Li Wang
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Publication
Journal: International Journal of Medical Informatics
May/13/2020
Abstract
Identify opportunities to improve the interaction between clinicians and Tele-Critical Care (Tele-CC) programs through an analysis of alert occurrence and reactivation in a specific Tele-CC application.Data were collected automatically through the Philips eCaremanager® software system used at multiple hospitals in the Avera health system. We evaluated the distribution of alerts per patient, frequency of alert types, time between consecutive alerts, and Tele-CC clinician choice of alert reactivation times.

RESULTS
Each patient generated an average of 79.8 alerts during their ICU stay (median 31.0; 25th - 75th percentile 10.0-89.0) with 46.4 for blood pressure and 38.4 for oxygenation. The most frequent alerts for continuous physiological parameters were: MAP limit (28.9 %), O2/RR (26.4 %), MAP trend (16.5 %), HR trend (12.1 %), and HR limit (11.3 %). The median time between consecutive alerts for one parameter was less than 10 min for 86 % of patients. Tele-CC providers responded to all alert types with immediate reactivation 47-88 % of the time. Limit alerts had longer reactivation times than their trend alert counterparts (p-value < .001).

The alert type specific differences in frequency, time occurrence and provider choice of reactivation time provide insight into how clinicians interact with the Tele-CC system. Systems engineering enhancements to Tele-CC software algorithms may reduce alert burden and thereby decrease clinicians' cognitive workload for alert assessment. Further study of Tele-CC alert generation, alert presentation to clinicians, and the clinicians' options to respond to these alerts may reduce provider workload, minimize alert desensitization, and optimize the ability of Tele-CC clinicians to provide efficient and timely critical care management.
Publication
Journal: American Journal of Alzheimer's Disease and other Dementias
May/5/2020
Abstract
Subjective cognitive decline (SCD) has been linked to Alzheimer's Disease in the literature. However, little is known about whether SCD is associated with social/emotional support (SES). To investigate this association, this study utilized the 2015 and 2016 Behavioral Risk Factor Surveillance System data. A study population of 17206 participants aged 45 years and older who responded to both the Emotional Support and Life Satisfaction survey module and the Cognition Decline survey module were included. Of this study population, 11.22% had SCD, and 21.83% reported insufficient SES. A much higher percentage of those with insufficient SES experienced SCD compared to those with sufficient SES (21.15% vs 8.45%, P < .0001). Insufficient SES was significantly associated with SCD (odds ratio = 1.68, 95% confidence interval: 1.37-2.06), after controlling for other factors. Furthermore, this study found certain demographic groups such as female, white, or married groups were more likely to receive sufficient SES.
Publication
Journal: Frontiers in Chemistry
April/30/2020
Abstract
Juncus is a perennial herb aquatic plant found worldwide, with high reproductive ability in warm regions. It has three-dimensional hierarchical porous triangular networks structures composited of tubular fibers. Here, juncus derived nitrogen-doped porous carbon (NDPC) was prepared by mixing juncus and ZnCl2 through one-step pyrolysis and activation which is a low-cost, simple, and environmentally friendly method. The NDPC had hierarchical porous structures and a high specific surface area and was applied for supercapacitor and oxygen reduction reaction (ORR). The resulted NDPC-3-800 was prepared by mixing juncus with ZnCl2 at a mass ratio of 1:3 and then carbonized at 800°C, it was used as electrode material of a supercapacitor. The supercapacitor exhibited excellent specific capacitance of 290.5 F g-1 and 175.0 F g-1 in alkaline electrolyte at the current densities of 0.5 A g-1 and 50 A g-1, respectively. The supercapacitor showed good cycle stability, and the capacitance was maintained at 94.5% after 10,000 cycles. The NDPC-5-800 was prepared by mixing juncus with ZnCl2 at a mass ratio of 1:5 and then carbonized at 800°C. It exhibited outstanding ORR catalytic activity and stability attributing to their high specific surface area and abundant actives sites. The juncus can derive various materials for application in different fields.
Publication
Journal: Animals
April/28/2020
Abstract
The deleted in azoospermia-like (DAZL) gene encoding an RNA binding protein is pivotal in gametogenesis in lots of species and also acts as a pre-meiosis marker. The current study was conducted to detect expression profiles and single nucleotide polymorphisms (SNPs) of DAZL in sheep using qPCR, DNA-pooled sequencing, improved multiplex ligase detection reaction (iMLDR®) and restriction fragment length polymorphism (RFLP) methods. The results confirmed that ovine DAZL showed the highest expression level at six-months of age across five developmental stage. At six-month stage, DAZL expressed primarily in testis across seven tissues analyzed. The abundance of DAZL in the large-testis group is higher than that in the small-testis group although it is not significant. In addition, six SNPs (SNP1-SNP6) were identified in DAZL. Of those, SNP1 (p < 0.05) and SNP6 (p < 0.01) were significantly correlated with the variation coefficient between left and right epididymis weight (VCTW). The current study implies DAZL may play important roles in testicular development and its SNPs are associated with testicular parameters, which supply important indicators for ram selection at early stage.
Publication
Journal: Nature Materials
April/21/2020
Abstract
Harvesting environmental energy to generate electricity is a key scientific and technological endeavour of our time. Photovoltaic conversion and electromechanical transduction are two common energy-harvesting mechanisms based on, respectively, semiconducting junctions and piezoelectric insulators. However, the different material families on which these transduction phenomena are based complicate their integration into single devices. Here we demonstrate that halide perovskites, a family of highly efficient photovoltaic materials1-3, display a photoflexoelectric effect whereby, under a combination of illumination and oscillation driven by a piezoelectric actuator, they generate orders of magnitude higher flexoelectricity than in the dark. We also show that photoflexoelectricity is not exclusive to halides but a general property of semiconductors that potentially enables simultaneous electromechanical and photovoltaic transduction and harvesting in unison from multiple energy inputs.
Publication
Journal: Bioscience Reports
April/20/2020
Abstract
Diabetic nephropathy (DN) is one of the most severe and frequent diabetic complications. MicroRNAs (miRNAs) have been reported to play a vital role in DN pathogenesis. This study aimed to investigate the molecular mechanism of miR-770-5p in DN.Podocyte injury model was established by treating mouse podocytes with high glucose (HG, 33 mM) for 24 h. The levels of miR-770-5p and TIMP3 were examined in kidney tissues and podocytes using quantitative real-time PCR (qRT-PCR). Flow cytometry analysis was applied to detect apoptosis in podocytes. Western blot assay was used to measure the protein levels of B-cell lymphoma 2 (Bcl-2), Bcl-2 Associated X (Bax) and tissue inhibitors of metalloproteinase 3 (TIMP3). Enzyme-linked immunosorbent assay (ELISA) was conducted to measure the levels of inflammatory factors. The interaction between miR-770-5p and TIMP3 was determined by MicroT-CDS and luciferase reporter assay.MiR-770-5p was upregulated and TIMP3 was down-regulated in DN kidney tissues and HG-stimulated podocytes. Depletion of miR-770-5p suppressed cell apoptosis and the release of pro-inflammatory factors in HG-treated podocytes. Additionally, TIMP3 was a target of miR-770-5p in HG-treated podocytes. TIMP3 inhibited cell apoptosis and inflammation in HG-treated podocytes. Moreover, TIMP3 knockdown alleviated the inhibitory effect of miR-770-5p silencing on podocyte apoptosis and inflammatory response.Knockdown of miR-770-5p suppressed podocyte apoptosis and inflammatory response by targeting TIMP3 in HG-treated podocytes, indicating that miR-770-5p may be a potential therapeutic target for DN therapy.
Authors
Publication
Journal: Gastroenterology Report
April/13/2020
Abstract
Observational studies suggest that hepatorenal syndrome (HRS) patients who receive pharmacological therapy before orthotopic liver transplantation display a post-transplant outcome similar to those without HRS. The aim of this study was to comprehensively compare and rank the pharmacological therapies for HRS.We reviewed PubMed, Elsevier, Medline, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies that were published between 1 January 1999 and 24 February 2018. The primary endpoint was reversal of HRS. The secondary endpoints were the changes in serum creatinine (Scr) and serum sodium. We evaluated the different therapeutic strategies using network meta-analysis on the basis of Bayesian methodology.The study included 24 articles with 1,419 participants evaluating seven different therapeutic strategies for HRS. The most effective treatments to induce reversal of HRS were terlipressin plus albumin, noradrenaline plus albumin, and terlipressin, which had a surface under the cumulative ranking curve (SUCRA) of 0.086, 0.151, and 0.451, respectively. The top two treatments for decreasing Scr were dopamine plus furosemide plus albumin (rank probability: 0.620) and terlipressin plus albumin (rank probability: 0.570). For increasing serum sodium, the optimal treatment was octreotide plus midodrine plus albumin (rank probability: 0.800), followed by terlipressin plus albumin (rank probability: 0.544).Terlipressin plus albumin and dopamine plus furosemide plus albumin should be prioritized for decreasing Scr in HRS, and octreotide plus midodrine plus albumin was the most effective at increasing serum sodium. Terlipressin plus albumin showed a comprehensive effect in both decreasing Scr and increasing serum sodium.
Publication
Journal: Clinical Transplantation
April/11/2020
Abstract
The role of antithymocyte globulin (ATG) in patients with hematologic diseases undergoing umbilical cord blood transplantation (UCBT) remains controversial. This systematic review and meta-analysis were conducted to comprehensively evaluate this issue. PubMed, Embase and the Cochrane Library were systematically searched. Clinical studies reporting the impact of ATG- vs. non-ATG-containing conditioning regimens on transplantation outcomes were identified. Twenty-five studies were included. ATG significantly prevented grades II-IV and III-IV acute graft-versus-host disease (GVHD) (11 studies, 5020 patients, HR: 0.49, 95% CI: 0.42 to 0.56, P < 0.001; 5 studies, 5490 patients, HR: 0.60, 95% CI: 0.46 to 0.80, P < 0.001) but not chronic GVHD (8 studies, 5952 patients, HR: 0.78, 95% CI: 0.51 to 1.20, P = 0.266). However, use of ATG was associated with increased transplantation-related mortality and inferior overall survival (9 studies, 4244 patients, HR: 1.79, 95% CI: 1.38 to 2.33, P < 0.001; 8 studies, 5438 patients, HR: 1.96, 95% CI: 1.56 to 2.46, P < 0.001). Our study did not recommend routine use of ATG in UCBT. Individualizing the ATG timing and dose based on patient characteristics to retain the prophylactic effects of ATG on GVHD without compromising the survival of UCBT recipients may be reasonable.
Publication
Journal: Journal of Cataract and Refractive Surgery
April/9/2020
Abstract
To evaluate the outcome of toric intraocular lens (IOL) implantation in eyes with previous laser in situ keratomileusis/photorefractive keratectomy (LASIK/PRK).Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.Retrospective case series.Consecutive cases that had previous myopic or hyperopic LASIK/PRK and had undergone cataract surgery with toric IOL implantation were retrospectively reviewed. Included were eyes that had (1) preoperative ocular biometry measurements with the Lenstar, (2) no intraoperative or postoperative complications, and (3) available postoperative manifest refraction at ≥3 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism.In 56 eyes with previous myopic LASIK/PRK and 19 eyes with previous hyperopic LASIK/PRK, respectively, the mean magnitudes of corneal astigmatism were 1.34 ± 0.62 diopters (D) and 1.66 ± 0.80 D, 5% and 0% of eyes had anterior corneal astigmatism ≤0.50 D, and the centroid values were 0.31 D at 19 degrees ± 1.45 D and 0.74 D at 92 degrees ± 1.72 D preoperatively. Postoperatively, the mean magnitudes of refractive astigmatism were 0.36 ± 0.31 D and 0.34 ± 0.34 D, 80% and 84% of eyes had refractive astigmatism of ≤0.50 D, and the centroid values were 0.12 D at 152 degrees ± 0.46 D and 0.05 D at 172 degrees ± 0.48 D (all P < .05).Toric IOLs were effective to correct preexisting corneal astigmatism in eyes with previous excimer laser corneal refractive surgery.
Publication
Journal: Journal of Materials Chemistry B
April/8/2020
Abstract
Magnetic core-shell ferrite nanocubes (MNCs) were prepared by a two-step pyrolysis. The MNCs not only exhibit an excellent magnetothermal effect, but also can be used as T2 magnetic resonance (MR) imaging agents. To obtain their good biocompatibility and targeting ability, MNCs were modified with poly(ethylene glycol) (PEG) and hyaluronic acid (HA). To further construct an integrated nanoplatform for theranostics, doxorubicin (DOX) was loaded onto the surface of MNCs by pH and heat sensitive chemical bonding. Notably, the MNCs showed a great stability and magnetothermal effect. Moreover, they showed negligible toxicity and synergistic therapy in vitro. Meanwhile, their MR imaging in vivo was further verified. A novel integrated nanoplatform facilitates excellent targeted MR imaging guided synergism of magnetothermal and chemotherapy. The multifunctional nanocubes will be capable of playing a vital role in future cancer therapy.
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