Sustainable ferritin from bovine by-product liver as a potential resource: Ultrasound assisted extraction and physicochemical, structural, functional, and stable analysis.

Ferritin is an iron-containing protein that is widely present in all organisms and has the function of regulating the metabolic balance of iron in organisms. It can be separated from animal by-product tissues and converted into value-added components to promote the development of a circular economy. This study established a method for extracting bovine liver ferritin (BLFer) using ultrasound-assisted buffer system. The optimal extraction conditions were determined through single factor and response surface optimization experiments as follows: ultrasound temperature of 70 °C, extraction time of 25 min, ultrasonic power of 400 W and solvent-to-solid ratio of 2 mL/g, the experimental value of the ferritin yield was 32.18 ± 0.12 g/kg. Compared with traditional methods, Ultrasound-assisted extraction improved the ferritin yield and enhanced its structural stability. Bioinformatics analysis revealed that BLFer is a hydrophilic protein with strong thermal stability. The BLFer has a ferrous oxidase active center, which plays an important role in the oxidative precipitation and reductive release of iron. It can dissociate under strong acids or bases but maintains good stability after heat treatment. These findings will help improve the comprehensive utilization of animal by-products, and promote the potential application of animal by-product ferritin in food and other industries.

Effectiveness of ulinastatin in critical care patients in real world: a retrospective multi-center study.

OBJECTIVES: Ulinastatin has been applied in various diseases associated with inflammation, but its effectiveness lacks real-world evidence. We aimed to evaluate the effectiveness of ulinastatin based on a real-world database in the intensive care unit (ICU) patients. METHODS: This was a retrospective cohort study. ICU patient data from multi-centers in China were collected. Propensity score matching (PSM) was applied. The effectiveness of ulinastatin was evaluated by mortality, length of stay in the ICU and mechanical ventilation duration. Kaplan-Meier method was used to estimate the hazard ratio and plot the survival curve. RESULTS: A total of 2036 patients were analyzed after PSM. Mortality was significantly lower in the ulinastatin group than in the non-ulinastatin group (hazard ratio for death: 0.77; 95% confidence interval: 0.62-0.96; p = 0.018). Ulinastatin significantly reduced mortality at 28 days (10.0% vs. 13.6%), 60 days (13.9% vs. 18.2%) and 90 days (14.7% vs. 18.5%), length of stay in the ICU (median 8.0 d vs. 13.0 d), and mechanical ventilation duration (median 24.0 h vs. 25.0 h; p < 0.05). CONCLUSIONS: Ulinastatin was beneficial for patients in the ICU, mainly by reducing mortality, length of ICU stay, and mechanical ventilation duration. This study provides evidence of the clinical effectiveness of ulinastatin.

Enhanced Interfacial Modification by Ordered Discotic Liquid Crystals for Thermotolerance Perovskite Solar Cells.

Traditionally used phenylethylamine iodide (PEAI) and its derivatives, such as ortho-fluorine o-F-PEAI, in interfacial modification, are beneficial for perovskite solar cell (PSC) efficiency but vulnerable to heat stability above 85 °C due to ion migration. To address this issue, we propose a composite interface modification layer incorporating the discotic liquid crystal 2,3,6,7,10,11-hexa(pentoxy)triphenylene (HAT5) into o-F-PEAI. The triphenyl core in HAT5 promotes π-π stacking self-assembly and enhances its interaction with o-F-PEAI, forming an oriented columnar phase that improves hole extraction along the one-dimensional direction. HAT5 repairs structural defects in the interfacial layer and retains the layered structure to inhibit ion migration after annealing. Ultimately, our approach increases the efficiency of solar cells from 23.36% to 25.02%. The thermal stability of the devices retains 80.1% of their initial efficiency after aging at 85 °C for 1008 hours without encapsulation. Moreover, the optimized PSCs maintained their initial efficiency of 82.4% after aging under one sunlight exposure for 1008 hours. This study provides a novel strategy using composite materials for interface modification to enhance the thermal and light stability of semiconductor devices.

Tapioca starch/konjac gum-based composite film incorporated with nanoliposomes encapsulated grape seed oil: Structure, functionality, controlled release and its preservation role for chilled mutton.

In this study, grape seed oil nanoliposomes (GSO-NLs) were constructed and doped into tapioca starch/konjac gum composite films (TK-GSO-NLs) to evaluate the preservation of chilled mutton. The results showed that the GSO-NLs have a good spherical or rounded state and good stability. The doping of GSO-NLs resulted in a smooth, flat, and dense structure on the surface and cross-section of the TK films. The TK-GSO-NLs showed the best compatibility among the components, with excellent mechanical and barrier properties. FTIR and XRD confirmed the presence of ionic bonds between the components, further improving the copolymer crystal structure. Notably, the packaging material provided ideal antioxidant and bacteriostatic stability as well as delayed GSO release. This packaging could effectively maintain the quality of chilled mutton and prolong the shelf-life to 15 days. The study provides ideas for the design of green and active food packaging and for extending the shelf life of meat.

Effects of sodium carboxymethyl cellulose-tea polyphenols ice coating on the quality degradation of frozen-thawed beef due to changes in protein structure and fat and protein oxidation.

During freeze-thaw (FT) cycles, protein structural degradation, lipid and protein oxidation can lead to quality deterioration of beef samples. To address this issue, we developed a cost-effective and easy-to-operate carboxymethyl cellulose sodium-tea polyphenol (CMC-TP) ice coating to inhibit quality deterioration caused by these factors. The beef samples were characterized for various quality attributes, lipid and protein oxidation, and protein structure. The results demonstrated that the CMC-TP ice coating significantly inhibited the deterioration in water-holding capacity (WHC) and tenderness of the beef samples (P < 0.05). Analysis of peroxide value (POV), thiobarbituric acid (TBARS), total volatile basic nitrogen (TVB-N), and carbonyl content revealed that the CMC-TP ice coating significantly suppressed lipid and protein oxidation during FT cycles (P < 0.05). Additionally, assessments of total sulfhydryl content, fluorescence intensity, and surface hydrophobicity indicated that the CMC-TP ice coating effectively mitigated protein structural degradation through antioxidant and cryoprotective effects (P < 0.05). Therefore, the CMC-TP ice coating can enhance the FT stability of beef.

Sequence and phylogenetic analysis of FMD virus isolated from two outbreaks in Egypt.

Despite intensive control efforts, Foot and mouth disease (FMD) outbreaks continue to occur regularly in Egypt and resulting in dramatic economic losses to the livestock industry. During 2018 and 2022, FMD was clinically suspected among previously vaccinated cattle in Beheira and Kafr El-Sheikh provinces, Egypt. FMDV RNA was detected in 18 (45%) out of 40 epithelial tissue samples using real-time RT-PCR based on a pan-FMDV primers set. The 2018 outbreak isolates (n = 8) included the FMDV serotypes A and SAT2, whereas all isolates (n = 10) from the 2022 outbreak belonged to the FMDV serotype A. Four selected isolates, designated FMDV/SAT2/EGY/Beheira/2018, FMDV/A/EGY/Kafr El-Sheikh/2018, FMDV/A/EGY/Kafr El-Sheikh/2022 and FMDV/A/EGY/Behiera/2022, were characterized on the basis of partial VP1 gene sequence analysis. The FMDV/SAT2/EGY/Beheira/2018 strain was clustered within the Lib-12 lineage of the topotype VII and shared 79.2-98.4% nucleotide identity with other Egyptian SAT2 strains available in Genbank database. On the other hand, the three FMDV serotype A sequences shared 74.4-99.1% nucleotide identity with each other. Also, they were phylogenetically classified within two distinct topotypes. The FMDV/A/Egy/Kafr El-Sheikh/2018 strain was grouped within the Asian topotype, meanwhile the FMDV/A/EGY/Kafr El-Sheikh/2022 and FMDV/A/EGY/Behiera/2022 strains were grouped together within the genotype IV of the African topotype. Interestingly, the deduced amino acid sequences of the four strains displayed numerous variations in comparison to the vaccine strains currently used in Egypt. In addition, most of these variations were present in prominent antigenic positions in the VP1 protein. These findings raise a crucial need to validate the protective potential of the vaccine strains against the newly emerging FMDV field strains and to update the vaccination strategy accordingly.

The potential presence of infection may be indicated through non-invasive prediction of procalcitonin and C-reactive protein levels within the initial three days after cervical cerclage: a retrospective case-control study.

PURPOSE: To identify which non-invasive infection indicators could better predict post-cervical cerclage (CC) infections, and on which days after CC infection indicators should be closely monitored. METHODS: The retrospective, single-center study included 619 single-pregnancy patients from January 2021 to December 2022. Patients were categorized into infected and uninfected groups based on physicians' judgments of post-CC infections. Registered information included patient characteristics, cervical insufficiency history, gestational age at CC, surgical method (McDonald/Shirodkar), purpose of CC, mid-pregnancy miscarriage/preterm birth, infection history or risk factors, and infection indices on days 1, 3, 5, and 7 after CC. Propensity score matching (PSM) was applied to reduce patient characteristic bias. Statistical analysis of C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), percentage of neutrophil count (NEU_P), interleukin-6 (IL-6), and procalcitonin (PCT) in the infected group compared with the uninfected group was performed using chi-square tests and t-tests. Receiver operating characteristic (ROC) curves were used to further assess the diagnostic value of CRP, PCT, and CRP-PCT in combination. RESULTS: Among the 619 included patients, 206 patients were matched using PSM and subsequently assessed. PCT values on day 1 and day 3 after CC exhibited significant differences between the two groups in two statistical ways (P < 0.01, P < 0.05). The CRP levels on day 1 were significantly higher in the infected group compared to the uninfected group in two statistical ways (P < 0.05). On day 3, the mean CRP value was significantly elevated in the infected group compared to the uninfected group (P < 0.05). Analyses of IL-6, WBC, NEU, and NEU_P did not yield clinically significant results. The area under the ROC curves for CRP, PCT, and CRP-PCT on day 1 and day 3 were all below 0.7. In the preventive CC group, the AUC values of CRP and CRP-PCT obtained on d1 were found to be higher than 0.7, indicating moderate diagnostic accuracy. CONCLUSION: For women after CC surgery, especially of preventive aim, increased serum CRP and PCT levels from post-CC day 1 to day 3 may signal a potential postoperative infection, warranting close monitoring.

Monitoring Cattle Ruminating Behavior Based on an Improved Keypoint Detection Model.

Cattle rumination behavior is strongly correlated with its health. Current methods often rely on manual observation or wearable devices to monitor ruminating behavior. However, the manual monitoring of cattle rumination is labor-intensive, and wearable devices often harm animals. Therefore, this study proposes a non-contact method for monitoring cattle rumination behavior, utilizing an improved YOLOv8-pose keypoint detection algorithm combined with multi-condition threshold peak detection to automatically identify chewing counts. First, we tracked and recorded the cattle's rumination behavior to build a dataset. Next, we used the improved model to capture keypoint information on the cattle. By constructing the rumination motion curve from the keypoint information and applying multi-condition threshold peak detection, we counted the chewing instances. Finally, we designed a comprehensive cattle rumination detection framework to track various rumination indicators, including chewing counts, rumination duration, and chewing frequency. In keypoint detection, our modified YOLOv8-pose achieved a 96% mAP, an improvement of 2.8%, with precision and recall increasing by 4.5% and 4.2%, enabling the more accurate capture of keypoint information. For rumination analysis, we tested ten video clips and compared the results with actual data. The experimental results showed an average chewing count error of 5.6% and a standard error of 2.23%, verifying the feasibility and effectiveness of using keypoint detection technology to analyze cattle rumination behavior. These physiological indicators of rumination behavior allow for the quicker detection of abnormalities in cattle's rumination activities, helping managers make informed decisions. Ultimately, the proposed method not only accurately monitors cattle rumination behavior but also provides technical support for precision management in animal husbandry, promoting the development of modern livestock farming.

A bioinformatic analysis found low expression and clinical significance of ATF4 in breast cancer.

Background: Activating Transcription Factor 4 (ATF4) expression exhibits differential patterns across different types of tumors. Besides, the pathogenesis of breast cancer is complex, and the exact relationship between ATF4 and ATF4 remains uncertain. Methods: The analysis of ATF4 expression was conducted by utilizing The Cancer Genome Atlas (TCGA) pan-cancer data, while the gene expression profile of breast cancer was checked by the comprehensive database-Gene Expression Omnibus database. In order to gain a more comprehensive understanding of the specific cell types that exhibit ATF4 expression within the microenvironment of breast cancer, we conducted a single-cell analysis of ATF4 using two distinct datasets of human breast cancer (GSE114717 and GSE11088, respectively). The spatial distribution of ATF4 within a tissue was demonstrated based on datasets obtained from the Human Protein Atlas (HPA) and SpatialDB. The clinical prognostic significance of ATF4 was assessed by analyzing clinical survival data obtained from TCGA, GSE4830, and GSE25055 datasets. We used the R package clusterProfiler to carry out an enrichment analysis of ATF4. We assessed how ATF4 impacts the growth and movement of breast cancer cell lines. We manipulated ATF4 levels using plasmid transfection techniques. Results: The expression of ATF4 was found to be suboptimal and demonstrated a significant correlation with enhanced disease-specific survival (p = 0.012) and overall survival (p = 0.032) in breast cancer as well as other malignancies. We conducted an analysis to investigate the interaction between the infiltration level of immune cells and the expression of ATF4, using samples obtained from TCGA with known immune cell infiltration scores. Furthermore, a notable positive correlation exists between the elevated expression of ATF4 and immune-related genomes, specifically those associated with chemokine as well as immunity. Subsequent examination revealed a notable augmentation in the cytodifferentiation of T cells into regulatory T (Treg) cells within tissues exhibiting elevated levels of ATF4 expression. ATF4 exhibits notable upregulation in the MDA-MB-231 cell, thereby exerting a substantial impact on cell proliferation and migration upon its knockdown. Conversely, the overexpression of ATF4 in the MCF7 Luminal A breast cancer cell line can also modulate cellular function. Conclusions: Our study suggests that ATF4 helps T cells differentiate into Treg cells in breast cancer. ATF4 can represent a clinically useful biomarker to predict the overall survival rate, especially in patients with different subtypes of breast cancer. Provide certain guidance value for the development of targeted drugs or inhibitors targeting ATF4.

Genetic Parameters of Semen Traits and Their Correlations with Conformation Traits in Chinese Holstein Bulls.

The elite bull plays an extremely important role in the genetic progression of the dairy cow population. The previous results indicated the potential positive relationship of large scrotal circumference (SC) with improved semen volume, concentration, and motility. In order to improve bull's semen quantity and quality by selection, it is necessary to estimate the genetic parameters of semen traits and their correlations with other conformation traits such as SC that could be used for an indirect selection. In this study, the genetic parameters of seven semen traits (n = 66,260) and nine conformation traits (n = 3,642) of Holstein bulls (n = 453) were estimated by using the bivariate repeatability animal model with the average information-restricted maximum likelihood (AI-REML) approach. The results showed that the estimated heritabilities of semen traits ranged from 0.06 (total number of motile sperm, TNMS) to 0.37 (percentage of abnormal sperm, PAS) and conformation traits ranged from 0.23 (pin width, PW) to 0.69 (hip height, HH). The highest genetic correlations were found between semen volume per ejaculation (SVPE), semen concentration per ejaculation (SCPE), total number of sperm (TNS), and TNMS traits that were 0.97, 0.98, 1.00, and 0.99, respectively. Phenotypic correlations between SC and SVPE, SCPE, TNS, and TNMS were 0.35, 0.35, 0.48, and 0.42, respectively. In summary, the moderate or high heritability of semen traits indicates that genetic improvement of semen quality by selection is feasible, where SC could be a useful trait for indirect selection or as correlated information to improve semen quantity and production in the practical bull breeding programs.

Kinetics Controlled Perovskite Crystallization for High Performance Solar Cells.

The power conversion efficiencies (PCEs) of perovskite solar cells have recently developed rapidly compared to crystalline silicon solar cells. To have an effective way to control the crystallization of perovskite thin films is the key for achieving good device performance. However, a paradox in perovskite crystallization is from the mismatch between nucleation and Oswald ripening. Usually, the large numbers of nucleation sites tend to weak Oswald ripening. Here, we proposed a new mechanism to promote the formation of nucleation sites by reducing surface energy from 44.9 mN/m to 36.1 mN/m, to spontaneously accelerate the later Oswald ripening process by improving the grain solubility through the elastic modulus regulation. The ripening rate is increased from 2.37 Åm ⋅ s-1 to 4.61 Åm ⋅ s-1 during annealing. Finally, the solar cells derived from the optimized films showed significantly improved PCE from 23.14 % to 25.32 %. The long-term stability tests show excellent thermal stability (the optimized device without encapsulation maintaining 82 % of its initial PCE after 800 h aging at 85 °C) and an improved light stability under illumination. This work provides a new method, the elastic modulus regulation, to enhance the ripening process.

Carnitine palmitoyl-transferase 1A is potentially involved in bovine herpesvirus 1 productive infection.

Bovine herpesvirus 1(BoHV-1) is an important bovine pathogen that causes great economic loss to cattle farms worldwide. The virus-productive infection in bovine kidney (MDBK) cells results in ATP depletion. The mechanisms are not well understood. Mitochondrial fatty acid ß-oxidation (FAO) is an important energy source in many tissues with high energy demand. Since carnitine palmitoyl-transferase 1 A (CPT1A) is the rate-limiting enzyme of FAO, we investigated the interactions between virus-productive infection and CPT1A signaling. Here, we found that virus-productive infection at the later stage significantly decreased CPT1A protein levels in all the detected cells, including MDBK, A549, and Neuro-2A cells, differentially altered the accumulation of CPT1A proteins in the nucleus and cytosol, and re-localized the protein in the nucleus. Etomoxir (ETO), an irreversible inhibitor of CPT1A, inhibited viral replication and partially interfered with the ability of BoHV-1 to alter CPT1A accumulation in the nucleus but not in the cytosol. Furthermore, ETO consistently reduced RNA levels of two viral regulatory proteins (bICP0 and bICP22) and protein expression of virion-associated proteins during productive infection, further supporting the important roles of CPT1A signaling in BoHV-1 productive infection. These data, for the first time, suggest that CPT1A is potentially involved in BoHV-1 productive infection.

Au Nanocluster Assisted Microstructural Reconstruction for Buried Interface Healing for Enhanced Perovskite Solar Cell Performance.

The heterogeneity of perovskite film crystallization along the vertical direction leads to voids and traps at the buried interfaces, hampering both efficiency and stability of perovskite solar cells. Here, bovine serum albumin-functionalized Au nanoclusters (ABSA), combined with heavy gravity, high surface charge density, and strong interactions with the electron transport layer, are designed to reconstruct the buried interfaces for not only high-quality crystallization, but also improved carrier transfer. The ABSA macromolecules with amine function groups and larger surface charge density interact with the perovskite to improve the crystallinity, and gradually migrate towards the buried interface, healing the defective voids, hence suppressing surface recombination velocity from 3075 to 452 cm s-1 . The healed buried interface and the higher surface potential of ABSA-modified TiO2 lead to improved carrier extraction at the interface. The resulting solar cell attains a power conversion efficiency of 25.0% with negligible hysteresis and remarkable stability, maintaining 92.9% of their initial efficiency after 3200 h of exposure to the ambient atmosphere, they also exhibit better continuous irradiation stability compared to control devices. These findings provide a new metal-protein complex to eliminate the deleterious voids and defects at the buried interface for improved photovoltaic performance and stability.

Identification of genetic associations and functional SNPs of bovine KLF6 gene on milk production traits in Chinese holstein.

BACKGROUND: Our previous research identified the Kruppel like factor 6 (KLF6) gene as a prospective candidate for milk production traits in dairy cattle. The expression of KLF6 in the livers of Holstein cows during the peak of lactation was significantly higher than that during the dry and early lactation periods. Notably, it plays an essential role in activating peroxisome proliferator-activated receptor α (PPARα) signaling pathways. The primary aim of this study was to further substantiate whether the KLF6 gene has significant genetic effects on milk traits in dairy cattle. RESULTS: Through direct sequencing of PCR products with pooled DNA, we totally identified 12 single nucleotide polymorphisms (SNPs) within the KLF6 gene. The set of SNPs encompasses 7 located in 5' flanking region, 2 located in exon 2 and 3 located in 3' untranslated region (UTR). Of these, the g.44601035G > A is a missense mutation that resulting in the replacement of arginine (CGG) with glutamine (CAG), consequently leading to alterations in the secondary structure of the KLF6 protein, as predicted by SOPMA. The remaining 7 regulatory SNPs significantly impacted the transcriptional activity of KLF6 following mutation (P < 0.005), manifesting as changes in transcription factor binding sites. Additionally, 4 SNPs located in both the UTR and exons were predicted to influence the secondary structure of KLF6 mRNA using the RNAfold web server. Furthermore, we performed the genotype-phenotype association analysis using SAS 9.2 which found all the 12 SNPs were significantly correlated to milk yield, fat yield, fat percentage, protein yield and protein percentage within both the first and second lactations (P < 0.0001 ~ 0.0441). Also, with Haploview 4.2 software, we found the 12 SNPs linked closely and formed a haplotype block, which was strongly associated with five milk traits (P < 0.0001 ~ 0.0203). CONCLUSIONS: In summary, our study represented the KLF6 gene has significant impacts on milk yield and composition traits in dairy cattle. Among the identified SNPs, 7 were implicated in modulating milk traits by impacting transcriptional activity, 4 by altering mRNA secondary structure, and 1 by affecting the protein secondary structure of KLF6. These findings provided valuable molecular insights for genomic selection program of dairy cattle.

Differences in Milk Proteomic Profiles between Estrous and Non-Estrous Dairy Cows.

Efficient reproductive management of dairy cows depends primarily upon accurate estrus identification. However, the currently available estrus detection methods, such as visual observation, are poor. Hence, there is an urgent need to discover novel biomarkers in non-invasive bodily fluids such as milk to reliably detect estrus status. Proteomics is an emerging and promising tool to identify biomarkers. In this study, the proteomics approach was performed on milk sampled from estrus and non-estrus dairy cows to identify potential biomarkers of estrus. Dairy cows were synchronized and timed for artificial insemination, and the cows with insemination leading to conception were considered to be in estrus at the day of insemination (day 0). Milk samples of day 0 (estrus group) and day -3 (non-estrus group) from dairy cows confirming to be pregnant were collected for proteomic analysis using the tandem mass tags (TMT) proteomics approach. A total of 89 differentially expressed proteins were identified, of which 33 were upregulated and 56 were downregulated in the estrus milk compared with the non-estrus milk. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that acetyl coenzyme A carboxylase α (ACACA), apolipoprotein B (APOB), NAD(P)H steroid dehydrogenase-like (NSDHL), perilipin 2 (PLIN2), and paraoxonase 1 (PON1) participated in lipid binding, lipid storage, lipid localization, and lipid metabolic process, as well as fatty acid binding, fatty acid biosynthesis, and fatty acid metabolism, and these processes are well documented to be related to estrus regulation. These milk proteins are proposed as possible biomarkers of estrus in dairy cows. Further validation studies are required in a large population to determine their potential as estrus biomarkers.

Prospective prescription review system correlated with more rational PPI medication use, better clinical outcomes and reduced PPI costs: experience from a retrospective cohort study.

INTRODUCTION: Proton pump inhibitor (PPI) abuse poses an overwhelming threat to the allocation of medical resources and places a heavy burden on global medical expenses. In this study, we put forward our prospective prescription review system and evaluated the effects of this system on clinical outcomes, rational medication use and costs related to PPIs. METHODS: A retrospective cohort study was conducted in which the included patients were divided into a preintervention group (2019.10-2020.09) and a postintervention group (2020.10-2021.09). To reduce the bias of patients' baseline characteristics, the propensity score matching (PSM) method was employed. The primary endpoints were the incidence of stress ulcers (SUs), the improvement and cure rates of gastrointestinal haemorrhage, the defined daily dose (DDD), the drug utilization index (DUI) and the DDD/100 patient-days. The secondary endpoints included the types of unreasonable medication orders for PPIs, the PPI utilization rate and PPI costs. RESULTS: A total of 53,870 patients were included to evaluate the secondary endpoints, and 46,922 patients were paired by PSM and assessed to evaluate the primary endpoints. The number of PPIs used and PPI costs were significantly lower in the postintervention group than in the preintervention group (P < 0.001). The rationality evaluation results showed that the frequency of PPI use and the number of drug interactions were significantly higher in the preintervention group than in the postintervention group (P < 0.01). The proportion of patients taking oral PPIs was significantly increased in the postintervention group (29.30% vs. 34.56%, p < 0.01). For the utilization of PPIs both for prevention and treatment, the DUI and DDD/100 patient-days were substantially decreased in the postintervention group (P < 0.001 and P < 0.05, respectively). The incidence of SUs in the postintervention group was 44.95%, and that in the preintervention group was 51.93% (p < 0.05). CONCLUSION: The implementation of the prospective prescription review system on rational PPI use correlated with reduced PPI costs, more rational PPI medication use and better clinical outcomes, and this system is worthy of long-term implementation for further improvement of rational drug use.

Efficacy and safety of selenium or vitamin E administration alone or in combination in ICU patients: A systematic review and meta-analysis.

BACKGROUND: Micronutrient administration that contributes to antioxidant defense has been extensively studied in critically ill patients, but consensus remains elusive. Selenium and vitamin E are two important micronutrients that have synergistic antioxidant effects. This meta-analysis aimed to assess the effect of selenium or vitamin E administration alone and the combination of both on clinical outcomes in patients hospitalized in the ICU. METHODS: After electronic searches on PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), SinoMed, VIP database and Wanfang data, initially 1767 papers were found, and 30 interventional studies were included in this analysis. We assessed the risk-difference between treatment and control (standard treatment) groups by pooling available data on length of stay (ICU length of stay and hospital length of stay), mortality (ICU mortality, hospital mortality, 28-day mortality, 6-month mortality and all-cause mortality), duration of mechanical ventilation, adverse events and new infections. RESULTS: By analyzing the included studies, we found no significant effect of selenium administration alone on mortality, mechanical ventilation duration, or adverse events in ICU patients. However, after excluding studies with high heterogeneity, the meta-analysis showed that selenium alone reduced the length of hospital stay (MD: -1.38; 95% CI: -2.52, -0.23; I-square: 0%). Vitamin E administration alone had no significant effect on mortality, duration of mechanical ventilation, or adverse events in ICU patients. However, after excluding studies with high heterogeneity, the meta-analysis showed that vitamin E alone could reduce the length of ICU stay (MD: -1.27; 95% CI: -1.86, -0.67; I-square: 16%). Combined administration of selenium and vitamin E had no significant effect on primary outcomes in ICU patients. CONCLUSIONS: Selenium administration alone may shorten the length of hospital stay, while vitamin E alone may reduce the length of ICU stay. The putative synergistic beneficial effect of combined administration of selenium and vitamin E in ICU patients has not been observed, but more clinical studies are pending to confirm it further.

Understanding Microstructural Development of Perovskite Crystallization for High Performance Solar Cells.

Solution crystallization in film devices has attracted broad interest from various fields such as perovskite solar cells. However, the detailed perovskite crystallization kinetics remain unclear due to the difficulty of in situ observation of grain cluster growth during annealing. This article presents the development of an in situ laser scanning confocal polarized microscopy with a temperature-controlled stage to observe nucleation and growth of perovskite crystal clusters. It is found that enhanced interactions by a liquid crystal with perovskite form a new intermediate complex that induces diffusion-controlled growth according to Avrami equation. The retarded cluster growth (63 nm s-1 ) originates from enlarged diffusion activation energy 40 kJ mol-1 compared with 152 nm s-1 and 37 kJ mol-1 for the Control film during annealing. Finally, the optimized perovskite films with enhanced crystallographic and optical characteristics are applied in solar cells to achieve a champion efficiency of 24.53% with open circuit voltage of 1.172 V and fill factor of 82.78%. The bare device without any protection maintains 89% of its initial efficiency after 6600 h of aging in ambient environment. This work implies that the in situ observation using fluorescence microscopy is a critical for understanding of crystallization kinetics in film devices.

Bilateral malignant glaucoma with bullous keratopathy: A case report.

BACKGROUND: Malignant glaucoma, caused by aqueous misdirection, is a challenging post-surgical complication presented with normal/high intraocular pressure and shallowing of the central and peripheral anterior chambers. Its incidence is about 0.6%-4.0%. It can be secondary to filtering surgeries, laser iridotomy, and cataract surgery. Short axial length and a history of angle closure glaucoma are its main risk factors. Here, we report a bilateral malignant glaucoma with bullous keratopathy in the patient's left eye. CASE SUMMARY: We present a case of bilateral malignant glaucoma. The cause of malignant glaucoma for each eye of this patient was different. Hence, the management strategy and selection of surgical methods were also different. However, the normal anterior chamber was ultimately maintained, and maximum visual function was preserved. Even though the left eye received multiple surgeries and corneal endothelial decompensation occurred, the formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium. CONCLUSION: The formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium.

Infection and the evaluation of biomarkers in obstetrics and gynecology patients with infectious disease: a retrospective observational study from clinical pharmacists' consultation experience.

BACKGROUND: The use of empirical anti-infective medication calls for the identification of common pathogens and accurate infectious biomarkers. However, clinical pharmacists' anti-infective experience in the field of obstetrics and gynaecology is rare in the literature. This study aimed to retrospectively analyze the correlation between the anti-infective effectiveness after 7 days of antibiotic treatment and infectious biomarkers, according to clinical pharmacists' consultation cases of gynecological and obstetric infections. METHODS: In this retrospective study, clinical pharmacists' anti-infective consultation experiences applied by physicians from January 1, 2018, to December 31, 2020, were included. The exclusion criteria were as follows: (1) the patient died or left the hospital before undergoing an effectiveness evaluation after the consultation; (2) treatment was discontinued due to adverse reactions related to antibiotics; (3) the patient did not undergo an effectiveness evaluation within 3 or 7 days after application of the clinical pharmacist's treatment plan; and (4) the physician did not adopt the clinical pharmacist's suggestions. The registered information included patient characteristics, pathological bacteria, anti-infective medication and changes in infection indices before and after treatment. Statistical analysis of temperature, white blood cells (WBCs), C-reactive protein (CRP), procalcitonin (PCT) and WBCs in urine after 3 days and 7 days of anti-infective treatment, compared with before anti-infective treatment, was performed by the chi-square test. A t test was conducted to further study WBC count and CRP. A receiver operating characteristic curve verified the sensitivity and specificity of WBC count, CRP and PCT. RESULTS: A total of 265 cases were included. The CRP levels of patients 3 d and 7 d after antibiotic treatment were significantly lower than before antibiotic treatment (P < 0.05, P < 0.01), while the WBC count showed a downward trend after 3 days and a significant decrease after 7 days (P < 0.01). The areas under the curve (AUCs) for prognosis on the 7th day for WBC count, CRP and PCT were 0.90, 0.75 and 0.522, respectively. The AUC for WBC count combined with CRP was 0.90, which was higher than that for the biomarkers tested separately, especially compared to PCT. The most common gynecological infections were surgical site infection (SSI), urinary tract infection and fever of unknown origin, and the most common pathogens were E. coli and E. faecalis in Gram-negative and Gram-positive samples, respectively. Pharmacists' recommended treatment plans included carbapenems and ß-lactam antibiotics. CONCLUSIONS: Our dual-center study indicates that the combination of WBC count and CRP can improve diagnostic accuracy and treatment efficiency, and PCT alone is insensitive to gynecological infections, according to clinical pharmacists' experience.