Artificial intelligence (AI) is rapidly being applied to a wide range of fields, including medicine, and has been considered as an approach that may augment or substitute human professionals in ...primary healthcare. However, AI also raises several challenges and ethical concerns. In this article, the author investigates and discusses three aspects of AI in medicine and healthcare: the application and promises of AI, special ethical concerns pertaining to AI in some frontier fields, and suggestive ethical governance systems. Despite great potentials of frontier AI research and development in the field of medical care, the ethical challenges induced by its applications has put forward new requirements for governance. To ensure "trustworthy" AI applications in healthcare and medicine, the creation of an ethical global governance framework and system as well as special guidelines for frontier AI applications in medicine are suggested. The most important aspects include the roles of governments in ethical auditing and the responsibilities of stakeholders in the ethical governance system.
Behcet's syndrome (BS) is a complex, heterogeneous disorder. However, classification of its subgroups is still debated. The purpose of this study was to investigate the clinical features and ...aggregation of patients with BS in China, based on manifestations and organ involvements.
This was a cross-sectional study of BS patients in Huadong Hospital of Fudan University between September 2012 and January 2020. We calculated relative risks (RRs) of clinical variables according to sex. Moreover, we conducted a hierarchical cluster analysis applied according to eighteen variables to determine subgroups of patients.
A total of 860 BS patients were included. Male sex was associated with ocular involvement (RR 2.32, 95% CI 1.67, 3.22, P < 0.0001), vascular involvement (RR 2.00, 95% CI 1.23, 3.23, P = 0.004), cardiac lesion (RR 5.46, 95% CI 2.33, 12.77, P < 0.0001), and central nervous system involvement (RR 2.95, 95% CI 1.07, 6.78, P = 0.007) and was negatively associated with genital ulcers (RR 0.84, 95% CI 0.79, 0.91, P < 0.0001). Five clusters (C1-C5) were observed. C1 (n = 307) showed the skin and mucosa type. In C2 (n = 124), all had articular involvement, barely having major organ involvement except for 18 cases with intestinal lesions. In C3 (n = 156), the gastrointestinal type, 144 patients presented with intestinal involvement, and 36 patients with esophageal ulcers. In C4 (n = 142), all subjects presented with uveitis. C5 (n = 131) consisted of 44 patients with cardiac lesions, 58 with vascular involvement, and 26 cases having central nervous system involvement.
Our analysis confirmed sex differences in phenotypes of BS. Cluster analysis identified gastrointestinal, uveitis, and cardiovascular involvement cluster separately in different subsets, which represents the most commonly involved organs. Further research is required to replicate and clarify the patterns of phenotype in BS.
•Density and viscosity of Athabasca bitumen and its diluted mixtures with n-tetradecane.•Temperatures varying from ambient temperature up to 343K and at pressures up to 10MPa.•Pseudo-binary mixtures ...with 0.05, 0.1, 0.2, 0.3, 0.4, and 0.5 weight fractions of n-tetradecane.•Density data are well predicted with an equation that assumes no volume change upon mixing occurs.•Power law and Lederer’s models represent mixture viscosity better than Arrhenius’, Cragoe’s, and Shu’s models.
The viscosity of bitumen is extremely high at ambient temperature and in order to produce and transport the bitumen, it is necessary to reduce its viscosity. One of the methods to reduce the bitumen viscosity is the dilution with liquid solvent. In this manuscript, the density and viscosity of bitumen, tetradecane, and their mixtures at different weight fractions have accurately been measured. The measurements were taken under conditions applicable for both in situ recovery methods and pipeline transportation of heavy oil. The experiments were conducted using Athabasca bitumen and tetradecane at temperatures varying from ambient up to 343K and at pressures up to 10MPa on mixtures with 0.05, 0.1, 0.2, 0.3, 0.4, and 0.5 weight fractions of solvent. The generated experimental data for raw bitumen and tetradecane were correlated with the existing correlation models in the literature. The data for the mixtures were also evaluated with predictive schemes as well as with correlation models representing certain mixing rules proposed in the literature. The influence of pressure, temperature, and solvent weight fraction on the density and viscosity of mixtures was considered in the models and evaluated from the experimental results. The density data are reasonably predicted using an equation without adjustable parameter in which it is assumed that no volume change occurs. The viscosity data for the mixtures are well correlated with Lederer’s and power law models.
WORKPLACE VIOLENCE IN HEALTH CARE：A CONTINUOUS GLOBAL PROBLEM AND ITS CHARACTERISTICS IN CHINA
Workplace violence is a persistent problem in health care worldwide. The victims are usually nurses and ...workers in the emergency department. The academic debate, as it develops overtime, would allow us to gain an integral insight about this problem. The author searched the related research and debate articles in English in PubMed （www.pubmed.conl） dated from 1990 to 2016 Figure 1 . In total, 1899 items with the keywords of＂workplace violence,＂ 600 items with ＂workplace violence healthcare,＂ 786 items with ＂＇workplace violence nursing,＂ and 279 items with ＂workplace violence emergency＂ （there is some overlap between these four groups） have been published.
Display omitted
•Clearance routes of nanoparticles in the lung are presented.•Factors influencing nanoparticle transaction are discussed.•Physicochemical properties of the nanoparticles could ...influence their fate in the lung.
The inhaled delivery of nanomedicines has attracted much attention in the treatment of lung diseases or systemic diseases. However, there is a lack of understanding about their fate upon lung delivery. Thus, the objective of this review is to summarize physicochemical properties affecting the fate of nanoparticles after deposition in the lung. First, physiological structure and characteristics of the lung are described. Thereafter, physicochemical properties that could influence the clearance and translocation of nanoparticles in the lung are discussed, including particle size, surface charge and surface hydrophilicity. It is believed that, with a better understanding of the fate of nanoparticles in the lung, it will broaden their application in inhalation for a better therapeutic effect in the future.
Twin-field (TF) quantum key distribution (QKD) promises high key rates over long distances to beat the rate-distance limit. Here, applying the sending-or-not-sending TF QKD protocol, we ...experimentally demonstrate a secure key distribution that breaks the absolute key-rate limit of repeaterless QKD over a 509-km-long ultralow loss optical fiber. Two independent lasers are used as sources with remote-frequency-locking technique over the 500-km fiber distance. Practical optical fibers are used as the optical path with appropriate noise filtering; and finite-key effects are considered in the key-rate analysis. The secure key rate obtained at 509 km is more than seven times higher than the relative bound of repeaterless QKD for the same detection loss. The achieved secure key rate is also higher than that of a traditional QKD protocol running with a perfect repeaterless QKD device, even for an infinite number of sent pulses. Our result shows that the protocol and technologies applied in this experiment enable TF QKD to achieve a high secure key rate over a long distribution distance, and is therefore practically useful for field implementation of intercity QKD.
Inflammatory signals from immunological cells may cause damage to intestinal epithelial cells (IECs), resulting in intestinal inflammation and tissue impairment. Interferon‐γ‐inducible protein 16 ...(IFI16) was reported to be involved in the pathogenesis of Behçet's syndrome (BS). This study aimed to investigate how inflammatory cytokines released by immunological cells and IFI16 participate in the pathogenesis of intestinal BS. RNA sequencing and real‐time quantitative PCR (qPCR) showed that the positive regulation of tumor necrosis factor‐α (TNF‐α) production in peripheral blood mononuclear cells (PBMCs) of intestinal BS patients may be related to the upregulation of polo like kinase 1 (PLK1) in PBMCs (P = 0.012). The plasma TNF‐α protein level in intestinal BS was significantly higher than in healthy controls (HCs; P = 0.009). PBMCs of intestinal BS patients and HCs were co‐cultured with human normal IECs (NCM460) to explore the interaction between immunological cells and IECs. Using IFI16 knockdown, PBMC‐NCM460 co‐culture, TNF‐α neutralizing monoclonal antibody (mAb), stimulator of interferon genes (STING) agonist 2′3′‐cGAMP, and the PLK1 inhibitor SBE 13 HCL, we found that PLK1 promotes the secretion of TNF‐α from PBMCs of intestinal BS patients, which causes overexpression of IFI16 and induces apoptosis of IECs via the STING–TBK1 pathway. The expressions of IFI16, TNF‐α, cleaved caspase 3, phosphorylated STING (pSTING) and phosphorylated tank binding kinase 1 (pTBK1) in the intestinal ulcer tissue of BS patients were significantly higher than that of HCs (all P < 0.05). PLK1 in PBMCs of intestinal BS patients increased TNF‐α secretion, inducing IEC apoptosis via activation of the IFI16–STING–TBK1 pathway. PLK1 and the IFI16–STING–TBK1 pathway may be new therapeutic targets for intestinal BS.
Model summarizing interactions between peripheral blood mononuclear cells (PBMCs) of intestinal Behçet's syndrome (BS) and intestinal epithelial cells (IECs). High expression of polo like kinase 1 (PLK1) promoted tumor necrosis factor‐α (TNF‐α) production and secretion from intestinal BS PBMCs that furthers the increase of interferon‐γ‐inducible protein 16 (IFI16) in IECs. IFI16 then induces IEC apoptosis via activation of the STING–TBK1 pathway.
In the past, long-distance free-space quantum communication experiments could only be implemented at night. During the daytime, the bright background sunlight prohibits quantum communication in ...transmission under conditions of high channel loss over long distances. Here, by choosing a working wavelength of 1,550 nm and developing free-space single-mode fibre-coupling technology and ultralow-noise upconversion single-photon detectors, we have overcome the noise due to sunlight and demonstrate free-space quantum key distribution over 53 km during the day. The total channel loss is ∼48 dB, which is greater than the 40 dB channel loss between the satellite and ground and between low-Earth-orbit satellites. Our system thus demonstrates the feasibility of satellite-based quantum communication in daylight. Moreover, given that our working wavelength is located in the optical telecom band, our system is naturally compatible with ground fibre networks and thus represents an essential step towards a satellite-constellation-based global quantum network.
Femtosecond lasers enable flexible and thermal‐damage‐free ablation of solid materials and are expected to play a critical role in high‐precision cutting, drilling, and shaping of electronic chips, ...display panels, and industrial parts. Although the potential applications are theoretically predicted, true 3D nano‐sculpturing of solids such as glasses and crystals, has not yet been demonstrated, owing to the technical challenge of negative cumulative effects of surface changes and debris accumulation on the delivery of laser pulses and subsequent material removal during direct‐write ablation. Here, a femtosecond laser‐induced cavitation‐assisted true 3D nano‐sculpturing technique based on the ingenious combination of cavitation dynamics and backside ablation is proposed to achieve stable clear‐field point‐by‐point material removal in real time for precise 3D subtractive fabrication on various difficult‐to‐process materials. As a result, 3D devices including free‐form silica lenses, micro‐statue with vivid facial features, and rotatable sapphire micro‐mechanical turbine, all with surface roughness less than 10 nm are readily produced. The true 3D processing capability can immediately enable novel structural and functional micro‐nano optics and non‐silicon micro‐electro‐mechanical systems based on various hard solids.
From technical points to cavitation mechanism, this work demonstrates an unprecedented laser nano‐subtractive technology based on continuous controllable precise ablation with both true 3D and wide material applicability, especially for hard crystals. This versatile technology will surely become a standard manufacturing method for various 3D devices in the micro‐nano field.
T lymphocytes are the major components of adaptive immunity in Behçet's syndrome (BS) pathology. However, the precise mechanism of T‐cell‐induced inflammatory condition remains to be determined. We ...applied bulk sequencing of the T‐cell receptor (TCR) β chain in peripheral blood samples from 45 patients with BS and 10 healthy donors as controls. TCR repertoires in BS patients displayed more clonality and less diversity than in healthy donors. Male patients exhibited lower diversity metrics of TCR and had a larger proportion in the top 10 clones than females (p = 0.016). There were no TCR clonality differences in other clinical features, such as age, disease duration, organ involvement, disease severity, and activity. By “Grouping of Lymphocyte Interactions by Paratope Hotspots” (GLIPH2) for antigen prediction, we found distinct 2477 clusters of TCR‐β sequences that potentially recognize similar antigens shared between BS patients. We observed clonal T‐cell expansion in BS patients. Sexual differences in TCR clonal expansion and public TCR groups deserve further study to reveal the underline T‐cell‐mediated immunity in BS.
Bulk sequencing of the TCR repertoires in BS patients displayed more clonality and less diversity than in healthy donors. Male patients exhibited lower diversity metrics of TCR than females. GLIPH2 predicted distinct clusters of TCR‐β sequences in BS patients.
PDF
