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  • SAGE Publications  (88)
  • 2020-2024  (88)
  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2022
    In:  Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Vol. 236, No. 3 ( 2022-03), p. 376-384
    In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, SAGE Publications, Vol. 236, No. 3 ( 2022-03), p. 376-384
    Abstract: Differentiation of standing and walking based on plantar pressures is helpful in developing strategies to reduce health risks in the workplace. In order to improve the differentiation ability, the paper proposes a new metric for posture differentiation, that is, the pressure ratio on the two anatomical plantar regions. The plantar pressures were collected from 30 persons during walking and standing. After verifying the normal distribution of the pressure ratio by the Monte Carlo method, two-way repeated-measures ANOVA was conducted for the pressure ratios. The advantage of the pressure ratio over two conventional pressure metrics (the average pressure and the peak pressure) is demonstrated by its much larger size effect. Furthermore, the pressure ratio permits to establish value ranges corresponding to walking and standing, which are less influenced by specific person factors, thus facilitating the design of a standardized posture recognition system. The underlying mechanism underlying the pressure ratio is discussed from the aspect of biomechanics of movement.
    Type of Medium: Online Resource
    ISSN: 0954-4119 , 2041-3033
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2032763-8
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 2022
    In:  The International Journal of Lower Extremity Wounds Vol. 21, No. 1 ( 2022-03), p. 50-56
    In: The International Journal of Lower Extremity Wounds, SAGE Publications, Vol. 21, No. 1 ( 2022-03), p. 50-56
    Abstract: The purpose of this study is to investigate the influence of an outpatient multidisciplinary diagnosis and treatment model on the health economic indices of diabetic foot patients. We included 142 diabetic foot patients who received treatment in 2 target hospitals from January to April 2018 in this prospective cohort study. According to their exposure factors, the patients were divided into a MDT group and a control group, with 71 patients in each group. The patients’ baseline data were collected. The follow-up period was 12 months; all patients were followed up to April 30, 2019. Health economic indicators were collected when the patients were discharged from the hospital. The prognosis of each group was followed every month. If a wound healed, a major amputation occurred, or the patient died within 12 months, the follow-up was stopped. A total of 129 patients were followed, and their baseline data were comparable. During the follow-up period, the healing rate of the 2 groups was significantly different ( P = .034). The healing rate of Wagner grade 4 patients was significantly better than Wagner grade 2 and grade 3 patients ( P = .001). Health economic indicators demonstrated significant differences in bed waiting time ( P = .038), transfer time ( P = .001), surgery waiting time ( P = .003), length of hospital stay ( P = .047), and hospitalization expenses ( P = .011). In conclusion, an outpatient multidisciplinary diagnosis and treatment model for diabetic foot can support cost-effective patient management.
    Type of Medium: Online Resource
    ISSN: 1534-7346 , 1552-6941
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2135166-1
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  • 3
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 11 ( 2020-01), p. 204062232094241-
    Abstract: We aimed to determine the role of non-mydriatic fundus examination and artificial intelligence (AI) in screening diabetic retinopathy (DR) in patients with diabetes in the Metabolic Disease Management Center (MMC) in Tianjin, China. Methods: Adult patients with type 2 diabetes mellitus who were first treated by MMC in Tianjin First Central Hospital and Tianjin 4th Center Hospital were divided into two groups according to the time that MMC was equipped with the non-mydriatic ophthalmoscope and AI system and could complete fundus examination independently (the former was the control group, the latter was the observation group). The observation indices were as follows: the incidence of DR, the fundus screening rate of the two groups, and fundus screening of diabetic patients with different course of disease. Results: A total of 5039 patients were enrolled in this study. The incidence rate of DR was 18.6%, 29.8%, and 49.6% in patients with diabetes duration of ⩽1 year, 1–5 years, and 〉 5 years, respectively. The screening rate of fundus in the observation group was significantly higher compared with the control group (81.3% versus 28.4%, χ 2  = 1430.918, p  〈  0.001). The DR screening rate of the observation group was also significantly higher compared with the control group in patients with diabetes duration of ⩽1 year (77.3% versus 20.6%; χ 2  = 797.534, p  〈  0.001), 1–5 years (82.5% versus 31.0%; χ 2  = 197.124, p  〈  0.001) and ⩾5 years (86.9% versus 37.1%; χ 2  = 475.609, p  〈  0.001). Conclusions: In the case of limited medical resources, MMC can carry out one-stop examination, treatment, and management of DR through non-mydratic fundus examination and AI assistance, thus incorporating the DR screening process into the endocrine clinic, so as to facilitate early diagnosis.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2554816-5
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  • 4
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 13 ( 2022-01), p. 204062232210973-
    Abstract: To observe the consistency of a preliminary report of artificial intelligence (AI) in the clinical practice of fundus screening for diabetic retinopathy (DR) using non-mydriatic fundus photography. Methods: Patients who underwent DR screening in the Metabolic Disease Management Center (MMC) of our hospital were selected as research participants. The degree of coincidence of the AI preliminary report and the ophthalmic diagnosis was compared and analyzed, and the kappa value was calculated. Fundus fluorescein angiography (FFA) was performed in patients referred to the out-of-hospital ophthalmology department, and the consistency between fluorescein angiography and AI diagnosis was evaluated. Results: In total, 6146 patients (12,263 eyes) completed the non-mydriasis fundus examination. The positive DR screening rate was 24.3%. When considering moderate nonproliferative retinopathy as the cut-off point, the kappa coefficient was 0.75 ( p  〈  0.001), the sensitivity was 0.973, and the precision was 0.642, which was shown in the precision–recall curve. Fifty-nine patients referred to receive FFA were compared with non-mydriatic AI diagnoses. The kappa coefficient was 0.53, and the coincidence rate was 66.9%. Conclusion: Non-mydriasis fundus examination combined with AI has a medium-high consistency with ophthalmologists in DR diagnosis, conducive to early DR screening. Combining diagnosis and treatment modes with the Internet can promote the development of telemedicine, alleviate the shortage of ophthalmology resources, and promote the process of blindness prevention and treatment projects.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2554816-5
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  • 5
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Journal of International Medical Research Vol. 48, No. 8 ( 2020-08), p. 030006052094758-
    In: Journal of International Medical Research, SAGE Publications, Vol. 48, No. 8 ( 2020-08), p. 030006052094758-
    Abstract: Self-management is beneficial for improving health outcomes in adults with type 1 diabetes. However, there are no validated instruments to assess self-management in Chinese adults with type 1 diabetes. The aim of this study was to develop and validate the Self-Management of Type 1 Diabetes for Chinese Adults (SMOD-CA) scale. Methods Qualitative and quantitative methods were used to develop the SMOD-CA. We conducted a literature review and semi-structured interviews to generate an initial item pool. An expert panel examined the content validity. We conducted a cross-sectional survey to evaluate scale reliability and validity. A total of 243 participants were recruited. Exploratory factor analyses were used to test the construct validity, and internal consistency and test-retest reliability were assessed. Results The expert panel determined that the SMOD-CA content validity index was satisfactory. The final 30-item scale consisted of four factors explaining 49.50% of the total variance in the data. Cronbach’s α was 0.901 for the total scale and 0.911 for test–retest reliability. Conclusions The SMOD-CA demonstrated good reliability and validity. The scale is a credible and effective instrument that can be used by social workers and health care professionals to assess self-management in Chinese adults with type 1 diabetes. Trial registration number NCT03610984
    Type of Medium: Online Resource
    ISSN: 0300-0605 , 1473-2300
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2082422-1
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  • 6
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 15 ( 2023-01), p. 175883592311659-
    Abstract: Epidermal growth factor receptor (EGFR) is a well-known target for cancer treatment. However, the authorized anti-EGFR monoclonal antibodies generally cause several toxic effects, especially severe cutaneous toxicities as well as infusion reactions, and the clinical indications are limited. Here we developed Ametumumab, a fully human recombinant anti-EGFR monoclonal antibody. Objectives: To assess the safety, tolerability, pharmacokinetics (PK), and immunogenicity of Ametumumab. Design: A first-in-human phase Ia dose escalation study of Ametumumab in patients with advanced solid malignancies. Methods: An open-label, first-in-human dose escalation study was done in 22 patients with advanced malignancies who received six ascending dosages ranging from 75 to 750 mg/m 2 . Following a single dosage and a 28-day dose-limiting toxicity (DLT) monitoring period, patients were given repeated doses weekly. Blood samples were taken to determine the PK parameters of Ametumumab and anti-drug antibody concentrations. Every 8 weeks, radiographic tumor evaluations were conducted. Results: In this trial, no DLT was observed, and the maximum tolerated dose was not reached at doses up to 750 mg/m 2 . There were no severe adverse events but mild and moderate adverse effects, such as headache, proteinuria, and rash. Single-dose PK results demonstrated a straightforward linear relationship with dosage escalation. The medication concentrations accumulated and attained steady-state after four rounds of injections. It was calculated that 10 patients with disease control would be observed in the 22 evaluable patients. The disease control rate was 45.5%. Conclusion: The Ametumumab was well tolerated and safe in patients with advanced solid malignancies, exhibiting minimal immunogenicity, a long half-life, high levels of drug exposure in the blood, and preliminary effectiveness. Registration: The trial was registered with CTR20170343 on 10 April 2017, The China Center for Drug Evaluation.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2503443-1
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2023
    In:  Journal of Biomaterials Applications Vol. 37, No. 10 ( 2023-05), p. 1835-1846
    In: Journal of Biomaterials Applications, SAGE Publications, Vol. 37, No. 10 ( 2023-05), p. 1835-1846
    Abstract: Triple-negative breast cancer (TNBC), which accounts for 10%–20% of breast cancer cases, is characterized by a higher metastasis rate, higher recurrence risk, and worse prognosis. Traditional treatments such as chemotherapy, surgery, and radiotherapy have limited therapeutic effects. Although immune checkpoint blockade (ICB) therapy represented by anti-programmed death 1 (aPD-1) antibody has made further progress in treating TNBC, its therapeutic effect is still not optimistic. Ataxia telangiectasia mutated (ATM) is a critical factor in the DNA damage response (DDR) pathway, which is associated with the development of tumors. Recent studies have found that it can regulate the tumor immune microenvironment, affecting ICB responsiveness. Inhibition of ATM could enhance ICB therapy by promoting mitochondrial DNA cytoplasmic leakage and activating the innate immune signaling pathway. To explore the effect of ATM siRNA(siATM) on the ICB responsiveness of TNBC, we designed and synthesized nanoparticles using 1,2-dioleoyl-glycero-3-phosphatidylcholine (DOPC) liposomes to deliver siATM. In vitro and in vivo experiments demonstrated that DOPC/siATM could enhance the ability of siRNA to enter tumor cells and effectively inhibit the expression of ATM protein. Our study found that nanoparticles carrying siATM could activate cytotoxic T lymphocytes and regulate the immunosuppressive tumor microenvironment (ITM) by activating the cGAS-STING pathway. Its combination with aPD-1 may be a potential way to improve the efficacy of TNBC.
    Type of Medium: Online Resource
    ISSN: 0885-3282 , 1530-8022
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2072559-0
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    SAGE Publications ; 2021
    In:  INQUIRY: The Journal of Health Care Organization, Provision, and Financing Vol. 58 ( 2021-01), p. 004695802110096-
    In: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, SAGE Publications, Vol. 58 ( 2021-01), p. 004695802110096-
    Abstract: Pharmacists are health care professionals who are actively involved in identifying and solving drug-related problems (DRPs) in neoplasm patients. However, the effectiveness of pharmaceutical services at outpatient clinic for neoplasm patients have not been reported in China. This study aims to describe and investigate the impacts of pharmacists-managed oncology outpatient clinic on ambulatory neoplasm patients. We performed a descriptive, prospective study from June 6, 2018 to June 6, 2020. Firstly, we established a pharmacists-managed oncology outpatient clinic and a Pharmacists Work System of Medication Therapy Management (MTM) software with the cooperation of oncologists, pharmacists and software engineers in 2018. Subjects were neoplasm patients who visited the pharmacists-managed outpatient clinic. The pharmacists performed a comprehensive assessment of the patient’s medication and made planned interventions based on the DRPs identified. A total of 215 eligible patients with 707 visits were enrolled and recorded in the MTM software. A total of 316 DRPs (1.47 per patient) were identified. Adverse reactions, non-adherence, untreated indication, and drug interactions were the leading DRPs. 261 (82.6%) of the identified DRPs had been confirmed as resolved and 104 (78.2%) of adverse reactions were improved following pharmacist interventions and 2 to 3 course follow-up. Of the 382 planned interventions, 345 (90.3%) were accepted by patients or physicians. This is the first pharmacists-managed oncology outpatient clinic to describe the type of DRPs in neoplasm patients and evaluate the effectiveness of pharmacist interventions in China. Pharmacist interventions were efficacious in resolving DRPs and improving adverse reactions. We confirmed that pharmacists have an important role in ambulatory neoplasm patients care.
    Type of Medium: Online Resource
    ISSN: 0046-9580 , 1945-7243
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2147137-X
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  • 9
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Journal of International Medical Research Vol. 48, No. 4 ( 2020-04), p. 030006052091870-
    In: Journal of International Medical Research, SAGE Publications, Vol. 48, No. 4 ( 2020-04), p. 030006052091870-
    Abstract: A 30-year-old woman was admitted to a different hospital with a 2-day history of fever, cough, and expectoration. She had a history of left pulmonary tuberculosis 8 years previously. Chest computed tomography showed an infiltrate in the inferior lobe of the left lung and spot-like calcifications in the anterior lobe of the upper left lobe and lower lobe of the left lung. After antibacterial treatment, the patient’s condition deteriorated and she developed significant pleural effusion on the left side. The pleural effusion assay showed a lymphocyte-predominant exudate with a significantly increased adenosine deaminase level. The patient was transferred to our hospital with a suspected diagnosis of tuberculous pleuritis. A serum test for Mycoplasma pneumoniae-specific immunoglobulin M was positive. Because of the limitations of this test in determining the occurrence of recent infection, a thoracoscopic pleural biopsy was performed, and M. pneumoniae DNA was detected in the biopsy tissue using M. pneumoniae-specific polymerase chain reaction. Thus, the patient was diagnosed with M. pneumoniae-related parapneumonic effusion. Clinicians must be aware of the usefulness and limitations of a high adenosine deaminase level and know that lymphocyte predominance in pleural effusion does not always indicate tuberculous pleurisy, especially in areas of high tuberculosis prevalence.
    Type of Medium: Online Resource
    ISSN: 0300-0605 , 1473-2300
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2082422-1
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  • 10
    In: DIGITAL HEALTH, SAGE Publications, Vol. 8 ( 2022-01), p. 205520762211344-
    Abstract: Facet tropism is defined as the asymmetry between the left and right facet joints relative to the sagittal plane. Published clinical studies have found that facet tropism is associated with cervical disc herniation. However, the relationship between the facet orientation and the side of cervical disc herniation remains controversial. Therefore, this study used the finite-element technique to investigate the biomechanical effects of the sagittal angle of the cervical facet joints on the cervical intervertebral disc. Objective The biomechanical effects of the sagittal angle of the cervical facet joint on the cervical disc and facet joint were investigated using the finite-element technique. Methods The finite-element model was constructed using computed tomography scans of a 26-year-old female volunteer. First, a cervical model was constructed from C3 to C7. The model was verified using data from previously published studies. Second, the facet orientation at the C5–C6 level was altered to simulate different sagittal angles of cervical facet joints. Five models, F70, F80, F90, F100, and F110, were simulated with different facet joint orientations (70°, 80°, 90°, 100°, and 110° facet joint angles at the left side, respectively, and 90° facet joint angles at the right side) at the C5–C6 facet joints. In each model, annular fibres stress and facet cartilage pressure were studied under six pure moments and two combined moments. Results Comparing the stress of the annulus fibres in flexion combined with right axial rotation and in flexion combined with left axial rotation in the same model, no difference in the maximum stress of the annulus fibres was noted between these two different moments in the F90 model, whereas differences of 12.80%, 8.84%, 14.95% and 33.32% were noted in the F70, F80, F100 and F110 models, respectively. The same trend was observed when comparing the maximum stress of the annulus fibres in each model during left and right axial rotation. No differences in annular fibres stress and facet cartilage pressure were noted among the five models in flexion, extension, lateral bending, left axial rotation, and flexion combined with left axial rotation in this study. However, compared with the F70 model in flexion combined with right axial rotation, the annulus fibres stress of the F80, F90, F100, and F110 models increased by 5.53%, 13.03%, 35.04%, and 72.94%, respectively, and the pressure of the left facet joint of these models decreased by 5.65%, 12.10%, 18.41%, and 25.74%, respectively. The same trend was observed in the right axial moment. Conclusion Facet tropism leads to unbalanced stress distribution on the annulus fibres at the cervical intervertebral disc. The greater the sagittal angle of the facet joint, the greater the annular fibres stress on this side. We hypothesised that the side with the larger sagittal angle of the facet joint exhibits a greater risk of disc herniation.
    Type of Medium: Online Resource
    ISSN: 2055-2076 , 2055-2076
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2819396-9
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