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With the development of new technologies such as the Internet, big data, and AI, digital therapy has gradually developed into an emerging sector in digital diagnosis and treatment. Even 6 years after the global development of digital therapy, numerous problems that need to be solved have been identified through research and investigation. Through comparative analysis of the current development status of digital therapy both domestically and internationally, this study proposes opportunities for its development in China from both policy and technology perspectives, as well as corresponding challenges from the perspectives of cognition, classification, and quality. In response to these challenges, it proposes prospects and suggestions for the future development of digital therapy.
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Internet , Tecnología , ChinaRESUMEN
BACKGROUND: Appropriate passive-active immunoprophylaxis effectively reduces mother-to-child transmission (MTCT) of hepatitis B virus (HBV), but the immunoprophylaxis failure was still more than 5% under the current strategy. The study objective was to investigate the effects of high dose of HB vaccine on MTCT and immune response for infants born to hepatitis B surface antigen (HBsAg)-positive mothers. METHODS: This was a prospective, multicenter, large-sample cohort study in four sites of China, and 955 pairs of HBsAg-positive mothers and their infants were enrolled in our investigation. The infants were given 10 µg or 20 µg HB vaccine (at age 0, 1, and 6 months) plus HB immunoglobulin (at age 0 and 1 month). Serum HBsAg, antibody to HBsAg (anti-HBs), and/or HBV DNA levels in the infants were determined at age 12 months. The safety of 20 µg HB vaccine was evaluated by adverse events and observing the growth indexes of infants. RESULTS: Thirteen of 955 infants were HBsAg-positive at 12 months. Stratification analysis showed that immunoprophylaxis failure rates in the 20 µg group were not significantly different from the 10 µg group, whatever maternal HBV load was high or not. But the high dose of HB vaccine significantly reduced low-response rate (anti-HBs 10-100 IU/L) (P = 0.002) and middle-response rate (anti-HBs 100-1000 IU/L) (P = 0.022) and improved high-response rate (anti-HBs ≥ 1000 IU/L) (P < 0.0001) in infants born to mothers with HBV DNA < 5 log10 IU/mL. For infants born to mothers with HBV DNA ≥ 5 log10 IU/mL, 20 µg HB vaccine did not present these above response advantages. The 20 µg HB vaccine showed good safety for infants. CONCLUSIONS: The 20 µg HB vaccine did not further reduce immunoprophylaxis failure of infants from HBsAg-positive mothers, but increased the high-response and decreased low-response rates for infants born to mothers with HBV DNA < 5 log10 IU/mL. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-PRC-09000459.
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Hepatitis B Crónica , Complicaciones Infecciosas del Embarazo , Niño , Preescolar , Estudios de Cohortes , Femenino , Vacunas contra Hepatitis B , Virus de la Hepatitis B , Humanos , Inmunidad , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Madres , Embarazo , Estudios ProspectivosRESUMEN
Osteocalcin, expressed in osteoblasts of the bone marrow, undergoes post-translational carboxylation and deposits in mineralized bone matrix. A portion of osteocalcin remains uncarboxylated (uncarboxylated osteocalcin, GluOC) that is released into blood where it functions as a hormone to regulate insulin secretion and insulin sensitivity. As insulin resistance is closely associated with metabolic syndrome, this study is aimed to elucidate how GluOC regulates glucose and lipid metabolism in KKAy mice, an animal model displaying obese, hyperglycemia, hyperinsulinemia, insulin resistance, and hepatic steatosis. GluOC (3, 30 ng/g per day, ig) was orally administered to female KKAy mice for 4 weeks. Whole-body insulin sensitivity, glucose metabolism, hepatic steatosis, dyslipidemia were examined using routine laboratory assays. We found that GluOC administration significantly enhanced insulin sensitivity in KKAy mice by activating hepatic IRß/PI3K/Akt pathway and elevated the whole-body insulin sensitivity with decreased FPI and HOMA-IR index. Furthermore, GluOC administration alleviated hyperglycemia through suppressing gluconeogenesis and promoting glycogen synthesis in KKAy mice and in cultured hepatocytes in vitro. Moreover, GluOC administration dose-dependently ameliorated dyslipidemia and attenuated hepatic steatosis in KKAy mice by inhibiting hepatic de novo lipogenesis and promoting fatty-acid ß-oxidation. These results demonstrate that GluOC effectively enhances hepatic insulin sensitivity, improves hyperglycemia and ameliorates hepatic steatosis in KKAy mice, suggesting that GluOC could be a promising drug candidate for treating metabolic syndrome.
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Glucemia/metabolismo , Diabetes Mellitus Experimental/metabolismo , Insulina/metabolismo , Hígado/metabolismo , Osteocalcina/metabolismo , Administración Oral , Animales , Modelos Animales de Enfermedad , Femenino , Prueba de Tolerancia a la Glucosa , Metabolismo de los Lípidos , Ratones , Ratones Obesos , Osteocalcina/administración & dosificación , Transducción de SeñalRESUMEN
Uncarboxylated osteocalcin (unOc) is an osteoblast-derived hormone with multiple regulatory functions. Osteocalcin knockdown delays the maturation of mineral species and downregulates the expression of osteogenic-specific genes in human mesenchymal stromal cells. However, the underlying mechanisms remain unclear. Here, we investigated the effects of unOc on the osteogenic differentiation of mouse bone marrow-derived mesenchymal stem cells (BMSCs) and discovered that unOc promoted osteogenic differentiation of BMSCs, which was characterized by increases in alkaline phosphatase (ALP) activity, type I collagen (COLI) production, calcified nodule formation, and expression of osteogenic-specific genes including the osterix, runt-related transcription factor 2 (Runx2), ALP, and COLI genes. Further experiments indicated that unOc promoted the osteogenic differentiation of BMSCs via activation of the Erk-Smad/ß-catenin signalling pathways. SIGNIFICANCE OF THE STUDY: Osteoporosis is associated with the osteogenic differentiation of BMSCs. In recent years, the role of unOc function as an endocrine hormone has received much attention. In this study, we reported for the first time that unOc promoted the osteogenic differentiation of mouse BMSCs through Erk-Smad/ß-catenin signalling pathway. Our results highlight the importance of unOc as a hormone in promoting the osteogenic differentiation of BMSCs, indicating that this hormone may be beneficial in treatments for osteoporosis and fracture healing.
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Médula Ósea/efectos de los fármacos , Células Madre Mesenquimatosas/efectos de los fármacos , Osteocalcina/farmacología , Osteogénesis/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Animales , Médula Ósea/metabolismo , Diferenciación Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Relación Dosis-Respuesta a Droga , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Masculino , Células Madre Mesenquimatosas/metabolismo , Ratones , Ratones Endogámicos C57BL , Osteoporosis/tratamiento farmacológico , Osteoporosis/metabolismo , Proteínas Smad/metabolismo , Relación Estructura-Actividad , beta Catenina/metabolismoRESUMEN
Flexible and compressible temperature sensors are highly desired for artificial skin and epidermal electronics. Here we demonstrated a flexible and compressible resistive temperature sensor using hierarchically buckled carbon nanotube/rubber bi-sheath-core structure (a buckled carbon nanotube outer sheath and a buckled rubber inner sheath wrapped around a rubber fiber core). When heated, lateral contacts of the adjacent buckles increase, resulting in electrical resistance decrease and serving as highly sensitive temperature sensors. This bi-sheath-core fiber temperature sensor showed high linearity, good repeatability, large negative temperature coefficient of resistance (NTC = -54.7/°C), and insensitivity to compressive deformations (up to -20% strain). The NTC and temperature dependence of percent resistance change can be easily tuned by modulating the buckling bi-sheath-core structures such as varying the number of nanotube layers and the rubber sheath stiffness.
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Aerogel fibers, combining the nanoporous characteristics of aerogels with the slenderness of fibers, have emerged as a rising star in nanoscale materials science. However, endowing nanoporous aerogel fibers with good strength and high toughness remains elusive due to their high porosity and fragile mechanics. To address this challenge, this paper reports supertough aerogel fibers (SAFs) initially started from ionic-liquid-dissociated cellulose via wet-spinning and supercritical drying in sequence. The supertough nanoporous aerogel fibers assembled with cellulose nanofibers exhibit a high specific surface area (372 m2/g), good mechanical strength (30 MPa), and large elongation (107%). Benefiting from their high strength and elongation, the resultant cellulose nanoporous aerogel fibers show ultrahigh toughness up to 21.85 MJ/m3, much outperforming the known aerogel materials in the literature. Moreover, the toughness of this nanoporous aerogel fiber is 7.4 times higher than that of human knee ligaments, and its specific toughness is comparable to that of commonly used solid polyester fibers. In addition, we also verified the weavability, desirable thermal insulation performance, and supertoughness to resist the transient impact of SAFs. The long-sought strategy to simultaneously resolve the strength and toughness of nanoporous aerogel fibers, in combination with the biodegradable nature of the cellulose, provides multifaceted opportunities for broad potential applications, including lightweight wearable textiles and beyond.
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Human muscles can grow and change their length with body development; therefore, artificial muscles that modulate their morphology according to changing needs are needed. In this paper, we report a strategy to transform an artificial muscle into a new muscle with a different morphology by thermodynamic-twist coupling, and illustrate its structural evolution during actuation. The muscle length can be continuously modulated over a large temperature range, and actuation occurs by continuously changing the temperature. This strategy is applicable to different actuation modes, including tensile elongation, tensile contraction and torsional rotation. This is realized by twist insertion into a fibre to produce torsional stress. Fibre annealing causes partial thermodynamic relaxation of the spiral molecular chains, which serves as internal tethering and inhibits fibre twist release, thus producing a self-supporting artificial muscle that actuates under heating. At a sufficiently high temperature, further relaxation of the spiral molecular chains occurs, resulting in a new muscle with a different length. A structural study provides an understanding of the thermodynamic-twist coupling. This work provides a new design strategy for intelligent materials.
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In waste rock piles, the leaching process involved in acid rock drainage is mainly controlled by water flow. This paper (Part 2) investigates the effects of heterogeneities on the water flow patterns by applying probability density functions to hydrogeological properties. In this study, a piecewise constant distribution is proposed to describe the permeability inside waste rock piles, which reflects the effect of both finer and coarser pores. Compared with uniform water flow obtained from traditional homogeneous modeling, various water flow patterns and their pathways inside waste rock piles can be simulated by the proposed model. In addition, the leaching process is also investigated by coupling the calculated water flow with the geochemical reaction based on the water film model proposed in part 1. For demonstration, these models are integrated and applied to the full-scale waste rock pile at Equity Silver mine in British Columbia, Canada. Because the iron loading is highly correlated to the acidity at this site, it is found that the fluctuation of annual lime consumption for neutralization at this site can be well predicted by the integrated model. In addition, the results indicate that waste rock piles with different spatial patterns of permeability distribution, but with the same probability density function, may have different water flow patterns and spatial distributions of iron concentrations inside the pile. However, the total water flow discharge rate and iron loading profiles from the pile are almost the same on the temporal scale.
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Contaminantes del Agua , Colombia Británica , Modelos Teóricos , Fenómenos Físicos , Agua , Contaminantes del Agua/análisisRESUMEN
Somatosensitive soft crawling robotics is highly desired for load carrying and multi-terrain locomotion. The motor-driven skeleton robots and pneumatic robots are effective and well-developed, while the bulk size, rigidity, or complexity limit their applications. In this paper, a somatosensitive film soft crawling robot driven by an artificial muscle was developed, which can carry heavy loads and crawl on multiple terrains. A bow-shaped film skeleton connected with a twisted-fiber artificial muscle is not easily deformed while carrying a load. A strain sensor coating on the film skeleton was used to detect the body deformation of the robot and a controller was designed for feedback control to make the robot self-crawling. This film soft crawling robot was demonstrated to crawl on the multi-terrain such as flat, mountainous, and underwater, as well as surfaces with different roughness. This work provides a new design strategy for multi-functional compact soft crawling robotics.
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Robótica , Locomoción , MúsculosRESUMEN
In this paper, a machine learning algorithm based on artificial neural network architecture investigates the correlation between drainage chemistries in seepage water and ambient weather conditions around waste rock piles. The proposed neural network consists of a long short-term memory unit and a fully connected neural network which uses sequenced input to consider current and previous weather impact on the drainage chemistries. A 20-year (1998-2017) monitoring database obtained from the full-scale waste rock pile of the Equity Silver mine in BC, Canada is used for validating the proposed approach. The neural network is trained based on total precipitation and mean temperature as input and the acidity as output. The results indicate that the calculated acidity from the trained neural network matches with that measured in the field well. In addition, the accuracy of calculated acidity can be further increased by adding a time tag of acidity measurement date into the input layer. This refined approach can capture the long-term evolution and dynamics of hydrogeochemical and biochemical properties inside the waste rock piles.
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Contaminantes del Agua , Canadá , Redes Neurales de la Computación , Agua , Contaminantes del Agua/análisis , Tiempo (Meteorología)RESUMEN
Geochemical reactions taking place at the rock surface and pore water interface, and rapid preferential water flow through waste rock piles are identified as two primary steps for acid rock drainage (ARD) and metal leaching (ML) processes. This paper (Part I) develops a water film model to describe the interactions among sulphide minerals, pore water and oxygen, which considers the reactive surface areas as the primary sites to capture geochemical reactions including sulphide oxidation and neutralization reactions, and also considers acid and metal ion storage in pore water. In addition, the proposed water film model is further coupled with a pile-scale mass transport model to investigate a specific case of the main waste rock pile at the Equity Silver mine, Canada. Overall, the simulated profile of oxygen concentration matches the historical monitoring data. The modeling results revealed potential controlling mechanisms for ARD generation inside the waste rock pile and provided insights into the impact of an engineered cover on the waste rock pile.
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Contaminantes del Agua , Agua , Canadá , Drenaje , Modelos TeóricosRESUMEN
Surface/ground waters could be polluted when rain-water and/or snow-melt water infiltrate through waste rock piles at mine sites and dissolve secondary minerals (salts) from rock surfaces. It is important to reduce solute loading by the optimal configuration of waste rock piles. This requires the proper definition and determination of the characteristic properties of waste rock piles in terms of metal leaching and, in particular, rate control mechanisms and scaling laws, and their dependence upon configuration variables. For revealing these characteristic properties this paper proposes a pile-scale C-Q relation: Câ¯=â¯Cs(1â¯-â¯e-P/Q), (Pâ¯≡â¯kλßψ), where C and Cs are respectively solute concentration and particle's saturation concentration, Q is the flow rate of the water through a waste rock pile, k represents the effective or average dissolution coefficient of a mineral specie from rock surfaces, ß represents rock pile depth, λ represents the ratio of the sum of the surface areas of rocks to the volume that the rocks occupy, and ψ is the sum of the cross-sections of water-flow channels in a waste rock pile. The two characteristic properties revealed by the C-Q relation are: (1) P, the product of k, λ, ß, and ψ (Pâ¯≡â¯kλßψ), which is the characteristic property of a waste rock pile in terms of metal leaching, named here the solute production potential; and (2) the ratio of P to Q, P/Q, a non-dimensional number, designated as α (αâ¯≡â¯P/Q), named here the rate control quotient, which is the scaling law and the rate control mechanism indicator. The value of α quantitatively indicates what controls the rate of mineral dissolution, and it also relates smaller-scale metal-leaching testing results to their corresponding full scales. When α becomes small, say αâ¯<â¯0.5, the rate of solute production potential P becomes in control, and the solute loading is nearly independent of Q; when α becomes larger, say αâ¯>â¯2.5, solute concentration would become close to its saturation concentration Cs, and Q determines solute loading (that is, the solute loading is proportional to Q). When 0.5â¯<â¯αâ¯<â¯2.5, both Q and P are in control, a mixed control mechanism. The 20â¯years of measurements of mine drainage chemistry from the main waste rock piles at the Equity Silver mine, BC, Canada, are used to illustrate how to determine the two characteristic properties P and α, and how well they are able to describe the waste rock piles in terms of metal leaching.
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Agua Subterránea , Contaminantes del Agua , Canadá , Metales , Modelos TeóricosRESUMEN
Inflatable conducting devices providing improved properties and functionalities are needed for diverse applications. However, the difficult part in making high-performance inflatable devices is the enabling of two-dimensional (2D) buckles with controlled structures on inflatable catheters. Here, we report the fabrication of highly inflatable devices with controllable structures by wrapping the super-aligned carbon nanotube sheet (SACNS) on the pre-inflated catheter. The resulting structure exhibits unique 2D buckled structures including quasi-parallel buckles, crisscrossed buckles, and hierarchically buckled structures, which enables reversible structural changes of 7470% volumetric strain. The 2D SACNS buckled structures show stable electrical conductance and surface wettability during large strain inflation/deflation cycles. Inflatable devices including inflatable tumor ablation, capacitive volumetric strain sensor, and communication via inflatable radio frequency antenna based on these structures are demonstrated.
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Higher-efficiency, lower-cost refrigeration is needed for both large- and small-scale cooling. Refrigerators using entropy changes during cycles of stretching or hydrostatic compression of a solid are possible alternatives to the vapor-compression fridges found in homes. We show that high cooling results from twist changes for twisted, coiled, or supercoiled fibers, including those of natural rubber, nickel titanium, and polyethylene fishing line. Using opposite chiralities of twist and coiling produces supercoiled natural rubber fibers and coiled fishing line fibers that cool when stretched. A demonstrated twist-based device for cooling flowing water provides high cooling energy and device efficiency. Mechanical calculations describe the axial and spring-index dependencies of twist-enhanced cooling and its origin in a phase transformation for polyethylene fibers.
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Reported results of coarse-grained molecular dynamics simulations rationalize the effect of water on the phase-segregated morphology of Nafion ionomers. We analyzed density maps and radial distribution functions and correlated them with domain structures, distributions of protogenic side chains, and water transport properties. The mesoscopic structures exhibit spongelike morphologies. Hydrophilic domains of water, protons, and anionic side chains form a random three-dimensional network, which is embedded in a matrix of hydrophobic backbone aggregates. Sizes of hydrophilic domains increase from 1 to 3 nm upon water uptake. At low water content, hydrophilic domains are roughly spherical and poorly connected. At higher water content, they convert into elongated cylindrical shapes with high connectivity. Further structural analysis provides a reasonable estimate of the percolation threshold. Radial distribution functions from coarse-grained and atomistic molecular dynamics models exhibit a good agreement. Water cluster size distributions from coarse-grained molecular dynamics and dissipative particle dynamics are consistent with small angle x-ray scattering data. Moreover, we calculated the water diffusivity by molecular dynamics methods and corroborated the results by comparison with pulsed field gradient NMR.
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The increasing demand for wearable glucose sensing has stimulated growing interest in stretchable electrodes. The development of the electrode materials having large stretchability, low detection limit, and good selectivity is the key component for constructing high performance wearable glucose sensors. In this work, we presented fabrication of stretchable conductor based on the copper coated carbon nanotube sheath-core fiber, and its application as non-enzymatic electrode for glucose detection with high stretchability, low detection limit, and selectivity. The sheath-core fiber was fabricated by coating copper coated carbon nanotube on a pre-stretched rubber fiber core followed by release of pre-stretch, which had a hierarchically buckled structure. It showed a small resistance change as low as 27% as strain increasing from 0% to 500% strain, and a low resistance of 0.4 Ω·cm-1 at strain of 500%. This electrode showed linear glucose concentration detection in the range between 0.05 mM and 5 mM and good selectivity against sucrose, lactic acid, uric acid, acrylic acid in phosphate buffer saline solution, and showed stable signal in high salt concentration. The limit of detection (LOD) was 0.05 mM, for the range of 0.05â»5 mM, the sensitivity is 46 mA·M-1. This electrode can withstand large strain of up to 60% with negligible influence on its performance.
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Hair-like-diameter superelastic conducting fibers, comprising a buckled carbon nanotube sheath on a rubber core, are fabricated, characterized, and deployed as weavable wires, biosensors, supercapacitors, and strain sensors. These downsized sheath-core fibers provide the demonstrated basis for glucose sensors, supercapacitors, and electrical interconnects whose performance is undegraded by giant strain, as well as ultrafast strain sensors that exploit strain-dependent capacitance changes.
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Técnicas Biosensibles , Capacidad Eléctrica , Nanotubos de CarbonoRESUMEN
Using intelligent textiles for clothing represents one possibility for weavable superelastic conducting fibers that can store energy, sense body motions, and detect biochemicals. On page 4998, S. Yin, R. H. Baughman, and co-workers demonstrate that these hair-like-diameter fibers, comprising buckled carbon nanotube sheaths on a rubber core, can be used as glucose sensors, supercapacitors, ultrafast strain sensors, and electrical interconnectors. The performance of these structures is maintained also under giant strain.