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1.
J Chem Phys ; 160(18)2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38738613

RESUMO

Metal ion-induced water pollution is attracting increasing public attention. Perovskite quantum dots and metal-organic frameworks (MOFs), owing to their outstanding properties, hold promise as ideal probes for detecting metal ions. In this study, a composite material, MAPbBr3@PCN-221(Fe), was prepared by encapsulating MAPbBr3 quantum dots with PCN-221(Fe), demonstrating high chemical stability and good reusability. The composite material shows a sensitive fluorescence turn-on signal in the presence of silver ions. The fluorescence intensity of the composite material exhibits a linear relationship with the concentration of Ag+ in the solution, with a low detection limit of 8.68 µM. Moreover, the fluorescence signal exhibits a strong selectivity for Ag+, enabling the detection of Ag+ concentration. This fluorescence turn-on signal originates from the Ag+-bridged energy transfer from the conductive band of MAPbBr3 to the excited state of the MOF, which is directly proportional to the concentration of silver ions. Simultaneously, this finding may open up a new possibility in artificial controlled energy transfer from perovskite to MOF for future development.

3.
ACS Nano ; 18(11): 8496-8510, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38456818

RESUMO

Designing three-dimensional (3D) porous carbonaceous skeletons for K metal is one of the most promising strategies to inhibit dendrite growth and enhance the cycle life of potassium metal batteries. However, the nucleation and growth mechanism of K metal on 3D skeletons remains ambiguous, and the rational design of suitable K hosts still presents a significant challenge. In this study, the relationships between the binding energy of skeletons toward K and the nucleation and growth of K are systematically studied. It is found that a high binding energy can effectively decrease the nucleation barrier, reduce nucleation volume, and prevent dendrite growth, which is applied to guide the design of 3D current collectors. Density functional theory calculations show that P-doped carbon (P-carbon) exhibits the highest binding energy toward K compared to other elements (e.g., N, O). As a result, the K@P-PMCFs (P-binding porous multichannel carbon nanofibers) symmetric cell demonstrates an excellent cycle stability of 2100 h with an overpotential of 85 mV in carbonate electrolytes. Similarly, the perylene-3,4,9,10-tetracarboxylic dianhydride || K@P-PMCFs cell achieves ultralong cycle stability (85% capacity retention after 1000 cycles). This work provides a valuable reference for the rational design of 3D current collectors.

4.
Adv Mater ; 36(15): e2310347, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38174663

RESUMO

Anode-free sodium metal battery (AFSMB) promises high energy density but suffers from the difficulty of maintaining high cycling stability. Nonuniform sodium (Na) deposition on the current collector is largely responsible for capacity decay in the cycling process of AFSMB. Here, a unique copper phosphide (Cu3P) nanowire is constructed on copper (Cu3P@Cu) as a sodium deposition substrate by an in situ growth method. Superior electrochemical performance of Cu3P@Cu anode is delivered in asymmetric cells with an average Coulombic efficiency of 99.8% for over 800 cycles at 1 mA cm-2 with 1 mA h cm-2. The symmetric cell of Cu3P@Cu displayed a cycling lifespan of over 2000 h at 2 mA cm-2 with 1 mA h cm-2. Cryo-transmission electron microscope characterization and first principles calculation revealed that the low Na+ absorption energy and low Na+ diffusion energy barrier on Na3P promoted uniform Na nucleation and deposition, thus enhancing the Na surface stability. Moreover, anode-free Na3V2(PO4)3//Cu3P@Cu full pouch cell delivered a considerable cycling capacity of ≈15 mA h in 170 cycles, demonstrating its practical feasibility.

5.
Nanoscale ; 16(5): 2621-2631, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38226862

RESUMO

A heterojunction of CdSe quantum dots in situ grown on the perovskite CsPb2Br5 (CsPb2Br5/CdSe) for water-stable photoelectrochemical (PEC) sensing was simply synthesized using the hot-injection method. Due to the inherent built-in electric field and the matching band structure between CsPb2Br5 and CdSe, the CsPb2Br5/CdSe p-n heterojunction demonstrates enhanced photoelectrochemical properties. Accelerated interfacial charge transfer and increased electron-hole pair separation enable hydrolysis-resistant CsPb2Br5/CdSe sensors to exhibit heightened sensitivity with an ultra-low detection limit (0.0124 µM) and a wide linear range (0.4-303.9 µM) in subsequent dopamine detection. Moreover, the CsPb2Br5/CdSe sensors show excellent anti-interference ability, as well as remarkable stability and reproducibility in water solvent. It is noteworthy that this work is conducted in an aqueous environment, which provides an inspiring and convenient way for photoelectric and photoelectrocatalysis applications based on water-resistant perovskites.

6.
Nat Commun ; 14(1): 8269, 2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38092794

RESUMO

Reactive negative electrodes like lithium (Li) suffer serious chemical and electrochemical corrosion by electrolytes during battery storage and operation, resulting in rapidly deteriorated cyclability and short lifespans of batteries. Li corrosion supposedly relates to the features of solid-electrolyte-interphase (SEI). Herein, we quantitatively monitor the Li corrosion and SEI progression (e.g., dissolution, reformation) in typical electrolytes through devised electrochemical tools and cryo-electron microscopy. The continuous Li corrosion is validated to be positively correlated with SEI dissolution. More importantly, an anti-corrosion and interface-stabilizing artificial passivation layer comprising low-solubility polymer and metal fluoride is designed. Prolonged operations of Li symmetric cells and Li | |LiFePO4 cells with reduced Li corrosion by ~74% are achieved (0.66 versus 2.5 µAh h-1). The success can further be extended to ampere-hour-scale pouch cells. This work uncovers the SEI dissolution and its correlation with Li corrosion, enabling the durable operation of Li metal batteries by reducing the Li loss.

7.
Rev Sci Instrum ; 94(4)2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38081248

RESUMO

We have developed a rapid detection instrument to characterize the behavior of light on the surface of devices during light-matter interactions. The equipment enables the non-destructive and real-time observations of the dispersion curves for microstructures, providing the basis for a large number of new planar photonic chip applications. The method is based on the traditional prismatic reflection and makes full use of the grating dispersion capabilities, enabling simultaneous multi-wavelength and multi-angle reflectance measurements over a wide range. This method is beneficial for designing new microstructure devices and brings convenience to delicate microstructure processing. The instruments do not require any mechanical scanning, allowing for rapid acquisition, and the integrated and reusable optics make them easily miniaturized. Additionally, the functionalized design allows for spectral analysis applications, such as far-field spectral measurements. The instrument can also be easily integrated into established microscopic imaging systems, extending their observational characterization capabilities as well as accomplishing dynamic monitoring in proven system-on-a-chip devices.

8.
Adv Sci (Weinh) ; 10(30): e2301724, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37675807

RESUMO

Helicobacter pylori (H. pylori) causes infection in the stomach and is a major factor for gastric carcinogenesis. The application of antimicrobial peptides (AMPs) as an alternative treatment to traditional antibiotics is limited by their facile degradation in the stomach, their poor penetration of the gastric mucosa, and the cost of peptide production. Here, the design and characterization of a genetically encoded H. pylori-responsive microbicidal protein crystal Cry3Aa-MIIA-AMP-P17 is described. This designed crystal exhibits preferential binding to H. pylori, and when activated, promotes the targeted release of the AMP at the H. pylori infection site. Significantly, when the activated Cry3Aa-MIIA-AMP-P17 crystals are orally delivered to infected mice, the Cry3Aa crystal framework protects its cargo AMP against degradation, resulting in enhanced in vivo efficacy against H. pylori infection. Notably, in contrast to antibiotics, treatment with the activated crystals results in minimal perturbation of the mouse gut microbiota. These results demonstrate that engineered Cry3Aa crystals can serve as an effective platform for the oral delivery of therapeutic peptides to treat gastrointestinal diseases.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Animais , Camundongos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/metabolismo , Estômago , Mucosa Gástrica/metabolismo , Antibacterianos
9.
Int J Surg ; 109(10): 3159-3168, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37318877

RESUMO

PURPOSE: Bertolotti's syndrome is a prevalent congenital deformity. However, many physicians fail to include it in their differential diagnosis for low back pain (LBP), which results in missed diagnosis or misdiagnosis. There is still a lack of standardized treatment and management strategies for Bertolotti's syndrome. This study aimed to review the clinical characteristics and management of Bertolotti's syndrome and reports bibliometric insights in advancements in Bertolotti's syndrome research. METHODS: Studies published until 30 September 2022 were systematically reviewed according to the PRISMA guidelines. Three independent reviewers extracted the data and assessed the quality and risk of bias of the studies based on the methodological index of non-randomized studies (MINORS). SPSS, VOS viewer, and the Citespace software were used for the systematic review, visual analysis, data mining, mapping, and clustering of the retrieved articles, which presented clear and visual presentations of the structural patterns of published research in graphs. RESULT: A total of 118 articles, describing a total of 419 patients with Bertolotti's syndrome, were included. There was an upward trend with a steady increase in the number of publications. The world map distribution showed that most publications were predominantly from North America and Asia. The most cited articles were published in the following journals: Spine, J Bone Joint Surg, and Radiology. The mean age of the patients was 47.7 years, and 49.6% of them were male. A total of 159 (96.4%) patients had LBP symptoms. The mean symptom duration was 41.4 months (74.8%), and most of the patients had Castellvi type II. Disc degeneration was the most reported comorbid spinal diseases. The mean methodological index of non-randomized studies score was 4.16±3.95 points (range, 1-21). A total of 265 (68.3%) patients underwent surgical treatments. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration were the current main research areas of Bertolotti's syndrome. CONCLUSIONS: The steady increase in the number of publications demonstrated the increased attention of researchers on this topic. Our results showed a significant prevalence of Bertolotti's syndrome in patients with LBP and a long symptom duration before the initiation of treatment. Surgical treatments were commonly used to treat patients with Bertolotti's syndrome after a non-effective conservative treatment. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration are the major research areas of Bertolotti's syndrome.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Dor Lombar/terapia , Vértebras Lombares/cirurgia , Radiografia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
10.
Small ; 19(42): e2303210, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37330662

RESUMO

The use of poly(1,3-dioxolane) (PDOL) electrolyte for lithium batteries has gained attention due to its high ionic conductivity, low cost, and potential for large-scale applications. However, its compatibility with Li metal needs improvement to build a stable solid electrolyte interface (SEI) toward metallic Li anode for practical lithium batteries. To address this concern, this study utilized a simple InCl3 -driven strategy for polymerizing DOL and building a stable LiF/LiCl/LiIn hybrid SEI, confirmed through X-ray photoelectron spectroscopy (XPS) and cryogenic-transmission electron microscopy (Cryo-TEM). Furthermore, density functional theory (DFT) calculations and finite element simulation (FES) verify that the hybrid SEI exhibits not only excellent electron insulating properties but also fast transport properties of Li+ . Moreover, the interfacial electric field shows an even potential distribution and larger Li+ flux, resulting in uniform dendrite-free Li deposition. The use of the LiF/LiCl/LiIn hybrid SEI in Li/Li symmetric batteries shows steady cycling for 2000 h, without experiencing a short circuit. The hybrid SEI also provided excellent rate performance and outstanding cycling stability in LiFePO4 /Li batteries, with a high specific capacity of 123.5 mAh g-1 at 10 C rate. This study contributes to the design of high-performance solid lithium metal batteries utilizing PDOL electrolytes.

11.
Small ; 19(44): e2304094, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37386782

RESUMO

Aqueous rechargeable zinc-based batteries (ZBBs) are emerging as desirable energy storage systems because of their high capacity, low cost, and inherent safety. However, the further application of ZBBs still faces many challenges, such as the issues of uncontrolled dendrite growth and severe parasitic reactions occurring at the Zn anode. Herein, an amino-grafted bacterial cellulose (NBC) film is prepared as artificial solid electrolyte interphase (SEI) for the Zn metal anodes, which can significantly reduce zinc nucleation overpotential and lead to the dendrite-free deposition of Zn metal along the (002) crystal plane more easily without any external stimulus. More importantly, the chelation between the modified amino groups and zinc ions can promote the formation of an ultra-even amorphous SEI upon cycling, reducing the activity of hydrate ions, and inhibiting the water-induced side reactions. As a result, the Zn||Zn symmetric cell with NBC film exhibits lower overpotential and higher cyclic stability. When coupled with the V2 O5 cathode, the practical pouch cell achieves superior electrochemical performance over 1000 cycles.

12.
Foods ; 12(9)2023 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-37174300

RESUMO

Pathogenic variants of Burkholderia gladioli pose a serious threat to human health and food safety, but there is a lack of rapid and sensitive field detection methods for Burkholderia gladioli. In this study, the CRISPR/Cas12a system combined with recombinant enzyme polymerase amplification (RPA) was used to detect Burkholderia gladioli in food. The optimized RPA-CRISPR/Cas12a assay was able to specifically and stably detect Burkholderia gladioli at a constant 37 °C without the assistance of large equipment. The detection limit of the method was evaluated at two aspects, the genomic DNA (gDNA) level and bacterial quantity, of which there were 10-3 ng/µL and 101 CFU/mL, respectively. Three kinds of real food samples were tested. The detection limit for rice noodles, fresh white noodles, and glutinous rice flour samples was 101 CFU/mL, 102 CFU/mL, and 102 CFU/mL, respectively, without any enrichment steps. The whole detection process, including sample pretreatment and DNA extraction, did not exceed one hour. Compared with the qPCR method, the established RPA-CRISPR /Cas12a method was simpler and even more sensitive. Using this method, a visual detection of Burkholderia gladioli that is suitable for field detection can be achieved quickly and easily.

13.
Small ; 19(19): e2207540, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36755179

RESUMO

Sodium (Na) metal is able to directly use as a battery anode but have a highly reductive ability of unavoidably occurring side reactions with organic electrolytes, resulting in interfacial instability as a primary factor in performance decay. Therefore, building stable Na metal anode is of utmost significance for both identifying the electrochemical performance of laboratory half-cells employed for quantifying samples and securing the success of room-temperature Na metal batteries. In this work, we propose an NaF-rich interface rapidly prepared by pressure and diglyme-induced defluorination reaction for stable Na metal anode. Once the electrolyte is dropped into the coin-type cells followed by a slight squeeze, the Na metal surface immediately forms a protective layer consisting of amorphous carbon and NaF, effectively inhibiting the dendrite growth and dead Na. The resultant Na metal anode exhibits a long-term cycling lifespan over 1800 h even under the area capacity of 3.0 mAh cm-2 . Furthermore, such a universal and facile method is readily applied in daily battery assembly regarding Na metal anode.

14.
World Neurosurg ; 2023 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-36841533

RESUMO

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.

15.
Small ; 19(15): e2207742, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36610025

RESUMO

In consideration of high specific capacity and low redox potential, lithium metal anodes have attracted extensive attention. However, the cycling performance of lithium metal batteries generally deteriorates significantly under the stringent conditions of high temperature due to inferior heat tolerance of the solid electrolyte interphase (SEI). Herein, controllable SEI nanostructures with excellent thermal stability are established by the (trifluoromethyl)trimethylsilane (TMSCF3 )-induced interface engineering. First, the TMSCF3 regulates the electrolyte decomposition, thus generating an SEI with a large amount of LiF, Li3 N, and Li2 S nanocrystals incorporated. More importantly, the uniform distributed nanocrystals have endowed the SEI with enhanced thermostability according to the density functional theory simulations. Particularly, the sub-angstrom visualization on SEI through a conventional transmission electron microscope (TEM) is realized for the first time and the enhanced tolerance to the heat damage originating from TEM imaging demonstrates the ultrahigh thermostability of SEI. As a result, the highly thermostable interphase facilitates a substantially prolonged lifespan of full cells at a high temperature of 70 °C. As such, this work might inspire the universal interphase design for high-energy alkali-metal-based batteries applicated in a high-temperature environment.

16.
J Org Chem ; 88(12): 7800-7809, 2023 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-36417355

RESUMO

Here we uncovered that the dienones generated from the Morita-Baylis-Hillman carbonates of 2-cyclopentenone under Pd(0) catalysis could be umpolunged by regioselectively forming η2-Pd(0) complexes via π-Lewis base activation, and underwent asymmetric inverse-electron-demand oxa-Diels-Alder reaction with α-cyano chalcones. An array of fused pyran frameworks with dense substitutions was constructed with excellent stereoselectivity (up to 99% ee, >19:1 dr), which could be elaborated to access enantioenriched architectures with higher molecular complexity.


Assuntos
Elétrons , Paládio , Estrutura Molecular , Estereoisomerismo , Reação de Cicloadição , Carbonatos , Catálise
17.
Eur Spine J ; 32(1): 228-243, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36372842

RESUMO

PURPOSE: Lung cancer is one of the most common malignant tumors. Most patients develop spinal metastases during the course of cancer and suffer skeletal-related events. Currently, no consensus has been reached on the prognostic factors in patients undergoing surgeries. This study aimed to answer two questions: (1) what are the effects of surgical intervention, and (2) what are the factors associated with postoperative survival. METHODS: Searches were performed on electronic databases including PubMed, Ovid/MEDLINE, Cochrane, and Scopus for articles published before February of 2022, involving the survival factors of patients with spinal metastasis. Multiple data items were considered, such as baseline demographics, surgical details, clinical outcome, and prognostic factors. The analysis was performed in Review Manager (RevMan) 5.5. The prognostic factors of survival were analyzed with univariate and multivariate cox regression analysis. RESULTS: Finally, 14 studies with 813 patients were identified. Their 6, 12, and 24 months survival rates ranged from 18 to 58%, 18 to 22.4%, and 0 to 58.5%, respectively. The pooled hazard ratio of preoperative ambulatory status and the number of involved vertebrae demonstrated statistical significance, while no significant prognostic effect on the overall survival was found for targeted therapy, visceral metastases, chemotherapy, radiotherapy, or postoperative ambulatory status. CONCLUSION: Overall, surgical intervention could achieve significant pain relief and neurological function improvements. For patients receiving surgery for spinal metastasis from lung cancer, preoperative ambulatory status and the number of involved vertebrae were significant prognostic factors associated with their survival.


Assuntos
Neoplasias Pulmonares , Neoplasias da Coluna Vertebral , Humanos , Prognóstico , Neoplasias da Coluna Vertebral/secundário , Neoplasias Pulmonares/cirurgia , Coluna Vertebral/patologia , Análise Multivariada , Estudos Retrospectivos
18.
Artigo em Inglês | MEDLINE | ID: mdl-33685890

RESUMO

We have designed, synthesized, and characterized a library of 38 novel flavonoid compounds linked with amines. Some of these amine-linked flavonoids have potent in vitro activity against parasites that cause cutaneous leishmaniasis, a tropical disease endemic in 80 countries worldwide. The most promising candidate, FM09h, was highly active with IC50 of 0.3 µM against L. amazonensis, L. tropica and L. braziliensis amastigotes. It was metabolically stable (39% and 66% of FM09h remaining after 30-minute incubation with human and rat liver microsomes respectively). In L. amazonensis LV78 cutaneous leishmaniasis mouse model, intralesional injection of FM09h (10 mg/kg, once every 4 days for 8 times) demonstrated promising effect in reducing the footpad lesion thickness by 72%, displaying an efficacy comparable to SSG (63%).

19.
Journal of Preventive Medicine ; (12): 803-806, 2023.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-997166

RESUMO

Objective@#To investigate the epidemiological characteristics of 45 norovirus clusters in Baoshan District, Shanghai Municipality from 2019 to 2021, so as to provide the evidence for improving the management of norovirus clusters. @*Methods@#The epidemiological characteristics and laboratory testing of 45 norovirus clusters were collected in Baoshan District from 2019 to 2021, and the temporal distribution, population distribution, distribution of places of norovirus clusters, clinical manifestations, laboratory testing results, origin of norovirus infection and transmission routes of norovirus clusters were analyzed using a descriptive epidemiological method. @*Results@#A total of 45 norovirus clusters involving 29 379 individuals were reported in Baoshan District from 2019 to 2021, and 435 cases with norovirus infections were identified, with an average attack rate of 1.48%. Norovirus infection most often occurred from November to April of the following year, and the infection predominantly occurred among students (408 cases, 93.79%). There were 25 norovirus clusters in kindergartens (55.56%), 18 clusters in primary and middle schools (40.00%), one cluster in a social care facility and one cluster in a geriatric ward. Vomiting was the predominant clinical symptom (416 cases, 95.63%). The positive rate of norovirus was 37.35% in 597 samples. There were 40 norovirus clusters caused by the norovirus GⅡ genotype (88.89%), and the median duration of the norovirus cluster was 6 days (interquartile range, 1 day). In addition, 82.22% of the norovirus clusters reported to centers for disease control and prevention within 1 day,and 88.89% of the clusters were transmitted through human to human transmission or vomitus of cases.@*Conclusion@#The norovirus clusters predominantly occur in winter/spring and among students in Baoshan District from 2019 to 2021. Kindergartens and primary and middle schools are main places of norovirus infections, and the norovirus GⅡ genotype is the main type of pathogens. Human-to-human transmission and exposure to patients' vomitus are the main routes of transmission.

20.
Front Oncol ; 12: 1075217, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568214

RESUMO

Purpose: Patients with lung cancer with bone metastasis (LCBM) often have a very poor prognosis. The purpose of this study is to characterize the prevalence and associated factors and to develop a prognostic nomogram to predict the overall survival (OS) and cancer-specific survival (CSS) for patients with LCBM using multicenter population-based data. Methods: Patients with LCBM at the time of diagnosis were identified using the Surveillance, Epidemiology, and End Results (SEER) Program database of the National Cancer Institute (NCI) from 2010 to 2015. Multivariable and univariate logistic regression analyses were performed to identify factors associated with all-cause mortality and lung cancer (LC)-specific mortality. The performance of the nomograms was evaluated with the calibration curves, area under the curve (AUC), and decision curve analysis (DCA). Kaplan-Meier analysis and log-rank tests were used to estimate the survival times of patients with LCBM. Results: We finally identified 26,367 patients with LCBM who were selected for survival analysis. Multivariate analysis demonstrated age, sex, T stage, N stage, grade, histology, radiation therapy, chemotherapy, primary site, primary surgery, liver metastasis, and brain metastasis as independent predictors for LCBM. The AUC values of the nomogram for the OS prediction were 0.755, 0.746, and 0.775 in the training cohort; 0.757, 0.763, and 0.765 in the internal validation cohort; and 0.769, 0.781, and 0.867 in the external validation cohort. For CSS, the values were 0.753, 0.753, and 0.757 in the training cohort; 0.753, 0.753, and 0.757 in the internal validation cohort; and 0.767, 0.774, and 0.872 in the external validation cohort. Conclusions: Our study constructs a new prognostic model and clearly presents the clinicopathological features and survival analysis of patients with LCBM. The result indicated that the nomograms had favorable discrimination, good consistency, and clinical benefits in patients. In addition, our constructed nomogram prediction models may assist physicians in evaluating individualized prognosis and deciding on treatment for patients.

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