RESUMEN
BACKGROUND: Diabetes mellitus (DM) and coronary microvascular dysfunction (CMD) increase the risk of adverse cardiac events in patients with non-ST-segment elevation myocardial infarction (NSTEMI). This study aimed to evaluate the combined risk estimates of DM and CMD, assessed by the angiography-derived index of microcirculatory resistance (angio-IMR), in patients with NSTEMI. METHODS: A total of 2212 patients with NSTEMI who underwent successful percutaneous coronary intervention (PCI) were retrospectively enrolled from three centers. The primary outcome was a composite of cardiac death or readmission for heart failure at a 2-year follow-up. RESULTS: Post-PCI angio-IMR did not significantly differ between the DM group and the non-DM group (20.13 [17.91-22.70] vs. 20.19 [18.14-22.77], P = 0.530). DM patients exhibited a notably higher risk of cardiac death or readmission for heart failure at 2 years compared to non-DM patients (9.5% vs. 5.4%, P < 0.001). NSTEMI patients with both DM and CMD experienced the highest cumulative incidence of cardiac death or readmission for heart failure at 2 years (24.0%, P < 0.001). The combination of DM and CMD in NSTEMI patients were identified as the most powerful independent predictor for cardiac death or readmission for heart failure at 2 years (adjusted HR: 7.894, [95% CI, 4.251-14.659], p < 0.001). CONCLUSIONS: In patients with NSTEMI, the combination of DM and CMD is an independent predictor of cardiac death or readmission for heart failure. Angio-IMR could be used as an additional evaluation tool for the management of NSTEMI patients with DM. TRIAL REGISTRATION: URL: https://www. CLINICALTRIALS: gov ; Unique identifier: NCT05696379.
Asunto(s)
Angiografía Coronaria , Circulación Coronaria , Diabetes Mellitus , Microcirculación , Infarto del Miocardio sin Elevación del ST , Readmisión del Paciente , Intervención Coronaria Percutánea , Valor Predictivo de las Pruebas , Resistencia Vascular , Humanos , Masculino , Femenino , Persona de Mediana Edad , Infarto del Miocardio sin Elevación del ST/diagnóstico por imagen , Infarto del Miocardio sin Elevación del ST/mortalidad , Infarto del Miocardio sin Elevación del ST/terapia , Infarto del Miocardio sin Elevación del ST/fisiopatología , Anciano , Medición de Riesgo , Estudios Retrospectivos , Intervención Coronaria Percutánea/efectos adversos , Factores de Riesgo , Factores de Tiempo , Diabetes Mellitus/epidemiología , Diabetes Mellitus/diagnóstico , Resultado del Tratamiento , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/epidemiología , China/epidemiologíaRESUMEN
The characteristics of dopamine self-polymerization were used to cover the nano-titanium dioxide (TiO2) surface and produce nano-titanium dioxide-polydopamine (TiO2-PDA). The reducing nature of dopamine was then used to reduce silver nitrate to silver elemental particles on the modified nano-titanium dioxide: The resulting TiO2-PDA-Ag nanoparticles were used as antimicrobial agents. Finally, the antibacterial agent was mixed with silicone to obtain an antibacterial silicone composite material. The composition and structure of antibacterial agents were analyzed by scanning electron microscopy, transmission electron microscopy, X-ray photoelectron energy spectroscopy, and X-ray diffraction. Microscopy and the antibacterial properties of the silicone antibacterial composites were studied as well. The TiO2-PDA-Ag antimicrobial agent had good dispersion versus nano-TiO2. The three were strongly combined with obvious characteristic peaks. The antibacterial agents were evenly dispersed in silicone, and the silicone composite has excellent antibacterial properties. Bacillus subtilis (B. subtilis) adhesion was reduced from 246 × 104 cfu/cm2 to 2 × 104 cfu/cm2, and colibacillus (E. coli) reduced from 228 × 104 cfu/cm2 leading to bacteria-free adhesion.
Asunto(s)
Bacillus subtilis , Escherichia coli , Siliconas , Plata , Titanio , Titanio/química , Titanio/farmacología , Siliconas/química , Plata/química , Plata/farmacología , Escherichia coli/efectos de los fármacos , Bacillus subtilis/efectos de los fármacos , Nanopartículas del Metal/química , Antibacterianos/farmacología , Antibacterianos/química , Antiinfecciosos/farmacología , Antiinfecciosos/química , Polímeros/química , Polímeros/farmacología , Difracción de Rayos X , Pruebas de Sensibilidad Microbiana , Adhesión Bacteriana/efectos de los fármacos , IndolesRESUMEN
The low delamination tendency and high damage tolerance of three-dimensional (3D) braided composites highlight their significant potential in handling defects. To enhance the engineering potential of three-dimensional four-directional (3D4d) braided composites and assess the failure mode of hole defects, this study introduces a series of 3D4d braided composites with prefabricated holes, studying their compressive properties and failure mechanisms through experimental and finite element methods. Digital image correlation (DIC) was used to monitor the compressive strain on the surface of materials. Scanning acoustic microscope (SAM) and scanning electron microscopy (SEM) were used to characterize the longitudinal compression failure mode inside the material. A macroscopic model is established, and the porous materials are predicted by using the general braided composite material prediction theory. While reducing the forecast cost, the error is also controlled within 21%. The analysis of failure mechanisms elucidates the damage extension mode, and the porous damage tolerance ability aligns closely with the bearing mode of braided material structure. Different braiding angles will lead to different bearing modes of materials. Under longitudinal compression, the average strength loss of 15° specimens is 38.21%, and that of 30° specimens is 8.1%. The larger the braided angle, the stronger the porous damage tolerance. Different types of prefabricated holes will also affect their mechanical properties and damage tolerance.
RESUMEN
Cation ordering in multication perovskites is related to many important material properties and performances, but computational determination of the cation ordering remains a major challenge. Here, we propose a new computational approach by introducing a machine learning recommender system into the basin-hopping framework (RBH) for optimizing cation ordering. Taking the electrocatalyst Ba0.5Sr0.5Co0.8Fe0.2O3 (BSCF5582) as a showcase example, we found that the efficiency of RBH in identifying low-energy configurations outperforms the methods of cluster expansion and conventional basin-hopping. The RBH results revealed that the BSCF5582 catalyst tended to have a layered ordering of A-site cations and disordered B-site cations both in bulk and on the surfaces. Further, on the A-site-terminated surface, we found the segregation of large Ba atoms. Similarly, on the A-site- terminated surface of the recently developed Cs0.2Sr0.8Co0.4Fe0.6O3 (CSCF2846) catalyst, layered ordering at the A-site and surface enrichment of large Cs atoms were also found. The layered ordering was robust against thermal effects, as found from molecular dynamics simulations at 800 K. This work provides a new approach for thermodynamic global optimization of chemical ordering in multicomponent materials.
RESUMEN
BACKGROUND: This study aimed to investigate the accuracy of identifying enthesitis along with other inflammatory lesions and structural lesions on the MRI of the sacroiliac joints (SIJ) by readers of varying experience and how training sessions and workshops could help improve the accuracy. METHODS: A total of 224 patients with clinical diagnosis of axial spondyloarthritis who underwent SIJ MRI examinations were retrospectively included in this study. Three readers with 5 years, 3 years and 1 year of experience in musculoskeletal imaging were invited to review the SIJ MRI images independently, while the imaging reports of a senior radiologist (> 10 years' experience) were used as reference. After the first round of image review, a training session and a workshop on the imaging of SIJ in spondyloarthritis were held and the three readers were asked to review the images in the second round. We calculated the accuracy of identifying inflammatory and structural lesions of the three readers as well as the intra-reader agreement. RESULTS: Enthesitis could be observed in 52.23% of the axial spondyloarthritis patients, while 81.58% of the patients with enthesitis were accompanied with bone marrow edema. All the three readers showed better accuracy at identifying structural lesions than inflammatory lesions. In the first round of image review, the three readers only correctly identified 15.07%, 2.94% and 0.74% of the enthesitis sites. After the training session and workshop, the accuracy rose to 61.03%, 39.34% and 20.22%. The intra-reader agreement of enthesitis calculated as Cohen's kappa was 0.23, 0.034 and 0.014, respectively. CONCLUSION: Readers with less experience in musculoskeletal imaging showed lower accuracy of identifying inflammatory lesions, notably enthesitis. Training sessions and workshops could help improve the diagnostic accuracy of the junior readers.
RESUMEN
Multi-instance learning (MIL) is a widely applied technique in practical applications that involve complex data structures. MIL can be broadly categorized into two types: traditional methods and those based on deep learning. These approaches have yielded significant results, especially regarding their problem-solving strategies and experiment validation, providing valuable insights for researchers in the MIL field. However, considerable knowledge is often trapped within the algorithm, leading to subsequent MIL algorithms that rely solely on the model's data fitting to predict unlabeled samples. This results in a significant loss of knowledge and impedes the development of more powerful models. In this article, we propose a novel data-driven knowledge fusion for deep MIL (DKMIL) algorithm. DKMIL adopts a completely different idea from existing deep MIL methods by analyzing the decision-making of key samples in the dataset (referred to as the data-driven) and using the knowledge fusion module designed to extract valuable information from these samples to assist the model's learning. In other words, this module serves as a new interface between data and the model, providing strong scalability and enabling prior knowledge from existing algorithms to enhance the model's learning ability. Furthermore, to adapt the downstream modules of the model to more knowledge-enriched features extracted from the data-driven knowledge fusion (DDKF) module, we propose a two-level attention (TLA) module that gradually learns shallow-and deep-level features of the samples to achieve more effective classification. We will prove the scalability of the knowledge fusion module and verify the efficiency of the proposed architecture by conducting experiments on 62 datasets across five categories.
RESUMEN
Targeting senescence has emerged as a promising strategy for liver cancer treatment. However, the lack of a safe agent capable of inducing complete senescence and being combined with senolytics poses a limitation. Here, we screened a natural product library and identified tryptanthrin (TRYP) as a potent inducer of cellular senescence in liver cancer cells both in vitro and in vivo. Mechanistically, Glutathione S-transferase P1 (GSTP1), a key regulator for redox homeostasis, was identified as a target protein for TRYP-induced senescence. TRYP directly bound to GSTP1 and inhibited its enzymatic activity, mediating reactive oxygen species (ROS) accumulation, followed by DNA damage response (DDR), consequently contributing to initiating primary senescence. Furthermore, TRYP triggered DNA damage-dependent activation of NF-κB pathway, which evoked senescence-associated secretory phenotype (SASP), thereby leading to senescence reinforcement. Importantly, TRYP exposed the vulnerability of tumor cells and sensitized senescent cells to apoptosis induced by senolytic agent ABT263, a Bcl2 inhibitor. Taken together, our findings reveal that TRYP induces cellular senescence via GSTP1/ROS/DDR/NF-κB/SASP axis, providing a novel potential application in synergizing with senolytic therapy in liver cancer.
RESUMEN
BACKGROUND: The index of microcirculatory resistance is a reliable measure for evaluating coronary microvasculature, but its prognostic value in patients with non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear. OBJECTIVES: This study aimed to evaluate the prognostic impact of post-percutaneous coronary intervention (PCI) angiography-derived index of microcirculatory resistance (angio-IMR) in patients with NSTEMI. METHODS: The culprit vessel's angio-IMR was measured after PCI in 2,212 NSTEMI patients at 3 sites. The primary endpoint was 2-year major adverse cardiac events (MACEs), defined as a composite of cardiac death, readmission for heart failure, myocardial reinfarction, and target vessel revascularization. RESULTS: The mean post-PCI angio-IMR was 20.63 ± 4.17 in NSTEMI patients. Two hundred six patients were categorized as the high post-PCI angio-IMR group according to maximally selected log-rank statistics. Patients with angio-IMR >25 showed a higher rate of MACEs than those with angio-IMR ≤25 (32.52% vs 9.37%; P < 0.001). Post-PCI angio-IMR >25 was an independent predictor of MACEs (HR: 4.230; 95% CI: 3.151-5.679; P < 0.001) and showed incremental prognostic value compared with conventional risk factors (AUC: 0.774 vs 0.716; P < 0.001; net reclassification index: 0.317; P < 0.001; integrated discrimination improvement: 0.075; P < 0.001). CONCLUSIONS: In patients undergoing PCI for NSTEMI, an increased post-PCI angio-IMR is associated with a higher risk of MACEs. The addition of post-PCI angio-IMR into conventional risk factors significantly improves the ability to reclassify patients and estimate the risk of MACEs. (Angiograph-Derived Index of Microcirculatory Resistance in Patients With Acute Myocardial Infarction; NCT05696379).
RESUMEN
INTRODUCTION: Radiological imaging has played an important role in diagnostic medicine for over a century, though it is known to contribute to dermatological conditions, cataracts, and cancer. The associated risk of harm has led to the introduction of protective regulations around the world. Present-day NHS clinicians are increasingly requesting and relying on diagnostic imaging. Knowledge surrounding the radiation doses of common radiological investigations and the associated risks is imperative, and on a global level has been found to be inadequate. Consequently, there is a need for the formal inclusion of teaching within training programmes. AIMS/OBJECTIVES: This prospective audit aims to establish the knowledge of radiation doses and risks of common radiological investigations of both medical students and referrers within four NHS Health Boards based in the North of Scotland. It also seeks to establish prior teaching and the preference for further educational interventions. AUDIT STANDARD: Referrers should have adequate knowledge of radiation doses and the risks associated with common radiological investigations. AUDIT TARGET: The standard should be achieved by 90% of referrers. METHODS: A 19-question online survey was devised to include subjective and objective questions on ionising radiation awareness, education preference, and respondent demographics, based on RCR (Royal College of Radiologists) audit criteria and previous studies. Data collection was conducted between the 22/02/23 to the 22/03/2023 and the questionnaire was distributed to senior medical students and radiological referrers of different grades within NHS Grampian, NHS Highland, NHS Shetland, and NHS Orkney. A descriptive analysis of the data was undertaken using Microsoft Excel Version 16.71. RESULTS: Two hundred eight questionnaires were completed. 22.11% (n = 46) of the sample population had received no prior teaching on the topic of ionising radiation. Over half of the respondents (51.92%, n = 108) rated the importance of radiation risks as either important or extremely important, with 69.71% (n = 145) of participants rating their perceived knowledge as limited or average. Most correctly identified that a CT scan (n = 203), PET-CT scan (n = 199) and a chest x-ray (n = 196) exposed patients to ionising radiation. A small proportion of the participants incorrectly thought that an MRI scan (n = 21) and an ultrasound scan (n = 2) involved ionising radiation. The results obtained failed to meet the RCR audit target, which states that 90% of doctors should be aware of common radiological doses. It was observed that only 17.79% (n = 37) of survey respondents scored over 50% in the knowledge assessment, with the median knowledge score of the whole cohort being 2.5 out of 9 (27.78%). Respondents who had prior teaching on the topic performed better those who had no prior teaching, with average scores of 3.19 (35.44%) and 2.04 (22.67%) respectively. Senior clinicians performed better when compared to junior clinicians and medical students. CONCLUSION & FUTURE RECOMMENDATIONS: This audit found that the knowledge of radiation risks within the North of Scotland in the selected sample population was insufficient across all levels of the clinical team. Further, continuous education around the topic and future audit opportunities may help to optimise knowledge and training.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Dosis de Radiación , Estudiantes de Medicina , Humanos , Escocia , Estudios Prospectivos , Femenino , Derivación y Consulta , Masculino , Encuestas y Cuestionarios , Adulto , Auditoría MédicaRESUMEN
Designing high-entropy oxyhydroxides (HEOs) electrocatalysts with controlled nanostructures is vital for efficient and stable water-splitting electrocatalysts. Herein, a novel HEOs material (FeCoNiWCuOOH@Cu) containing five non-noble metal elements derived by electrodeposition on a 3D double-continuous porous Cu support is created. This support, prepared via the liquid metal dealloying method, offers a high specific surface area and rapid mass/charge transfer channels. The resulting high-entropy FeCoNiWCuOOH nanosheets provide a dense distribution of active sites. The heterostructure between Cu skeletons and FeCoNiWCuOOH nanosheets enhances mass transfer, electronic structure coupling, and overall structural stability, leading to excellent activities in the oxygen evolution reaction (OER), hydrogen evolution reaction (HER), and water splitting reaction. At 10 mA cm-2, the overpotentials for OER, HER, and water splitting in 1.0 m KOH solution are 200, 18, and 1.40 V, respectively, outperforming most current electrocatalysts. The catalytic performance remains stable even after operating at 300 mA cm-2 for 100, 100, and over 1000 h, correspondingly. This material has potential applications in integrated hydrogen energy systems. More importantly, density functional theory (DFT) calculations demonstrate the synergy of the five elements in enhancing water-splitting activity. This work offers valuable insights for designing industrial water electrolysis systems.
RESUMEN
Objective: Frailty is a significant public health issue facing aging societies and can be reduced by physical activity (PA), but the dose-response relationship between PA and frailty is not clear. This systematic review and dose-response meta-analysis aimed to assess the effect of PA on frailty in adults by aggregating data from observational studies. Methods: PubMed, Embase, Web of Science, Cochrane Library, Scopus, SAGE Reference Online, SinoMed, CINAHL and CNKI were retrieved for articles published before May 2024. After quality evaluation, data on PA and the risk of frailty were extracted. Stata/MP 17.0 was used for dose-response meta-analysis. Results: A total of 15 articles were included, involving 34,754 participants, including 4250 subjects with frailty or pre-frailty. The consequence of the dose-response meta-analysis revealed that compared with those who were not active at all, a 22 % (95 % CI, 16 %-28 %) reduction in the risk of frailty in individuals with 11.25 MET h/week of cumulative activity and a 55 % (95 % CI, 44 %-63 %) reduction in the risk of frailty in those with 22.5 MET h/week of cumulative activity; for higher activity levels (36.75 MET h/week), the risk of frailty was reduced by 68 % (95 % CI, 58 %-76 %) and continued to be reduced as PA volum increased. Conclusions: There is a non-linear dose-response relationship between PA and frailty risk. Even small amounts of PA could reduce the risk of frailty. Meeting the minimum recommended PA target could reduce some risks, and doubling the recommended PA volumes could reduce most risks, which continue to increase as the volum of PA accumulates.
RESUMEN
The densities of eutectic (LiF)2-BeF2 and mixtures of this salt (FLiBe) with LaF3 were measured by dilatometry and by neutron attenuation from 673 K to 1,073 K. Because LaF3 has a limited solubility in FLiBe, it was necessary to determine the amount of LaF3 in solution before the density could be determined. The FLiBe density determination was favorably benchmarked against the literature data. A simple comparison was not available for the LaF3-FLiBe mixtures, so extrapolation of published data was necessary based on analysis using the Molten Salt Thermal Properties Database-Thermochemistry, or MSTDB-TC, developed by the US Department of Energy. Solubilities for LaF3 in FLiBe ranged from 1 to 4 mol % over 673 to 1,073 K. The salt system was heated and cooled over 24 h to evaluate potential changes in composition and hysteresis during the measurement. Changes in the meniscus were observed, and these were included in the correction for density determinations. Salt surface tension may have led to supersaturation of LaF3 in the salt because the solubility curve was nonlinear with respect to the inverse temperature, as would be expected for an ideal system. Surface tension measurements are currently underway to test this hypothesis.
RESUMEN
Conventional ex situ analytical methods for sediment pore water are susceptible to disruptions in the speciation equilibrium of metals due to changes in external conditions. This study introduced an innovative in situ method for detecting the three-dimensional distribution of labile copper (CuLabile) in sediment pore water with high spatial resolution using a highly stable microneedle electrochemical sensor. The sensor featured a nanoporous tip structure and embedded gold nanomaterials with excellent electrocatalytic performance. The nanoporous structure could prevent the nanomaterials from falling off because of friction during the in situ detection process in sediments. The sensor exhibited good detection performance under different salinity conditions with a detection limit of 0.2 nM. Vertical and three-dimensional distributions of CuLabile in sediment pore water were successfully obtained using the in situ microneedle sensor. The results showed that the concentration of CuLabile was in the range of 5.2-43.5 nM, with a maximum value at a depth of approximately 4 cm, while there was almost no difference in the horizontal direction of a specific sediment sample column. Furthermore, this functional sensor could be extended to the in situ detection of other labile metals in sediment pore water.
RESUMEN
Carbaryl is widely used as a highly effective insecticide which harms the marine environment. This study aimed to assess the reproductive toxicity of chronic carbaryl exposure on female marine medaka and their female offspring. After a 180-day exposure from embryonic period to adulthood, females exhibited reduced attraction to males, decreased ovulation, increased gonadosomatic index and a higher proportion of mature and atretic follicles. These reproductive toxic effects of carbaryl may stem from changes in hormone levels and transcription levels of key genes along the HPG axis. Furthermore, maternal carbaryl exposure had detrimental effects on the offspring. F1 females showed the reproductive disorders similar to those observed in F0 females. The significant changes in the transcription levels of DNA methyltransferase and demethylase genes in the F0 and F1 generations of ovaries indicate changes in their DNA methylation levels. The changes in DNA methylation levels in F1 female marine medaka may lead to changes in the expression of certain reproductive key genes, such as an increase in the transcription level of cyp19a, which may be the reason for F1 reproductive toxicity. These findings indicate that maternal exposure may induce severe generational toxicity through alterations in DNA methylation levels. This study assesses the negative impacts of whole life-cycle carbaryl exposure on the reproductive and developmental processes of female marine medaka and its female offspring, while offering data to support the evaluation of the ecological risk posed by carbaryl in marine ecosystems.
Asunto(s)
Carbaril , Insecticidas , Oryzias , Reproducción , Contaminantes Químicos del Agua , Animales , Oryzias/fisiología , Femenino , Carbaril/toxicidad , Reproducción/efectos de los fármacos , Contaminantes Químicos del Agua/toxicidad , Insecticidas/toxicidad , Exposición Materna/efectos adversos , Metilación de ADN/efectos de los fármacos , MasculinoRESUMEN
Creativity is an indispensable competency in today's innovation-driven society. Yet, the influences of instructional strategy, a key determinant of educational outcomes, on the creativity-fostering process remains an unresolved mystery. We proposed that instructional strategy affects creativity cultivation and further investigated the intricate neural mechanisms underlying this relationship. In a naturalistic laboratory setting, 66 instructor-learner dyads were randomized into three groups (scaffolding, explanation, and control), with divergent thinking instructions separately. Functional near-infrared spectroscopy (fNIRS) hyperscanning simultaneously collected brain signals in the prefrontal cortex and temporal-parietal junction regions. Results indicated that learners instructed with a scaffolding strategy demonstrated superior creative performance both in acquisition (direct learning) and transfer (use in a novel context) of creativity skills, compared to pretest levels. In contrast, the control and explanation groups did not exhibit such effects. Notably, we also observed remarkable interbrain neural synchronization (INS) between instructors and learners in the left superior frontal cortex in the scaffolding group, but not in the explanation or control groups. Furthermore, INS positively predicted enhancements in creativity performance (acquisition and transfer), indicating that it is a crucial neural mechanism in the creativity-fostering process. These findings reveal that scaffolding facilitates the acquisition and transfer of creativity and deepen our understanding of the neural mechanisms underlying the process of creativity-fostering. The current study provides valuable insights for implementing teaching strategies to fostering creativity.
Asunto(s)
Creatividad , Espectroscopía Infrarroja Corta , Transferencia de Experiencia en Psicología , Humanos , Masculino , Femenino , Transferencia de Experiencia en Psicología/fisiología , Adulto Joven , Espectroscopía Infrarroja Corta/métodos , Adulto , Encéfalo/fisiología , Encéfalo/diagnóstico por imagen , Aprendizaje/fisiología , Enseñanza , Corteza Prefrontal/fisiología , Corteza Prefrontal/diagnóstico por imagenRESUMEN
The integration of artificial intelligence (AI) into clinical management of aortic stenosis (AS) has redefined our approach to the assessment and management of this heterogenous valvular heart disease (VHD). While the large-scale early detection of valvular conditions is limited by socioeconomic constraints, AI offers a cost-effective alternative solution for screening by utilizing conventional tools, including electrocardiograms and community-level auscultations, thereby facilitating early detection, prevention, and treatment of AS. Furthermore, AI sheds light on the varied nature of AS, once considered a uniform condition, allowing for more nuanced, data-driven risk assessments and treatment plans. This presents an opportunity to re-evaluate the complexity of AS and to refine treatment using data-driven risk stratification beyond traditional guidelines. AI can be used to support treatment decisions including device selection, procedural techniques, and follow-up surveillance of transcatheter aortic valve replacement (TAVR) in a reproducible manner. While recognizing notable AI achievements, it is important to remember that AI applications in AS still require collaboration with human expertise due to potential limitations such as its susceptibility to bias, and the critical nature of healthcare. This synergy underpins our optimistic view of AI's promising role in the AS clinical pathway.
RESUMEN
OBJECTIVE: The aim of this study is to evaluate the clinical efficacy of injectable cemented hollow pedicle screw (CICPS) in the treatment of osteoporotic lumbar degenerative diseases through a large sample long-term follow-up study. Additionally, we aim to explore the risk factors affecting interbody fusion. METHODS: A total of 98 patients who underwent CICPS for transforaminal lumbar interbody fusion (TLIF) for osteoporotic lumbar degenerative disease from March 2011 to September 2017 were analyzed. X-ray and electronic computed tomography (CT) imaging data were collected during preoperative, postoperative, and follow-up periods. The data included changes in intervertebral space height (ΔH), screw failure, cement leakage (CL), and intervertebral fusion. The patients were divided into two groups based on their fusion status one year after surgery: satisfied group A and dissatisfied group B. Surgical data such as operation time, intraoperative bleeding volume and surgical complications were recorded, and visual analog scale (VAS) and Oswestry disability index (ODI) were used to evaluate the improvement of lumbar and leg pain. RESULTS: The mean follow-up time was 101.29 months (ranging from 70 to 128 months). A total of 320 CICPS were used, with 26 screws (8.13%) leaking, 3 screws (0.94%) experiencing cement augmentation failure, and 1 screw (0.31%) becoming loose and breaking. The remaining screws were not loose or pulled out. Female gender, decreased bone density, and CL were identified as risk factors affecting interbody fusion (P < 0.05). Early realization of interbody fusion can effectively prevent the loss of intervertebral space height (P < 0.05) and maintain the surgical treatment effect. Both VAS and ODI scores showed significant improvement during the follow-up period (P < 0.05). Binary logistic regression analysis revealed that decreased bone density and cement leakage were risk factors for prolonged interbody fusion. CONCLUSIONS: The results of long-term follow-up indicate that PMMA enhanced CICPS has unique advantages in achieving good clinical efficacy in the treatment of osteoporosis lumbar degenerative diseases. Attention should be paid to identify female gender, severe osteoporosis, and CL as risk factors affecting interbody fusion.
Asunto(s)
Cementos para Huesos , Vértebras Lumbares , Osteoporosis , Tornillos Pediculares , Fusión Vertebral , Humanos , Femenino , Masculino , Vértebras Lumbares/cirugía , Vértebras Lumbares/diagnóstico por imagen , Estudios de Seguimiento , Anciano , Osteoporosis/cirugía , Osteoporosis/complicaciones , Persona de Mediana Edad , Fusión Vertebral/métodos , Fusión Vertebral/instrumentación , Degeneración del Disco Intervertebral/cirugía , Degeneración del Disco Intervertebral/diagnóstico por imagen , Resultado del Tratamiento , Factores de Tiempo , Inyecciones , Estudios RetrospectivosRESUMEN
We demonstrate nearly a microsecond of spin coherence in Er3+ ions doped in cerium dioxide nanocrystal hosts, despite a large gyromagnetic ratio and nanometric proximity of the spin defect to the nanocrystal surface. The long spin coherence is enabled by reducing the dopant density below the instantaneous diffusion limit in a nuclear spin-free host material, reaching the limit of a single erbium spin defect per nanocrystal. We observe a large Orbach energy in a highly symmetric cubic site, further protecting the coherence in a qubit that would otherwise rapidly decohere. Spatially correlated electron spectroscopy measurements reveal the presence of Ce3+ at the nanocrystal surface, which likely acts as extraneous paramagnetic spin noise. Even with these factors, defect-embedded nanocrystal hosts show tremendous promise for quantum sensing and quantum communication applications, with multiple avenues, including core-shell fabrication, redox tuning of oxygen vacancies, and organic surfactant modification, available to further enhance their spin coherence and functionality in the future.
RESUMEN
[This corrects the article DOI: 10.3389/fphar.2023.1260288.].
RESUMEN
V2CTx MXenes have gained considerable attention in lithium ion batteries (LIBs) owing to their special two-dimensional (2D) construction with large lithium storage capability. However, engineering high-capacity V2CTx MXenes is still a great challenge due to the limited interlayer space and poor surface terminations. In view of this, alkalized and oxidized V2CTx MXenes (OA-V2C) are envisaged. SEM characterization confirms the accordion-like layered morphology of OA-V2C. The XPS technique illustrates that undergoing alkalized and oxidized treatment, V2CTX MXene replaces -F and -OH with -O groups, which are more conducive to pseudocapacitive properties as well as Na ion diffusion, providing more active sites for ion storage in OA-V2C. Accordingly, the electrochemical performance of OA-V2C as anode materials for LIBs is evaluated in this work, showing excellent performance with high reversible capacity (601 mAh g-1 at 0.2 A g-1 over 500 cycles), competitive rate performance (222.2 mAh g-1 and 152.8 mAh g-1 at 2 A g-1 and 5 A g-1), as well as durable long-term cycling property (252 mAh g-1 at 5 A g-1 undergoing 5000 cycles). It is noted that the intercalation of Na+ ions and oxidation co-modification greatly reduces F surface termination and concurrently increases interlayer spacing in OA-V2C, significantly expediting ion/electron transportation and providing an efficient way to maximize the performance of MXenes in LIBs. This innovative refinement methodology paves the way for building high-performance V2CTx MXenes anode materials in LIBs.