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1.
Science ; 383(6687): 1080-1083, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38452084

RESUMO

High-Q microresonators are indispensable components of photonic integrated circuits and offer several useful operational modes. However, these modes cannot be reconfigured after fabrication because they are fixed by the resonator's physical geometry. In this work, we propose a Moiré speedup dispersion tuning method that enables a microresonator device to operate in any of three modes. Electrical tuning of Vernier coupled rings switches operating modality to Brillouin laser, bright microcomb, and dark microcomb operation on demand using the same hybrid-integrated device. Brillouin phase matching and microcomb operation across the telecom C-band is demonstrated. Likewise, by using a single-pump wavelength, the operating mode can be switched. As a result, one universal design can be applied across a range of applications. The device brings flexible mixed-mode operation to integrated photonic circuits.

2.
J Cancer Res Clin Oncol ; 149(20): 17781-17793, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37934255

RESUMO

BACKGROUND: The epithelial-mesenchymal transition (EMT) plays a vital role in the progression of lung adenocarcinoma (LUAD). Long non-coding RNAs (lncRNAs) participate in the EMT process as an important regulatory factor and have the potential to serve as prognostic biomarkers. We aimed to construct a novel lncRNA prognostic signature for LUAD based on EMT-related lncRNAs, identify EMT-related hub lncRNA, and investigate its biological functions. METHODS: RNA-seq data, clinical and survival information were obtained from The Cancer Genome Atlas database. The EMT-related lncRNA prognostic signature (EMTscore) was constructed using the Least Absolute Shrinkage and Selection Operator Cox regression analysis. The efficiency of EMTscore in predicting the prognosis of LUAD was evaluated through the area under the time-dependent receiver operating characteristic (ROC) curves. The hub lncRNA of the prognostic signature was selected using a co-expression network map, and its effects on cell proliferation and metastasis were explored by in vitro experiments. RESULTS: We constructed a prognostic signature (EMTscore) containing 8 tumor-high expressed lncRNAs. The EMTscore performed well in predicting overall survival rates with AUC values of 0.708 at 5 years in the training set. EMTscore could independently predict the survival of LUAD, with HR = 4.011 (95% CI 2.430-6.622) in the multivariate Cox regression. Importantly, we identified LINC01615 as the hub lncRNA in the EMTscore and revealed that LINC01615 enhanced the proliferation, migration, and EMT of lung cancer cells. CONCLUSIONS: A new EMT-related lncRNA prognostic signature named EMTscore was developed, and LINC01615 was identified as the hub lncRNA of EMTscore. The hub lncRNA LINC01615 had an oncogenic biological function in LUAD.


Assuntos
Adenocarcinoma , RNA Longo não Codificante , Humanos , RNA Longo não Codificante/genética , Prognóstico , Transição Epitelial-Mesenquimal/genética , Proliferação de Células/genética , Adenocarcinoma/genética
3.
Int J Clin Pract ; 2023: 3473603, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874383

RESUMO

Objective: Atrial fibrillation (AF) is one of the most common complications of acute coronary syndrome (ACS) patients. Possible risk factors related to new-onset AF (NOAF) in ACS patients have been reported in some studies, and several prediction models have been established. However, the predictive power of these models was modest and lacked independent validation. The aim of this study is to define risk factors of NOAF in patients with ACS during hospitalization and to develop a prediction model and nomogram for individual risk prediction. Methods: Retrospective cohort studies were conducted. A total of 1535 eligible ACS patients from one hospital were recruited for model development. External validation was performed using an external cohort of 1635 ACS patients from another hospital. The prediction model was created using multivariable logistic regression and validated in an external cohort. The discrimination, calibration, and clinical utility of the model were evaluated, and a nomogram was constructed. A subgroup analysis was performed for unstable angina (UA) patients. Results: During hospitalization, the incidence of NOAF was 8.21% and 6.12% in the training and validation cohorts, respectively. Age, admission heart rate, left atrial diameter, right atrial diameter, heart failure, brain natriuretic peptide (BNP) level, less statin use, and no percutaneous coronary intervention (PCI) were independent predictors of NOAF. The AUC was 0.891 (95% CI: 0.863-0.920) and 0.839 (95% CI: 0.796-0.883) for the training and validation cohort, respectively, and the model passed the calibration test (P > 0.05). The clinical utility evaluation shows that the model has a clinical net benefit within a certain range of the threshold probability. Conclusion: A model with strong predictive power was constructed for predicting the risk of NOAF in patients with ACS during hospitalization. It might help with the identification of ACS patients at risk and early intervention of NOAF during hospitalization.


Assuntos
Síndrome Coronariana Aguda , Fibrilação Atrial , Intervenção Coronária Percutânea , Humanos , Estudos Retrospectivos , Átrios do Coração
4.
Opt Express ; 30(14): 25147-25161, 2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-36237052

RESUMO

Narrow-linewidth lasers are important to many applications spanning precision metrology to sensing systems. Characterization of these lasers requires precise measurements of their frequency noise spectra. Here we demonstrate a correlated self-heterodyne (COSH) method capable of measuring frequency noise as low as 0.01 Hz2/Hz at 1 MHz offset frequency. The measurement setup is characterized by both commercial and lab-built lasers, and features low optical power requirements, fast acquisition time and high intensity noise rejection.

5.
Nature ; 610(7930): 54-60, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36171286

RESUMO

Integrated photonics has profoundly affected a wide range of technologies underpinning modern society1-4. The ability to fabricate a complete optical system on a chip offers unrivalled scalability, weight, cost and power efficiency5,6. Over the last decade, the progression from pure III-V materials platforms to silicon photonics has significantly broadened the scope of integrated photonics, by combining integrated lasers with the high-volume, advanced fabrication capabilities of the commercial electronics industry7,8. Yet, despite remarkable manufacturing advantages, reliance on silicon-based waveguides currently limits the spectral window available to photonic integrated circuits (PICs). Here, we present a new generation of integrated photonics by directly uniting III-V materials with silicon nitride waveguides on Si wafers. Using this technology, we present a fully integrated PIC at photon energies greater than the bandgap of silicon, demonstrating essential photonic building blocks, including lasers, amplifiers, photodetectors, modulators and passives, all operating at submicrometre wavelengths. Using this platform, we achieve unprecedented coherence and tunability in an integrated laser at short wavelength. Furthermore, by making use of this higher photon energy, we demonstrate superb high-temperature performance and kHz-level fundamental linewidths at elevated temperatures. Given the many potential applications at short wavelengths, the success of this integration strategy unlocks a broad range of new integrated photonics applications.

6.
Chin Med J (Engl) ; 135(12): 1451-1458, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35869861

RESUMO

BACKGROUND: The CHA 2 DS 2 -VASc score was initially applied to stratify stroke risk in patients with atrial fibrillation (AF) and was found to be effective in predicting all-cause mortality outcomes. To date, it is still unclear whether circulating long non-coding RNAs (lncRNAs) as emerging biomarkers, can improve the predictive power of the CHA 2 DS 2 -VASc score in stroke and all-cause mortality. METHODS: Candidate lncRNAs were screened by searching the literature and analyzing previous RNA sequencing results. After preliminary verification in 29 patients with AF, the final selected lncRNAs were evaluated by Cox proportional hazards regression in 192 patients to determine whether their relative expression levels were associated with stroke and all-cause mortality. The c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement of the patients were calculated to evaluate the discrimination and reclassification power for stroke and all-cause mortality when adding lncRNA expression levels to the CHA 2 DS 2 -VASc score model. RESULTS: Five plasma lncRNAs associated with stroke and all-cause mortality in AF patients were selected in our screening process. Patients with elevated H19 levels were found to have a higher risk of stroke (hazard ratio [HR] 3.264, 95% confidence interval [CI]: 1.364-7.813, P  = 0.008). Adding the H19 expression level to the CHA 2 DS 2 -VASc score significantly improved the discrimination and reclassification power of the CHA 2 DS 2 -VASc score for stroke in AF patients. In addition, the H19 level showed a marginally significant association with all-cause mortality (HR 2.263, 95% CI: 0.889-5.760, P  = 0.087), although it appeared to have no significant improvement for the CHA 2 DS 2 -VASc model for predicting all-cause mortality. CONCLUSIONS: Plasma expression of H19 was associated with stroke risk in AF patients and improved the discriminatory power of the CHA 2 DS 2 -VASc score. Therefore, lncRNA H19 served as an emerging non-invasive biomarker for stroke risk prediction in patients with AF.


Assuntos
Fibrilação Atrial , RNA Longo não Codificante , Acidente Vascular Cerebral , Fibrilação Atrial/complicações , Fibrilação Atrial/genética , Humanos , Modelos de Riscos Proporcionais , RNA Longo não Codificante/genética , Medição de Risco/métodos , Fatores de Risco , Acidente Vascular Cerebral/etiologia
7.
Front Cardiovasc Med ; 9: 1072164, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36698935

RESUMO

Background: Interleukin (IL)-34 and IL-38 are associated with cardiovascular disease (CVD). However, their involvement in atrial fibrillation (AF) and AF-associated adverse events remains uncertain. Therefore, we aimed to investigate their association with various AF prognostic factors in a cohort study and assessed their predictive value for the prognosis of patients with AF. Methods: Patients with new-onset non-valvular AF were consecutively enrolled between 2013 and 2015 at the Department of Cardiovascular Medicine of the Southwest Hospital of the Army Medical University (Third Military Medical University) in Chongqing, China. The endpoints included stroke and all-cause mortality. The baseline levels of plasma IL-34, IL-38, NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and GDF-15 were measured and their correlation with AF-related adverse events were analyzed in a Cox proportional-hazards regression model. The C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the performance of the AF prognostic models. Decision curve analysis (DCA) was used to evaluate the clinical net benefit of the original and modified models. Results: A total of 299 patients with new-onset AF were enrolled. During the median follow-up time of 28 (IQR: 27, 29) months, the higher levels of IL-34 were associated with a lower risk of stroke, and the higher levels of IL-38 were associated with an increased risk of all-cause death (all adjusted P < 0.05). In addition, elevated hs-cTnT and NT-proBNP concentrations were associated with a higher risk of stroke and all-cause mortality (all adjusted P < 0.05). Furthermore, the CHA2DS2-VASc score combined with IL-38 and NT-proBNP significantly improved the C-statistic, IDI, and NRI (all P < 0.01). There was no statistically significant difference (all P > 0.05) in the discrimination power between the preference models and the ABC (age, biomarkers, and clinical history) score for the two prognostic outcomes. Conclusion: Our results suggested that IL-34 and IL-38 were independently associated with stroke and all-cause mortality in patients with AF. Moreover, adding IL-38 and NT-proBNP to the CHA2DS2-VASc score significantly improved its predictive ability of AF-related all-cause death. Finally, the preference model performed equally well as the ABC score in predicting AF prognosis.

8.
Nat Commun ; 12(1): 6573, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772953

RESUMO

Dual-comb spectroscopy (DCS) offers high sensitivity and wide spectral coverage without the need for bulky spectrometers or mechanical moving parts. And DCS in the mid-infrared (mid-IR) is of keen interest because of inherently strong molecular spectroscopic signatures in these bands. We report GHz-resolution mid-IR DCS of methane and ethane that is derived from counter-propagating (CP) soliton microcombs in combination with interleaved difference frequency generation. Because all four combs required to generate the two mid-IR combs rely upon stability derived from a single high-Q microcavity, the system architecture is both simplified and does not require external frequency locking. Methane and ethane spectra are measured over intervals as short as 0.5 ms, a time scale that can be further reduced using a different CP soliton arrangement. Also, tuning of spectral resolution on demand is demonstrated. Although at an early phase of development, the results are a step towards mid-IR gas sensors with chip-based architectures for chemical threat detection, breath analysis, combustion studies, and outdoor observation of trace gases.

9.
Opt Lett ; 46(20): 5201-5204, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34653151

RESUMO

We self-injection-lock a diode laser to a 1.41 m long, ultra-high Q integrated resonator. The hybrid integrated laser reaches a frequency noise floor of 0.006Hz2/Hz at 4 MHz offset, corresponding to a Lorentzian linewidth below 40 mHz-a record among semiconductor lasers. It also exhibits exceptional stability at low-offset frequencies, with frequency noise of 200Hz2/Hz at 100 Hz offset. Such performance, realized in a system comprised entirely of integrated photonic chips, marks a milestone in the development of integrated photonics; and, for the first time, to the best of our knowledge, exceeds the frequency noise performance of commercially available, high-performance fiber lasers.

10.
BMC Infect Dis ; 21(1): 1012, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579666

RESUMO

BACKGROUND: The receptor of severe respiratory syndrome coronavirus 2 (SARS-CoV-2), angiotensin-converting enzyme 2, is more abundant in kidney than in lung tissue, suggesting that kidney might be another important target organ for SARS-CoV-2. However, our understanding of kidney injury caused by Coronavirus Disease 2019 (COVID-19) is limited. This study aimed to explore the association between kidney injury and disease progression in patients with COVID-19. METHODS: A retrospective cohort study was designed by including 2630 patients with confirmed COVID-19 from Huoshenshan Hospital (Wuhan, China) from 1 February to 13 April 2020. Kidney function indexes and other clinical information were extracted from the electronic medical record system. Associations between kidney function indexes and disease progression were analyzed using Cox proportional-hazards regression and generalized linear mixed model. RESULTS: We found that estimated glomerular filtration rate (eGFR) and creatinine clearance (Ccr) decreased in 22.0% and 24.0% of patients with COVID-19, respectively. Proteinuria was detected in 15.0% patients and hematuria was detected in 8.1% of patients. Hematuria (HR 2.38, 95% CI 1.50-3.78), proteinuria (HR 2.16, 95% CI 1.33-3.51), elevated baseline serum creatinine (HR 2.84, 95% CI 1.92-4.21) and blood urea nitrogen (HR 3.54, 95% CI 2.36-5.31), and decrease baseline eGFR (HR 1.58, 95% CI 1.07-2.34) were found to be independent risk factors for disease progression after adjusted confounders. Generalized linear mixed model analysis showed that the dynamic trajectories of uric acid was significantly related to disease progression. CONCLUSION: There was a high proportion of early kidney function injury in COVID-19 patients on admission. Early kidney injury could help clinicians to identify patients with poor prognosis at an early stage.


Assuntos
Injúria Renal Aguda , COVID-19 , Estudos de Coortes , Progressão da Doença , Humanos , Rim , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
11.
Diabetes Res Clin Pract ; 180: 109041, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34500004

RESUMO

AIMS: We aimed to investigate the role of Fasting Plasma Glucose (FPG) and glucose fluctuation in the prognosis of COVID-19 patients stratified by pre-existing diabetes. METHODS: The associations of FPG and glucose fluctuation indexes with prognosis of COVID-19 in 2,642 patients were investigated by multivariate Cox regression analysis. The primary outcome was in-hospital mortality; the secondary outcome was disease progression. The longitudinal changes of FPG over time were analyzed by the latent growth curve model in COVID-19 patients stratified by diabetes and severity of COVID-19. RESULTS: We found FPG as an independent prognostic factor of overall survival after adjustment for age, sex, diabetes and severity of COVID-19 at admission (HR: 1.15, 95% CI: 1.06-1.25, P = 1.02 × 10-3). Multivariate logistic regression analysis indicated that the standard deviation of blood glucose (SDBG) and largest amplitude of glycemic excursions (LAGE) were also independent risk factors of COVID-19 progression (P = 0.03 and 0.04, respectively). The growth trajectory of FPG over the first 3 days of hospitalization was steeper in patients with critical COVID-19 in comparison to moderate patients. CONCLUSIONS: Hyperglycemia and glucose fluctuation were adverse prognostic factors of COVID-19 regardless of pre-existing diabetes. This stresses the importance of glycemic control in addition to other therapeutic management.


Assuntos
COVID-19 , Diabetes Mellitus , Glicemia , Diabetes Mellitus/epidemiologia , Jejum , Glucose , Humanos , Prognóstico , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
12.
Clin Cosmet Investig Dermatol ; 14: 723-731, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34211290

RESUMO

BACKGROUND: Post-adolescent acne is a common skin disease faced by adults. However, whether air pollution (AP) serves as a risk factor for post-adolescent acne remains elusive. AIM: To determine the relationship between short-term AP exposure (within 7 days) and outpatient visits for post-adolescent acne. METHODS: Daily outpatient visit data for post-adolescent acne and routinely AP data between 2010 and 2013 were collected from Xi'an, China. A generalized additive regression model was used to analyze the relationship between outpatient visits for post-adolescent acne and short-term ambient AP exposure. The gender-specific analyses were conducted as well. RESULTS: Totally, 27,190 outpatient visits for post-adolescent acne were included. The results revealed that a 10 µg/m3 increase in PM10, SO2, and NO2 at lag 0-7 day was associated with the increase of outpatient visits for post-adolescent acne at 0.84% (95% CI: 0.53%, 1.16%), 1.61% (95% CI: 0.12%, 3.10%), and 3.50% (95% CI: 1.60%, 5.40%), respectively. The significant positive associations of PM10, SO2, and NO2 were found at both single-lag models and moving average models. The gender-specific analyses showed that the effect estimates of PM10 was stronger for females than for males, while there was no observed gender difference in the effects of SO2 and NO2. CONCLUSION: Short-term exposure to AP was associated with increased outpatient visits for post-adolescent acne, especially for females in the effects of PM10.

13.
Int J Biol Sci ; 17(8): 2124-2134, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34131411

RESUMO

The efficacy of tocilizumab on the prognosis of severe/critical COVID-19 patients is still controversial so far. We aimed to delineate the inflammation characteristics of severe/critical COVID-19 patients and determine the impact of tocilizumab on hospital mortality. Here, we performed a retrospective cohort study which enrolled 727 severe or critical inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Huoshenshan Hospital (Wuhan, China), among which 50 patients received tocilizumab. This study confirmed that most recovered patients manifested relatively normal inflammation levels at admission, whereas most of the deceased cases presented visibly severe inflammation at admission and even progressed into extremely aggravated inflammation before their deaths, proved by some extremely high concentrations of interleukin-6, procalcitonin, C-reactive protein and neutrophil count. Moreover, based on the Cox proportional-hazards models before or after propensity score matching, we demonstrated that tocilizumab treatment could lessen mortality by gradually alleviating excessive inflammation and meanwhile continuously enhancing the levels of lymphocytes within 14 days for severe/critical COVID-19 patients, indicating potential effectiveness for treating COVID-19.


Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Tratamento Farmacológico da COVID-19 , Inflamação/tratamento farmacológico , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , COVID-19/sangue , COVID-19/mortalidade , COVID-19/fisiopatologia , Comorbidade , Feminino , Humanos , Inflamação/sangue , Interleucina-6/sangue , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pró-Calcitonina/sangue , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Retrospectivos
14.
BMC Cardiovasc Disord ; 21(1): 308, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154526

RESUMO

BACKGROUND: Circular RNA (circRNA) have been reported to play important roles in cardiovascular diseases including myocardial infarction and heart failure. However, the role of circRNA in atrial fibrillation (AF) has rarely been investigated. We recently found a circRNA hsa_circ_0099734 was significantly differentially expressed in the AF patients atrial tissues compared to paired control. We aim to investigate the functional role and molecular mechanisms of mmu_circ_0005019 which is the homologous circRNA in mice of hsa_circ_0099734 in AF. METHODS: In order to investigate the effect of mmu_circ_0005019 on the proliferation, migration, differentiation into myofibroblasts and expression of collagen of cardiac fibroblasts, and the effect of mmu_circ_0005019 on the apoptosis and expression of Ito, INA and SK3 of cardiomyocytes, gain- and loss-of-function of cell models were established in mice cardiac fibroblasts and HL-1 atrial myocytes. Dual-luciferase reporter assays and RIP were performed to verify the binding effects between mmu_circ_0005019 and its target microRNA (miRNA). RESULTS: In cardiac fibroblasts, mmu_circ_0005019 showed inhibitory effects on cell proliferation and migration. In cardiomyocytes, overexpression of mmu_circ_0005019 promoted Kcnd1, Scn5a and Kcnn3 expression. Knockdown of mmu_circ_0005019 inhibited the expression of Kcnd1, Kcnd3, Scn5a and Kcnn3. Mechanistically, mmu_circ_0005019 exerted biological functions by acting as a miR-499-5p sponge to regulate the expression of its target gene Kcnn3. CONCLUSIONS: Our findings highlight mmu_circ_0005019 played a protective role in AF development and might serve as an attractive candidate target for AF treatment.


Assuntos
Potenciais de Ação , Comunicação Celular , Fibroblastos/metabolismo , Frequência Cardíaca , Miócitos Cardíacos/metabolismo , RNA Circular/metabolismo , Animais , Linhagem Celular , Movimento Celular , Proliferação de Células , Transdiferenciação Celular , Técnicas de Cocultura , Fibroblastos/patologia , Humanos , Camundongos Endogâmicos C57BL , MicroRNAs/genética , MicroRNAs/metabolismo , Miócitos Cardíacos/patologia , Miofibroblastos/metabolismo , Miofibroblastos/patologia , Canal de Sódio Disparado por Voltagem NAV1.5/genética , Canal de Sódio Disparado por Voltagem NAV1.5/metabolismo , RNA Circular/genética , Canais de Potássio Shal/genética , Canais de Potássio Shal/metabolismo , Canais de Potássio Ativados por Cálcio de Condutância Baixa/genética , Canais de Potássio Ativados por Cálcio de Condutância Baixa/metabolismo
15.
BMC Pulm Med ; 21(1): 120, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33853568

RESUMO

BACKGROUND: During outbreak of Coronavirus Disease 2019 (COVID-19), healthcare providers are facing critical clinical decisions based on the prognosis of patients. Decision support tools of risk stratification are needed to predict outcomes in patients with different clinical types of COVID-19. METHODS: This retrospective cohort study recruited 2425 patients with moderate or severe COVID-19. A logistic regression model was used to select and estimate the factors independently associated with outcomes. Simplified risk stratification score systems were constructed to predict outcomes in moderate and severe patients with COVID-19, and their performances were evaluated by discrimination and calibration. RESULTS: We constructed two risk stratification score systems, named as STPCAL (including significant factors in the prediction model: number of clinical symptoms, the maximum body temperature during hospitalization, platelet count, C-reactive protein, albumin and lactate dehydrogenase) and TRPNCLP (including maximum body temperature during hospitalization, history of respiratory diseases, platelet count, neutrophil-to-lymphocyte ratio, creatinine, lactate dehydrogenase, and prothrombin time), to predict hospitalization duration for moderate patients and disease progression for severe patients, respectively. According to STPCAL score, moderate patients were classified into three risk categories for a longer hospital duration: low (Score 0-1, median = 8 days, with less than 20.0% probabilities), intermediate (Score 2-6, median = 13 days, with 30.0-78.9% probabilities), high (Score 7-9, median = 19 days, with more than 86.5% probabilities). Severe patients were stratified into three risk categories for disease progression: low risk (Score 0-5, with less than 12.7% probabilities), intermediate risk (Score 6-11, with 18.6-69.1% probabilities), and high risk (Score 12-16, with more than 77.9% probabilities) by TRPNCLP score. The two risk scores performed well with good discrimination and calibration. CONCLUSIONS: Two easy-to-use risk stratification score systems were built to predict the outcomes in COVID-19 patients with different clinical types. Identifying high risk patients with longer stay or poor prognosis could assist healthcare providers in triaging patients when allocating limited healthcare during COVID-19 outbreak.


Assuntos
Teste para COVID-19/métodos , COVID-19/diagnóstico , COVID-19/terapia , Regras de Decisão Clínica , Progressão da Doença , Hospitalização/estatística & dados numéricos , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica/métodos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Triagem/métodos , Adulto Jovem
16.
Nat Commun ; 12(1): 1442, 2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664265

RESUMO

Compact, low-noise microwave sources are required throughout a wide range of application areas including frequency metrology, wireless-communications and airborne radar systems. And the photonic generation of microwaves using soliton microcombs offers a path towards integrated, low noise microwave signal sources. In these devices, a so called quiet-point of operation has been shown to reduce microwave frequency noise. Such operation decouples pump frequency noise from the soliton's motion by balancing the Raman self-frequency shift with dispersive-wave recoil. Here, we explore the limit of this noise suppression approach and reveal a fundamental noise mechanism associated with fluctuations of the dispersive wave frequency. At the same time, pump noise reduction by as much as 36 dB is demonstrated. This fundamental noise mechanism is expected to impact microwave noise (and pulse timing jitter) whenever solitons radiate into dispersive waves belonging to different spatial mode families.

17.
Int J Cardiol ; 320: 83-89, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32603741

RESUMO

BACKGROUND: Chemokines play an important role in inflammation and atherosclerosis. However, little is known about the relationship between chemokines and the prognosis of atrial fibrillation (AF). This "real-world" cohort study was designed to observe the prognostic value of plasma CC motif chemokine ligand (CCL) 18, CCL23, CCL28, CXC motif chemokine ligand (CXCL) 14, CXCL16 in newly diagnosed AF patients. METHODS: Baseline plasma levels of chemokines were measured in a cohort with 299 AF patients using Bio-plex Pro™ xMAP arrays. A Cox proportional hazard model was used to evaluate the associations of chemokines with AF outcomes. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated to evaluate the improvement of chemokines to CHA2DS2-VASc score. RESULTS: High CCL18 (hazard ratio [HR] 2.65, 95% confidence interval [CI] 1.18-5.98, P = 0.019) and CCL23 levels (HR 2.78, 95%CI 1.07-7.22, P = 0.036) were associated with stroke in AF patient. Patients with low CXCL14 (HR 0.39, 95%CI 0.15-0.97, P = 0.042) and high CXCL16 levels (HR 3.02, 95%CI 1.39-6.58, P = 0.005) have increased risk of all-cause mortality. High CCL16 levels (HR 5.41, 95%CI 2.32-12.63, P < 0.001) were associated with cardiovascular death. However, CCL28 had no significant association with outcomes. Adding chemokines to CHA2DS2-VASc score increased the reclassification and clinical net benefit. CONCLUSIONS: Plasma levels of CCL18, CCL23, CXCL14, and CXCL16 were independently associated with AF outcomes. Chemokines added to CHA2DS2-VASc score significantly enhanced risk assessment for the outcomes. Incorporation of chemokines into clinical decisions may help the management of AF treatment.


Assuntos
Fibrilação Atrial , Acidente Vascular Cerebral , Fibrilação Atrial/diagnóstico , Quimiocinas , Estudos de Coortes , Humanos , Prognóstico , Medição de Risco , Fatores de Risco
18.
Nat Commun ; 11(1): 1610, 2020 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-32235844

RESUMO

Exceptional points are singularities of open systems, and among their many remarkable properties, they provide a way to enhance the responsivity of sensors. Here we show that the improved responsivity of a laser gyroscope caused by operation near an exceptional point is precisely compensated by increasing laser noise. The noise, of fundamental origin, is enhanced because the laser mode spectrum loses the oft-assumed property of orthogonality. This occurs as system eigenvectors coalesce near the exceptional point and a bi-orthogonal analysis confirms experimental observations. While the results do not preclude other possible advantages of the exceptional-point-enhanced responsivity, they do show that the fundamental sensitivity limit of the gyroscope is not improved through this form of operation. Besides being important to the physics of microcavities and non-Hermitian photonics, these results help clarify fundamental sensitivity limits in a specific class of exceptional-point sensor.

19.
Nature ; 576(7785): 65-69, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31802018

RESUMO

Exceptional points (EPs) are special spectral degeneracies of non-Hermitian Hamiltonians that govern the dynamics of open systems. At an EP, two or more eigenvalues, and the corresponding eigenstates, coalesce1-3. Recently, it was predicted that operation of an optical gyroscope near an EP results in improved response to rotations4,5. However, the performance of such a system has not been examined experimentally. Here we introduce a precisely controllable physical system for the study of non-Hermitian physics and nonlinear optics in high-quality-factor microresonators. Because this system dissipatively couples counter-propagating lightwaves within the resonator, it also functions as a sensitive gyroscope for the measurement of rotations. We use our system to investigate the predicted EP-enhanced Sagnac effect4,5 and observe a four-fold increase in the Sagnac scale factor by directly measuring rotations applied to the resonator. The level of enhancement can be controlled by adjusting the system bias relative to the EP, and modelling results confirm the observed enhancement. Moreover, we characterize the sensitivity of the gyroscope near the EP. Besides verifying EP physics, this work is important for the understanding of optical gyroscopes.

20.
ACS Nano ; 13(3): 3106-3116, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30776213

RESUMO

Thin films with large compressive residual stress and low interface adhesion can buckle and delaminate from relatively rigid substrates, which is a common failure mode of film/substrate interfaces. Current studies mainly focused on the geometry of various buckling patterns and related physical origins based on a static point of view. However, fundamental understanding of dynamic propagation of buckles, particularly for the complicated web buckles, remains challenging. We adopt strained two-dimensional MoS2 thin films to study the phenomenon of web buckling because their interface adhesion, namely van der Waals interaction, is naturally low. With a delicately site-controlled initiation, web buckles can be triggered and their dynamic propagation is in situ observed facilely. Finite element modeling shows that the formation of web buckles involves the propagation and multilevel branching of telephone-cord blisters. These buckled semiconducting films can be patterned by spatial confinement and potentially used in diffuse-reflective coatings, microfluidic channels, and hydrogen evolution reaction electrodes. Our work not only reveals the hidden mechanisms and kinematics of propagation of web buckles on rigid substrates but also sheds light on the development of semiconducting devices based on buckling engineering.

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