Construction of Preoperative Assessment Program for Day Surgery in Geriatric Cataract Patients: An Evidence-Based Delphi Study.

PURPOSE: To construct a scientific cataract day surgery preoperative assessment program to provide a scientific assessment tool for health care providers. DESIGN: Literature review, two-round e-Delphi study, and quantitative studies. METHODS: With the recommended opinions of clinical practice guidelines for cataract surgery as the guiding framework, an item pool was formed on the basis of literature review and guideline content analysis, and the dimensions and items of evaluation program were determined by two rounds of correspondence consultation using Delphi expert method. Then, 315 patients from an ophthalmic hospital were selected for investigation to analyze its reliability and validity. FINDINGS: The positive coefficients for the 2 rounds of correspondence with experts were 100.00% and 95.83%, and the authority coefficients were 0.90 and 0.89. Kendall's coordination coefficient W values of 0.29 and 0.24 for the first and second rounds and the differences were statistically different (P < .05). The coefficient of variation was 0.14 and 0.10, respectively. The formal assessment items included 3 first-level indicators, 12 secondary-level indicators, and 48 tertiary indicators, with an overall Cronbach's coefficient of 0.66 and cumulative variance contributions of 69.19%, 65.84%, and 57.15% for the 3 first-level indicators. CONCLUSION: The high reliability of the preoperative cataract day surgery program compiled by applying evidence-based analysis and the Delphi method can provide scientific guidance to clinical nurses for preoperative assessment, which in turn ensures patient safety and improves the quality of patient access services.

High ammonia adsorption in copper-carboxylate materials: host-guest interactions and crystalline-amorphous-crystalline phase transitions.

We report the high NH3 uptake in a series of copper-carboxylate materials, namely MFM-100, MFM-101, MFM-102, MFM-126, MFM-127, MFM-190(F), MFM-170, and Cu-MOP-1a. At 273 K and 1 bar, MFM-101 shows an exceptional uptake of 21.9 mmol g-1. The presence of Cu(II)⋯NH3 interactions and changes in coordination at the [Cu2(O2CR)4] paddlewheel are analysed and discussed.

TME-responsive nanoplatform for multimodal imaging-guided synergistic precision therapy of esophageal cancer via inhibiting HIF-1α signal pathway.

Esophageal cancer (EC) is the sixth leading cause of cancer-related deaths, and its treatment poses significant challenges. In recent years, photodynamic, photothermal, and chemodynamic therapies have emerged as alternative strategies for tumor intervention. However, limitations such as poor tumor targeting, insufficient microenvironment responsiveness, and unclear mechanisms hinder their application. In this study, we found that hypoxia-inducible factor 1 alpha (HIF-1α) was highly expressed in clinical EC samples, which contributed to tumor malignancy and metastasis. We developed a carbon dots (CDs)-based tumor microenvironment (TME)-responsive nanoplatform, CDs-MnO2-Au-Cet (CMAC), designed for multimodal imaging-guided precision therapy in EC. Both in vitro and in vivo experiments demonstrated that CMAC effectively targeted and imaged EC cells and tissues. CMAC significantly inhibited tumor growth by inducing apoptosis and reducing lung metastasis. Mechanistically, CMAC administration led to a substantial downregulation of HIF-1α and its downstream targets, GLUT1 and MMP9. In summary, we presented a novel nanoplatform for imaging-guided synergistic therapy in EC, which demonstrated excellent anti-tumor growth and metastasis capabilities, along with favorable biocompatibility. This study laid the groundwork for developing innovative theranostic strategies for EC.

Layer-by-Layer Nanoparticles for Calcium Overload in situ Enhanced Reactive Oxygen Oncotherapy.

Background: Challenges such as poor drug selectivity, non-target reactivity, and the development of drug resistance continue to pose significant obstacles in the clinical application of cancer therapeutic drugs. To overcome the limitations of drug resistance in chemotherapy, a viable treatment strategy involves designing multifunctional nano-platforms that exploit the unique physicochemical properties of tumor microenvironment (TME). Methods: Herein, layer-by-layer nanoparticles with polyporous CuS as delivery vehicles, loaded with a sonosensitizer (tetra-(4-aminophenyl) porphyrin, TAPP) and sequentially functionalized with pH-responsive CaCO3, targeting group hyaluronic acid (HA) were designed and synthesized for synergistic treatment involving chemodynamic therapy (CDT), sonodynamic therapy (SDT), photothermal therapy (PTT), and calcium overload. Upon cleavage in an acidic environment, CaCO3 nanoparticles released TAPP and Ca2+, with TAPP generating 1O2 under ultrasound trigger. Exposed CuS produced highly cytotoxic ·OH in response to H2O2 and also exhibited a strong PTT effect. Results: CuS@TAPP-CaCO3/HA (CTCH) delivered an enhanced ability to release more Ca2+ under acidic conditions with a pH value of 6.5, which in situ causes damage to HeLa mitochondria. In vitro and in vivo experiments both demonstrated that mitochondrial dysfunction greatly amplified the damage caused by reactive oxygen species (ROS) to tumor, which strongly confirms the synergistic effect between calcium overload and reactive oxygen therapy. Conclusion: Collectively, the development of CTCH presents a novel therapeutic strategy for tumor treatment by effectively responding to the acidic TME, thus holding significant clinical implications.

Nanosheets of a Layered Metal-Organic Framework for Separation of CO2/CH4 using Mixed Matrix Membranes.

Mixed matrix membranes represent an important technology for gas separations. Nanosheets of metal-organic framework (MOF) materials of high aspect ratio and size-selective gas transport properties have the potential to promote the efficient mixing of components to form membranes for gas separation. Herein, we report a bottom-up synthesis of extended sheets of kagomé (kgm) topology, kgmt-Bu, via the linkage of [Cu2(O2CR)4] paddlewheels with 5-tert-butylisophthalic acid. The growth of the layered structure can be controlled by the choice of solvent and modulator. Nanosheets of kgmt-Bu of average thickness of 20 nm and aspect ratio of 40 to 50 can be obtained, and the sieving effect of the channels in kgmt-Bu boost the efficient separation of CO2 over CH4. A mixed matrix membrane comprising kgmt-Bu nanosheets with Matrimid shows a 32% enhancement in CO2/CH4 selectivity compared with the membrane incorporating the MOF in the particulate form.

mPPTMP195 nanoparticles enhance fracture recovery through HDAC4 nuclear translocation inhibition.

Delayed repair of fractures seriously impacts patients' health and significantly increases financial burdens. Consequently, there is a growing clinical demand for effective fracture treatment. While current materials used for fracture repair have partially addressed bone integrity issues, they still possess limitations. These challenges include issues associated with autologous material donor sites, intricate preparation procedures for artificial biomaterials, suboptimal biocompatibility, and extended degradation cycles, all of which are detrimental to bone regeneration. Hence, there is an urgent need to design a novel material with a straightforward preparation method that can substantially enhance bone regeneration. In this context, we developed a novel nanoparticle, mPPTMP195, to enhance the bioavailability of TMP195 for fracture treatment. Our results demonstrate that mPPTMP195 effectively promotes the differentiation of bone marrow mesenchymal stem cells into osteoblasts while inhibiting the differentiation of bone marrow mononuclear macrophages into osteoclasts. Moreover, in a mouse femur fracture model, mPPTMP195 nanoparticles exhibited superior therapeutic effects compared to free TMP195. Ultimately, our study highlights that mPPTMP195 accelerates fracture repair by preventing HDAC4 translocation from the cytoplasm to the nucleus, thereby activating the NRF2/HO-1 signaling pathway. In conclusion, our study not only proposes a new strategy for fracture treatment but also provides an efficient nano-delivery system for the widespread application of TMP195 in various other diseases.

High adsorption of ammonia in a titanium-based metal-organic framework.

We report the high adsorption of NH3 in a titanium-based metal-organic framework, MFM-300(Ti), comprising extended [TiO6]∞ chains linked by biphenyl-3,3',5,5'-tetracarboxylate ligands. At 273 K and 1 bar, MFM-300(Ti) shows an exceptional NH3 uptake of 23.4 mmol g-1 with a record-high packing density of 0.84 g cm-3. Dynamic breakthrough experiments confirm the excellent uptake and separation of NH3 at low concentration (1000 ppm). The combination of in situ neutron powder diffraction and spectroscopic studies reveal strong, yet reversible binding interactions of NH3 to the framework oxygen sites.

Tailored Phototherapy Agent by Infection Site In Situ Activated Against Methicillin-Resistant S. aureus.

Phototherapy, including photodynamic therapy (PDT) and photothermal therapy (PTT), is a promising treatment approach for multidrug resistant infections. PDT/PTT combination therapy can more efficiently eliminate pathogens without drug resistance. The key to improve the efficacy of photochemotherapy is the utilization efficiency of non-radiation energy of phototherapy agents. Herein, a facile phototherapy molecule (SCy-Le) with the enhancement of non-radiative energy transfer is designed by an acid stimulation under a single laser. Introduction of the protonated receptor into SCy-Le results in a distorted intramolecular charge in the infected acidic microenvironment, pH ≈ 5.5, which in turn, enhances light capture, reduces the singlet-triplet transition energies (ΔES1-T1), promotes electron system crossing, enhances capacity of reactive oxygen species generation, and causes a significant increase in temperature by improving vibrational relaxation. SCy-Le shows more than 99% bacterial killing rate against both methicillin-resistant Staphylococcus aureus and its biofilms in vitro and causes bacteria-induced wound healing in mice. This work will provide a new perspective for the design of phototherapy agents, and the emerging photochemotherapy will be a promising approach to combat the problem of antibiotic resistance.

Precise Design of TiO2@CoOx Heterostructure via Atomic Layer Deposition for Synergistic Sono-Chemodynamic Oncotherapy.

Sonodynamic therapy (SDT), a tumor treatment modality with high tissue penetration and low side effects, is able to selectively kill tumor cells by producing cytotoxic reactive oxygen species (ROS) with ultrasound-triggered sonosensitizers. N-type inorganic semiconductor TiO2 has low ROS quantum yields under ultrasound irradiation and inadequate anti-tumor activity. Herein, by using atomic layer deposition (ALD) to create a heterojunction between porous TiO2 and CoOx, the sonodynamic therapy efficiency of TiO2 can be improved. Compared to conventional techniques, the high controllability of ALD allows for the delicate loading of CoOx nanoparticles into TiO2 pores, resulting in the precise tuning of the interfaces and energy band structures and ultimately optimal SDT properties. In addition, CoOx exhibits a cascade of H2O2→O2→·O2 - in response to the tumor microenvironment, which not only mitigates hypoxia during the SDT process, but also contributes to the effect of chemodynamic therapy (CDT). Correspondingly, the synergistic CDT/SDT treatment is successful in inhibiting tumor growth. Thus, ALD provides new avenues for catalytic tumor therapy and other pharmaceutical applications.

Direct Synthesis of N-formamides by Integrating Reductive Amination of Ketones and Aldehydes with CO2 Fixation in a Metal-Organic Framework.

Formamides are important feedstocks for the manufacture of many fine chemicals. State-of-the-art synthesis of formamides relies on the use of an excess amount of reagents, giving copious waste and thus poor atom-economy. Here, we report the first example of direct synthesis of N-formamides by coupling two challenging reactions, namely reductive amination of carbonyl compounds, particularly biomass-derived aldehydes and ketones, and fixation of CO2 in the presence of H2 over a metal-organic framework supported ruthenium catalyst, Ru/MFM-300(Cr). Highly selective production of N-formamides has been observed for a wide range of carbonyl compounds. Synchrotron X-ray powder diffraction reveals the presence of strong host-guest binding interactions via hydrogen bonding and parallel-displaced π⋅⋅⋅π interactions between the catalyst and adsorbed substrates facilitating the activation of substrates and promoting selectivity to formamides. The use of multifunctional porous catalysts to integrate CO2 utilisation in the synthesis of formamide products will have a significant impact in the sustainable synthesis of feedstock chemicals.

Exceptional capture of methane at low pressure by an iron-based metal-organic framework.

The selective capture of methane (CH4) at low concentrations and its separation from N2 are extremely challenging owing to the weak host-guest interactions between CH4 molecules and any sorbent material. Here, we report the exceptional adsorption of CH4 at low pressure and the efficient separation of CH4/N2 by MFM-300(Fe). MFM-300(Fe) shows a very high uptake for CH4 of 0.85 mmol g-1 at 1 mbar and 298 K and a record CH4/N2 selectivity of 45 for porous solids, representing a new benchmark for CH4 capture and CH4/N2 separation. The excellent separation of CH4/N2 by MFM-300(Fe) has been confirmed by dynamic breakthrough experiments. In situ neutron powder diffraction, and solid-state nuclear magnetic resonance and diffuse reflectance infrared Fourier transform spectroscopies, coupled with modelling, reveal a unique and strong binding of CH4 molecules involving Fe-OH⋯CH4 and C⋯phenyl ring interactions within the pores of MFM-300(Fe), thus promoting the exceptional adsorption of CH4 at low pressure.

Effect of industrial sludge particle size on the performance of baking-free sludge bricks.

Cement solidification is essential to reduce heavy metal leaching from industrial sludge and make it recyclable. This paper studied the effect of aggregate grading optimized by sludge containing heavy metal of different particle sizes on the performance of baking-free sludge bricks, which was mixed with industrial sludge cured by both micro-silica fume and cement. First, the gradation of fine natural aggregates was adjusted according to the Fuller curve. Fine aggregates in baking-free bricks were replaced by artificially processed sludge with particle sizes of 0.15 mm ~0.3 mm and 2.36 mm ~4.75 mm. In this case, a mixed proportion scheme was designed. Then, the strength, water absorption, porosity, and heavy metal leaching were measured. With the help of nuclear magnetic resonance (NMR) and scanning electron microscopy (SEM), the phase and pore structures were observed. The test results showed that: (1) Sludge can replace part of the fine aggregates to make baking-free bricks, resulting in the reduction of the strength of baking-free bricks, but the strength still meets the standard strength requirements of GB/T 21,144-2007. (2) When fine aggregates are partly replaced by sludge with finer particle sizes, baking-free sludge bricks exhibit higher strength, lower water absorption, better pore structures and microphase structure, and stronger solidification of heavy metals, the leaching number of heavy metals meets the standard requirements of GB5085.3-2007, which will be provided support for actual industrial production.Implications: Cement solidification is an essential means to reduce the heavy metal leaching from industrial sludge and make it recyclable. This paper studied sludge containing heavy metal of different particle sizes on the performance of baking-free sludge bricks. This paper analyzed the compressive strength, porosity and water absorption of baking-free bricks mixed with sludge of different partical sizes, and adopted the NMR to characterize the pores of baking-free bricks, and the SEM to observe the baking-free bricks resultants and the interfacial transition zone (ITZ). The heavy metal leaching test verified the environmental benefits of baking-free bricks mixed with sludge instead of aggregates. There not only make full use of solid wastes, but also thus minimizing pollution to the environment, which provide support for actual industrial production and a reference for studying industrial sludge recycling technology.

Multimodal imaging and photothermal/chemodynamic therapy of cervical cancer using GSH-responsive MoS2@MnO2 theranostic nanoparticles.

The development of nanoparticles capable of inducing reactive oxygen species (ROS) formation has become an important strategy for cancer therapy. Simultaneously, the preparation of multifunctional nanoparticles that respond to the tumor microenvironment is crucial for the diagnosis and treatment of tumors. In this study, we designed a Molybdenum disulfide (MoS2) core coated with Manganese dioxide (MnO2), which possessed a good photothermal effect and could produce Fenton-like Mn2+ in response to highly expressed glutathione (GSH) in the tumor microenvironment, thereby generating a chemodynamic therapy (CDT). The nanoparticles were further modified with Methoxypoly(Ethylene Glycol) 2000 (mPEG-NH2) to improve their biocompatibility, resulting in the formation of MoS2@MnO2-PEG. These nanoparticles were shown to possess significant Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) imaging capabilities, making them useful in tumor diagnosis. In vitro and in vivo experiments demonstrated the antitumor ability of MoS2@MnO2-PEG, with a significant killing effect on tumor cells under combined treatment. These nanoparticles hold great potential for CDT/photothermal therapy (PTT) combined antitumor therapy and could be further explored in biomedical research.

Efficient capture and storage of ammonia in robust aluminium-based metal-organic frameworks.

The development of stable sorbent materials to deliver reversible adsorption of ammonia (NH3) is a challenging task. Here, we report the efficient capture and storage of NH3 in a series of robust microporous aluminium-based metal-organic framework materials, namely MIL-160, CAU-10-H, Al-fum, and MIL-53(Al). In particular, MIL-160 shows high uptakes of NH3 of 4.8 and 12.8 mmol g-1 at both low and high pressure (0.001 and 1.0 bar, respectively) at 298 K. The combination of in situ neutron powder diffraction, synchrotron infrared micro-spectroscopy and solid-state nuclear magnetic resonance spectroscopy reveals the preferred adsorption domains of NH3 molecules in MIL-160, with H/D site-exchange between the host and guest and an unusual distortion of the local structure of [AlO6] moieties being observed. Dynamic breakthrough experiments confirm the excellent ability of MIL-160 to capture of NH3 with a dynamic uptake of 4.2 mmol g-1 at 1000 ppm. The combination of high porosity, pore aperture size and multiple binding sites promotes the significant binding affinity and capacity for NH3, which makes it a promising candidate for practical applications.

Rational design of graphite carbon nitride-decorated zinc oxide nanoarrays on three-dimensional nickel foam for the efficient production of reactive oxygen species through stirring-promoted piezo-photocatalysis.

Stirring-promoted piezo-photocatalysis based on a three-dimensional foam architecture has great potential applications in wastewater treatment and water splitting. However, the detailed mechanism of stirring-promoted piezo-photocatalysis has not been quantitatively studied, and the utilization of visible light needs to be further improved. In this work, the high solar-driven piezo-photocatalytic ability of graphite carbon nitride (g-C3N4)-decorated zinc oxide (ZnO) nanoarrays on nickel (Ni) foam is experimentally achieved and first simulated by the finite element method (FEM). The water flow velocity, depending on the stirring rate, is significantly increased by turbulence-induced fluid eddies while flowing through 3D macropores and nanoarrays, resulting in higher piezoelectricity. Reactive oxygen species (ROS) are experimentally examined by the electron spin resonance (ESR) technique and theoretically calculated by density functional theory (DFT) to confirm the configurations of the heterojunction under photocatalysis and piezo-photocatalysis. In particular, the large enhancement of 1O2 generation suggests the potential of piezo-photocatalysis in biological applications. The mechanism of piezo-photocatalysis is proposed in which the S-scheme heterojunction is realized by piezoelectricity to improve photocatalysis by retaining high redox ability and inhibiting recombination. This work provides a possible approach to harvesting energy sources for piezoelectricity and expands the scope of solar-driven piezo-photocatalysis.

Experience of patients with diabetic retinopathy: A qualitative study.

AIMS: To understand the status quo and needs of self-management of patients with diabetic retinopathy (DR) and to provide a reference for formulating management programs that meet the needs of these patients. DESIGN: A qualitative interview study. METHODS: Semi-structured, in-depth interviews were conducted between November and December 2021. A purposive sample of 15 patients with DR who were hospitalized in the Retinal Department of Eye Hospital was recruited. Colaizzi's analysis was used to organize and analyse the interview data. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: The experience of patients with DR can be summarized into four themes: (1) lack of DR knowledge, (2) low quality of life, (3) poor self-management behaviour and (4) seek for support from many aspects. CONCLUSION: Patients with DR lack disease knowledge and have poor self-management abilities and adherence. Medical staff should provide personalized care according to the patient's self-management status and needs, promote the establishment of self-management behaviours and prevent and delay disease progression. IMPACT: This study helps assist medical staff in the early management of patients with DR and provides a reference for the construction of prevention programs for patients.

Efficient Optical Modulation of Exciton State Population in Monolayer MoS2 at Room Temperature.

The modulation of exciton energy and state density of layer-structured transition metal dichalcogenides (TMDs) is required for diverse optoelectronic device applications. Here, the spontaneous inversion of exciton state population in monolayer MoS2 is observed by turning the pump light power. The excitons prefer to exist in low energy state under low pump power, but reverse under high pump power. To discuss the mechanism in depth, we propose a semiclassical model by combining the rate equation and photo-exciton interaction. Considering the modifying of exciton-exciton annihilation, the spontaneous inversion of exciton state population is phenomenologically described.

Targeted chemo-photodynamic therapy toward esophageal cancer by GSH-sensitive theranostic nanoplatform.

As the sixth leading cause of cancer death, esophageal cancer is threatening the life of people worldwide. Traditional treatments, such as surgery, chemotherapy, radiotherapy, are facing always augmented challenges including invasion, multidrug resistance (MDR), off-target toxicity. Chemo & Photodynamic synergistic therapy represents one promising strategy for improved treatment efficiency. But it is still hindered by the lack of tumor targeting, deleterious side effects, and unfavorable microenvironment for photodynamic therapy (PDT). To overcome those obstacles, one theranostic nano-assambly drug, GCDs-Ce6/Pt-EGF, was designed and fabricated. Green fluorescence carbon dots (GCDs) with the excellent optical properties, modifiability and low toxicity were prepared as drug carrier. Epidermal growth factor (EGF) was conjugated to the nano-assembly to realize tumor specific targeting. Chlorin e6 (Ce6) in the presence of laser irradiation achieved PDT by generating proapoptosis reactive oxygen species (ROS). Moreover, Ce6 incorporated into GCDs endowed the nano-assambly imaging ability and facilitate image-guided therapy. Pt(IV), cisplatin prodrug, in the nano-assambly depleted the glutathione (GSH) of tumor microenvironment when it was reduced to cytotoxicity Pt(II). Compared with single treatment, GCDs-Ce6/Pt-EGF exhibited enhanced tumor cell killing capacity and better biosafety in vitro and in vivo, especially for EGFR bearing tumor. It paved ways for developing novel theranostic agent to be potentially applied in clinic.

Construction of mitochondria targeted and FRET based ratiometric sensing nanoplatform for sulfur dioxide accurate detection in vitro and in vivo.

Sulfur dioxide (SO2) is a key molecule in organisms that is involved in the regulation of different physiological procedures. Aberrant SO2 causes a variety of diseases, such as cancer and neurodegeneration. Thus, sensitive and selective detection of SO2 is of great importance. Based on the Förster resonance energy transfer (FRET) between green fluorescence carbon dots (GCDs) donor and amide-linked near-infrared fluorescence emissive organic small molecular dye (CDDBT) acceptor, one ratiometric fluorescent nano platform, Mito-GCDs-CDDBT for mitochondria SO2 sensing was constructed. In this FRET sensing system, CDDBT served as the receptor for SO2, and the presence of SO2 enhanced GCDs green fluorescence signal and quenched CDDBT near-infrared fluorescence signal due to the disruption of FRET. Mito-GCDs-CDDBT could sensitively detect SO2 with a detection limit of as low as 0.701 µM. Meanwhile, Mito-GCDs-CDDBT achieved fluorescence imaging to measure the response of cellular exogenous and endogenous SO2 with remarkable mitochondrial targeting. Moreover, Mito-GCDs-CDDBT also realized SO2 sensing in vivo including zebrafish and mice. The as-prepared versatile nanoplatform displayed several advantages, such as mitochondria targeting, FRET-based sensitive detection, and sensing capabilities in biological milieu. Potentially, it could be applied in the diagnostics of SO2 involved diseases.

Direct Visualization of Supramolecular Binding and Separation of Light Hydrocarbons in MFM-300(In).

The purification of light olefins is one of the most important chemical separations globally and consumes large amounts of energy. Porous materials have the capability to improve the efficiency of this process by acting as solid, regenerable adsorbents. However, to develop translational systems, the underlying mechanisms of adsorption in porous materials must be fully understood. Herein, we report the adsorption and dynamic separation of C2 and C3 hydrocarbons in the metal-organic framework MFM-300(In), which exhibits excellent performance in the separation of mixtures of ethane/ethylene and propyne/propylene. Unusually selective adsorption of ethane over ethylene at low pressure is observed, resulting in selective retention of ethane from a mixture of ethylene/ethane, thus demonstrating its potential for a one-step purification of ethylene (purity > 99.9%). In situ neutron powder diffraction and inelastic neutron scattering reveal the preferred adsorption domains and host-guest binding dynamics of adsorption of C2 and C3 hydrocarbons in MFM-300(In).