This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, ...EMBASE and Chinese databases (China National Knowledge Interne (CNKI), WanFang Data and SinoMed). Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval CI: 12.1%-18.5%). No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6%) was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%). The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001). The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults.
CRD 42016043620.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recently, rapid phenotypic antimicrobial susceptibility testing (AST) based on microscopic imaging analysis has been developed. The aim of this study was to determine whether implementation of ...antimicrobial stewardship programmes (ASP) based on rapid phenotypic AST can increase the proportion of patients with haematological malignancies who receive optimal targeted antibiotics during early periods of bacteraemia.
This randomized controlled trial enrolled patients with haematological malignancies and at least one positive blood culture. Patients were randomly assigned 1:1 to conventional (n = 60) or rapid phenotypic (n = 56) AST. The primary outcome was the proportion of patients receiving optimal targeted antibiotics 72 hr after blood collection for culture.
The percentage receiving optimal targeted antibiotics at 72 hr was significantly higher in the rapid phenotypic AST group (45/56, 80.4%) than in conventional AST group (34/60, 56.7%) (relative risk (RR) 1.42, 95% confidence interval (CI) 1.09–1.83). The percentage receiving unnecessary broad-spectrum antibiotics at 72 hr was significantly lower (7/26, 12.5% vs 18/60, 30.0%; RR 0.42, 95% CI 0.19–0.92) and the mean time to optimal targeted antibiotic treatment was significantly shorter (38.1, standard deviation (SD) 38.2 vs 72.8, SD 93.0 hr; p < 0.001) in the rapid phenotypic AST group. The mean time from blood collection to the AST result was significantly shorter in the rapid phenotypic AST group (48.3, SD 17.6 vs 83.1, SD 22.2 hr).
ASP based on rapid phenotypic AST can rapidly optimize antibiotic treatment for bacteraemia in patients with haematological malignancy. Rapid phenotypic AST can improve antimicrobial stewardship in immunocompromised patients.
Background/Aim: This prospective multi-central randomized phase II trial evaluated the efficacy and safety of oral Vitamin B12 500 μg/day replacement compared with oral Vitamin B12 1,500 μg/day in ...patients with Vitamin B12 deficiency after total gastrectomy for gastric cancer. Patients and Methods: Patients were randomly assigned to receive oral Vitamin B12 500 μg/day or Vitamin B12 1,500 μg/day in a 1:1 ratio with a minimization method. The primary endpoint was the incidence of a normal serum Vitamin B12 level at three months after treatment. Results: From January 2018 to December 2021, 3 institutions collaborated with the present study, and 74 patients were registered from these 3 institutions. The study was prematurely closed due to poor accrual after reaching almost 50% of its goal. Among the 74 recruited patients, 36 were allocated to the Vitamin B12 500 μg/day arm and 38 to Vitamin B12 1,500 μg/day arm. The incidences of patients with a normal Vitamin B12 level at 3 months (serum Vitamin B12 level >200 pg/ml) were 91.7% (33/36) in the Vitamin B12 500 μg/day arm and 100% (38/38) in the Vitamin B12 1,500 μg/day arm (p=0.3587). The types of clinical symptoms with Vitamin B12 deficiency that improved with Vitamin B12 treatment and the degree of improvement were also similar. Conclusion: Although the primary endpoint of the present study was not met, it was found that oral Vitamin B12 500 μg/day replacement is as effective and safe as oral Vitamin B12 1,500 μg/day replacement for Vitamin B12 deficiency.
Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the ...alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model.
In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value.
Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment.
LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this paper, we identify the different determinants of the location of research and development (R&D) on foreign direct investment (FDI) in both developed and developing countries. In the case of ...host developed countries, we find that private R&D investment is positively associated with attracting R&D on FDI. In contrast, in the case of host developing countries, we find that private R&D investment is not significantly associated with attracting R&D FDI, but public R&D induces it. These findings imply that the objective of R&D FDI in developed economies is to advance multinational corporations’ (MNCs) technology further by targeting the local technology market. In contrast, the R&D FDI of MNCs in developing countries is attracted toward localities where the R&D infrastructure is better developed due to public R&D investment. MNCs in developing countries do not direct considerable attention to the R&D activities of the local private sector because their goal is to modify their own technology or products for the local product or export markets in the host countries. Therefore, although one obvious policy implication is the importance of conducting local R&D to attract foreign R&D, the more important factors are to stimulate private R&D further in the case of developed countries and to initiate public R&D first in the case of developing countries.
American Indian and Alaskan Natives (AIAN) and Native Hawaiian and Pacific Islanders (NHPI) research is limited, particularly in postoperative surgical outcomes. This study analyzes disparities in ...AIAN and NHPI surgical complications across all surgical types and identifies factors that contribute to postoperative complications.
This retrospective cohort study examined all surgeries from 2011 to 2020 in the National Surgical Quality Improvement Program, queried by race. Multivariable models analyzed the association of race and ethnicity and 30-day postoperative complication. Next, multivariable models were used to identify preoperative variables associated with postoperative complications, specifically in AIAN and NHPI patients. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated.
AIAN patients were associated with higher odds of postoperative complication (AOR: 1.008 CI: 1.005-1.011, P < 0.001) compared to non-Hispanic white patients. The comorbidities that were of higher incidence in AIAN patients, which also adversely contributed to postoperative complication, included dependent functional status, diabetes, congestive heart failure (CHF), open wounds, preoperative weight loss, bleeding disorders, preoperative transfusion, sepsis, hypoalbuminemia, along with an active smoking status and ASA ≥3. In NHPI patients, dependent functional status, CHF, renal failure, preoperative transfusion, open wounds, and sepsis were of higher incidence and significantly contributed to postoperative complication.
Surgical outcome disparities exist particularly in AIAN patients. Identification of modifiable patient risk factors may benefit perioperative care for AIAN and NHPI patients, which are historically understudied racial groups.
Abstract Background Little is known about the extent to which transplant recipients face psychologic distress with the receipt of a transplanted organ. The purpose of this study was to investigate ...health-related quality of life (HRQoL) and psychologic distress in 105 adults who had undergone kidney transplantation (KT). Methods HRQoL was measured with the use of the Korean version of Medical Outcome Study Short Form 36 version 2, and psychologic distress with the use of the Transplant Effects Questionnaire (TEQ). Clinical and demographic data were collected from questionnaires. The data were collected from August 2014 to November 2014 at 2 medical centers in Korea. Results Of the 105 patients, 53.3% were male and the overall mean age was 46.99 years. The mean score of each of the TEQ subscales ranged from 2.45 to 4.62. In the subscales of HRQoL, the mean score of physical component summary (PCS) was 50.23, and the mean score of mental component summary (MCS) was 46.19. MCS was negatively correlated with worry ( P = .001) and guilt ( P = .037) and positively correlated with adherence ( P = .006) in the TEQ subscales, whereas there was no significant correlation between PCS and the TEQ subscales. Conclusions The study indicates that mental HRQoL is correlated with psychologic distress. Therefore, to increase the HRQoL, continuous attention is needed in kidney transplant recipients who experience psychologic distress and adherence problem. In addition, further empirical studies should be conducted to explain the mechanisms underlying this relationship.
Alternative splicing (AS), the process of removing introns from pre-mRNA and the rearrangement of exons to produce several types of mature transcripts, is a remarkable step preceding protein ...synthesis. In particular, it has now been conclusively shown that up to ∼95% of genes are alternatively spliced to generate a complex and diverse proteome in eukaryotic organisms. Consequently, AS is one of the determinants of the functional repertoire of cells. Many studies have revealed that AS in plants can be regulated by cell type, developmental stage, environmental stress, and the circadian clock. Moreover, increasing amounts of evidence reveal that chemical compounds can affect various steps during splicing to induce major effects on plant physiology. Hence, the chemical modulation of AS can serve as a good strategy for molecular-target identification in attempts to potentially control plant genetics. However, the kind of mechanisms involved in the chemical modulation of AS that can be used in agrochemical research remain largely unknown. This review introduces recent studies describing the specific roles AS plays in plant adaptation to environmental stressors and in the regulation of development. We also discuss recent advances in small molecules that induce alterations of AS and the possibility of using this strategy in agrochemical-target identification, giving a new direction for potential genetic control in agrochemical research.
We present the results from the 43 GHz Very Long Baseline Array (VLBA) observations of 124 compact radio-loud active galactic nuclei (AGNs) that were conducted between 2014 November and 2016 May. The ...typical dimensions of the restoring beam in each image are about 0.5 mas × 0.2 mas. The highest resolution of 0.2 mas corresponds to a physical size of 0.02 pc for the lowest redshift source in the sample. The 43 GHz very long baseline interferometry (VLBI) images of 97 AGNs are presented for the first time. We study the source compactness on milliarcsecond and submilliarcsecond scales, and suggest that 95 sources in our sample are suitable for future space VLBI observations. By analyzing our data supplemented with other VLBA AGN surveys from the literature, we find that the core brightness temperature increases with increasing frequency below a break frequency ∼7 GHz, and decreases between ∼7 and 240 GHz but increases again above 240 GHz in the rest frame of the sources. This indicates that the synchrotron opacity changes from optically thick to thin. We also find a strong statistical correlation between radio and γ-ray flux densities. Our correlation is tighter than those in the literature derived from lower-frequency VLBI data, suggesting that the γ-ray emission is produced more cospatially with the 43 GHz VLBA core emission. This correlation can also be extrapolated to the unbeamed AGN population, implying that a universal γ-ray production mechanism might be at work for all types of AGNs.