Ultrasensitive CCL2 Detection in Urine for Diabetic Nephropathy Diagnosis Using a WS2-Based Plasmonic Biosensor.

The accurate diagnosis of diabetic nephropathy relies on achieving ultrasensitive biosensing for biomarker detection. However, existing biosensors face challenges such as poor sensitivity, complexity, time-consuming procedures, and high assay costs. To address these limitations, we report a WS2-based plasmonic biosensor for the ultrasensitive detection of biomarker candidates in clinical human urine samples associated with diabetic nephropathy. Leveraging plasmonic-based electrochemical impedance microscopy (P-EIM) imaging, we observed a remarkable charge sensitivity in monolayer WS2 single crystals. Our biosensor exhibits an exceptionally low detection limit (0.201 ag/mL) and remarkable selectivity in detecting CC chemokine ligand 2 (CCL2) protein biomarkers, outperforming conventional techniques such as ELISA. This work represents a breakthrough in traditional protein sensors, providing a direction and materials foundation for developing ultrasensitive sensors tailored to clinical applications for biomarker sensing.

2-D Heterometallic Pb-Iodoargentate Framework [PbAg2I6]n with a Diskoid [Pb(18-crown-6)]2+ Linker and Cocatalyst for Synergistically Enhanced Photocatalytic Properties via g-C3N4 Doping.

The heterometallic Pb-iodoargentate hybrid [Pb(18-crown-6)(PbAg2I6)]n (1; 18-crown-6 = 1,4,7,10,13,16-hexaoxacyclooctadecane) was prepared via self-assembly of the tetrahedal AgI4 and octahedral PbI6 primary units using crown ether 18-crown-6 as an organic ligand in DMF solvent. The hybrid heterocomposite cocatalyst based on 1 and graphitic carbon nitride (g-C3N4) was prepared by a facile solvothermal method. In 1, the dimeric units Ag2I6 and Pb2I10 are joined via face sharing, leading to a ternary heterometallic 1-D [PbAg2I62-]n chain containing novel Ag2Pb2I4 cubes. The 1-D chains are joined by the discoid [Pb(18-crown-6)]2+ complex cations, forming the 2-D [Pb(18-crown-6)(PbAg2I6)]n hybrid with the skeleton of [Pb2Ag2I6]n. Compound 1 shows photocatalytic activity in the degradation of MB at room temperature under visible-light irradiation. The photoelectric response measurement showed that the photocurrent of 1 increased from 1.41 to 2.43 µA/cm-2 when g-C3N4 was loaded, indicating that the introduction of a certain amount of g-C3N4 on the surface of 1 improves the separation and migration rate of photoinduced electrons and holes. The 1/g-C3N4 composite showed much higher photocatalytic efficiency in comparison to pristine 1 and g-C3N4 for MB degradation, which suggests the synergistic effect between 1 and g-C3N4 toward visible-light-driven photocatalytic performance. Meanwhile, the 1/g-C3N4 composite exhibited good reusability and stability in the photocatalytic reaction. Free radical quenching experiments showed that the •O2- radical is the main reactive substance over catalyst 1, while h+, •OH, and •O2- species have synergistic effects over the 1/g-C3N4 composite catalyst in the process of photodegradation.

Impact of the Time-Weighted Average Glucose Concentration and Diabetes on In-Hospital Mortality in Critically Ill Patients Older Than 75 Years: A Retrospective Cohort Study.

OBJECTIVE: To evaluate the effects of diabetes and hyperglycemia on in-hospital mortality in critically ill patients older than 75 years. METHODS: This was a single-center retrospective cohort study of patients older than 75 years in the first intensive care unit stay. The patients were divided into the following 4 groups: time-weighted average glucose (TWAG) <140 mg/dL without diabetes (group 1), TWAG ≥140 mg/dL without diabetes (group 2), TWAG <180 mg/dL with diabetes (group 3), and TWAG ≥180 mg/dL with diabetes (group 4). Clinical and laboratory data were analyzed. RESULTS: A total of 6760 patients over 75 years of age were included, including 2089 patients previously diagnosed with diabetes. The patients in group 2 had the highest in-hospital mortality (27.4%). In the fully adjusted regression model, the risk of in-hospital mortality increased by 76% (odds ratio = 1.76, 95% CI: 1.49-2.08) in group 2 as compared with group 1. Those from groups 3 and 4 exhibited risks equivalent to the risks of those in group 1; similar results were observed in the subgroup analysis. A J-shaped curve relationship and threshold effect were observed in patients without diabetes. For those with diabetes, a flatter curve pattern with a small slope was observed. CONCLUSION: Stress hyperglycemia was more detrimental to short-term prognosis than diabetes status in these patients. Looser glucose control may be suitable for patients older than 75 years with diabetes but unnecessary for those without diabetes. Patients with diabetes may be more resistant to the detrimental effects of glucose variations.

Group Decision Making-Based Fusion for Human Activity Recognition in Body Sensor Networks.

Ensemble learning systems (ELS) have been widely utilized for human activity recognition (HAR) with multiple homogeneous or heterogeneous sensors. However, traditional ensemble approaches for HAR cannot always work well due to insufficient accuracy and diversity of base classifiers, the absence of ensemble pruning, as well as the inefficiency of the fusion strategy. To overcome these problems, this paper proposes a novel selective ensemble approach with group decision-making (GDM) for decision-level fusion in HAR. As a result, the fusion process in the ELS is transformed into an abstract process that includes individual experts (base classifiers) making decisions with the GDM fusion strategy. Firstly, a set of diverse local base classifiers are constructed through the corresponding mechanism of the base classifier and the sensor. Secondly, the pruning methods and the number of selected base classifiers for the fusion phase are determined by considering the diversity among base classifiers and the accuracy of candidate classifiers. Two ensemble pruning methods are utilized: mixed diversity measure and complementarity measure. Thirdly, component decision information from the selected base classifiers is combined by using the GDM fusion strategy and the recognition results of the HAR approach can be obtained. Experimental results on two public activity recognition datasets (The OPPORTUNITY dataset; Daily and Sports Activity Dataset (DSAD)) suggest that the proposed GDM-based approach outperforms the well-known fusion techniques and other state-of-the-art approaches in the literature.

Application of 3-Alkyl-2-vinylindoles in Catalytic Asymmetric Dearomative (2+3) Cycloadditions.

The first application of 3-alkyl-2-vinylindoles in catalytic asymmetric dearomative cycloadditions was established by chiral phosphoric acid (CPA)-catalyzed (2+3) cycloaddition with azoalkenes, leading to the generation of chiral pyrroloindolines bearing two tetrasubstituted stereogenic centers in good yields (61-96%) and excellent stereoselectivities (all >95:5 dr, 86-99% ee). This reaction has realized the first enantioselective dearomative cycloaddition of 3-alkyl-2-vinylindoles, which brings a new reactivity to this class of vinylindoles and will enrich the chemistry of 3-alkyl-2-vinylindoles. In addition, this approach has provided a useful strategy for the construction of enantioenriched pyrroloindoline skeletons bearing two tetrasubstituted stereogenic centers. More importantly, the bioassay of these chiral pyrroloindolines has revealed that some compounds exhibit strong anti-cancer activity against Hela and MCF-7 cell lines, which will be helpful for discovering anti-cancer drug candidates.

Polymeric Iodoargentate Hybrids Incorporating Octakis- or Heptakis-Solvated Lanthanide Complexes: Syntheses, Crystal Structures, and Photocatalysis.

New iodoargentate hybrids containing lanthanide complexes, [La(DMA)8]Ag9I12·2H2O (1) and [Ln(DMA)7]2Ag16I22 (Ln = Pr (2), Sm(3); DMA = N,N-dimethylacetamide), were prepared by diffusion methods using DMA-solvated lanthanide complexes as structure-directing agents. The octakis-solvated La3+ cation leads to formation of the 1-D nonanuclear [Ag9I12]n3n- polymeric anion constructed by AgI4 tetrahedral units through edge sharing, while the heptakis-solvated Ln3+ (Ln = Pr, Sm) cation affords the new 1-D hexadecanuclear [Ag16I22]n6n- polymeric anion built up from AgI4 units by both corner and edge sharing. Compounds 1-3 possess band gaps of 2.58, 2.77, and 2.74 eV, respectively, and show steady photocurrents in the range 14.2-18.0 µA under Xe light irradiation. They are photocatalytic active in the degradation of organic pollutants of crystal violet (CV) and rhodamine B (RhB) in water at room temperature. 2 and 3 perform higher photocatalytic activities than 1 in the CV degradation, which is attributed to the different photocurrent intensities. Photocatalytic mechanism investigations on compounds 2 and 3 show that h+ hole and ·O2- radical play major roles in the CV degradation, respectively.

Gga-miR-30d regulates infectious bronchitis virus infection by targeting USP47 in HD11 cells.

Avian infectious bronchitis virus (IBV) is a coronavirus which infects chickens and causes severe economic losses to the poultry industry worldwide. MicroRNAs (miRNAs) are important intracellular regulators and play a pivotal role in viral infections. In previous studies, we have revealed that IBV infection caused a significant down-regulation of gga-miR-30d expression in chicken kidneys. In present study, we investigated the role of gga-miR-30d in the process of IBV infection of HD11 cell line in vitro. By transfecting the mimics and inhibitor of gga-miR-30d, it was found that overexpressed gga-miR-30d inhibited IBV replication. Contrarily, low-expressed gga-miR-30d promoted IBV replication. In addition, dual-luciferase reporter assays revealed that ubiquitin-specific protease 47 (USP47), a deubiquitinase-encoding gene, was a target for gga-miR-30d. This is the first study demonstrating that miRNAs regulate IBV replication by regulating the deubiquitinating enzyme (DUBs).

Optimizing Sensor Deployment for Multi-Sensor-Based HAR System with Improved Glowworm Swarm Optimization Algorithm.

Human activity recognition (HAR) technology that analyzes and fuses the data acquired from various homogeneous or heterogeneous sensor sources has motivated the development of enormous human-centered applications such as healthcare, fitness, ambient assisted living and rehabilitation. The concurrent use of multiple sensor sources for HAR is a good choice because the plethora of user information provided by the various sensor sources may be useful. However, a multi-sensor system with too many sensors will bring large power consumption and some sensor sources may bring little improvements to the performance. Therefore, the multi-sensor deployment research that can gain a tradeoff among computational complexity and performance is imperative. In this paper, we propose a multi-sensor-based HAR system whose sensor deployment can be optimized by selective ensemble approaches. With respect to optimization of the sensor deployment, an improved binary glowworm swarm optimization (IBGSO) algorithm is proposed and the sensor sources that have a significant effect on the performance of HAR are selected. Furthermore, the ensemble learning system based on optimized sensor deployment is constructed for HAR. Experimental results on two datasets show that the proposed IBGSO-based multi-sensor deployment approach can select a smaller number of sensor sources while achieving better performance than the ensemble of all sensors and other optimization-based selective ensemble approaches.

The "hyper-triglyceridemic waist phenotype" is a reliable marker for prediction of accumulation of abdominal visceral fat in Chinese adults.

PURPOSE: The "hyper-triglyceridemic waist (HTW) phenotype" is relatively convenient to identify, acquired readily, and is inexpensive. We explored the relationship between the HTW phenotype and abdominal-fat accumulation in Chinese adults. METHODS: The study cohort comprised 195 adults divided into four groups according to triglyceride (TG) concentration and waist circumference (WC): normal (A), "hyper-TG" (B), "hyper-WC" (C) and the HTW phenotype (D). The abdominal-fat compartment was measured by magnetic resonance imaging. A 75-g oral glucose tolerance test (OGTT) was administered after an overnight fast. Clinical, anthropometric and laboratory data were analyzed. RESULTS: Individuals with the HTW phenotype had the highest WC, Conicity Index, waist:hip ratio and abdominal visceral fat (AVF) area, and the highest TG and uric-acid concentrations among the four groups. People with the HTW phenotype were older, had higher blood pressure than those with normal WC (groups A and B). In the OGTT, participants with the HTW phenotype had the highest insulin resistance and lowest insulin sensitivity. In binary logistic regression analysis, age, sex, Body Mass Index, high concentrations of density lipoprotein-cholesterol and low-density lipoprotein-cholesterol, and the HTW phenotype were independent risk factors for predicting AVF accumulation with a sensitivity of 81.08% and specificity of 90.91%. CONCLUSIONS: Chinese adults with the HTW phenotype had the highest AVF area and insulin resistance, and were associated with higher blood pressure than individuals with normal WC. The HTW phenotype is a reliable marker for prediction of AVF accumulation associated with insulin resistance. LEVEL OF EVIDENCE: IV.

Genetic characterization of a novel G9P[23] rotavirus A strain identified in southwestern China with evidence of a reassortment event between human and porcine strains.

Group A rotaviruses (RVAs) are important zoonotic pathogens that cause intestinal disease in humans and other mammals. In this study, the novel strain RVA/Pig/China/SC11/2017/G9P[23](SC11) was isolated from fecal samples from a pig farm in Sichuan province, southwestern China. The complete genome was found to be 18,347 bp in length with 11 segments. The genotype constellation of strain SC11 was G9-P[23]-I12-R1-C1-M1-A1-N1-T1-E1-H1, according to whole-genome sequencing analysis. The VP1, VP2, VP4, VP6, NSP1-NSP3, and NSP5 genes of RVA strain SC11 were found to be closely related to those of porcine and/or porcine-like human RVAs. Meanwhile, the VP7 and NSP4 genes of strain SC11 were closely related to genes of human RVAs. However, it was difficult to pinpoint the porcine or human origin of the VP3 gene of strain SC11 based on the available data. These results showed that SC11 originated from a natural reassortment event between human and pig RVA strains, and crossover points for recombination were identified at nucleotides (nt) 109-806 of NSP2. This is the first report of such a reassortant and recombinant RVA strain in the southwestern region of China.

Selective Ensemble Based on Extreme Learning Machine for Sensor-Based Human Activity Recognition.

Sensor-based human activity recognition (HAR) has attracted interest both in academic and applied fields, and can be utilized in health-related areas, fitness, sports training, etc. With a view to improving the performance of sensor-based HAR and optimizing the generalizability and diversity of the base classifier of the ensemble system, a novel HAR approach (pairwise diversity measure and glowworm swarm optimization-based selective ensemble learning, DMGSOSEN) that utilizes ensemble learning with differentiated extreme learning machines (ELMs) is proposed in this paper. Firstly, the bootstrap sampling method is utilized to independently train multiple base ELMs which make up the initial base classifier pool. Secondly, the initial pool is pre-pruned by calculating the pairwise diversity measure of each base ELM, which can eliminate similar base ELMs and enhance the performance of HAR system by balancing diversity and accuracy. Then, glowworm swarm optimization (GSO) is utilized to search for the optimal sub-ensemble from the base ELMs after pre-pruning. Finally, majority voting is utilized to combine the results of the selected base ELMs. For the evaluation of our proposed method, we collected a dataset from different locations on the body, including chest, waist, left wrist, left ankle and right arm. The experimental results show that, compared with traditional ensemble algorithms such as Bagging, Adaboost, and other state-of-the-art pruning algorithms, the proposed approach is able to achieve better performance (96.7% accuracy and F1 from wrist) with fewer base classifiers.

Wearable Sensor-Based Human Activity Recognition via Two-Layer Diversity-Enhanced Multiclassifier Recognition Method.

Sensor-based human activity recognition can benefit a variety of applications such as health care, fitness, smart homes, rehabilitation training, and so forth. In this paper, we propose a novel two-layer diversity-enhanced multiclassifier recognition method for single wearable accelerometer-based human activity recognition, which contains data-based and classifier-based diversity enhancement. Firstly, we introduce the kernel Fisher discriminant analysis (KFDA) technique to spatially transform the training samples and enhance the discrimination between activities. In addition, bootstrap resampling is utilized to increase the diversities of the dataset for training the base classifiers in the multiclassifier system. Secondly, a combined diversity measure for selecting the base classifiers with excellent performance and large diversity is proposed to optimize the performance of the multiclassifier system. Lastly, majority voting is utilized to combine the preferred base classifiers. Experiments showed that the data-based diversity enhancement can improve the discriminance of different activity samples and promote the generation of base classifiers with different structures and performances. Compared with random selection and traditional ensemble methods, including Bagging and Adaboost, the proposed method achieved 92.3% accuracy and 90.7% recall, which demonstrates better performance in activity recognition.

Complete genome sequence and pathogenicity of fowl adenovirus serotype 4 involved in hydropericardium syndrome in Southwest China.

Since 2015, an emerging infectious disease of inclusion body hepatitis and hydropericardium syndrome (IBH-HPS) has been occurred in China, which caused economic loss in poultry farming. In this study, we isolated four fowl adenovirus strains from flocks with an outbreak of HPS. The complete nucleotide sequence of SC-Neijiang was determined and its pathogenicity was evaluated. Phylogenetic analysis based on hexon gene revealed that all the isolates belonged to fowl adenovirus serotype 4. The full genome sequence of SC-Neijiang has a size of 43,719 bp, with 54.85% G + C content. Compared with JSJ13, 11-amino-acid deletion at the ORF29 was appeared on SC-Neijiang. In infectious experiments, 80% (16/20) birds died in intramuscular route and lesions characteristic for Hydropericardium Syndrome (HPS), while 5% (1/20) birds died in nasal route. The viral DNA was further detected by real-time PCR in several chicken organs. The highest titers were recorded in all the organs at day 5 post-infection. To our knowledge, this is first report on the prevalence of fowl adenovirus in Southwest China. This research elucidated the characteristics of genome sequence and pathogenicity of Chinese FAdV-4 strain and provided theoretical support for the prevention and control of the disease.

Molecular characterization and recombination analysis of porcine reproductive and respiratory syndrome virus emerged in southwestern China during 2012-2016.

Porcine reproductive and respiratory syndrome virus (PRRSV) is an important swine pathogen causing tremendous economic losses to the swine industry. To investigate the prevalence of PRRSV of genotype 2 (North American type, NA-type) in southwestern China, the Nsp2 hypervariable region (Nsp2 HV) and ORF5 of 61 PRRS viruses collected during 2012-2016 were sequenced and analyzed. All the virus detected clustered into the JXA1-like (52/61), VR-2332-like (7/61), and NADC30-like (2/61) sub-genotypes. Five deletions in Nsp2 HV were detected in addition to the typical 30aa discontinuous deletion in HP-PRRSV, and two of these five were not reported previously. Strikingly, two PRRS virus (SCnj16 and SCcd16) isolated in 2016 contained the classic HP-PRRSV molecular marker in the Nsp2-coding region, but belonged to the NADC30-like sub-genotype on the ORF5 gene. Further recombination and phylogenetic analysis on the two complete genomic sequences revealed that they may have originated from recombination events between the NADC30 and Chinese HP-PRRSV strains. The present study suggests that the endemic PRRSVs in the region have continuously evolved and new vaccine strategies are necessary for more efficient control of the virus.

Acute bilateral uveitis and right macular edema induced by a single infusion of zoledronic acid for the treatment of postmenopausal osteoporosis as a substitution for oral alendronate: a case report.

BACKGROUND: Zoledronic acid-induced uveitis (ZAIU) is rare but severe, and has been recently considered part of an acute phase reaction. Only 15 cases have been reported since 2005. Here we describe a case with macular edema, which is the first reported case observed after long-term alendronate tolerance. CASE PRESENTATION: A 63-year-old Asian woman received her first intravenous zoledronic acid treatment for the management of postmenopausal osteoporosis as a more convenient substitute for oral alendronate. Twenty-four hours later, bilateral eye irritations, periorbital swelling, blurred vision, and diplopia presented. The complete blood count and transaminase levels were normal, but the erythrocytic sedimentation, C-reactive protein, and serum C4 levels were elevated. On detailed ophthalmological examination, a diagnosis of bilateral acute uveitis and macular edema in the right eye was made. The ocular symptoms were not improved until administration of topical and oral steroids. Complete resolution was achieved. There was no rechallenge of bisphosphonates, and no recurrence at 6 months follow-up. Based on an extensive review, abnormal fundus is rarely reported, especially in cases of macular edema. Rechallenge with zoledronic acid in five cases induced no additional uveitis, and changing the medication to pamidronate in another patient was also tolerated. Interestingly, our patient suffered from uveitis soon after intravenous zoledronate exposure after a two-year tolerance to oral alendronate. CONCLUSIONS: This is the first report of zoledronic acid induced uveitis with macular edema after long-term alendronate tolerance. Prior oral alendronate may not entirely prevent ZAIU. Steroids are usually necessary in the treatment of ZAIU. Bisphosphonate rechallenge is not fully contraindicated, and prior steroid administration may be a more reasonable treatment choice according to the available evidence.

Glucan polysaccharides isolated from Lactarius hatsudake Tanaka mushroom: Structural characterization and in vitro bioactivities.

Commercially available mushroom polysaccharides have found widespread use as adjuvant tumor treatments. However, the bioactivity of polysaccharides in Lactarius hatsudake Tanaka (L. hatsudake), a mushroom with both edible and medicinal uses, remains relatively unexplored. To address this gap, five L. hatsudake polysaccharides with varying molecular weights were isolated, named LHP-1 (898 kDa), LHP-2 (677 kDa), LHP-3 (385 kDa), LHP-4 (20 kDa), and LHP-5 (4.9 kDa). Gas chromatography-mass spectrometry, nuclear magnetic resonance, and atomic force microscopy, etc., were employed to determine their structural characteristics. The results confirmed that spherical aggregates with amorphous flexible fiber chains dominated the conformation of the LHP. LHP-1 and LHP-2 were identified as glucans with α-(1,4)-Glcp as the main chain; LHP-3 and LHP-4 were classified as galactans with varying molecular weights but with α-(1,6)-Galp as the main chain; LHP-5 was a glucan with ß-(1,3)-Glcp as the main chain and ß-(1,6)-Glcp connecting to the side chains. Significant differences were observed in inhibiting tumor cell cytotoxicity and the antioxidant activity of the LHPs, with LHP-5 and LHP-4 identified as the principal bioactive components. These findings provide a theoretical foundation for the valuable use of L. hatsudake and emphasize the potential application of LHPs in therapeutic tumor treatments.

Facile synthesis of graphene/metal nanoparticle composites via self-catalysis reduction at room temperature.

Graphene/metal nanoparticle (NP) composites have attracted great interest for various applications as catalysts, electrodes, sensors, etc., due to their unique structures and extraordinary properties. A facile synthesis of graphene/metal NP composites with good control of size and morphology of metal NPs is critical to the practical applications. A simple method to synthesize graphene/metal NPs under a controllable manner via a self-catalysis reduction at room temperature has been developed in this paper. At first, metal NPs with desirable size and morphology were decorated on GO and then used as catalyst to accelerate the hydrolysis reaction of NaBH4 to reduce the graphene oxide. Compared to the existing methods, the method reported here features several advantages in which graphene/metal NPs are prepared without using toxic and explosive reductant, such as hydrazine or its derivatives, making it environmentally benign, and the reaction can be processed at room temperature with high efficiency and in a large range of pH values. The approach has been demonstrated to successfully synthesize graphene composites with various metal NPs in large quantity, which opens up a novel and simple way to prepare large-scale graphene/metal or graphene/metal oxide composites under mild conditions for practical applications. For example, graphene/AuNP composites synthesized by the method show excellent catalytic capability.

Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis.

OBJECTIVE: To compare the biomechanical performance of the hybrid lumbar fixation technique with the traditional and cortical bone trajectory techniques using the finite element method. METHODS: Four adult wet lumbar spine specimens were provided by the Department of Anatomy and Research of Xinjiang Medical University, and four L1-S1 lumbar spine with transforaminal lumbar interbody fusion (TLIF) models at L4-L5 segment and four different fixation techniques were established: bilateral traditional trajectory screw fixation (TT-TT), bilateral cortical bone trajectory screw fixation (CBT-CBT), hybrid CBT-TT (CBT screws at L4 and TT screws at L5) and TT-CBT (TT screws at L4 and CBT screws at L5). The range of motion (ROM) of the L4-L5 segment, von Mises stress of cage, internal fixation, and rod were compared in flexion, extension, left and right bending, and left and right rotation. RESULTS: Compared with the TT-TT group, the TT-CBT group exhibited lower ROM of L4-L5 segment, especially in left-sided bending; the CBT-TT group had the lowest ROM of L4-L5 segment in flexion and extension among the four fixation methods. Compared with the CBT-CBT group, the peak cage stress in the TT-CBT group was reduced by 9.9%, 18.1%, 21.5%, 23.3%, and 26.1% in flexion, left bending, right bending, left rotation, and right rotation conditions, respectively, but not statistically significant (P > 0.05). The peak stress of the internal fixation system in the TT-CBT group was significantly lower than the other three fixation methods in all five conditions except for extension, with a statistically significant difference between the CBT-TT and TT-CBT groups in the left rotation condition (P = 0.017). In addition, compared with the CBT-CBT group, the peak stress of the rod in the CBT-TT group decreased by 34.8%, 32.1%, 28.2%, 29.3%, and 43.0% under the six working conditions of flexion, extension, left bending, left rotation, and right rotation, respectively, but not statistically significant (P > 0.05). CONCLUSIONS: Compared with the TT-TT and CBT-CBT fixation methods in TLIF, the hybrid lumbar fixation CBT-TT and TT-CBT techniques increase the biomechanical stability of the internal fixation structure of the lumbar fusion segment to a certain extent and provide a corresponding theoretical basis for further development in the clinic.

Stress-induced Hyperglycemia Ratio as an Independent Risk Factor of In-hospital Mortality in Nonresuscitation Intensive Care Units: A Retrospective Study.

PURPOSE: To determine whether the stress-induced hyperglycemia ratio (SHR) is independently associated with in-hospital mortality in critically ill patients in nonresuscitation ICUs. METHODS: In this retrospective cohort study, clinical- and laboratory-related data from patients first admitted to nonresuscitation ICUs were extracted from an open-access database of >50,000 ICU admissions. Patients were assigned to one of two groups according to an SHR threshold of 1.1. The primary end point of this study was the in-hospital mortality rate. The associations between SHR and length of stay in the ICU and hospital, duration of mechanical ventilation use, and vasopressor use were secondary end points. Logistic regression models were established in the analysis of in-hospital mortality risk, and areas under the receiver operating characteristic curve (AUC) were analyzed to investigate the association between the primary end point and SHR used alone or together with the Simplified Acute Physiology Scale (SAPS) II score. The Youden index, specificity, and sensitivity of SHR and SAPS-II were also assessed. FINDINGS: In this study, 1859 patients were included, 187 of whom (10.06%) died during hospitalization. The group with an SHR of ≥1.1 had a greater in-hospital mortality rate (13.7% vs 7.4%; P < 0.001), longer length of stay both in the ICU and in the hospital, a longer duration of mechanical ventilation use, and a greater rate of vasopressor use. On adjustment for multivariate risk, a 0.1-point increment in SHR was significantly associated with in-hospital mortality (OR = 1.08; 95% CI, 1.00-1.16; P = 0.036). The AUC of the association between risk and the SAPS-II score was significantly greater than that with SHR (0.797 [95% CI, 0.576-0.664] vs 0.620 [95% CI, 0.764-0.830]; P < 0.001). The AUC with SAPS-II + SHR was significantly greater than that with SAPS-II used alone (0.802 [95% CI, 0.770-0.835] vs 0.797 [95% CI, 0.764-0.830]; P = 0.023). The Youden index, specificity, and sensitivity of SAPS-II + SHR were 0.473, 0.703, and 0.770, respectively. IMPLICATIONS: Stress-induced hyperglycemia, as evaluated using the SHR, was associated with increased in-hospital mortality and worse clinical outcomes in these critically ill patients in nonresuscitation ICUs. SHR was an independent risk factor for in-hospital mortality, and when used together with the SAPS-II, added to the capacity to predict mortality in these patients in nonresuscitation ICUs. Prospective data are needed to validate the capacity of SHR in predicting in-hospital mortality in patients in the nonresuscitation ICU.

Near-Infrared Light-Responsive Multifunctional Photothermal/Photodynamic Titanium Diboride Nanocomposites for the Treatment of Antibiotic-Resistant Bacterial Infections.

Diseases caused by bacterial infection have resulted in serious harm to human health. It is crucial to develop a multifunctional antibiotic-independent antibacterial platform for combating drug-resistant bacteria. Herein, titanium diboride (TiB2) nanosheets integrated with quaternized chitosan (QCS) and indocyanine green (ICG) were successfully prepared as a synergetic photothermal/photodynamic antibacterial nanoplatform (TiB2-QCS-ICG). The TiB2-QCS-ICG nanocomposites exhibit effective photothermal conversion efficiency (24.92%) and excellent singlet oxygen (1O2) production capacity simultaneously under 808 nm near-infrared irradiation. QCS improved TiB2 stability and dispersion, while also enhancing adhesion to bacteria and further accelerating the destruction of bacteria by heat and 1O2. In vitro experiments indicated that TiB2-QCS-ICG had excellent antibacterial properties with an inhibition rate of 99.99% against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA), respectively. More importantly, in vivo studies revealed that the nanoplatform can effectively inhibit bacterial infection and accelerate wound healing. The effective wound healing rate in the TiB2-QCS-ICG treatment group was 99.6% which was much higher than control groups. Taken together, the as-developed TiB2-QCS-ICG nanocomposite provides more possibilities to develop metal borides for antibacterial infection applications.