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OBJECTIVES: Malnutrition is prevalent in geriatric patients and associated with poor prognosis. This study aimed to evaluate the incremental prognostic value of different nutritional assessment tools in patients (90 years and older) with multimorbidity in China. METHODS: Patients aged ≥90 years with multimorbidity from the Geriatric Research Center in Nanjing Jinling Hospital from January 1, 2008 to December 31, 2018 were analyzed. Patients were followed until December 31,2022. The nutrition status was assessed according to the mini nutritional assessment (MNA), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index score (PNI), respectively. The outcome was all-cause death. Kaplan-Meier method was used to draw the survival curve, and univariate and multivariate Cox proportional risk regression analysis was used to explore the influencing factors of all-cause death in the patients. RESULTS: 160 participants aged 90(90,91) years were included. During a median follow-up of 5.41(3.12-7.64) years, 106(66.25 %) patients died. Deceased patients had lower MNA [20.75(16.75,23.00) vs. 26.00(24.00,26.00); p < 0.001], lower GNRI [96.21±8.75 vs. 100.94±6.80; p = 0.001] and lower PNI [46.16(40.77,49.57) vs. 47.75(45.36,51.53); p = 0.010] than did survivors. According to MNA, GNRI, and PNI score, 93(58.1 %), 72(45.0 %) and 41(25.6 %) of participants were at risk of malnutrition. Multivariate analysis revealed that malnutrition was independently associated with increased risk for mortality by MNA score (adjusted hazard ratio [HR] 2.502, 95 % confidence interval [CI] 1.561-4.009, p<0.001), GNRI score (adjusted HR 1.650, 95 % CI, 1.117-2.438, p = 0.012), and PNI score (adjusted HR 2.894, 95 % CI, 1.891-4.431, p<0.001). Furthermore, the inclusion of malnutrition indicators in the survival prediction model significantly improved the predictive power of mortality. CONCLUSION: The risk of malnutrition, as assessed by MNA, GNRI and PNI, in long-lived patients with multimorbidity is a strong independent predictor of mortality and adds significant prognostic information to the survival models.
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Myocardial ischemia-reperfusion injury (MIRI) is fatal to patients, leading to cardiomyocyte death and myocardial remodeling. Reactive oxygen species (ROS) and oxidative stress play important roles in MIRI. There is a complex crosstalk between ROS and regulatory cell deaths (RCD) in cardiomyocytes, such as apoptosis, pyroptosis, autophagy, and ferroptosis. ROS is a double-edged sword. A reasonable level of ROS maintains the normal physiological activity of myocardial cells. However, during myocardial ischemia-reperfusion, excessive ROS generation accelerates myocardial damage through a variety of biological pathways. ROS regulates cardiomyocyte RCD through various molecular mechanisms. Targeting the removal of excess ROS has been considered an effective way to reverse myocardial damage. Many studies have applied antioxidant drugs or new advanced materials to reduce ROS levels to alleviate MIRI. Although the road from laboratory to clinic has been difficult, many scholars still persevere. This article reviews the molecular mechanisms of ROS inhibition to regulate cardiomyocyte RCD, with a view to providing new insights into prevention and treatment strategies for MIRI.
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In the present work, the three stable MXenes Mn+1CnO2(M = Nb,Ta) are explored based on first-principles calculations. These materials are important derivatives of 2D materials and exhibit distinctive properties, holding vast potential in nanodevices. All these Mn+1CnO2(M = Nb,Ta) materials exhibit outstanding superconducting performance, with corresponding superconducting transition temperatures of 23.00 K, 25.00 K, and 29.00 K. Analysis reveals that the high superconducting transition temperatures of MXenes Mn+1CnO2(M = Nb,Ta) are closely associated with the high value of the logarithmic average of phonon frequencies,ωlog, and the strong electron-phonon coupling, attributed to the crucial contribution of low-frequency phonons. Additionally, we applied strain treatments of 2% and 4% to Mn+1CnO2(M = Nb,Ta), resulting in varying changes in superconducting transition temperatures under different strains.
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Yutu-2 rover conducted an exciting expedition on the 41st lunar day to investigate a fin-shaped rock at Longji site (45.44°S, 177.56°E) by extending its locomotion margin on perilous peaks. The varied locomotion encountered, especially multi-form wheel slippage, during the journey to the target rock, established unique conditions for a fin-grained lunar regolith analysis regarding bearing, shear and lateral properties based on terramechanics. Here, we show a tri-aspect characterization of lunar regolith and infer the rock's origin using a digital twin. We estimate internal friction angle within 21.5°-42.0° and associated cohesion of 520-3154 Pa in the Chang'E-4 operational site. These findings suggest shear characteristics similar to Apollo 12 mission samples but notably higher cohesion compared to regolith investigated on most nearside lunar missions. We estimate external friction angle in lateral properties to be within 8.3°-16.5°, which fills the gaps of the lateral property estimation of the lunar farside regolith and serves as a foundational parameter for subsequent engineering verifications. Our in-situ spectral investigations of the target rock unveil its composition of iron/magnesium-rich low-calcium pyroxene, linking it to the Zhinyu crater (45.34°S, 176.15°E) ejecta. Our results indicate that the combination of in-situ measurements with robotics technology in planetary exploration reveal the possibility of additional source regions contributing to the local materials at the Chang'E-4 site, implying a more complicated geological history in the vicinity.
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Apelin/APJ is widely distributed in various tissues in the body and participates in the regulation of physiological and pathological mechanisms such as autophagy, apoptosis, inflammation, and oxidative stress. Apelin-13 is an adipokine family member with multiple biological roles and has been shown to be involved in the development and progression of bone diseases. In the process of osteoporosis and fracture healing, Apelin-13 plays an osteoprotective role by regulating the autophagy and apoptosis of BMSCs, and promotes the osteogenic differentiation of BMSCs. In addition, Apelin-13 also attenuates the progression of arthritis by regulating the inflammatory response of macrophages. In conclusion, Apelin-13 has an important connection with bone protection, which provides a new strategy for the clinical treatment of bone-related diseases.
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Inflamación , Osteogénesis , Humanos , Receptores de Apelina , Autofagia , ApoptosisRESUMEN
Two-dimensional (2D) XY magnets with easy magnetization planes support the nontrivial topological spin textures whose dissipationless transport is highly desirable for 2D spintronic devices. Here, we predicted that Janus monolayer V2XN (X = P, As) with a square lattice is a 2D-XY ferromagnet using first-principles calculations. Both magnetocrystalline anisotropy and magnetic shape anisotropy favor an in-plane magnetization, leading to an easy magnetization xy-plane in Janus monolayer V2XN. With the help of the Monte Carlo simulations, we observed the Berezinskii-Kosterlitz-Thouless (BKT) phase transition in monolayer V2XN with the transition temperature TBKT being above room temperature. In particular, monolayer V2AsN has a magnetic anisotropy energy (MAE) of 292.0 µeV per V atom and a TBKT of 434 K, which is larger than that of monolayer V2PN. Moreover, a tensile strain of 5% can further improve the TBKT of monolayer V2XN to be above 500 K. Our results indicated that Janus monolayer V2XN (X = P, As) can be candidate materials to realize high-temperature 2D-XY ferromagnetism for spintronics applications.
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Recently, two-dimensional (2D) Indium Selenide (InSe) has been receiving much attention in the scientific community due to its reduced size, extraordinary physical properties, and potential applications in various fields. In this review, we discussed the recent research advancement in the carrier and phonon transport properties of 2D InSe and its related Janus structures. We first introduced the progress in the synthesis of 2D InSe. We summarized the recent experimental and theoretical works on the carrier mobility, thermal conductivity, and thermoelectric characteristics of 2D InSe. Based on the Boltzmann transport equation (BTE), the mechanisms underlying carrier or phonon scattering of 2D InSe were discussed in detail. Moreover, the structural and transport properties of Janus structures based on InSe were also presented, with an emphasis on the theoretical simulations. At last, we discussed the prospects for continued research of 2D InSe.
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Spinal cord injury (SCI) often brings devastating consequences to patients and their families. Pathophysiologically, the primary insult causes irreversible damage to neurons and glial cells and initiates the secondary damage cascade, further leading to inflammation, ischemia, and cells death. In SCI, the release of various inflammatory mediators aggravates nerve injury. Pyroptosis is a new pro-inflammatory pattern of regulated cell death (RCD), mainly mediated by caspase-1 or caspase-11/4/5. Gasdermins family are pore-forming proteins known as the executor of pyroptosis and the gasdermin D (GSDMD) is best characterized. Pyroptosis occurs in multiple central nervous system (CNS) cell types, especially plays a vital role in the development of SCI. We review here the evidence for pyroptosis in SCI, and focus on the pyroptosis of different cells and the crosstalk between them. In addition, we discuss the interaction between pyroptosis and other forms of RCD in SCI. We also summarize the therapeutic strategies for pyroptosis inhibition, so as to provide novel ideas for improving outcomes following SCI.
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The search and design of two-dimensional (2D) magnetic semiconductors for spintronics applications are particularly significant. In this work, we investigated the electronic and magnetic properties of Janus structure based on Dirac half-metallic vanadium phosphide (VP) monolayer (ML) by first-principles calculations. Due to the vertical symmetry breaking, Janus V2AsP ML becomes an intrinsic ferromagnetic semiconductor with a narrow band gap of 0.21 eV. We analyzed the electronic structure and origin of the in-plane easy axis in Janus V2AsP. The electron effective mass is anisotropic and only 0.129 m0along thex-direction. The Curie temperatureTcand magnetic anisotropy energy (MAE) of Janus V2AsP reach 490 K and 178 µeV per V atom, respectively. A uniaxial tensile stainÉxof 5% can increase its band gap and MAE to 0.39 eV and 210.6 µeV per V atom while maintaining itsTcbeing above room temperature. Moreover, the direction of the easy axis can be changed between the in-planex- andy-direction by a small uniaxial tensile strainÉxof 2%. Our study can motivate further research on the design the magnetic semiconductors in Janus structures based on 2D Dirac half-metals for spintronics applications.
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Two-dimensional intrinsic antiferromagnetic semiconductors are expected to stand out in the spintronic field. The present work finds the monolayer T'-MoTeI is intrinsically an antiferromagnetic semiconductor by using first-principles calculation. Firstly, the dimerized distortion of the Mo atoms causes T'-MoTeI to have dynamic stability, which is different from the small imaginary frequency in the phonon spectrum of T-MoTeI. Secondly, T'-MoTeI is an indirect-bandgap semiconductor with 1.35 eV. Finally, in the systematic study of strain effects, there are significant changes in the electronic structure as well as the bandgap, but the antiferromagnetic ground state is not affected. Monte Carlo simulations predict that the Néel temperature of T'-MoTeI is 95 K. The results suggest that the monolayer T'-MoTeI can be a potential candidate for spintronics applications.
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Purpose: The age-adjusted Charlson comorbidity index (ACCI) is a useful measure of comorbidity to standardize the evaluation of elderly patients and has been reported to predict mortality in various cancers. To our best knowledge, no studies have examined the relationship between the ACCI and survival of elderly patients with cancer. Therefore, the primary objective of this study was to investigate the relationship between the ACCI and survival of elderly patients with cancer. Patients and Methods: A total of 64 elderly patients (>80 years) with cancer between 2011 and 2021 were enrolled in this study. According to the ACCI, the age-adjusted comorbidity index was calculated by weighting individual comorbidities; patients with ACCI<11 were considered the low-ACCI group, whereas those with ACCI≥11 were considered the high-ACCI group. The correlations between the ACCI score and survival outcomes were statistically analyzed. Results: There was a significant difference in overall survival (OS) and progression-free survival (PFS) between the high-ACCI group and the low-ACCI group (P<0.001). The median OS time of the high-ACCI group and the low-ACCI group were 13.9 (10.5-22.0) months and 51.9 (34.1-84.0) months, respectively. The 2-, 3-, and 5-year survival rates of the high-ACCI group were 28.1%, 18.8%, and 4.2%, respectively, whereas the 2-, 3-, and 5-year survival rates of the low-ACCI group were 77.3%, 66.4%, and 39.1%, respectively. Multivariate analysis showed that ACCI was independently associated with OS (HR=1.402, 95% CI: 1.226-1.604, P < 0.05) and PFS (HR=1.353, 95% CI: 1.085-1.688, P = 0.0073). Conclusion: The ACCI score is a significant independent predictor of prognosis in elderly patients with cancer.
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The Mars' climate is cold and dry in the most recent epoch, and liquid water activities are considered extremely limited. Previous orbital data only show sporadic hydrous minerals in the northern lowlands of Mars excavated by large impacts. Using the short-wave infrared spectral data obtained by the Zhurong rover of China's Tianwen-1 mission, which landed in southern Utopia Planitia on Mars, we identify hydrated sulfate/silica materials on the Amazonian terrain at the landing site. These hydrated minerals are associated with bright-toned rocks, interpreted to be duricrust developed locally. The lithified duricrusts suggest that formation with substantial liquid water originates by either groundwater rising or subsurface ice melting. In situ evidence for aqueous activities identified at Zhurong's landing site indicates a more active Amazonian hydrosphere for Mars than previously thought.
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Charged facets of a nanocrystal can form an intrinsic nanometer-size electric dipole. When the spacing between these nano dipoles is adjusted, the dipolar interaction energy is tuned from a fraction to a multiple of the thermal energy. Consequently, the one-dimensional oriented attachment can be switched on or off, as is the growth of nanorods. This kinetically controlled growth is achieved at relatively low reaction temperatures while the thermodynamically controlled growth dominates at higher temperatures. The synthesized PbSe nanorods are branchless, exhibiting a single-exponential photoluminescence decay trace with an e-folding lifetime of 1.3 µs and a photoluminescence quantum yield of 35%.
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Two-dimensional (2D) intrinsic half-metallic materials are of great interest to explore the exciting physics and applications of nanoscale spintronic devices, but no such materials have been experimentally realized. Using first-principles calculations based on density-functional theory, we predicted that single-layer MnAsS4 was a 2D intrinsic ferromagnetic (FM) half-metal. The half-metallic spin gap for single-layer MnAsS4 is about 1.46 eV, and it has a large spin splitting of about 0.49 eV in the conduction band. Monte Carlo simulations predicted the Curie temperature (T c) was about 740 K. Moreover, within the biaxial strain ranging from -5% to 5%, the FM half-metallic properties remain unchanged. Its ground-state with 100% spin-polarization ratio at Fermi level may be a promising candidate material for 2D spintronic applications.
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Recently, boron arsenide (BAs) has been measured with high thermal conductivity in the experiments, great encouragement for low-power photoelectric devices. Hence we systematically investigate the direct and indirect optical absorptions of BAs and BSb by using first-principles calculations. We obtain the absorption onset corresponding to the value of indirect bandgap by considering the phonon-assisted second-order indirect optical absorption. The temperature-dependent calculations also capture the redshift of absorption onset, enhancement, and smoothness of optical absorption spectra. Moreover, in order to introduce the first-order absorption in the visible range, the doping effect of congeners is studied without the assist of phonon. It is found that the decrease of local direct bandgap derives from either the decrease of bonding-antibonding repulsion of p orbital states by the heavier III group elements or the similar influence of lighter V group elements on the s orbital states. Thus, the doping of congeners can improve the visible optical absorptions.
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Recently, two-dimensional ferromagnetic semiconductors have been an important class of materials for many potential applications in spintronic devices. Based on density functional theory, we systematically explore the magnetic and electronic properties of CrGeS3 with the monolayer structures. It is found that the bandgap of spin-up state is 1.01 eV when it is 1.07 eV in spin-down state. The exchange splitting is calculated as 0.67 eV (2.21 eV by HSE06 functional), which originates from bonding [Formula: see text] hybridized states of Cr e g -S pâ and unoccupied Cr t 2g -Ge pâ hybridization. After that, the comparison of total energy between different magnetic states ensures the ferromagnetic ground state of monolayer CrGeS3. The reason of the magnetic states originates mainly from the competition between antiferromagnetic direct neighboring Cr-Cr exchange and ferromagnetic superexchange mediated by S atom. And the results also show the magnetic moment of 6 [Formula: see text] per unit cell, including two Cr atoms. Besides, we estimate that the monolayer CrGeS3 possesses the Curie temperature of 161 K by mean-field theory. The results suggest that monolayer CrGeS3 crystals will possess potential applications in nanoscale spintronics.
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BACKGROUND: Sarcopenia is a decrease in skeletal muscle mass, physical performance, and muscle strength in older people. In this study, we aimed to explore the correlation between comorbidity and skeletal muscle mass and physical performance in older people. METHODS: This retrospective study included 168 subjects. Their medical history, physical function, computed tomography (CT) chest scans, and blood tests for nutrition were evaluated. The patients were divided into two groups: (1) a low muscle mass group and (2) a normal muscle mass group. Multivariate analysis of variance was used to compare multiple sets of mean vectors. RESULTS: Overall, 72.02% of the subjects had a low skeletal muscle index (SMI) and low gait speed. The patients with low skeletal muscle mass and physical performance were older, had more serious comorbidities, and had longer average hospitalization periods and lower albumin and hemoglobin levels. Subjects with a high Charlson comorbidity index (CCI) were more likely to be in the sarcopenic group than in the non-sarcopenic group. In addition, there was a linear correlation between the CCI and SMI (r = - 0.549, P < 0.05), and between the CCI and gait speed (r = - 0.614, P < 0.05). The area under the curve (AUC) value for low skeletal muscle mass with the CCI was 0.879. CONCLUSIONS: We identified an independent association between comorbidity and skeletal muscle mass/physical performance by researching the correlation between the CCI and SMI/gait speed. Our results suggested that the CCI score may have important clinical diagnostic value for sarcopenia.
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Fuerza Muscular/fisiología , Músculo Esquelético/fisiopatología , Sarcopenia/epidemiología , Velocidad al Caminar/fisiología , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Masculino , Músculo Esquelético/diagnóstico por imagen , Rendimiento Físico Funcional , Estudios Retrospectivos , Sarcopenia/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Sepsis is a life-threatening organ dysfunction caused by the host's imbalance in response to infection, which is still the leading cause of death in critically ill patients. In recent years, studies have found that vitamin D deficiency or insufficiency is common in critically ill patients, especially sepsis. The relationship between vitamin D and sepsis has attracted more and more attention. The mechanism of vitamin D in sepsis is described from the aspects of immune regulation, inflammation regulation, endothelial cell protection, carbon monoxide regulation, and receptor gene polymorphism, by analyzing the related literatures of vitamin D and sepsis in recent years in order to provide new ideas for clinical diagnosis and treatment of sepsis.
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Sepsis/metabolismo , Deficiencia de Vitamina D , Vitamina D/metabolismo , Enfermedad Crítica , Humanos , InflamaciónRESUMEN
The two most common surgical interventions for spontaneous intracerebral hemorrhage in the basal ganglia of patients more than 65 years old are either minimally invasive puncture and drainage or craniotomy. This study aimed to compare the curative effects of these two procedures in such patients. A retrospective study of patients older than years with spontaneous intracerebral hemorrhage was conducted between January 2012 and December 2015. Of the 86 patients, 47 received minimally invasive puncture and drainage and 39 underwent craniotomy. One year after surgery no statistically significant difference was observed between the two groups with respect to: evacuation rate of the hematoma five days after the operation, volume of residual hematoma, occurrence of rebleeding, development of infectious meningitis, length of hospitalization, fatality, or Glasgow Outcome Scale and Barthel Index scores. However, the amount of blood loss during the procedure (P < 0.001), total cost of hospitalization (P = 0.004), and incidence of epilepsy (P = 0.045) were significantly higher for the craniotomy group than the minimally invasive puncture and drainage group. It was found that, in patients older than 65 years with basal ganglia hemorrhage, minimally invasive puncture and drainage is less invasive, more cost efficient and induces less bleeding during surgery than craniotomy.
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Hemorragia de los Ganglios Basales/cirugía , Craneotomía/métodos , Paracentesis/métodos , Anciano , Anciano de 80 o más Años , Craneotomía/normas , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/normas , Paracentesis/normas , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
We systematically investigated the phonon and electron transport properties of monolayer InSe and its Janus derivatives including monolayer In2SSe and In2SeTe by first-principles calculations. The breaking of mirror symmetry produces a distinguishable A 1 peak in the Raman spectra of monolayer In2SSe and In2SeTe. The long-range harmonic and anharmonic interactions play an important role in the heat transport of the group-III chalcogenides. The room-temperature thermal conductivity ([Formula: see text]) of monolayer InSe, In2SSe and In2SeTe are 44.6, 46.9, and 29.9 W (mK)-1, respectively. There is a competition effect between atomic mass, phonon group velocity and phonon lifetime. The [Formula: see text] can be further effectively modulated by sample size for the purpose of thermoelectric applications. Meanwhile, monolayer In2SeTe exhibits a direct band gap of 1.8 eV and a higher electron mobility than that of monolayer InSe, due to the smaller electron effective mass caused by tensile strain on the Se side and smaller deformation potential. These results indicate that 2D Janus group-III chalcogenides can provide a platform to design the new electronic, optoelectronic and thermoelectric devices.