Zeta Potential and Size Analysis of Zeolitic Imidazolate Framework-8 Nanocrystals Prepared by Surfactant-Assisted Synthesis.

The crystal nucleation and growth mechanism of monodispersed metal-organic framework nanoparticles were studied using time-resolved light dynamic, electrokinetic, and powder X-ray diffraction methods. We confirmed that zeolitic imidazolate framework-8 (ZIF-8) nanocrystals follow a nonclassical crystal growth pathway, where a fast nucleation occurs with dense liquid clusters or nanocrystals forming spontaneously when two precursors are mixed. We also explored the zeta potential and solvodynamic size changes of ZIF-8 prepared by a surfactant-assisted synthesis. Three modulators, including 1-methylimidazole (1-mIm), tris(hydroxymethyl)aminomethane (THAM), and (1-hexadecyl)trimethylammonium bromide (CTAB), were studied. We found that 1-mIm dramatically increases the rate of nucleation of ZIF-8. With an increasing amount of 1-mIm, which functions as a coordination modulator, the size increases, and the zeta potential of ZIF-8 decreases. Whereas THAM, as both a coordination and a deprotonation modulator, increases the size and zeta potential of ZIF-8 simultaneously, CTAB, as a long alkyl cationic surfactant, mainly adsorbs on the surface of ZIF-8, and the zeta potential of the formed ZIF-8 is controlled by the amount of CTAB in solution compared with its critical micelle concentration. Overall, we reveal that the modulator type and concentration can be used to control the size and zeta potential of the dispersed ZIF-8 nanocrystals in a colloid system. The experiments also enable identification of the nucleation and crystal growth processes of ZIF-8. The findings will be applicable to other nanocrystals in colloid systems, which are used for heterogeneous catalysis and guest molecular loadings.

Nirmatrelvir-ritonavir compared with other antiviral drugs for the treatment of COVID-19 patients: A systematic review and meta-analysis.

At present, there are some differences in the research results of nirmatrelvir-ritonavir compared with other antiviral drugs for the treatment of COVID-19 patients. We aimed to evaluate the efficacy and safety of nirmatrelvir-ritonavir compared with other antiviral drugs and the impact of different antiviral drugs on the short- and long-term effects of COVID-19. PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, Google Scholar, and MedRxiv were searched to identify relevant studies from inception to March 30, 2023. We conducted a meta-analysis to estimate the effects of nirmatrelvir-ritonavir compared with other antiviral drugs for the treatment of COVID-19 patients and safety outcomes. The RoB1 and ROBINS-I were used to assess the bias risk of the included studies. Revman 5.4 software was used for meta-analysis (PROSPERO Code No: CRD42023397816). Twelve studies were included, including 30 588 COVID-19 patients, of whom 13 402 received nirmatrelvir-ritonavir. The meta-analysis results showed that the nirmatrelvir-ritonavir group had a lower proportion of patients than the control group in terms of long-term mortality (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.13-0.66), hospitalization (OR = 0.44, 95% CI: 0.37-0.53, short term; OR = 0.52, 95% CI: 0.36-0.77, long term), and disease progression (OR = 0.56, 95% CI: 0.38-0.83, short term; OR = 0.60, 95% CI: 0.48-0.74, long term), and nirmatrelvir ritonavir showed little difference in safety compared to the control group. Nirmatrelvir-ritonavir can reduce the mortality and hospitalization of COVID-19 patients compared with other antiviral drugs. Further large-scale studies remain to validate these findings.

Electrodeposition of Ag/ZIF-8-Modified Membrane for Water Remediation.

Metal-organic framework (MOF)-based membranes have been widely used in gas and liquid separation due to their porous structures and tunable compositions. Depending on the guest components, heterostructured MOFs can exhibit multiple functions. In the present work, we report a facile and rapid preparation of zeolitic imidazolate framework-8 (ZIF-8) and silver nanoparticle incorporated ZIF-8 (Ag/ZIF-8)-based membranes on stainless-steel mesh (SSM) through a "green" electrodeposition method. The SSM was first coated with a Zn-plated layer which contains mainly zinc hydroxide nitrate (Zn5(OH)8(NO3)2·2H2O) with a "leaf-like" morphology, providing anchoring points for the deposition of ZIF-8 and Ag/ZIF-8. It takes only 10 min to prepare a uniform coating of Zn5(OH)8(NO3)2·2H2O in aqueous conditions without the use of a strong base; this is by far the most efficient way of making zinc hydroxide nitrate nanocrystals. Following a similar electrodeposition approach, ZIF-8 and Ag/ZIF-8-coated SSM can be prepared within 20 min by applying a small current. The encapsulation of Ag does not alter the chemical composition nor the crystal structure of ZIF-8. The resulting ZIF-8 and Ag/ZIF-8-coated SSM have been tested for their effectiveness for rhodamine B dye removal in a fast vacuum filtration setting. Additionally, growth of E. coli was significantly inhibited after overnight incubation with Ag/ZIF-8-coated SSM. Overall, we demonstrate a fast synthesis procedure to make ZIF-8 and Ag/ZIF-8-coated SSM membranes for organic dye removal with excellent antimicrobial activity.

Polypharmacy, potentially inappropriate medications, and drug-drug interactions in older COVID-19 inpatients.

OBJECTIVES: The purpose of this study was to assess the impact of polypharmacy, potentially inappropriate medications, and drug-drug interactions on in-hospital mortality in older COVID-19 inpatients. METHODS: A cross-sectional study was conducted using electronic medical data from a tertiary hospital in Chengdu from December 2022 to January 2023. The 2019 AGS/Beers criteria was used to evaluate the potentially inappropriate mediation (PIM) status of older COVID-19 inpatients (age ≥ 65 years), the drug-drug interactions were evaluated on Medscape, and multivariate logistic regression was used to identify the risk factors associated with in-hospital mortality. RESULTS: A total of 206 older COVID-19 inpatients were included in the study. The mean number of drugs per day was 13.04. The prevalence of PIM use based on the 2019 AGS Beers Criteria was 66.99%. The prevalence of drug-drug interactions was 61.65%. Logistic regression demonstrated that age ≥ 80 (OR: 10.321, 95% CI: 1.649, 64.579, P = 0.013), renal insufficiency (OR: 4.740, 95% CI: 1.366, 16.447, P = 0.014), long-term hospitalization (OR: 6.637, 95% CI: 1.030, 42.779, P = 0.046), severe pneumonia (OR: 50.230, 95% CI: 5.180, 487.041, P = 0.001) were influencing factors associated with in-hospital mortality in older COVID-19 inpatients. CONCLUSIONS: The polypharmacy, potentially inappropriate medications, and drug-drug interactions were seen in many older COVID-19 inpatients.

Safety and efficacy of COVID-19 vaccines in children and adolescents: A systematic review of randomized controlled trials.

To systematically review and synthesize the safety and efficacy of coronavirus disease-2019 (COVID-19) vaccines in children and adolescents. PubMed, EMBASE, Web of Science, Cochrane Library databases, the International Clinical Trials Registry Platform (ICTRP), the Chinese Clinical Trials Registry (ChiCTR), and ClinicalTrials.gov website were searched to collect accessible randomized controlled trials (RCTs) about the safety and efficacy of human COVID-19 vaccines in children and adolescents until May 1, 2022. Three steps, including duplicate removal, title and abstract screening, and full-text review, were used to screen the studies. The Cochrane risk-of-bias tool for RCTs was used to assess the bias risk of the included studies. Microsoft Excel 16.57 (2021) software was used for data extraction and analysis. (PROSPERO Code No: CRD42021295422). COVID-19 vaccines were evaluated in a total of 10 950 children and adolescents in seven published studies and over 49 530 participants in 26 ongoing randomized controlled trials. Descriptive findings of the included published studies were reported stratified by vaccine type. The overall, local, and systemic adverse events following immunization (AEFIs) reported in most trials were similar between the vaccine and placebo groups. Most of the reactions reported were mild to moderate, whereas a few were severe. The common adverse events were injection-site pain, fever, headache, cough, fatigue, and muscle pain. Few clinical trials reported serious adverse events, but most of them were unrelated to vaccination. In terms of efficacy, the investigated messenger RNA (mRNA) vaccine was found to be 90.7%-100% efficacious in preventing COVID-19 among children and adolescents, revealing good efficacy profiles in this age group. Among children and adolescents, the safety of current COVID-19 vaccines is acceptable, and studies have suggested that mRNA vaccines can provide high protection against COVID-19 infection in pediatric age groups.

pH-Responsive Metal-Organic Framework Thin Film for Drug Delivery.

In this work, surface-supportive MIL-88B(Fe) was explored as a pH-stimuli thin film to release ibuprofen as a model drug. We used surface plasmon resonance microscopy to study the pH-responsive behaviors of MIL-88B(Fe) film in real time. A dissociation constant of (6.10 ± 0.86) × 10-3 s-1 was measured for the MIL-88B(Fe) film in an acidic condition (pH 6.3), which is about 10 times higher than the dissociation of the same film in a neutral pH condition. MIL-88B(Fe) films are also capable of loading around 6.0 µg/cm2 of ibuprofen, which was measured using a quartz crystal microbalance (QCM). Drug release profiles were compared in both acidic and neutral pH conditions (pH 6.3 and 7.4) using a QCM cell to model the drug release in healthy body systems and those containing inflammatory tissues or cancerous tumors. It was found that the amount of drug released in acidic environments had been significantly higher compared to that in a neutral system within 55 h of testing time. The pH-sensitive chemical bond breaking between Fe3+ and the carboxylate ligands is the leading cause of drug release in acidic conditions. This work exhibits the potential of using MOF thin films as pH-triggered drug delivery systems.

Interventions for reducing inflammation in familial Mediterranean fever.

BACKGROUND: Familial Mediterranean fever (FMF), a hereditary auto-inflammatory disease, mainly affects ethnic groups living in the Mediterranean region. Early studies reported colchicine may potentially prevent FMF attacks. For people who are colchicine-resistant or intolerant, drugs such as anakinra, rilonacept, canakinumab, etanercept, infliximab or adalimumab might be beneficial. This is an update of the review last published in 2018. OBJECTIVES: To evaluate the efficacy and safety of interventions for reducing inflammation in people with FMF. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and four Chinese databases on in August 2021. We searched clinical trials registries and references listed in relevant reports. The last search was 17 August 2021. SELECTION CRITERIA: We included randomized controlled trials (RCTs) of people with FMF, comparing active interventions (including colchicine, anakinra, rilonacept, canakinumab, etanercept, infliximab, adalimumab, thalidomide, tocilizumab, interferon-α and ImmunoGuard (herbal dietary supplement)) with placebo or no treatment, or comparing active drugs to each other. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodology. We assessed certainty of the evidence using GRADE. MAIN RESULTS: We included 10 RCTs with 312 participants (aged three to 53 years), including five parallel and five cross-over designed studies. Six studies used oral colchicine, one used oral ImmunoGuard, and the remaining three used rilonacept, anakinra or canakinumab as a subcutaneous injection. The duration of each study arm ranged from one to eight months. There were inadequacies in the design of the four older colchicine studies and the two studies comparing a single to a divided dose of colchicine. However, the four studies of ImmunoGuard, rilonacept, anakinra and canakinumab were generally well-designed.  We aimed to report on the number of participants experiencing an attack, the timing of attacks, the prevention of amyloid A amyloidosis, adverse drug reactions and the response of a number of biochemical markers from the acute phase of an attack; but no study reported on the prevention of amyloid A amyloidosis. Colchicine (oral) versus placebo After three months, colchicine 0.6 mg three times daily may reduce the number of people experiencing attacks (risk ratio (RR) 0.21, 95% confidence interval (CI) 0.05 to 0.95; 1 study, 10 participants; low-certainty evidence). One study (20 participants) of colchicine 0.5 mg twice daily showed there may be no difference in the number of participants experiencing attacks at two months (RR 0.78, 95% CI 0.49 to 1.23; low-certainty evidence). There may be no differences in the duration of attacks (narrative summary; very low-certainty evidence), or in the number of days between attacks: (narrative summary; very low-certainty evidence). Regarding adverse drug reactions, one study reported loose stools and frequent bowel movements and a second reported diarrhea (narrative summary; both very low-certainty evidence). There were no data on acute-phase response. Rilonacept versus placebo There is probably no difference in the number of people experiencing attacks at three months (RR 0.87, 95% CI 0.59 to 1.26; moderate-certainty evidence).  There may be no differences in the duration of attacks (narrative summary; low-certainty evidence) or in the number of days between attacks (narrative summary; low-certainty evidence). Regarding adverse drug reactions, the rilonacept study reported there may be no differences in gastrointestinal symptoms, hypertension, headache, respiratory tract infections, injection site reactions and herpes, compared to placebo (narrative summary; low-certainty evidence). The study narratively reported there may be no differences in acute-phase response indicators after three months (low-certainty evidence). ImmunoGuard versus placebo The ImmunoGuard study observed there are probably no differences in adverse effects (moderate-certainty evidence) or in acute-phase response indicators after one month of treatment (moderate-certainty evidence). No data were reported for the number of people experiencing an attack, duration of attacks or days between attacks. Anakinra versus placebo A study of anakinra given to 25 colchicine-resistant participants found there is probably no difference in the number of participants experiencing an attack at four months (RR 0.76, 95% CI 0.54 to 1.07; moderate-certainty evidence).  There were no data for duration of attacks or days between attacks. There are probably no differences between anakinra and placebo with regards to injection site reaction, headache, presyncope, dyspnea and itching (narrative summary; moderate-certainty evidence). For acute-phase response, anakinra probably reduced C-reactive protein (CRP) after four months (narrative summary; moderate-certainty evidence). Canakinumab versus placebo Canakinumab probably reduces the number of participants experiencing an attack at 16 weeks (RR 0.41, 95% CI 0.26 to 0.65; 1 study, 63 colchicine-resistant participants; moderate-certainty evidence). There were no data for the duration of attacks or days between attacks. The included study reported the number of serious adverse events per 100 patient-years was probably 42.7 with canakinumab versus 97.4 with placebo among people with colchicine-resistant FMF (moderate-certainty evidence). For acute-phase response, canakinumab probably caused a higher proportion of participants to have a CRP level of 10 mg/L or less compared to placebo (68% with canakinumab versus 6% with placebo; 1 study, 63 participants; moderate-certainty evidence). Colchicine single dose versus divided dose There is probably no difference in the duration of attacks at three months (MD -0.04 hours, 95% CI -10.91 to 10.83) or six months (MD 2.80 hours, 95% CI -5.39 to 10.99; moderate-certainty evidence). There were no data for the number of participants experiencing an attack or days between attacks. There is probably no difference in adverse events (including anorexia, nausea, diarrhea, abdominal pain, vomiting and elevated liver enzymes) between groups (narrative summary; moderate-certainty evidence). For acute-phase response, there may be no evidence of a difference between groups (narrative summary; low- to moderate-certainty evidence). AUTHORS' CONCLUSIONS: There were limited RCTs assessing interventions for people with FMF. Based on the evidence, three times daily colchicine may reduce the number of people experiencing attacks, colchicine single dose and divided dose may not be different for children with FMF, canakinumab probably reduces the number of people experiencing attacks, and anakinra or canakinumab probably reduce CRP in colchicine-resistant participants; however, only a few RCTs contributed data for analysis. Further RCTs examining active interventions, not only colchicine, are necessary before a comprehensive conclusion regarding the efficacy and safety of interventions for reducing inflammation in FMF can be drawn.

Iron-containing metal-organic framework thin film as a drug delivery system.

Selective bulk metal-organic frameworks (MOFs) have exhibited great potential in biomedical applications. However, topical treatments and drug elution coatings will require uniform films as drug delivery systems. This work studies the use of surface supportive MOF thin films for drug loading and releasing. More specifically, we focus on an iron-containing MOF, MIL-88B(Fe), on a COOH-terminated self-assembled monolayer (SAM) modified Au surface for encapsulating ibuprofen as a model drug. A combined experimental and computational approach was employed to study the fabrication of MIL-88B(Fe) film on functionalized Au surfaces. We used several surface characterization techniques, including infrared spectroscopy and scanning electron microscopy, to confirm the chemical composition and morphological changes of the surface after each modification step. The resulting MIL-88B(Fe) thin film was found capable of loading 8.7 wt% of ibuprofen using quartz crystal microbalance analysis. Moreover, we applied cluster simulations to study the binding mechanisms of MIL-88B(Fe) and its interactions with ibuprofen based on the density functional theory (DFT). The unsaturated Fe site was confirmed kinetically more favorable to bind to the COOH-end group on the SAM. Hydrogen bonding and π-CH interactions between ibuprofen and MIL-88B(Fe) promote ibuprofen being retained inside of the cages of MIL-88B(Fe).

Qianliexin capsule exerts anti-inflammatory activity in chronic non-bacterial prostatitis and benign prostatic hyperplasia via NF-κB and inflammasome.

Qianliexin capsule (QLX) is a standardized traditional Chinese herbal preparation that has long been used to treat chronic non-bacterial prostatitis (CNP) and benign prostatic hyperplasia (BPH). This study investigated the anti-inflammatory activity of QLX in improving lower urinary tract symptoms (LUTS) associated with CNP and BPH. Rat models of CNP and BPH were induced by oestradiol or testosterone (hormonal imbalance) or chemical inflammation (carrageenan). QLX significantly relieved LUTS in CNP and BPH rat model by reducing prostate enlargement, epithelial thickness, pain response time, urine volume and bleeding time, and by improving prostatic blood flow. The expression of the pro-inflammatory cytokines interleukin (IL)-1ß and tumour necrosis factor (TNF)-α, the pro-inflammatory transcription factor nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and inflammasome components (NLRP3, caspase-1 and ASC) in CNP and BPH tissues was reduced by QLX addition. QLX treatment was followed by reduced cellular malondialdehyde and increased superoxide dismutase, catalase and glutathione peroxidase activity, consistent with antioxidant activity. Increases in Beclin-1 expression and the LC3II/I ratio following QLX treatment indicated that autophagy had been induced. QLX relieved LUTS in CNP and BPH rat models by inhibiting inflammation. The underlying mechanisms included inhibition of inflammasome activation, NF-κB activation, oxidant stress and autophagy.

Potentially inappropriate medications in Chinese older outpatients in tertiary hospitals according to Beers criteria: A cross-sectional study.

OBJECTIVES: Multimorbidity and polypharmacy in older adults always increase the prevalence of potentially inappropriate medications (PIMs) and affect the quality of life of older adults. Currently, the data of PIMs on Chinese geriatric outpatients based on Beers criteria 2015 and 2019 have not been studied. The purposes of this study were aimed to investigate the prevalence of PIMs prescription and the most frequent PIMs amongst outpatients according to the two criteria and to explore related risk factors for PIMs. METHODS: The cross-sectional retrospective study was conducted amongst geriatric outpatients in Chengdu in tertiary hospitals from January 2018 to December 2018. The Beers criteria 2015 and 2019 were used to assess PIMs in geriatric outpatients. Univariate analysis and multivariate logistic regression analysis were adopted to determine the factors that may affect the prevalence of PIMs. RESULTS: A total of 12 005 patient prescriptions were enrolled. The prevalence of PIMs in the Beers criteria 2015 and 2019 was 30.98% and 34.39%, respectively. Benzodiazepines, diuretics and selective serotonin reuptake inhibitors (SSRIs) were the most frequent PIMs used according to both criteria. Logistic regression analysis showed that patients with female, advanced age, polypharmacy and sleep disorder were the most important factors associated with PIMs use. CONCLUSION: The results showed a high prevalence of PIMs amongst geriatric outpatients in China. The Beers criteria 2019 had a higher detection rate of PIMs, and it was more sensitive to assess the Chinese geriatric population.

Semiconducting Langmuir-Blodgett Films of Porphyrin Paddle-Wheel Frameworks for Photoelectric Conversion.

Understanding the photocurrent transportation within porphyrin-containing metal-organic frameworks (PMOFs) will be a critical step in applying these materials in light-harvesting molecular devices in the future. Two copper porphyrin paddle-wheel frameworks (Cu-PPFs) were employed to study the influence of metal ions coordinated into the porphyrin ligands on conductivity and photoelectron transfer capability. To compare the electronic and optical properties of both materials, we prepared an ultrathin film of each PPF via a Langmuir-Blodgett method. The resulting films exhibited uniform morphology and single-crystalline domains, in addition to photoelectric conversion capabilities. We confirmed that both Cu-PPFs have semiconducting properties with an optical band gap of around 2.7 eV. The current density generated by both Cu-PPFs was studied through a mercury drop junction approach. We observed a slightly higher conductivity from the Cu-PPF film consisting of metalloporphyrins than the one without copper doping in the porphyrin centers. In addition, the copper-ion-coordinated porphyrins were found to be more favorable for facilitating photoinduced electron transfer from the Cu-PPF film to a conductive glass substrate. This work presents a new approach of combining thin film fabrication and electro-heterojunction measurement to study electron transfer within an ultrathin film.

Low-Temperature Adsorption and Diffusion of Methanol in ZIF-8 Nanoparticle Films.

The adsorption of methanol by a zeolitic imidazolate framework-8 (ZIF-8) nanoparticle thin film was studied in situ using temperature-programmed desorption and X-ray photoelectron spectroscopy under low-temperature, low-pressure conditions. Partial pore penetration was observed at 90 K, but upon increasing the exposure temperature of the film to 130 K pore penetration was significantly enhanced. Although many studies exist involving bulk powders, this is the first work to our knowledge that demonstrates the ability to control and monitor the entry of a molecule into a metal organic framework (MOF) film in situ using temperature. In this case, nanoparticle films of ZIF-8 were prepared and studied in ultrahigh vacuum. The ability to control and monitor surface adsorption versus pore adsorption in situ is key to future fundamental study of MOFs, for example, in the identification of active sites in reaction mechanisms.

Fabrication of redox-responsive magnetic protein microcapsules from hen egg white by the sonochemical method.

Redox-responsive magnetic protein microcapsules with Fe3O4 magnetic nanoparticles (MNPs) encapsulated inside have been obtained using a facile, cost-effective and fast sonochemical method from hen egg white proteins. Such prepared redox-responsive magnetic hen egg white protein microcapsules (MHEWPMCs) could be easily manipulated to do magnetic-guided targeting delivery. The synchronous loading of the hydrophobic dye Coumarin 6 as a model of drug into MHEWPMCs was readily achieved during the fabrication of MHEWPMCs by dissolving them into the oil phase before ultrasonication. TEM images indicated that Fe3O4 MNPs were encapsulated in MHEWPMCs. Confocal laser scanning microscopic images indicated that the dye was distributed evenly in the MHEWPMCs and no leakage of dye from the MHEWPMCs was observed due to the protection of protein shells. The MHEWPMCs are potential candidates as attractive carriers for drug targeting delivery and stimuli-responsive release due to their magnetic and redox responsiveness of the disulfide in the microcapsule shells.

[Assessment of the predictive value of the model for end-stage liver disease scoring system combined with the indocyanine green clearance test for short-term prognosis of acute-on-chronic hepatitis B liver failure].

OBJECTIVE: To investigate the short-term prognostic value of the indocyanine green clearance test when used in combination with the model for end-stage liver disease (MELD) scoring system to assess patients with hepatitis B virus acute-on-chronic liver failure (HBV-ACLF). METHODS: Clinical data of 105 patients diagnosed with HBV-ACLF were retrospectively analyzed. The indocyanine green retention rate at 15 minutes (ICGR15), clinical data within 24 h after diagnosis, Child-Turcotte-Pugh (CTP) classification, MELD score, MELD combined with sodium concentration (MELD-Na) score, and King's Hospital (KCH) criteria data were collected for analysis. Measurement data were assessed by t-test and count data by the chi-square test. Short-term predictive accuracy for patients with HBV-ACLF was compared between different models using the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS: The mortality rate for all patients was 45.71%. Comparison of the survivors versus the non-survivors showed that age, total bilirubin, albumin, cholinesterase, creatinine, international normalized ratio, and incidence positive rate of relative complications (hepatorenal syndrome, hepatic encephalopathy) were significantly different between the two groups (all, P less than 0.05). The ICGR15 was found to be positively correlated with MELD score (r = 0.205, P less than 0.05). The MELD-ICGR15 model constructed by logistic regression analysis was: Logit(P) = 0.193 * MELD + 0.130 * ICGR15 - 11.256. The AUC was 0.880 and the cut-off was -0.706, with 89.6% sensitivity and 75.4% specificity. The AUC of the MELD-ICGR15 model was significantly higher than that of the ICGR15 (0.820), MELD score (0.779), MELD-Na score (0.761), KCH criteria (0.680), and CTP classification (0.631) (all, P less than 0.05). CONCLUSION: ICGR15, MELD score, and MELD-Na score had higher predictive values for HBV-ACLF than did CTP classification or KCH criteria. Furthermore, the MELD-ICGR15 model was better than any single parameter model for predicting the short-term prognosis of patients with HBV-ACLF.

Cost-effectiveness analysis of bevacizumab combined with lomustine in the treatment of progressive glioblastoma using a Markov model simulation analysis.

Background: Progressive glioblastoma (GBM) is a malignancy with extremely poor prognosis. Chemotherapy is one of the approved systemic treatment modalities. The aim of this study is to assess the cost-effectiveness of using bevacizumab (BEV) in combination with lomustine (LOM) regimen for the treatment of progressive glioblastoma in China. Methods: The estimation results are derived from a multicenter randomized phase III trial, which demonstrated improved survival in GBM patients receiving BEV+LOM combination therapy. To calculate the incremental cost-effectiveness ratio (ICER) from the perspective of Chinese society, a Markov model was established. Univariate deterministic analysis and probabilistic sensitivity analysis were employed to address the uncertainties within the model. Results: Compared to LOM monotherapy, the total treatment cost for BEV+LOM combination therapy increased from $2,646.70 to $23,650.98. The health-adjusted life years (QALYs) for BEV+LOM combination therapy increased from 0.26 QALYs to 0.51 QALYs, representing an increment of 0.25 QALYs. The incremental cost-effectiveness ratio (ICER) was $84,071.12. The cost-effectiveness curve indicates that within the willingness-to-pay (WTP) range of $35,906 per QALY, BEV+LOM combination therapy is not a cost-effective treatment option for unresectable malignant pleural mesothelioma patients. Conclusions: Taken as a whole, the findings of this study suggest that, from the perspective of payers in China, BEV+LOM combination therapy as a first-line treatment for GBM is not a cost-effective option. However, considering the survival advantages this regimen may offer for this rare disease, it may still be one of the clinical treatment options for this patient population.

The neurocognitive mechanism linking temperature and humidity with miners' alertness: an fNIRS study.

As the depth of coal mining increases, the temperature and humidity of the underground environment also rise, which can negatively impact the physiological health of miners, and may even pose a threat to their safety and lives. However, studies on the neurocognitive mechanisms underlying the relationship between temperature, humidity, and miners' alertness are scant. This study investigates several research objectives: (A) the differences in reaction time and error rate in different temperature and humidity conditions, which factor has a greater impact; (B) the differences in the levels of Oxy-Hb in different conditions and which factor has a greater impact; (C) the differences of activation degree between different regions of interest; and (D) the differences in the shape of Oxy-Hb time course between different conditions between different regions of interests. The fNIRS was used to measure the activity in 100 participants' prefrontal cortex in this study. The results showed that both temperature and humidity would lead to decreased alertness of miners, which would not only prolong the reaction time, increase the error rate, and increase the Oxy-Hb concentration, but also lead to increased activation of the prefrontal cortex and greater activation of the right side than that of the left side, the Oxy-Hb time course was different on both sides, and temperature has a greater effect on alertness than humidity.

Silicon surface functionalization targeting Si-N linkages.

Silicon substrates have been a fascinating topic of fundamental and applied research for well over 50 years. They have attracted even more attention over the last couple of decades with advances in chemical functionalization that made oxide-free silicon surfaces a reality. Fundamentally new electronic properties and chemical reactivity became available, and the focus of chemical research turned more toward targeting specific chemical bonds and functionalities on silicon. Although thermodynamics clearly drives most processes under ambient conditions toward the formation of an oxide layer, kinetic control of the oxidation processes and thermodynamic tricks based on gaining stability of surface monolayers with high-density assembly have allowed for the formation of stable Si-C bonds and Si-O-C linkages on oxide-free silicon crystals. This feature article targets recent advances in making Si-N linkages on the same oxide-free single crystals. It covers the range of chemical approaches to achieving this goal and offers possible chemistry that can take advantage of the systems produced. The present status of the field and the future directions of its development will be considered.

Evaluation of oral small molecule drugs for the treatment of COVID-19 patients: a systematic review and network meta-analysis.

INTRODUCTION: At present, there are some randomized controlled trials (RCTs) of oral small molecule drugs. The purpose of this study was to evaluate the efficacy and safety of oral small molecule drug treatment for COVID-19. METHODS: RCTs were identified through systematic searches of PubMed, Embase, and Cochrane Central Register of Controlled Trials through 1 April 2023. A total of nine RCTs were included, including 30,970 COVID-19 patients comparing five treatments (azvudine, molnupiravir, paxlovid, VV116, and placebo). The Cochrane risk of bias tool for randomized trials (RoB) was used to assess the bias risk of the included studies. The direct and indirect evidence were combined using a Bayesian network meta-analysis (PROSPERO Code No: CRD42023397837). RESULTS: Direct analysis showed that paxlovid was associated with a reduced risk of mortality (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.06-0.25) and hospitalization (OR = 0.04, 95% CI: 0.00-0.67) compared with placebo. Network meta-analysis showed that paxlovid had the highest probability of being the best management strategy in patients with COVID-19, reducing mortality (OR = 0.11, 95% CI: 0.01-1.99; surface under the cumulative ranking curve [SUCRA]: 0.77) and hospitalization (OR = 0.06, 95% CI: 0.00-1.03; SUCRA: 0.95). For prespecified safety outcomes, SUCRA values ranked VV116 (OR = 0.09, 95% CI: 0.00-2.07: SUCRA 0.86) as the most beneficial intervention for the prevention of serious adverse events. CONCLUSIONS: When compared to other antiviral medications, paxlovid can reduce the mortality and hospitalization of COVID-19 patients.

Efficacy and safety of azvudine in patients with COVID-19: A systematic review and meta-analysis.

Introduction: Azivudine has undergone a few randomized controlled trials (RCTs) as of late. This study aimed to assess the COVID-19 treatment with azvudine's efficacy and safety. Methods: Through January 20, 2023, systematic searches of PubMed, Embase, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), Cochrane Central Register of Controlled Trials (CENTRAL), and MedRxiv were conducted to find the RCTs. The included studies' bias risk was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed using Revman 5.4 (PROSPERO Code: CRD42023395022). Results: A total of five RCTs with 1142 COVID-19 patients, 575 of whom received azvudine, were included. Additionally, seven RCTs are currently being conducted. In terms of clinical improvement and PT-PCR (reverse transcription polymerase chain reaction) negativity, the azvudine group had a greater patient percentage than the usual treatment or placebo group. It also took less time for the PT-PCR to become negative. In comparison to the placebo or standard treatment groups, the frequency of adverse events was reduced in the azvudine group (risk ratio [RR] = 0.89, 95% confidence interval [CI]: 0.80 to 0.99) and major adverse events (RR = 0.63, 95% CI: 0.22 to 1.79) groups. Conclusions: Without the burden of side effects, azvudine can hasten the clinical symptoms of COVID-19 patients and PT-PCR negative. It will take more extensive research to confirm these conclusions.

Development and validation of a nomogram to predict the risk of potentially inappropriate medication use in older lung cancer outpatients with multimorbidity.

BACKGROUND: At present, there is no predictive model that can predict the prevalence of potentially inappropriate medication (PIM) use in older lung cancer outpatients. RESEARCH DESIGN AND METHODS: We measured PIM by the 2019 Beers criteria. Significant factors were identified to develop the nomogram using logistic regression. We validated the nomogram internally and externally in two cohorts. The discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, and decision curve analysis (DCA), respectively. RESULTS: A total of 3300 older lung cancer outpatients were divided into a training cohort (n = 1718) and two validation cohorts, including an internal validation cohort (n = 739) and an external validation cohort (n = 843). A nomogram for predicting PIM use patients was developed using six significant factors. ROC curve analysis showed that the area under the curve was 0.835 in the training cohort and 0.810 and 0.826 in the internal validation and external validation cohorts, respectively. The Hosmer‒Lemeshow test yielded P = 0.180, 0.779 and 0.069, respectively. The nomogram demonstrated a high net benefit in DCA. CONCLUSIONS: The nomogram could be a convenient, intuitive, and personalized clinical tool for assessing the risk of PIM in older lung cancer outpatients.