Tuning Main Group Element-based Metal-Organic Framework to Boost Electrocatalytic Nitrogen Reduction Under Ambient Conditions.

Main group element-based materials are emerging catalysts for ammonia (NH3 ) production via a sustainable electrochemical nitrogen reduction reaction (N2 RR) pathway under ambient conditions. However, their N2 RR performances are less explored due to the limited active behavior and unclear mechanism. Here, an aluminum-based defective metal-organic framework (MOF), aluminum-fumarate (Al-Fum), is investigated. As a proof of concept, the pristine Al-Fum MOF is synthesized by the solvothermal reaction process, and the defect engineering method namely solvent-assisted linker exchange, is applied to create the defective Al sites. The defective Al sites play an important role in ensuring the N2 RR activity for defective Al-Fum. It is found that only the defective Al-Fum enables stable and effective electrochemical N2 RR, in terms of the highest production rate of 53.9 µg(NH3 ) h-1 mgcat -1 (in 0.4 m K2 SO4 ) and the Faradaic efficiency of 73.8% (in 0.1 m K2 SO4 ) at -0.15 V vs reversible hydrogen electrode) under ambient conditions. Density functional theory calculations confirm that the N2 activation can be achieved on the defective Al sites. Such sites also allow the subsequent protonation process via the alternating associative mechanism. This defect characteristic gives the main group Al-based MOFs the ability to serve as promising electrocatalysts for N2 RR and other attractive applications.

Integration of Metal-Organic Frameworks and Metals: Synergy for Electrocatalysis.

Electrocatalysis is a highly promising technology widely used in clean energy conversion. There is a continuing need to develop advanced electrocatalysts to catalyze the critical electrochemical reactions. Integrating metal active species, including various metal nanostructures (NSs) and atomically dispersed metal sites (ADMSs), into metal-organic frameworks (MOFs) leads to the formation of promising heterogeneous electrocatalysts that take advantage of both components. Among them, MOFs can provide support and protection for the active sites on guest metals, and the resulting host-guest interactions can synergistically enhance the electrocatalytic performance. In this review, three key concerns on MOF-metal heterogeneous electrocatalysts regarding the catalytic sites, conductivity, and catalytic stability are first presented. Then, rational integration strategies of MOFs and metals, including the integration of metal NSs via surface anchoring, space confining, and MOF coating, as well as the integration of ADMSs either with the metal nodes/linkers or within the pores of MOFs, along with their recent progress on synergistic cooperation for specific electrochemical reactions are summarized. Finally, current challenges and possible solutions in applying these increasingly concerned electrocatalysts are also provided.

Synchronized locomotion can improve spatial accessibility inside ant colonies.

Synchronization is a conspicuous form of collective behaviour that is of crucial importance in numerous biological systems. Ant colonies from the genera Leptothorax and Temnothorax form small colonies, typically made up of only a few hundred workers, and exhibit a form of synchronized behaviour where workers inside colonies' nests become active together in rhythmic cycles that have a period of approximately 20-200 min. However, it is not currently known if these synchronized rhythms of locomotion confer any functional benefit to colonies. By using a combination of multiple image analysis techniques, we show that inactive Leptothorax ants can act as immobile obstacles to moving ants, and that synchronized activity has the potential to reduce the likelihood that individual ants will encounter regions of immobile obstacles that impede access to portions of the nest. We demonstrate qualitatively similar findings using a computational model of confined active particles with oscillating activity.

Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021.

BACKGROUND: The epidemiology and treatment of acute promyelocytic leukaemia (APL) are changing. We have incorporated oral arsenic trioxide (oral-ATO) into induction/maintenance. METHODS: Newly-diagnosed APL from 1991 to 2021 divided into three 10-year periods were studied to define its epidemiology and how oral-ATO impacted on its outcome. Primary endpoints included APL incidence, early deaths (ED, first 30 days), and overall survival (OS). Secondary endpoints included post-30-day OS, relapse-free survival (RFS), and incidence of second cancers. RESULTS: APL occurred in 374 males and 387 females at a median age of 44 (1-97) years. Annual incidences increased progressively, averaging 0.32 per 100,000 people. All-trans retinoic acid (ATRA)-based and oral-ATO-based regimens were used in 469 and 282 patients. There were 144 EDs, occurring almost exclusively in ATRA-based inductions (N = 139), being more with males, age > 50 years, leucocyte > 10 × 109/L, diagnosis during 1991-2009 and fewer with oral-ATO-based regimens. After a median of 75 (interquartile range: 14-161) months, 5-year and 10-year OS were 68.1% and 63.3%, inferior with males, age > 50 years, leucocyte > 10 × 109/L, high-risk Sanz score and superior with oral-ATO-based regimens. Factoring out EDs, 5-year and 10-year post-30-day OS were 84.0% and 78.1%, inferior with males and superior with oral-ATO-based regimens. In 607 CR1 patients, the 5-year RFS was 83.8%, superior with diagnosis in 2010-2021 and oral-ATO-based regimens. Second cancers developed in 21 patients, unrelated to oral-ATO-based regimens. CONCLUSIONS: There was an increasing incidence of APL, and all survivals were superior with the use of oral-ATO-based regimens. This study formed part of the Acute Promyelocytic Leukaemia Asian Consortium Project (ClinicalTrials.gov identifier: NCT04251754).

Promoting the Water-Reduction Kinetics and Alkali Tolerance of MoNi4 Nanocrystals via a Mo2 TiC2 Tx Induced Built-In Electric Field.

Mo-Ni alloy-based electrocatalysts are regarded as promising candidates for the hydrogen evolution reaction (HER), despite their vulnerable stability in alkaline solution that hampers further application. Herein, Mo2 TiC2 Tx MXene, is employed as a support for MoNi4 alloy nanocrystals (NCs) to fabricate a unique nanoflower-like MoNi4 -MXn electrocatalyst. A remarkably strong built-in electric field is established at the interface of two components, which facilitates the electron transfer from Mo2 TiC2 Tx to MoNi4 . Due to the accumulation of electrons at the MoNi4 sites, the adsorption of the catalytic intermediates and ionic species on MoNi4 is affected consequently. As a result, the MoNi4 -MX10 nanohybrid exhibits the lowest overpotential, even lower than 10% Pt/C catalyst at the current density of 10 mA cm-2 in 1 m KOH solution (122.19 vs 129.07 mV, respectively). Furthermore, a lower Tafel slope of 55.88 mV dec-1 is reported as compared to that of the 10% Pt/C (65.64 mV dec-1 ). Additionally, the MoNi4 -MX10 catalyst also displays extraordinary chemical stability in alkaline solution, with an activity loss of only 0.15% per hour over 300 h of operation. This reflects the great potential of using MXene-based interfacial engineering for the synthesis of a highly efficient and stable electrocatalyst.

Cardiovascular benefits of SGLT2 inhibitors in type 2 diabetes, interaction with metformin and role of erythrocytosis: a self-controlled case series study.

BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have proven cardiovascular benefits in patients with type 2 diabetes (T2D). This self-controlled case series study aims to evaluate whether metformin use and SGLT2i-associated erythrocytosis influence its cardiovascular benefits. METHODS: T2D patients with metformin and/or SGLT2i prescriptions between 2015 and 2020 were identified from the Hong Kong population. Study outcomes were composite cardiovascular diseases (CVD), coronary heart disease (CHD), hospitalisation for heart failure (HHF), stroke, and erythrocytosis. Risk periods were patient-time divided into four mutually exclusive windows: (i) 'baseline period' of metformin use without SGLT2i; (ii) pre-SGLT2i period; (iii) exposure to SGLT2i without metformin; and (iv) exposure to the drug combination. Another SCCS model was applied to evaluate the association between erythrocytosis and cardiovascular outcomes regarding SGLT2i exposure. Four mutually exclusive risk periods included (i) SGLT2i exposure with erythrocytosis; (ii) SGLT2i exposure without erythrocytosis; (iii) absence of SGLT2i exposure with erythrocytosis; and (iv) absence of SGLT2i exposure without erythrocytosis. Incidence rate ratios (IRR) of events at different risk periods were estimated using conditional Poisson regression model. RESULTS: Among 20,861 patients with metformin and/or SGLT2i prescriptions, 2575 and 1700 patients with events of composite CVD and erythrocytosis were identified, respectively. Compared to metformin use without SGLT2i, SGLT2i initiation was associated with lower risks of composite CVD, CHD, and HHF-regardless of the presence (CVD: IRR = 0.43, 95% CI 0.37-0.51; CHD: IRR = 0.44, 95% CI 0.37-0.53; HHF: IRR = 0.29, 95% CI 0.22-0.40; all p < 0.001) and absence of concomitant metformin (CVD: IRR = 0.31, 95% CI 0.20-0.48; CHD: IRR = 0.38, 95% CI 0.25-0.59; HHF: IRR = 0.17, 95% CI 0.09-0.31; all p < 0.001); while SGLT2i was neutral on stroke risk. Compared to metformin-SGLT2i combination, exposure to SGLT2i alone was associated with comparable risks of all cardiovascular outcomes (all p > 0.05). Incidence rates of erythrocytosis at baseline, SGLT2i without and with metformin use periods were 0.75, 3.06 and 3.27 per 100 person-years, respectively. SGLT2i users who developed erythrocytosis had lower risk of HHF (IRR = 0.38, 95% CI 0.14-0.99, p = 0.049) than those who did not. CONCLUSIONS: Our real-world data suggested that SGLT2i-associated cardiovascular benefits were not attenuated by metformin use. Further studies will delineate the role of erythrocytosis as a surrogate marker of SGLT2i-associated cardiovascular benefit in reducing HHF.

Multiple droplets on a conical fiber: formation, motion, and droplet mergers.

Small droplets on slender conical fibers spontaneously move along the fiber due to capillary action. The droplet motion depends on the geometry of the cone, the surface wettability, the surface tension, the viscosity, and the droplet size. Here we study with experiments and numerical simulations, the formation, spontaneous motion, and the eventual merger, of multiple droplets on slender conical fibers as they interact with each other. The droplet size and their spacing on the fibre is controlled by the Plateau-Rayleigh instability after dip-coating the conical fiber. Once these droplets are formed on the fiber, they spontaneously start to move. Since droplets of different size move with different speeds, they effectively coarsen the droplet patterning by merging on the fiber. The droplet merging process affects locally the droplet speed and alters the spatiotemporal film deposition on the fiber.

Communication in youth mental health clinical encounters: Introducing the agential stance.

When young people seek support from mental health care practitioners, the encounters may affect the young people's sense of self, and in particular undermine their sense of agency. For this study, an interdisciplinary team of academics and young people collaboratively analysed video-recorded encounters between young people and mental healthcare practitioners in emergency services. They identified five communication techniques that practitioners can use to avoid undermining the young person's sense of agency in the clinical encounter. They conceptualise the use of those techniques as the adoption of an agential stance towards the young person. The agential stance consists of: (a) validating the young person's experiences, (b) legitimising the young person's choice to seek help, (c) refraining from objectifying the young person, (d) affirming the young person's capacity to contribute to positive change, and (e) involving the young person in the decision-making process.

Droplet migration on conical fibers.

The spontaneous migration of droplets on conical fibers is studied experimentally by depositing silicone oil droplets onto conical glass fibers. Their motion is recorded using optical microscopy and analyzed to extract the relevant geometrical parameters of the system. The speed of the droplet can be predicted as a function of geometry and the fluid properties using a simple theoretical model, which balances viscous dissipation against the surface tension driving force. The experimental data are found to be in good agreement with the model.

Effects of the COVID-19 pandemic on medical students: a multicenter quantitative study.

BACKGROUND: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy. METHODS: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. RESULTS: Seven hundred forty-one (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved. Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). CONCLUSIONS: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.

The DigniCap Scalp Cooling System and its use in the treatment of chemotherapy-induced alopecia.

Chemotherapy-induced alopecia remains an emotionally traumatic side effect for cancer patients that impacts the quality of life, may be protracted in duration and may influence treatment decisions. Scalp cooling has been shown to be effective in preventing chemotherapy-induced alopecia. The DigniCap Scalp Cooling System is designed to prevent hair loss by cooling the scalp to reduce the impact of chemotherapy on hair follicle cells. Recent studies have shown the safety, efficacy and low-grade toxicity of the DigniCap System with a 66.3% success rate in hair preservation (n = 106) relative to 0% in a nonrandomized control group according to a prospective pivotal study. Data also support improved quality of life in several domains. Two scalp cooling devices including the DigniCap are now US FDA cleared and can be offered as a part of standard of care.

The Consequences of Overlapping G-Quadruplexes and i-Motifs in the Platelet-Derived Growth Factor Receptor ß Core Promoter Nuclease Hypersensitive Element Can Explain the Unexpected Effects of Mutations and Provide Opportunities for Selective Targeting of Both Structures by Small Molecules To Downregulate Gene Expression.

The platelet-derived growth factor receptor ß (PDGFR-ß) signaling pathway is a validated and important target for the treatment of certain malignant and nonmalignant pathologies. We previously identified a G-quadruplex-forming nuclease hypersensitive element (NHE) in the human PDGFR-ß promoter that putatively forms four overlapping G-quadruplexes. Therefore, we further investigated the structures and biological roles of the G-quadruplexes and i-motifs in the PDGFR-ß NHE with the ultimate goal of demonstrating an alternate and effective strategy for molecularly targeting the PDGFR-ß pathway. Significantly, we show that the primary G-quadruplex receptor for repression of PDGFR-ß is the 3'-end G-quadruplex, which has a GGA sequence at the 3'-end. Mutation studies using luciferase reporter plasmids highlight a novel set of G-quadruplex point mutations, some of which seem to provide conflicting results on effects on gene expression, prompting further investigation into the effect of these mutations on the i-motif-forming strand. Herein we characterize the formation of an equilibrium between at least two different i-motifs from the cytosine-rich (C-rich) sequence of the PDGFR-ß NHE. The apparently conflicting mutation results can be rationalized if we take into account the single base point mutation made in a critical cytosine run in the PDGFR-ß NHE that dramatically affects the equilibrium of i-motifs formed from this sequence. We identified a group of ellipticines that targets the G-quadruplexes in the PDGFR-ß promoter, and from this series of compounds, we selected the ellipticine analog GSA1129, which selectively targets the 3'-end G-quadruplex, to shift the dynamic equilibrium in the full-length sequence to favor this structure. We also identified a benzothiophene-2-carboxamide (NSC309874) as a PDGFR-ß i-motif-interactive compound. In vitro, GSA1129 and NSC309874 downregulate PDGFR-ß promoter activity and transcript in the neuroblastoma cell line SK-N-SH at subcytotoxic cell concentrations. GSA1129 also inhibits PDGFR-ß-driven cell proliferation and migration. With an established preclinical murine model of acute lung injury, we demonstrate that GSA1129 attenuates endotoxin-mediated acute lung inflammation. Our studies underscore the importance of considering the effects of point mutations on structure formation from the G- and C-rich sequences and provide further evidence for the involvement of both strands and associated structures in the control of gene expression.

The diffusion of a new method of suicide: charcoal-burning suicide in Hong Kong and Taiwan.

PURPOSE: In the late 1990s, an epidemic rise in suicides by carbon monoxide poisoning from burning barbecue charcoal began in Hong Kong and Taiwan. This study investigates the diffusion of this new method of suicide. METHOD: Official mortality data for 1998-2010 in Taiwan and 1998-2009 in Hong Kong were collected; overall and method-specific suicide rates in different socio-demographic subgroups over the study period were compared. Multiple logistic regression analyses were conducted to assess the socio-demographic risk factors for charcoal-burning vs. non-charcoal-burning suicide. RESULTS: In Hong Kong, the incidence of charcoal-burning suicide increased steeply within 1 year of the first reported cases, but its use has declined from 24.2% of all suicides during the peak period (2002-2004) to 17.1% (2007-2009); in Taiwan, the pace of diffusion was slower in onset, but it remains a popular method accounting for 31.0% of all suicides in 2008-2010. The early adopters in both places tended to be young- and middle-aged men. As the epidemic progressed, the method has also been gradually adopted by older age groups and women, particularly in Taiwan, but in 2009/10, the method still accounted for <8% of suicides in those aged >60 years in both areas. CONCLUSIONS: Common features of the epidemic in both places were the greater levels of early uptake by the young- and middle-aged males. The different course of the charcoal-burning suicide epidemic may reflect social, geographic and media reporting differences. Surveillance to identify the emergence of new suicide methods is crucial in suicide prevention.

Suicides by jumping from a height in Hong Kong: a review of coroner court files.

PURPOSE: Jumping from a height is the most common method for suicide in Hong Kong and other urban cities, but it remains understudied locally and internationally. We used Coroner records in exploring the ecological factors associated with these deaths and the personal characteristics of persons who jumped to their death (hereafter, "jumping suicides"). We compared suicides by jumping with all other suicides and examined the suicides that occurred at ten different jumping sites. METHODS: The Coroner's files of all suicides in Hong Kong from 2002 to 2007 included 6,125 documented deaths. RESULTS: 2,964 (48.4%) involved jumping during the study period. Eighty-three percent (83%) of suicide jumps occurred in residential buildings, and of these, 61% occurred from the decedent's own home. Jumping suicides differed from non-jumping suicides in terms of their socio-demographic characteristics (e.g., for male: 60.8 vs. 67.3% of jumping suicide and non-jumping suicides, p < 0.0001) and the presence of physical illness (44.4 vs. 42.7% for jumping and non-jumping suicides, p < 0.0001). While statistically significant, these differences are relatively modest. In contrast, 40.7 documented illnesses vs. 23.1% for jumping and non-jumping suicides (p < 0.0001). CONCLUSIONS: Means restriction is a key strategy for suicide prevention. Installation of physical barriers, one of the mean restriction strategies, at common places for suicide has strong evidence to avert suicides without substitution effects. There seems to be challenges to implement physical barriers to prevent residential jumping suicides. Simply applying physical barriers to preclude jumping in Hong Kong appears to be difficult given its ubiquitous "high-rise" residential dwellings. Hence, we also need to develop alternative strategies aimed at preventing people from becoming suicidal.

Drivers and Pathways for the Recovery of Critical Metals from Waste-Printed Circuit Boards.

The ever-increasing importance of critical metals (CMs) in modern society underscores their resource security and circularity. Waste-printed circuit boards (WPCBs) are particularly attractive reservoirs of CMs due to their gamut CM embedding and ubiquitous presence. However, the recovery of most CMs is out of reach from current metal-centric recycling industries, resulting in a flood loss of refined CMs. Here, 41 types of such spent CMs are identified. To deliver a higher level of CM sustainability, this work provides an insightful overview of paradigm-shifting pathways for CM recovery from WPCBs that have been developed in recent years. As a crucial starting entropy-decreasing step, various strategies of metal enrichment are compared, and the deployment of artificial intelligence (AI) and hyperspectral sensing is highlighted. Then, tailored metal recycling schemes are presented for the platinum group, rare earth, and refractory metals, with emphasis on greener metallurgical methods contributing to transforming CMs into marketable products. In addition, due to the vital nexus of CMs between the environment and energy sectors, the upcycling of CMs into electro-/photo-chemical catalysts for green fuel synthesis is proposed to extend the recycling chain. Finally, the challenges and outlook on this all-round upgrading of WPCB recycling are outlined.

Alloying Pd with Ru enables electroreduction of nitrate to ammonia with ∼100% faradaic efficiency over a wide potential window.

Electrocatalytic nitrate (NO3-) reduction reaction (eNO3-RR) to ammonia under ambient conditions is deemed a sustainable route for wastewater treatment and a promising alternative to the Haber-Bosch process. However, there is still a lack of efficient electrocatalysts to achieve high NH3 production performance at wastewater-relevant low NO3- concentrations. Herein, we report a Pd74Ru26 bimetallic nanocrystal (NC) electrocatalyst capable of exhibiting an average NH3 FE of ∼100% over a wide potential window from 0.1 to -0.3 V (vs. reversible hydrogen electrode, RHE) at a low NO3- concentration of 32.3 mM. The average NH3 yield rate at -0.3 V can reach 16.20 mg h-1 cm-2. Meanwhile, Pd74Ru26 also demonstrates excellent electrocatalytic stability for over 110 h. Experimental investigations and density functional theory (DFT) calculations suggest that the electronic structure modulation between Pd and Ru favors the optimization of NO3- transport with respect to single components. Along the *NO3 reduction pathway, the synergy between Pd and Ru can also lower the energy barrier of the rate-determining steps (RDSs) on Ru and Pd, which are the protonation of *NO2 and *NO, respectively. Finally, this unique alloying design achieves a high-level dynamic equilibrium of adsorption and coupling between *H and various nitrogen intermediates during eNO3-RR.

Guiding principles for the responsible development of artificial intelligence tools for healthcare.

Several principles have been proposed to improve use of artificial intelligence (AI) in healthcare, but the need for AI to improve longstanding healthcare challenges has not been sufficiently emphasized. We propose that AI should be designed to alleviate health disparities, report clinically meaningful outcomes, reduce overdiagnosis and overtreatment, have high healthcare value, consider biographical drivers of health, be easily tailored to the local population, promote a learning healthcare system, and facilitate shared decision-making. These principles are illustrated by examples from breast cancer research and we provide questions that can be used by AI developers when applying each principle to their work.

Phenobarbital treatment of alcohol withdrawal in the emergency department: A systematic review and meta-analysis.

OBJECTIVE: Despite frequent treatment of alcohol withdrawal syndrome (AWS) in the emergency department (ED), evidence for phenobarbital (PB) as an ED alternative therapy is mixed. We conducted a systematic review and meta-analysis comparing safety and efficacy of PB to benzodiazepines (BZDs) for treatment of AWS in the ED. METHODS: We searched articles and references published in English in PubMed, Web of Science, and Embase from inception through May 2022. We included randomized trials and cohort studies comparing treatment with PB to BZD controls and excluded studies focused on non-AWS conditions. Review was conducted by two blinded investigators and a third author; eight of 59 (13.6%) abstracts met inclusion criteria for review and meta-analysis using a random-effects model. Treatment superiority was evaluated through utilization, pharmacologic, and clinical outcomes. Primary outcomes for meta-analysis were the proportion of patients (1) admitted to the intensive care unit (ICU), (2) admitted to the hospital, (3) readmitted to the ED after discharge, and (4) who experienced adverse events. RESULTS: Eight studies (two randomized controlled trials, six retrospective cohorts) comprised data from 1507 patients in 2012 treatment encounters for AWS. All studies were included in meta-analysis for adverse events, seven for hospital admission, five for ICU admission, and three for readmission to the ED after discharge. Overall methodological quality was low-moderate, risk of bias moderate-high, and statistical heterogeneity moderate. Pooled relative risk of ICU admission for those treated with PB versus BZD was 0.92 (95% confidence interval [CI] 0.54-1.55). Risk for admission to the hospital was 0.98 (95% CI 0.89-1.07) and for any adverse event was 1.1 (95% CI 0.78-1.57); heterogeneity prevented meta-analysis for ED readmission. CONCLUSIONS: The current literature base does not show that treatment with PB significantly reduces ICU admissions, hospital admissions, ED readmissions, or adverse events in ED patients with AWS compared with BZDs alone.

Recent Advances in Metal-Organic Framework-Based Nanomaterials for Electrocatalytic Nitrogen Reduction.

The production of ammonia under moderate conditions is of environmental and sustainable importance. The electrochemical nitrogen reduction reaction (E-NRR) method has been intensively investigated in the recent decades. Nowadays, the further development of E-NRR is largely hindered by the lack of competent electrocatalysts. Metal-organic frameworks (MOFs) are considered as the next-generation catalysts for E-NRR, featuring their tailorable structures, abundant active sites and favorable porosity. To present a comprehensive review on both the fundamental and advanced development in MOFs catalyst-based E-NRR field, this paper first introduces the basic principles of E-NRR, including the reaction mechanism, major apparatus components, performance criteria, and ammonia detection protocols. Next, the synthesis and characterization methods for MOFs and their derivatives are discussed. In addition, a reaction mechanism study via density functional theory calculations is also presented. After that, the recent advancement of MOF-based catalysts in the E-NRR field as well as the modification approaches on MOFs for E-NRR optimization is elaborated. Finally, the current challenges and outlook of MOF catalyst-based E-NRR field are emphasized.

Implying implausibility and undermining versus accepting peoples' experiences of suicidal ideation and self-harm in Emergency Department psychosocial assessments.

Background: Patients seeking emergency care for self-harm and suicidality report varying experiences from being believed and taken seriously to not being believed and taken seriously. Epistemic injustice provides a conceptual framework to explore how peoples' experiences of self-harm and suicidality are believed or not. We use an empirical method -conversation analysis - to analyze epistemics in clinical communication, focusing on how knowledge is claimed, contested and negotiated. In courtroom, police and political interaction, conversation analysis has identified communication practices implying implausibility in a person's story to contest and recharacterize their accounts. Aims: To investigate communication practices in Emergency Department (ED) biopsychosocial assessments that may (1) undermine, imply implausibility and recharacterize or (2) accept peoples' experiences of suicidal ideation and self-harm. Methods: Using conversation analysis, we micro-analyzed verbal and non-verbal communication in five video-recorded biopsychosocial assessments with people presenting to the ED with self-harm or suicidal ideation, and conducted supplementary analysis of participants' medical records and post-visit interviews. We present three cases where experiences were not accepted and undermined/recharacterized and two cases where experiences were accepted and validated. Results: When peoples' experiences of suicidality and self-harm were not accepted or were undermined, questioners: did not acknowledge or accept the person's account; asked questions that implied inconsistency or implausibility ("Didn't you tell your GP that you were coping okay?"); juxtaposed contrasting information to undermine the person's account ("You said you were coping okay before, and now you're saying you feel suicidal"); asked questions asserting that, e.g., asking for help implied they were not intending to end their life ("So when you called 111 what were you expecting them to do"); and resistinged or directly questioned the person's account. Multiple practices across the assessment built on each other to assert that the person was not suicidal, did not look or act like they were suicidal; that the person's decision to attend the ED was not justified; that an overdose was impulsive and not intended to end life; asking why the person didn't take a more harmful medication to overdose; that self-harming behaviors were not that serious and should be in the person's control. Alternative characterizations were used to justify decisions not to provide further support or referrals to specialist services. At times, these practices were also delivered when speaking over the patient. When peoples' experiences were accepted, practitioners acknowledged, accepted, validated suicidality/self-harm and introduced a shared understanding of experiences that patients found helpful. Non-verbal feedback such as nodding and eye contact was central in acceptance of patients' accounts. Conclusion: These findings advance our understanding of how peoples' experiences of suicidality or self-harm are undermined or accepted in mental health encounters in the ED. They have important clinical implications: patients report that when their experiences are not accepted or undermined, this makes them more distressed, less hopeful about the future and discourages future help-seeking when in crisis. Conversely, acknowledging, accepting and validating suicidality/self-harm and introducing a new ways of understanding peoples' experiences may make people less suicidal and more hopeful, generates shared understanding and encourages future help-seeking.