Value of early critical care transthoracic echocardiography for patients undergoing mechanical ventilation: a retrospective study

OBJECTIVES

To evaluate whether early intensive care transthoracic echocardiography (TTE) can improve the prognosis of patients with mechanical ventilation (MV).

DESIGN

A retrospective cohort study.

SETTING

Patients undergoing MV for more than 48 hours, based on the Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU-CRD), were selected.

PARTICIPANTS

2931 and 6236 patients were recruited from the MIMIC-III database and the eICU database, respectively.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was in-hospital mortality. Secondary outcomes were 30-day mortality from the date of ICU admission, days free of MV and vasopressors 30 days after ICU admission, use of vasoactive drugs, total intravenous fluid and ventilator settings during the first day of MV.

RESULTS

We used propensity score matching to analyse the association between early TTE and in-hospital mortality and sensitivity analysis, including the inverse probability weighting model and covariate balancing propensity score model, to ensure the robustness of our findings. The adjusted OR showed a favourable effect between the early TTE group and in-hospital mortality (MIMIC: OR 0.78; 95% CI 0.65 to 0.94, p=0.01; eICU-CRD: OR 0.76; 95% CI 0.67 to 0.86, p<0.01). Early TTE was also associated with 30-day mortality in the MIMIC database (OR 0.71, 95% CI 0.57 to 0.88, p=0.001). Furthermore, those who had early TTE had both more ventilation-free days (only in eICU-CRD: 23.48 vs 24.57, p<0.01) and more vasopressor-free days (MIMIC: 18.22 vs 20.64, p=0.005; eICU-CRD: 27.37 vs 28.59, p<0.001) than the control group (TTE applied outside of the early TTE and no TTE at all).

CONCLUSIONS

Early application of critical care TTE during MV is beneficial for improving in-hospital mortality. Further investigation with prospectively collected data is required to validate this relationship.

Phosphatidylcholine-mediated regulation of growth kinetics for colloidal synthesis of cesium tin halide nanocrystals

Cesium tin halide (CsSnX₃, where X is halogen) perovskite nanocrystals (NCs) are one of the most representative alternatives to their lead-based cousins. However, a fundamental understanding of how to regulate the growth kinetics of colloidal CsSnX₃ NCs is still lacking and, specifically, the role of surfactants in affecting their growth kinetics remains incompletely understood. Here we report a general approach for colloidal synthesis of CsSnX₃ perovskite NCs through a judicious combination of capping agents. We demonstrate that introducing a small amount of zwitterionic phosphatidylcholine in the reaction is of vital importance for regulating the growth kinetics of CsSnX₃ NCs, which otherwise merely leads to the formation of large-sized powders. Based on a range of experimental characterization, we propose that the formation of intermediate complexes between zwitterionic phosphatidylcholine and the precursors and the steric hindrance effect of branched fatty acid side-chains of phosphatidylcholine can regulate the growth kinetics of CsSnX₃, which enables us to obtain CsSnX₃ NCs with emission quantum yields among the highest values ever reported. Our finding of using zwitterionic capping agents to regulate the growth kinetics may inspire more research on the synthesis of high-quality tin-based perovskite NCs that could speed up their practical applications in optoelectronic devices.

Deuterated Covalent Organic Frameworks with Significantly Enhanced Luminescence

Luminescent covalent organic frameworks (COFs) find promising applications in chemical sensing, photocatalysis, and optoelectronic devices, however, the majority of COFs are non or weakly emissive owing to the aggregation-caused quenching (ACQ) or the molecular thermal motion-based energy dissipation. Here, we report a previously unperceived approach to improve luminescence performance of COFs by introducing isotope effect, which is achieved through substitution of hydrogen from high-frequency oscillators X-H (X=O, N, C) by heavier isotope deuterium. Combining the "bottom-up" and in situ deuteration methods generates the first deuterated COF, which exhibits an impressively 19-fold enhancement in quantum yield over that of the non-deuterated counterpart. These results are interpreted by theoretical calculations as the consequence of slower C/N-D and OD⋅⋅⋅O vibrations that impede the nonradiative deactivation process. The proposed strategy is proved applicable to many other types of emissive COFs.

Copper niobate nanowires boosted by a N, S co-doped carbon coating for superior lithium storage

With the development of electric vehicles, more and more attention has been paid to the kinetic performance of batteries, which is related to rapid charge/discharge and safety issues. To improve this aspect, Cu₂Nb₃₄O₈₇ nanowires covered by nitrogen and sulfur co-doped carbon (Cu₂Nb₃₄O₈₇/NSC nanowires) are prepared by electrospinning combined with surface coating. As-prepared Cu₂Nb₃₄O₈₇/NSC nanowires present a high ion diffusion coefficient and electronic conductivity, showing good a kinetic performance. Specifically, they deliver a splendid capacity of 311.2 mA h g^-1 at 1 C and a superior cycling stability with a capacity fading of 0.031% per cycle upon 1000 cycles. At the same time, the electrochemical and structural reversibility is fully discussed and demonstrated by ex situ XRD, ex situ SEM and ex situ XPS based on the redox couples of Cu²⁺/Cu⁺, Nb⁵⁺/Nb⁴⁺, and Nb⁴⁺/Nb³⁺. Contributing to peculiar physico-chemical properties, Cu₂Nb₃₄O₈₇/NSC nanowires are expected to be a candidate material for the anode in lithium-ion batteries.

Expounding the Initial Alloying Behavior of Na-K Liquid Alloy Electrodes

Primary electrodeposition is an accepted strategy to elucidate the nucleation and growth kinetics of metal electrodes. Nevertheless, when confronted with the phase transition process caused by bi-active metals such as NaK liquid alloys, the research process becomes complex and elusive. Herein, we have reduced the intricate issues to relatively simple initial alloying behaviors. Two exchange diffusion mechanisms of the Na atom embedded in K crystals and K atom embedded in Na crystals are investigated by first-principles density functional theory (DFT) calculation and mechanical simulation. As a result, the process of embedding the Na atom in K crystals shows a better thermodynamic stability and lower activation barrier and structural stress than those of the other. The abovementioned conclusions are further proved by stepwise Na and K electrodeposition experiments, and the prepared NaK alloy electrode displays excellent electrochemical performance. Our findings correlate the original alloying mechanism model specification with electrodeposition experimental verification and provide strategies to achieve controllable NaK electrode construction.

Prussian Blue Analogues in Aqueous Batteries and Desalination Batteries

In the applications of large-scale energy storage, aqueous batteries are considered as rivals for organic batteries due to their environmentally friendly and low-cost nature. However, carrier ions always exhibit huge hydrated radius in aqueous electrolyte, which brings difficulty to find suitable host materials that can achieve highly reversible insertion and extraction of cations. Owing to open three-dimensional rigid framework and facile synthesis, Prussian blue analogues (PBAs) receive the most extensive attention among various host candidates in aqueous system. Herein, a comprehensive review on recent progresses of PBAs in aqueous batteries is presented. Based on the application in different aqueous systems, the relationship between electrochemical behaviors (redox potential, capacity, cycling stability and rate performance) and structural characteristics (preparation method, structure type, particle size, morphology, crystallinity, defect, metal atom in high-spin state and chemical composition) is analyzed and summarized thoroughly. It can be concluded that the required type of PBAs is different for various carrier ions. In particular, the desalination batteries worked with the same mechanism as aqueous batteries are also discussed in detail to introduce the application of PBAs in aqueous systems comprehensively. This report can help the readers to understand the relationship between physical/chemical characteristics and electrochemical properties for PBAs and find a way to fabricate high-performance PBAs in aqueous batteries and desalination batteries.

A TiSe2 -Graphite Dual Ion Battery: Fast Na-Ion Insertion and Excellent Stability

The sodium dual ion battery (Na-DIB) technology is proposed as highly promising alternative over lithium-ion batteries for the stationary electrochemical energy-storage devices. However, the sluggish reaction kinetics of anode materials seriously impedes their practical implementation. Herein, a Na-DIB based on TiSe₂ -graphite is reported. The high diffusion coefficient of Na-ions (3.21×10^-11 -1.20×10^-9  cm²  s^-1 ) and the very low Na-ion diffusion barrier (0.50 eV) lead to very fast electrode kinetics, alike in conventional surface capacitive storage systems. In-situ investigations reveal that the fast Na-ion diffusion involves four insertion stage compositions. A prototype cell shows a reversible capacity of 81.8 mAh g^-1 at current density of 100 mA g^-1 , excellent stability with 83.52 % capacity retention over 200 cycles and excellent rate performance, suggesting its potential for next-generation large scale high-performance stationary energy storage systems.

LEAFY COTYLEDON1 expression in the endosperm enables embryo maturation in Arabidopsis

The endosperm provides nutrients and growth regulators to the embryo during seed development. LEAFY COTYLEDON1 (LEC1) has long been known to be essential for embryo maturation. LEC1 is expressed in both the embryo and the endosperm; however, the functional relevance of the endosperm-expressed LEC1 for seed development is unclear. Here, we provide genetic and transgenic evidence demonstrating that endosperm-expressed LEC1 is necessary and sufficient for embryo maturation. We show that endosperm-synthesized LEC1 is capable of orchestrating full seed maturation in the absence of embryo-expressed LEC1. Inversely, without LEC1 expression in the endosperm, embryo development arrests even in the presence of functional LEC1 alleles in the embryo. We further reveal that LEC1 expression in the endosperm begins at the zygote stage and the LEC1 protein is then trafficked to the embryo to activate processes of seed maturation. Our findings thus establish a key role for endosperm in regulating embryo development.

Electron Beam Irradiation-Induced Formation of Defect-Rich Zeolites under Ambient Condition within Minutes

Zeolites are a well-known family of microporous aluminosilicate crystals with a wide range of applications. Their industrial synthetic method under hydrothermal condition requires elevated temperature and long crystallization time and is therefore quite energy-consuming. Herein, we utilize high-energy electron beam irradiation generated by an industrial accelerator as a distinct type of energy source to activate the formation reaction of Na-A zeolite. The initial efforts afford an attractive reaction process that can be achieved under ambient conditions and completed within minutes with almost quantitative yield, leading to notable energy saving of one order of magnitude compared to the hydrothermal reaction. More importantly, electron beam irradiation simultaneously exhibits an etching effect during the formation of zeolite generating a series of crystal defects and additional pore windows that can be controlled by irradiation dose. These observations give rise to significantly enhanced surface area and heavy metal removal capabilities in comparison with Na-A zeolite synthesized hydrothermally. Finally, we show that this method can be applied to many other types of zeolites.

Evaluation of the application of TSH receptor stimulating autoantibodies and the optimization of detection strategy in Graves' disease

BACKGROUND

We evaluated the use of thyroid stimulating immunoglobulin (TSI) assay to optimize the detection strategy for Graves' disease.

METHODS

Five hundred and forty-four well characterized serum samples from the Clinical Laboratory of Shanghai Tongren Hospital were collected from August 2019 to April 2020. The serum samples were obtained from 52 untreated GD patients, 155 treated GD patients, 83 patients with Hashimoto's thyroiditis, 70 patients with thyroid nodules, 83 patients with thyroid cancer, and 101 healthy subjects. All samples were evaluated by both TSI assay and TSH receptor autoantibodies (TRAb) assay. Moreover, 23 patients without a distinct thyroid disease diagnosis at the first visit were monitored for 6 months to make a final diagnosis.

RESULTS

The clinical sensitivity of the TSI and TRAb assays was 98.10% and 94.20% respectively, while the clinical specificity was 92.30% and 96.70% respectively. ROC plot analysis based on sera of UT-GD (newly diagnosed GD patients) revealed an area under the curve (AUC) of 0.974 for the TSI assay. The best cutoff value was 0.58 IU/l (98.0% of sensitivity, 92.8% of specificity). The AUC for the TRAb assay was 0.961. Furthermore, combining TSI and TRAb results, the area under the curve was 0.981. In a pilot study of 23 patients with an uncertain initial diagnosis, the follow-up results showed the clinical diagnosis of 22 out of 23 cases were resolved in agreement with the results obtained by the TSI assay, and one case matched the result obtained by TRAb assay.

CONCLUSION

The TSI assay presents very promising analytical characteristics and could be adopted in clinical practice to improve GD diagnosis. The TSI assay might be better than TRAb assay in initial differential diagnosis of GD from other thyroid diseases.

Hydrogen Bond-Assisted Ultra-Stable and Fast Aqueous NH4+ Storage

Aqueous ammonium ion batteries are regarded as eco-friendly and sustainable energy storage systems. And applicable host for NH₄⁺ in aqueous solution is always in the process of development. On the basis of density functional theory calculations, the excellent performance of NH₄⁺ insertion in Prussian blue analogues (PBAs) is proposed, especially for copper hexacyanoferrate (CuHCF). In this work, we prove the outstanding cycling and rate performance of CuHCF via electrochemical analyses, delivering no capacity fading during ultra-long cycles of 3000 times and high capacity retention of 93.6% at 50 C. One of main contributions to superior performance from highly reversible redox reaction and structural change is verified during the ammoniation/de-ammoniation progresses. More importantly, we propose the NH₄⁺ diffusion mechanism in CuHCF based on continuous formation and fracture of hydrogen bonds from a joint theoretical and experimental study, which is another essential reason for rapid charge transfer and superior NH₄⁺ storage. Lastly, a full cell by coupling CuHCF cathode and polyaniline anode is constructed to explore the practical application of CuHCF. In brief, the outstanding aqueous NH₄⁺ storage in cubic PBAs creates a blueprint for fast and sustainable energy storage.

Functional characterization of the long noncoding RNA MIR22HG as a tumour suppressor in cervical cancer by targeting IGF2BP2

OBJECTIVE

Cervical cancer is the most common malignant tumour in the female reproductive tract, ranking second in the global cause of female cancer and seriously endangering women's health. However, the underlying mechanisms leading to cervical cancer are unclear. Previous studies have reported the roles and general underlying mechanisms of the long noncoding RNA MIR22HG (MIR22HG) in multiple types of tumours.

PATIENTS AND METHODS

In this study, we describe the functional role of MIR22HG as a tumour suppressor lincRNA by regulating metastasis, growth and invasion by performing a series of in vivo and in vitro experiments.

RESULTS

Our data suggested that MIR22HG dramatically promoted cervical cancer apoptosis and inhibited invasion by targeting IGF2BP2.

CONCLUSIONS

The long noncoding RNA MIR22HG targets IGF2BP2 as a tumour suppressor in cervical cancer. Our findings will be helpful for developing potential therapeutics for cervical cancer.

Genome-wide occupancy of Arabidopsis SWI/SNF chromatin remodeler SPLAYED provides insights into its interplay with its close homolog BRAHMA and Polycomb proteins

SPLAYED (SYD) is a SWItch/Sucrose Non-Fermentable (SWI/SNF)-type chromatin remodeler identified in Arabidopsis thaliana (Arabidopsis). It is believed to play both redundant and differential roles with its closest homolog BRAHMA (BRM) in diverse plant growth and development processes. To better understand how SYD functions, we profiled the genome-wide occupancy of SYD and its impact on the global transcriptome and trimethylation of histone H3 on lysine 27 (H3K27me3). To map the global occupancy of SYD, we generated a GFP-tagged transgenic line and used it for chromatin immunoprecipitation experiments followed by next-generation sequencing, by which more than 6000 SYD target genes were identified. Through integrating SYD occupancy and transcriptome profiles, we found that SYD preferentially targets to nucleosome-free regions of expressed genes. Further analysis revealed that SYD occupancy peaks exhibit five distinct patterns, which were also shared by BRM and BAF60, a conserved SWI/SNF complex component, indicating the common target sites of these SWI/SNF chromatin remodelers and the functional relevance of such distinct patterns. To investigate the interplay between SYD and Polycomb-group (PcG) proteins, we performed a genome-wide analysis of H3K27me3 in syd-5. We observed both increases and decreases in H3K27me3 levels at a few hundred genes in syd-5 compared to wild type. Our results imply that SYD can act antagonistically or synergistically with PcG at specific genes. Together, our SYD genome-wide occupancy data and the transcriptome and H3K27me3 profiles provide a much-needed resource for dissecting SYD's crucial roles in the regulation of plant growth and development.

Theory-Guided Synthesis of Highly Luminescent Colloidal Cesium Tin Halide Perovskite Nanocrystals

The synthesis of highly luminescent colloidal CsSnX₃ (X = halogen) perovskite nanocrystals (NCs) remains a long-standing challenge due to the lack of a fundamental understanding of how to rationally suppress the formation of structural defects that significantly influence the radiative carrier recombination processes. Here, we develop a theory-guided, general synthetic concept for highly luminescent CsSnX₃ NCs. Guided by density functional theory calculations and molecular dynamics simulations, we predict that, although there is an opposing trend in the chemical potential-dependent formation energies of various defects, highly luminescent CsSnI₃ NCs with narrow emission could be obtained through decreasing the density of tin vacancies. We then develop a colloidal synthesis strategy that allows for rational fine-tuning of the reactant ratio in a wide range but still leads to the formation of CsSnI₃ NCs. By judiciously adopting a tin-rich reaction condition, we obtain narrow-band-emissive CsSnI₃ NCs with a record emission quantum yield of 18.4%, which is over 50 times larger than those previously reported. Systematic surface-state characterizations reveal that these NCs possess a Cs/I-lean surface and are capped with a low density of organic ligands, making them an excellent candidate for optoelectronic devices without any postsynthesis ligand management. We showcase the generalizability of our concept by further demonstrating the synthesis of highly luminescent CsSnI_2.5Br_0.5 and CsSnI_2.25Br_0.75 NCs. Our findings not only highlight the value of computation in guiding the synthesis of high-quality colloidal perovskite NCs but also could stimulate intense efforts on tin-based perovskite NCs and accelerate their potential applications in a range of high-performance optoelectronic devices.

Laparoscopic middle-hepatic-vein-guided anatomical hemihepatectomy in the treatment of hepatolithiasis: a 10-year case study

BACKGROUND

This retrospective 10-year case study evaluated the perioperative results and long-term efficacy of laparoscopic middle-hepatic-vein-guided hemihepatectomy (L-MHV-H) and traditional anatomical hemihepatectomy (TAH) in the treatment of hepatolithiasis (HL).

METHODS

From January 2010 to December 2019, 99 patients with regional HL underwent laparoscopic anatomical hemihepatectomy (LAH) at our centre, including 43 patients in the L-MHV-H group and 56 patients in the TAH group.

RESULTS

All patients in both groups were Child-Pugh grade A before operation. No significant between-group differences in general information, stone distribution, comorbidities, history of previous abdominal surgery or co-occurrence of gallstones and common bile duct stones were observed. The L-MHV-H group exhibited a higher intraoperative stone clearance rate (95.3% vs. 75.0%, p = 0.014) and a lower postoperative complication rate (10.1% vs. 48.2%, p = 0.005) compared with the TAH group. In the median follow-up time of 60 months (range 6-125 months), the L-MHV-H group had lower stone recurrence (2.3% vs. 19.6%, p = 0.013) and cholangitis recurrence (2.3% vs. 17.9%, p = 0.034) rates. No significant between-group differences in the other results were observed.

CONCLUSIONS

L-MHV-H is safe and feasible for HL with certain advantages over TAH in improving the intraoperative stone clearance rate, reducing postoperative complication incidence and reducing stone and cholangitis recurrence rates.

Understanding the sodium ion transport properties, deintercalation mechanism, and phase evolution of a Na2Mn2Si2O7 cathode by atomistic simulation

Molecular dynamics (MD) together with the first principles method (DFT) reveal that Na+ is capable of migrating three dimensionally in a Na2Mn2Si2O7 cathode material. Migration along the a-axis and c-axis have the same mechanism, that is, alternating between the Na1 and Na2 route with a similar local environment and distance. Long-distance hopping between two Na2 atoms or between Na1 and Na2 atoms is crucial for continuous migration along the b-axis. Also, the anti-site phenomenon is identified, and it facilitates the migration of the Na ions. Four intermediate phases are determined according to the formation energy curve and, as a result, the voltage profile is predicted accurately. The state of charge (SOC) dependency of the Na+ energy shows that the mobility of Na+ is highly inhibited in the fully discharged state. Upon the deintercalation of sodium ions, Na+ is activated immediately. A maximal DNa+ value of 3.6 × 10-9 cm2 s-1 and a low energy barrier of ca. 0.26 eV at the deintercalation level of x = 0.25 are observed. Because of the scarcity of Na+, DNa+ experiences a sharp decrease at the end of deintercalation. Despite the low level of Na+ mobility in the range of 0.25 < x < 1, Na2Mn2Si2O7 is still a potential cathode material for use in sodium ion batteries (SIBs).