Safety

安全
  • 文章类型: Journal Article
    人体肠道微生物组在免疫功能中起着至关重要的作用。合生元联盟或定义的微生物组装™(DMA™)医疗食品,由益生菌微生物和益生元纤维组成的SBD121被设计用于类风湿性关节炎的临床饮食管理。进行28天重复给药研究以评估SBD121在雄性和雌性大鼠(研究开始时的年龄/体重:60天/156-264克)中的口服毒性,所述大鼠施用水平为0、4.96×1010、2.48×1011或4.96×1011集落形成单位(CFU)/kg-bw。没有治疗相关的眼科效果变化,死亡率,发病率,一般健康和临床观察,尿液分析,血液学,血清化学,绝对或相对器官重量,肉眼尸检,或组织病理学。据报道,低浓度和高浓度组的女性体重显着下降,这在一定程度上与食物消费的显著减少相对应。功能观察电池的结果表明,与对照组相比,高浓度男性的前握力明显更大;然而,这种效应不被认为是不利的.基于这些发现,在测试的最高水平为4.96x1011CFU/kg-bw时,对雄性和雌性大鼠施用医疗食品SBD121具有未观察到的不良反应水平(NOAEL)。
    The human gut microbiome plays a crucial role in immune function. The synbiotic consortium or Defined Microbial Assemblage™ (DMA™) Medical Food product, SBD121, consisting of probiotic microbes and prebiotic fibers was designed for the clinical dietary management of rheumatoid arthritis. A 28-day repeated administration study was performed to evaluate the oral toxicity of SBD121 in male and female rats (age/weight at study start: 60 days/ 156-264 grams) administered levels of 0, 4.96 x 1010, 2.48 x 1011, or 4.96 x 1011 colony forming units (CFU)/kg-bw. No treatment related changes in ophthalmological effects, mortality, morbidity, general health and clinical observations, urinalysis, hematology, serum chemistry, absolute or relative organ weights, gross necropsy, or histopathology. A significant decrease in body weight was reported in females in the low and high-concentration groups, which corresponded in part with a significant decrease in food consumption. Results of the functional observation battery indicated front grip strength was significantly greater in the high-concentration males compared to the controls; however, this effect was not considered adverse. Based on these findings, the administration of the Medical Food SBD121 to male and female rats has a no-observable adverse effect level (NOAEL) at the highest level tested of 4.96 x 1011 CFU/kg-bw.
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  • 文章类型: Journal Article
    额叶纤维化脱发(FFA)的特征是由于毛囊逐渐消失,然后是毛囊干细胞和毛囊纤维化,额颞区的发际线逐渐消失。卵泡干细胞在化学剥离和其他表面修复程序后的皮肤愈合中至关重要。尽管FFA可能与面部和头皮外科手术的历史有关,没有关于FFA患者整容手术安全性的信息。我们报告了5名FFA患者,他们在进行深层化学剥离(苯酚和巴豆油)后经历了异常和复杂的结果。随着全球FFA的流行率继续上升,必须提高人们对这种皮肤病与特定整容手术的潜在不相容性的认识,例如更深的果皮和其他重铺方式。
    Frontal fibrosing alopecia (FFA) is characterized by a receding hairline in the frontotemporal region due to the gradual loss of hair follicles and then follicular stem cells and follicular fibrosis. Follicular stem cells are crucial in skin healing after chemical peeling and other resurfacing procedures. Although there is a possible association of FFA with a history of facial and scalp surgical procedures, there is no information on the safety of cosmetic procedures in patients with FFA. We report five patients with FFA who experienced unusual and complicated outcomes after undergoing a deep chemical peel (phenol and croton oil). As the prevalence of FFA continues to increase globally, it is essential to raise awareness about the potential incompatibility of this dermatologic disorder with specific cosmetic procedures, such as deeper peels and other resurfacing modalities.
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  • 文章类型: Journal Article
    背景:人工智能(AI)医疗设备具有改变现有临床工作流程并最终改善患者预后的潜力。人工智能医疗设备已经显示出用于诊断等一系列临床任务的潜力。预测,和治疗决策,如药物剂量。有,然而,迫切需要确保这些技术对所有人口都是安全的。最近的文献表明,需要进行严格的性能误差分析,以识别诸如伪相关性的算法编码等问题(例如,受保护的特征)或可能导致患者伤害的特定故障模式。评估人工智能医疗设备的研究报告指南要求提及性能错误分析;然而,仍然缺乏对临床研究中应如何分析性能错误的理解,以及作者应该旨在发现和报告的危害。
    目的:本系统评价将评估研究AI医疗设备作为临床干预措施的随机对照试验(RCT)中AI错误和不良事件(AE)的频率和严重程度。审查还将探讨如何分析绩效错误,包括分析是否包括对子组级结果的调查。
    方法:本系统综述将确定和选择评估AI医疗设备的RCT。搜索策略将部署在MEDLINE(Ovid)中,Embase(Ovid),科克伦中部,和临床试验登记处,以确定相关论文。书目数据库中确定的RCT将与临床试验注册中心交叉引用。感兴趣的主要结果是AI错误的频率和严重程度,病人的伤害,并报告AE。RCT的质量评估将基于Cochrane偏差风险工具(RoB2)的第2版。数据分析将包括比较研究小组之间的错误率和患者伤害,在适当情况下,将对对照组和干预组的患者伤害率进行荟萃分析.
    结果:该项目于2023年2月在PROSPERO上注册。初步搜索已经完成,搜索策略是与信息专家和方法学家协商设计的。标题和摘要筛选于2023年9月开始。全文筛选正在进行中,数据收集和分析于2024年4月开始。
    结论:对人工智能医疗器械的评估显示出了有希望的结果;然而,研究报告是可变的。检测,分析,以及报告性能错误和患者危害对于可靠地评估RCT中AI医疗设备的安全性至关重要。范围搜索表明,危害的报告是可变的,通常没有提到AE。这项系统评价的结果将确定AI表现错误和患者危害的频率和严重程度,并深入了解如何分析错误以考虑整体和小组表现。
    背景:PROSPEROCRD42023387747;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=387747。
    PRR1-10.2196/51614。
    BACKGROUND: Artificial intelligence (AI) medical devices have the potential to transform existing clinical workflows and ultimately improve patient outcomes. AI medical devices have shown potential for a range of clinical tasks such as diagnostics, prognostics, and therapeutic decision-making such as drug dosing. There is, however, an urgent need to ensure that these technologies remain safe for all populations. Recent literature demonstrates the need for rigorous performance error analysis to identify issues such as algorithmic encoding of spurious correlations (eg, protected characteristics) or specific failure modes that may lead to patient harm. Guidelines for reporting on studies that evaluate AI medical devices require the mention of performance error analysis; however, there is still a lack of understanding around how performance errors should be analyzed in clinical studies, and what harms authors should aim to detect and report.
    OBJECTIVE: This systematic review will assess the frequency and severity of AI errors and adverse events (AEs) in randomized controlled trials (RCTs) investigating AI medical devices as interventions in clinical settings. The review will also explore how performance errors are analyzed including whether the analysis includes the investigation of subgroup-level outcomes.
    METHODS: This systematic review will identify and select RCTs assessing AI medical devices. Search strategies will be deployed in MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, and clinical trial registries to identify relevant papers. RCTs identified in bibliographic databases will be cross-referenced with clinical trial registries. The primary outcomes of interest are the frequency and severity of AI errors, patient harms, and reported AEs. Quality assessment of RCTs will be based on version 2 of the Cochrane risk-of-bias tool (RoB2). Data analysis will include a comparison of error rates and patient harms between study arms, and a meta-analysis of the rates of patient harm in control versus intervention arms will be conducted if appropriate.
    RESULTS: The project was registered on PROSPERO in February 2023. Preliminary searches have been completed and the search strategy has been designed in consultation with an information specialist and methodologist. Title and abstract screening started in September 2023. Full-text screening is ongoing and data collection and analysis began in April 2024.
    CONCLUSIONS: Evaluations of AI medical devices have shown promising results; however, reporting of studies has been variable. Detection, analysis, and reporting of performance errors and patient harms is vital to robustly assess the safety of AI medical devices in RCTs. Scoping searches have illustrated that the reporting of harms is variable, often with no mention of AEs. The findings of this systematic review will identify the frequency and severity of AI performance errors and patient harms and generate insights into how errors should be analyzed to account for both overall and subgroup performance.
    BACKGROUND: PROSPERO CRD42023387747; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387747.
    UNASSIGNED: PRR1-10.2196/51614.
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  • 文章类型: Journal Article
    目的评价贝利木单抗联合标准方案治疗儿童活动性狼疮性肾炎的疗效和安全性。这个单一中心,回顾性队列研究使用2004年12月至2023年2月期间在肾内科住院的新活动性狼疮性肾炎患儿的临床资料.根据患者是否接受贝利木单抗,将患者分为贝利木单抗组或传统治疗组。比较两组的肾脏缓解率和复发率以及糖皮质激素剂量。纳入47名儿童(平均年龄11岁),包括传统治疗和贝利木单抗组的30和17名儿童,分别。belimumab组儿童系统性红斑狼疮疾病活动指数-2000(SLEDAI-2000)评分(23.59±7.78)高于传统治疗组(19.13±6.10)(P=0.035)。两组出现脓尿的频率差异无统计学意义,肉眼血尿,以及24小时蛋白尿水平和估计的肾小球滤过率。贝利木单抗组补体C3/C4较传统治疗组恢复快(P<0.05)。6个月或12个月时肾脏完全缓解率无组间差异(P=0.442,P=0.759)。组间1年复发率无差异(P=0.303)。此外,治疗后6个月和12个月,贝利木单抗的糖皮质激素剂量低于传统治疗组(17.87±6.96mg/dvs.27.33±8.40mg/d,P=0.000;10.00(5.3)mg/dvs.13.75(10.0)mg/d,P=0.007),分别。
    结论:在肾脏缓解率相等的情况下,贝利木单抗联合标准传统方案可能促进糖皮质激素的减量,不良事件发生率较低。
    背景:•Belimumab被证明是对系统性红斑狼疮(c-SLE)LN具有疗效的辅助治疗。•由于缺乏研究,其在儿童LN中的作用和副作用尚不清楚。
    背景:•这种单中心,回顾性队列研究评估了贝利木单抗联合标准方案治疗儿童增殖性LN的疗效和安全性.•Belimumab与标准传统治疗相结合可能会促进糖皮质激素的逐渐减少,同时表现出不良事件的低发生率。
    The purpose of this study is to evaluate the efficacy and safety of belimumab combined with the standard regimen in treating children with active lupus nephritis. This single-center, retrospective cohort study used clinical data of children with newly active lupus nephritis hospitalized in the Department of Nephrology between December 2004 and February 2023. Patients were divided into a belimumab or traditional treatment group according to whether or not they received belimumab. Renal remission and recurrence rates and glucocorticoid dose were compared between groups. Forty-seven children (median age 11 years) were enrolled, including 30 and 17 children in the traditional treatment and belimumab groups, respectively. The Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2000) score of children in the belimumab group (23.59 ± 7.78) was higher than that in the traditional treatment group (19.13 ± 6.10) (P = 0.035). The two groups showed no significant difference in the frequency of pyuria, gross hematuria, and the levels of 24-h proteinuria and estimated glomerular filtration rate. The complement C3/C4 in the belimumab group recovered faster than that in the traditional treatment group (P < 0.05). There were no between-group differences in the complete renal remission rate at 6 or 12 months (P = 0.442, P = 0.759). There were no between-group differences in 1-year recurrence rate (P = 0.303). Furthermore, 6 and 12 months after treatment, glucocorticoid doses were lower in the belimumab than the traditional treatment group (17.87 ± 6.96 mg/d vs. 27.33 ± 8.40 mg/d, P = 0.000; 10.00 (5.3) mg/d vs. 13.75 (10.0) mg/d, P = 0.007), respectively.
    CONCLUSIONS: With an equivalent renal remission rate, belimumab combined with the standard traditional regimen might promote the tapering of glucocorticoids, and the incidence of adverse events is low.
    BACKGROUND: • Belimumab is documented as an adjunctive treatment with systemic lupus erythematosus (c-SLE) LN with efficacy. • Due to the paucity of studies, its effects and side effects in children with LN remain unclear.
    BACKGROUND: • This single-center, retrospective cohort study evaluated the efficacy and safety of belimumab combined with the standard regimen in treating children with proliferative LN. • Belimumab combined with the standard traditional treatment might promote the tapering of glucocorticoids, while exhibiting a low occurrence of adverse events.
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  • 文章类型: Journal Article
    原位聚合的固态电解质由于具有较高的锂离子电导率而备受关注。共形界面接触,和低界面电阻,但是被锂枝晶困扰,界面退化,和较差的热稳定性,这由此导致高能锂金属电池(LMBs)的寿命有限和严重的安全隐患。在这里,我们提出了通过共聚1,3-二氧戊环与1,3,5-三缩水甘油酯异氰脲酸酯(TGIC)作为交联剂的原位聚合电解质,这实现了电池热安全性和与锂阳极的界面兼容性的协同作用。功能性TGIC增强电解质聚合物水平。独特的碳形成机制促进了阻燃性并消除了电池火灾风险。同时,TGIC衍生的富无机物中间相抑制界面副反应并促进均匀的Li电镀。实现了在极端温度(130°C)下具有不燃性和出色电化学性能的本质安全型LMB。这种功能聚合物设计显示了开发安全LMB的前景。本文受版权保护。保留所有权利。
    In-situ polymerized solid-state electrolytes have attracted much attention due to high Li-ion conductivity, conformal interface contact, and low interface resistance, but are plagued by lithium dendrite, interface degradation, and inferior thermal stability, which thereby leads to limited lifespan and severe safety hazards for high-energy lithium metal batteries (LMBs). Herein, we propose an in-situ polymerized electrolyte by copolymerization of 1,3-dioxolane with 1,3,5-tri glycidyl isocyanurate (TGIC) as a cross-linking agent, which realizes a synergy of battery thermal safety and interface compatibility with Li anode. Functional TGIC enhances the electrolyte polymeric level. The unique carbon-formation mechanism facilitates flame retardancy and eliminates the battery fire risk. In the meantime, TGIC-derived inorganic-rich interphase inhibits interface side reactions and promotes uniform Li plating. Intrinsically safe LMBs with nonflammability and outstanding electrochemical performances under extremely temperatures (130 °C) are achieved. This functional polymer design shows a promising prospect for the development of safe LMBs. This article is protected by copyright. All rights reserved.
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  • 文章类型: Journal Article
    目标:由于教育迁移到波兰,来自乌克兰和白俄罗斯的学生可能会在不同程度上体验安全。这项研究的目的是检查在卢布林学习的乌克兰和白俄罗斯人感到安全的程度,考虑到自己的生命和健康。还尝试建立被调查学生的安全感与选定特征之间的关系。
    方法:这项研究是使用调查方法对来自乌克兰的403名学生进行的,白俄罗斯和波兰。八个自变量被引入到关系分析中:性别,年龄,对财务状况的自我评估,原产国,原产地,学习期间的居住地,和学习的年份。依赖性分析使用Wilcoxon和Kruskal-Wallisau检验以及CATREG最佳缩放分析。
    结果:研究表明,波兰和外国学生在波兰以及在卢布林学习期间的安全水平都很高。白天比天黑后更安全。波兰学生更害怕盗窃,强奸和被车撞比白俄罗斯和乌克兰的学生,来自乌克兰的学生更害怕言语虐待。影响学生不安全感的预测因素是,其中,他们的财务状况和性别。
    结论:对获得的结果进行的研究和分析表明,在卢布林学习的乌克兰和白俄罗斯学生的情况,波兰,在安全方面,与波兰学生相似,在某些方面甚至更好。这一结果表明,卢布林是波兰东部边境学生的友好学术中心。
    OBJECTIVE: Due to educational migration to Poland, students from Ukraine and Belarus may experience security to varying degrees. The aim of the study was to check the extent to which people from Ukraine and Belarus studying in Lublin feel safe, taking into account their own life and health. An attempt was also made to establish the relationship between the sense of security and selected features of the surveyed students.
    METHODS: The research was conducted using a survey method among 403 students from Ukraine, Belarus and Poland. Eight independent variables were introduced into the analysis of relationships: gender, age, self-assessment of the financial situation, country of origin, place of origin, place of residence during studies, and year of study. The dependency analysis used Wilcoxon and Kruskal-Wallisau tests and CATREG optimal scaling analysis.
    RESULTS: The study showed that both Polish and foreign students assessed the level of safety in Poland and during their studies in Lublin as high. They feel safer during the day than after dark. Polish students are more afraid of theft, rape and being hit by a car than students from Belarus and Ukraine, and students from Ukraine are more afraid of verbal abuse. The predictors influencing students\' sense of insecurity are, among others, their financial situation and gender.
    CONCLUSIONS: The conducted research and analysis of the obtained results suggest that the situation of students from Ukraine and Belarus studying in Lublin, Poland, in terms of safety, is similar to that of Polish students, and even better in some aspects. This result suggests that Lublin is a friendly academic centre for students from across the eastern border of Poland.
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  • 文章类型: Journal Article
    暴露于电离辐射是临床心脏病学中固有的职业健康危害。健康风险以前已经报道过,包括对癌症的偏爱.此外,由于长时间穿着沉重的保护性铅围裙而造成的骨科伤害,这是降低辐射风险的强制性要求,已被广泛记录。随着越来越复杂的手术数量的增加,心脏病学作为一门专业已经发展起来。这包括电生理,冠状动脉,和结构性干预,晚期心力衰竭/移植管理,和诊断成像。操作员和成像专家都受到辐射,特别是在结构干预中,介入心脏病学家和结构成像仪密切合作。越来越多,由于辐射问题,对心脏病学感兴趣的女性可能会取消选择该领域。这份专家文件强调了心脏病学中辐射暴露的风险,包括各种亚专业领域的实用技巧,如介入/结构心脏病学,电生理学,成像,晚期心力衰竭,和儿科心脏病学.
    Exposure to ionizing radiation is an inherent occupational health hazard in clinical cardiology. Health risks have been reported previously, including predilection to cancer. In addition, orthopedic injury due to prolonged wearing of heavy protective lead aprons, which are mandatory to reduce radiation risk, have been extensively documented. Cardiology as a specialty has grown with rising volumes of increasingly complex procedures. This includes electrophysiological, coronary, and structural intervention, advanced heart failure/transplant management, and diagnostic imaging. Both the operator as well imaging specialists are exposed to radiation, particularly in structural interventions where interventional cardiologists and structural imagers work closely. Increasingly, women interested in cardiology may deselect the field due to radiation concerns. This expert document highlights the risks of radiation exposure in cardiology, including practical tips within various subspecialty fields such as interventional/structural cardiology, electrophysiology, imaging, advanced heart failure, and pediatric cardiology.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    根据欧盟委员会的要求,EFSA被要求就动物饲喂含有硒作为活性物质的饲料添加剂的产品对消费者的安全性提供科学意见。基于可用的有限数据集和几个不确定性,FEEDAP小组的结论是,在目前最大授权使用水平为0.2mg有机来源补充硒/kg完整饲料(在最大0.5mg总硒/kg完整饲料内)的情况下,有机硒的使用导致所有人口类别(老年人和非常老年人除外)的UL超标,这表明了对消费者安全的担忧。对于所有消费类别,目前最大使用水平为0.5mg总硒/kg完全饲料的安全性是不可能的。进行适当的风险评估需要来自专门设计用于测量由于使用不同来源的硒而导致的动物来源的组织和产品中硒沉积的研究的其他数据。
    Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety for the consumer of products from animals fed diets with feed additives containing selenium as an active substance. Based on the limited data set available and the several uncertainties, the FEEDAP Panel concluded that the use of organic selenium at the currently maximum authorised use level of 0.2 mg supplemented selenium from organic sources/kg complete feed (within a maximum of 0.5 mg total selenium/kg complete feed) leads to an exceedance of the UL for all the population categories (except elderly and very elderly), suggesting a concern for consumer safety. It was not possible to conclude on the safety of the currently maximum use level of 0.5 mg total selenium/kg complete feed for all consumer categories. Additional data from studies specifically designed to measure deposition of selenium in tissues and products from animal origin resulting from the use of the different sources of selenium would be required to perform a proper risk assessment.
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  • 文章类型: Journal Article
    嗜盐细菌在工业化学和食品生产中的使用受到了极大的关注,因为这些细菌具有独特的特性;然而,他们的安全仍在调查中。Halomonassp.KM-1在有氧条件下在细胞内储存聚-D-β-羟基丁酸,并在微氧条件下依次分泌D-β-羟基丁酸(D-BHB)。因此,我们测试了Halomonassp的安全性。KM-1衍生的D-BHB和D-BHB制造过程中产生的杂质在使用小鼠的急性测试中浓度增加了100倍,日本成年人每天摄入16.0gD-BHB12周。在老鼠测试中,饲喂纯化的D-BHB或其杂质的小鼠的体重或健康状况没有异常。在日本成人测试中,血液参数和身体状况无医学问题波动.这些发现表明Halomonassp。KM-1是安全的,可用于D-BHB及其衍生物的商业生产。
    The use of halophilic bacteria in industrial chemical and food production has received great interest because of the unique properties of these bacteria; however, their safety remains under investigation. Halomonas sp. KM-1 intracellularly stores poly-D-β-hydroxybutyric acid under aerobic conditions and successively secretes D-β-hydroxybutyric acid (D-BHB) under microaerobic conditions. Therefore, we tested the safety of Halomonas sp. KM-1-derived D-BHB and the impurities generated during D-BHB manufacturing at a 100-fold increased concentration in acute tests using mice and daily intake of 16.0 g D-BHB in Japanese adults for 12 weeks. In the mice test, there were no abnormalities in the body weights or health of mice fed the purified D-BHB or its impurities. In the Japanese adult test, blood parameters and body condition showed no medically problematic fluctuations. These findings indicate that Halomonas sp. KM-1 is safe and can be used for commercial production of D-BHB and its derivatives.
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