Coronary heart disease (CHD) is a common heart disease and the leading cause of cardiovascular death. Apoptosis and autophagy are two forms of programmed cell deaths which participate in the ...pathogenesis, development and prognosis of CHD. They are activated by several different pathways respectively and can interact with each other through the Beclin 1-Bcl-2/Bcl-xL complex, mTOR, TRAIL, TNF-α, ER stress and nucleus p53 pathways. Excessive apoptosis can promote myocardial ischemia, ischemia/reperfusion (I/R) injury, post-ischemia cardiac remodeling and coronary atherosclerosis except for VSMC-induced atherosclerosis progress. In contrast, activated autophagy protects heart from myocardial ischemia injury and post-ischemia cardiac remodeling, but can exert controversial effects on I/R injury and coronary atherosclerosis. Therefore, considering the pathological significance and mechanisms of apoptosis and autophagy underlying CHD, therapeutic implication of targeting apoptosis and autophagy is obvious. Fortunately, some therapeutic drugs and pharmacologic compounds involving mTOR inhibitor and AMPK activator have been reported to regulate apoptosis and autophagy. Although recent studies are limited and insufficient, they have pointed out the complex interplay between apoptosis and autophagy and further provided treatment concept for CHD by balancing the switch between the two responses.
•Apoptosis and autophagy have complex interplays via different pathways.•Apoptosis promotes the pathogenesis of CHD generally.•Autophagy resists against myocardial ischemia and postischemia cardiac remodeling.•Autophagy plays controversial roles in I/R injury and coronary atherosclerosis.•Regulation of apoptosis and autophagy is an appealing therapy for CHD.
Nonplanar, electronically destabilized amides have emerged as powerful intermediates in organic synthesis. We report a highly selective method for transamidation of common secondary amides under ...mild, metal-free conditions that relies on transient N-selective functionalization to weaken amidic resonance. The combination of rational modification of the amide bond with nucleophilic addition mechanism, and the thermodynamic collapse of the resultant tetrahedral intermediate constitutes a two-step procedure to accomplish a challenging transamidation of secondary amides under mild conditions.
The development of efficient catalytic methods for N–C bond cleavage in amides remains an important synthetic challenge. The first Pd-catalyzed Suzuki–Miyaura cross-coupling of N-acylsaccharins with ...boronic acids by selective N–C bond activation is reported. The reaction enables preparation of a variety of functionalized diaryl and alkyl-aryl ketones with broad functional group tolerance and in good to excellent yields. Of general interest, N-acylsaccharins serve as new, highly reactive, bench-stable, economical, amide-based, electrophilic acyl transfer reagents via acyl-metal intermediates. Mechanistic studies strongly support the amide N–C(O) bond twist as the enabling feature of N-acylsaccharins in the N–C bond cleavage.
Hypertension, which directly threatens quality of life, is a major contributor to cardiovascular and cerebrovascular events. Over the past two decades, domestic and foreign scholars have agreed upon ...various standards in the treatment of hypertension, and considerable progress has been made in the field of antihypertensive drugs. Oral antihypertensive drugs represent a milestone in hypertension therapy. However, the blood pressure standard for patients with hypertension is far from satisfactory. The study of Chinese herbal formulas for treating hypertension has received much research attention. These studies seek to integrate traditional and Western medicine in China. Currently, Chinese herbal formulas are known to have an outstanding advantage with regard to bodily regulation. Research shows that Chinese medicine has many protective mechanisms. This paper addresses the process of the antihypertensive mechanisms in Chinese herbal formulas for treating hypertension. These mechanisms are to be discussed in future research.
In this work, we synthesized gold clusters, Au n (n = 10, 18, 25, 39), with atomically controlled sizes on hydroxyapatite (HAP) and studied the catalysis for aerobic oxidation of cyclohexane. These ...Au n /HAP catalysts could efficiently oxidize cyclohexane to cyclohexanol and cyclohexanone. The turnover frequency monotonically increased with an increase in the size, reaching values as high as 18 500 h−1 Au atom−1 at n = 39, and thereafter decreased with a further increase in n up to n ∼ 85. This finding provides a fundamental insight into size-specific catalysis of gold in the cluster regime (diameter < 2 nm) and a guiding principle for rational design of Au cluster-based catalysts.
Massive, easily accessible online health information empowers users to cope with health problems better. Most patients search for relevant online health information before seeing a doctor to ...alleviate information asymmetry. However, the mechanism of how online health information affects health empowerment is still unclear.
To study how online health information processing affects health empowerment.
We conducted a cross-sectional questionnaire study that included 343 samples from participants who had searched online health information before the consultation. Respondents' perceptions of online information cues, benefits, health literacy, and health empowerment were assessed.
Perceived argument quality and perceived source credibility have significant and positive effects on perceived information benefits, but only perceived argument quality has a significant effect on perceived decision-making benefits. Two types of perceived benefits, in turn, affect health empowerment. The effects of perceived argument quality on perceived informational benefits and perceived decision-making benefits on health empowerment are significantly stronger for the high health literacy group than the low health literacy group (t
=7.156, P<.001; t
=23.240, P<.001). While, the effects of perceived source credibility on perceived informational benefits and perceived informational benefits on health empowerment are significantly weaker for the high health literacy group than the low health literacy group (t
=-10.497, P<.001; t
=-6.344, P<.001). The effect of perceived argument quality on perceived informational benefits shows no significant difference between high and low health literacy groups.
In the context of online health information, perceived information benefits and perceived decision-making benefits are the antecedents of health empowerment, which in turn will be affected by perceived argument quality and perceived source credibility. Health literacy plays a moderating role in the relationship of some variables. To maximize health empowerment, online health information providers should strengthen information quality and provide differentiated information services based on users' health literacy.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
IMPORTANCE: In China, diabetes prevalence has increased substantially in recent decades, but there are no reliable estimates of the excess mortality currently associated with diabetes. OBJECTIVES: To ...assess the proportional excess mortality associated with diabetes and estimate the diabetes-related absolute excess mortality in rural and urban areas of China. DESIGN, SETTING, AND PARTICIPANTS: A 7-year nationwide prospective study of 512 869 adults aged 30 to 79 years from 10 (5 rural and 5 urban) regions in China, who were recruited between June 2004 and July 2008 and were followed up until January 2014. EXPOSURES: Diabetes (previously diagnosed or detected by screening) recorded at baseline. MAIN OUTCOMES AND MEASURES: All-cause and cause-specific mortality, collected through established death registries. Cox regression was used to estimate adjusted mortality rate ratio (RR) comparing individuals with diabetes vs those without diabetes at baseline. RESULTS: Among the 512 869 participants, the mean (SD) age was 51.5 (10.7) years, 59% (n = 302 618) were women, and 5.9% (n = 30 280) had diabetes (4.1% in rural areas, 8.1% in urban areas, 5.8% of men, 6.1% of women, 3.1% had been previously diagnosed, and 2.8% were detected by screening). During 3.64 million person-years of follow-up, there were 24 909 deaths, including 3384 among individuals with diabetes. Compared with adults without diabetes, individuals with diabetes had a significantly increased risk of all-cause mortality (1373 vs 646 deaths per 100 000; adjusted RR, 2.00 95% CI, 1.93-2.08), which was higher in rural areas than in urban areas (rural RR, 2.17 95% CI, 2.07-2.29; urban RR, 1.83 95% CI, 1.73-1.94). Presence of diabetes was associated with increased mortality from ischemic heart disease (3287 deaths; RR, 2.40 95% CI, 2.19-2.63), stroke (4444 deaths; RR, 1.98 95% CI, 1.81-2.17), chronic liver disease (481 deaths; RR, 2.32 95% CI, 1.76-3.06), infections (425 deaths; RR, 2.29 95% CI, 1.76-2.99), and cancer of the liver (1325 deaths; RR, 1.54 95% CI, 1.28-1.86), pancreas (357 deaths; RR, 1.84 95% CI, 1.35-2.51), female breast (217 deaths; RR, 1.84 95% CI, 1.24-2.74), and female reproductive system (210 deaths; RR, 1.81 95% CI, 1.20-2.74). For chronic kidney disease (365 deaths), the RR was higher in rural areas (18.69 95% CI, 14.22-24.57) than in urban areas (6.83 95% CI, 4.73-9.88). Among those with diabetes, 10% of all deaths (16% rural; 4% urban) were due to definite or probable diabetic ketoacidosis or coma (408 deaths). CONCLUSIONS AND RELEVANCE: Among adults in China, diabetes was associated with increased mortality from a range of cardiovascular and noncardiovascular diseases. Although diabetes was more common in urban areas, it was associated with greater excess mortality in rural areas.
In the physician-patient relationship, patients' uncertainty about diseases and the lack of trust in physicians not only hinder patients' rehabilitation but also disrupt the harmony in this ...relationship. With the development of the web-based health industry, patients can easily access web-based information about health care and physicians, thus reducing patients' uncertainty to some extent. However, it is not clear how patients' web-based health information-seeking behaviors reduce their uncertainty.
On the basis of the principal-agent theory and the perspective of uncertainty reduction, this study aims to investigate the mechanism of how web-based disease-related information and web-based physician-related information reduce patients' uncertainty.
A web-based survey involving 337 participants was conducted. In this study, we constructed a structural equation model and used SmartPLS (version 3.3.3; SmartPLS GmbH) software to test the reliability and validity of the measurement model. The path coefficients of the structural model were also calculated to test our hypotheses.
By classifying patients' uncertainties into those concerning diseases and those concerning physicians, this study identified the different roles of the two types of patients' uncertainty and revealed that web-based disease-related information quality and web-based physician-related information can act as uncertainty mitigators. The quality of disease-related information reduces patients' perceived information scarcity about the disease (β=-.588; P<.001), and the higher the information scarcity perceived by patients, the higher their uncertainty toward the disease (β=.111; P=.02). As for physician-related information, web-based word-of-mouth information about physicians reduces patients' perceived information scarcity about the physician (β=-.511; P<.001), mitigates patients' fears about physician opportunism (β=-.268; P<.001), and facilitates patients' trust (β=.318; P<.001). These factors further influence patients' uncertainty about the physician. In addition, from the test of mediating effect, patients' trust in the physician fully mediates the relationship between their perceived information scarcity about the physician's medical service and their uncertainty about the physician. Patients' trust also partially mediates the relationship between their fear of the physician's opportunism and their uncertainty about the physician. As for the two different types of uncertainty, patients' uncertainty about the physician also increases their uncertainty about the diseases (β=.587; P<.001).
This study affirms the role of disease-related web-based information quality and physician-related web-based word-of-mouth information in reducing patients' uncertainties. With regard to the traits of principal-agent relationships, this study describes the influence mechanism based on patients' perceived information scarcity, fears of physicians' opportunism, and patients' trust. Moreover, information about physicians is effective in reducing patients' uncertainties, but only if the information enhances patients' trust in their physicians. This research generates new insights into understanding the impact of web-based health information on patients' uncertainties.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
This study sought to determine the relationship of cardiovascular magnetic resonance (CMR) measures of tissue composition to age in the Multi-Ethnic Study of Atherosclerosis (MESA).
Animal and human ...studies have demonstrated increased collagen deposition in senescent hearts. New CMR indices of tissue composition by using T1 mapping are sensitive to the presence of myocardial fibrosis.
A total of 1,231 study participants (51% women; age range 54 to 93 years) of the MESA cohort were evaluated with T1 mapping by using 1.5-T CMR scanners. None of the participants had focal scar on delayed enhancement CMR. Single-slice T1 mapping was performed at the midventricular level before and at 12- and 25-min delay after administration of gadolinium contrast by using a modified Look-Locker inversion recovery sequence. The partition coefficient was determined by the slope of the linear relationship of (1/T1myo vs. 1/T1blood). The extracellular volume fraction (ECV) was derived accounting for the hematocrit level. Multivariable regression analyses were performed, adjusting for traditional risk factors and left ventricular structure.
Women had significantly greater partition coefficient, ECV, and precontrast T1 than men, as well as lower post-contrast T1 values (all p < 0.05). In general, linear regression analyses demonstrated that greater partition coefficient, pre-contrast T1 values, and ECV were associated with older age in men (multivariate regression coefficients = 0.01; 5.9 ms; and 1.04% per 10 years' change; all p < 0.05). ECV was also significantly associated with age in women after multivariable adjustments.
CMR parameters that have been associated with myocardial fibrosis were related to older age in the MESA study. Women had higher ECV than men but less ECV change over time.
Previously, most studies used 5-star and 1-star ratings to represent reviewers' positive and negative attitudes, respectively. However, this premise is not always true because individuals' attitudes ...have more than one dimension. In particular, given the credence traits of medical service, to build durable physician-patient relationships, patients may rate their physicians with high scores to avoid lowering their physicians' web-based ratings and help build their physicians' web-based reputations. Some patients may express complaints only in review texts, resulting in ambivalence, such as conflicting feelings, beliefs, and reactions toward physicians. Thus, web-based rating platforms for medical services may face more ambivalence than platforms for search or experience goods.
On the basis of the tripartite model of attitudes and uncertainty reduction theory, this study aims to consider both the numerical rating and sentiment of each web-based review to explore whether there is ambivalence and how ambivalent attitudes influence the helpfulness of web-based reviews.
This study collected 114,378 reviews of 3906 physicians on a large physician review website. Then, based on existing literature, we operationalized numerical ratings as the cognitive dimension of attitudes and sentiment in review texts as the affective dimension of attitudes. Several econometric models, including the ordinary least squares model, logistic regression model, and Tobit model, were used to test our research model.
First, this study confirmed the existence of ambivalence in each web-based review. Then, by measuring ambivalence through the inconsistency between the numerical rating and sentiment for each review, this study found that the ambivalence in different web-based reviews has a different impact on the helpfulness of the reviews. Specifically, for reviews with positive emotional valence, the higher the degree of inconsistency between the numerical rating and sentiment, the greater the helpfulness is (β
=.046; P<.001). For reviews with negative and neutral emotional valence, the impact is opposite, that is, the higher the degree of inconsistency between the numerical rating and sentiment, the lesser the helpfulness is (β
=-.059, P<.001; β
=-.030, P=.22). Considering the traits of the data, the results were also verified using the logistic regression model (θ
=0.056, P=.005; θ
=-0.080, P<.001; θ
=-0.060, P=.03) and Tobit model.
This study confirmed the existence of ambivalence between the cognitive and affective dimensions in single reviews and found that for reviews with positive emotional valence, the ambivalent attitudes lead to more helpfulness, but for reviews with negative and neutral emotion valence, the ambivalence attitudes lead to less helpfulness. The results contribute to the web-based review literature and inspire a better design for rating mechanisms in review websites to enhance the helpfulness of reviews.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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