Abstract Background Large cohort studies provide conflicting evidence regarding the potential for oral macrolide antibiotics to increase the risk of serious cardiac events. Objectives This study ...performed a meta-analysis to examine the link between macrolides and risk of sudden cardiac death (SCD) or ventricular tachyarrhythmias (VTA), cardiovascular death, and death from any cause. Methods We performed a search of published reports by using MEDLINE (January 1, 1966, to April 30, 2015) and EMBASE (January 1, 1980, to April 30, 2015) with no restrictions. Studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. Results Thirty-three studies involving 20,779,963 participants were identified. Patients taking macrolides, compared with those who took no macrolides, experienced an increased risk of developing SCD or VTA (RR: 2.42; 95% CI: 1.61 to 3.63), SCD (RR: 2.52; 95% CI: 1.91 to 3.31), and cardiovascular death (RR: 1.31; 95% CI: 1.06 to 1.62). No association was found between macrolides use and all-cause death or any cardiovascular events. The RRs associated with SCD or VTA were 3.40 for azithromycin, 2.16 for clarithromycin, and 3.61 for erythromycin, respectively. RRs for cardiovascular death were 1.54 for azithromycin and 1.48 for clarithromycin. No association was noted between roxithromycin and adverse cardiac outcomes. Treatment with macrolides is associated with an absolute risk increase of 118.1 additional SCDs or VTA, and 38.2 additional cardiovascular deaths per 1 million treatment courses. Conclusions Administration of macrolide antibiotics is associated with increased risk for SCD or VTA and cardiovascular death but not increased all-cause mortality.
Background Stroke remains one of the most common causes of adult disability in the world. In recent years, diverse telerehabilitation programs have been conceived and studied to improve the abilities ...of the activities of daily living and increased independence of stroke patients living at home. The systematic review was conducted to determine whether telerehabilitation leads to an improvement in abilities of activities of daily living for stroke patients. Methods Randomized controlled trials (RCTs) evaluating the effects of telerehabilitation in stroke survivors living at home were identified by searching 7 electronic databases from inception to March 2015, and by hand searching for conference literatures between 2000 and 2015. Assessments of risk bias and data extraction were conducted independently by 2 reviews. Results The search strategy identified 2587 records, of which 11 studies were thought to be eligible. Pooled results from 7 studies showed no significant differences in abilities of activities of daily living (Barthel Index scale: standardized mean difference SMD −.05, 95% confidence interval CI −.24 to .13; Berg Balance Scale: SMD −.05, 95% CI −.7 to .37) and motor function (Fugl-Meyer Extremity: SMD .05, 95% CI −.09 to 1.09) between groups. Conclusions This review provides limited, moderate evidence that telerehabilitation of all approaches has equal effects with conventional rehabilitation in improving abilities of activities of daily living and motor function for stroke survivors. Further research of RCTs in this area (rehabilitation field of telemedicine) is ungently required to extend the evidence base.
We investigated molecular mechanisms responsible for azole resistance in Candida tropicalis isolates.
We studied 507 C. tropicalis isolates causing invasive candidiasis from ten hospitals over ...5 years. Antifungal susceptibility was determined by broth microdilution methods. Point mutations in the C. tropicalis ERG11 gene that may confer azole resistance were explored and verified. The expression levels of ERG11, CYTb, MDR1 and CDR1 genes were compared in 20 fluconazole-susceptible and 20 fluconazole-resistant isolates.
Fluconazole-susceptible, -susceptible dose-dependent and -resistant strains accounted for 76.7% (389/507), 10.5% (53/507) and 12.8% (65/507) of C. tropicalis isolates, respectively. The ERG11 mutation A395T/W occurred in 10.7% (54/507) of isolates, all of which were resistant to fluconazole. The nucleotide mutation C461T/Y was the second most common (50/507 isolates, 9.9%), and all isolates carrying C461T/Y also had the mutation A395T/W. However, the presence of C461T did not contribute to the azole-resistant phenotype. Substitutions V125A, Y257H and G464S (<2% of isolates), which were reported for the first time in C. tropicalis, also conferred fluconazole non-susceptible phenotypes. Compared with fluconazole susceptible isolates, fluconazole-resistant isolates had higher ERG11 (fold expression level 1.42 versus 0.79, p < 0.01) but lower CYTb (fold expression level 1.26 versus 2.67, p < 0.01) gene expression levels. Three azole-resistant isolates carrying the wild-type ERG11 gene had higher levels of CDR1 and MDR1 expression.
ERG11 missense mutations were the major mechanism responsible for azole resistance in C. tropicalis isolates, but overexpression of ERG11, CDR1 and MDR1, as well as reduced expression of CYTb, also contributed to resistance.
The mandarin fish
Siniperca chuatsi
is a commercially important cultured freshwater fish in China. However, little information is available regarding the intestinal microbiota of
S. chuatsi
. ...Intestinal samples of the pond- and recirculating ponds aquaculture system (RAS)-farmed
Siniperca chuatsi
were collected, and characterized by16S rRNA gene amplicon sequencing.
Fusobacteria
and
Firmicutes
were the predominant bacterial phyla found in the RAS- and pond-farmed perch. The principal bacterial genera recorded were
Cetobacterium
and
Mycoplasma
in the farmed mandarin fish. Compared to pond-farmed perch, the RAS-farmed perch had a higher abundance of
Fusobacteria
. The number and composition of gut microbes might play crucial roles in farmed mandarin fish nutrient metabolism.
In this paper, the effects and mechanism of crystalline morphology on dielectric loss and breakdown strength of PP film were studied. The crystalline morphology was modified by adding the ...β-nucleating agent (β-NA). The crystalline types and crystalline morphologies of samples were analysed by the X-Ray diffraction (XRD) and the polarized optical microscopy (POM), respectively. The current integration, representing the dielectric loss, was investigated using the Q(t) method. The DC conductivity was measured at temperature from 25 to 85 °C. The effects of crystalline morphology on the trap energy level distribution were analysed by the isothermal discharge current (IDC). The DC breakdown strength was tested using a pair of ball-plate electrodes at 85 °C. The results of XRD and POM indicate that the addition of β-NA introduced β-spherulites in PP film and the spherulite size of samples with β-NA are smaller the spherulites size of PP without β-NA. The results of IDC indicate that the special structure of β-spherulites introduced deep trap energy levels. The results of Q(t) and DC conductivity indicate that β-spherulites can effectively suppress the current though samples. Besides, the addition of β-nucleating agent increases the DC breakdown strength at 85 °C.
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•Improved dielectric properties by modulating the crystalline morphology.•Applied current integration Q(t) method to analyze the dielectric loss of samples.•Obtained the effect of crystalline morphology on dielectric properties of PP film.
There are few data on the molecular epidemiology of cryptococcosis in China. Here we investigated the species distribution, molecular types and antifungal susceptibilities of 312 Cryptococcus ...neoformans species complex isolates from ten hospitals over 5 years. Isolates were identified by internal transcribed spacer (ITS) sequencing and by two matrix-assisted laser desorption–ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems. Multilocus sequence typing (MLST) was used to verify species/variety and to designate molecular types. Susceptibility to six antifungal drugs was determined by the Sensititre YeastOne™ method. Cryptococcus neoformans was the predominant species (305/312 isolates (97.8%), all were ITS type 1, serotype A), of which 89.2% (272/305) were C. neoformans var. grubii MLST sequence type (ST) 5 and 6.2% (19/305) were ST31. Other C. neoformans var. grubii STs were rare but included six novel STs. Only two strains were C. neoformans var. neoformans (both serotype AD). Cryptococcus gattii was uncommon (n = 7, four ITS types) and comprised five MLST STs including one novel ST. For C. neoformans var. grubii, the proportion of isolates with non-wild-type MICs to fluconazole significantly rose in the fourth study year (from 0% (0/56 isolates) in the first year to 23.9% (17/71) in the fourth year), including five isolates with fluconazole MICs of ≥32 mg/L. The study has provided useful data on the species epidemiology and their genetic diversity and antifungal susceptibility. The proportional increase in isolates with non-wild-type MICs to fluconazole is noted.
Starch is a natural polymer which possesses many unique properties and some shortcoming simultaneously. Some synthetic polymers are biodegradable and can be tailor-made easily. Therefore, by ...combining the individual advantages of starch and synthetic polymers, starch-based completely biodegradable polymers (SCBP) are potential for applications in biomedical and environmental fields. Therefore it received great attention and was extensively investigated. In this paper, the structure and characteristics of starch and some synthetic degradable polymers are briefly introduced. Then, the recent progress about the preparation of SCBP via physical blending and chemical modification is reviewed and discussed. At last, some examples have been presented to elucidate that SCBP are promising materials for various applications and their development is a good solution for reducing the consumption of petroleum resources and environmental problem.
Effects of the arbuscular mycorrhizal fungus (AMF), Glomus mosseae, on growth, antioxidant, osmoregulation, and nutrition were investigated in "Britewell" (Vaccinium ashei) and "Misty" (Vaccinium ...corymbosum) plants exposed to low temperature (10°C). At low temperature, the two cultivars showed similar decreases in leaf concentrations of soluble sugars, phosphorus (P), and potassium (K). However, similar increases were observed in levels of leaf antioxidants, malondialdehyde (MDA), hydrogen peroxide (H
2
O
2
), superoxide anion radical (
), and proline. AM inoculation increased leaf activities of superoxide dismutase, ascorbate peroxidase, guaiacol peroxidase, ascorbate, and glutathione, but decreased leaf concentrations of
, MDA, and H
2
O
2
in the two cultivars. AMF caused greater changes in leaf composition in "Britewell." AM-inoculated "Britewell" and "Misty" plants had higher concentrations of soluble sugar, proline, P, and K than non-AM-inoculated plants, especially in the former cultivar. These results indicate that G. mosseae has the potential to enhance resistance of "Britewell" blueberry plants against low-temperature stress.
Objective
Our study aims to determine whether sarcopenia is a predictive factor of future hip fractures.
Design
Systematic review and meta-analysis.
Set
We searched for potentially suitable articles ...in PubMed, Cochrane library, Medline and EMBASE from inception to March 2020. The quality of the research was assessed by the Newcastle-Ottawa Scale (NOS). Finally, a meta-analysis was conducted with the Stata software.
Participants
Older community-dwelling residents.
Measurements
Hip fracture due to sarcopenia.
Results
We retrieved 2129 studies through our search strategy, and five studies with 23,359 individuals were analyzed in our pooled analyses. Sarcopenia increases the risk of future hip fractures with a pooled hazard ratio (HR) of 1.42 (95% CI: 1.18–1.71, P <0.001, I2 = 37.7%). In addition, in subgroup analyses based on different definitions of sarcopenia, sarcopenia was associated with the risk of future hip fractures with the Asian Working Group for Sarcopenia (AWGS) criteria with a pooled HR of 2.13(95% CI: 1.33–3.43). When subgroup analyses were conducted by sex, sarcopenia was associated with the risk for future hip fractures in females with pooled HRs of 1.69 (95% CI: 1.18–2.43). Sarcopenia was associated with the risk of future hip fractures in the group with a follow-up period of more than 5 years, with a pooled HR of 1.32 (95% CI: 1.08–1.61), and in the group with a follow-up period of less than 5 years, with a pooled HR of 2.13 (95% CI: 1.33–3.43).
Conclusions
Sarcopenia could significantly increase the risk of future hip fracture in old people; thus, it is necessary to prevent hip fractures in individuals with sarcopenia.
To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations.
In ...this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015.
As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage
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