I Single-Atom Doped P-Rich CoPn Nanocluster@CoP with Enhanced HER.

Constructing I single-atom (ISA) doped CoP electrocatalyst for HER is extremely challenging and has not been reported to date. Herein, an ISA doping-phosphatization strategy is proposed to prepare a novel I single-atom doped P-rich CoPn nanocluster@CoP electrocatalyst (ISA-CoPn/CoP) with enhanced HER performance first. ISA-CoPn/CoP shows a low overpotential of only 44 and 81 mV in 0.5 m H2SO4 solution, to drive a current density of 10 and 100 mA cm-2. ISA and P-rich CoPn nanocluster show unique synergies, which can optimize the H adsorption energy and accelerate the kinetics of HER in the CoP system. The intermediate I─H bond vibration peak is directly observed through in situ Raman testing, demonstrating that ISA doping helps accelerate the HER process. Additionally, the ΔGH of ISA-CoPn/CoP is only 0.05 eV by density functional theory (DFT) calculation, which is conducive to H2 evolution.

Effects of Qishen Dihuang Granules on Intestinal Microbiota in Experimental Autoimmune Myasthenia Gravis Model Rats.

Objective: Effects of Qishen Dihuang (QSDH) granules on intestinal flora of an experimental autoimmune myasthenia gravis (EAMG) model rat were investigated (CNBI:PRJNA910532). Methods: Thirty-six female Lewis rats were assigned to Control, EAMG, QSDH-low-dose, QSDH-medium-dose, QSDH-high-dose, and Prednisone groups using the random number table method (6 rats/group). A rat EAMG model was established by injecting Rα97-116 peptide antigen. Each day for 30 days, gavages were administered to rats in the Chinese medicine group (QSDH granules in different concentrations), Prednisone group (prednisone), and Control and Model groups (0.5% CMC). After 30-day gavages, rat fecal samples were collected and the microbial community composition and diversity differences between intestinal microbiota of EAMG and QSDH granule-treated groups were analyzed using 16S amplicon sequencing to explore the effect underlying QSDH granules alleviation of EAMG. Results: The clinical symptoms of rats in each treatment group improved significantly after the intervention treatment with QSDH granules. Comparison of the relative abundance of microorganisms in the gut flora of different groups with that of the EAMG group rats revealed: significantly lower phylum-level Bacteroidetes abundance and significantly greater Actinobacteria abundance in the QSDH-high-dose group and a significantly greater Firmicutes/Bacteroidetes ratio in the QSDH-medium-dose group; significantly increased family-level QSDH-high-dose group abundances of Lachnospiraceae and Trichospiraceae (Firmicutes), significantly increased QSDH-medium-dose group Lactobacillaceae abundance, and significantly increased QSDH-low-dose group Bacteroidaceae abundance; genus-level, QSDH-high-dose group Prevotella and Coprococcus abundances were significantly increased and Turicibacter and Lactobacillus abundances were significantly decreased, while QSDH-medium-dose group Akkermansia and Lactobacillus abundances were significantly increased. Greater overall community richness, diversity, and genetic diversity were observed in QSDH granules-treated groups, but differences were insignificant (P > .05). The most significant inter-group genus-level community marker differences involved Prevotella, Ruminococcus, Coprococcus, and Turicibacter. Conclusion: QSDH granules may regulate EAMG rat intestinal flora by decreasing relative abundances of Turicibacter and Clostridium and increasing relative abundances of Bifidobacterium, Lachnospiraceae, and Prevotella.

Plasma exchange versus intravenous immunoglobulin in AChR subtype myasthenic crisis: A prospective cohort study.

Myasthenic crisis (MC) is a life-threatening state with respiratory failure in patients with myasthenia gravis (MG). The fast-acting immunomodulatory therapies for treating MC included plasma exchange (PE) and intravenous immunoglobulin (IVIG). However, the efficacy and the impact on antibody changes remained unknown. We prospectively followed 40 anti-acetylcholine receptors (AChR) antibody-positive MC patients who received either PE (n = 12) or IVIG (n = 28) at crisis. PE was associated with a reduced ICU stay length (p = 0.018) and an early response by the average changes in MGFA-QMG (p = 0.003), MMT (p = 0.020), and ADL (p = 0.011) at one-week off-ventilation. However, the clinical efficacy was equally comparable in both groups after 1 month. Post-treatment hemoglobin drop was significant in both groups, while IVIG was associated with a significant reduction in anti-AChR antibody titers (p < 0.001). This analysis provides real-world evidence in supporting the use of PE as a fast-acting therapy for shortening the ICU stay in AChR-associated MC.

The route to a 200 MHz, all-PM femtosecond Yb-doped fiber laser with a high output coupling ratio.

Based on the time-independent rate equations and nonlinear Schrödinger equation, we simulate a 200 MHz all-polarization-maintaining (PM) mode-locked Yb-doped fiber laser. The cavity round trip evolution toward stable mode locking is present. Additionally, the gain coefficients along the gain fiber as well as the pulses, chirp, and spectra at different locations in the cavity are examined. The effects of chirped fiber Bragg grating parameters on the pulse shape and spectrum profile are also investigated. According to the calculations, we experimentally realize a 200 MHz femtosecond fiber laser with 115 mW output power. The timing jitter and integrated relative intensity noise are measured as 158 fs (1 kHz to 10 MHz) and 0.0513% (1 Hz to 300 kHz), respectively. Eventually, an amplified average power of 610 mW and 79 fs compressed pulses with a peak power of approximately 28 kW are obtained. The exhibited all-PM femtosecond fiber laser system can be adopted as the foundation for an optical frequency comb.

Predictive Score for In-Hospital Mortality of Myasthenic Crisis: A Retrospective Chinese Cohort Study.

INTRODUCTION: Myasthenic crisis (MC) is a life-threatening condition usually occurred in patients with myasthenia gravis (MG). OBJECTIVE: On the basis of a retrospective case series review, we try to develop a scoring system to evaluate the probability for in-hospital death in MC patients. METHODS: We retrospectively reviewed 78 MC patients who were hospitalized from January 2014 to December 2018. Clinical and laboratory data including 17 variables were analyzed univariately. The main clinical outcome was defined as the in-hospital death. Then eligible variables were evaluated by a stepwise multivariate regression and a scoring system was then generated. Calibration and discrimination methods were used to evaluate and validate the model performance. RESULTS: The overall in-hospital mortality was 11.5% (9/78) in the MC cohort. Five clinical variables including Myasthenia Gravis Foundation of America (MGFA) classification at onset, septic shock, thymoma classification, cardiac arrest, and the lowest serum albumin were found to be associated with in-hospital mortality. Further 3 variables entered the final regression, and internal validation showed that the area under the curve was 0.919 (95% CI 0.788-1.000). A scoring system with a full credit of 7 points was generated to predict the in-hospital mortality (MGFA at onset, 2 points; septic shock, 4 points; and cardiac arrest, 3 points). CONCLUSIONS: A 7-point scoring model was established on the basis of a retrospective review of MC patients to predict the in-hospital mortality.

CMTN-SP: A Novel Coverage-Control Algorithm for Moving-Target Nodes Based on Sensing Probability Model in Sensor Networks.

The non-consecutive coverage problem for the target nodes in Sensor Networks could lead to the coverage blind area and a large amount of redundant data, which causes the bottleneck phenomenon for the communication link. A novel Coverage Control Algorithm for Moving Target Nodes Based on Sensing Probability Model (CMTN-SP) is proposed in this work. Firstly, according to the probability theory, we derive the calculation method for the expectation of the coverage quality with multiple joint nodes, which aims to reduce the coverage blind area and improving network coverage rate. Secondly, we employ the dynamic transferring mechanism of the nodes to re-optimize the deployment of the nodes, which alleviates the rapid exhaustion of the proper network energy. Finally, it is verified via the results of the simulation that the network coverage quality could not only be improved by the proposed algorithm, but the proposed algorithm could also effectively curb the rapid exhaustion of the node energy.

Hydroxyl and amino dual-functionalized core-shell molecular sieves featuring hydrogen bond donor groups for efficient CO2 cycloaddition.

In CO2 cycloaddition reactions, hydrogen bond donor (HBD) groups are considered environmentally friendly substitutes for metals to promote epoxide ring-opening through interactions with nucleophilic anions. A core-shell structured ILs-based catalyst (mSiO2@MCM-NH2-OH) with dual hydrogen bond donors (-OH and -NH2) was synthesized by copolymerization strategy. Through in-depth characterization, it has been demonstrated that the catalyst (mSiO2@MCM-NH2-OH) possesses multiple catalytic active sites including -OH, -NH2, Br- groups, and the synergistic effect of double HBD groups (-OH and -NH2) and Lewis base (Br-) significantly improved the catalytic activity. Meanwhile, the core-shell structure of the catalyst effectively prevents the loss of active components, which makes the yield remain at about 94 % after 10 cycles. Based on Density Functional Theory (DFT) calculations, a synergistic catalytic mechanism, which involves dual hydrogen-bond donors (-OH and -NH2) and Lewis bases (Br-) was proposed. The cooperative interaction between -OH/-NH2 and Br- reduced the ring-opening barrier of epoxide from 58.6 to 32.0 kcal mol-1 significantly, and thereby facilitated the CO2 cycloaddition reaction.

Dispersion Management Nonlinear Multimode Interference Mode-Locked Ytterbium Fiber Laser.

Dispersion management plays an important role in improving the output performance of a mode-locked fiber laser. Therefore, dispersion management is carried out by introducing the grating pair in our experiment. Through adjusting the distance between the grating pair, mode-locked pulses corresponding to different dispersion regimes can be realized, which typically range from soliton state in the anomalous dispersion regime to the dissipative soliton format in the normal dispersion regime. Furthermore, tunable spectrum distribution can be achieved by adjusting two intra-cavity polarization controllers. The proposed dispersion management method complements mode-locking techniques based on nonlinear multimode interference (NL-MMI). The laser can operate with self-start mode locking stably and is useful for practice applications.

Defect-Enriched Hollow Porous Carbon Nanocages Enable Highly Efficient Chlorine Evolution Reaction.

Metal-free carbon-based catalysts are crucial for the electrocatalytic chlorine evolution reaction (CER) to reduce the usage of noble metals and industrial cost. However, the corresponding catalytic activity of high overpotential and low durability hinders their wide application. Here, a hollow porous carbon (HPC) nanocage with a controlled oxygen electronic state around designed carbon defects for CER activity is reported. Alkali etching can bring defects in zeolite with a hollow structure. In a hard template strategy, the type of carbon defects is directly related to etching degree of the zeolite template. More importantly, the oxygen atoms can be "borrowed" from the zeolite framework by the defective carbon. The electron density around unsaturated O atoms can be decreased on the minor defects in carbon compared with that on large defects which is favorable for the adsorption of Cl- . Consequently, the as-synthesized HPC nanocages with minor defects show excellent electrocatalytic performance for CER with a low overpotential of 94 mV at current density of 10 mA cm-2 with good stability, which is superior to the commercial precious metal catalyst of dimensionally stable anode (DSA), and the best in the reported carbon materials. The designed carbon materials provide an option for metal-free industrial catalysts with significant CER activities.

MnFe phosphides doped in hollow Prussian blue analogues with Ru modification as an efficient cathode for Li-O2 batteries.

A highly efficient catalyst for Li-O2 batteries based on Ru and MnFe phosphides nanoparticles entrapped in a MnFe Prussian blue analogue (PBA) substrate (Ru-MnFeP/PBA) was explored. Synergy between homogeneous Ru and MnFe phosphides nanoparticles improved the catalytic activity and alleviated side reactions. The Li-O2 battery based on Ru-MnFeP/PBA exhibited excellent performance.

Ternary alloy (FeCoNi) nanoparticles supported on hollow porous carbon with defects for enhanced oxygen evolution reaction.

Low-cost non-noble metal nanoparticles are promising electrocatalysts that can catalyze oxygen evolution reaction (OER). Various factors such as poor activity and stability hinder the practical applications of these materials. The electroactivity and durability of the electrocatalysts can be improved by optimizing the morphology and composition of the materials. Herein, we report the successful synthesis of hollow porous carbon (HPC) catalysts loaded with ternary alloy (FeCoNi) nanoparticles (HPC-FeCoNi) for efficient OER. HPC is firstly synthesized by a facile carbon deposition method using the hierarchical porous zeolite ZSM-5 as the hard template. Numerous defects are generated on the carbon shell during the removal of zeolite template. Subsequently, FeCoNi alloy nanoparticles are supported on HPC by a sequence of impregnation and H2 reduction processes. The synergistic effect between carbon defects and FeCoNi alloy nanoparticles endows the catalyst with an excellent OER performance (low overpotential of 219 mV; Tafel slope of 60.1 mV dec-1) in a solution of KOH (1 M). A stable potential is maintained during the continuous operation over 72 h. The designed HPC-FeCoNi presents a platform for the development of electrocatalysts that can be potentially applied for industrial OER.

Short-term outcome prediction for myasthenia gravis: an explainable machine learning model.

Background: Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatigability. The fluctuating nature of the disease course impedes the clinical management. Objective: The purpose of the study was to establish and validate a machine learning (ML)-based model for predicting the short-term clinical outcome in MG patients with different antibody types. Methods: We studied 890 MG patients who had regular follow-ups at 11 tertiary centers in China from 1 January 2015 to 31 July 2021 (653 patients for derivation and 237 for validation). The short-term outcome was the modified post-intervention status (PIS) at a 6-month visit. A two-step variable screening was used to determine the factors for model construction and 14 ML algorithms were used for model optimisation. Results: The derivation cohort included 653 patients from Huashan hospital [age 44.24 (17.22) years, female 57.6%, generalized MG 73.5%], and the validation cohort included 237 patients from 10 independent centers [age 44.24 (17.22) years, female 55.0%, generalized MG 81.2%]. The ML model identified patients who were improved with an area under the receiver operating characteristic curve (AUC) of 0.91 [0.89-0.93], 'Unchanged' 0.89 [0.87-0.91], and 'Worse' 0.89 [0.85-0.92] in the derivation cohort, whereas identified patients who were improved with an AUC of 0.84 [0.79-0.89], 'Unchanged' 0.74 [0.67-0.82], and 'Worse' 0.79 [0.70-0.88] in the validation cohort. Both datasets presented a good calibration ability by fitting the expectation slopes. The model is finally explained by 25 simple predictors and transferred to a feasible web tool for an initial assessment. Conclusion: The explainable, ML-based predictive model can aid in forecasting the short-term outcome for MG with good accuracy in clinical practice.

[Systematic review of Shuxuetong injection for progressive ischaemic stroke].

OBJECTIVE: To assess the clinical efficacy and safety of Shuxuetong injection against progressive ischaemic stroke. METHOD: Randomized controlled trials (RCTs) and quasi randomized controlled trials (quasi-RCTs), which focused on treating patients with progressive ischaemic stroke using Shuxuetong injection were identified from Cochrane library, Medline, EMbase, CBM database, CNKI database, VIP database and Wanfang database. Data was extracted and evaluated with designed form. RevMan 5.1 software was used for data analysis. RESULT: Eleven RCTs with 972 patients were included in this review. Only one research reported the mortality rate. None of the trials mentioned dependency of the patients during the follow-up period. The results of Meta analysis were listed as follows. Compared with normal treatment measures, total effective rate of 11 RCTs suggested that Shuxuetong were more effective with OR 4.46, 95% CI [3.02-6.59]. A greater difference in patients using Shuxuetong injection was found in 7 RCTs about the NDS with MD 5.86, 95% CI [4.80-6.93], compared with normal treatment measures. Researches with ADR/AE information of Shuxuetong injection showed that the symptoms of ADR/AE were moderate. CONCLUSION: Conclusions from this review may have a high risk of bias because of the low quality of the researches, hence it was not adequate to draw any reliable conclusions about the efficacy of Shuxuetong injection in progressive ischaemic stroke. More trials with high quality are required in the following researches.

[Literature review report on safety evaluation about Kudiezi injection].

OBJECTIVE: To explore safety evaluation information about Kudiezi injection used in the clinical practice. METHOD: Three Chinese literature databases were searched and 96 articles were downloaded. Safety information about the study question was extracted by researchers in the Excel form. Finally, 22 articles including 24 case reports were analyzed in this article. Five aspects about safety information were summarized. RESULT: It was found that all the adverse drug reaction reports in the literature were improper. There was no clear causality relation inference. It was inaccurate that those reports were identified as adverse drug reactions. CONCLUSION: Although 24 case reports were identified as adverse drug reaction the evidence for each report was insufficient. There is no scientific causality judgment among these reports, which were implied little significance to future health decision about Kudiezi injection.

[Reasonable application of traditional Chinese medicines injections promoting blood circulation and removing blood stasis in treating ischemic cerebrovascular diseases].

Currently, there are many traditional Chinese medicine (TCM) injections for treating ischemic stroke in the market, most of them have the efficacy of promoting blood circulation and removing blood stasis, but their reasonable applications are worth consideration. From the angles of traditional Chinese medicine and modern medicine, TCM injections that are commonly used in clinics were detected for their indications and pharmacological effects, compared in terms of their characteristics of clinical application, precautions, prohibition on use, caution and adverse reactions and categorized, in order to help clinicians with reasonable application of TCM injections.

Full-Color and Switchable Circularly Polarized Light from a Macroscopic Chiral Dendritic Film through a Solid-State Supramolecular Assembly.

Chiral materials displaying chirality across multiple length scales have attracted increasing interest due to their potential applications in diverse fields. Herein, we report an efficient approach for the construction of macroscopic crystal dendrites with hierarchical chirality based on an in situ solid assembly in a block copolymer film. Chiral fluorescent crystals are formed by enantiopure d-/l-dibenzoyl tartaric acid and pyrenecarboxylic acid in a poly(1,4-butadiene)-b-poly(ethylene oxide) film. The chiro-optical activity of the crystalline dendrites can be greatly amplified in the absorption and scattering regions and goes along with the dimension of dendrites. Notably, the chiral dendrites exhibited strong circularly polarized luminescence emission with a high dissymmetric factor (0.03). The enhancement of the quantum yield of the chiral film was up to 28%, which was 14 times higher that of the corresponding fluorescent molecules. The circularly polarized emission bands of the films can be fine-tuned by contriving the emissive bands of fluorescent molecules. More importantly, the chiral signals are able to be wiped when the fluorescent group photodimerizes under UV irradiation. This work provides an efficient way to develop functional materials through solid self-assembly.

The prevention of stroke by statins: A meta-analysis.

PURPOSE: The objectives of this study were to determine the preventive effects of statins on stroke. METHODS: The published randomized controlled trials of statins for stroke prevention were searched from PubMed, EMBASE, Cochrane Library, and China Journal databases. We performed the meta-analysis via calculating the odds ratio (OR) and 95% confidence interval (CI) to study the mortality rate, incidence, and recurrence rate of patients with stroke in the prevention group and the control group. Chi-square-based Q test and I2 statistics were performed to test the potential heterogeneity; we conducted the sensitivity analysis to assess the stability of our analysis. Moreover, we performed the Begg and Egger tests to assess the publication bias. RESULTS: Nine studies were included to perform meta-analysis, which included 15,497 patients (prevention group [n = 4114]; control group [n = 11383]). We found that the statins were not associated with the patients with stroke in mortality rate (OR = 1.00, 95% CI [0.82, 1.23]) and incidence (OR = 0.94, 95% CI [0.46, 1.92]) between the 2 groups. However, there was a significant differences in recurrence rate between the 2 groups (OR = 0.31, 95% CI [0.19, 0.51]). CONCLUSIONS: Our findings indicated that the statins were associated with the patients with stroke in recurrence rate, but there was no significant correlation with the mortality and morbidity of patients with stroke.

Electrocatalytic HER Enhancement of C3 N4 in NiCo2 O4.

Generally, C3 N4 was widely used in the field of photocatalytic hydrogen production, but only few studies focused on electrocatalytic hydrogen production field in Ni/Co based systems. Herein, to investigate the enhanced HER property of C3 N4 , NiCo2 O4 @C3 N4 were fabricated successfully via a simple mixture method. With the introduction of C3 N4 , NiCo2 O4 @C3 N4 showed better HER property with small overpotential (89 mV, η10  mA cm-2 ), low Tafel slope (146 mV dec-1 ) and superior long-term stability, thereby indicating the excellent synergistic effect between NiCo2 O4 and C3 N4 . Besides, compared with NiCo2 O4 , the large electrochemically active surface areas of NiCo2 O4 @C3 N4 (ca. 126 cm2 ) indicated the abundant active sites, directly proofing the HER enhancement of C3 N4 . According to Density Functional Theory (DFT) calculation results, when NiCo2 O4 combined with C3 N4 , the EH2O* of NiCo2 O4 @C3 N4 decreased from 3.80 to 2.76 eV and, accordingly, the heterostructure possessed an appropriate ΔGH* (0.19 eV, close to Pt), suggesting the unique synergistic effect between NiCo2 O4 and C3 N4 . Meanwhile, H2 O interacted with the d orbital of the Co atom and induced more electrons to transfer from NiCo2 O4 to C3 N4 and H2 O sequentially, thereby accumulating plenty of electrons on H2 O molecule and further activating H2 O molecule. Accordingly, the H-O-H bond angle of H2 O was narrowed from 104.3° to 103.2°, meanwhile, the O-H bond length was extended from 0.975 to 0.989 Å, demonstrating the HER enhancement of C3 N4 .

Factors related to the risk of stroke in the population with type 2 diabetes: A protocol for systematic review and meta-analysis.

BACKGROUND: Type 2 diabetes is an independent risk factor for stroke. The main role of the current study is to study the mechanism of stroke induced by diabetes, but there is no systematic summary of daily management and stroke prevention for patients with type 2 diabetes. In order to provide a more detailed stroke prevention program for patients with type 2 diabetes, we included in the study and looked forward to analyzing the risk factors that were more in line with the clinical characteristics of type 2 diabetes. METHODS: We will search the following Chinese and English databases: PubMed, Web of science, Cochrane Library, Medline, and China National Knowledge Infrastructure database. All of the above electronic databases will be searched from inception to June 30, 2021. In addition, we will manually search for conference papers, ongoing experiments, and internal reports to supplement the studies retrieved via electronic search. We will use the STATA 16.0 provided by Cochrane Collaboration Network for statistical analysis. RESULTS: The study will prove a collective view on the relationship between related factors and stroke in the type 2 diabetes population. CONCLUSION: We plan to submit this systematic review to a peer-reviewed journal.INPLASY registration number: INPLASY2021100046.

Exploring the Potential Mechanism of Qi-Shen-Di-Huang Drug Formulary for Myasthenia Gravis (MG) based on UHPLC-QE-MS Network Pharmacology and Molecular Docking Techniques.

Myasthenia gravis (MG) is a rare and refractory autoimmune disease, and Qi Shen Di Huang (QSDH) drug formulary is an in-hospital herbal decoction with proven clinical efficacy in treating MG. Currently, most of the research on the QSDH drug formulary has concentrated on its clinical efficacy, and there is a lack of systematic study on the material basis. The active compounds and their mechanism of action have not been entirely determined. Therefore, this study sought to identify the active compounds in the QSDH drug formulary and analyze the key targets and potential mechanisms. We used ultra-performance liquid chromatography Q Exactive-mass spectrometry (UHPLC-QE-MS) and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database to identify and screen 85 active ingredients corresponding to 59 potential targets (17 herbs) associated with myasthenia gravis, and further identified AKT1 as the primary core target and the PI3K/AKT signaling pathway as the most substantial enriched pathway. Molecular docking and UPLC-MS analysis identified quercetin, luteolin, wogonin, kaempferol, laccasein, and epigallocatechin gallate are the core compounds of the QSDH drug formulary. In vivo rat studies showed that the QSDH drug formulary reduced Lennon's clinical score and decreased acetylcholine receptor antibody levels in peripheral blood rats with experimental autoimmune myasthenia gravis. In addition, the QSDH drug formulary downregulated P-PI3K/PI3K and P-Akt/Akt protein expression. Collectively, these findings describe the role and potential mechanism of the QSDH drug formulary in the treatment of MG, which exerts potential value by acting on AKT targets and regulating the PI3K/AKT signaling pathway and providing a theoretical reference for QSDH drug formulary application in the clinical treatment of MG.