[A multicenter retrospective study on clinical features and pathogenic composition of septic shock in children]

Objective: To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China. Methods: Multi-center retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results: A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality (OR=1.04, 1.09, 0.67, 95%CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions: Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.

Microplastics colonized by Hafnia paralvei through biofilm formation regulated by c-di-GMP and cAMP promote its spread in water

Microplastics (MPs) colonized by pathogens pose significant risks to the environment and health of animals and humans, however, the strategies for pathogens colonization in MPs and the effects of its colonization on spread of pathogens have not been fully characterized. Here, we investigated the biofilm formation mechanism regulated by c-di-GMP in Hafnia paralvei Z11, and determined the effect of MPs colonized by H. paralvei Z11 on the spread of strain Z11. Overexpression of yhjH, a c-di-GMP phosphodiesterase gene, attenuated intracellular c-di-GMP level in strain Z11, leading to an increase in biofilm dispersal and a decrease in biofilm formation. Meanwhile, the decline of c-di-GMP inhibited the expression of cAMP phosphodiesterase genes, increasing the cAMP content and promoting bacterial motility, that was responsible for the increase of biofilm dispersal. Furthermore, the formation of biofilms by strain Z11 on MPs promotes its colonization, which contributes to its vertical and horizontal spread in water after colonizing polyvinyl chloride-MPs and polypropylene-MPs, respectively. Therefore, this study reveals, for the first time, MPs colonized by H. paralvei Z11 through biofilms regulated by crosstalk between c-di GMP and cAMP promote the spread of strain Z11 in water, which expands the understanding of colonization strategy of pathogens on MPs and its risk on spread of pathogens.

Association of depressive symptoms and incident chronic kidney disease in middle-aged and older adults

BACKGROUND

Emerging evidence suggests that depressive symptoms may be a risk factor for the development of Chronic kidney disease (CKD). This study aimed to investigate the association between depressive symptoms and the incidence of CKD in middle-aged and older Chinese adults.

METHODS

We utilized data from the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Incident CKD was defined based on the estimated glomerular filtration rate ≤ 60 mL/min/m2 or self-reported. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95 % confidence intervals (95 % CI) for incident CKD, adjusting for potential confounders.

RESULTS

Among the 10,996 participants without baseline CKD, 890 developed CKD during a median follow-up of 9.0 years. After adjusting for potential covariates, participants with depressive symptoms had a significantly higher risk of developing CKD compared to those without depressive symptoms (HR: 1.450; 95 % CI: 1.249-1.682). The association remained statistically significant when the CES-D was scored according to the severity of depressive symptoms, i.e., quintiles. A linear positive association between total CES-D score and risk of incident CKD was also found using restricted cubic spline regression (Pfor non-linearity = 0.114).

CONCLUSIONS

Depressive symptoms are significantly associated with an increased risk of incident CKD in middle-aged and older Chinese adults. These findings underscore the importance of mental health screening and interventions in preventing CKD in this population.

Spiroannulations of β-Ketothioamides with Bromoenals via Selective C-Michael Addition and S-Michael Addition-Triggered Cascade Reactions

A spiroannulation reaction of β-ketothioamides with aromatic β-bromoenals and aromatic α-bromoenals via selective C-Michael addition and S-Michael addition-triggered cascade reactions has been developed. This protocol provides a novel and rapid approach for the synthesis of substituted spirothiopyran and spirothiophene derivatives under mild conditions with moderate to good yields and a broad substrate scope.

High-resolution motion compensation for brain PET imaging using real-time electromagnetic motion tracking

BACKGROUND

Substantial improvements in spatial resolution in brain positron emission tomography (PET) scanners have greatly reduced partial volume effect, making head movement the main source of image blur. To achieve high-resolution PET neuroimaging, precise real-time estimation of both head position and orientation is essential for accurate motion compensation.

PURPOSE

A high-resolution electromagnetic motion tracking (EMMT) system with an event-by-event motion correction is developed for PET-CT scanners.

METHODS

EMMT is comprised of a source, an array of sensors, and a readout electronic unit (REU). The source acts as a transmitter and emits an EM dipole field. It is placed in close proximity to the sensor array and detects changes in EM flux density due to sensor movement. The REU digitizes signals from each sensor and captures precise rotational and translational movements in real time. Tracked motion in the EMMT coordinate system is synchronized with the PET list-mode data and transformed into the scanner coordinate system by locating paired positions in both systems. The optimal rigid motion is estimated using singular value decomposition. The rigid motion and depth-of-interaction (DOI) parallax effect are corrected by event-by-event rebinning of mispositioned lines-of-response (LORs). We integrated the EMMT with our recently developed ultra-high resolution Prism-PET prototype brain scanner and a commercial Siemens Biograph mCT PET-CT scanner. We assessed the imaging performance of the Prism-PET/EMMT system using multi-frame motion of point sources and phantoms. The mCT/EMMT system was validated using a set of point sources attached to both a mannequin head and a human volunteer, for simulating multiframe and continuous motions, respectively. Additionally, a human subject for [18F]MK6240 PET imaging was included.

RESULTS

The tracking accuracy of the Prism-PET/EMMT system was quantified as a root-mean-square (RMS) error of 0.49∘ $^{\circ }$ for 100∘ $^{\circ }$ axial rotations, and an RMS error of 0.15 mm for 100 mm translations.The percent difference (%diff) in average full width at half maximum (FWHM) of point source between motion-corrected and static images, within a motion range of± 20 ∘ $\pm 20^\circ$ and ± $\pm$ 10 mm from the center of the scanner's field-of-view (FOV), was 3.9%. The measured recovery coefficients of the 2.5-mm diameter sphere in the activity-filled partial volume correction phantom were 23.9%, 70.8%, and 74.0% for the phantom with multi-frame motion, with motion and motion compensation, and without motion, respectively. In the mCT/EMMT system, the %diff in average FWHM of point sources between motion-corrected and static images, within a motion range of± 30 ∘ $\pm 30^\circ$ and ± $\pm$ 10 mm from the center of the FOV, was 14%. Applying motion correction to the [18F]MK6240 PET imaging reduced the motion-induced spill-in artifact in the lateral ventricle region, lowering its standardized uptake value ratio (SUVR) from 0.70 to 0.34.

CONCLUSIONS

The proposed EMMT system is a cost-effective, high frame-rate, and none-line-of-sight alternative to infrared camera-based tracking systems and is capable of achieving high rotational and translational tracking accuracies for mitigating motion-induced blur in high-resolution brain dedicated PET scanners.

Electro-Spun P(VDF-HFP)/Silica Composite Gel Electrolytes for High-Performance Lithium-Ion Batteries

This work presents a facile way to fabricate a polymer/ceramics composite gel electrolyte to improve the overall properties of lithium-ion batteries. Lithium salt-grafted silica was synthesized and mixed with P(VDF-HFP) to produce a nanofiber film by the electrostatic spinning method. After coating a layer of SiO2 onto the surface of nanofibers through a sol-gel method, a composite nanofiber film was obtained. It was then immersed in plasticizer until saturation to make a composite gel electrolyte film. Electrochemical test results showed that the obtained gel electrolyte film shows high thermal stability (~450 °C), high ionic conductivity of 1.3 × 10-3 S cm-1 at 25 °C and a lithium-ion transference number of 0.58, and superior cycling stability, providing a new direction for manufacturing secondary batteries with higher safety and performance.

Rational Design of a Highly Sensitive Carboxylesterase Probe and Its Application in High-Throughput Screening for Uncovering Carboxylesterase Inhibitors

Tracking carboxylesterases (CESs) through noninvasive and dynamic imaging is of great significance for diagnosing and treating CES-related metabolic diseases. Herein, three BODIPY-based fluorescent probes with a pyridine unit quaternarized via an acetoxybenzyl group were designed and synthesized to detect CESs based on the photoinduced electron transfer process. Notably, among these probes, BDPN2-CES exhibited a remarkable 182-fold fluorescence enhancement for CESs within 10 min. Moreover, BDPN2-CES successfully enabled real-time imaging of endogenous CES variations in living cells. Using BDPN2-CES, a visual high-throughput screening method for CES inhibitors was established, culminating in the discovery of an efficient inhibitor, WZU-13, sourced from a chemical library. These findings suggest that BDPN2-CES could provide a new avenue for diagnosing CES-related diseases, and WZU-13 emerges as a promising therapeutic candidate for CES-overexpression pathological processes.

A Novel Method for Rapid Screening of Salmonidae Ingredients and Accurate Detection of Atlantic Salmon (Salmo salar) Simultaneously Using Duplex Real-Time PCR Coupled with Melting Curve Analysis

The substitution of ingredients with Salmonidae, particularly Salmo salar, has led to widespread reports of financial losses and health risks globally, emphasizing the urgent need for the development of a rapid and precise method for species identification. The aim of the present study was to develop a novel method for the rapid screening of Salmonidae ingredients and the accurate detection of S. salar simultaneously using multiplex real-time PCR coupled with melting curve analysis. Specifically, primer sets specific for S. salar and Salmonidae were cross-confirmed. Moreover, the reaction system and conditions of a real-time duplex PCR were optimized, and the proposed methodology was verified, proving that the assay has good specificity and sensitivity. Clear and distinguishable melting peaks, with expected Tm values of around 80 °C (S. salar) and 84 °C (Salmonidae), were observed for twelve products, proving the presence of S. salar. However, four products were not derived from S. salar, but they could have belonged to another species within the Salmonidae family due to the presence of only one specific melting peak at a Tm value of about 84 °C. Therefore, the novel assay in the present study allows for the fast and accurate screening of Salmonidae ingredients and the detection of S. salar simultaneously.

A practical approach to estimate analytical method variability from routine testing

The performance of analytical test methods is critical to ensure decisions that affect efficacy and quality of pharmaceutical products are based on accurate and reliable results. As described in USP <1220> and advocated for in ICH Q14, continued verification of critical method attributes linked to bias and precision is essential to ensure method performance throughout the lifecycle of an analytical test method. As continued verification programs for analytical methods within the pharmaceutical industry mature, additional monitoring tools are required to deliver robust and cost-effective verification programs. Herein, a novel methodology is presented to evaluated analytical method variability directly from results generated during routine method execution. The implementation of the methodology is demonstrated for a small molecule liquid chromatographic assay method utilizing a single-point external reference calibration. Approaches to reduce the required data to be collected and broaden the applicability of the methodology to a wide range of analytical methods is described. Finally, the application of the methodology to method development activities is discussed to aid in the identification of variability sources and effectively select replication strategies, thus allowing a holistic understanding of method variability throughout the entirety of the method lifecycle.

Modulation in work function of CoTe as bifunctional electrocatalyst for rechargeable zinc air battery

The sluggish kinetics and inferior stability of oxygen electrocatalyst in rechargeable zinc air battery (ZAB) hamper its industrialization. In this work, we activate cobalt telluride (CoTe) by introduction of metallic cobalt (Co) to modulate the work function to facilitate the electron transfer from Co to CoTe during oxygen catalysis; additionally, the three-dimensional porous carbon nanosheets (3DPC) are invited to reduce the resistance towards electrolyte/oxygen diffusion. Thereby, Co-CoTe@3DPC only demands 280 mV overpotential to reach 10 mA cm-2 under alkaline oxygen evolution reaction (OER) condition, relatively lower than commercial iridium oxides (IrO2); besides, the operando electrochemical impedance spectroscopy (EIS) indicates a better resistance towards surface reconstruction than Co@3DPC leading to a superior stability. A Pt-like oxygen reduction reaction (ORR) performance, half-wave potential associated with kinetic current density, is achieved for Co-CoTe@3DPC. A maximum power density of 203 mW cm-2 is achieved and sustains for 800 h. Furthermore, the all-solid-state ZAB offers 97 mW cm-2. Theoretical calculation suggests that the incorporation of metallic Co to CoTe maintains the superb ORR activity and promotes the OER catalysis.

Bivalirudin vs Heparin Anticoagulation in STEMI: Confirmation of the BRIGHT-4 Results

BACKGROUND

In the BRIGHT-4 (Bivalirudin With Prolonged Full-Dose Infusion During Primary PCI Versus Heparin Trial-4), anticoagulation with bivalirudin plus a 2- to 4-hour high-dose infusion after percutaneous coronary intervention (PCI) reduced all-cause mortality and bleeding without increasing reinfarction or stent thrombosis compared with heparin alone in patients with ST-segment elevation myocardial infarction (STEMI). These findings require external validation.

OBJECTIVES

This study sought to determine outcomes of bivalirudin vs heparin anticoagulation during PCI in STEMI.

METHODS

We performed an individual-patient-data meta-analysis of all large randomized trials of bivalirudin vs heparin in STEMI patients undergoing primary PCI performed before BRIGHT-4. The primary endpoint was all-cause mortality.

RESULTS

Six trials randomizing 15,254 patients were included. Pooled across all regimens of bivalirudin and glycoprotein IIb/IIIa inhibitor (GPI) use, bivalirudin reduced 30-day all-cause mortality (2.5% vs 2.9%; adjusted OR: 0.78; 95% CI: 0.62-0.99), cardiac mortality (adjusted OR: 0.69; 95% CI: 0.54-0.88), and major bleeding (adjusted OR: 0.53; 95% CI: 0.44-0.64) but increased reinfarction (adjusted OR: 1.30; 95% CI: 1.02-1.65) and stent thrombosis (adjusted OR: 1.43; 95% CI: 1.05-1.93) compared with heparin. In 4 trials in which 6,244 patients were randomized to bivalirudin plus a high-dose post-PCI infusion vs heparin without planned GPI use (the BRIGHT-4 regimens), 30-day all-cause mortality occurred in 1.8% vs 2.9% of patients, respectively (adjusted OR: 0.74; 95% CI: 0.48-1.12), and bivalirudin reduced cardiac mortality (adjusted OR: 0.62; 95% CI: 0.39-0.97) and major bleeding (adjusted OR: 0.49; 95% CI: 0.35-0.70), with similar rates of reinfarction (adjusted OR: 0.89; 95% CI: 0.58-1.38) and stent thrombosis (adjusted OR: 0.80; 95% CI: 0.41-1.57).

CONCLUSIONS

In STEMI patients undergoing primary PCI, bivalirudin with a 2- to 4-hour post-PCI high-dose infusion reduced cardiac mortality and major bleeding without an increase in ischemic events compared with heparin monotherapy with provisional GPI use, confirming the BRIGHT-4 results.

Effect of modified cellulose-based emulsion on gel properties and protein conformation of Nemipterus virgatus surimi

Microcrystalline cellulose was modified by TEMPO oxidation combined with ultrasound to prepare modified cellulose-based emulsion. The effect of different emulsion concentration on gel properties and protein conformation of surimi was investigated. The results showed the length and width of microcrystalline cellulose were reduced, and a large amount of -COOH was introduced into modified cellulose. Direct addition of flaxseed oil decreased the gel strength and WHC from 3640.49 g·mm and 76.94% to 2702.95 g·mm and 75.89%, respectively, while 5% modified cellulose-based emulsion could improve the gel properties of surimi. Surimi gel containing 5% emulsion had the highest hydrophobic interaction, disulfide bond and β-sheet content. Moreover, protein network structure was the densest in 5% emulsion group. Therefore, modified cellulose-based emulsion could be used to compensating for the negative impact of direct addition of flaxseed oil on surimi, which provided a new idea for the development of healthy and new emulsified surimi products.

An innovative triple interface reinforced photocatalytic system based on BiOCl/BaTiO3@Co-BDC-MOF composite for the simultaneous detoxification of Cr(VI) and sulfamethoxazole

The development of effective photocatalysts for the reduction of Cr(VI) and the degradation of antibiotics remains a challenge. The present work reports the development of a novel heterojunction composite material, BiOCl/BaTiO3@Co-BDC-MOF (BOC/BTO@Co-MOF), based on solvothermal techniques. To characterize the surface and bulk features of the material, techniques such as FE-SEM, HR-TEM, BET/BJH, XPS, FT-IR, p-XRD, and UV-Vis-DRS were used. Based on the results, the BiOCl/BaTiO3 nanocomposites are uniformly dispersed on the rod-shaped Co-BDC MOF, resulting in a layered texture on the surface. A further advantage of the composite structure is the strong interfacial enhancement facilitating the separation of photoexcited electron-hole pairs. Also, compared to its pristine counterparts, the heterostructure material exhibited excellent surface area and pore properties. The photocatalytic efficiency towards reduction and degradation of Cr(VI)/SMX pollutants were evaluated by optimizing various analytical parameters, such as pH, catalytic loading concentrations, analyte concentration, and scavenger role. The specially designed BOC/BTO@Co-MOF composite achieved a 96.5% Cr(VI) reduction and 98.2% SMX degradation under 60.0-90.0 min of visible light illumination at pH 3.0. This material is highly reusable and has a six-time recycling potential. The findings of this study contribute to a better understanding of the efficient decontamination of inorganic and organic pollutants in water purification systems.

Environmental information disclosure and green transformation: Evidence from Chinese manufacturing enterprises

Green transformation (GT) is pivotal for global sustainability, with environmental information disclosure (EDI) playing a significant role, especially in the Chinese corporate landscape. This study, spanning 2009 to 2020 and leveraging a comprehensive dataset of listed companies, explores the intricate relationship between EDI and GT in Chinese manufacturing enterprises by constructing a fixed-effect model. Motivated by the imperative to address crucial issues in GT in China, this research utilizes empirical data to uncover the mechanisms through which EDI fosters GT. The study reveals how EDI reinforces environmental consciousness within manufacturing firms. Findings underscore the crucial role of EDI in enhancing GT in manufacturing enterprises, operating through two primary mechanisms. Firstly, EDI alleviates financing constraints towards GT within these firms. Secondly, it facilitates the adoption of enhanced internal governance practices, catalyzing the development of high-quality capital renewal projects. A battery of mechanism tests provides robust evidence that EDI enhances environmental awareness, mitigates financing constraints, and amplifies the motivation and capability of manufacturing enterprises for GT. This multifaceted approach ultimately fosters high-quality GT within companies. Further research reveals that the incentive effect of EDI on GT is more significant among private enterprises and heavily polluting industries. The study reveals the subtle interplay between EDI and GT, highlighting its relevance to policymaking and practical considerations. It provides valuable insights into the ongoing pursuit of sustainability and the integration of green practices into the corporate world.

Performance of Artificial Intelligence in Diagnosing Lumbar Spinal Stenosis: A Systematic Review and Meta-analysis

STUDY DESIGN

The present study followed the reporting guidelines for systematic reviews and meta-analyses.

OBJECTIVE

Therefore, we conducted this study to review the diagnostic value of AI for various types of LSS and the level of stenosis, offering evidence-based support for the development of smart diagnostic tools.

SUMMARY OF BACKGROUND DATA

Artificial intelligence (AI) is currently being utilized for image processing in clinical practice. Some studies have explored AI techniques for identifying the severity of lumbar spinal stenosis (LSS) in recent years. Nevertheless, there remains a shortage of structured data proving its effectiveness.

METHODS

Four databases (PubMed, Cochrane, Embase, and Web of Science) were searched until March 2024, including original studies that utilized deep learning and machine learning models to diagnose LSS. The risk of bias (RoB) of included studies was assessed using QUADAS-2. The accuracy in the validation set was extracted for a meta-analysis. The meta-analysis was completed in R4.4.0.

RESULTS

A total of 48 articles were included, with an overall accuracy of 0.885 (95% CI: 0.860-0907) for dichotomous tasks. Among them, the accuracy was 0.892 (95% CI: 0.867-0915) for deep learning (DL) and 0.833 (95% CI: 0.760-0895) for machine learning (ML). The overall accuracy for LSS was 0.895 (95% CI: 0.858-0927), with an accuracy of 0.912 (95% CI: 0.873-0.944) for DL and 0.843 (95% CI: 0.766-0.907) for ML. The overall accuracy for central canal stenosis was 0.875 (95% CI: 0.821-0920), with an accuracy of 0.881 (95% CI: 0.829-0.925) for DL and 0.733 (95% CI: 0.541-0.877) for ML. The overall accuracy for neural foramen stenosis was 0.893 (95% CI: 0.851-0.928). In polytomous tasks, the accuracy was 0.936 (95% CI: 0.895-0.967) for no LSS, 0.503 (95% CI: 0.391-0.614) for mild LSS, 0.512 (95% CI: 0.336-0.688) for moderate LSS, and 0.860 for severe LSS (95% CI: 0.733-0.954).

CONCLUSIONS

AI is highly valuable for diagnosing LSS. However, further external validation is necessary to enhance the analysis of different stenosis categories and improve the diagnostic accuracy for mild to moderate stenosis levels.

A nanoscale natural drug delivery system for targeted drug delivery against ovarian cancer: action mechanism, application enlightenment and future potential

Ovarian cancer (OC) is one of the deadliest gynecological malignancies in the world and is the leading cause of cancer-related death in women. The complexity and difficult-to-treat nature of OC pose a huge challenge to the treatment of the disease, Therefore, it is critical to find green and sustainable drug treatment options. Natural drugs have wide sources, many targets, and high safety, and are currently recognized as ideal drugs for tumor treatment, has previously been found to have a good effect on controlling tumor progression and reducing the burden of metastasis. However, its clinical transformation is often hindered by structural stability, bioavailability, and bioactivity. Emerging technologies for the treatment of OC, such as photodynamic therapy, immunotherapy, targeted therapy, gene therapy, molecular therapy, and nanotherapy, are developing rapidly, particularly, nanotechnology can play a bridging role between different therapies, synergistically drive the complementary role of differentiated treatment schemes, and has a wide range of clinical application prospects. In this review, nanoscale natural drug delivery systems (NNDDS) for targeted drug delivery against OC were extensively explored. We reviewed the mechanism of action of natural drugs against OC, reviewed the morphological composition and delivery potential of drug nanocarriers based on the application of nanotechnology in the treatment of OC, and discussed the limitations of current NNDDS research. After elucidating these problems, it will provide a theoretical basis for future exploration of novel NNDDS for anti-OC therapy.

Fixed Airflow Obstruction in Asthma Can Be Identified Early by Low FEF25-75% and is Associated with Environmental Exposure

Purpose

This study aimed to identify environmental risk factors associated with asthmatic fixed airflow obstruction (FAO) and assess the relationship between small airway abnormalities defined by forced expiratory flow at 25-75% (FEF25-75%) and FAO.

Patients and Methods

We analyzed data from 312 han Chinese patients with stable asthma on standard treatment. Low FEF25-75% was defined as post-bronchodilator FEF25-75% z-score <-0.8435, and FAO as post-bronchodilator FEV1/FVC z-score <-1.645. Exposure levels were retrospectively analyzed in relation to FAO risk in asthmatics. Asthmatics were grouped by low FEF25-75% and FAO, and lung function, environmental exposure, daily symptoms, and exacerbations in the previous year were compared cross-sectionally across groups.

Results

In retrospective analyses, pack-years of smoking in male patients (adjusted odd ratio [95% confidence interval] 1.05 [1.03-1.07], P<0.001), biomass exposure for >20 years (2.65 [1.13-6.43], P=0.027), occupational exposure for >10 years (2.01 [1.06-3.86], P=0.035) and occupational exposure for >20 years (2.67 [1.24-5.91], P=0.013) were associated with asthmatic FAO. In cross-sectional analyses, compared with the normal FEF25-75%/ asthmatics without FAO (NON-FAO) group, the low FEF25-75%/ asthmatics with FAO (FAO) group had lower FEV1 z-scores and FEV1/FVC z-scores, more pack-years and years of biomass and occupational exposure, higher Asthma Control Questionnaire-5 and Chronic Obstructive Pulmonary Disease Assessment Test scores, and more frequent exacerbations. The low FEF25-75%/NON-FAO group showed the same trend, but to a lesser extent.

Conclusion

Chronic airway inflammation is not the only driver of asthmatic FAO, and management and treatment targeting environmental risk factors (smoking and biomass and occupational exposures) may slow FAO progression in asthmatics. The FEF25-75% determined by the z-score is a reliable marker of small airway abnormalities, and patients with low FEF25-75% are at greater risk for FAO, requiring more frequent follow-up.

Comparison of clinical, laboratory and radiological characteristics between COVID-19 and Chlamydia psittaci pneumonia: a multicenter retrospective study

Chlamydia psittaci pneumonia (CPP) exhibits similar characteristics as of COVID-19 with respect to clustering outbreaks and onset symptoms. This study is aimed at exploring the different clinical manifestations of both pneumonias to establish a simple nomogram to distinguish them. This multicenter, retrospective, case-control study compared two independent cohorts of patients with CPP or COVID-19. The risk factors of CPP were analyzed using multivariate logistic regression, which was used to establish the nomogram. Both patients with CPP and COVID-19 exhibited similar clinical symptoms. As compared to patients with COVID-19, a higher proportion of patients with CPP had nervous system symptoms. Patients with CPP had higher inflammatory indicators, creatine kinase, and lower lymphocyte and albumin. They also had lower proportions of ground-glass opacity and bilateral lung involvement than COVID-19 patients. Furthermore, patients with CPP had higher 30 day mortality as well as higher rates of severe pneumonia, septic shock, and ICU admission. Multivariate logistic regression showed that nervous system symptoms, lymphocytes, creatine kinase, bilateral lung lesions, and ground-glass opacity were risk factors for CPP. Incorporating these five factors, the nomogram achieved good concordance index of 0.989 in differentiating CPP from COVID-19, and had well-fitted calibration curves. Despite similar clinical characteristics, nervous system symptoms, lymphocyte, creatine kinase, lesions in bilateral lungs, and ground-glass opacity may help in differentiating the pneumonias. These were combined into a clinically useful nomogram for rapid and early identification of CPP to avoid misdiagnosis and help in the decision-making process.

Temporal Shifts in Etiological Agents and Antibiotic Resistance Patterns of Biliary Tract Infections in Sichuan Province, China (2017-2023)

Purpose

We analyzed the pathogenic bacteria and antibiotic resistance distributions in patients with biliary tract infections (BTI) using samples from the Antimicrobial Resistant Investigation Network of Sichuan Province (ARINSP) to promote the rational use of antibiotics to reduce multidrug resistance.

Patients and Methods

Participating hospitals identified isolates between 2017 and 2023 and conducted antimicrobial susceptibility tests. Isolated bacteria were identified and tested for drug sensitivity using MOLDI-TOF mass spectrometry system, VITEK automated drug sensitivity system and paper diffusion method, and the results were interpreted with reference to CLSI M100 30th edition standards. WHONET 5.6 was used to analyze the results.

Results

In total, 25,573 bacterial isolates were collected; 18,134 were Gram-negative (70.9%). The top five most frequently isolated bacteria were Escherichia coli (8,181/25,573; 32.0%), Klebsiella pneumoniae (3,247/25,573; 12.7%), Enterococcus faecium (2,331/25,573; 9.1%), Enterococcus faecalis (1,714/25,573; 6.7%), and Enterobacter cloacae (1,429/25,573; 5.6%). E. coli and E. faecalis slowly declined over time, while K. pneumoniae slowly increased; E. faecium frequency was stable; E. coli resistance to ampicillin was the highest among all antibiotics tested; resistance rates decreased with the addition of sulbactam. K. pneumoniae resistance to aztreonam, imipenem, meropenem, ertapenem, and chloramphenicol remained low. E. cloacae was highly resistant to cephalosporins, especially cefoxitin and cefazolin. E. faecalis' resistance to teicoplanin remained low, decreasing from 6.9% in 2017 to 0.0% in 2019 before stabilizing.

Conclusion

The most frequently isolated bacteria from patients with BTIs were Enterobacteriaceae, including E. coli and K. pneumoniae, followed by E. faecium and E. faecalis. Isolates exhibited high resistance to routinely used antibiotics (cephalosporins) and were highly sensitive to tigecycline, carbapenem, amikacin, and vancomycin. The results guide the rational use and continual revision of antibiotic regimens for BTIs to reduce antibiotic resistance.

Upconversion circularly polarized luminescence of cholesteric liquid crystal polymer networks with NaYF4:Yb,Tm UCNPs

Upconversion circularly polarized luminescence (UC-CPL) exhibits promising potential for application for anti-counterfeiting and displays. Upconversion nanoparticles (UCNPs), NaYF4:Yb,Tm, with uniform morphology and high crystallinity, were prepared via a simple solvothermal method. These UCNPs were embedded into cholesteric liquid crystal polymer network (CLCN) films. The UC-CPL performance of these films was investigated using left- and right-handed circular polarizers. After calibration, the |gcallum| values (up to 0.33) were obtained for the free-standing CLCN-UCNPs films, while a |gcallum| value of 0.43 was achieved for the CLCN-UCNPs-coated PET film. Moreover, a combined system comprising a PMMA-UCNPs layer and a CLCN layer yielded an ultra-large |gcallum| value of up to 1.73. Flexible and colourful patterned CLCN films were fabricated using photomasks, offering potential applications in anti-counterfeiting. This study not only successfully prepared UC-CPL-active materials based on CLCNs and UCNPs, but also demonstrated the chiral filtering effect of CLCN films in upconversion luminescent materials.

Oxygen Vacancy Compensation-Induced Analog Resistive Switching in the SrFeO3-δ/Nb:SrTiO3 Epitaxial Heterojunction for Noise-Tolerant High-Precision Image Recognition

Neuromorphic computing, inspired by the brain's architecture, promises to surpass the limitations of von Neumann computing. In this paradigm, synaptic devices play a crucial role, with resistive switching memory (memristors) emerging as promising candidates due to their low power consumption and scalability advantages. This study focuses on the development of metal/oxide-semiconductor heterojunctions, which offer several technological advantages and have broad potential for applications in artificial neural synapses. However, constructing high-quality epitaxial interfaces between metal and oxide semiconductors and designing modifiable contact barriers are challenging. Herein, we construct high-quality epitaxial metal/semiconductor interfaces based on the metallicity of the perovskite phase SrFeO3-δ (PV-SFO) and a small Schottky barrier in contact with Nb-doped SrTiO3 (NSTO). X-ray diffraction patterns, reciprocal space mapping results, and cross-sectional transmission electron microscopy images reveal that the prepared PV-SFO film exhibits a perfect single-crystal structure and an excellent epitaxial interface with the NSTO (111) substrate. The corresponding memristor exhibits analog-type resistive-variable characteristics with an ON/OFF ratio of ∼1000, stable data retention after 10,000 s, and no noticeable fluctuation in resistance after 10,000 pulse cycles. Electron energy loss spectroscopy, first-principles calculations, and electrical measurements reveal that compensating or restoring oxygen vacancies at the NSTO surface decreases or increases the contact barrier between PV-SFO and NSTO, respectively, thereby gradually regulating the resistance value. Furthermore, high-quality epitaxial PV-SFO/NSTO devices achieve up to 98.21% recognition accuracy for handwriting recognition tasks using LeNet-5-based network structures and 92.21% accuracy for color images using visual geometry group (VGG) network structures. This work contributes to the advancement of interface-type memristors and provides valuable insights into enhancing synaptic functionality in neuromorphic computing systems.

Protein nanopore-based sensors for public health analyte detection

High-throughput and label-free protein nanopore-based sensors are extensively used in DNA sequencing, single-protein analysis, molecular sensing and chemical catalysis with single channel recording. These technologies show great potential for identifying various harmful substances linked to public health by addressing the limitations of current portability and the speed of existing techniques. In this review, we provide an overview of the fundamental principles of nanopore sensing, with a focus on chemical modification and genetic engineering strategies aimed at enhancing the detection sensitivity and identification accuracy of protein nanopores. The engineered protein nanopores enable direct sensing, while the introduction of aptamers and substrates enables indirect sensing, translating the physical structure and chemical properties of analytes into readable signals. These scientific discoveries and engineering efforts have provided new prospects for detecting and monitoring trace hazardous substances.

Circulating Levels of Vitamins A, C, and E-Alpha in Organ Donors After the Neurologic Determination of Death

INTRODUCTION

The antioxidant effects of vitamins may attenuate the oxidative stress on organs imposed by ischemia-reperfusion injury during the process of organ transplantation from brain-dead donors. Circulating levels of vitamins A, C, and E-α in donors after brain death and their relationships to donor demographics, management, organ utilization, and recipient outcomes are largely unknown.

METHODS

An observational, prospective, cohort study of 84 consecutive brain-dead organ donors managed at a single organ procurement recovery center was conducted. Vitamin levels were drawn immediately prior to procurement.

RESULTS

Levels of serum vitamins A and E-α and plasma vitamin C were below normal in 80%, 85%, and 92% of donors and deficient in 40%, 62%, and 63%, respectively. Vitamin C deficiency was associated with a longer time between death and specimen collection (P = .004). Death from head trauma and stroke were associated with lower levels of vitamin A than from anoxic causes (P = .003) and smokers had greater vitamin C deficiency (P = .03). During donor management, vitamin C deficiency was associated with longer vasopressor support (P = .03) and normal levels of vitamin E-α were associated with reaching a lower alanine transferase compared to those with subnormal levels (P < .05). Donors deficient in vitamin E-α were less likely to have a liver recovered for transplantation (P = .005). Vitamin levels were not associated with the recipient outcomes examined.

CONCLUSION

Circulating vitamins A, C, and E-α is profoundly low in brain-dead organ donors, associated with relevant demographic features of the donor, and may influence donor management and organ utilization.