing a symptom, the overall symptom incidence can be determined by proportions diseased, baseline symptom incidence, and risk ratios of developing the symptom due to the disease. There are various measures of association, including risk ratios. How risk ratios are linked to other measures of association, such as correlation coefficients and chi-squared statistics, has not been explicitly discussed. This study aims to demonstrate their connection via equations and simulations, assuming one disease causes symptoms. Methods The equations for correlation coefficients and chi-square statistics were rewritten using epidemiological measures: proportions diseased, baseline symptom incidence, and risk ratios. Simulations were conducted to test the accuracy of the equations. The baseline symptom incidence and the proportions diseased were assumed to be 0.05, 0.1, 0.2, 0.4, or 0.8. The risk ratios were assumed to be 0.5, 1, 2, 5, 10, and 25. Another disease that correlates with this disease was created (correlation = 0, 0.3, or 0.7). For each combination of symptom incidence, proportions diseased, risk ratios, and between-disease correlations, 10,000 subjects were simulated. The correlation coefficients and chi-squared statistics were approximated with epidemiologic measures and their interaction terms. R-squared was used to assess the importance of the epidemiologic measures. Results In the simulations, the overall symptom incidence, correlation coefficients, and chi-squared statistics between the disease and symptoms could be fully explained by the epidemiologic measures in the equations (R-squared = 1). When approximating correlation coefficients and chi-squared statistics with individual measures or their interaction terms, the importance of these measures depended on whether the at-risk incidence reached 1 or not. The numbers in the four cells in the contingency table predicted correlation coefficients, or chi-squared statistics, with different R-squared. Conclusion To our knowledge, this is the first study to translate the three epidemiologic measures (risk ratios, baseline symptom incidence, and proportions diseased) into correlation coefficients and chi-squared statistics. However, chi-squared statistics also depend on sample sizes. This study also provides a platform for developing teaching cases for students to investigate the causal relationship between diseases and symptoms or exposure and outcomes.

11.
Stud Health Technol Inform ; 315: 598-599, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39049340

RESUMO

In the post-pandemic era, the work pressure, trauma, anxiety, and burnout of shift nursing staff has continued to rise in all levels. By introducing Healing Games, turning interactions into game-like situations and using mindfulness as a framework, this will allow the nursing staff to realize their self-healing and help reduce stress.Through the establishment of this healing & stress-relieving game for nursing (HSR game-N) will also have a positive self-control effect on the negative emotions of work pressure. The application of such technology used by shift nurses can help negate and decrease the work pressure of shift nurses.


Assuntos
Estresse Ocupacional , Humanos , COVID-19 , Atenção Plena , Jogos de Vídeo , Esgotamento Profissional/prevenção & controle , Recursos Humanos de Enfermagem Hospitalar/psicologia , Pandemias , Jornada de Trabalho em Turnos , Estresse Psicológico
12.
Chem Commun (Camb) ; 60(61): 7914-7917, 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-38980122

RESUMO

A series of metalloligands bearing homoleptic 2,2':6',2''-terpyridine (tpy)-CdII complexes has been successfully synthesized. The formation of ML1 was accomplished through a sequence of Suzuki-Miyaura coupling and complexation reactions, offering an alternative method to produce tpy-based metalloligands under relatively mild conditions. Moreover, the metallomacrocycle C1 and metallocatenane C2 were self-assembled from heteroleptic complexation reactions involving ML1 and suitable counterparts.

13.
J Health Psychol ; : 13591053241258252, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38898617

RESUMO

Depression symptoms are prevalent among nursing students, especially those in Asia. This study assessed the association between rumination and depression symptoms among female nursing students (N = 148) and the chain mediation role of sleep-wake indexes and insomnia symptoms. The data were collected from a battery of questionnaires and consecutive 7-day actigraphy data for analyzing sleep-wake indexes. About 54.1% of the participants had either mild or moderate depression symptoms. Most students (89.2%) had a delayed circadian phase, and circadian activity rhythm (CAR) was not ideal. The path mediation model underwent analysis using the PROCESS macros. The results showed that rumination in students is directly positively correlated with depressive symptoms (b = 4.831). Moreover, the association between rumination and depressive symptoms is sequent (moderating effect = 0.12, 95% CI [0.017, 0.410]). The proposed model in this study provides a foundation for improving educational programs on sleep hygiene and promoting mental wellness.

14.
Infection ; 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38904891

RESUMO

INTRODUCTION: The COVID-19 pandemic has underscored the importance of its potential long-term health effects, including its link to new-onset asthma in children. Asthma significantly impacts children's health, causing adverse outcomes and increased absenteeism. Emerging evidence suggests a potential association between COVID-19 infection and higher rates of new-onset asthma in adults, raising concerns about its impact on children's respiratory health. METHODS: A retrospective cohort study design was employed, using electronic medical records from the TriNetX database, covering January 1, 2021, to December 31, 2022. Two cohorts of children aged 5 to 18 who underwent SARS-CoV-2 RT-PCR testing were analyzed: unvaccinated children with and without COVID-19 infection, and vaccinated children with and without infection. Propensity score matching was used to mitigate selection bias, and hazard ratio (HR) and 95% CI were calculated to assess the risk of new-onset asthma. RESULTS: Our study found a significantly higher incidence of new-onset asthma in COVID-19 infected children compared to uninfected children, regardless of vaccination status. In Cohort 1, 4.7% of COVID-19 infected children without vaccination developed new-onset asthma, versus 2.0% in their non-COVID-19 counterparts within a year (HR = 2.26; 95% CI = 2.158-2.367). For Cohort 2, COVID-19 infected children with vaccination showed an 8.3% incidence of new-onset asthma, higher than the 3.1% in those not infected (HR = 2.745; 95% CI = 2.521-2.99). Subgroup analyses further identified higher risks in males, children aged 5-12 years, and Black or African American children. Sensitivity analyses confirmed the reliability of these findings. CONCLUSION: The study highlights a strong link between COVID-19 infection and an increased risk of new-onset asthma in children, which is even more marked in those vaccinated. This emphasizes the critical need for ongoing monitoring and customized healthcare strategies to mitigate the long-term respiratory impacts of COVID-19 in children, advocating for thorough strategies to manage and prevent asthma amidst the pandemic.

15.
Soc Sci Med ; 353: 117064, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38941726

RESUMO

Using the risk information seeking and processing model, this study examined how five personality traits-extraversion, neuroticism, conscientiousness, openness to experience, and agreeableness-influenced individuals' information-seeking behaviors and vaccination intentions. An online survey was administered by a reputable polling company commissioned by this study. The survey employed age, education, gender, and income as distinct strata for sampling, which resulted in 1100 valid questionnaires. The following five conclusions were drawn from the data analysis: (1) Of the five personality traits, two-extraversion and conscientiousness-exhibited a notable impact on individuals' information-seeking behaviors and vaccination intentions. Individuals with the remaining three personality traits-neuroticism, agreeableness, and openness to experience-demonstrate either passive or no information-seeking behaviors on COVID-19. (2) Conscientiousness was the only personality trait linked to increased awareness of COVID-19 characteristics. Moreover, conscientious individuals were inclined to avoid depending on ISNs to seek COVID-19 information and developed vaccination intentions. In contrast, individuals high in agreeableness heavily depended on ISNs for COVID-19 information to initiate information-seeking behaviors. Meanwhile, individuals high in extraversion relied on two variables-affective responses and ISNs-to begin their information-seeking behaviors. (3) Respondents' perceptions of COVID-19 characteristics and their affective responses did not positively influence their perceived information insufficiency directly; instead, both needed to be mediated by ISNs to initiate their information-seeking behaviors. (4) In contrast to the two variables-perceived COVID-19 characteristics and affective responses-this study found that ISNs regarding COVID-19 played a more substantial role in shaping respondents' information-seeking behaviors and vaccination intentions. (5) Unexpectedly, openness to experience was found to have no impact on information-seeking behaviors during the COVID-19 pandemic.


Assuntos
COVID-19 , Comportamento de Busca de Informação , Intenção , Personalidade , Vacinação , Humanos , Masculino , Feminino , COVID-19/prevenção & controle , COVID-19/psicologia , COVID-19/epidemiologia , Adulto , Taiwan , Pessoa de Meia-Idade , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem , SARS-CoV-2 , Idoso
16.
BMC Nurs ; 23(1): 373, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38831334

RESUMO

BACKGROUND: The World Health Organization urged governments to prioritize the health and work well-being of nursing staff by promoting a positive working environment. A safe and healthy physical and psychosocial work environment is a basic human right for nurses. Job crafting is a necessary skill when facing challenging working conditions. OBJECTIVES: This cross-sectional correlational research based on the Job Demands-Resources Model aimed to explore the correlation between psychosocial work environment and work well-being among nurses working in the intensive care unit (ICU) and determine whether personal perceived health could mediate the relationship and whether job crafting can moderate the mediating effect. The study hypothesized that: 1. The psychosocial work environment would impact nurses' work well-being; 2. Personal perceived health would play a role as a mediator in the relationship between psychosocial work environment and work well-being; 3. Job crafting would moderate the relationship between personal perceived health and work well-being. METHODS: A total of 655 registered nurses (RNs) from 7 ICUs in a teaching hospital in Beijing participated in this study. The RNs completed a battery questionnaire measuring their health, psychosocial work environment, well-being, and job crafting. PROCESS macros analysis was used to test mediating and moderating effects. RESULTS: Personal perceived health mediated the relationship between psychosocial work environment and work well-being (b = 0.012, 95% CI [0.008, 0.016]). The moderated mediated analysis revealed that job crafting moderated perceived health's impact on work well-being (b = -0.007, 95% CI [- 0.010, - 0.003]). CONCLUSION: A better psychosocial work environment with well-designed work organization and job content through job crafting could positively impact nurses' health and work well-being.

17.
Diabetes Metab ; 50(4): 101546, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38843591

RESUMO

BACKGROUND: The influence of menopausal hormone therapy (MHT) on the probability of developing diabetes mellitus in individuals with prediabetes remains uncertain. METHODS: This retrospective cohort study, utilizing the TriNetX U.S. Collaborative Network, investigated cohorts, implemented propensity score matching, and analyzed outcomes associated with diabetes mellitus. The study focused on individuals aged 46-60 with prediabetes prior to menopause, categorizing them into MHT and non-MHT groups. Further stratified analyses, including variables such as age and race, were conducted to thoroughly examine potential variations in outcomes. RESULTS: The study involved 6566 individuals (MHT and non-MHT), with propensity score matching ensuring balanced cohorts. Over a 20-year follow-up, the MHT group demonstrated a lower incidence of diabetes mellitus compared to the non- MHT group, with a Hazard Ratio of 0.693 (95 % CI: 0.577, 0.832). Stratified analyses revealed age-specific nuances, with significant protective effects in individuals aged 46-50 and 55-60. Additionally, ethnicity played a role, with MHT demonstrating significant benefits in White individuals but not in the Black or Asian populations. BMI analysis indicated a significant risk reduction with MHT in individuals with BMI less than or equal to 24.9 and 25-29.9 kg/m 2, but not in those with BMI greater than or equal to 30 kg/m 2. CONCLUSION: In our study, we demonstrate a sustained 20-year decrease in the risk of diabetes among premenopausal individuals with prediabetes who undergo menopausal hormone therapy.


Assuntos
Estado Pré-Diabético , Humanos , Estado Pré-Diabético/epidemiologia , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Perimenopausa , Terapia de Reposição de Estrogênios/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus/epidemiologia , Incidência
18.
Cancer Rep (Hoboken) ; 7(5): e2102, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38775249

RESUMO

BACKGROUND: Thalidomide-containing regimens cause adverse events (AEs) that may require a reduction in treatment intensity or even treatment discontinuation in patients with multiple myeloma. As thalidomide toxicity is dose-dependent, identifying the most appropriate dose for each patient is essential. AIMS: This study aimed to investigate the effects of a thalidomide dose step-up strategy on treatment response and progression-free survival (PFS). METHODS AND RESULTS: This prospective observational study included 93 patients with newly diagnosed multiple myeloma (NDMM) who received bortezomib, thalidomide, and dexamethasone (VTD). The present study assessed the incidence of thalidomide dose reduction and discontinuation, the overall dose intensity, and their effects on therapeutic efficacy. Furthermore, this study used Cox proportional hazard models to analyze the factors contributing to thalidomide intolerability. The results showed the overall response rates in all patients and the evaluable patients were 78.5% and 98.7%, respectively. The median PFS in the study cohort was not reached. The most common thalidomide-related AEs were constipation (32.3%) and skin rash (23.7%), resulting in dose reduction and discontinuation rates of 22.6% and 21.5%, respectively. The responders had a significantly higher average thalidomide dose intensity than the nonresponders (88.6% vs. 42.9%, p < .001). CONCLUSION: The thalidomide dose step-up approach is a viable option for patients with NDMM receiving VTD induction therapy with satisfactory efficacy and tolerability. However, thalidomide intolerance may lead to dose reduction or discontinuation due to unpredictable AEs, leading to lower dose intensity and potentially inferior treatment outcomes. In addition to a dose step-up strategy, optimal supportive care is critical for patients with multiple myeloma receiving VTD induction therapy.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Bortezomib , Dexametasona , Mieloma Múltiplo , Talidomida , Humanos , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/mortalidade , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/patologia , Talidomida/administração & dosagem , Talidomida/efeitos adversos , Feminino , Dexametasona/administração & dosagem , Dexametasona/efeitos adversos , Masculino , Bortezomib/administração & dosagem , Bortezomib/efeitos adversos , Estudos Prospectivos , Idoso , Pessoa de Meia-Idade , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Adulto , Quimioterapia de Indução/métodos , Quimioterapia de Indução/efeitos adversos , Intervalo Livre de Progressão , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga
19.
Virus Res ; 345: 199387, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38719025

RESUMO

Influenza A virus can infect respiratory tracts and may cause severe illness in humans. Proteins encoded by influenza A virus can interact with cellular factors and dysregulate host biological processes to support viral replication and cause pathogenicity. The influenza viral PA protein is not only a subunit of influenza viral polymerase but also a virulence factor involved in pathogenicity during infection. To explore the role of the influenza virus PA protein in regulating host biological processes, we performed immunoprecipitation and LC‒MS/MS to globally identify cellular factors that interact with the PA proteins of the influenza A H1N1, 2009 pandemic H1N1, and H3N2 viruses. The results demonstrated that proteins located in the mitochondrion, proteasome, and nucleus are associated with the PA protein. We further discovered that the PA protein is partly located in mitochondria by immunofluorescence and mitochondrial fractionation and that overexpression of the PA protein reduces mitochondrial respiration. In addition, our results revealed the interaction between PA and the mitochondrial matrix protein PYCR2 and the antiviral role of PYCR2 during influenza A virus replication. Moreover, we found that the PA protein could also trigger autophagy and disrupt mitochondrial homeostasis. Overall, our research revealed the impacts of the influenza A virus PA protein on mitochondrial function and autophagy.


Assuntos
Mitocôndrias , Proteínas Virais , Replicação Viral , Humanos , Mitocôndrias/metabolismo , Mitocôndrias/virologia , Proteínas Virais/metabolismo , Proteínas Virais/genética , RNA Polimerase Dependente de RNA/metabolismo , RNA Polimerase Dependente de RNA/genética , Vírus da Influenza A/fisiologia , Vírus da Influenza A/genética , Vírus da Influenza A/patogenicidade , Vírus da Influenza A/metabolismo , Interações Hospedeiro-Patógeno , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/fisiologia , Vírus da Influenza A Subtipo H3N2/metabolismo , Autofagia , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/fisiologia , Vírus da Influenza A Subtipo H1N1/patogenicidade , Células HEK293 , Influenza Humana/virologia , Influenza Humana/metabolismo , Células A549 , Proteínas Mitocondriais/metabolismo , Proteínas Mitocondriais/genética , Espectrometria de Massas em Tandem
20.
Anticancer Res ; 44(6): 2545-2554, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38821599

RESUMO

BACKGROUND/AIM: Epidermal growth factor receptor (EGFR) over-expression is commonly observed in advanced head and neck squamous cell carcinoma (HNSCC) and is correlated with poor patient outcomes. However, the role of dual-specificity phosphatase 6 (DUSP6) in EGFR-associated HNSCC progression remains poorly understood. This study aimed to investigate the correlation between DUSP6 expression and EGFR signaling in malignant HNSCC tissues. MATERIALS AND METHODS: Data mining and in vitro assays were employed to assess DUSP6 expression levels in HNSCC tissues compared to normal tissues. Additionally, the correlation between DUSP6 and EGFR expression was examined. Functional assays were conducted to investigate the modulation of DUSP6 expression by EGFR signaling and its involvement in EGF-induced cell migration and anoikis resistance. RESULTS: Our analysis revealed a significant elevation in DUSP6 expression in HNSCC tissues compared to normal tissues and a strong correlation between DUSP6 and EGFR expression. EGFR signaling modulated DUSP6 expression in a dose- and time-dependent manner, primarily through the extracellular signal-regulated kinase (ERK) pathway. Knockdown experiments demonstrated the functional role of DUSP6 in EGF-induced cell migration and anoikis resistance. CONCLUSION: The findings of this study elucidate the intricate signaling networks governing DUSP6 expression and its interplay with EGFR signaling in HNSCC. Moreover, the results provide insights into the potential role of DUSP6 as a therapeutic target and highlight the importance of personalized treatment strategies in HNSCC management.


Assuntos
Movimento Celular , Fosfatase 6 de Especificidade Dupla , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas de Cabeça e Pescoço , Humanos , Anoikis/genética , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular Tumoral , Progressão da Doença , Fosfatase 6 de Especificidade Dupla/genética , Fosfatase 6 de Especificidade Dupla/metabolismo , Receptores ErbB/metabolismo , Receptores ErbB/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/metabolismo , Transdução de Sinais , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo
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