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Levosimendan and dobutamine are extensively used to treat sepsis-associated cardiovascular failure in ICU. Nevertheless, the role and mechanism of levosimendan in patients with sepsis-induced cardiomyopathy remains unclear. Moreover, previous studies on whether levosimendan is superior to dobutamine are still controversial. More importantly, these studies did not take changes (before-after comparison to the baseline) in quantitative parameters such as ejection fraction into account with the baseline level. Here, we aimed to determine the pros and cons of the two medicines by assessing the changes in cardiac function and blood lactate, mortality, with the standardized mean difference used as a summary statistic. Relevant studies were obtained by a thorough and disciplined literature search in several notable academic databases, including Google Scholar, PubMed, Cochrane Library and Embase until November 2020. Outcomes included changes in cardiac function, lactic acid, mortality and length of hospital stay. A total of 6 randomized controlled trials were included in this study, including 192 patients. Compared with dobutamine, patients treated with levosimendan had a greater improvement of cardiac index (ΔCI) (random effects, SMD = 0.90 [0.20,1.60]; I 2  = 76%, P  < 0.01) and left ventricular stroke work index (ΔLVSWI) (random effects, SMD = 1.56 [0.90,2.21]; I 2  = 65%, P  = 0.04), a significant decrease of blood lactate (Δblood lactate) (random effects, MD =  − 0.79 [− 1.33, − 0.25]; I 2  = 68%, P  < 0.01) at 24-h after drug intervention, respectively. There was no significant difference between levosimendan and dobutamine on all-cause mortality in ICU (fixed effect, OR = 0.72 [0.39,1.33]; I 2  = 0%, P  = 0.99). We combine effect sizes related to different measurement parameters to evaluate cardiac function, which implied that septic patients with myocardial dysfunction might have a better improvement of cardiac function by levosimendan than dobutamine (random effects, SMD = 1.05 [0.69,1.41]; I 2  = 67%, P  < 0.01). This study suggested a significant improvement of CI, LVSWI, and decrease of blood lactate in septic patients with myocardial dysfunction in ICU after 24-h administration of levosimendan than dobutamine. However, the administration of levosimendan has neither an impact on mortality nor LVEF. Septic patients with myocardial dysfunction may partly benefit from levosimendan than dobutamine, mainly embodied in cardiac function improvement.

Non-reciprocal devices, which allow non-reciprocal signal routing, serve as fundamental elements in photonic and microwave circuits and are crucial in both classical and quantum information processing. The radiation-pressure-induced coupling between light and mechanical motion in travelling-wave resonators has been exploited to break the Lorentz reciprocity, enabling non-reciprocal devices without magnetic materials. Here, we experimentally demonstrate a reconfigurable non-reciprocal device with alternative functions as either a circulator or a directional amplifier via optomechanically induced coherent photon–phonon conversion or gain. The demonstrated device exhibits considerable flexibility and offers exciting opportunities for combining reconfigurability, non-reciprocity and active properties in single photonic devices, which can also be generalized to microwave and acoustic circuits. Upconversion nanoparticles, which convert lower-energy light into higher-energy light, have many potential applications including sensing and imaging. Here, Wen et al. review recent advances that have addressed concentration quenching and enabled increasingly bright nanoparticles, opening up their full potential.

In this paper, on the basis of in-depth research on the key technology of binocular vision measurement; a set of multidimension online measurement system for image recognition is built. Canny operator is used as a tool to detect the contour features of parts, and the Canny operator is accelerated and improved from the aspects of mathematical reasoning and Gaussian pyramid. A synchronous external trigger circuit for a binocular camera and light source was designed. Finally, the improved algorithms in various aspects of visual measurement in this paper are applied to the measurement system. The experimental results show that the online measurement system has the advantages of high measurement accuracy and small repeatability errors.

Pollution by heavy metals limits the area of land available for cultivation of food crops. A potential solution to this problem might lie in the molecular breeding of food crops for phytoremediation that accumulate toxic metals in straw while producing safe and nutritious grains. Here, we identify a rice quantitative trait locus we name cadmium (Cd) accumulation in leaf 1 ( CAL1 ), which encodes a defensin-like protein. CAL1 is expressed preferentially in root exodermis and xylem parenchyma cells. We provide evidence that CAL1 acts by chelating Cd in the cytosol and facilitating Cd secretion to extracellular spaces, hence lowering cytosolic Cd concentration while driving long-distance Cd transport via xylem vessels. CAL1 does not appear to affect Cd accumulation in rice grains or the accumulation of other essential metals, thus providing an efficient molecular tool to breed dual-function rice varieties that produce safe grains while remediating paddy soils. Crops that allocate heavy metals to leaves rather than grains could allow phytoremediation of polluted soil while producing food that is safe to eat. Here, the authors show that a defensin-like protein promotes cadmium secretion from rice cells and allocation to leaves without causing accumulation in grain.

Axially chiral styrenes bearing a chiral axis between a sterically non-congested acyclic alkene and an aryl ring are difficult to prepare due to low rotational barrier of the axis. Disclosed here is an N -heterocyclic carbene (NHC) catalytic asymmetric solution to this problem. Our reaction involves ynals, sulfinic acids, and phenols as the substrates with an NHC as the catalyst. Key steps involve selective 1,4-addition of sulfinic anion to acetylenic acylazolium intermediate and sequential E -selective protonation to set up the chiral axis. Our reaction affords axially chiral styrenes bearing a chiral axis as the product with up to > 99:1 e.r ., > 20:1 E / Z selectivity, and excellent yields. The sulfone and carboxylic ester moieties in our styrene products are common moieties in bioactive molecules and asymmetric catalysis. Axially chiral styrenes bearing a chiral axis between a sterically non-congested acyclic alkene and an aryl ring are difficult to prepare due to low rotational barrier of the axis. Here the authors present a method to form axially chiral styrenes bearing sulfones and carboxylic acids via NHC catalysis.

Objective The study aimed to assess the value of pretreatment peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immune-inflammation index/albumin ratio (SII/ALB) for predicting immunotherapy prognosis and efficacy in Non-small cell lung carcinoma (NSCLC) treated with Immune checkpoint inhibitors (ICIs) and opioids. Methods A total of 78 NSCLC patients received ICIs and opioids were retrospectively collected. The optimal cut-off values were determined by receiver operating characteristic curves. The univariate and multivariate analysis investigated the effects of NLR, PLR, and SII/ALB on patients prognosis. Results NLR and PLR had predictive value of efficacy. SII/ALB > 17.79 was an independent risk factor for worse outcomes. Conclusion PLR and SII/ALB have predictive value of efficacy, but NLR was not. SII/ALB > 17.79 suggests a poor prognosis following immunotherapy in NSCLC patients receiving ICIs and opioids.

Non-magnetic non-reciprocal transparency and amplification is experimentally achieved by optomechanics using a whispering-gallery microresonator. The idea may lead to integrated all-optical isolators or non-reciprocal phase shifters. Non-reciprocal devices, such as circulators and isolators, are indispensable components in classical and quantum information processing in integrated photonic circuits 1 . Aside from these applications, the non-reciprocal phase shift is of fundamental interest for exploring exotic topological photonics 2 , such as the realization of chiral edge states and topological protection 3 , 4 . However, incorporating low-optical-loss magnetic materials into a photonic chip is technically challenging 5 . In this study we experimentally demonstrate non-magnetic non-reciprocity using optomechanical interactions in a whispering gallery microresonator, as proposed in a previous work 6 . Optomechanically induced non-reciprocal transparency and amplification are observed and a non-reciprocal phase shift of up to 40° is also demonstrated. The underlying mechanism of optomechanically induced non-reciprocity has great potential for all-optical controllable isolators and circulators, as well as non-reciprocal phase shifters in integrated photonic chips.

Background and aims Cancer will soon become the leading cause of death in every country in the twenty-first century. This study aimed to analyze the mortality and morbidity of 29 types of cancer in 204 countries or regions from 1990 to 2019 to guide global cancer prevention and control. Methods Detailed information for 29 cancer groups was collected from the Global Burden of Disease Study in 2019. The age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of the 29 cancer groups were calculated based on sex, age, region, and country. In addition, separate analyses were performed for major cancer types. Results In 2019, more than 10 million people died from cancer, which was approximately twice the number in 1990. Tracheal, bronchus, and lung (TBL) cancers collectively showed the highest death rate, and the ASDR of pancreatic cancer increased by 24%, which was cancer with the highest case fatality rate (CFR). The global cancer ASIR showed an increasing trend, with testicular cancer, thyroid cancer, and malignant skin melanoma showing a significant increase. The ASDR and ASIR of cancer in males were about 1.5 times higher than that in females. Individuals over 50 years had the highest risk of developing cancer, with incidences and deaths in this age group accounting for more than 85% of cancers in all age groups. Asia has the heaviest cancer burden due to its high population density, with esophageal cancer in this region accounting for 53% of the total fatalities related to this type of cancer in the world. In addition, the mortality and morbidity of most cancers increased with the increase in the development or socio-demographic index (SDI) in the SDI regions based on the World Bank's Human Development Index (HDI), with cancer characteristics varying in the different countries globally. Conclusions The global cancer burden continues to increase, with substantial mortality and morbidity differences among the different regions, ages, countries, gender, and cancer types. Effective and locally tailored cancer prevention and control measures are essential in reducing the global cancer burden in the future.