Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We ...Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis;later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined.展开更多
Ionic liquids(ILs)have been widely applied in the one-step fabrication of perovskite with noticeable enhancement in the device performance.However,in-depth mechanism of ionic-liquid-assisted perovskite film formation ...Ionic liquids(ILs)have been widely applied in the one-step fabrication of perovskite with noticeable enhancement in the device performance.However,in-depth mechanism of ionic-liquid-assisted perovskite film formation is not well understood for also important two-step perovskite fabrication method,with better control of crystallization behavior.In this work,we introduced ionic liquid methylammonium formate(MAFa)into organic salt to produce perovskite film via a two-step method.Systematic investigations on the influence of MAFa on the perovskite thin film formation mechanism were performed.Ionic liquid is shown to assist lowering the perovskite formation enthalpy upon the density functional theory(DFT)calculation,leading to an accelerated crystallization process evidenced by in-situ UV-Vis absorption measurement.A gradient up-down distribution of ionic liquid has been confirmed by timeof-flight SIMS.Importantly,besides the surface passivation,we found the HCOO-can diffuse into the perovskite crystals to fill up the halide vacancies,resulting in significant reduction of trap states.Uniform perovskite films with significantly larger grains and less defect density were prepared with the help of MAFa IL,and the corresponding device efficiency over 23%was obtained by two-step process with remarkably improved stability.This research work provides an efficient strategy to tune the morphology and opto-electronic properties of perovskite materials via ionic-liquid-assisted two-step fabrication method,which is beneficial for upscaling and application of perovskite photovoltaics.展开更多
AIM To assess liver fibrosis(LF)in hepatitis C virus(HCV)and alcoholic liver disease(ALD),estimate health outcomes and costs of new noninvasive testing strategies METHODS A Markov model was developed to simulate LF pr...AIM To assess liver fibrosis(LF)in hepatitis C virus(HCV)and alcoholic liver disease(ALD),estimate health outcomes and costs of new noninvasive testing strategies METHODS A Markov model was developed to simulate LF progression in HCV and ALD for a cohort of 40-yearold men with abnormal levels of transaminases.Three different testing alternatives were studied:a single liver biopsy;annual Enhanced liver fibrosis(ELF?)followed by liver stiffness measurement(LSM)imaging as a confirmation test if the ELF test is positive;and annual ELF test without LSM.The analysis was performed from the perspective of a university hospital in Spain.Clinical data were obtained from published literature.Costs were sourced from administrative databases of the hospital.Deterministic and probabilistic sensitivity analyses were performed.RESULTS In HCV patients,annual sequential ELF test/LSM and annual ELF test alone prevented respectively 12.9 and 13.3 liver fibrosis-related deaths per 100 persons tested,compared to biopsy.The incremental costeffectiveness ratios(ICERs)were respectively€13400 and€11500 per quality-adjusted life year(QALY).In ALD,fibrosis-related deaths decreased by 11.7 and 22.1 per 100 persons tested respectively with sequential ELF test/LSM and annual ELF test alone.ICERs were€280 and€190 per QALY,respectively.CONCLUSION The use of the ELF test with or without a confirmation LSM are cost-effective options compared to a single liver biopsy for testing liver fibrosis in HCV and ALD patients in Spain.展开更多
Glucosamine and chondroitin sulfate are molecules involved in the formation of articular cartilage and are frequently used for symptom relief in patients with arthrosis.These molecules are well tolerated with scarce s...Glucosamine and chondroitin sulfate are molecules involved in the formation of articular cartilage and are frequently used for symptom relief in patients with arthrosis.These molecules are well tolerated with scarce secondary effects.Very few cases of possible hepatotoxicity due to these substances have been described.The aim of this paper is to report the frequency of presumed glucosamine hepatotoxicity in patients with liver disease.A questionnaire was given to 151 consecutive patients with chronic liver disease of different etiology(mean age 59 years,56.9%women)attended in an outpatient clinic with the aim of evaluating the frequency of consumption of these drugs and determine whether their use coincided with a worsening in liver function test results.Twenty-three patients(15.2%)recognized having taken products containing glucosamine or chondroitin sulfate previously or at the time of the questionnaire.Review of the clinical records and liver function tests identified 2 patients presenting an elevation in aminotransferase values temporarily associated with glucosamine treatment;one of the cases simultaneously presented a skin rash attributed to the drug.Review of these two patients and the cases described in the literature suggest toxicity of glucosamine and chondroitin sulfate.The clinical spectrum is variable,and the mechanism of toxicity is not clear but may involve reactions of hypersensitivity.The consumption of products containing glucosamine and/or chondroitin sulfate is frequent among patients with chronic liver diseases and should be taken into account on the appearance of alterations in liver function tests not explained by the underlying disease.展开更多
This study was carried out to identify molecular responses of the two varieties with different cold tolerance under cold water stress (13℃) at the booting stage. Transcriptional responses of the genes were analyzed in
Global geopotential models have not included the very high frequencies of the Earth’s external gravity field.This is called omission error.This omission error becomes more important in mountainous areas(areas with hi...Global geopotential models have not included the very high frequencies of the Earth’s external gravity field.This is called omission error.This omission error becomes more important in mountainous areas(areas with highly variable topography).The work reported here consists in reducing the omission error in measurements of Bouguer gravity anomalies,by refining the global geopotential model EGM2008 using the spectral enhancement method.This method consists in computing the residual terrain effects and then coupling them to the gravimetric signal of the global geopotential model.To compute the residual terrain effects,we used the Residual Terrain Model(RTM)technique.To refine it required a reference surface(ETOPO1)developed up to degree 2190(the maximum degree of the EGM2008 model)and a detailed elevation model(AW3D30).Computation was performed with the TC program of the GRAVSOFT package.The topography of the study area was assumed to have a constant density of 2670 kg/m3.For the inner and outer zones,the respective integration radii of 10 km and 200 km have been chosen.We obtained very important RTM values ranging from−53.59 to 34.79 mGal.These values were added to the gravity anomalies grid of the EGM2008 model to improve accuracy at high frequencies.On a part of the Cameroon Volcanic Line and its surroundings(mountainous area),we made a comparison between the residual Bouguer anomalies before and after refinement.We report differences ranging from−37.40 to 26.40 mGal.We conclude that the impact of omission error on gravimetric signatures is observed especially in areas with high variable topography,such as on the Cameroon Volcanic Line and around the localities of Takamanda,Essu,Dumbo,and Ngambe.This finding illustrates the great influence that topography has on accurate measurement of these gravity anomalies,and thus why topography must be taken into account.We can conclude that in preparing a global geopotential model,a high resolution DTM must be used to decrease the omission error:the degree of expansion has to increase in order to take the higher frequencies into account.The refined Bouguer anomalies grid presented here can be used in addition to terrestrial gravity anomalies in the study area,especially in mountainous areas where gravimetric data are very sparse or nonexistent.展开更多
Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes.As it is associated with an increased risk of death,patients with this condition are candidates for receipt of a very wel...Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes.As it is associated with an increased risk of death,patients with this condition are candidates for receipt of a very well-structured and protocolized treatment.All patients should receive the fundamental pillars of sepsis management,which are infection control,initial resuscitation,and multiorgan support.However,specific subgroups of patients may benefit from a personalized approach with interventions targeted towards specific pathophysiological mechanisms.Herein,we will review the framework for identifying subpopulations of patients with sepsis,septic shock,and multiorgan dysfunction who may benefit from specific therapies.Some of these approaches are still in the early stages of research,while others are already in routine use in clinical practice,but together will help in the effective generation and safe implementation of precision medicine in sepsis.展开更多
The coronavirus disease 2019 crisis has had a major and highly complex impact on the clinical practice of radiation oncology worldwide.Spain is one of the countries hardest hit by the virus,with devastating consequenc...The coronavirus disease 2019 crisis has had a major and highly complex impact on the clinical practice of radiation oncology worldwide.Spain is one of the countries hardest hit by the virus,with devastating consequences.There is an urgent need to share experiences and offer guidance on decision-making with regard to the indications and standards for radiation therapy in the treatment of lung cancer.In the present article,the Oncological Group for the Study of Lung Cancer of the Spanish Society of Radiation Oncology reviews the literature and establishes a series of consensus-based recommendations for the treatment of patients with lung cancer in different clinical scenarios during the present pandemic.展开更多
Bi-doped glass fibers with controllable optical response are essential for next-generation broadband amplifiers and tunable lasers.However,achieving broad wavelength tunability and stable near-infrared(NIR)emission re...Bi-doped glass fibers with controllable optical response are essential for next-generation broadband amplifiers and tunable lasers.However,achieving broad wavelength tunability and stable near-infrared(NIR)emission remains challenging due to limited structural modification of conventional silica glasses and variability of Bi active centers(BACs).Here,we propose a cation hybridization strategy to overcome these issues,demonstrating an enhanced ultra-broadband,multi-band NIR optical response in Bi-doped photonic glasses.Alkaline earth metal ions,such as Mg^(2+)and Ba^(2+),were employed as the hybrid cations to“repair”(Mg^(2+))and“tailor”(Ba^(2+))the flexible glass network of germanate glasses,enabling precise customization of the local environment to stabilize different BACs.Impressively,this enables a tunable optical response,ranging from one main peak emission at 1142 nm to a stable multi-band emission spanning 920,1142,1265,and 1516 nm,with an emission bandwidth of 526 nm,which is distinct from conventional rare-earth ions doped glasses.Furthermore,Bi-doped hybrid germanate glass fibers were fabricated and a positive on-off gain in multiple communication bands(O+E+S+C bands)was successfully achieved.The results offer new insights into the Bi NIR luminescence behavior and introduce a promising strategy for developing advanced photonic glass materials.展开更多
Sensitive and fast detection of neutrons and gamma rays is vital for homeland security,high-energy physics,and proton therapy.Fast-neutron detectors rely on light organic scintillators,andγ-ray detectors use heavy in...Sensitive and fast detection of neutrons and gamma rays is vital for homeland security,high-energy physics,and proton therapy.Fast-neutron detectors rely on light organic scintillators,andγ-ray detectors use heavy inorganic scintillators and semiconductors.Efficient mixed-field detection using a single material is highly challenging due to their contradictory requirements.Here we report hybrid perovskites(C_(8)H_(12)N)_(2)Pb(Br_(0.95)Cl_(0.05))_(4)that combine light organic cations and heavy inorganic skeletons at a molecular level to achieve unprecedented performance for mixed-field radiation detection.High neutron absorption due to a high density of hydrogen,strong radiative recombination within the highly confined[PbX_(6)]^(4-)layer,and sub-nanometer distance between absorption sites and radiative centers,enable a light yield of 41000 photons/MeV,detection pulse width of 2.97 ns and extraordinary linearity response toward both fast neutrons andγ-rays,outperforming commonly used fast-neutron scintillators.Neutron energy spectrum,time-of-flight based fast-neutron/γ-ray discrimination and neutron yield monitoring were all successfully achieved using(C_(8)H_(12)N)_(2)Pb(Br_(0.95)Cl_(0.05))_(4)detectors.We further demonstrate the monitoring of reaction kinetics and total power of a nuclear fusion reaction.We envision that molecular hybridized scintillators open a new avenue for mixed-field radiation detection and imaging.展开更多
Platinum diselenide(PtSe_(2))is a promising two-dimensional(2D)material for the terahertz(THz)range as,unlike other transition metal dichalcogenides(TMDs),its bandgap can be uniquely tuned from a semiconductor in the ...Platinum diselenide(PtSe_(2))is a promising two-dimensional(2D)material for the terahertz(THz)range as,unlike other transition metal dichalcogenides(TMDs),its bandgap can be uniquely tuned from a semiconductor in the nearinfrared to a semimetal with the number of atomic layers.This gives the material unique THz photonic properties that can be layer-engineered.Here,we demonstrate that a controlled THz nonlinearity—tuned from monolayer to bulk PtSe_(2)—can be realized in wafer size polycrystalline PtSe_(2)through the generation of ultrafast photocurrents and the engineering of the bandstructure valleys.This is combined with the PtSe_(2)layer interaction with the substrate for a broken material centrosymmetry,permitting a second order nonlinearity.Further,we show layer dependent circular dichroism,where the sign of the ultrafast currents and hence the phase of the emitted THz pulse can be controlled through the excitation of different bandstructure valleys.In particular,we show that a semimetal has a strong dichroism that is absent in the monolayer and few layer semiconducting limit.The microscopic origins of this TMD bandstructure engineering are highlighted through detailed DFT simulations,and shows the circular dichroism can be controlled when PtSe_(2)becomes a semimetal and when the K-valleys can be excited.As well as showing that PtSe_(2)is a promising material for THz generation through layer controlled optical nonlinearities,this work opens up a new class of circular dichroism materials beyond the monolayer limit that has been the case of traditional TMDs,and impacting a range of domains from THz valleytronics,THz spintronics to harmonic generation.展开更多
Early and efficient disease diagnosis with low-cost point-of-care devices is gaining importance for personalized medicine and public health protection.Within this context,waveguide-(WG)-based optical biosensors on the...Early and efficient disease diagnosis with low-cost point-of-care devices is gaining importance for personalized medicine and public health protection.Within this context,waveguide-(WG)-based optical biosensors on the siliconnitride(Si_(3)N_(4))platform represent a particularly promising option,offering highly sensitive detection of indicative biomarkers in multiplexed sensor arrays operated by light in the visible-wavelength range.However,while passive Si_(3)N_(4)-based photonic circuits lend themselves to highly scalable mass production,the integration of low-cost light sources remains a challenge.In this paper,we demonstrate optical biosensors that combine Si_(3)N_(4)sensor circuits with hybrid on-chip organic lasers.These Si_(3)N_(4)-organic hybrid(SiNOH)lasers rely on a dye-doped cladding material that are deposited on top of a passive WG and that are optically pumped by an external light source.Fabrication of the devices is simple:The underlying Si_(3)N_(4)WGs are structured in a single lithography step,and the organic gain medium is subsequently applied by dispensing,spin-coating,or ink-jet printing processes.A highly parallel read-out of the optical sensor signals is accomplished with a simple camera.In our proof-of-concept experiment,we demonstrate the viability of the approach by detecting different concentrations of fibrinogen in phosphate-buffered saline solutions with a sensor-length(L-)-related sensitivity of S/L=0.16 rad nM^(-1)mm^(-1).To our knowledge,this is the first demonstration of an integrated optical circuit driven by a co-integrated low-cost organic light source.We expect that the versatility of the device concept,the simple operation principle,and the compatibility with cost-efficient mass production will make the concept a highly attractive option for applications in biophotonics and point-of-care diagnostics.展开更多
Broadband mid-infrared light sources are highly desired for wide-ranging applications that span free-space communications to spectroscopy.In recent years,silicon has attracted great interest as a platform for nonlinea...Broadband mid-infrared light sources are highly desired for wide-ranging applications that span free-space communications to spectroscopy.In recent years,silicon has attracted great interest as a platform for nonlinear optical wavelength conversion in this region,owing to its low losses(linear and nonlinear)and high stability.However,most research in this area has made use of small core waveguides fabricated from silicon-on-insulator platforms,which suffer from high absorption losses of the use of silica cladding,limiting their ability to generate light beyond 3μm.Here,we design and demonstrate a compact silicon core,silica-clad waveguide platform that has low losses across the entire silicon transparency window.The waveguides are fabricated from a silicon core fibre that is tapered to engineer mode properties to ensure efficient nonlinear propagation in the core with minimal interaction of the mid-infrared light with the cladding.These waveguides exhibit many of the benefits of fibre platforms,such as a high coupling efficiency and power handling capability,allowing for the generation of mid-infrared supercontinuum spectra with high brightness and coherence spanning almost two octaves(1.6-5.3μm).展开更多
Although tin monoxide (SnO) is an interesting compound due to its p-type conductivity,a widespread application of SnO has been limited by its narrow band gap of 0.7 eV.In this work,we theoretically investigate the str...Although tin monoxide (SnO) is an interesting compound due to its p-type conductivity,a widespread application of SnO has been limited by its narrow band gap of 0.7 eV.In this work,we theoretically investigate the structural and electronic properties of several SnO phases under high pressures through employing van der Waals (vdW) functionals.Our calculations reveal that a metastable SnO (β-SnO),which possesses space group P2_(1)/c and a wide band gap of 1.9 eV,is more stable than α-SnO at pressures higher than 80 GPa.Moreover,a stable (space group P2/c) and a metastable (space group Pnma) phases of SnO appear at pressures higher than 120 GPa.Energy and topological analyses show that P2/c-SnO has a high possibility to directly transform to β-SnO at around 120 GPa.Our work also reveals that β-SnO is a necessary intermediate state between high-pressure phase Pnma-SnO and low-pressure phase α-SnO for the phase transition path Pnma-SnO →β-SnO →α-SnO.Two phase transition analyses indicate that there is a high possibility to synthesize β-SnO under high-pressure conditions and have it remain stable under normal pressure.Finally,our study reveals that the conductive property of β-SnO can be engineered in a low-pressure range (0-9 GPa)through a semiconductor-to-metal transition,while maintaining transparency in the visible light range.展开更多
Dear Editor,Targeting the immune compartment in pancreatic duc-tal adenocarcinoma(PDAC)holds promise for prognostic improvement,yet our knowledge on the spatial and tem-poral dynamics and the molecular modulators of t...Dear Editor,Targeting the immune compartment in pancreatic duc-tal adenocarcinoma(PDAC)holds promise for prognostic improvement,yet our knowledge on the spatial and tem-poral dynamics and the molecular modulators of the PDAC-associated immunophenotype is scarce.展开更多
Entangled optical quantum states are essential towards solving questions in fundamental physics and are at the heart of applications in quantum information science. For advancing the research and development of quantu...Entangled optical quantum states are essential towards solving questions in fundamental physics and are at the heart of applications in quantum information science. For advancing the research and development of quantum technologies, practical access to the generation and manipulation of photon states carrying significant quantum resources is required. Recently, integrated photonics has become a leading platform for the compact and cost- efficient generation and processing of optical quantum states. Despite significant advances, most on-chip non- classical light sources are still limited to basic bi-photon systems formed by two-dimensional states （i.e., qubits）. An interesting approach beating large potential is the use of the time or frequency domain to enabled the scalable on- chip generation of complex states. In this manuscript, we review recent efforts in using on-chip optical frequency combs for quantum state generation and telecommunica- tions components for their coherent control. In particular, the generation of bi- and multi-photon entangled qubit states has been demonstrated, based on a discrete time domain approach. Moreover, the on-chip generation of high-dimensional entangled states （quDits） has recentlybeen realized, wherein the photons are created in a coherent superposition of multiple pure frequency modes. The time- and frequency-domain states formed with on-chip frequency comb sources were coherently manipulated via off-the-shelf telecommunications compo- nents. Our results suggest that microcavity-based entangled photon states and their coherent control using accessible telecommunication infrastructures can open up new venues for scalable quantum information science.展开更多
Unconventional resources (oil, gas, and geothermal) are often buried deep underground within dense rock strata and complex geological structures, making it increasingly difficult to create volumetric fractures through...Unconventional resources (oil, gas, and geothermal) are often buried deep underground within dense rock strata and complex geological structures, making it increasingly difficult to create volumetric fractures through conventional hydraulic fracturing. This paper introduces a novel method of supercritical energetic fluid thermal shock fracturing. It pioneers a CO_(2) deflagration impact triaxial pneumatic fracturing experimental system, using high-strength similar materials to simulate deep, hard rock masses. The study investigates the rock-breaking process and crack propagation patterns under supercritical CO_(2) thermal shock, revealing and discussing the types of thermal shock-induced fractures, their formation conditions, and discrimination criteria. The research indicates that higher supercritical CO_(2) thermal shock pressures and faster pressure release rates facilitate the formation of radial branching fractures, circumferential cracks, and branch cracks. Typically, CO_(2) thermal shock generates 3–5 radial main cracks, which is significantly more than the single main crack formed by hydraulic fracturing. The formation of branched cracks is often caused by compression-shear failure and occurs under relatively harsh conditions, determined by the confining pressure, rock properties, peak thermal shock pressure, and the pressure sustained post-decompression. The findings are expected to offer a safe, efficient, and controllable shockwave method of supercritical fluid thermal shock fracturing for the exploitation of deep unconventional oil and gas resources.展开更多
BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique mani...BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.展开更多
文摘Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis;later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined.
基金supported by the National Natural Science Foundation of China(Grant Nos.62004129,51472189,22005202)the Shenzhen Science and Technology Innovation Commission(JCYJ20200109105003940)+2 种基金the Research Grants Council of Hong Kong(GRF grant 15221320,CRF C5037-18G,C7018-20G)the Hong Kong Polytechnic University Funds(Sir Sze-yuen Chung Endowed Professorship Fund(8-8480)RISE(Q-CDA5)。
文摘Ionic liquids(ILs)have been widely applied in the one-step fabrication of perovskite with noticeable enhancement in the device performance.However,in-depth mechanism of ionic-liquid-assisted perovskite film formation is not well understood for also important two-step perovskite fabrication method,with better control of crystallization behavior.In this work,we introduced ionic liquid methylammonium formate(MAFa)into organic salt to produce perovskite film via a two-step method.Systematic investigations on the influence of MAFa on the perovskite thin film formation mechanism were performed.Ionic liquid is shown to assist lowering the perovskite formation enthalpy upon the density functional theory(DFT)calculation,leading to an accelerated crystallization process evidenced by in-situ UV-Vis absorption measurement.A gradient up-down distribution of ionic liquid has been confirmed by timeof-flight SIMS.Importantly,besides the surface passivation,we found the HCOO-can diffuse into the perovskite crystals to fill up the halide vacancies,resulting in significant reduction of trap states.Uniform perovskite films with significantly larger grains and less defect density were prepared with the help of MAFa IL,and the corresponding device efficiency over 23%was obtained by two-step process with remarkably improved stability.This research work provides an efficient strategy to tune the morphology and opto-electronic properties of perovskite materials via ionic-liquid-assisted two-step fabrication method,which is beneficial for upscaling and application of perovskite photovoltaics.
基金Supported by Siemens.Marcelo Soto received financial support from Plataforma ITEMAS PT13/0006/0009(FCRB PI043029,partially)
文摘AIM To assess liver fibrosis(LF)in hepatitis C virus(HCV)and alcoholic liver disease(ALD),estimate health outcomes and costs of new noninvasive testing strategies METHODS A Markov model was developed to simulate LF progression in HCV and ALD for a cohort of 40-yearold men with abnormal levels of transaminases.Three different testing alternatives were studied:a single liver biopsy;annual Enhanced liver fibrosis(ELF?)followed by liver stiffness measurement(LSM)imaging as a confirmation test if the ELF test is positive;and annual ELF test without LSM.The analysis was performed from the perspective of a university hospital in Spain.Clinical data were obtained from published literature.Costs were sourced from administrative databases of the hospital.Deterministic and probabilistic sensitivity analyses were performed.RESULTS In HCV patients,annual sequential ELF test/LSM and annual ELF test alone prevented respectively 12.9 and 13.3 liver fibrosis-related deaths per 100 persons tested,compared to biopsy.The incremental costeffectiveness ratios(ICERs)were respectively€13400 and€11500 per quality-adjusted life year(QALY).In ALD,fibrosis-related deaths decreased by 11.7 and 22.1 per 100 persons tested respectively with sequential ELF test/LSM and annual ELF test alone.ICERs were€280 and€190 per QALY,respectively.CONCLUSION The use of the ELF test with or without a confirmation LSM are cost-effective options compared to a single liver biopsy for testing liver fibrosis in HCV and ALD patients in Spain.
文摘Glucosamine and chondroitin sulfate are molecules involved in the formation of articular cartilage and are frequently used for symptom relief in patients with arthrosis.These molecules are well tolerated with scarce secondary effects.Very few cases of possible hepatotoxicity due to these substances have been described.The aim of this paper is to report the frequency of presumed glucosamine hepatotoxicity in patients with liver disease.A questionnaire was given to 151 consecutive patients with chronic liver disease of different etiology(mean age 59 years,56.9%women)attended in an outpatient clinic with the aim of evaluating the frequency of consumption of these drugs and determine whether their use coincided with a worsening in liver function test results.Twenty-three patients(15.2%)recognized having taken products containing glucosamine or chondroitin sulfate previously or at the time of the questionnaire.Review of the clinical records and liver function tests identified 2 patients presenting an elevation in aminotransferase values temporarily associated with glucosamine treatment;one of the cases simultaneously presented a skin rash attributed to the drug.Review of these two patients and the cases described in the literature suggest toxicity of glucosamine and chondroitin sulfate.The clinical spectrum is variable,and the mechanism of toxicity is not clear but may involve reactions of hypersensitivity.The consumption of products containing glucosamine and/or chondroitin sulfate is frequent among patients with chronic liver diseases and should be taken into account on the appearance of alterations in liver function tests not explained by the underlying disease.
文摘This study was carried out to identify molecular responses of the two varieties with different cold tolerance under cold water stress (13℃) at the booting stage. Transcriptional responses of the genes were analyzed in
文摘Global geopotential models have not included the very high frequencies of the Earth’s external gravity field.This is called omission error.This omission error becomes more important in mountainous areas(areas with highly variable topography).The work reported here consists in reducing the omission error in measurements of Bouguer gravity anomalies,by refining the global geopotential model EGM2008 using the spectral enhancement method.This method consists in computing the residual terrain effects and then coupling them to the gravimetric signal of the global geopotential model.To compute the residual terrain effects,we used the Residual Terrain Model(RTM)technique.To refine it required a reference surface(ETOPO1)developed up to degree 2190(the maximum degree of the EGM2008 model)and a detailed elevation model(AW3D30).Computation was performed with the TC program of the GRAVSOFT package.The topography of the study area was assumed to have a constant density of 2670 kg/m3.For the inner and outer zones,the respective integration radii of 10 km and 200 km have been chosen.We obtained very important RTM values ranging from−53.59 to 34.79 mGal.These values were added to the gravity anomalies grid of the EGM2008 model to improve accuracy at high frequencies.On a part of the Cameroon Volcanic Line and its surroundings(mountainous area),we made a comparison between the residual Bouguer anomalies before and after refinement.We report differences ranging from−37.40 to 26.40 mGal.We conclude that the impact of omission error on gravimetric signatures is observed especially in areas with high variable topography,such as on the Cameroon Volcanic Line and around the localities of Takamanda,Essu,Dumbo,and Ngambe.This finding illustrates the great influence that topography has on accurate measurement of these gravity anomalies,and thus why topography must be taken into account.We can conclude that in preparing a global geopotential model,a high resolution DTM must be used to decrease the omission error:the degree of expansion has to increase in order to take the higher frequencies into account.The refined Bouguer anomalies grid presented here can be used in addition to terrestrial gravity anomalies in the study area,especially in mountainous areas where gravimetric data are very sparse or nonexistent.
文摘Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes.As it is associated with an increased risk of death,patients with this condition are candidates for receipt of a very well-structured and protocolized treatment.All patients should receive the fundamental pillars of sepsis management,which are infection control,initial resuscitation,and multiorgan support.However,specific subgroups of patients may benefit from a personalized approach with interventions targeted towards specific pathophysiological mechanisms.Herein,we will review the framework for identifying subpopulations of patients with sepsis,septic shock,and multiorgan dysfunction who may benefit from specific therapies.Some of these approaches are still in the early stages of research,while others are already in routine use in clinical practice,but together will help in the effective generation and safe implementation of precision medicine in sepsis.
文摘The coronavirus disease 2019 crisis has had a major and highly complex impact on the clinical practice of radiation oncology worldwide.Spain is one of the countries hardest hit by the virus,with devastating consequences.There is an urgent need to share experiences and offer guidance on decision-making with regard to the indications and standards for radiation therapy in the treatment of lung cancer.In the present article,the Oncological Group for the Study of Lung Cancer of the Spanish Society of Radiation Oncology reviews the literature and establishes a series of consensus-based recommendations for the treatment of patients with lung cancer in different clinical scenarios during the present pandemic.
基金supported by the National Natural Science Foundation of China(62405092,62122027,62075063,62205109)the Postdoctoral Fellowship Program of China Postdoctoral Science Foundation(GZC20230852)the Guangdong Basic and Applied Basic Research Foundation(2025A1515010444).
文摘Bi-doped glass fibers with controllable optical response are essential for next-generation broadband amplifiers and tunable lasers.However,achieving broad wavelength tunability and stable near-infrared(NIR)emission remains challenging due to limited structural modification of conventional silica glasses and variability of Bi active centers(BACs).Here,we propose a cation hybridization strategy to overcome these issues,demonstrating an enhanced ultra-broadband,multi-band NIR optical response in Bi-doped photonic glasses.Alkaline earth metal ions,such as Mg^(2+)and Ba^(2+),were employed as the hybrid cations to“repair”(Mg^(2+))and“tailor”(Ba^(2+))the flexible glass network of germanate glasses,enabling precise customization of the local environment to stabilize different BACs.Impressively,this enables a tunable optical response,ranging from one main peak emission at 1142 nm to a stable multi-band emission spanning 920,1142,1265,and 1516 nm,with an emission bandwidth of 526 nm,which is distinct from conventional rare-earth ions doped glasses.Furthermore,Bi-doped hybrid germanate glass fibers were fabricated and a positive on-off gain in multiple communication bands(O+E+S+C bands)was successfully achieved.The results offer new insights into the Bi NIR luminescence behavior and introduce a promising strategy for developing advanced photonic glass materials.
基金China Postdoctoral Science Foundation,Grant/Award Number:2021T140234Fund for the Natural Science Foundation of Hubei Province,Grant/Award Numbers:2020CFA034,2021CFA036+3 种基金HCP Program for HUSTInnovation Fund of WNLOMajor State Basic Research Development Program of China,Grant/Award Numbers:2018YFA0703200,2021YFB3201000National Natural。
文摘Sensitive and fast detection of neutrons and gamma rays is vital for homeland security,high-energy physics,and proton therapy.Fast-neutron detectors rely on light organic scintillators,andγ-ray detectors use heavy inorganic scintillators and semiconductors.Efficient mixed-field detection using a single material is highly challenging due to their contradictory requirements.Here we report hybrid perovskites(C_(8)H_(12)N)_(2)Pb(Br_(0.95)Cl_(0.05))_(4)that combine light organic cations and heavy inorganic skeletons at a molecular level to achieve unprecedented performance for mixed-field radiation detection.High neutron absorption due to a high density of hydrogen,strong radiative recombination within the highly confined[PbX_(6)]^(4-)layer,and sub-nanometer distance between absorption sites and radiative centers,enable a light yield of 41000 photons/MeV,detection pulse width of 2.97 ns and extraordinary linearity response toward both fast neutrons andγ-rays,outperforming commonly used fast-neutron scintillators.Neutron energy spectrum,time-of-flight based fast-neutron/γ-ray discrimination and neutron yield monitoring were all successfully achieved using(C_(8)H_(12)N)_(2)Pb(Br_(0.95)Cl_(0.05))_(4)detectors.We further demonstrate the monitoring of reaction kinetics and total power of a nuclear fusion reaction.We envision that molecular hybridized scintillators open a new avenue for mixed-field radiation detection and imaging.
基金H2020 Future and Emerging Technologies,Grant/Award Number:964735H2020 Excellent Science,Grant/Award Number:881603+3 种基金Agence Nationale de la Recherche,Grant/Award Numbers:ANR-16-CE24-0023,ANR-2018-CE08-018-05National Research Foundation Singapore,Grant/Award Number:NRF-CRP26-2021-0004Region Ile de FranceEquipMeso,Grant/Award Number:ANR-10-EQPX-29-01。
文摘Platinum diselenide(PtSe_(2))is a promising two-dimensional(2D)material for the terahertz(THz)range as,unlike other transition metal dichalcogenides(TMDs),its bandgap can be uniquely tuned from a semiconductor in the nearinfrared to a semimetal with the number of atomic layers.This gives the material unique THz photonic properties that can be layer-engineered.Here,we demonstrate that a controlled THz nonlinearity—tuned from monolayer to bulk PtSe_(2)—can be realized in wafer size polycrystalline PtSe_(2)through the generation of ultrafast photocurrents and the engineering of the bandstructure valleys.This is combined with the PtSe_(2)layer interaction with the substrate for a broken material centrosymmetry,permitting a second order nonlinearity.Further,we show layer dependent circular dichroism,where the sign of the ultrafast currents and hence the phase of the emitted THz pulse can be controlled through the excitation of different bandstructure valleys.In particular,we show that a semimetal has a strong dichroism that is absent in the monolayer and few layer semiconducting limit.The microscopic origins of this TMD bandstructure engineering are highlighted through detailed DFT simulations,and shows the circular dichroism can be controlled when PtSe_(2)becomes a semimetal and when the K-valleys can be excited.As well as showing that PtSe_(2)is a promising material for THz generation through layer controlled optical nonlinearities,this work opens up a new class of circular dichroism materials beyond the monolayer limit that has been the case of traditional TMDs,and impacting a range of domains from THz valleytronics,THz spintronics to harmonic generation.
基金the Alfried Krupp von Bohlen und Halbach Foundation,by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)under Germany's Excellence Strategy via the Excellence Cluster 3D Matter Made to Order(EXC-2082/1-390761711)by the European Research Council(ERC Consolidator Grant TeraSHAPE,#773248)by the Karlsruhe School of Optics and Photonics(KSOP)。
文摘Early and efficient disease diagnosis with low-cost point-of-care devices is gaining importance for personalized medicine and public health protection.Within this context,waveguide-(WG)-based optical biosensors on the siliconnitride(Si_(3)N_(4))platform represent a particularly promising option,offering highly sensitive detection of indicative biomarkers in multiplexed sensor arrays operated by light in the visible-wavelength range.However,while passive Si_(3)N_(4)-based photonic circuits lend themselves to highly scalable mass production,the integration of low-cost light sources remains a challenge.In this paper,we demonstrate optical biosensors that combine Si_(3)N_(4)sensor circuits with hybrid on-chip organic lasers.These Si_(3)N_(4)-organic hybrid(SiNOH)lasers rely on a dye-doped cladding material that are deposited on top of a passive WG and that are optically pumped by an external light source.Fabrication of the devices is simple:The underlying Si_(3)N_(4)WGs are structured in a single lithography step,and the organic gain medium is subsequently applied by dispensing,spin-coating,or ink-jet printing processes.A highly parallel read-out of the optical sensor signals is accomplished with a simple camera.In our proof-of-concept experiment,we demonstrate the viability of the approach by detecting different concentrations of fibrinogen in phosphate-buffered saline solutions with a sensor-length(L-)-related sensitivity of S/L=0.16 rad nM^(-1)mm^(-1).To our knowledge,this is the first demonstration of an integrated optical circuit driven by a co-integrated low-cost organic light source.We expect that the versatility of the device concept,the simple operation principle,and the compatibility with cost-efficient mass production will make the concept a highly attractive option for applications in biophotonics and point-of-care diagnostics.
基金supported by the following research funds:the Engineering and Physical Sciences Research Council(EPSRC)(EP/P000940/1)the National Natural Science Foundation of China(NSFC)(61705072)+1 种基金the Norwegian Research Council(262232)the J.E.Sirrine Foundation.
文摘Broadband mid-infrared light sources are highly desired for wide-ranging applications that span free-space communications to spectroscopy.In recent years,silicon has attracted great interest as a platform for nonlinear optical wavelength conversion in this region,owing to its low losses(linear and nonlinear)and high stability.However,most research in this area has made use of small core waveguides fabricated from silicon-on-insulator platforms,which suffer from high absorption losses of the use of silica cladding,limiting their ability to generate light beyond 3μm.Here,we design and demonstrate a compact silicon core,silica-clad waveguide platform that has low losses across the entire silicon transparency window.The waveguides are fabricated from a silicon core fibre that is tapered to engineer mode properties to ensure efficient nonlinear propagation in the core with minimal interaction of the mid-infrared light with the cladding.These waveguides exhibit many of the benefits of fibre platforms,such as a high coupling efficiency and power handling capability,allowing for the generation of mid-infrared supercontinuum spectra with high brightness and coherence spanning almost two octaves(1.6-5.3μm).
基金This work is supported by the National Natural Science Foundation of China(Grant No.51872242)the Fundamental Research Funds for the Central Universities(Grant No.D5000200142)+1 种基金Vladislav A.BLATOV thanks the Russian Science Foundation(Grant No.16-13-10158)for support of developing the network topological modelArtem R.OGANOV thanks the Russian Science Foundation(Grant No.19-72-30043).
文摘Although tin monoxide (SnO) is an interesting compound due to its p-type conductivity,a widespread application of SnO has been limited by its narrow band gap of 0.7 eV.In this work,we theoretically investigate the structural and electronic properties of several SnO phases under high pressures through employing van der Waals (vdW) functionals.Our calculations reveal that a metastable SnO (β-SnO),which possesses space group P2_(1)/c and a wide band gap of 1.9 eV,is more stable than α-SnO at pressures higher than 80 GPa.Moreover,a stable (space group P2/c) and a metastable (space group Pnma) phases of SnO appear at pressures higher than 120 GPa.Energy and topological analyses show that P2/c-SnO has a high possibility to directly transform to β-SnO at around 120 GPa.Our work also reveals that β-SnO is a necessary intermediate state between high-pressure phase Pnma-SnO and low-pressure phase α-SnO for the phase transition path Pnma-SnO →β-SnO →α-SnO.Two phase transition analyses indicate that there is a high possibility to synthesize β-SnO under high-pressure conditions and have it remain stable under normal pressure.Finally,our study reveals that the conductive property of β-SnO can be engineered in a low-pressure range (0-9 GPa)through a semiconductor-to-metal transition,while maintaining transparency in the visible light range.
文摘Dear Editor,Targeting the immune compartment in pancreatic duc-tal adenocarcinoma(PDAC)holds promise for prognostic improvement,yet our knowledge on the spatial and tem-poral dynamics and the molecular modulators of the PDAC-associated immunophenotype is scarce.
文摘Entangled optical quantum states are essential towards solving questions in fundamental physics and are at the heart of applications in quantum information science. For advancing the research and development of quantum technologies, practical access to the generation and manipulation of photon states carrying significant quantum resources is required. Recently, integrated photonics has become a leading platform for the compact and cost- efficient generation and processing of optical quantum states. Despite significant advances, most on-chip non- classical light sources are still limited to basic bi-photon systems formed by two-dimensional states （i.e., qubits）. An interesting approach beating large potential is the use of the time or frequency domain to enabled the scalable on- chip generation of complex states. In this manuscript, we review recent efforts in using on-chip optical frequency combs for quantum state generation and telecommunica- tions components for their coherent control. In particular, the generation of bi- and multi-photon entangled qubit states has been demonstrated, based on a discrete time domain approach. Moreover, the on-chip generation of high-dimensional entangled states （quDits） has recentlybeen realized, wherein the photons are created in a coherent superposition of multiple pure frequency modes. The time- and frequency-domain states formed with on-chip frequency comb sources were coherently manipulated via off-the-shelf telecommunications compo- nents. Our results suggest that microcavity-based entangled photon states and their coherent control using accessible telecommunication infrastructures can open up new venues for scalable quantum information science.
基金supported by“Intergovernmental Cooperation in Science,Technology and Innovation(ISTI)”Key Special Project 2023“Intergovernmental Cooperation Programme between China and the United States”(Grant No.2023YFE0120500)the National Natural Science Foundation of China(Grant No.41702289)the Foundation of Hubei Key Laboratory of Blasting Engineering(Grant No.HKLBEF202004).
文摘Unconventional resources (oil, gas, and geothermal) are often buried deep underground within dense rock strata and complex geological structures, making it increasingly difficult to create volumetric fractures through conventional hydraulic fracturing. This paper introduces a novel method of supercritical energetic fluid thermal shock fracturing. It pioneers a CO_(2) deflagration impact triaxial pneumatic fracturing experimental system, using high-strength similar materials to simulate deep, hard rock masses. The study investigates the rock-breaking process and crack propagation patterns under supercritical CO_(2) thermal shock, revealing and discussing the types of thermal shock-induced fractures, their formation conditions, and discrimination criteria. The research indicates that higher supercritical CO_(2) thermal shock pressures and faster pressure release rates facilitate the formation of radial branching fractures, circumferential cracks, and branch cracks. Typically, CO_(2) thermal shock generates 3–5 radial main cracks, which is significantly more than the single main crack formed by hydraulic fracturing. The formation of branched cracks is often caused by compression-shear failure and occurs under relatively harsh conditions, determined by the confining pressure, rock properties, peak thermal shock pressure, and the pressure sustained post-decompression. The findings are expected to offer a safe, efficient, and controllable shockwave method of supercritical fluid thermal shock fracturing for the exploitation of deep unconventional oil and gas resources.
文摘BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.
