[Evidence-based progress for the risk events of paclitaxel devices in treatment of peripheral artery disease]

With the development of endovascular technology for peripheral arterial diseases, paclitaxel drug-eluting stents and drug-coated balloons have been widely used in recent years. It has been proved that paclitaxel-coated devices have good clinical effects in reducing vascular restenosis. However, the clinical safety of paclitaxel devices has encountered challenges, some of the studies have shown that paclitaxel-coated devices may increase long-term mortality. In addition, some studies have confirmed the effectiveness and safety of paclitaxel devices, leading to this topic becoming the focus and hot spot of global attention. Whether paclitaxel-coated devices increase the risk of long-term death, whether paclitaxel doses are related to mortality, and the pharmacokinetics of paclitaxel devices should be examined.

The Effect of Preoperative Antiplatelet Therapy on Early Postoperative Rehemorrhage and Outcomes in Patients With Spontaneous Intracranial Hematoma

Background and Purpose

The effect of antiplatelet therapy (APT) on early postoperative rehemorrhage and outcomes of patients with spontaneous intracerebral hemorrhage (ICH) is still unclear. This study is to evaluate the effect of preoperative APT on early postoperative rehemorrhage and outcomes in ICH patients.

Methods

This was a multicenter cohort study. ICH patients undergoing surgery were divided into APT group and no antiplatelet therapy (nAPT) group according to whether patients received APT or not. Chi-square test, t-test, and Mann–Whitney U test were used to compare the differences in variables, postoperative rehematoma, and outcomes between groups. Multivariate logistics regression analysis was used to correct for confounding variables, which were different in group comparison.

Results

One hundred fifty ICH patients undergoing surgical treatment were consecutively included in this study. Thirty five (23.33%) people were included in the APT group, while 115 (76.67%) people were included in the nAPT group. The incidence of early postoperative rehemorrhage in the APT group was significantly higher than that in the nAPT group (25.7% VS 10.4%, p = 0.047 < 0.05). After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT had no significant effect on early postoperative rehemorrhage (p = 0.067). There was no statistical difference between the two groups in early poorer outcomes (p = 0.222) at 14 days after surgery. After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT also had no significant effect on early poorer modified Rankin Scale (mRS) (p = 0.072).

Conclusion

In conclusion, preoperative APT appears to be safe and have no significant effect on early postoperative rehematoma and outcomes in ICH patients.

Treatment patterns and systemic therapy outcomes for patients with salivary duct carcinoma and adenocarcinoma NOS

6084

Background: Salivary duct carcinoma (SDC) and adenocarcinoma, not otherwise specified (Adeno-NOS) are rare and aggressive subtypes of salivary gland cancers. Biomarker studies revealed targetable alterations such as androgen receptor (AR) and HER2 overexpression; nevertheless, chemotherapy (CT) remains the cornerstone treatment of patients (pts) with locally advanced or metastatic disease based on limited efficacy data. We sought to describe the treatment patterns and outcomes of SDC and Adeno-NOS pts. Methods: We retrospectively collected clinicopathological, treatment, and outcomes data of SDC or Adeno-NOS pts that were seen at MD Anderson from 1990-2020. AR positivity was defined by IHC staining in ≥ 10% of tumor cells, and HER2 by IHC 2+ or 3+ scores. Overall response rate (ORR) was assessed by an independent radiologist per RECIST v1.1. Recurrence-free survival (RFS) and overall survival (OS) from diagnosis were estimated using log-rank test. A multivariable cox regression model was performed to estimate the hazard-ratio (HR) of risk factors on pts outcomes. Results: 200 pts were included, 110 had SDC and 90 Adeno-NOS. Most pts (61%) presented with locoregional disease (stage III-IVB), while 13% had distant metastasis (IVC). AR was positive in 77% of cases, and HER2 in 47%. In the curative setting (N=174), 98% pts underwent surgery and 90% radiotherapy (RT); 15 pts with stage IVA-B disease had aggressive trimodality therapy including surgery, RT, and systemic therapy. Overall, 55% pts recurred. The mRFS and 5-y RFS rate were 24 mos (95%CI, 16-43) and 34.5%, respectively. For pts with IV-A-B stage, trimodality therapy was associated with an improved OS in comparison to surgery and/or RT (39 mos vs NA, p=0.04). In the metastatic setting, 82 pts received ≥1 line of systemic therapy; the preferred 1st line regimen was platinum/taxane with or without trastuzumab (50%). Table summarizes the ORR and mPFS to each therapy line. ORR and PFS was higher for HER2-targeted therapy (1st line: 47% and 11 mos; 2nd line 29% and 6 mos; respectively); only 10 pts received androgen blockage. At a median follow-up of 7.5 y, the mOS was 5 ys and the 5-y OS rate was 50%. In multivariate analysis, higher T and N stages (HR 2.1 and 3.8, p<0.05), and positive margins (HR 2.0, p=0.003) were associated with worse RFS; older age (HR 1.03, p=0.003), and higher TNM stage (HR 1.78, p=0.006) were associated with worse OS. HER2 expression was not prognostic. Conclusions: This study validates prognostic factors in SDC and adeno-NOS and is the largest series to report outcomes to palliative systemic therapy per treatment line, providing a benchmark for future studies in these diseases. Aggressive trimodality therapy may improve outcomes of pts with stage IVA-B disease.[Table: see text]

Single Tungsten Atom-Modified Cotton Fabrics for Visible-Light-Driven Photocatalytic Degradation and Antibacterial Activity

Various single-atom materials exhibit distinguished performances in catalysis and biology. To boost their applications, single-atom-based strategies are highly demanded to exhibit repeatable functions on advanced wearable substrates. However, single-atom approaches are rarely reported to anchor on wearable materials, i.e., widely applied cotton fabrics. Here, we developed a simple method of loading uniformly dispersed single tungsten atoms on cotton via ordinary direct-dye processing to exhibit superior sustainable functions. The single sites of tungsten atom centers are constructed by binding oxygen-coordinated single tungsten atom on the cotton fabric surface via -COOH groups. Consequently, the band gap of single sites decreases significantly to 2.75 from 3.03 eV. Therefore, the single-site-modified cotton exhibits excellent visible-light-driven (>420 nm) photocatalytic degradation efficiency of organic dyes, which exceeds other reported cotton-based materials by nearly two orders of magnitude. Furthermore, the single-site-modified cotton also exhibits great antibacterial performance due to reactive oxygen species. Moreover, the cotton with anchored single sites possesses great washing-resistance ability during 20 laundry cycles under soap-washing conditions. After recycling, the single sites on cotton have no obvious changes in the microstructure, which demonstrates the success of our sustainable strategy of single sites anchored on cotton. The single-site technique can be extended to many other elemental atoms on various wearable devices, providing a playground for functional material communities.

Electrochemical Fixation of Nitrogen by Promoting N2 Adsorption and N-N Triple Bond Cleavage on the CoS2/MoS2 Nanocomposite

An electrochemical N₂ reduction reaction (NRR), as an environmentally benign method to produce NH₃, is a suitable alternative to substitute the energy-intensive Haber-Bosch technology. Unfortunately, to date, it is obstructed by the lack of efficient electrocatalysts. Here, a CoS₂/MoS₂ nanocomposite with CoS₂ nanoparticles decorated on MoS₂ nanosheets is fabricated and adapted as a catalyst for the NRR. As unveiled by experimental and theoretical results, the strong interaction between CoS₂ and MoS₂ modulates interfacial charge distribution with electrons transferring from CoS₂ to MoS₂. Consequently, a local electrophilic region is formed near the CoS₂ side, which enables effective N₂ absorption. On the other hand, the nucleophilic area formed near the MoS₂ side is in favor of breaking stable N≡N, the potential-determining step (*N₂ → *N₂H) which brings about a much decreased energy barrier than that on pure MoS₂. As a result, this catalyst exhibits an excellent NRR performance, NH₃ yield and Faradaic efficiency of 54.7 μg·h^-1·mg^-1 and 20.8%, respectively, far better than most MoS₂-based catalysts.

A nomogram to predict the risk of early postoperative ischemic events in patients with spontaneous intracranial hematoma

Spontaneous intracranial hematoma (ICH) is the second leading cause of stroke and has a high risk of postoperative ischemic events (PIEs). But, the evidence on PIEs in ICH patients still lacks. Therefore, a retrospective study was carried out to screen the risk factors for PIEs and construct a visual predictive model. This was a retrospective study whose population were divided into two groups based on the occurrence of PIEs. Univariate logistic regression analysis was used to determine factors associated with PIEs. Multifactorial logistic regression analysis was used to screen risk factors and construct the early PIEs risk nomogram. In addition, impact of PIEs on patient prognosis and surgery related costs was assessed. Out of 122 ICH patients, 24 (19.7%) were diagnosed with PIEs. Coronary heart disease history, ischemic stroke history, regular shaped hematoma and platelet number were identified as risk factors for early PIEs. Early PIEs risk nomogram showed good calibration and discrimination of the data with concordance index of 0.846 (95% confidence interval, 0.747-0.945) which was confirmed to be 0.827 through bootstrapping validation. In addition, there was statistical difference in discharged Glasgow Coma Scale score (P = 0.046) and surgery related costs (p = 0.031) between PIEs group and nPIEs group. These results showed the early PIEs risk nomogram was accurate for prediction risks of PIEs and the occurrence of PIEs affects prognosis of patients, and increases surgery related costs.

Co and Pt Dual-Single-Atoms with Oxygen-Coordinated Co-O-Pt Dimer Sites for Ultrahigh Photocatalytic Hydrogen Evolution Efficiency

The platinum single-atom-catalyst is verified as a very successful route to approach the size limit of Pt catalysts, while how to further improve the catalytic efficiency of Pt is a fundamental scientific question and is challenging because the size issue of Pt is approached at the ultimate ceiling as single atoms. Here, a new route for further improving Pt catalytic efficiency by cobalt (Co) and Pt dual-single-atoms on titanium dioxide (TiO₂ ) surfaces, which contains a fraction of nonbonding oxygen-coordinated Co-O-Pt dimers, is reported. These Co-Pt dimer sites originate from loading high-density Pt single-atoms and Co single-atoms, with them anchoring randomly on the TiO₂ substrate. This dual-single-atom catalyst yields 13.4% dimer sites and exhibits an ultrahigh and stable photocatalytic activity with a rate of 43.467 mmol g^-1 h^-1 and external quantum efficiency of ≈83.4% at 365 nm. This activity far exceeds those of equal amounts of Pt single-atom and typical Pt clustered catalysts by 1.92 and 1.64 times, respectively. The enhancement mechanism relies on the oxygen-coordinated Co-O-Pt dimer coupling, which can mutually optimize the electronic states of both Pt and Co sites to weaken H* binding. Namely, the "mute" Co single-atom is activated by Pt single-atom and the activity of the Pt atom is further enhanced through the dimer interaction. This strategy of nonbonding interactive dimer sites and the oxygen-mediated catalytic mechanisms provide emerging rich opportunities for greatly improving the catalytic efficiency and developing novel catalysts with creating new electronic states.

A polymer controlled nucleation route towards the generalized growth of organic-inorganic perovskite single crystals

Recently, there are significant progresses in the growth of organic-inorganic lead halide perovskite single crystals, however, due to their susceptible nucleation and growth mechanisms and solvent requirements, the efficient and generalized growth for these single crystals is still challenging. Here we report the work towards this target with a polymer-controlled nucleation process for the highly efficient growth of large-size high-quality simple ternary, mixed-cations and mixed-halide perovskite single crystals. Among them, the carrier lifetime of FAPbBr₃ single crystals is largely improved to 10199 ns. Mixed MA/FAPbBr₃ single crystals are synthesized. The crucial point in this process is suggested to be an appropriate coordinative interaction between polymer oxygen groups and Pb²⁺, greatly decreasing the nuclei concentrations by as much as 4 orders of magnitudes. This polymer-controlled route would help optimizing the solution-based OIHPs crystal growth and promoting applications of perovskite single crystals.

Research into single crystal organic-inorganic halide perovskites have gained momentum due to the potential applications, yet the growth is still a challenge. Here, the authors demonstrate a universal method based on polymer controlled nucleation process to achieve large-size and high-quality perovskite single crystals.

Analysis of Secreted Proteins and Potential Virulence via the ICEs-Mediated Pathway of the Foodborne Pathogen Vibrio parahaemolyticus

Vibrio parahaemolyticus uses bacterial secretion systems and integrative and conjugative elements (ICEs) to induce various diseases and to adapt to harsh environments, respectively. Information pertaining to the identity of secreted proteins and functional characterization of ICEs has been previously reported, but the relationship between these elements remains unclear. Herein we investigated secreted proteins of V. parahaemolyticus strains JHY20 and JHY20△ICE using two-dimensional gel electrophoresis and LC-MS/MS, which led to the identification of an ICE-associated secreted protein – dihydrolipoamide dehydrogenase (DLDH). Considering the data related to its physical and biochemical characterization, we predicted that DLDH is a novel immunogenic protein and associated with virulence in JHY20. Our findings indicate a potential relationship between ICE-associated transport and secreted proteins and shed light on the function of such transport mechanisms. We believe that our data should enhance our understanding of mobile genetic elements.

Symbiotic composite composed of MoS2 and pelagic clay with enhanced disinfection efficiency

Molybdenum disulfide (MoS2) has attracted increasing attention as a promising photocatalyst. In addition to its application in photocatalytic hydrogen production and pollutant degradation, MoS2 is also used in water disinfection. However, its poor disinfection performance limits its practical utility. Herein, we prepared a symbiotic composite composed of MoS2 and pelagic clay (MoS2/PC) as a photocatalyst for water disinfection. The composite achieved a high disinfection rate of 99.95% to Escherichia coli (E. coli) under visible light illumination, which is significantly higher than that of bulk MoS2 (61.87%). Characterization shows that abundant hydroxyl groups in illite/montmorillonite (I/M) formed during hydrothermal synthesis of MoS2, which contributed to the enhanced disinfection activity. Those hydroxyl groups can attract photogenerated holes through electrostatic attraction, and facilitate the separation of photogenerated charge carriers, thereby enhancing the disinfection activity. Moreover, the good hydrophilicity of pelagic clay improves the dispersity of MoS2 in water, which is beneficial for its utility in aqueous solutions. In addition, the symbiotic structure restricts the growth and aggregation of MoS2 nanosheets and shortens the diffusion distance of charge carriers to the material surface, further reducing the recombination of electrons and holes. This study provides a way to improve the disinfection activity of MoS2 and also sheds light on high value-added utilization of pelagic clay.

Boosting CO2 electroreduction to CO with abundant nickel single atom active sites

A facile route for a single-atom Ni catalyst (Ni–SAs–NC) with dense Ni–N₄ active sites is reported; the as-prepared Ni–SAs–N₄C shows a 98% faradaic efficiency (FE) at −0.65 V for CO generation.

The weekend effect in neurosurgery: the Leeds general infirmary experience

OBJECTIVE

In this article, we have studied what the impact of the 2016 contract has been on the weekend mortality rate in a single UK Neurosurgery centre for emergency admissions.

METHODS

All adult neurosurgery admissions and mortality data from Leeds General Infirmary in 2016 and 2018 was included. Weekday was defined as between 00:01 am Monday and 23:59 Friday. Weekend was defined as anything outside this timeframe. In the first part of the analysis, we excluded all public holiday admissions and compared mortality risks between weekday and weekend admissions. A Cox proportional hazard model was used to examine the time to in-hospital death or censorship. From the model, we compared the hazard ratio of weekend-vs.-weekday admissions for 7-day, 30-day and overall mortalities as well as compared the hazard of mortality on each day of the week to Wednesday admission. In the second part of the analysis, we compared mortality risks of weekday admissions versus public holiday admissions. Finally, to further evaluate whether there was any change in service standard from 2016 to 2018, we assessed the odds ratio of mortality between admission in 2018 and 2016 on weekends and weekdays excluding public holidays.

RESULTS

At 95% confidence interval, no significant difference in hazard ratio was found between admissions on different days in the week when compared to Wednesday in 2016 and 2018. There is a higher weekday admission 7-day mortality hazard ratio in 2018 compared to 2016 but overall there is no statistically significant difference in mortality hazard ratio between the two years. There is, however, a statistically significant difference in hazard ratio when comparing public holiday mortality in 2018 to weekday mortality.

CONCLUSIONS

There was no weekend effect in our unit in 2016 or in 2018, however there is a public holiday effect in 2018.

Ultra-small hollow ternary alloy nanoparticles for efficient hydrogen evolution reaction

Hollow nanoparticles with large specific surface area and high atom utilization are promising catalysts for the hydrogen evolution reaction (HER). We describe herein the design and synthesis of a series of ultra-small hollow ternary alloy nanostructures using a simple one-pot strategy. The same technique was demonstrated for hollow PtNiCu nanoparticles, hollow PtCoCu nanoparticles and hollow CuNiCo nanoparticles. During synthesis, the displacement reaction and oxidative etching played important roles in the formation of hollow structures. Moreover, our hollow PtNiCu and PtCoCu nanoparticles were single crystalline, with an average diameter of 5 nm. Impressively, ultra-small hollow PtNiCu nanoparticles, containing only 10% Pt, exhibited greater electrocatalytic HER activity and stability than a commercial Pt/C catalyst. The overpotential of hollow PtNiCu nanoparticles at 10 mA cm^-2 was 28 mV versus reversible hydrogen electrode (RHE). The mass activity was 4.54 A mg_Pt ^-1 at -70 mV versus RHE, which is 5.62-fold greater than that of a commercial Pt/C system (0.81 A mg_Pt ^-1). Through analyses of bonding and antibonding orbital filling, density functional theory calculations demonstrated that the bonding strength of different metals to the hydrogen intermediate (H^*) was in the order of Pt > Co > Ni > Cu. The excellent HER performance of our hollow PtNiCu nanoparticles derives from moderately synergistic interactions between the three metals and H^*. This work demonstrates a new strategy for the design of low-cost and high-activity HER catalysts.

Three phytotoxins produced by Neopestalotiopsis clavispora, the causal agent of ring spot on Kadsura coccinea

Phytotoxins are widely found in plant pathogens. In recent years, many diseases caused by Neopestalotiopsis clavispora have been reported. To better understand the pathogenicity of N. clavispora, a solid fermentation strategy was employed to isolate and identify virulence factors afritoxinone B, afritoxinone A and oxysporone. The phytotoxic activities of these toxins were evaluated. Oxysporone exhibited high levels of phytotoxic activity after 72 h and the lesion area ranged from 21.5-84.3 mm2 after 9 days of treatment. The phytotoxic activities of the other two compounds were lower than that for oxysporone. The phytotoxic activity towards non-host organisms was also assessed for the three analyzed compounds; phytotoxic activity was observed in each case. Based on these results, we conclude that oxysporone is the main virulence factor in N. clavispora. We also suggest that each of the three compounds were non-host-specific toxins (NHST). To our knowledge, this is the first study to analyze phytotoxins produced by N. clavispora.

Simulating the change of precipitation-runoff relationship during drought years in the eastern monsoon region of China

Most hydrological simulation and prediction methods assume that the precipitation-runoff relationship was stationary. However, this assumption was found to be questionable during drought years: the annual runoff coefficients (the ratio of annual runoff to annual precipitation) during drought years tend to be smaller than those during non-drought years. However, little is known about the spatial distribution of the magnitude of runoff coefficient change (RC_change) during drought years, and which factors dominate the spatial pattern of RC_change over a large spatial scale. To answer these questions, this study investigated the RC_change in 265 catchments in China that cover a broad range of climate and landscape conditions. We identified the significant factors affecting RC_change from ten catchment characteristics and developed a multivariate generalized additive model to simulate the spatial pattern of RC_change across the eastern monsoon region of China. Results indicated that the RC_change showed an increasing trend from north to south of China, with values ranging from -67.1% to -0.3%, with the average being -26.4%. The lower RC_change (corresponding to more significant runoff reduction) in drought years was more likely to occur in catchments with dryer climate and lower elevation. The simulated RC_change by the multivariate generalized additive model demonstrated a good agreement with observed RC_change, and the values of Nash-Sutcliffe efficiency between observed and simulated RC_change were 0.77 for training catchments and 0.72 for testing catchments. Finally, we applied the model to extrapolate RC_change to the entire eastern monsoon region of China. The result would benefit water resources management during drought years.

Dynamics of Kresling origami deployment

Origami-inspired structures have a rich design space, offering new opportunities for the development of deployable systems that undergo large and complex yet predictable shape transformations. There has been growing interest in such structural systems that can extend uniaxially into tubes and booms. The Kresling origami pattern, which arises from the twist buckling of a thin cylinder and can exhibit multistability, offers great potential for this purpose. However, much remains to be understood regarding the characteristics of Kresling origami deployment. Prior studies have been limited to Kresling structures' kinematics, quasistatic mechanics, or low-amplitude wave responses, while their dynamic behaviors with large shape change during deployment remain unexplored. These dynamics are critical to the system design and control processes, but are complex due to the strong nonlinearity, bistability, and potential for off-axis motions. To advance the state of the art, this research seeks to uncover the deployment dynamics of Kresling structures with various system geometries and operating strategies. A full, six-degrees-of-freedom model is developed and employed to provide insight into the axial and off-axis dynamic responses, revealing that the variation of key geometric parameters may lead to regions with qualitatively distinct mechanical responses. Results illustrate the sensitivity of dynamic deployment to changes in initial condition and small variations in geometric design. Further, analyses show how certain geometries and configurations affect the stiffness of various axial and off-axis deformation modes, offering guidance on the design of systems that deploy effectively while mitigating the effects of off-axis disturbances. Overall, the research outcomes suggest the strong potential of Kresling-based designs for deployable systems with robust and tunable performance.

Emergency surgery is an effective way to improve the outcome of severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet therapy

The necessity of emergency surgery for severe spontaneous intracerebral hemorrhage (SSICH) patients on long-term oral antiplatelet therapy (LOAPT) remains unclear. The aim of this study was to investigate the effect and safety of emergency surgery for SSICH patients on LOAPT (SSICH-LOAPT patients). In this study, a retrospective review of patients admitted to our institution for SSICH from January 2012 to December 2018 was conducted. The collected data included demographic, clinical, and surgical information. The outcome was recorded at 3 months after primary hemorrhage. The outcome of SSICH-LOAPT patients receiving emergency surgery and conservative treatment were compared. The risk of postoperative intracranial bleeding (PIB) in operated SSICH-LOAPT patients was further investigated. A total of 522 SSICH patients were retrospectively reviewed, including 181 SSICH-LOAPT patients and 269 operated patients. The total mortality and in-hospital mortality were 40.6% and 19.3%, respectively. As compared with SSICH-LOAPT patients receiving conservative treatment, the operated SSICH-LOAPT patients showed a lower total (p = 0.043) and in-hospital mortality (p = 0.024). When compared with operated patients not on LOAPT, the operated patients on LOAPT exhibited a higher rate of PIB (OR, 2.34; 95% CI 1.14-4.79; p = 0.018). As demonstrated by the multivariate logistic analysis, dual antiplatelet therapy were independent risk factors associated with PIB in operated SSICH-LOAPT patients (OR, 3.42; CI, 1.01-11.51; p = 0.047). Despite of increasing risk of PIB, emergency surgery could improve the outcome of SSICH-LOAPT patients as it could be effective in reducing mortality. Dual antiplatelet therapy was the independent risk factor related to the PIB in operated SSICH-LOAPT patients.

Predictive value of circulating plasma mitochondrial DNA for Sepsis in the emergency department: observational study based on the Sepsis-3 definition

Background

The definition of sepsis is regularly updated; however, there is no standard diagnostic test. To improve diagnosis and prognostic prediction, the aim of this study was to determine the predictive value of circulating plasma mitochondrial DNA (mtDNA) levels in patients admitted to the emergency department (ED) with sepsis.

Methods

A total of 107 patients hospitalized from June 2018 to January 2019 were divided into the sepsis (n = 72) and septic shock (n = 35) groups based on the sepsis-3 definition. Clinical and laboratory data were measured within 24 h of admission. The mtDNA concentrations in clarified plasma were estimated by quantitative polymerase chain reaction. Binary logistic regression analysis and the receiver operating characteristic (ROC) curve were used to determine predictive value of mtDNA and other markers for sepsis outcome (28-day mortality).

Results

The median plasma mtDNA levels on admission were significantly higher in the septic shock patients than in the sepsis patients (134,252(IQR 70215–203,184) vs. 59,945(IQR 13274–95,319) copies/μL, P < 0.01), and were also higher in non-survivors than in survivors within 28 days (165,291(IQR 89919–272,228)vs. 63,025(IQR 17031–98,401)copies/μL, P < 0.01). Binary logistic regression showed that plasma lactate and mtDNA levels were independent risk factors for 28-day mortality [odds ratio (OR) 1.341, 95% confidence interval (CI) 1.035–1.736, P = 0.026 and OR 13.299, 95%CI 2.765–63.956, P = 0.001, respectively). The area under the ROC curve values for plasma mtDNA levels, lactate concentration, and their combined were 0.781 (p < 0.001, 95%CI 0.671–0.891), 0.733 (p < 0.001, 95%CI 0.635–0.832), and 0.799 (p < 0.001, 95%CI 0.698–0.901), respectively. The calibration test for the combined variable showed X² of 2.559 and P = 0.923.

Conclusion

A higher plasma mtDNA level was associated with a poor prognosis of sepsis in the emergency room, and could serve as a predictor of sepsis for 28-day mortality.

Controllable Drug Release Behavior of Polylactic Acid (PLA) Surgical Suture Coating with Ciprofloxacin (CPFX)-Polycaprolactone (PCL)/Polyglycolide (PGA)

Polylactic acid (PLA) surgical suture can be absorbed by human body. In order to avoid surgical site infections (SSIs), the drug is usually loaded on the PLA suture, and then the drug can release directly to the wound. Because the different types of wounds heal at different times, it is needed to control the drug release rate of PLA suture to consistent to the wound healing time. Two biopolymers, polyglycolide (PGA) and polycaprolactone (PCL), were selected as the carrier of ciprofloxacin (CPFX) drug, and then the CPFX-PCL/PGA was coated on the PLA suture. The degradation rate of drug-carrier can be controlled by adjusting the proportion of PCL/PGA, which can regulate the rate of CPFX drug release from PLA suture. The results show that the surface of PLA suture, coating with PCL/PGA, was very rough, which led to increased stitching resistance when we were suturing the wound. These materials, such as the PLA suture, the PCL/PGA carriers and the CPFX drug, were just physically mixed rather than chemically reacted, which was very useful for ensuring the original efficacy of CPFX drug. With the increasing of PCL in the carriers, both the breaking strength and elongation of these un-degraded sutures increased. During degradation, the breaking strength of all sutures gradually decreased, and the more PCL in the coating materials, the longer effective strength-time for the suture. With the increasing of PCL in the drug-carrier, the rate of drug releasing became lower. The drug release mechanism of CPFX-PCL/PGA was a synergistic effect of drug diffusion and PCL/PGA carrier dissolution.

CD4+CXCR4+ T cells as a novel prognostic biomarker in patients with idiopathic inflammatory myopathy-associated interstitial lung disease

BACKGROUD

There is an unmet need for the development of new biomarkers for idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD).

METHODS

Peripheral CD4+CXCR4+ T cells, stromal cell-derived factor-1 and Krebs von den Lungen-6 were measured in patients with IIM-ILD (n = 85) and controls. The relation to pulmonary functions, high-resolution CT scores, specific clinical phenotypes and survival was analysed. Cytokine-expression profiling of these CD4+CXCR4+ T cells and their co-culture with pulmonary fibroblasts were conducted.

RESULTS

The peripheral percentages of CD4+CXCR4+ T cells were significantly elevated in IIM-ILD patients, and correlated with high-resolution CT score (r = 0.7136, P < 0.0001) and pulmonary function impairments, such as percentage of forced volume vital capacity (r = -0.4734, P = 0.0005). They were associated with anti-melanoma differentiation-associated gene 5 autoantibodies and the amyopathic DM phenotype. In IIM-ILD, peripheral percentages of CD4+CXCR4+ T cells ⩾30% revealed a 6-month mortality as high as 47%. These CD4+CXCR4+ T cells express high levels of IL-21 and IL-6. In vitro blockade of IL-21 signalling by neutralization of IL-21 or Janus kinase inhibitor could abolished the fibroblast proliferation.

CONCLUSION

Overall, peripheral CD4+CXCR4+ T cells appear to be a potentially valuable novel biomarker associated with the severity and prognosis of IIM-ILD. They promote pulmonary fibroblast proliferation via IL-21, which may herald future targeted treatments for this severe disease.

Ultra-small subnano TiOx clusters as excellent cocatalysts for the photocatalytic degradation of tetracycline on plasmonic Ag/AgCl

Subnano TiO_x clusters as cocatalysts on Ag/AgCl exhibit an unparalleled TC photodegradation reaction rate under simulated sunlight irradiation.

Ultrahigh Photocatalytic Rate at a Single-Metal-Atom-Oxide

Metal oxides, as one of the mostly abundant and widely utilized materials, are extensively investigated and applied in environmental remediation and protection, and in energy conversion and storage. Most of these diverse applications are the result of a large diversity of the electronic states of metal oxides. Noticeably, however, many metal oxides present obstacles for applications in catalysis, mainly due to the lack of efficient active sites with desired electronic states. Here, the fabrication of single-tungsten-atom-oxide (STAO) is demonstrated, in which the metal oxide's volume reaches its minimum as a unit cell. The catalytic mechanism in the STAO is determined by a new single-site physics mechanism, named as quasi-atom physics. The photogenerated electron transfer process is enabled by an electron in the spin-up channel excited from the highest occupied molecular orbital to the lowest unoccupied molecular orbital +1 state, which can only occur in STAO with W⁵⁺ . STAO results in a record-high and stable sunlight photocatalytic degradation rate of 0.24 s^-1 , which exceeds the rates of available photocatalysts by two orders of magnitude. The fabrication of STAO and its unique quasi-atom photocatalytic mechanism lays new ground for achieving novel physical and chemical properties using single-metal-atom oxides (SMAO).

Automatic localization and identification of mitochondria in cellular electron cryo-tomography using faster-RCNN

BACKGROUND

Cryo-electron tomography (cryo-ET) enables the 3D visualization of cellular organization in near-native state which plays important roles in the field of structural cell biology. However, due to the low signal-to-noise ratio (SNR), large volume and high content complexity within cells, it remains difficult and time-consuming to localize and identify different components in cellular cryo-ET. To automatically localize and recognize in situ cellular structures of interest captured by cryo-ET, we proposed a simple yet effective automatic image analysis approach based on Faster-RCNN.

RESULTS

Our experimental results were validated using in situ cyro-ET-imaged mitochondria data. Our experimental results show that our algorithm can accurately localize and identify important cellular structures on both the 2D tilt images and the reconstructed 2D slices of cryo-ET. When ran on the mitochondria cryo-ET dataset, our algorithm achieved Average Precision >0.95. Moreover, our study demonstrated that our customized pre-processing steps can further improve the robustness of our model performance.

CONCLUSIONS

In this paper, we proposed an automatic Cryo-ET image analysis algorithm for localization and identification of different structure of interest in cells, which is the first Faster-RCNN based method for localizing an cellular organelle in Cryo-ET images and demonstrated the high accuracy and robustness of detection and classification tasks of intracellular mitochondria. Furthermore, our approach can be easily applied to detection tasks of other cellular structures as well.