Influence of Nutritional Status on Prognosis of Stroke Patients With Dysphagia.

Context: Stroke is an acute cerebrovascular disease and a neurological disorder that occurs due to a cerebral arterial embolism and rupture. Acute stroke is often accompanied by dysphagia, which reduces patients' intake of food and nutrients, decreases their nutritional status, and affects their quality of life. Objective: The study intended to identify the demographic and clinical characteristics of stroke patients with dysphagia and to explore the relationship of those characteristics to nutritional status and prognosis. Methods: The research team retrospectively collected the clinical data of patients to compare the nutritional status and prognoses of patients with different demographic and clinical characteristics. Setting: The study took place in the Department of Neurology at the First People's Hospital of Shenyang in Shenyang, China. Participants: Participants were 789 stroke patients with dysphagia who had been admitted to the general ward of the neurology departments of hospitals of Grade 3 or higher in Northeast China between January 2019 and September 2020. Based on the results of the Nutrition Risk Screening (NRS-2002) and Subjective Global Assessment (SGA) scales at baseline, participants were enrolled in this study. Outcome Measures: The outcomes were the correlations between participants' demographic and clinical characteristics and their nutritional statuses and prognoses. The Modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at seven days and three months after participants' enrollment in the study. Using the SPSS 26.0, a t test, chi-square test, and F test were performed to analyze and verify the presence of fundamental differences in baseline characteristics between participants with good nutrition and those with poor nutrition. Also, a statistical correlation analysis was performed. Results: The study showed that participants with different nutritional levels had statistically significant differences in the presence or absence of infections and body temperature and scores on the Standardized Swallowing Assessment (SSA) and National Institutes of Health Stroke Scale (NIHSS), with all P < .001. At baseline seven days after enrollment, the prognoses of participants were significantly different for different previous histories of stroke (P < .001), family history of stroke (P = .005), presence or absence of infections (P < .001), body temperature (P < .001), and SSA (P < .001) and NIHSS (P < .001) scale scores. At three months after enrollment, the prognoses of participants were significantly different for previous history of stroke (P = .003), different body temperatures (P < .001), presence or absence of infections(P < .001), and SSA (P < .001) and NIHSS (P < .001) scale scores. Age, gender, family history of stroke, smoking, alcohol consumption, previous history of stroke, education level, SSA scale score, NIHSS scale score, body mass index (BMI), body temperature, and infection were adjusted in the model. Nutritional status as classified by NRS-2002 and SGA was significantly correlated with prognosis (P < .001). The prognosis of stroke patients with dysphagia was associated with nutritional status by unconditional logistic regression. Conclusion: The prognosis of stroke patients with dysphagia is related to their nutritional status. A better nutritional status indicates the better prognosis, and vice versa. In clinical treatment, attention should be paid to use of a nutritional intervention.

Beyond C3N4 π-conjugated metal-free polymeric semiconductors for photocatalytic chemical transformations.

Photocatalysis with stable, efficient and inexpensive metal-free catalysts is one of the most promising options for non-polluting energy production. This review article covers the state-of-the-art development of various effective metal-free polymeric photocatalysts with large π-conjugated units for chemical transformations including water splitting, CO2 and N2 reduction, organic synthesis and monomer polymerisation. The article starts with the catalytic mechanisms of metal-free photocatalysts. Then a particular focus is on the rational manipulation of π-conjugation enlargement, charge separation, electronic structures and band structures in the design of metal-free polymeric photocatalysts. Following the design principles, the selection and construction of functional units are discussed, as well as the connecting bonds and dimensions of π-conjugated polymeric photocatalysts. Finally the hot and emerging applications of metal-free polymeric photocatalysts for photocatalytic chemical transformations are summarized. The strategies provide potential avenues to address the challenges of catalyst activity, selectivity and stability in the further development of highly effective metal-free polymeric photocatalysts.

Unpaired Electron-Induced Wide-Range Light Absorption within Zn (or Cu) MOFs Containing Electron-Withdrawing Ligands: A Theoretical and Experimental Study.

In photocatalysis, it is of general interest to understand and design wide-range light-absorbing inorganic/organic hybrid materials with an excellent photo-induced intramolecular charge-transfer (ICT) effect. To verify the role of unpaired electrons in enhancing ICT within electron-withdrawing ligand-based metal-organic frameworks (MOFs), the molecular structure, density of states (DOS), and electronic structure of strong electron-deficient pyridine-diketopyrrolopyrrole (P-DPP)-based Zn (or Cu) MOFs were calculated in Gaussian package to validate the unpaired electron ICT. The electron spin resonance technique has detected the unpaired electrons for the coordination systems containing Zn-O or Cu-O clusters and P-DPP ligand on photoexcitation. The estimated band gaps from the DOS calculation for P-DPP-Cu and P-DPP-Zn are 1.4 and 2.4 eV, respectively, showing a good agreement with the experimental UV-vis optical spectra. The partial DOS, dipole moment, and frontier orbital analysis prove that the ICT should happen from Zn-O or Cu-O clusters to P-DPP ligands. This research may contribute to a comprehensive understanding of electron-withdrawing ligand-induced ICT within MOFs and shed light on the design of light-absorbing MOFs with excellent ICT or conductivity.