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Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .
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Índice Tobillo Braquial , Hipertensión , Retinopatía Hipertensiva , Análisis de la Onda del Pulso , Humanos , Masculino , Femenino , Índice Tobillo Braquial/métodos , Persona de Mediana Edad , China/epidemiología , Estudios Transversales , Análisis de la Onda del Pulso/métodos , Hipertensión/fisiopatología , Hipertensión/epidemiología , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/complicaciones , Anciano , Retinopatía Hipertensiva/epidemiología , Retinopatía Hipertensiva/diagnóstico , Prevalencia , Prevención Primaria/métodos , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/prevención & control , Accidente Cerebrovascular/fisiopatología , Factores de Riesgo , Antihipertensivos/uso terapéuticoRESUMEN
INTRODUCTION: Rhegmatogenous retinal detachment (RRD) is one of the most common fundus diseases. Many rural areas of China have few ophthalmologists, and ophthalmologic ultrasound examination is of great significance for remote diagnosis of RRD. Therefore, this study aimed to develop and evaluate a deep learning (DL) model, to be used for automated RRD diagnosis based on ophthalmologic ultrasound images, in order to support timely diagnosis of RRD in rural and remote areas. METHODS: A total of 6,000 ophthalmologic ultrasound images from 1,645 participants were used to train and verify the DL model. A total of 5,000 images were used for training and validating DL models, and an independent testing set of 1,000 images was used to test the performance of eight DL models trained using four different DL model architectures (fully connected neural network, LeNet5, AlexNet, and VGG16) and two preprocessing techniques (original, original image augmented). Receiver operating characteristic (ROC) curves were used to analyze their performance. Heatmaps were generated to visualize the process of the best DL model in the identification of RRD. Finally, five ophthalmologists were invited to diagnose RRD independently on the same test set of 1,000 images for performance comparison with the best DL model. RESULTS: The best DL model for identifying RRD achieved an area under the ROC curve (AUC) of 0.998 with a sensitivity and specificity of 99.2% and 99.8%, respectively. The best preprocessing method in each model architecture was the application of original image augmentation (average AUC = 0.982). The best model architecture in each preprocessing method was VGG16 (average AUC = 0.998). CONCLUSION: The best DL model determined in this study has higher accuracy, sensitivity, and specificity than the ophthalmologists' diagnosis in identifying RRD based on ophthalmologic ultrasound images. This model may provide support for timely diagnosis in locations without access to ophthalmologic care.
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Aprendizaje Profundo , Desprendimiento de Retina , Humanos , Desprendimiento de Retina/diagnóstico , Redes Neurales de la Computación , Fondo de Ojo , Curva ROCRESUMEN
Green glutinous rice is a unique genetic germplasm that has yet to be adequately studied. This study investigated antioxidant capacity and flavonoid metabolites in the bran layer of green glutinous rice (LvH) compared to purple (HeiH), red (HongH) and white (GJG) varieties. The results showed that LvH bran had significantly higher content of total flavonoids and anthocyanin than that of HongH (1.91-fold and 4.34-fold) and GJG (2.45-fold and 13.30-fold). LvH bran also showed significantly higher levels of vitamin B1 and vitamin E than that of HeiH (1.94-fold and 1.15-fold) and HongH (1.22-fold and 1.13-fold), indicating that green glutinous rice bran was rich in bioactive components. LvH bran showed significantly lower IC50 values for scavenging DPPH and ATBS radicals than GJG and even significantly lower IC50 value for scavenging DPPH radicals than HongH, highlighting its potential as an effective source of antioxidants. LvH bran had significantly different downstream metabolite synthesis in the flavonoid pathway compared to HeiH, HongH, and GJG, with 40, 26, and 22 different metabolites, 23, 20, and 33 up-regulated differentially expressed metabolites (DEMs), and 73, 50, and 13 down-regulated DEMs, respectively. Of the 139 flavonoid metabolites identified in colored rice bran, 26 metabolites showed significant positive correlation with both ABTS and DPPH radical scavenging capacity. Typically, quercetin derivatives showed potential for evaluating the antioxidant capacity of colored rice bran. These findings offer valuable insights into the antioxidant properties of green glutinous rice bran and provide references for better understanding of flavonoid metabolites in different colored rice bran.
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Antioxidantes , Oryza , Antioxidantes/química , Flavonoides/química , Oryza/química , Vitamina E/análisis , Semillas/química , Extractos Vegetales/químicaRESUMEN
Benefited from the rapid development of MBH reaction, the reaction of MBH adducts have been established as the most synthetically useful transformations. However, compared with the well-established allylic alkylations and (3+2)-annulations, the (1+4)-annulations of MBH adducts have not developed rapidly until recently. As a helpful complement to the (3+2)-annulations of MBH adducts, the (1+4)-annulations of MBH adducts opens a robust access to structurally diverse five-membered carbo- and heterocycles. This paper summarizes recent advances in organocatalytic (1+4)-annulations using MBH adducts as 1â C-synthons for the construction of functionalized five-membered carbo- and heterocycles.
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Phosphogypsum and red mud are bulk industrial solid wastes that trigger local environmental problems. In the present investigation, an efficient valorization process was developed through which phosphogypsum and red mud can be transformed into a precursor for the synthesis of high-strength, alkali-activated materials with a seawater-bearing sodium silicate solution as the alkaline activator. The effects of the activator modulus and liquid-to-solid ratio on the strength evolution of the synthesized AAMs as well as the microstructure and chemistry of the reaction products were investigated. The results showed that mineral reconstruction between PG and RM took place during calcination at 950 °C, forming ye'elimite, anhydrite and gehlenite, which then took part in the alkali-activation process and generated thenardite and C-A-S-H gel. The mechanical properties of the synthesized AAMs, ranging from 12.9 MPa to 40.6 MPa, were determined with the activator modulus and liquid-to-solid ratio. Results from the present investigation contributed to the facile and efficient valorization of phosphogypsum and red mud into cementitious construction materials.
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The development of sustainable cementitious materials is essential and urgent for the construction industry. Benefiting from excellent engineering properties and a reduced greenhouse gas footprint, alkali-activated materials (AAM) are among the robust alternatives to Portland cement for civil infrastructure. Meanwhile, concrete production also accounts for around 20% of all industrial water consumption, and the global freshwater shortage is increasing. This review discusses recent investigations on seawater-mixed AAMs, including the effects of seawater on workability, reaction mechanism, shrinkage, short and long-term strength, binding of chloride and corrosion of steel reinforcement. Attention is also paid to the utilization of sea sand as aggregate, as well as discussions on the challenges and further research perspectives on the field application of AAMs with seawater and sea sand.
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The complexity of municipal sludge dewatering is a bottleneck problem limiting resource utilization. In this paper, adding municipal solid waste incineration fly ash (MSWI FA) to municipal sludge for enhanced dewatering was applied, while the chlorine salt in MSWI FA was simultaneously removed using water in municipal sludge. The effects of different dosages and chemical components of MSWI FA on municipal sludge dewatering, and the removal effect of municipal sludge washing on Cl element were investigated. The results showed that the municipal sludge's specific resistance to filtration after co-treatment was significantly reduced, and more hydrophobic channels were formed in the vacuum suction filtration of the treated municipal sludge, conducive to efficient water removal. The moisture content of municipal sludge was reduced from 96.0% to 48.3%, and the moisture reduction rate increased from 17.7% to 32.1%. The chemical composition of MSWI FA could effectively promote the dewatering of municipal sludge, among which CaO was the best, followed by CaCl2 and NaCl, and KCl was the worst. Simultaneously, the municipal sludge showed a good effect on removing Cl from MSWI FA. The minimum Cl content in the mixture after Co-treatment is 1.5%. These results could provide a new way to dispose of MSWI FA and municipal sludge.
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Metales Pesados , Eliminación de Residuos , Incineración , Ceniza del Carbón , Residuos Sólidos , Aguas del Alcantarillado , Material Particulado , Metales Pesados/química , Carbono/química , Cloro/química , Cloruros , Cloruro de Sodio , AguaRESUMEN
MSWI fly ash and municipal sludge are solid wastes. Melting vitrification treatment was a resource utilization method. However, the flow temperature of grate furnace MSWI fly ash and municipal sludge was high (>1325 °C), which increased the energy consumption in the melting process. MSWI fly ash contained a large amount of CaO, and municipal sludge contained a large amount of SiO2, Al2O3, and Fe2O3. The temperature of melting vitrification can be reduced using these two kinds of CITY garbage as raw materials to change the proportion of ingredients. The eutectic characteristics of MSWI fly ash and municipal sludge and the phase diagrams of CaO-SiO2-Al2O3 (C-S-A) and CaO-SiO2-Al2O3-Fe2O3 (C-S-A-F) were analyzed in this paper. It established a low melting point mixing system. The results showed that when the amount of municipal sludge was 50-70%, the flow temperature of the mixtures was <1215 °C, which was significantly lower than that of MSWI fly ash (1490 °C) and municipal sludge (1325 °C). The optimal range of low melting point components was 14.1-36.3% CaO, 21.6-40.4% SiO2, 6.7-12.6% Al2O3, and 6.3-11.4% Fe2O3. At 400-1400 °C, the minerals in the mixtures mainly changed as follows: CaCO3 + SiO2 + Al2O3 â Ca2SiO4 + Ca3SiO5 + Ca2Al2SiO7 + Ca3Al2O6 + Ca12Al14O33 â CaAl2Si2O8. In the melting experiment, with the increase in temperature, most of the phases in the mixtures might become amorphous. Therefore, the low melting point phase anorthite (CaAl2Si2O8) only accounted for a small part of the final molten product.
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With the aid of acetic acid, a 1,10-conjugate addition-mediated formal [3 + 3] cyclization of alkynyl indole imine methides formed in situ from α-(6-indolyl) propargylic alcohols with 1,3-dicarbonyl compounds such as 4-hydroxycoumarins and cyclohexane-1,3-diones was developed, which provided robust access to a wide range of pyranocoumarin and pyran derivatives containing an indole skeleton with high efficiency under mild conditions.
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Iminas , Indoles , Catálisis , Ciclización , PiranosRESUMEN
An asymmetric organocatalytic remote 1,10-addition of alkynyl indole imine methides generated in situ from α-(6-indolyl) propargylic alcohols with thiazolones has been developed for the first time, affording axially chiral tetrasubstituted allenes featuring vicinal sulfur-containing quaternary carbon stereocenters in high yields with excellent stereoselectivities. The representative scale-up reaction and transformations of the 1,10-adduct were examined. The reaction mechanism was expounded by control experiments and DFT calculations.
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The combustion-supporting effect of steam to coke breeze in sintering has the potential to improve sinter quality and reduce pollutants emissions. The results show that increasing the by-product steam injection concentration (0.32-0.47vol%) and prolonging the injection time (5 min) within a proper range (10-15 min) can improve sinter quality. 2.13kgce/t-sinter of the fuel consumption was decreased by reducing coke breeze usage from 5.60 to 5.45% under the recommended parameters, with 15.16% decrease of CO in sintering waste gas. By comparing experimental data with thermodynamic calculations, although the reaction between CO and steam can reduce CO emission and generate H2, steam tends to react with coke breeze to generate H2 and CO (react at 674â), and OH radical produced by H2 which can reduce the activation energy of CO oxidation reaction is the key to reducing pollutant emissions. The potential economic benefit of steam injection technology was calculated based on a 360m2 sintering machine (the annual sinter output is 3.2million tons), excluding the equipment modification and steam injection cost of $300,000; a profit of $737491.2 per year or 0.23 dollars per ton sinter can be achieved. Therefore, low-carbon and cleaner iron ore sintering production can be realized through applying by-product steam.
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Coque , Hierro , VaporRESUMEN
Phosphine-catalyzed enantioselective formal (4 + 2)-cycloadditions of 2-(4H-benzo[d][1,3]oxazin-4-yl)acrylates with isocyanates have been developed for the first time. The initial SN2' attack of the chiral phosphine organocatalyst on 2-(4H-benzo[d][1,3]oxazin-4-yl)acrylates generated the key phosphine-containing dipolar intermediates, and the subsequent formal cycloaddition with isocyanates furnished a broad scope of 3,4-dihydroquinazolin-2-ones in 60-84% yields with 61-92% ee.
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Acrilatos , Isocianatos , Catálisis , Reacción de Cicloadición , Fosfinas , EstereoisomerismoRESUMEN
A type of Morita-Baylis-Hillman (MBH) carbonates has been developed from ninhydrin. These MBH carbonates have been successfully employed as 3C-synthons in the organocatalytic asymmetric [3 + 2]-annulations of the isatin-derived electron-deficient olefins, affording structurally diverse spirooxindoles in high yield with excellent stereoselectivity. In particular, the regioselectivity of MBH carbonates was controlled by the reaction partner, 3-methyleneoxindoles with carbonyl groups (R = ArCO), affording ß-selective products and 3-methyleneoxindoles with ester groups (R = CO2Me) furnishing γ-selective products. The representative scale-up reactions and transformation of product were examined. The reaction mechanism was expounded by control experiments.
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Isatina , Ninhidrina , Carbonatos , Catálisis , EstereoisomerismoRESUMEN
Despite its high antitumor activity, the clinical application of chemotherapy is greatly impeded by lacking of specific accumulation and poor solubility. To address the above challenges, we designed a AS1411 aptamer modified nanoparticles based on molecular recognition of nucleobases. Firstly, a redox sensitive Paclitaxel-SS-Zidovudine (PZ) prodrug was synthesized. Then PZ/ß-lapachone/AS1411/DSPE-PEG nanoparticles were prepared and AS1411 aptamer was connected through molecular recognition between the nucleoside analogue Zidovudine (ZDV) and the thymine on aptamer. DSPE-PEG (DP) was incorporated into nanoparticles to prolong the residence time of nanoparticles in the blood circulation. Furthermore, to realize the combination treatment, ß-lapachone (LAP) has been incorporated into nanoparticles with high drug loading efficiency through the interaction of π-π stacking force and H-bonding between LAP and Paclitaxel (PTX). LAP can generate abundant exogenous reactive oxygen species (ROS) via the bioactivation of NAD(P)H: quinone oxidoreductase-1 (NQO1). Moreover, the connection of Zidovudine (ZDV) and AS1411 through molecular recognition of nucleobases further optimized the nanoparticles with high affinity to nucleolin which overexpressed on tumor cell membrane, thereby inducing the specific accumulation of nanoparticles in tumor sites. In vivo and in vitro studies showed that the obtained nanoparticles of PZ/LAP/AS1411/DP exhibited better tumor growth inhibition and lower systemic side effects. Herein, we have rationally conducted a novel self-codelivery system for effectively synergistic antitumor treatment.
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Nanopartículas Multifuncionales , Nanopartículas , Profármacos , Aptámeros de Nucleótidos , Línea Celular Tumoral , Naftoquinonas , Nucleósidos , Oligodesoxirribonucleótidos , Oxidación-Reducción , Paclitaxel , Profármacos/farmacologíaRESUMEN
Purpose: This study aimed to investigate the association between hypertensive retinopathy and the risk of first stroke, examine possible effect modifiers in hypertensive patients, and test the appropriateness of the Keith-Wagener-Barker (KWB) classification for predicting stroke risk. Methods: In total, 9793 hypertensive participants (3727 males and 6066 females) without stroke history from the China Stroke Primary Prevention Trial were included in this study. The primary outcome was first stroke. Results: Over a median follow-up of 4.4 years, 592 participants experienced their first stroke (509 ischemic, 77 hemorrhagic, and six unclassifiable strokes). In total, 5590 participants were diagnosed with grade 1 retinopathy (57.08%), 1466 with grade 2 retinopathy (14.97%), 231 with grade 3 retinopathy (2.36%), and three with grade 4 retinopathy (0.03%). Grades 1 and 2 were merged and classified as mild retinopathy, and grades 3 and 4 were merged and classified as severe retinopathy. There was a significant positive association between hypertensive retinopathy and the risk of first stroke and first ischemic stroke, and no effect modifiers were found. The hazard ratios (HRs) for first stroke were as follows: mild versus no retinopathy, 1.26 (95% confidence interval [CI], 1.01-1.58, P = 0.040), and severe versus no retinopathy, 2.40 (95% CI, 1.49-3.84, P < 0.001). The HRs for ischemic stroke were as follows: severe versus no retinopathy, 2.35 (95% CI, 1.41-3.90, P = 0.001), and nonsignificantly increased HRs for mild versus no retinopathy, 1.26 (95% CI, 0.99-1.60, P = 0.057). Conclusions: There was a significant positive association between hypertensive retinopathy and the risk of first stroke in patients with hypertension, indicating that hypertensive retinopathy may be a predictor of the risk of stroke. A simplified two-grade classification system based on the KWB classification is recommended for predicting stroke risk.
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Presión Sanguínea/fisiología , Hipertensión/complicaciones , Retinopatía Hipertensiva/complicaciones , Prevención Primaria/métodos , Medición de Riesgo/métodos , Accidente Cerebrovascular/epidemiología , Anciano , China/epidemiología , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/fisiopatología , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & controlRESUMEN
An enantioselective [2 + 4]-annulation of γ-substituted allenoates with N-acyldiazenes has been developed for the first time. In the presence of an l-proline-derived DMAP analogue, the annulation proceeded smoothly to afford a broad range of 1,3,4-oxadiazine derivatives in good to excellent yields with high stereoselectivities.
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In this paper, a novel redox-responsive nanoparticles has been designed for targeted delivery of docetaxel (DTX). Chondroitin sulfate (CS) was used to construct the nanoparticles due to the ability of tumor targeting through binding with CD44 receptor that overexpresses on the surfaces of various tumor cells. A redox-responsive small-molecular DTX prodrug was prepared through modifying with cystamine containing disulfide bonds (Cys-DTX). Then the DTX prodrug was grafted to the CS to construct the amphiphilic polymer (CS-ss-DTX). Further, Cys-DTX/CS-ss-DTX nanoparticles were formed by self-assembly of amphiphilic polymer and incorporation of free Cys-DTX prodrug. This category of nanosized DTX delivery system was expected for not only exhibiting high permeability and cytotoxicity of Cys-DTX prodrug, but also targeting transportation of encapsulated redox-responsive Cys-DTX prodrug. According to results of related researches on physicochemical properties and biological evaluation, the novel redox-responsive Cys-DTX/CS-ss-DTX nanoparticles increased amount of DTX released from the nanoparticles in reductive environment, improved permeability in tumor tissues, enhanced cytotoxicity and decreased side effects compared with free DTX. All of these results showed that this kind of Cys-DTX/CS-ss-DTX nanoparticles were worthy of being expectation in tumor chemotherapy in future.
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Antineoplásicos/farmacología , Sulfatos de Condroitina/química , Docetaxel/farmacología , Glicoconjugados/farmacología , Melanoma Experimental/tratamiento farmacológico , Profármacos/farmacología , Neoplasias Cutáneas/tratamiento farmacológico , Animales , Antineoplásicos/química , Antineoplásicos/metabolismo , Supervivencia Celular/efectos de los fármacos , Docetaxel/química , Docetaxel/metabolismo , Portadores de Fármacos/síntesis química , Portadores de Fármacos/metabolismo , Portadores de Fármacos/farmacología , Liberación de Fármacos , Femenino , Glicoconjugados/química , Glicoconjugados/metabolismo , Humanos , Células MCF-7 , Melanoma Experimental/metabolismo , Melanoma Experimental/patología , Ratones , Micelas , Nanopartículas/administración & dosificación , Nanopartículas/química , Nanopartículas/ultraestructura , Oxidación-Reducción , Profármacos/química , Profármacos/metabolismo , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Carga Tumoral/efectos de los fármacosRESUMEN
Alkali-activated materials (AAMs) are considered to be alternative cementitious materials for civil infrastructures. Nowadays, efforts have been made in developing AAMs with self-compacting ability. The obtained self-compacting AAMs (SCAAMs) accomplish superior passing and filling properties as well as excellent mechanical and environmental advantages. This work critically revisits recent progresses in SCAAMs including mixture proportions, fresh properties, mechanical strength, microstructure, acid and sulfate resistance, high temperature behaviors, impact resistance and interface shear strength. To facilitate direct comparison and interpretation of data from different publications, mixture proportions were normalized in terms of the content of key reactive components from precursors and activators, and correlation with mechanical behaviors was made. Moreover, special attention was paid to current research challenges and perspectives to promote further investigation and field application of SCAAMs as advanced construction material.
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Conventional melting for disposing municipal solid waste incineration (MSWI) fly ash or bottom slag needed high temperature and consumed high energy. High calcium content in fly ash and high silicon content in bottom slag brought them high melting point, respectively. Based on the analysis of chemical composition and phase diagram, suitable contents, namely 30%-40% CaO, 45%-60% SiO2 and 10%-15% Al2O3, were proposed to obtain a lower-melting-point mixture system. When the mass ratio of fly ash to bottom slag was 1:5, lowest melting point can be obtained. It was 1,190 â, lower than that of fly ash (1,448 â) and bottom slag (1,310 â). The toxicity characteristic leaching procedure of slags obtained from low melting treatment met the leaching toxicity of Chinese standard GB 5085.3-2007, and the slags containing about 25 wt% CaO, 10 wt% Al2O3 and 45 wt% SiO2 can be used for preparing CaO-Al2O3-SiO2 glass ceramics. The co-process of fly ash and bottom slag realized the low temperature melting treatment with low energy consumption.