OBJECTIVES: This study sought to assess the impact of the selective aldosterone blocker eplerenone on mortality 30 days after randomization in patients after acute myocardial infarction(AMI) with a left ventricular ej...OBJECTIVES: This study sought to assess the impact of the selective aldosterone blocker eplerenone on mortality 30 days after randomization in patients after acute myocardial infarction(AMI) with a left ventricular ejection fraction(LVEF) ≤40%and clinical signs of heart failure. BACKGROUND: In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study(EPHESUS), eplerenone reduced all-cause mortality by 15%(p=0.008) over a mean followup of 16 months when used with standard therapy in patients after AMI with an LVEF ≤40%and clinical signs of heart failure. METHODS: We analyzed the effect of eplerenone 25 mg/day initiated 3 to 14 days after AMI(mean, 7.3 days) on the co-primary end points of time to death from any cause and the composite end point of time to death from cardiovascular(CV) causes or hospitalization for CV events, and the secondary end points of CV mortality, sudden cardiac death, and fatal/nonfatal hospitalization for heart failure, after 30 days of therapy in the EPHESUS trial. RESULTS: At 30 days after randomization, eplerenone reduced the risk of all-cause mortality by 31%(3.2%vs. 4.6%in eplerenone and placebo-treated patients, respectively; p=0.004) and reduced the risk of CV mortality/CV hospitalization by 13%(8.6%vs. 9.9%in eplerenone and placebo-treated patients, respectively; p=0.074). Eplerenone also reduced the risk of CV mortality by 32%(p=0.003) and the risk of sudden cardiac death by 37%(p=0.051). CONCLUSIONS: Eplerenone 25 mg/day significantly reduced all-cause mortality 30 days after randomization(when initiated at a mean of 7.3 days after AMI) in addition to conventional therapy in patients with an LVEF ≤40%and signs of heart failure. Based on its early survival benefit, eplerenone should be administered in the hospital after AMI.展开更多
Background Sleep problem is a highly prevalent health issue among pediatric populations across the world.In this review,we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in chil...Background Sleep problem is a highly prevalent health issue among pediatric populations across the world.In this review,we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children.Potential biological,psychosocial,and environmental mechanisms as well as research gaps in the literature are also discussed.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info.Both relevant data based and systematic reviews are included.Results This paper summarizes many risk factors for childhood sleep problems,including biological(e.g.,genetics,gender,age and puberty,prenatal factors,postnatal factors);nutritional(e.g.,macronutrients,micronutrients,omega-3 fatty acids,obesity);environmental(e.g.,heavy metals,noise,light,air pollution);interpersonal(e.g.,family,exposure to violence,screen media use,physical injury);and community/socioeconomic variables(e.g.,racial/ethnicity and cultural factors,neighborhood conditions and socioeconomic status,school factors,public health disasters/emergencies),to better understand the development of sleep problems in children.Conclusions Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological,environmental,and psychosocial risk factors and contributors.A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.展开更多
Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s...Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s sleep problems.In this paper,we aimed to identify and summarize the consequences and implications of child sleep problems.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info published in the past two decades.Both relevant data-based articles and systematic reviews are included.Results Many adverse consequences are associated with child sleep deficiency and other sleep problems,including physical outcomes(e.g.,obesity),neurocognitive outcomes(e.g.,memory and attention,intelligence,academic performance),and emotional and behavioral outcomes(e.g.,internalizing/externalizing behaviors,behavioral disorders).Current prevention and intervention approaches to address childhood sleep problems include nutrition,exercise,cognitive–behavioral therapy for insomnia,aromatherapy,acupressure,and mindfulness.These interventions may be particularly important in the context of coronavirus disease 2019.Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.Conclusions Given the increasing prevalence of child sleep problems,which have been shown to affect children’s physical and neurobehavioral wellbeing,understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention,thus improving sleep-related child development and health.展开更多
An overset grid methodology is developed for the fully coupled analysis of fluid-structure interaction (FSI) problems. The overset grid approach alleviates some of the computational geometry difficulties traditionally...An overset grid methodology is developed for the fully coupled analysis of fluid-structure interaction (FSI) problems. The overset grid approach alleviates some of the computational geometry difficulties traditionally associated with Arbitrary-Lagrangian-Eulerian (ALE) based, moving mesh methods for FSI. Our partitioned solution algorithm uses separate solvers for the fluid (finite volume method) and the structure (finite element method), with mesh motion computed only on a subset of component grids of our overset grid assembly. Our results indicate a significant reduction in computational cost for the mesh motion, and element quality is improved. Numerical studies of the benchmark test demonstrate the benefits of our overset mesh method over traditional approaches.展开更多
Objective:To investigate the banding patterns of whole cell protein(WCP) and outer membrane protein (OMP) of Burkholderia pseudomallei(B.pseudomallei) in clinical isolates from patients with melioidosis. Methods:WCP a...Objective:To investigate the banding patterns of whole cell protein(WCP) and outer membrane protein (OMP) of Burkholderia pseudomallei(B.pseudomallei) in clinical isolates from patients with melioidosis. Methods:WCP and OMP of of B.pseudomallei in 50 clinical isolates,from 47 patients with melioidosis were prepared and separated by polyacrylamide gel electrophoresis(SDS-PAGE) using 10%gels and stained with Coomassie brilliant blue.The banding patterns were compared by using a laser densitometer and dendrogram. Results:There were 6 different banding patterns of WCP and 2 types of OMP.Type 1 -5 WCP had 8 common protein bands at 19.0 - 45.0 kDa with identical OMP pattern.The banding patterns of WCP in type 6 were distinct from the others and also its OMP profile.The majority of clinical isolates(37/50,74%) were in type 1 WCP.Of the remaining isolates,8 were in type 2,2 in type 3,and one each was in type 4 to 6.There was no significant association between the WCP typing and the demographic or clinical features of the investigated patients.Conclusion:Despite the wide variation of clinical features of melioidosis,the results of this study show that B.pseudomallei had a few differences in the WCP and OMP profiles.Therefore typing of WCP and OMP,using SDS-PAGE analysis,could be an alternative method for phenotypic differentiation in clinical isolates of B.pseudomallei.展开更多
文摘OBJECTIVES: This study sought to assess the impact of the selective aldosterone blocker eplerenone on mortality 30 days after randomization in patients after acute myocardial infarction(AMI) with a left ventricular ejection fraction(LVEF) ≤40%and clinical signs of heart failure. BACKGROUND: In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study(EPHESUS), eplerenone reduced all-cause mortality by 15%(p=0.008) over a mean followup of 16 months when used with standard therapy in patients after AMI with an LVEF ≤40%and clinical signs of heart failure. METHODS: We analyzed the effect of eplerenone 25 mg/day initiated 3 to 14 days after AMI(mean, 7.3 days) on the co-primary end points of time to death from any cause and the composite end point of time to death from cardiovascular(CV) causes or hospitalization for CV events, and the secondary end points of CV mortality, sudden cardiac death, and fatal/nonfatal hospitalization for heart failure, after 30 days of therapy in the EPHESUS trial. RESULTS: At 30 days after randomization, eplerenone reduced the risk of all-cause mortality by 31%(3.2%vs. 4.6%in eplerenone and placebo-treated patients, respectively; p=0.004) and reduced the risk of CV mortality/CV hospitalization by 13%(8.6%vs. 9.9%in eplerenone and placebo-treated patients, respectively; p=0.074). Eplerenone also reduced the risk of CV mortality by 32%(p=0.003) and the risk of sudden cardiac death by 37%(p=0.051). CONCLUSIONS: Eplerenone 25 mg/day significantly reduced all-cause mortality 30 days after randomization(when initiated at a mean of 7.3 days after AMI) in addition to conventional therapy in patients with an LVEF ≤40%and signs of heart failure. Based on its early survival benefit, eplerenone should be administered in the hospital after AMI.
文摘Background Sleep problem is a highly prevalent health issue among pediatric populations across the world.In this review,we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children.Potential biological,psychosocial,and environmental mechanisms as well as research gaps in the literature are also discussed.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info.Both relevant data based and systematic reviews are included.Results This paper summarizes many risk factors for childhood sleep problems,including biological(e.g.,genetics,gender,age and puberty,prenatal factors,postnatal factors);nutritional(e.g.,macronutrients,micronutrients,omega-3 fatty acids,obesity);environmental(e.g.,heavy metals,noise,light,air pollution);interpersonal(e.g.,family,exposure to violence,screen media use,physical injury);and community/socioeconomic variables(e.g.,racial/ethnicity and cultural factors,neighborhood conditions and socioeconomic status,school factors,public health disasters/emergencies),to better understand the development of sleep problems in children.Conclusions Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological,environmental,and psychosocial risk factors and contributors.A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
基金funded by the National Institute of Child Health and Development(NIH/NICHD R01-HD087485)supported by the National Natural Science Foundation of China(Nos.82073568,82071493)+2 种基金Innovative Research Team of High-level Local Universities in Shanghai(Nos.SHSMUZDCX20211100,20211900)Science and Technology Commission of Shanghai Municipality(No.2018SHZDZX05)Shanghai Municipal Health Commission(Nos.2022XD056,2020CXJQ01).
文摘Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s sleep problems.In this paper,we aimed to identify and summarize the consequences and implications of child sleep problems.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info published in the past two decades.Both relevant data-based articles and systematic reviews are included.Results Many adverse consequences are associated with child sleep deficiency and other sleep problems,including physical outcomes(e.g.,obesity),neurocognitive outcomes(e.g.,memory and attention,intelligence,academic performance),and emotional and behavioral outcomes(e.g.,internalizing/externalizing behaviors,behavioral disorders).Current prevention and intervention approaches to address childhood sleep problems include nutrition,exercise,cognitive–behavioral therapy for insomnia,aromatherapy,acupressure,and mindfulness.These interventions may be particularly important in the context of coronavirus disease 2019.Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.Conclusions Given the increasing prevalence of child sleep problems,which have been shown to affect children’s physical and neurobehavioral wellbeing,understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention,thus improving sleep-related child development and health.
文摘An overset grid methodology is developed for the fully coupled analysis of fluid-structure interaction (FSI) problems. The overset grid approach alleviates some of the computational geometry difficulties traditionally associated with Arbitrary-Lagrangian-Eulerian (ALE) based, moving mesh methods for FSI. Our partitioned solution algorithm uses separate solvers for the fluid (finite volume method) and the structure (finite element method), with mesh motion computed only on a subset of component grids of our overset grid assembly. Our results indicate a significant reduction in computational cost for the mesh motion, and element quality is improved. Numerical studies of the benchmark test demonstrate the benefits of our overset mesh method over traditional approaches.
基金supported by the Mahidol-Oxford Tropical Medicine Research Unit,UK.
文摘Objective:To investigate the banding patterns of whole cell protein(WCP) and outer membrane protein (OMP) of Burkholderia pseudomallei(B.pseudomallei) in clinical isolates from patients with melioidosis. Methods:WCP and OMP of of B.pseudomallei in 50 clinical isolates,from 47 patients with melioidosis were prepared and separated by polyacrylamide gel electrophoresis(SDS-PAGE) using 10%gels and stained with Coomassie brilliant blue.The banding patterns were compared by using a laser densitometer and dendrogram. Results:There were 6 different banding patterns of WCP and 2 types of OMP.Type 1 -5 WCP had 8 common protein bands at 19.0 - 45.0 kDa with identical OMP pattern.The banding patterns of WCP in type 6 were distinct from the others and also its OMP profile.The majority of clinical isolates(37/50,74%) were in type 1 WCP.Of the remaining isolates,8 were in type 2,2 in type 3,and one each was in type 4 to 6.There was no significant association between the WCP typing and the demographic or clinical features of the investigated patients.Conclusion:Despite the wide variation of clinical features of melioidosis,the results of this study show that B.pseudomallei had a few differences in the WCP and OMP profiles.Therefore typing of WCP and OMP,using SDS-PAGE analysis,could be an alternative method for phenotypic differentiation in clinical isolates of B.pseudomallei.
