ABSTRACT
Charge and spin are two intrinsic attributes of carriers governing almost all of the physical processes and operation principles in materials. Here, we demonstrate the manipulation of electronic and spin states in designed Co-quantum dot/WS2 (Co-QDs/WS2) heterostructures by employing a metal-dielectric composite substrate and via scanning tunneling microscope. By repeatedly scanning under a unipolar bias, switching the bias polarity, or applying a pulse through nonmagnetic or magnetic tips, the Co-QDs morphologies exhibit a regular and reproducible transformation between bright and dark dots. First-principles calculations reveal that these tunable characters are attributed to the variation of density of states and the transition of magnetic anisotropy energy induced by carrier accumulation. It also suggests that the metal-dielectric composite substrate is successful in creating the interfacial potential for carrier accumulation and realizes the electrically controllable modulations. These results will promote the exploration of electron-matter interactions in quantum systems and provide an innovative way to facilitate the development of spintronics.
ABSTRACT
The gradual guidance of the formation of metal-organic structures through surface-based Cu atoms for 1,4-diaminoanthraquinones (DAQs) has been studied by scanning tunneling microscopy (STM) at room temperature. On the Ag(110) surface, the transition from a hydrogen-bond network structure to metal-organic coordination structures of DAQs can be induced by introducing foreign copper atoms. Due to the weak interaction between DAQs and Ag(110), thermal treatment easily leads to the desorption of DAQs from the surface. To address this challenge, Cu(111) is selected as the substrate. Under thermal driving and in the presence of copper adatoms, the hydrogen-bond network structure of DAQs on the surface gradually undergoes a transition into a metal-coordinated structure, eventually leading to the formation of metal-organic complexes through amino dehydrogenation. It is demonstrated that the construction of a metal-organic coordination structure on metal surfaces is a result of the competition among factors such as metal atoms, functional groups of molecules, surface chemical activity, and temperature.
ABSTRACT
The delicate regulation of structural phase transition can provide advanced approaches for fabricating desired and well-organized nanoarchitectures on surfaces. Introduction of metal ions into pure organic systems can facilitate the phase transition from hydrogen-bonded structures to metal-organic structures by coordinating with organic molecules. However, it remains a challenge to attain a phase transition dominated by variable metal coordination configurations through adjustment of the metal ion concentration. Herein, we report the phase transitions of naphthalene-2,3-carbonitride (2,3-DCN) molecules on highly oriented pyrolytic graphite (HOPG) under varying solvents and Cu2+ ion concentrations. By integrating data from scanning tunneling microscopy imaging and density functional theory calculations, it is demonstrated that phase transitions of 2,3-DCN occur through forming diverse coordination configurations where Cu2+ ions can coordinate with 2,3-DCN and 1-nonanoic acid or Cl- ions to form different ligand components with a coordination number of 4 when varying the molar ratios of 2,3-DCN to Cu2+ ion in the 1-nonanoic acid solvent. However, in the case of 1-heptanoic acid as a solvent, the self-assembly structure of 2,3-DCN only changes via the alteration of hydrogen bonding sites and Cu2+ ions do not coordinate with 2,3-DCN molecules. These findings provide valuable insights into the coordination behavior of metal ions in different solvents.
ABSTRACT
Pharmaceuticals and Personal Care Products (PPCPs) are inadvertently released into the aquatic environment, causing detrimental effects on aquatic ecosystem. There is an urgent need of an in-deep investigation on contamination information of PPCPs in aquatic environment as well as the ecological risks to the aquatic ecosystem. This study was carried out in Lipu River basin, China, to investigate the distribution pattern and ecological risks of PPCPs. Results showed that PPCPs pollution is ubiquitous, 29 out of 30 targeted PPCPs were detected in Lipu River. Fourteen PPCPs were detected with a frequency of 100% in all water samples, and ten PPCPs were detected with a frequency of more than 80%. The cumulated PPCPs concentrations ranged from 33.30 ng/L to 99.60 ng/L, with a median value of 47.20 ng/L in Lipu River. Caffeine, flumequine, nifedipine, and lomefloxacin were the predominant PPCPs in study area. Caffeine showed high ecological risk, five and seven individual PPCP showed medium and low ecological risk to algae.
Subject(s)
Cosmetics , Environmental Monitoring , Rivers , Water Pollutants, Chemical , China , Water Pollutants, Chemical/analysis , Risk Assessment , Rivers/chemistry , Pharmaceutical Preparations/analysis , Cosmetics/analysisABSTRACT
BACKGROUND: Hip fractures are a serious health concern among the elderly, particularly in patients with hypertension, where the incidence of acute heart failure preoperatively is high, significantly affecting surgical outcomes and prognosis. This study aims to assess the risk of preoperative acute heart failure in elderly patients with hypertension and hip fractures by constructing a predictive model using machine learning on potential risk factors. METHODS: A retrospective study design was employed, collecting preoperative data from January 2018 to December 2019 of elderly hypertensive patients with hip fractures at the Third Hospital of Hebei Medical University. Using SPSS 24.0 and R software, predictive models were established through LASSO regression and multivariable logistic regression analysis. The models' predictive performance was evaluated using metrics such as the concordance index (C-index), receiver operating characteristic curve (ROC curve), and decision curve analysis (DCA), providing insights into the nomogram's predictive accuracy and clinical utility. RESULTS: Out of 1038 patients screened, factors such as gender, age, history of stroke, arrhythmias, anemia, and complications were identified as independent risk factors for preoperative acute heart failure in the study population. Notable predictors included Sex (OR 0.463, 95% CI 0.299-0.7184, P = 0.001), Age (OR 1.737, 95% CI 1.213-2.488, P = 0.003), Stroke (OR 1.627, 95% CI 1.137-2.327, P = 0.008), Arrhythmia (OR 2.727, 95% CI 1.490-4.990, P = 0.001), Complications (OR 2.733, 95% CI 1.850-4.036, P < 0.001), and Anemia (OR 3.258, 95% CI 2.180-4.867, P < 0.001). The prediction model of acute heart failure was Logit(P) = -2.091-0.770 × Sex + 0.552 × Age + 0.487 × Stroke + 1.003 × Arrhythmia + 1.005 × Complications + 1.181 × Anemia, and the prediction model nomogram was established. The model's AUC was 0.785 (95% CI, 0.754-0.815), Decision curve analysis (DCA) further validated the nomogram's excellent performance, identifying an optimal cutoff value probability range of 3% to 58% for predicting preoperative acute heart failure in elderly patients with hypertension and hip fractures. CONCLUSION: The predictive model developed in this study is highly accurate and serves as a powerful tool for the clinical assessment of the risk of preoperative acute heart failure in elderly hypertensive patients with hip fractures, aiding in the optimization of preoperative risk assessment and patient management.
Subject(s)
Anemia , Heart Failure , Hip Fractures , Hypertension , Stroke , Aged , Humans , Retrospective Studies , Hip Fractures/complications , Hip Fractures/diagnosis , Hip Fractures/epidemiology , Heart Failure/complications , Heart Failure/diagnosis , Heart Failure/epidemiology , Machine Learning , Arrhythmias, Cardiac , Risk FactorsABSTRACT
BACKGROUND: Hip fractures in the elderly are a common traumatic injury. Due to factors such as age and underlying diseases, these patients exhibit a high incidence of acute heart failure prior to surgery, severely impacting surgical outcomes and prognosis. OBJECTIVE: This study aims to explore the potential risk factors for acute heart failure before surgery in elderly patients with hip fractures and to establish an effective clinical prediction model. METHODS: This study employed a retrospective cohort study design and collected baseline and preoperative variables of elderly patients with hip fractures. Strict inclusion and exclusion criteria were adopted to ensure sample consistency. Statistical analyses were carried out using SPSS 24.0 and R software. A prediction model was developed using least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression. The accuracy of the model was evaluated by analyzing the area under the receiver operating characteristic (ROC) curve (AUC) and a calibration curve was plotted to assess the model's calibration. RESULTS: Between 2018 and 2019, 1962 elderly fracture patients were included in the study. After filtering, 1273 were analyzed. Approximately 25.7% of the patients experienced acute heart failure preoperatively. Through LASSO and logistic regression analyses, predictors for preoperative acute heart failure in elderly patients with hip fractures were identified as Gender was male (OR = 0.529, 95% CI: 0.381-0.734, P < 0.001), Age (OR = 1.760, 95% CI: 1.251-2.479, P = 0.001), Coronary Heart Disease (OR = 1.977, 95% CI: 1.454-2.687, P < 0.001), Chronic Obstructive Pulmonary Disease (COPD) (OR = 2.484, 95% CI: 1.154-5.346, P = 0.020), Complications (OR = 1.516, 95% CI: 1.033-2.226, P = 0.033), Anemia (OR = 2.668, 95% CI: 1.850-3.847, P < 0.001), and Hypoalbuminemia (OR 2.442, 95% CI: 1.682-3.544, P < 0.001). The linear prediction model of acute heart failure was Logit(P) = -2.167-0.637×partial regression coefficient for Gender was male + 0.566×partial regression coefficient for Age + 0.682×partial regression coefficient for Coronary heart disease + 0.910×partial regression coefficient for COPD + 0.416×partial regression coefficient for Complications + 0.981×partial regression coefficient for Anemia + 0.893×partial regression coefficient for Hypoalbuminemia, and the nomogram prediction model was established. The AUC of the predictive model was 0.763, indicating good predictive performance. Decision curve analysis revealed that the prediction model offers the greatest net benefit when the threshold probability ranges from 4 to 62%. CONCLUSION: The prediction model we developed exhibits excellent accuracy in predicting the onset of acute heart failure preoperatively in elderly patients with hip fractures. It could potentially serve as an effective and useful clinical tool for physicians in conducting clinical assessments and individualized treatments.
Subject(s)
Heart Failure , Hip Fractures , Humans , Hip Fractures/surgery , Retrospective Studies , Male , Heart Failure/epidemiology , Heart Failure/diagnosis , Heart Failure/etiology , Female , Aged , Aged, 80 and over , Risk Factors , Preoperative Period , Risk Assessment/methods , Acute Disease , PrognosisABSTRACT
BACKGROUND: Elderly patients with hip fracture who develop perioperative acute heart failure (AHF) have a poor prognosis. The aim of the present study is to investigate the potential risks of AHF in elderly hip-fracture patients in the postoperative period and to evaluate the prognostic significance of AHF. METHODS: A retrospective analysis was conducted on hip fracture patients at the Third Hospital of Hebei Medical University, who were continuously in hospital from September 2018 to August 2020. To identify independent risk factors for AHF in elderly patients with hip fracture, univariate and multivariate Logistic regression analysis was employed. The Kaplan-Meier survival curve illustrated the relationship between all-cause mortality in the AHF and non-AHF groups. An assessment of the correlation between baseline factors and all-cause mortality was conducted by means of univariable and multivariable Cox proportional hazards analysis. RESULTS: We eventually recruited 492 patients,318 of whom were in the AHF group. Statistical significance was found between the two groups for age group, concomitant coronary heart disease, COPD, haemoglobin level below 100 g/L on admission, albumin level below 40 g/L on admission, and increased intraoperative blood loss. Age over 75, concomitant coronary artery disease, hemoglobin level below 100 g/L and albumin level below 40 g/L on admission were independent risk factors for AHF in older hip fracture patients. The AHF group exhibited a higher incidence of perioperative complications, such as anemia, cardiovascular issues, and stress hyperglycemia, as well as all-cause mortality. Based on our COX regression analysis, we have identified that the main risk factors for all-cause mortality in AHF patients are concomitant coronary heart disease, absence of pulmonary infection, absence of diabetes, absence of cancer, and absence of urinary tract infection. CONCLUSION: Enhancing hip fracture prevention for AHF is particularly important. It is crucial to make informed decisions to avoid poor prognoses. Patients whose age over 75 years old, concomitant coronary heart disease, hemoglobin < 100 g/L and album< 40 g/L on admission are more likely to develop perioperative AHF. To avert complications and potential fatalities, patients with AHF must receive appropriate care during the perioperative period.
Subject(s)
Coronary Disease , Heart Failure , Hip Fractures , Humans , Aged , Retrospective Studies , Cohort Studies , Prognosis , Case-Control Studies , Hip Fractures/epidemiology , Hip Fractures/surgery , Risk Factors , Heart Failure/epidemiology , Hemoglobins/analysis , AlbuminsABSTRACT
Route topography is an important test boundary of real driving emission (RDE) tests. However, the RDE test boundaries, such as atmospheric environment, driver behavior, route topography, and traffic congestion, are random, uncertain, and completely coupled. It is difficult to know to what extent route topography can determine on-road emissions, especially in a region with hilly topography. In this regard, the neural network predictor importance algorithms were proposed to measure the importance of the route topography test boundary. Based on tens of thousands of data window samples from the RDE tests in Chongqing, factor analysis was performed to reduce the data dimensionality and eliminate information overlap, and neural network models were established to predict pollutant emissions and calculate the relative importance of input variables. The results show that route topography is comparable to trip dynamics for on-road emissions but the importance of the route topography test boundary is not fully appreciated in the existing RDE regulation, making mountain cities suffer from severe vehicle emissions that are not effectively controlled.
Subject(s)
Air Pollutants , Environmental Pollutants , Vehicle Emissions/analysis , Air Pollutants/analysis , Cities , Environmental Pollutants/analysis , Neural Networks, ComputerABSTRACT
INTRODUCTION: Atrial fibrillation is the most common atrial arrhythmia in the perioperative period and is associated with prolonged hospital stay, increased costs, and increased mortality. However, there are few data on the predictors and incidence of preoperative atrial fibrillation in hip fracture patients. Our aim was to identify predictors of preoperative atrial fibrillation and to propose a valid clinical prediction model. METHODS: Predictor variables included demographic and clinical variables. LASSO regression analyzes were performed to identify predictors of preoperative atrial fibrillation, and models were constructed and presented as nomograms. Area under the curve, calibration curve, and decision curve analysis (DCA) were used to examine the discriminative power, calibration, and clinical efficacy of the predictive models. Bootstrapping was used for validation. RESULTS: A total of 1415 elderly patients with hip fractures were analyzed. Overall, 7.1% of patients had preoperative atrial fibrillation, and they were at significant risk for thromboembolic events. Patients with preoperative AF had a significantly longer delay in surgery than those without preoperative atrial fibrillation (p < 0.05). Predictors for preoperative atrial fibrillation were hypertension (OR 1.784, 95% CI 1.136-2.802, p < 0.05), C-reactive protein at admission (OR 1.329, 95% CI 1.048-1.662, p < 0.05), systemic inflammatory response index at admission (OR 2.137, 95% CI, 1.678-2.721 p < 0.05), Age-Adjusted Charlson Comorbidity Index (OR 1.542, 95% CI 1.326-1.794, p < 0.05), low potassium(OR 2.538, 95% CI 1.623-3.968, p < 0.05), anemia(OR 1.542, 95% CI 1.326-1.794, p < 0.05). Good discrimination and calibration effect of the model was showed. Interval validation could still achieve the C-index value of 0.799. DCA demonstrated this nomogram has good clinical utility. CONCLUSION: This model has a good predictive effect on preoperative atrial fibrillation in elderly patients with hip fractures, which can help to better plan clinical evaluation.
Subject(s)
Atrial Fibrillation , Hip Fractures , Humans , Aged , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Atrial Fibrillation/epidemiology , Risk Factors , Models, Statistical , Retrospective Studies , Prognosis , Hip Fractures/epidemiology , Hip Fractures/surgeryABSTRACT
We previously identified a lipopeptide, EK1C4, by linking cholesterol to EK1, a pan-CoV fusion inhibitory peptide via a polyethylene glycol (PEG) linker, which showed potent pan-CoV fusion inhibitory activity. However, PEG can elicit antibodies to PEG in vivo, which will attenuate its antiviral activity. Therefore, we designed and synthesized a dePEGylated lipopeptide, EKL1C, by replacing the PEG linker in EK1C4 with a short peptide. Similar to EK1C4, EKL1C displayed potent inhibitory activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other coronaviruses. In this study, we found that EKL1C also exhibited broad-spectrum fusion inhibitory activity against human immunodeficiency virus type 1 (HIV-1) infection by interacting with the N-terminal heptad repeat 1 (HR1) of viral gp41 to block six-helix bundle (6-HB) formation. These results suggest that HR1 is a common target for the development of broad-spectrum viral fusion inhibitors and EKL1C has potential clinical application as a candidate therapeutic or preventive agent against infection by coronavirus, HIV-1, and possibly other class I enveloped viruses.
Subject(s)
COVID-19 , HIV Fusion Inhibitors , HIV Infections , HIV-1 , Humans , Lipopeptides/pharmacology , SARS-CoV-2 , Anti-Retroviral Agents , HIV Envelope Protein gp41 , HIV Fusion Inhibitors/pharmacologyABSTRACT
BACKGROUND: In elderly, hip fracture is often complicated by perioperative heart failure, related to worse prognosis. We aimed to analyze the effects of integrated management bundle incorporating with multidisciplinary measures on in-hospital outcomes and early survival in elderly hip fracture patients with perioperative heart failure. METHODS: In this retrospective cohort study, a total of 421 hip fracture patients aged 65 and over who developed perioperative heart failure were included. According to different perioperative management modes applied, patients were retrospectively divided into multidisciplinary management group (Group A), including 277 patients, and integrated management bundle group (Group B), including 144 patients. The B-type natriuretic peptide (BNP) and C-reactive protein (CRP) levels, complications, length of stay, and hospitalization costs were observed and compared between two groups. Overall survival was compared by Kaplan-Meier methods. Cox regression analysis was used to identify prognostic factors associated with overall survival. RESULTS: A total of 421 patients were enrolled for analysis, including 277 in Group A and 144 in Group B. BNP and CRP levels were significantly decreased compared with admission (P < 0.05). Furthermore, BNP and CRP in Group B decreased much more than those in Group A (P < 0.05). The reductions were observed in length of stay, hospitalization costs and incidence of pulmonary infection, hypoproteinemia, and acute cerebral infarction in Group B (all P < 0.05). The Kaplan-Meier plots showed significantly superior overall survival in Group B. Integrated management bundle was independent favorable prognostic factors. CONCLUSIONS: The integrated management bundle incorporating with multidisciplinary measures significantly improved the therapeutic effect of perioperative heart failure, reduced inflammatory response, and yielded better hospital outcomes. It brought better survival benefits for geriatric hip fracture patients with perioperative heart failure. The results of this study can play an important role in clinical work and provide a valuable theoretical basis for selection of management model in elderly hip fracture patients with perioperative heart failure.
Subject(s)
Heart Failure , Hip Fractures , Aged , Heart Failure/complications , Heart Failure/therapy , Hip Fractures/complications , Hip Fractures/surgery , Hospitalization , Hospitals , Humans , Length of Stay , Retrospective StudiesABSTRACT
BACKGROUND: Patients with acute ischemic stroke (AIS) after hip fracture in the elderly have worse prognosis. We aimed to describe the characteristics and complications of hip fracture with AIS in the elderly. METHODS: This cross-sectional study selected patients with hip fracture (age ≥65 years) from January 2018 to September 2020. The collected data included age, sex, fracture types, comorbidities. In above screened patients, we further collected cerebral infarction related information of AIS patients. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to identify the strongest predictors of AIS after hip fracture. Multivariate logistic regression analysis was conducted to find independent risk factors for AIS after hip fracture. RESULTS: Sixty patients (mean age 79.7 years;female 56.7%) occurred AIS after hip fracture in 1577 cases. The most common infarction type was partial anterior circulation infarction (PACI) (70.0%). The majority of these infarction lesions were single (76.7%) and most infarction lesions(65.0%) were located in the left side. 81.7% of AIS patients had mild (Health stroke scale NIHSS <4) AIS. Older patients with AIS after hip fracture were more frequently complicated by hypertension(73.3%), prior stroke (46.7%), diabetes(35.0%) and were more likely to have hypoproteinemia(68.3%), electrolyte disorders ( 66.7%), anemia (65.0%), deep vein thrombosis (51.6%), pneumonia (46.6%),cardiac complications (45.0%). Combined with hypertension (OR 2.827, 95%CI 1.557-5.131) and male sex(OR 1.865, 95%CI 1.095-3.177) were associated with the increased risk of AIS after hip fracture. CONCLUSIONS: Older patients combined with hypertension are more likely to have AIS after hip fracture. For these patients, early preventions should be administered. AIS patients after hip fracture are prone to have multiple complications under traumatic stress, and we should enhance the management of these patients to reduce the stress and avoid occurrence of complications.
Subject(s)
Hip Fractures , Hypertension , Ischemic Stroke , Stroke , Aged , Cross-Sectional Studies , Female , Hip Fractures/complications , Hip Fractures/epidemiology , Hip Fractures/surgery , Humans , Hypertension/complications , Hypertension/epidemiology , Infarction/complications , Male , Stroke/epidemiology , Stroke/etiologyABSTRACT
BACKGROUND: Due to concomitant factors like frailty and comorbidity, super elderly (≥90 years) patients with hip fracture differ from patients aged 65-89 years in perioperative complications and mortality. The integrated management bundle referred to bundled application of multiple clinical measures. The aim of this study was to analyze effect of integrated management bundle on 1-year overall survival and perioperative outcomes in super elderly patients with hip fracture, with multidisciplinary management group serving as the control group. METHODS: In this retrospective cohort study, super elderly patients with hip fracture were included from Jan 2017 to Nov 2020. Patients were retrospectively divided to multidisciplinary management group and integrated management bundle group. The primary outcome was 1- year overall survival, and the secondary outcome was perioperative outcomes. Kaplan-Meier methods was used to compare survival probability. Multivariable Cox's modeling was used to explain the effect of integrated bundle on 1-year overall survival adjusted for confounders. The perioperative outcomes including complications and in-hospital data of two groups were compared. The multivariable logistic regression was used to explain the effect of integrated bundle on the occurrence of perioperative complications adjusted for confounders. Prognostic factors related to survival was identified by multivariable Cox's regression analysis. RESULTS: Ninety-seven patients comprised multidisciplinary management group, and 83 comprised integrated management bundle group. The Kaplan-Meier plots showed that the survival probability of integrated management bundle group was significantly better than multidisciplinary management group (HR:0.435, 95%CI:0.207-0.914, P = 0.039). Multivariable analysis after adjustment for confounders showed a 42.8% lower incidence of mortality integrated management bundle group than multidisciplinary management group (HR:0.428, 95%CI:0.186-0.986, P = 0.046). Incidence of hypoproteinemia, and electrolyte disturbance in integrated management bundle group was significantly lower than multidisciplinary management group (all P < 0.05). In addition, significant reduction was observed in length of stay (P < 0.05) in integrated management bundle group. Multivariable logistic regression showed integrated management bundle was independent protective factor of hypoproteinemia, and electrolyte disturbance. mECM score ≥ 6 and ASA score > 2 were independent risk factors of overall survival (HR: 1.940, 95%CI: 1.067-3.525,P = 0.030; HR: 2.281, 95%CI: 1.113-4.678,P = 0.024). CONCLUSIONS: The integrated management bundle improved 1-year overall survival and played positive effects in improving perioperative outcomes. It might be a more suitable management modality for super elderly patients with hip fracture.
Subject(s)
Hip Fractures , Hypoproteinemia , Aged , Cohort Studies , Electrolytes , Hip Fractures/epidemiology , Hip Fractures/surgery , Humans , Hypoproteinemia/complications , Postoperative Complications/etiology , Retrospective Studies , Risk FactorsABSTRACT
Acute pulmonary embolism (PE) remains a significant cause of cardiovascular morbidity and mortality worldwide. Brain natriuretic peptide (BNP) combined with catheter-directed therapy (CDT) may improve right ventricular (RV) dysfunction and stabilize hemodynamics in acute PE.We retrospectively studied 159 patients with confirmed acute PE who were treated with CDT and admitted to the intensive care unit of our department between September 2016 and May 2020. The patients were divided into the control group and the rhBNP group based on whether to receive recombinant human BNP treatment (rhBNP) or not. The basic characteristics of the patients between the control group and the rhBNP group was systematically compared during admission and follow-up. Risk factors for all-cause mortality within 30 days were determined using multivariate logistic regression analysis.Respiratory rate was found to be significantly lower in the rhBNP group than in the control group. Patients in the rhBNP group had significantly lower levels of white blood cell, C-reactive protein (CRP), D-dimers, troponin I, creatinine, and N-terminal (NT) -proBNP compared with those in the control group. Levels of tricuspid annular plane systolic excursion were significantly higher in the rhBNP group than in the control group. The percentage of patients with rehospitalization readmission due to PE differed significantly between the control group and the rhBNP group. On the basis of the multivariate regression analysis, CRP, creatinine, troponin I, and NT-proBNP were independent factors of all-cause mortality in 30 days.rhBNP is effective in the treatment of patients with RV dysfunction caused by acute PE who underwent CDT, which may be an alternative treatment option for improving clinical prognosis.
Subject(s)
Catheterization, Swan-Ganz , Natriuretic Agents/therapeutic use , Natriuretic Peptide, Brain/therapeutic use , Pulmonary Embolism/therapy , Ventricular Dysfunction, Right/drug therapy , Acute Disease , Aged , Female , Humans , Male , Mechanical Thrombolysis , Middle Aged , Pulmonary Embolism/complications , Pulmonary Embolism/diagnosis , Recombinant Proteins , Retrospective Studies , Thrombolytic Therapy , Treatment Outcome , Ventricular Dysfunction, Right/diagnosis , Ventricular Dysfunction, Right/etiologyABSTRACT
This study was designed as a pilot test to analyze the effect of patient-centered care (PCC) bundle intervention on perioperative respiratory complications and other outcomes in hip fracture patients aged ≥80. Between Jan 2018 and Dec 2019, 198 patients comprised the routine care group and 187 comprised the PCC bundle group. After propensity score matching, 151 remained in each group. Incidence of perioperative respiratory complications in the PCC bundle group was significantly lower than in the routine care group (all P < 0.05). Furthermore, significant reductions were observed in surgery delay, length of stay, incidence of arrhythmia, hypoproteinemia, and electrolyte disturbance (all P < 0.05) in the PCC bundle group. Age-Adjusted Charlson Comorbidity Index score was related, but only weakly, to length of stay and the number of perioperative complications. These results suggested that the PCC bundle might be a more suitable care modality for patients ≥80 with hip fracture.
Subject(s)
Hip Fractures , Aged , Aged, 80 and over , Hip Fractures/surgery , Humans , Incidence , Length of Stay , Patient-Centered Care , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Retrospective StudiesABSTRACT
Atomically thin two-dimensional (2D) metals may be key ingredients in next-generation quantum and optoelectronic devices. However, 2D metals must be stabilized against environmental degradation and integrated into heterostructure devices at the wafer scale. The high-energy interface between silicon carbide and epitaxial graphene provides an intriguing framework for stabilizing a diverse range of 2D metals. Here we demonstrate large-area, environmentally stable, single-crystal 2D gallium, indium and tin that are stabilized at the interface of epitaxial graphene and silicon carbide. The 2D metals are covalently bonded to SiC below but present a non-bonded interface to the graphene overlayer; that is, they are 'half van der Waals' metals with strong internal gradients in bonding character. These non-centrosymmetric 2D metals offer compelling opportunities for superconducting devices, topological phenomena and advanced optoelectronic properties. For example, the reported 2D Ga is a superconductor that combines six strongly coupled Ga-derived electron pockets with a large nearly free-electron Fermi surface that closely approaches the Dirac points of the graphene overlayer.
ABSTRACT
The role of silver localized surface plasmons (LSPs) on the luminescence of a Si(111)-(7 × 7) surface has been investigated by scanning tunneling microscopy (STM) with a silver tip at 77 K. On a bare Si(111)-(7 × 7) surface, a characteristic peak at 1.85 eV dominates the STM-induced luminescence spectrum, although the luminescence intensity is extremely weak. Once Ag atoms are deposited onto the Si surface to form islands with a few atomic layers, it is found that the intensity of the characteristic peak from the Si surface underneath the Ag islands is significantly enhanced by about one order. In addition to the luminescence from the Si surface, light emission originating from the irradiation decay of the Ag plasmons is also detected. Such great enhancement of the luminescence from the Si surface is attributed to the strong coupling between the surface states of the Si and the LSPs of the Ag islands.
ABSTRACT
BACKGROUND: Plasmid-mediated mechanisms of drug resistance accelerate the spread of polymyxin resistance, leaving clinicians with few or no antibacterial options for the treatment of infections caused by MDR bacteria, especially carbapenemase-producing strains. OBJECTIVES: To evaluate the associations among promoter sequence variation, mcr-1 expression, host factors and levels of colistin resistance and to propose antisense agents such as peptide nucleic acids (PNAs) targeting mcr-1 as a tool to restore colistin susceptibility through modulation of MCR-1 expression in Escherichia coli. METHODS: A ß-galactosidase assay was performed to study mcr-1 promoter activity. Quantitative real-time PCR and western blot assays were used to identify the expression level of MCR-1 in WT strains and transformants. Three PNAs targeting different regions of mcr-1 were designed and synthesized to determine whether they can effectively inhibit MCR-1 expression. MIC was measured to test colistin susceptibility in the presence or absence of PNA-1 in mcr-1-carrying E. coli. RESULTS: Variation in the mcr-1 promoter sequence and host species affect promoter activity, MCR-1 expression levels and colistin MICs. One PNA targeting the ribosome-binding site fully inhibited the expression of mcr-1 at a concentration of 4 µM, resulting in significantly increased susceptibility to colistin. The MIC90 of colistin decreased from 8 to 2 mg/L (P < 0.05) in the presence of 4 µM PNA. CONCLUSIONS: These findings suggest that the antisense approach is a possible strategy to combat mcr-1-mediated resistance as well as other causes of emerging global resistance.
Subject(s)
Escherichia coli Infections , Escherichia coli Proteins , Peptide Nucleic Acids , Anti-Bacterial Agents/pharmacology , Colistin/pharmacology , Drug Resistance, Bacterial , Escherichia coli/genetics , Escherichia coli Proteins/genetics , Humans , Microbial Sensitivity Tests , Peptide Nucleic Acids/genetics , Peptide Nucleic Acids/pharmacology , Plasmids/geneticsABSTRACT
The aim of this study was to investigate the effect and mechanism of miR-142-5p/212-5p on the proliferation and collagen formation of cardiac fibroblasts (CFs) after myocardial infarction (MI). The mouse MI model was established by ligation of the left anterior descending coronary artery. CFs were induced by transforming growth factor-beta 1 (TGF-ß1) or angiotensin (Ang II). The molecule expressions were measured by qRT-PCR and Western blot. CF proliferation was detected by an MTT assay. The effect of miR-142-5p/212-5p on the luciferase activity of c-Myc 3'UTR was assessed by the luciferase reporter assay. miR-142-5p and miR-212-5p were downregulated in cardiac tissues of MI mice and in TGF-ß1- or Ang II-induced CFs, while the protein levels of collagen I and III were upregulated. Moreover, simultaneous overexpression of miR-142-5p/212-5p inhibited the proliferation and collagen formation of TGF-ß1- or Ang II-stimulated CFs to a greater extent than either miR-142-5p or miR-212-5p overexpression alone. MiR-142-5p/212-5p targeted c-Myc and negatively regulated its expression. The effects of miR-142-5p/212-5p overexpression on the TP53INP1 protein level and the proliferation and collagen formation of CFs were reversed by c-Myc overexpression. Moreover, overexpression of miR-142-5p/212-5p improved cardiac function and collagen formation of MI mice. Overexpression of miR-142-5p/212-5p cooperatively suppresses the proliferation and collagen formation after MI by regulating c-Myc/TP53INP1.
Subject(s)
Collagen/biosynthesis , Fibroblasts/cytology , MicroRNAs/genetics , Myocardium/cytology , Nuclear Proteins/genetics , Proto-Oncogene Proteins c-myc/genetics , Animals , Base Sequence , Cell Proliferation/genetics , Fibroblasts/metabolism , Mice , Myocardial Infarction/geneticsABSTRACT
BACKGROUND: Medical and clinical question answering (QA) is highly concerned by researchers recently. Though there are remarkable advances in this field, the development in Chinese medical domain is relatively backward. It can be attributed to the difficulty of Chinese text processing and the lack of large-scale datasets. To bridge the gap, this paper introduces a Chinese medical QA dataset and proposes effective methods for the task. METHODS: We first construct a large scale Chinese medical QA dataset. Then we leverage deep matching neural networks to capture semantic interaction between words in questions and answers. Considering that Chinese Word Segmentation (CWS) tools may fail to identify clinical terms, we design a module to merge the word segments and produce a new representation. It learns the common compositions of words or segments by using convolutional kernels and selects the strongest signals by windowed pooling. RESULTS: The best performer among popular CWS tools on our dataset is found. In our experiments, deep matching models substantially outperform existing methods. Results also show that our proposed semantic clustered representation module improves the performance of models by up to 5.5% Precision at 1 and 4.9% Mean Average Precision. CONCLUSIONS: In this paper, we introduce a large scale Chinese medical QA dataset and cast the task into a semantic matching problem. We also compare different CWS tools and input units. Among the two state-of-the-art deep matching neural networks, MatchPyramid performs better. Results also show the effectiveness of the proposed semantic clustered representation module.