The resources available to fight an epidemic are typically limited, and the time and effort required to control it grow as the start date of the containment effort are delayed. When the population is ...afflicted in various regions, scheduling a fair and acceptable distribution of limited available resources stored in multiple emergency resource centers to each epidemic area has become a serious problem that requires immediate resolution.
This study presents an emergency medical logistics model for rapid response to public health emergencies. The proposed methodology consists of two recursive mechanisms: (1) time-varying forecasting of medical resources and (2) emergency medical resource allocation. Considering the epidemic's features and the heterogeneity of existing medical treatment capabilities in different epidemic areas, we provide the modified susceptible-exposed-infected-recovered (SEIR) model to predict the early stage emergency medical resource demand for epidemics. Then we define emergency indicators for each epidemic area based on this. By maximizing the weighted demand satisfaction rate and minimizing the total vehicle travel distance, we develop a bi-objective optimization model to determine the optimal medical resource allocation plan.
Decision-makers should assign appropriate values to parameters at various stages of the emergency process based on the actual situation, to ensure that the results obtained are feasible and effective. It is necessary to set up an appropriate number of supply points in the epidemic emergency medical logistics supply to effectively reduce rescue costs and improve the level of emergency services.
Overall, this work provides managerial insights to improve decisions made on medical distribution as per demand forecasting for quick response to public health emergencies.
Hypertension, diabetes, and hyperlipidemia significantly impact chronic diseases and mortality. Magnesium is an essential nutrient for maintaining critical physiological functions, and magnesium ...deficiency is often associated with adverse health outcomes. In a cross-sectional study of US adults, we aimed to explore dietary magnesium intake and its association with the prevalence of hypertension, diabetes, and hyperlipidemia in US adults over 20 years of age in NHANES 2007-2018. We obtained data on 24,171 samples of hypertension, 9950 samples of diabetes, and 12,149 samples of hyperlipidemia. We used multivariable logistic regression models adjusted for multiple sociodemographic, anthropometric, and lifestyle factors, with participants subdivided into five groups based on quintiles of daily dietary magnesium. After adjusting for the major lifestyle and dietary variables, an independent and significant inverse relationship between dietary magnesium and hypertension, diabetes, and hyperlipidemia was observed. Compared with the lowest quintile of magnesium intake, the prevalence of hypertension, diabetes, and hyperlipidemia was significantly reduced in the highest magnesium quintile. The OR of hypertension in the highest quintile was 0.66 (95% CI: 0.51-0.87; P trend < 0.001), the OR of diabetes was 0.56 (95% CI: 0.39-0.81; P trend < 0.001), and the OR of hyperlipidemia was 0.68 (95% confidence interval: 0.53-0.86; P trend = 0.007). In the subgroup analysis, most of the inverse relationships persisted. Our findings highlight the potential of magnesium-rich foods to prevent hypertension, diabetes, and hyperlipidemia in US adults. This article summarizes and discuss recent findings on: 1) A high dietary magnesium intake was associated with a lower prevalence of hypertension; 2) An inverse relationship between dietary magnesium with diabetes hyperlipidemia; 3) Monitoring and management of magnesium was important.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Patients with HER2-positive (HER2
) metastatic breast cancer (MBC) have poor prognoses. Pyrotinib has shown promising antitumor activity in MBC to improve progression-free survival (PFS). However, ...findings based on real-world data to analyze whether pyrotinib affects overall survival (OS) remain scarce.
This real-world study is an exploratory analysis of brain metastasis (BM) and the final update of our preceding study of 168 patients with HER2
MBC. PFS, OS, tumor mutation burden (TMB), clinical benefit rate (CBR), and overall response rate (ORR) were analyzed.
Pyrotinib treatment led to a median PFS time of 8.00 months and a median OS of 19.07 months in the 168 participants. High TMB was associated with poor OS (
= 0.0072) and PFS (
= 0.0028). In the 39 patients with BM, the median PFS and OS were 8.67 and 13.93 months, respectively. The surgery/radiation (S/R) group of patients with BM had prolonged survival (PFS: 9.97 vs. 7.73 months
= 0.19; OS: 20.67 vs. 12.43 months
= 0.021) compared with the no surgery/no radiation group (NS/NR). The CBR was 58.6% (S/R) vs. 41.4% (NS/NR), while the ORR was 24.1% (S/R) vs. 31.0% (NS/NR).
Pyrotinib shows promise as a novel pan-HER2 tyrosine kinase inhibitor (TKI) for the treatment of BM and should be evaluated further. Surgical or radiotherapy in combination with pyrotinib was found to statistically improve OS in our cohort. TMB could be an exploratory biomarker for predicting PFS and OS, but its clinical application still needs further verification.
Excitons in two-dimensional transition metal dichalcogenides have a valley degree of freedom that can be optically manipulated for quantum information processing. Here, we integrate MoS2 monolayers ...with achiral silicon disk array metasurfaces to enhance and control valley-specific absorption and emission. Through the coupling to the metasurface electric and magnetic Mie modes, the intensity and lifetime of the emission of neutral excitons, trions, and defect bound excitons can be enhanced and shortened, respectively, while the spectral shape can be modified. Additionally, the degree of polarization (DOP) of exciton and trion emission from the valley can be symmetrically enhanced at 100 K. The DOP increase is attributed to both the metasurface-enhanced chiral absorption of light and the metasurface-enhanced exciton emission from the Purcell effect. Combining Si-compatible photonic design with large-scale 2D materials integration, our work makes an important step toward on-chip valleytronic applications approaching room-temperature operation.
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IJS, KILJ, NUK, PNG, UL, UM
The photoinduced decarboxylative 1,6-addition of para -quinone methides with α-keto acids in an eco-friendly approach to α,α′-diarylated ketones is developed. This reaction proceeds smoothly with a ...broad substrate scope in the presence of cheap photocatalysts. Some of α,α′-diarylated ketones were applied as fluorescent dyes into the fluorescence spectrum and live-cell imaging.
Cervical spine injury (CSI) accounts for significant mortality in the intensive care unit (ICU), whereas sepsis remains one of the major causes of death in patients with CSI. However, there is no ...effective method to diagnose sepsis timely. The aim of this study is to investigate the effect of metagenomic next-generation sequencing (mNGS) on the pathogen features and the prognostic prediction of CSI patients with sepsis. A total of 27 blood samples from 17 included patients were tested by mNGS. Data of mNGS were compared with the conventional culture method. The Kaplan–Meier plots were used to visualize survival curves. A Cox proportional hazards model was used to identify independent prognostic factors for survival. Results showed that mNGS detected a wide spectrum of pathogens in CSI patients with sepsis, including 129 bacterial species, 8 viral species, and 51 fungal species. mNGS indicated 85.2% positive results, while the conventional culture method only showed 11.1% positive results in the blood samples. Further analyses revealed that mNGS had no prognostic effect on the septic CSI patients in ICU, whereas positive results of blood culture were closely correlated with an increased hazard ratio (HR) (HR 77.7067, 95%CI 2.860–2641.4595,
p
= 0.0155). Our results suggested that the mNGS application may provide evidence for clinicians to use antibiotics when a CSI case is diagnosed with sepsis.
Excitons in two-dimensional transition metal dichalcogenides have a valley degree of freedom that can be optically manipulated for quantum information processing. Here, we integrate MoS
monolayers ...with achiral silicon disk array metasurfaces to enhance and control valley-specific absorption and emission. Through the coupling to the metasurface electric and magnetic Mie modes, the intensity and lifetime of the emission of neutral excitons, trions, and defect bound excitons can be enhanced and shortened, respectively, while the spectral shape can be modified. Additionally, the degree of polarization (DOP) of exciton and trion emission from the valley can be symmetrically enhanced at 100 K. The DOP increase is attributed to both the metasurface-enhanced chiral absorption of light and the metasurface-enhanced exciton emission from the Purcell effect. Combining Si-compatible photonic design with large-scale 2D materials integration, our work makes an important step toward on-chip valleytronic applications approaching room-temperature operation.
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IJS, KILJ, NUK, PNG, UL, UM
Deletion of master regulators of the B cell lineage reprograms B cells into T cells. Here we found that the transcription factor Hoxb5, which is expressed in uncommitted hematopoietic progenitor ...cells but is not present in cells committed to the B cell or T cell lineage, was able to reprogram pro-pre-B cells into functional early T cell lineage progenitors. This reprogramming started in the bone marrow and was completed in the thymus and gave rise to T lymphocytes with transcriptomes, hierarchical differentiation, tissue distribution and immunological functions that closely resembled those of their natural counterparts. Hoxb5 repressed B cell 'master genes', activated regulators of T cells and regulated crucial chromatin modifiers in pro-pre-B cells and ultimately drove the B cell fate-to-T cell fate conversion. Our results provide a de novo paradigm for the generation of functional T cells through reprogramming in vivo.
Pluripotent stem cells (PSC)-generated induced PTP could only reconstitute functional T lymphopoiesis in vivo when pre-embedded in congenic fetal thymic lobes, indicative of a cell-intrinsic flaw of ...homing capacity in vivo.In this study, we identified certain transcription factors that were absently expressed in induced hemogenic endothelial cells but abundantly expressed in their natural counterparts and further screened their combinatory roles in specifying T lymphopoiesis by tandem-TF-knock-in strategy. Coordinated inducible expression of TF1 and TF2 during endothelial to hematopoietic transition (EHT) and subsequent blood cell maturation stages in vitro preferentially resulted in full T lymphopoiesis in vivo after transplanting the derived ETP-abundant hematopoietic progenitors into conditioned NOD scid gamma mice via intravenous delivery. Remarkably, even a single induced hemogenic endothelial cells (iHEC) was able to generate T cells (iT cells) in vitro and reconstitute T lymphopoiesis in vivo. Following the same protocol, another TF-cocktails led to induced hematopoietic progenitors preferentially giving rise to B lymphopoiesis including B1 cells in vivo, strongly supporting the concept that certain transcription factors can specify lymphoid-lineage potentials at the early developmental stages before the emergence of hematopoietic stem cells. Physiologically, the mature iT cells distributed into lymphoid and other solid organs and exhibited abundant TCRαβ repertoire. Functionally, these regenerated iT cells successfully rejected allogeneic skin grafts and formed immune memory response. Translationally, the tumor-antigen-specific TCR-iT cells derived from gene-edited PSC successfully repressed tumor growth in vivo. This study provides insight into reconstituting T lymphopoiesis using PSC source.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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