CAP

CAP
  • 文章类型: Journal Article
    越来越多的证据表明,活性氧和氮(RONS)在调节抗肿瘤免疫作用和免疫抑制中的作用。RONS修饰生物分子并在可以警告吞噬细胞的蛋白质上诱导氧化翻译后修饰(oxPTM)。然而,目前尚不清楚通过技术手段进行蛋白质氧化是否以及如何成为促进抗肿瘤免疫和治疗的策略。为此,利用冷气体等离子体技术同时产生各种RON以氧化两种黑素瘤相关抗原MART和PMEL。通过质谱法测定,冷等离子体氧化的MART(oxMART)和PMEL(oxPMEL)用oxPTM进行了大量装饰。在用活黑素瘤细胞攻击之前用氧化的MART或PMEL疫苗免疫与细胞因子分泌的显著变化和肿瘤浸润的白细胞(TIL)的T细胞分化改变相关。oxMART促进细胞毒性中枢记忆T细胞的活性,而oxPMEL导致细胞毒性效应T细胞的增殖增加。在用B16F10黑素瘤细胞孵育荷瘤小鼠的脾细胞后观察到类似的T细胞结果。这项研究,第一次,提供了两种黑素瘤相关抗原的氧化修饰在引发抗癌免疫中的重要性的证据。
    Increasing evidence suggests the role of reactive oxygen and nitrogen species (RONS) in regulating antitumor immune effects and immunosuppression. RONS modify biomolecules and induce oxidative post-translational modifications (oxPTM) on proteins that can alarm phagocytes. However, it is unclear if and how protein oxidation by technical means could be a strategy to foster antitumor immunity and therapy. To this end, cold gas plasma technology producing various RONS simultaneously to oxidize the two melanoma-associated antigens MART and PMEL is utilized. Cold plasma-oxidized MART (oxMART) and PMEL (oxPMEL) are heavily decorated with oxPTMs as determined by mass spectrometry. Immunization with oxidized MART or PMEL vaccines prior to challenge with viable melanoma cells correlated with significant changes in cytokine secretion and altered T-cell differentiation of tumor-infiltrated leukocytes (TILs). oxMART promoted the activity of cytotoxic central memory T-cells, while oxPMEL led to increased proliferation of cytotoxic effector T-cells. Similar T-cell results are observed after incubating splenocytes of tumor-bearing mice with B16F10 melanoma cells. This study, for the first time, provides evidence of the importance of oxidative modifications of two melanoma-associated antigens in eliciting anticancer immunity.
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  • 文章类型: Journal Article
    目的:冷物理血浆(CPP)通过在各种癌细胞中诱导细胞毒性作用,已成为肿瘤学中的有效疗法,包括软骨肉瘤(CS),尤因肉瘤(ES),骨肉瘤(OS)。当前的研究调查了CPP对CS(CAL-78)中细胞运动的影响,ES(A673),和OS(U2-OS)细胞系,专注于肌动蛋白细胞骨架。
    方法:使用CASY细胞计数器和分析仪研究细胞增殖,并确定胎牛血清的最佳浓度,以维持活力而不刺激细胞增殖。CellTiter-BlueCell活力测定用于确定CPP对骨肉瘤细胞活力的影响。使用Radius测定来确定细胞迁移。脱氧核糖核酸酶Ⅰ染色,G-肌动蛋白,和F-肌动蛋白用于测定对细胞骨架的影响。
    结果:在CPP处理后,在所有细胞系中观察到细胞活力和运动性的降低。CPP诱导肌动蛋白细胞骨架的变化,导致细胞运动性下降。
    结论:CPP通过改变肌动蛋白细胞骨架有效降低骨肉瘤细胞的运动性。这些发现强调了CPP作为骨肉瘤治疗工具的潜力,并强调了该领域进一步研究的必要性。
    OBJECTIVE: Cold physical plasma (CPP) has emerged as an effective therapy in oncology by inducing cytotoxic effects in various cancer cells, including chondrosarcoma (CS), Ewing\'s sarcoma (ES), and osteosarcoma (OS). The current study investigated the impact of CPP on cell motility in CS (CAL-78), ES (A673), and OS (U2-OS) cell lines, focusing on the actin cytoskeleton.
    METHODS: The CASY Cell Counter and Analyzer was used to study cell proliferation and determine the optimal concentrations of fetal calf serum to maintain viability without stimulation of cell proliferation. CellTiter-BlueCell viability assay was used to determine the effects of CPP on the viability of bone sarcoma cells. The Radius assay was used to determine cell migration. Staining for Deoxyribonuclease I, G-actin, and F-actin was used to assay for the effects on the cytoskeleton.
    RESULTS: Reductions in cell viability and motility were observed across all cell lines following CPP treatment. CPP induced changes in the actin cytoskeleton, leading to decreased cell motility.
    CONCLUSIONS: CPP effectively reduces the motility of bone sarcoma cells by altering the actin cytoskeleton. These findings underscore CPP\'s potential as a therapeutic tool for bone sarcomas and highlight the need for further research in this area.
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  • 文章类型: Journal Article
    背景:前列腺特异性抗原(PSA)检测在前列腺癌(PCa)筛查中的作用近几十年来随着多项随机对照试验(RCT)促使指南的改变而不断发展。目前,由于许多前列腺癌的惰性性质以及过度诊断和过度治疗的相关风险,存在争议.这篇综述审查了评估PSA筛查的主要RCT,以告知临床实践。
    方法:我们总结了从主要RCT调查PSA筛查对PCa死亡率和发病率的影响的结果:前列腺,肺,结肠直肠,和卵巢癌(PLCO)筛查试验,欧洲前列腺癌筛查随机研究(ERSPC),和前列腺癌PSA检测(CAP)的集群随机试验。
    结果:PLCO试验将男性随机接受每年PSA和DRE筛查或常规治疗,报告17岁时各组间PCa死亡率无显著差异(RR0.93,[95%CI:0.81-1.08]),然而,在筛查组中,格里森6(RR1.17,[95%CI:1.11-1.23])和8-10疾病(RR0.89,[95%CI:0.80-0.99])的检测显着增加,同时检测降低,分别。ESPRC试验将7个欧洲国家的男性随机进行PSA筛查,每2-4年或常规治疗。注意到9年时PCa死亡率降低20%(RR0.81,[95%CI:0.65-0.98]),12年时转移性疾病显著降低(RR0.70,[95%CI:0.60-0.82]).CAP试验评估了单一PSA筛查试验对PCa死亡率的影响,结果在10年时PCa死亡率无显著差异(RR0.96,[95%CI:0.85-1.08])。研究的局限性包括研究组之间的高度污染和对研究方案的低依从性。
    结论:虽然CAP和最初的PLCO试验显示PCa死亡率没有显著降低,ERSPC在13年时减少了21%,在延长随访中进一步受益。结果的差异归因于试验设计的变化,污染,坚持率,PSA阈值。未来的研究需要集中在优化筛查间隔上,针对高危人群,并纳入非侵入性诊断工具,以提高筛查效果并减少相关危害。
    BACKGROUND: The role of prostate-specific antigen (PSA) testing in prostate cancer (PCa) screening has evolved over recent decades with multiple randomized controlled trials (RCTs) spurring guideline changes. At present, controversy exists due to the indolent nature of many prostate cancers and associated risks of overdiagnosis and overtreatment. This review examines major RCTs evaluating PSA screening to inform clinical practices.
    METHODS: We summarize findings from primary RCTs investigating PSA screening\'s impact on PCa mortality and incidence: the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, the European Randomized Study of Screening for Prostate Cancer (ERSPC), and the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP).
    RESULTS: The PLCO Trial randomized men to annual PSA and DRE screening or usual care, reporting no significant difference in PCa mortality between groups at 17 years (RR 0.93, [95% CI: 0.81-1.08]), yet significantly increased detection and concomitant decreased detection in Gleason 6 (RR 1.17, [95% CI: 1.11-1.23]) and 8-10 disease (RR 0.89, [95% CI: 0.80-0.99]) in the screening group, respectively. The ESPRC Trial randomized men across seven European countries to PSA screening every 2-4 years or usual care, noting a 20% reduction in PCa mortality at 9 years (RR 0.81, [95% CI: 0.65-0.98]) and significant decrease in metastatic disease at 12 years (RR 0.70, [95% CI: 0.60-0.82]). The CAP Trial assessed a single PSA screening test\'s impact on PCa mortality yielding no significant difference in PCa mortality at 10 years (RR 0.96, [95% CI: 0.85-1.08]). Limitations amongst studies included high contamination between study arms and low compliance with study protocols.
    CONCLUSIONS: While the CAP and initial PLCO trials showed no significant reduction in PCa mortality, the ERSPC demonstrated a 21% reduction at 13 years, with further benefits at extended follow-up. Differences in outcomes are attributed to variations in trial design, contamination, adherence rates, and PSA thresholds. Future studies are needed focus on optimizing screening intervals, targeting high-risk populations, and incorporating non-invasive diagnostic tools to improve screening efficacy and reduce associated harms.
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  • 文章类型: Journal Article
    临床治疗,包括皮肤科和肿瘤科,需要安全的应用程序。体外实验只能得出关于体内效应的有限结论,而在动物研究中,例如,啮齿动物有大规模的道德约束。在受精后第15天之前,鸡胚缺乏疼痛接收,使卵内模型成为体内安全性评估的合适替代方法。此外,在绒毛尿囊膜试验的鸡蛋试验允许局部治疗的潜在刺激分析,但是到目前为止,标准化分析是有限的。医用气体等离子体是一种局部,常规,批准的皮肤病治疗。最近的工作表明该技术在肿瘤学中的潜力。其主要作用方式是同时释放各种活性物质。有趣的是,不同的等离子体原料气成分产生定制的反应性物种分布,先前显示为针对特定应用进行了优化,如皮肤癌治疗。为了支持临床意义,我们开发了一种新颖的鸡胚CAM评分和研究方案,并利用该模型分析了由大气压等离子体等离子体等离子体产生的16种不同的等离子体进料气体设置kINPen,以及常见的抗癌药物(例如,顺铂)和生理介质(例如,VEGF)。进行了广泛的气相和液相等离子体反应性物种分析,发现与刺激潜在参数的相关性令人惊讶。尽管反应物种模式明显不同,与标准氩等离子体相比,进料气体调制的kINPen等离子体的耐受性相同。治疗48小时后,气体等离子体而非抗癌剂对CAM的刺激被逆转,强调医用气体等离子体唯一的暂时组织效应。我们的结果表明反应性物种的安全治疗应用。
    Clinical therapies, including dermatology and oncology, require safe application. In vitro experiments allow only limited conclusions about in vivo effects, while animal studies in, e.g., rodents have ethical constraints at a large scale. Chicken embryos lack pain reception until day 15 postfertilization, making the in ovo model a suitable alternative to in vivo safety assessment. In addition, the hen\'s egg test on chorioallantoic membrane assay allows irritation potential analysis for topical treatments, but standardized analysis has been limited so far. Medical gas plasma is a topical, routine, approved dermatology treatment. Recent work suggests the potential of this technology in oncology. Its main mode of action is the release of various reactive species simultaneously. Intriguingly, varying plasma feed gas compositions generates customized reactive species profiles previously shown to be optimized for specific applications, such as skin cancer treatment. To support clinical implications, we developed a novel chicken embryo CAM scoring and study scheme and employed the model to analyze 16 different plasma feed gas settings generated by the atmospheric pressure plasmajet kINPen, along with common anticancer drugs (e.g., cisplatin) and physiological mediators (e.g., VEGF). Extensive gas- and liquid-phase plasma reactive species profiling was done and was found to have a surprisingly low correlation with irritation potential parameters. Despite markedly different reactive species patterns, feed gas-modulated kINPen plasma was equally tolerated compared to standard argon plasma. CAM irritation with gas plasmas but not anticancer agents was reversed 48 h after treatment, underlining the only temporary tissue effects of medical gas plasma. Our results indicate a safe therapeutic application of reactive species.
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  • 文章类型: Journal Article
    我们以前的研究表明,嗜酸乳杆菌在体内对PCV2增殖具有抑制作用,尽管潜在的机制仍然难以捉摸。已知益生菌如嗜酸乳杆菌通过其代谢物发挥抗病毒作用。因此,在这项研究中,非靶向代谢组学用于检测嗜酸乳杆菌增殖24h后代谢产物的变化。随后,高通量分子对接用于分析这些代谢物与PCV2Cap和Rep的对接得分,旨在鉴定具有潜在抗PCV2作用的化合物。结果表明,128种化合物如Dl-乳酸盐显著增加。高通量分子对接的结果表明,麦戈司汀等化合物,和替米沙坦与Cap和Rep形成复合物,表明它们潜在的抗PCV2特性。此外,像维生素C这样的化合物,表现出与嗜酸乳杆菌一致的药理作用,这增加了嗜酸乳杆菌可能通过其代谢产物发挥药理作用的想法。这些结果将为嗜酸乳杆菌的研究奠定基础。
    Our previous studies have revealed that L. acidophilus possesses inhibitory effects on PCV2 proliferation in vivo, although the underlying mechanisms remain elusive. Probiotics like L. acidophilus are known to exert antiviral through their metabolites. Therefore, in this study, non-targeted metabolomics was used to detect the changes in metabolites of L. acidophilus after 24 h of proliferation. Subsequently, high-throughput molecular docking was utilized to analyze the docking scores of these metabolites with PCV2 Cap and Rep, aiming to identify compounds with potential anti-PCV2 effects. The results demonstrated that 128 compounds such as Dl-lactate were significantly increased. The results of high-throughput molecular docking indicated that compounds such as ergocristine, and telmisartan formed complexes with Cap and Rep, suggesting their potential anti-PCV2 properties. Furthermore, compounds like vitamin C, exhibit pharmacological effects consistent with L. acidophilus adding credence to the idea that L. acidophilus may exert pharmacological effects through its metabolites. These results will provide a foundation for the study of L. acidophilus.
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  • 文章类型: Journal Article
    血吸虫病是寄生虫病发病和死亡的最常见原因之一。由于治疗后反复感染和出现对药物治疗具有抗性的菌株,大量治疗已被证明是不够的。因此,免疫是控制疾病和限制血吸虫病病理后果的一种新方法。评价壳聚糖纳米粒(CSNPs)载药尾蚴抗原(CAP)作为曼氏血吸虫感染小鼠潜在疫苗的预防效果。使用分为2组的130只小鼠:I组:对照组(50只小鼠),再分为Ia亚组(10只小鼠):未感染小鼠(正常对照),Ib亚组(20只小鼠):血吸虫感染的小鼠(感染的对照)和Ic亚组(20只小鼠):仅接受NP的未感染小鼠。组II:疫苗接种组(80只小鼠)等分为亚组IIa(CAP):接受子囊抗原和亚组IIb(CAP+CSNP):接受装载在壳聚糖NP上的子囊抗原,然后两个疫苗接种组在初始疫苗接种剂量后3周用曼氏链球菌感染。CAP+CSNP和CAP组显示成虫数量显著减少,肝卵计数,与感染对照组相比,肝肉芽肿的数量和大小。血清IgG和IgM水平升高,CD4+和CD8+T细胞频率,CAP+CSNP组IL-4、IL-10和INF-γ水平高于CAP组。CAPCSNP是一种有前途的新的血吸虫抗原制剂,比单独使用CAP免疫效果更好。CSNP增强了CAP的免疫和保护作用,如通过寄生虫学验证,组织病理学和免疫组织化学研究。
    Schistosomiasis is one of the most common causes of morbidity and mortality from parasitic diseases. Mass treatment has proven to be insufficient because of repeated infection after treatment and the appearance of strains resistant to drug therapy. Hence, immunization is a new approach to control the disease and limit the pathological consequences of schistosomiasis. To evaluate the prophylactic effect of Cercarial antigen (CAP) loaded on chitosan nanoparticles (CSNPs) as a potential vaccine against Schistosoma mansoni-infected mice. 130 mice divided into 2 groups were used: Group I: Control groups (50 mice) subdivided into subgroup Ia (10 mice): Non-infected mice (normal control), subgroup Ib (20 mice): Schistosoma infected mice (infected control) and subgroup Ic (20 mice): Non-infected mice receiving NPs only. Group II: Vaccinated group (80 mice) subdivided equally into subgroup IIa (CAP): Received cercarial antigen and subgroup IIb (CAP + CSNP): Received cercarial antigen loaded on chitosan NPs then both vaccinated groups were infected with S. mansoni 3 weeks following the initial vaccination dose. CAP + CSNP and CAP groups showed significant reduction in adult worms count, hepatic egg count, hepatic granulomas number and size in comparison to the infected control group. Elevation of serum IgG and IgM levels, CD4+ and CD8+ T cell frequencies, IL-4, IL-10 and INF-γ levels was more significant in CAP + CSNP group than CAP group. CAP + CSNP is a promising new preparation of Schistosomal antigens that gave better results than immunization with CAP alone. CSNPs enhanced the immune and protective effect of CAP as validated by parasitological, histopathological and immunohistochemical studies.
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  • 文章类型: Systematic Review
    据推测,听神经(AN)功能会随着年龄和噪声暴露而恶化。这里,我们对已发表的研究进行了系统回顾,发现与年龄相关的AN功能缺陷的证据在文献中基本一致,但噪声暴露史的研究结果不一致。Further,来自动物研究的证据表明,在暴露于噪声的老年小鼠中发现了AN响应幅度的最大缺陷,但是尚未在人类中进行年龄和噪声暴露对AN功能的影响之间的相互作用的测试。我们报告了一项我们自己的研究,在大量人类参与者(63名18-30岁的年轻成年人,有和没有自我报告的噪声暴露史的年轻人和老年人之间,复合动作电位N1(CAPN1)的反应幅度的差异,103名50-86岁的老年人)。老年人的CAPN1反应幅度小于年轻人。噪声暴露历史似乎无法预测CAPN1响应幅度,噪声暴露史的影响与年龄也没有交互作用。然后,我们将我们的结果纳入两个已发表的关于年龄和噪声暴露历史对神经典型人类样本中AN响应幅度的影响的研究的荟萃分析。荟萃分析发现,不同研究的年龄效应是稳健的(r=-0.407),但噪声暴露效应较弱(r=-0.152)。我们得出的结论是,噪声暴露效应可能是高度可变的,具体取决于样本特征,研究设计,和统计方法,研究人员在解释结果时应该谨慎。与年龄相关和噪声引起的AN功能变化的潜在病理学在活体人类中很难确定,需要对整个生命周期中AN功能的变化进行纵向研究,并从死后收集的颞骨对AN进行组织学检查。
    Auditory nerve (AN) function has been hypothesized to deteriorate with age and noise exposure. Here, we perform a systematic review of published studies and find that the evidence for age-related deficits in AN function is largely consistent across the literature, but there are inconsistent findings among studies of noise exposure history. Further, evidence from animal studies suggests that the greatest deficits in AN response amplitudes are found in noise-exposed aged mice, but a test of the interaction between effects of age and noise exposure on AN function has not been conducted in humans. We report a study of our own examining differences in the response amplitude of the compound action potential N1 (CAP N1) between younger and older adults with and without a self-reported history of noise exposure in a large sample of human participants (63 younger adults 18-30 years of age, 103 older adults 50-86 years of age). CAP N1 response amplitudes were smaller in older than younger adults. Noise exposure history did not appear to predict CAP N1 response amplitudes, nor did the effect of noise exposure history interact with age. We then incorporated our results into two meta-analyses of published studies of age and noise exposure history effects on AN response amplitudes in neurotypical human samples. The meta-analyses found that age effects across studies are robust (r = -0.407), but noise exposure effects are weak (r = -0.152). We conclude that noise exposure effects may be highly variable depending on sample characteristics, study design, and statistical approach, and researchers should be cautious when interpreting results. The underlying pathology of age-related and noise-induced changes in AN function are difficult to determine in living humans, creating a need for longitudinal studies of changes in AN function across the lifespan and histological examination of the AN from temporal bones collected post-mortem.
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  • 文章类型: Journal Article
    目的:受控衰减参数(CAP)是一种评估肝脂肪变性的无创定量方法,这在儿童中没有得到很好的评价。这项研究的目的是根据MR质子密度脂肪分数(PDFF)检查CAP对肥胖儿童肝性脂肪变性的诊断价值。
    方法:对108例非酒精性脂肪性肝病(NAFLD)患儿进行了PDFF评估,CAP,并纳入其他实验室结果.在这项研究中,儿科患者分为肥胖组(n=80)和重度肥胖组(n=28).肝脏脂肪变性等级(0-3)根据PDFF使用6.4的临界值进行分类,17.4%,22.1%。
    结果:肥胖组和重度肥胖组之间的CAP存在显着差异(p<0.05)。CAP在NAFLD儿科患者中显示出与PDFF的良好相关性,用于使用265dB/m的截止值(p<0.001)诊断肝性脂肪变性。同时,在诊断肝脂肪变性等级的受试者工作曲线(ROC)分析中,ALT显着优于CAP。CAP对脂肪变性的诊断准确率为77.8%,ALT对脂肪变性的诊断准确率为83.3%。
    结论:虽然CAP有望成为小儿NAFLD的诊断工具,它的诊断性能值得谨慎。CAP的潜力是显而易见的;然而,ALT作为一种更简单,更准确的检测儿童肝脏脂肪变性的方法出现。进一步的研究对于确定CAP在小儿NAFLD诊断和治疗中的最佳作用至关重要。
    OBJECTIVE: Controlled attenuation parameter (CAP) is a noninvasive and quantitative method to evaluate hepatic steatosis, which is not well evaluated in children. The aim of this study was to examine the diagnostic value of CAP for hepatic steatosis in children with obesity based on MR proton density fat fraction (PDFF).
    METHODS: About 108 pediatric patients with nonalcoholic fatty liver disease (NAFLD) who were assessed for PDFF, CAP, and other laboratory results were enrolled. In this study, pediatric patients were separated for the obese group (n=80) and the severe obese group (n=28). Hepatic steatosis grades (0-3) were classified according to PDFF using cutoff values of 6.4 , 17.4, and 22.1 %.
    RESULTS: There are significant differences in CAP between the obese and severe obese groups (p<0.05). CAP showed a good correlation with PDFF in pediatric patients with NAFLD for diagnosing hepatic steatosis using a cutoff value of 265 dB/m (p<0.001). Meanwhile, ALT significantly outperforms CAP in receiver-operating curve (ROC) analysis for diagnosing hepatic steatosis grades. The diagnostic accuracy of CAP for steatosis is 77.8 %, and the diagnostic accuracy of ALT for steatosis is 83.3 %.
    CONCLUSIONS: While CAP holds promise as a diagnostic tool for pediatric NAFLD, its diagnostic performance warrants some caution. The potential of CAP is evident; however, ALT emerges as a simpler and more accurate measure for detecting hepatic steatosis in children. Further research is essential to determine the optimal role of CAP in pediatric NAFLD diagnosis and management.
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  • 文章类型: Preprint
    这项研究的最初目的是通过分析公开可用的深度测序数据集的从头组装来阐明小DNA肿瘤病毒的进化。该调查生成了一个可搜索的重叠群快照数据库,代表100,000多个序列读取存档记录。使用现代结构感知搜索工具,我们反复扩大搜索范围,以包括越来越广泛的其他病毒家族。分析揭示了令人惊讶的不同范围的嵌合体,涉及不同的病毒组。在某些情况下,类似于已知DNA复制模块或已知病毒体蛋白操纵子的基因与无法识别的序列配对,结构预测表明这些序列可能代表以前未知的复制酶和新型病毒体结构。在代表人类和其他灵长类动物的数据集中发现了一个新兴群体的离散进化枝,称为腺体病毒。作为概念的证明,我们表明,重叠群数据库也可用于发现RNA病毒和候选古细菌噬菌体。辅助搜索揭示了不同病毒组之间嵌合的其他实例。这些观察结果支持以基因为中心的分类学框架,该框架应该对未来的病毒狩猎工作有用。
    The initial objective of this study was to shed light on the evolution of small DNA tumor viruses by analyzing de novo assemblies of publicly available deep sequencing datasets. The survey generated a searchable database of contig snapshots representing more than 100,000 Sequence Read Archive records. Using modern structure-aware search tools, we iteratively broadened the search to include an increasingly wide range of other virus families. The analysis revealed a surprisingly diverse range of chimeras involving different virus groups. In some instances, genes resembling known DNA-replication modules or known virion protein operons were paired with unrecognizable sequences that structural predictions suggest may represent previously unknown replicases and novel virion architectures. Discrete clades of an emerging group called adintoviruses were discovered in datasets representing humans and other primates. As a proof of concept, we show that the contig database is also useful for discovering RNA viruses and candidate archaeal phages. The ancillary searches revealed additional examples of chimerization between different virus groups. The observations support a gene-centric taxonomic framework that should be useful for future virus-hunting efforts.
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  • 文章类型: Journal Article
    目的:因社区获得性肺炎(CAP)住院的患者可能有较高的新发房颤(NOAF)风险。开发了C2HEST评分以评估普通人群中的NOAF风险。缺乏关于CAP急性患者的C2HEST评分值的数据。我们希望建立C2HEST评分对CAP患者NOAF的预测价值。
    方法:纳入SIXTUS队列的CAP患者。在基线计算C2HEST评分。记录了医院中的NOAF。进行受试者工作特征(ROC)曲线和多变量Cox比例风险回归分析。
    结果:我们招募了473名患者(36%的女性,平均年龄70.6±16.5岁),发生了54次NOAF。NOAF患者年龄较大,更常受到高血压的影响,心力衰竭,既往卒中/短暂性脑缺血发作,外周动脉疾病和甲状腺功能亢进。NOAF患者的CURB-65、PSI等级和CHA2DS2-VASc评分也较高。NOAF的C2HEST评分的C指数为0.747(95%置信区间[95CI]0.705-0.786),与CURB-65相比更高(0.611,95CI0.566-0.655,p=0.0016),PSI(0.665,95CI0.621-0.708,p=0.0199)和CHA2DS2-VASc评分(0.696,95CI0.652-0.737,p=0.0762)。在C2HEST评分≥4的情况下,观察到灵敏度(67%)和特异性(70%)的最佳组合。多变量Cox分析证实了这一结果(C2HEST评分≥4的危险比[HR]为10.7,95CI2.0-57.9;p=0.006),与肺炎的严重程度无关。
    结论:C2HEST评分是一种有用的预测工具,可用于识别因CAP住院期间NOAF风险较高的患者。
    背景:www.
    结果:gov(NCT01773863)。
    OBJECTIVE: Patients hospitalized for community-acquired pneumonia (CAP) may have a higher risk of new-onset atrial fibrillation (NOAF). The C2HEST score was developed to evaluate the NOAF risk in the general population. Data on the value of the C2HEST score in acute patients admitted with CAP are lacking. We want to establish the predictive value of C2HEST score for NOAF in patients with CAP.
    METHODS: Patients with CAP enrolled in the SIXTUS cohort were enrolled. C2HEST score was calculated at baseline. In-hospital NOAF was recorded. Receiver-operating Characteristic (ROC) curve and multivariable Cox proportional hazard regression analysis were performed.
    RESULTS: We enrolled 473 patients (36% women, mean age 70.6 ± 16.5 years), and 54 NOAF occurred. Patients with NOAF were elderly, more frequently affected by hypertension, heart failure, previous stroke/transient ischemic attack, peripheral artery disease and hyperthyroidism. NOAF patients had also higher CURB-65, PSI class and CHA2DS2-VASc score. The C-index of C2HEST score for NOAF was 0.747 (95% confidence interval [95%CI] 0.705-0.786), higher compared to CURB-65 (0.611, 95%CI 0.566-0.655, p = 0.0016), PSI (0.665, 95%CI 0.621-0.708, p = 0.0199) and CHA2DS2-VASc score (0.696, 95%CI 0.652-0.737, p = 0.0762). The best combination of sensitivity (67%) and specificity (70%) was observed with a C2HEST score ≥ 4. This result was confirmed by the multivariable Cox analysis (Hazard Ratio [HR] for C2HEST score ≥ 4 was 10.7, 95%CI 2.0-57.9; p = 0.006), independently from the severity of pneumonia.
    CONCLUSIONS: The C2HEST score was a useful predictive tool to identify patients at higher risk for NOAF during hospitalization for CAP.
    BACKGROUND: www.
    RESULTS: gov (NCT01773863).
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