Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to success...Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.展开更多
Two classes of rate controlling medications—beta blockers (BBs) and non- dihydropyridine calcium channel blockers (CCBs)—are given to patients who present with atrial fibrillation (AF) with rapid ventricular respons...Two classes of rate controlling medications—beta blockers (BBs) and non- dihydropyridine calcium channel blockers (CCBs)—are given to patients who present with atrial fibrillation (AF) with rapid ventricular response (RVR). Both are Class I recommendations from the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS) for the management of AF with RVR. Multiple studies support the view that diltiazem is more effective than metoprolol, even though data from the AFFIRM trial suggests BBs are more frequently used. CCBs are generally avoided in AF with RVR patients who have concomitant heart failure with reduced ejection fraction (HFrEF) for concern of triggering decompensation. However, some recent studies indicate this idea may be unfounded. The aim of this article is to compare the efficacy of diltiazem and metoprolol for rate control in AF with RVR and examine the use of diltiazem in patients with both AF with RVR and HFrEF.展开更多
Acrylonitrile (AN) was copolymerized with N-isopropylacrylamide (NIPA) to synthesize thermosensitive hy-drogels, and the on-off switch behavior of poly(NIPA-co-AN) hydrogels with different fraction of hydrophobic comp...Acrylonitrile (AN) was copolymerized with N-isopropylacrylamide (NIPA) to synthesize thermosensitive hy-drogels, and the on-off switch behavior of poly(NIPA-co-AN) hydrogels with different fraction of hydrophobic compo-nent (AN) was investigated. It is found that the lower critical solution temperature (LCST), the swelling ratio at certain temperature and the reswelling rate of poly(NIPA-co-AN) hydrogels decreased as AN unit fraction in copolymers in-creased. In order to improve the responsive rate of poly(NIPA-co-AN) hydrogels, they were further treated by surface crosslinking using N, N′-methylene bisacrylamide (BIS) as a crosslinking agent. The swelling and deswelling behaviors of these copolymers were compared with those of the untreated hydrogels. The results indicated that the responsive rate of poly(NIPA-co-AN) hydrogel was improved by surface crosslinking. The resulting hydrogels bearing cyano groups with fast response have potential applications in the field of drug-controlled release and immobilization of biomolecules.展开更多
Organic–inorganic single-crystalline perovskites have attracted significant attentions due to their exceptional progress in intrinsic properties＇ investigation and applications in photovoltaics and optoelectronics. ...Organic–inorganic single-crystalline perovskites have attracted significant attentions due to their exceptional progress in intrinsic properties＇ investigation and applications in photovoltaics and optoelectronics. In this study, the large perovskite CH3NH3PbI3 single crystal with the largest length of 80 mm was prepared through the method of inverse-temperature crystallization. Meanwhile, the mass production of integrate photodetectors have been fabricated on the single-crystalline wafer and the photoresponse performances were investigated. The results show that the single-crystalline photodetectors have broad spectrum response to 900 nm, rapid response speed（〈40 μs） and excellent stability. These findings are of great importance for future promising perovskite single crystalline for integrated photoelectronic application.展开更多
A new chance of developing traditional manufacturing industry comes forth with the development of network technology. Application technology oriented rapid response manufacturing in the distributed network environment...A new chance of developing traditional manufacturing industry comes forth with the development of network technology. Application technology oriented rapid response manufacturing in the distributed network environments, that is, how to take advantage of the Intranet and Internet, combine the numerous manufacturing resources spread around the region, the country and even the globe is the key to the agile design, manufacturing and the buildup of comprehensively competitive power, at the same time, is also an important research direction in the field of advanced manufacturing technology. Rapid response manufacturing in the distributed network environment is a newly manufactory pattern that can be used to implement the conception of agile design and manufacturing, but there are some new problems coming with it, which will directly influence the enterprise’s ability of rapid response in the distributed network manufacturing pattern and lead to the failure of the league and the lost of the given orders. In this paper, we establish some approaches to solve these problems in product development process. The paper then presents the research on key application technologies and solutions includes: network safety strategy which guarantees data transferring among the leaguer members, production data management based on Web/DOT (Distributed Object Technology) and XML criteria which guarantees data exchange in structure-variance characteristic environments, the network platform which provides the conversion service of different types of CAD files each other. All of these solutions are aim for technology problems existing in the distributed network environments and among the league members. Finally, the paper takes one project, that is, the establishment of the online application service system for Shanghai Advance Manufacturing Technology Research Center as a good instance.展开更多
A new flame detector with one ultraviolet and two infrared detectors is designed. The ultraviolet detector is of rapid response(≤10 μs) while the two infrared detectors usually have a response time of more than 5 ms...A new flame detector with one ultraviolet and two infrared detectors is designed. The ultraviolet detector is of rapid response(≤10 μs) while the two infrared detectors usually have a response time of more than 5 ms. The ultraviolet detector is applied to deal with the flame of large scales. When facing the flame of mid or small scales, the three detectors cooperate. Employing the high-order derivatives of the sample data of the infrared circuits to improve the sensitivity, the response speed is greatly improved. The data of the temperature sensor is used to adjust circuit parameters in real time, thus reducing the effect of temperature drift. The flame detectors are tested at different distances and the response time is as rapid as 0.65 ms. The test results show that the new flame detector has the characteristics of high speed and a low rate of false alarms.展开更多
Objectives:This study aimed to study the characteristics of in-hospital deterioration in patients with congenital heart disease who required rapid response system activation and identify risk factors associated with 1...Objectives:This study aimed to study the characteristics of in-hospital deterioration in patients with congenital heart disease who required rapid response system activation and identify risk factors associated with 1-month mortality.Methods:We retrospectively analysed data from a Japanese rapid response system registry with 35 participating hospitals.We included consecutive patients with congenital heart disease who required rapid response system activation between January 2014 and March 2018.Logistic regression analyses were performed to examine the associations between 1-month mortality and other patient-specific variables.Results:Among 9,607 patients for whom the rapid response system was activated,only 82(0.9%)had congenital heart disease.Only few patients with congenital heart disease were being treated at the cardiology and cardiovascular surgery departments(12.3%and 9.9%,respectively).Moreover,the incidences of rapid-response events after intensive care unit discharge or surgery were low(6.8% and 12.2%,respectively).The most common reason for rapid response system activation was respiratory dysfunction(desaturation:35.4%,tachypnoea:25.6%,and new dyspnoea:19.5%).Rapid response system interventions and intensive care unit transfers were required for 65.9% and 20.7%of patients,respectively.The mortality rate was 1.2% at the end of the rapid response system intervention and 11.0% after 1 month.Moreover,decreased respiratory rate and decreased heart rate at rapid response system activation were associated with increased 1-month mortality.The adjusted odds ratio was 1.10(95% confidence interval 1.02–1.19)and 1.02(95% confidence interval,1.00–1.04) for respiratory rate and heart rate,respectively.Conclusions:Rapid response systems were rarely activated after cardiac surgery and intensive care unit discharge,which were situations with a high risk of sudden deterioration in patients with congenital heart disease.Therefore,encouraging the use of the rapid response system in these departments will enable intervention by a third,specialised team for in-hospital emergencies and help provide comprehensive medical care to patients.Furthermore,1-month mortality was associated with vital signs at rapid response system activation.These findings may guide treatment selection for patients with congenital heart disease showing deterioration.展开更多
Introduction: Monitoring vital signs is a basic indicator of a patient’s health status and allows prompt detection of delayed recovery or adverse effects and early intervention. Patients with adverse events during ho...Introduction: Monitoring vital signs is a basic indicator of a patient’s health status and allows prompt detection of delayed recovery or adverse effects and early intervention. Patients with adverse events during hospitalization often display clinical decline for several hours before the event is observed. Non-critical care Nurses’ inconsistent recognition and response to patient deterioration lead to an increase in the length of hospital stay, unexpected admissions to the ICU, and increased morbidity and mortality. Aim: The study aimed to assess the factors that facilitate or impede the detection of early warning signs among adult patients hospitalized in tertiary care settings. Training should be provided to improve nurses’ knowledge, practice and attitude toward early warning signs of deteriorating patients leading to enhanced clinical judgment, skills and decision-making in addressing alerts. Methodology: A literature search was carried out in various databases;these were Cumulative Index to Nursing and Allied Health Literature (CINHAL), Google Scholar, PubMed, Science Direct, and Sage. The search area was narrowed from 2017 to 2022. The keywords used were “prevalence” AND “unplanned ICU admission”, “the importance of early warning signs” “outcome failure in rescue” “patient deterioration, communication” “improvement in early detection” AND “patient outcome admission” AND “early warning signs” AND “Pakistan”. After the analysis process, around 33 articles that met the inclusion criteria and were most relevant to the scope and context of the current study were considered. Conclusion: Most of the studies had reviewed literature in a qualitative retrospective observational study, content analysis, mixed method, and quasi-experimental study. The literature review identified that long hours of shift, nurse staffing levels, missed vital signs, lack of nursing training and education, and communication impact nurses’ ability to recognize and respond to early warning signs.展开更多
AIM To investigate peg-interferon(peg-IFN) and ribavirin(RBV) therapy in Myanmar and to predict sustained virologic response(SVR).METHODS This single-center, open-label, study was conducted in Myanmar between 2009 and...AIM To investigate peg-interferon(peg-IFN) and ribavirin(RBV) therapy in Myanmar and to predict sustained virologic response(SVR).METHODS This single-center, open-label, study was conducted in Myanmar between 2009 and 2014. A total of 288 patients infected with HCV genotypes 1, 2, 3 and 6 were treated with peg-IFN alpha-2a(180 μg/wk) or alpha-2b(50 to 100 μg as a weight-based dose) and RBV as a weight-based dose(15 mg/kg/d). Treatment duration was 48 wk for genotypes 1 and 6, 24 wk for genotype 2, and 24 or 48 wk for genotype 3 based on rapid virologic response(RVR). Those co-infected with hepatitis B received 48 wk of therapy.RESULTS Overall, SVR was achieved for 82% of patients and the therapy was well tolerated. All patients achieved SVR at equivalent rates regardless of HCV genotype(P = 0.314). Low fibrosis scores(P < 0.001), high baseline albumin levels(P = 0.028) and low baseline viral loads(P = 0.029) all independently predicted SVR. On the other hand, IL-28 B TT and CC genotypes were not found to significantly predict SVR(P = 0.634; P = 0.618). Among those who completed treatment, the occurrence of RVR showed a > 96% positive predictive value for achieving SVR. Treatment duration did not significantly impact the likelihood of achieving SVR for patients infected with genotype 3 HCV(P = 0.371). The most common adverse events were fatigue(71%) and poor appetite(60%). Among patients with genotype 3 HCV, more patients in the 48-wk treatment group required erythropoietin than in the 24-wk treatment group(61.1% vs 49.2%).CONCLUSION SVR rates were high with peg-IFN and RBV therapy in Myanmar. Fibrosis scores, baseline albumin, HCV RNA levels and RVR independently predicted SVR.展开更多
Constellation reconfiguration is a critical issue to recover from the satellite failure,maintain the regular operation,and enhance the overall performance.The constellation reconfiguration problem faces the difficulti...Constellation reconfiguration is a critical issue to recover from the satellite failure,maintain the regular operation,and enhance the overall performance.The constellation reconfiguration problem faces the difficulties of high dimensionality of design variables and extremely large decision space due to the great and continuously growing constellation size.To solve such real-world problems that can be hardly solved by traditional algorithms,the evolutionary operators should be promoted with available domain knowledge to guide the algorithm to explore the promising regions of the trade space.An adaptive innovationdriven multi-objective evolutionary algorithm(MOEA-AI)employing automated innovation(AI)and adaptive operator selection(AOS)is proposed to extract and apply domain knowledge.The available knowledge is extracted from the final or intermediate solution sets and integrated into an operator by the automated innovation mechanism.To prevent the overuse of knowledgedependent operators,AOS provides top-level management between the knowledge-dependent operators and conventional evolutionary operators.It evaluates and selects operators according to their actual performance,which helps to identify useful operators from the candidate set.The efficacy of the MOEAAI framework is demonstrated by the simulation of emergency missions.It was verified that the proposed algorithm can discover a non-dominant solution set with better quality,more homogeneous distribution,and better adaptation to practical situations.展开更多
In this work a Support Vector Machine Regression（SVMR） algorithm is used to calculate local magnitude（MI） using only five seconds of signal after the P wave onset of one three component seismic station. This algor...In this work a Support Vector Machine Regression（SVMR） algorithm is used to calculate local magnitude（MI） using only five seconds of signal after the P wave onset of one three component seismic station. This algorithm was trained with 863 records of historical earthquakes, where the input regression parameters were an exponential function of the waveform envelope estimated by least squares and the maximum value of the observed waveform for each component in a single station. Ten-fold cross validation was applied for a normalized polynomial kernel obtaining the mean absolute error for different exponents and complexity parameters. The local magnitude（MI） could be estimated with 0.19 units of mean absolute error. The proposed algorithm is easy to implement in hardware and may be used directly after the field seismological sensor to generate fast decisions at seismological control centers, increasing the possibility of having an effective reaction.展开更多
COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating li...COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of “participation-limitation” for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation—an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidence-based methods to ensure contextually-relevant enquiry to identify the “occupational-participation issues”—<em>i.e.</em>, an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.展开更多
To investigate interferon-γ-inducible protein-10’s (IP-10) potential to anticipate rapid (RVR)- and sustained virological responses (SVR) to chronic hepatitis C (CHC) treatment. METHODSWe included case series examin...To investigate interferon-γ-inducible protein-10’s (IP-10) potential to anticipate rapid (RVR)- and sustained virological responses (SVR) to chronic hepatitis C (CHC) treatment. METHODSWe included case series examining RVR or SVR in relation to 24 or 48 wk treatment for CHC, in patients treatment free for at least six months, with genotype 1 or 4, and in relation to 24 wk treatment for genotype 2 and 3, with pegylated interferon in combination with ribavirin. Patients had to have both a baseline IP-10 level as well as a hepatitis C virus (HCV)-RNA determination 4 wk after treatment initiation or 24 wk after end of treatment. Studies including patients with liver diseases other than CHC, human immunodeficiency virus-infection, treatment with immunosuppresents or cytostatica, alcohol dependency or active intravenous drug-use were excluded. We found 81 articles by searching the MEDLINE and EMBASE databases. Eight studies were eligible for inclusion. Their quality were assesed using an 18 point checklist for case series, developed using a modified Delphi technique. Information was extracted from the articles, and no raw data was requisitioned. The review protocol was registered at the International Prospective Register of Systematic Reviews (reg. number: CRD42014008736). RESULTSThree studies reported on baseline IP-10 level in association with RVR. A signigficant association was found for HCV genotype 1 infection by two studies. Only two studies reported on HCV genotype 4 infected and genotype 2 and 3 infected patients, respectively. A trend was seen for an association between RVR and baseline IP-10 for genotype 4, while no association was found for genotype 2 and 3. Seven studies provided information regarding baseline IP-10 and SVR. Following the pattern regarding rapid virological response all five studies examining SVR in relation to baseline IP-10 levels for HCV, genotype 1 infected patients showed a significant association. Likewise a significant association was seen for HCV, genotype 4 infected, while no association was found for HCV, genotype 2 and 3 infected. Though only two studies examined the assosiation for HCV genotype 4 infected and HCV genotype 2 and 3 infected respectively. CONCLUSIONWe found indications of a possible association between baseline IP-10 level and virological responses in patients with CHC genotype 1 and 4.展开更多
Globally,marine bioinvasions threaten marine ecosystem structure and function,with the Mediterranean Sea being one of the most affected regions.Such invasions are expected to increase due to climate change.We conducte...Globally,marine bioinvasions threaten marine ecosystem structure and function,with the Mediterranean Sea being one of the most affected regions.Such invasions are expected to increase due to climate change.We conducted a risk screening of marine organisms(37 fishes,38 invertebrates,and 9 plants),both extant and‘horizon’(i.e.,not present in the area but likely to enter it).Based on expert knowledge for the Eastern Adriatic Sea coasts of Slovenia,Croatia,and Montenegro,screenings were conducted under both current and predicted climate conditions indicating with an increase in sea surface temperature and salinity of the Adriatic Sea together with changes in precipitation regime.Our aims were to:(1)identify non-native extant and horizon marine species that may pose threats to native biodiversity and(2)evaluate the risk of invasiveness of the selected species under current and predicted climate conditions.Of the 84 species screened,there was an increase in those ranked as‘high risk’from 33(39.3%)under current climate conditions and to 47(56.0%)under global warming scenarios.For those ranked as‘very high’risk,the increase was from 6(7.1%)to 21(25.0%).Amongst the screened species,the already established high-risk species Pacific oyster Magallana gigas and Atlantic blue crab Callinectes sapidus represent a threat to ecosystem services.Given the under-representation of marine species in the current European Union List,the species we have ranked as high to very high risk should be included.展开更多
With the rapid development of science and technology,the emergence of new application scenarios,such as robots,driverless vehicles and smart city,puts forward high requirements for artificial visual systems.Optoelectr...With the rapid development of science and technology,the emergence of new application scenarios,such as robots,driverless vehicles and smart city,puts forward high requirements for artificial visual systems.Optoelectronic synaptic devices have attracted much attention due to their advantages in sensing,memory and computing integration.In this work,via band structure engineering and heterostructure designing,a heterojunction optoelectronic synaptic device based on Cu doped with n-type SrTiO_(3)(Cu:STO)film combined with p-type CuAlO_(2)(CAO)thin film was fabricated.It is found surprisingly that the optoelectronic device based on Cu:STO/CAO p-n heterojunction exhibits a rapid response of 2 ms,and that it has a wideband response from visible to near-infrared(NIR)region.Additionally,a series of important synaptic functions,including excitatory postsynaptic current(EPSC),paired-pulse facilitation(PPF),shortterm potentiation(STP)to long-term potentiation(LTP)transition,learning experience behavior and image sharpening,have been successfully simulated on the device.More importantly,the performance of the device remains still stable and reliable after several months which were stored at room temperature and atmospheric pressure.Based on these advantages,the optoelectronic synaptic devices demonstrated here provide great potential in the new generation of artificial visual systems.展开更多
Plants have evolved intricate signaling cascades to rapidly and effectively respond to biotic and abiotic challenges. The precise timing of these responses enables optimal resource reallocation to maintain the balance...Plants have evolved intricate signaling cascades to rapidly and effectively respond to biotic and abiotic challenges. The precise timing of these responses enables optimal resource reallocation to maintain the balance between stress adaptation and growth. Thus, an in-depth understanding of the immediate and long-term mechanisms regulating resource allocation is critical in deciphering how plants withstand environmental challenges. To date however, understanding of this tradeoff has focused on the amplitude of long-term responses, rather than the timing of rapid stress responses. This review presents current knowledge on kinetics of secondary messengers involved in regulation of rapid and general stress responses, followed by rapid stress responsive transduction machinery, and finally the transcriptional response of a functional general stress responsive cis-element. Within this context we discuss the role of timing of initial peak activation and later oscillating peak responses, and explore hormonal and stress signaling crosstalk confounding greater understanding of these cascades.展开更多
Government departments act on proposals put forward by CPPCC members It is the third year Li Lanjuan, an academician of the Chinese Academy of Engineering and a member of the 11th
This study explored a Bayesian belief networks(BBNs)approach,developing two distinct models for prioritizing the seven indicators related to the“rapid response to and mitigation of the spread of an epidemic”category...This study explored a Bayesian belief networks(BBNs)approach,developing two distinct models for prioritizing the seven indicators related to the“rapid response to and mitigation of the spread of an epidemic”category within the context of both the specifc category and the Global Health Security Index(GHS index).Utilizing data from the 2021 GHS index,the methodology involves rigorous preprocessing,the application of the augmented naive Bayes algorithm for structural learning,and k-fold cross-validation.Key fndings show unique perspectives in both BBN models.In the mutual value of information analysis,“linking public health and security authorities”emerged as the key predictor for the“rapid response to and mitigation of the spread of an epidemic”category,while“emergency preparedness and response planning”assumed precedence for the GHS index.Sensitivity analysis highlighted the critical role of“emergency preparedness and response planning”and“linking public health and security authorities”in extreme performance states,with“access to communications infrastructure”and“trade and travel restrictions”exhibiting varied signifcance.The BBN models exhibit high predictive accuracy,achieving 83.3%and 82.3%accuracy for extreme states in“rapid response to and mitigation of the spread of an epidemic”and the GHS index,respectively.This study contributes to the literature on GHS by modeling the dependencies among various indicators of the rapid response dimension of the GHS index and highlighting their relative importance based on the mutual value of information and sensitivity analyses.展开更多
Acidity-activatable magnetic resonance imaging(MRI)nanoprobes offer great potential for in vivo cancer imaging by targeting the acidic tumor microenvironment(TME).However,their effectiveness is limited by the delayed ...Acidity-activatable magnetic resonance imaging(MRI)nanoprobes offer great potential for in vivo cancer imaging by targeting the acidic tumor microenvironment(TME).However,their effectiveness is limited by the delayed response at tumor sites and uncontrollable background noise,compromising imaging accuracy and reliability.Herein,an acidic TME-responsive nanoprobe,SPIO@ZIF-8@Gd(SZG),with dually activatable T_(1) and T_(2) MR signals is shown for acidity-selective contrast enhancement in a rapid response manner.It shows decreased T_(1) and T_(2) contrast intensity in normal physiological conditions.Once targeting acidic TME,the zeolitic imidazolate framework-8(ZIF-8)layer undergoes instantaneous decomposition,releasing Gd^(3+)(T_(1)-weighted),and exposing the inner SPIO(T_(2)-weighted)core,thereby sequentially recovering the signals.Compared to previously reported T_(1)-T_(2) nanoprobes,SZG demonstrates noticeable“dual activation”after just 30 min and reaches its peak 4 h after acid incubation.Additionally,it shows an excellent“acidity correlation”between relaxation times and pH values.When the SZG nanoprobe is used combined with“dual-contrast enhanced subtraction(DESI)”,the contrast difference between diseased and normal tissue can be increased by 10 times,which is significantly higher than traditional single-mode T_(1)/T_(2) contrast agents.Collectively,these findings demonstrate a rapid imaging strategy of dual-activation MR imaging of the acidic TME and simultaneous background suppression,thus paving the way for precise tumor malignancy differentiation,early tumor detection,and accurate tumor grading.展开更多
Background An epidemiologic link between hepatitis C virus （HCV） and abnormal glycometabolism had been established.This study was designed to investigate the prevalence of type 2 diabetes rnellitus and insulin resis...Background An epidemiologic link between hepatitis C virus （HCV） and abnormal glycometabolism had been established.This study was designed to investigate the prevalence of type 2 diabetes rnellitus and insulin resistance,and to explore the relation between insulin resistance and hepatitis C virus genotype,serum hepatitis C virus-RNA level in chronic hepatitis C（CHC） patients.Methods Three hundred and fifty-nine consecutive patients （CHC,n=296;chronic hepatitis B （CHB）,n=63） were evaluated.HCV genotyping was performed by restriction fragment method and serum hepatitis C virus-RNA quantified PCR for all CHC patients in the baseline serum.Fasting levels of insulin and glucose were measured in all patients and the homeostatic assessment of insulin resistance was calculated in the baseline serum.Results Type 2 diabetes mellitus was diagnosed in 15.5% of 296 CHC patients.Insulin resistance was present in 23.8% of the 235 nondiabetic CHC patients,in 23.1% of the 182 nondiabetic and noncirrhotic CHC patients,and associated with high serum HCV RNA level （OR： 1.754;95% CI：1.207-2.548,P=0.003） and age 〉40 years （OR.3.542;95% CI：1.257-9.978,P=0.017）.Insulin resistance was less frequent in CHB than in matched CHC （7.9% vs.21.4%respectively,P 〈0.0001）.Conclusion The incidence of insulin resistance in CHC was significantly higher than that in CHB patients,associated with high serum HCV RNA level and age 〉40 years.展开更多
文摘Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.
文摘Two classes of rate controlling medications—beta blockers (BBs) and non- dihydropyridine calcium channel blockers (CCBs)—are given to patients who present with atrial fibrillation (AF) with rapid ventricular response (RVR). Both are Class I recommendations from the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS) for the management of AF with RVR. Multiple studies support the view that diltiazem is more effective than metoprolol, even though data from the AFFIRM trial suggests BBs are more frequently used. CCBs are generally avoided in AF with RVR patients who have concomitant heart failure with reduced ejection fraction (HFrEF) for concern of triggering decompensation. However, some recent studies indicate this idea may be unfounded. The aim of this article is to compare the efficacy of diltiazem and metoprolol for rate control in AF with RVR and examine the use of diltiazem in patients with both AF with RVR and HFrEF.
文摘Acrylonitrile (AN) was copolymerized with N-isopropylacrylamide (NIPA) to synthesize thermosensitive hy-drogels, and the on-off switch behavior of poly(NIPA-co-AN) hydrogels with different fraction of hydrophobic compo-nent (AN) was investigated. It is found that the lower critical solution temperature (LCST), the swelling ratio at certain temperature and the reswelling rate of poly(NIPA-co-AN) hydrogels decreased as AN unit fraction in copolymers in-creased. In order to improve the responsive rate of poly(NIPA-co-AN) hydrogels, they were further treated by surface crosslinking using N, N′-methylene bisacrylamide (BIS) as a crosslinking agent. The swelling and deswelling behaviors of these copolymers were compared with those of the untreated hydrogels. The results indicated that the responsive rate of poly(NIPA-co-AN) hydrogel was improved by surface crosslinking. The resulting hydrogels bearing cyano groups with fast response have potential applications in the field of drug-controlled release and immobilization of biomolecules.
基金support from the National Key Research and Development Program of China(no.2016YFA0202403)National Natural Science Foundation of China(nos.61604091/61674098)+3 种基金the 111 Project(B14041)the National University Research Fund(grant nos.GK261001009,GK201603107)Changjiang Scholar and Innovative Research Team(IRT_14R33)the Chinese National 1000-talent-plan program(1110010341)
文摘Organic–inorganic single-crystalline perovskites have attracted significant attentions due to their exceptional progress in intrinsic properties＇ investigation and applications in photovoltaics and optoelectronics. In this study, the large perovskite CH3NH3PbI3 single crystal with the largest length of 80 mm was prepared through the method of inverse-temperature crystallization. Meanwhile, the mass production of integrate photodetectors have been fabricated on the single-crystalline wafer and the photoresponse performances were investigated. The results show that the single-crystalline photodetectors have broad spectrum response to 900 nm, rapid response speed（〈40 μs） and excellent stability. These findings are of great importance for future promising perovskite single crystalline for integrated photoelectronic application.
文摘A new chance of developing traditional manufacturing industry comes forth with the development of network technology. Application technology oriented rapid response manufacturing in the distributed network environments, that is, how to take advantage of the Intranet and Internet, combine the numerous manufacturing resources spread around the region, the country and even the globe is the key to the agile design, manufacturing and the buildup of comprehensively competitive power, at the same time, is also an important research direction in the field of advanced manufacturing technology. Rapid response manufacturing in the distributed network environment is a newly manufactory pattern that can be used to implement the conception of agile design and manufacturing, but there are some new problems coming with it, which will directly influence the enterprise’s ability of rapid response in the distributed network manufacturing pattern and lead to the failure of the league and the lost of the given orders. In this paper, we establish some approaches to solve these problems in product development process. The paper then presents the research on key application technologies and solutions includes: network safety strategy which guarantees data transferring among the leaguer members, production data management based on Web/DOT (Distributed Object Technology) and XML criteria which guarantees data exchange in structure-variance characteristic environments, the network platform which provides the conversion service of different types of CAD files each other. All of these solutions are aim for technology problems existing in the distributed network environments and among the league members. Finally, the paper takes one project, that is, the establishment of the online application service system for Shanghai Advance Manufacturing Technology Research Center as a good instance.
基金Project of Special Zone for National Defense Science and Technology Innovation(No.Y7GW04C001)
文摘A new flame detector with one ultraviolet and two infrared detectors is designed. The ultraviolet detector is of rapid response(≤10 μs) while the two infrared detectors usually have a response time of more than 5 ms. The ultraviolet detector is applied to deal with the flame of large scales. When facing the flame of mid or small scales, the three detectors cooperate. Employing the high-order derivatives of the sample data of the infrared circuits to improve the sensitivity, the response speed is greatly improved. The data of the temperature sensor is used to adjust circuit parameters in real time, thus reducing the effect of temperature drift. The flame detectors are tested at different distances and the response time is as rapid as 0.65 ms. The test results show that the new flame detector has the characteristics of high speed and a low rate of false alarms.
基金This work was supported by the Japan Society for the Promotion of Science KAKENHI(Grant Nos.JP24592755,JP18K16548)the Japanese Society of Intensive Care Medicine,and the Japanese Society of Emergency Medicine.
文摘Objectives:This study aimed to study the characteristics of in-hospital deterioration in patients with congenital heart disease who required rapid response system activation and identify risk factors associated with 1-month mortality.Methods:We retrospectively analysed data from a Japanese rapid response system registry with 35 participating hospitals.We included consecutive patients with congenital heart disease who required rapid response system activation between January 2014 and March 2018.Logistic regression analyses were performed to examine the associations between 1-month mortality and other patient-specific variables.Results:Among 9,607 patients for whom the rapid response system was activated,only 82(0.9%)had congenital heart disease.Only few patients with congenital heart disease were being treated at the cardiology and cardiovascular surgery departments(12.3%and 9.9%,respectively).Moreover,the incidences of rapid-response events after intensive care unit discharge or surgery were low(6.8% and 12.2%,respectively).The most common reason for rapid response system activation was respiratory dysfunction(desaturation:35.4%,tachypnoea:25.6%,and new dyspnoea:19.5%).Rapid response system interventions and intensive care unit transfers were required for 65.9% and 20.7%of patients,respectively.The mortality rate was 1.2% at the end of the rapid response system intervention and 11.0% after 1 month.Moreover,decreased respiratory rate and decreased heart rate at rapid response system activation were associated with increased 1-month mortality.The adjusted odds ratio was 1.10(95% confidence interval 1.02–1.19)and 1.02(95% confidence interval,1.00–1.04) for respiratory rate and heart rate,respectively.Conclusions:Rapid response systems were rarely activated after cardiac surgery and intensive care unit discharge,which were situations with a high risk of sudden deterioration in patients with congenital heart disease.Therefore,encouraging the use of the rapid response system in these departments will enable intervention by a third,specialised team for in-hospital emergencies and help provide comprehensive medical care to patients.Furthermore,1-month mortality was associated with vital signs at rapid response system activation.These findings may guide treatment selection for patients with congenital heart disease showing deterioration.
文摘Introduction: Monitoring vital signs is a basic indicator of a patient’s health status and allows prompt detection of delayed recovery or adverse effects and early intervention. Patients with adverse events during hospitalization often display clinical decline for several hours before the event is observed. Non-critical care Nurses’ inconsistent recognition and response to patient deterioration lead to an increase in the length of hospital stay, unexpected admissions to the ICU, and increased morbidity and mortality. Aim: The study aimed to assess the factors that facilitate or impede the detection of early warning signs among adult patients hospitalized in tertiary care settings. Training should be provided to improve nurses’ knowledge, practice and attitude toward early warning signs of deteriorating patients leading to enhanced clinical judgment, skills and decision-making in addressing alerts. Methodology: A literature search was carried out in various databases;these were Cumulative Index to Nursing and Allied Health Literature (CINHAL), Google Scholar, PubMed, Science Direct, and Sage. The search area was narrowed from 2017 to 2022. The keywords used were “prevalence” AND “unplanned ICU admission”, “the importance of early warning signs” “outcome failure in rescue” “patient deterioration, communication” “improvement in early detection” AND “patient outcome admission” AND “early warning signs” AND “Pakistan”. After the analysis process, around 33 articles that met the inclusion criteria and were most relevant to the scope and context of the current study were considered. Conclusion: Most of the studies had reviewed literature in a qualitative retrospective observational study, content analysis, mixed method, and quasi-experimental study. The literature review identified that long hours of shift, nurse staffing levels, missed vital signs, lack of nursing training and education, and communication impact nurses’ ability to recognize and respond to early warning signs.
文摘AIM To investigate peg-interferon(peg-IFN) and ribavirin(RBV) therapy in Myanmar and to predict sustained virologic response(SVR).METHODS This single-center, open-label, study was conducted in Myanmar between 2009 and 2014. A total of 288 patients infected with HCV genotypes 1, 2, 3 and 6 were treated with peg-IFN alpha-2a(180 μg/wk) or alpha-2b(50 to 100 μg as a weight-based dose) and RBV as a weight-based dose(15 mg/kg/d). Treatment duration was 48 wk for genotypes 1 and 6, 24 wk for genotype 2, and 24 or 48 wk for genotype 3 based on rapid virologic response(RVR). Those co-infected with hepatitis B received 48 wk of therapy.RESULTS Overall, SVR was achieved for 82% of patients and the therapy was well tolerated. All patients achieved SVR at equivalent rates regardless of HCV genotype(P = 0.314). Low fibrosis scores(P < 0.001), high baseline albumin levels(P = 0.028) and low baseline viral loads(P = 0.029) all independently predicted SVR. On the other hand, IL-28 B TT and CC genotypes were not found to significantly predict SVR(P = 0.634; P = 0.618). Among those who completed treatment, the occurrence of RVR showed a > 96% positive predictive value for achieving SVR. Treatment duration did not significantly impact the likelihood of achieving SVR for patients infected with genotype 3 HCV(P = 0.371). The most common adverse events were fatigue(71%) and poor appetite(60%). Among patients with genotype 3 HCV, more patients in the 48-wk treatment group required erythropoietin than in the 24-wk treatment group(61.1% vs 49.2%).CONCLUSION SVR rates were high with peg-IFN and RBV therapy in Myanmar. Fibrosis scores, baseline albumin, HCV RNA levels and RVR independently predicted SVR.
基金supported by the National Natural Science Foundation of China(11802333)the Scientific Research Program of the National University of Defence Technology(ZK18-03-34)。
文摘Constellation reconfiguration is a critical issue to recover from the satellite failure,maintain the regular operation,and enhance the overall performance.The constellation reconfiguration problem faces the difficulties of high dimensionality of design variables and extremely large decision space due to the great and continuously growing constellation size.To solve such real-world problems that can be hardly solved by traditional algorithms,the evolutionary operators should be promoted with available domain knowledge to guide the algorithm to explore the promising regions of the trade space.An adaptive innovationdriven multi-objective evolutionary algorithm(MOEA-AI)employing automated innovation(AI)and adaptive operator selection(AOS)is proposed to extract and apply domain knowledge.The available knowledge is extracted from the final or intermediate solution sets and integrated into an operator by the automated innovation mechanism.To prevent the overuse of knowledgedependent operators,AOS provides top-level management between the knowledge-dependent operators and conventional evolutionary operators.It evaluates and selects operators according to their actual performance,which helps to identify useful operators from the candidate set.The efficacy of the MOEAAI framework is demonstrated by the simulation of emergency missions.It was verified that the proposed algorithm can discover a non-dominant solution set with better quality,more homogeneous distribution,and better adaptation to practical situations.
文摘In this work a Support Vector Machine Regression（SVMR） algorithm is used to calculate local magnitude（MI） using only five seconds of signal after the P wave onset of one three component seismic station. This algorithm was trained with 863 records of historical earthquakes, where the input regression parameters were an exponential function of the waveform envelope estimated by least squares and the maximum value of the observed waveform for each component in a single station. Ten-fold cross validation was applied for a normalized polynomial kernel obtaining the mean absolute error for different exponents and complexity parameters. The local magnitude（MI） could be estimated with 0.19 units of mean absolute error. The proposed algorithm is easy to implement in hardware and may be used directly after the field seismological sensor to generate fast decisions at seismological control centers, increasing the possibility of having an effective reaction.
文摘COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of “participation-limitation” for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation—an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidence-based methods to ensure contextually-relevant enquiry to identify the “occupational-participation issues”—<em>i.e.</em>, an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.
基金Supported by Amagar and Hvidovre Hospital Research Foun-dation of 45000 Dkr.(to Bastian Neesgaard)The Family Hede Nielsen Foundation of 10000 Dkr.(to Bastian Neesgaard)
文摘To investigate interferon-γ-inducible protein-10’s (IP-10) potential to anticipate rapid (RVR)- and sustained virological responses (SVR) to chronic hepatitis C (CHC) treatment. METHODSWe included case series examining RVR or SVR in relation to 24 or 48 wk treatment for CHC, in patients treatment free for at least six months, with genotype 1 or 4, and in relation to 24 wk treatment for genotype 2 and 3, with pegylated interferon in combination with ribavirin. Patients had to have both a baseline IP-10 level as well as a hepatitis C virus (HCV)-RNA determination 4 wk after treatment initiation or 24 wk after end of treatment. Studies including patients with liver diseases other than CHC, human immunodeficiency virus-infection, treatment with immunosuppresents or cytostatica, alcohol dependency or active intravenous drug-use were excluded. We found 81 articles by searching the MEDLINE and EMBASE databases. Eight studies were eligible for inclusion. Their quality were assesed using an 18 point checklist for case series, developed using a modified Delphi technique. Information was extracted from the articles, and no raw data was requisitioned. The review protocol was registered at the International Prospective Register of Systematic Reviews (reg. number: CRD42014008736). RESULTSThree studies reported on baseline IP-10 level in association with RVR. A signigficant association was found for HCV genotype 1 infection by two studies. Only two studies reported on HCV genotype 4 infected and genotype 2 and 3 infected patients, respectively. A trend was seen for an association between RVR and baseline IP-10 for genotype 4, while no association was found for genotype 2 and 3. Seven studies provided information regarding baseline IP-10 and SVR. Following the pattern regarding rapid virological response all five studies examining SVR in relation to baseline IP-10 levels for HCV, genotype 1 infected patients showed a significant association. Likewise a significant association was seen for HCV, genotype 4 infected, while no association was found for HCV, genotype 2 and 3 infected. Though only two studies examined the assosiation for HCV genotype 4 infected and HCV genotype 2 and 3 infected respectively. CONCLUSIONWe found indications of a possible association between baseline IP-10 level and virological responses in patients with CHC genotype 1 and 4.
基金funded by an ERASMUS+(EPPKA2-Cooperation for innovation and the exchange of good practices,CBHE-JP-Capacity building in higher education)within the project “Educational capacity strengthening for risk management of non-native aquatic species in Western Balkans(Albania,Bosnia and Herzegovina and Montenegro)-RiskMan”(project reference:619384-EPP-1-2020-1-TR-EPPKA2-CBHEJP)the national research project“Monitoring the species diversity and abundance of non-native species in the Slovenian Sea”and the Slovenian Research Agency(research core funding No.P1-0237)the Croatian Science Foundation for the support under Project No.HRZZ-IP-2019-04-6702(Benthic NIS).
文摘Globally,marine bioinvasions threaten marine ecosystem structure and function,with the Mediterranean Sea being one of the most affected regions.Such invasions are expected to increase due to climate change.We conducted a risk screening of marine organisms(37 fishes,38 invertebrates,and 9 plants),both extant and‘horizon’(i.e.,not present in the area but likely to enter it).Based on expert knowledge for the Eastern Adriatic Sea coasts of Slovenia,Croatia,and Montenegro,screenings were conducted under both current and predicted climate conditions indicating with an increase in sea surface temperature and salinity of the Adriatic Sea together with changes in precipitation regime.Our aims were to:(1)identify non-native extant and horizon marine species that may pose threats to native biodiversity and(2)evaluate the risk of invasiveness of the selected species under current and predicted climate conditions.Of the 84 species screened,there was an increase in those ranked as‘high risk’from 33(39.3%)under current climate conditions and to 47(56.0%)under global warming scenarios.For those ranked as‘very high’risk,the increase was from 6(7.1%)to 21(25.0%).Amongst the screened species,the already established high-risk species Pacific oyster Magallana gigas and Atlantic blue crab Callinectes sapidus represent a threat to ecosystem services.Given the under-representation of marine species in the current European Union List,the species we have ranked as high to very high risk should be included.
基金financially supported by the National Science Funds for Excellent Young Scholars of China(No.61822106)the Natural Science Foundation of China(Nos.U19A2070,62074025)the National Key Research&Development Program(No.2020YFA0309200)。
文摘With the rapid development of science and technology,the emergence of new application scenarios,such as robots,driverless vehicles and smart city,puts forward high requirements for artificial visual systems.Optoelectronic synaptic devices have attracted much attention due to their advantages in sensing,memory and computing integration.In this work,via band structure engineering and heterostructure designing,a heterojunction optoelectronic synaptic device based on Cu doped with n-type SrTiO_(3)(Cu:STO)film combined with p-type CuAlO_(2)(CAO)thin film was fabricated.It is found surprisingly that the optoelectronic device based on Cu:STO/CAO p-n heterojunction exhibits a rapid response of 2 ms,and that it has a wideband response from visible to near-infrared(NIR)region.Additionally,a series of important synaptic functions,including excitatory postsynaptic current(EPSC),paired-pulse facilitation(PPF),shortterm potentiation(STP)to long-term potentiation(LTP)transition,learning experience behavior and image sharpening,have been successfully simulated on the device.More importantly,the performance of the device remains still stable and reliable after several months which were stored at room temperature and atmospheric pressure.Based on these advantages,the optoelectronic synaptic devices demonstrated here provide great potential in the new generation of artificial visual systems.
基金supported by National Institute of Health(R01GM107311)National Science Foundation(IOS1036491 and IOS-1352478)+1 种基金Agriculture experiment station (CA-D-PLB-3510-H) grants awarded to KDsupported by the John F.Steindler Fellowship
文摘Plants have evolved intricate signaling cascades to rapidly and effectively respond to biotic and abiotic challenges. The precise timing of these responses enables optimal resource reallocation to maintain the balance between stress adaptation and growth. Thus, an in-depth understanding of the immediate and long-term mechanisms regulating resource allocation is critical in deciphering how plants withstand environmental challenges. To date however, understanding of this tradeoff has focused on the amplitude of long-term responses, rather than the timing of rapid stress responses. This review presents current knowledge on kinetics of secondary messengers involved in regulation of rapid and general stress responses, followed by rapid stress responsive transduction machinery, and finally the transcriptional response of a functional general stress responsive cis-element. Within this context we discuss the role of timing of initial peak activation and later oscillating peak responses, and explore hormonal and stress signaling crosstalk confounding greater understanding of these cascades.
文摘Government departments act on proposals put forward by CPPCC members It is the third year Li Lanjuan, an academician of the Chinese Academy of Engineering and a member of the 11th
基金supported,in part,by the Faculty Research Grant(FRG23-E-B91)from the American University of Sharjah.
文摘This study explored a Bayesian belief networks(BBNs)approach,developing two distinct models for prioritizing the seven indicators related to the“rapid response to and mitigation of the spread of an epidemic”category within the context of both the specifc category and the Global Health Security Index(GHS index).Utilizing data from the 2021 GHS index,the methodology involves rigorous preprocessing,the application of the augmented naive Bayes algorithm for structural learning,and k-fold cross-validation.Key fndings show unique perspectives in both BBN models.In the mutual value of information analysis,“linking public health and security authorities”emerged as the key predictor for the“rapid response to and mitigation of the spread of an epidemic”category,while“emergency preparedness and response planning”assumed precedence for the GHS index.Sensitivity analysis highlighted the critical role of“emergency preparedness and response planning”and“linking public health and security authorities”in extreme performance states,with“access to communications infrastructure”and“trade and travel restrictions”exhibiting varied signifcance.The BBN models exhibit high predictive accuracy,achieving 83.3%and 82.3%accuracy for extreme states in“rapid response to and mitigation of the spread of an epidemic”and the GHS index,respectively.This study contributes to the literature on GHS by modeling the dependencies among various indicators of the rapid response dimension of the GHS index and highlighting their relative importance based on the mutual value of information and sensitivity analyses.
基金supported by the National Natural Science Foundation of China (82272057 and 32301160)。
文摘Acidity-activatable magnetic resonance imaging(MRI)nanoprobes offer great potential for in vivo cancer imaging by targeting the acidic tumor microenvironment(TME).However,their effectiveness is limited by the delayed response at tumor sites and uncontrollable background noise,compromising imaging accuracy and reliability.Herein,an acidic TME-responsive nanoprobe,SPIO@ZIF-8@Gd(SZG),with dually activatable T_(1) and T_(2) MR signals is shown for acidity-selective contrast enhancement in a rapid response manner.It shows decreased T_(1) and T_(2) contrast intensity in normal physiological conditions.Once targeting acidic TME,the zeolitic imidazolate framework-8(ZIF-8)layer undergoes instantaneous decomposition,releasing Gd^(3+)(T_(1)-weighted),and exposing the inner SPIO(T_(2)-weighted)core,thereby sequentially recovering the signals.Compared to previously reported T_(1)-T_(2) nanoprobes,SZG demonstrates noticeable“dual activation”after just 30 min and reaches its peak 4 h after acid incubation.Additionally,it shows an excellent“acidity correlation”between relaxation times and pH values.When the SZG nanoprobe is used combined with“dual-contrast enhanced subtraction(DESI)”,the contrast difference between diseased and normal tissue can be increased by 10 times,which is significantly higher than traditional single-mode T_(1)/T_(2) contrast agents.Collectively,these findings demonstrate a rapid imaging strategy of dual-activation MR imaging of the acidic TME and simultaneous background suppression,thus paving the way for precise tumor malignancy differentiation,early tumor detection,and accurate tumor grading.
基金This study was supported by grants from the National Major Project for Infectious Diseases Control （No. 2008ZX10002-013）, the National Natural Science Foundation of China （No. 30771906）, and the Ph.D. Programs Foundation of Ministry of Education of China （No. 20090001110081）.Acknowledgements： The authors thank Dr. ZENG Zheng for his helpful suggestions, also thank Dr. ZHAO Pei-li, CHEN Hong, XIAO Ping, WU Yun and FENG Yi-nong for providing CHC sera.
文摘Background An epidemiologic link between hepatitis C virus （HCV） and abnormal glycometabolism had been established.This study was designed to investigate the prevalence of type 2 diabetes rnellitus and insulin resistance,and to explore the relation between insulin resistance and hepatitis C virus genotype,serum hepatitis C virus-RNA level in chronic hepatitis C（CHC） patients.Methods Three hundred and fifty-nine consecutive patients （CHC,n=296;chronic hepatitis B （CHB）,n=63） were evaluated.HCV genotyping was performed by restriction fragment method and serum hepatitis C virus-RNA quantified PCR for all CHC patients in the baseline serum.Fasting levels of insulin and glucose were measured in all patients and the homeostatic assessment of insulin resistance was calculated in the baseline serum.Results Type 2 diabetes mellitus was diagnosed in 15.5% of 296 CHC patients.Insulin resistance was present in 23.8% of the 235 nondiabetic CHC patients,in 23.1% of the 182 nondiabetic and noncirrhotic CHC patients,and associated with high serum HCV RNA level （OR： 1.754;95% CI：1.207-2.548,P=0.003） and age 〉40 years （OR.3.542;95% CI：1.257-9.978,P=0.017）.Insulin resistance was less frequent in CHB than in matched CHC （7.9% vs.21.4%respectively,P 〈0.0001）.Conclusion The incidence of insulin resistance in CHC was significantly higher than that in CHB patients,associated with high serum HCV RNA level and age 〉40 years.
