The clinical characteristics of subcutaneous and mediastinal emphysema in anti-melanoma differentiation-associated 5 positive dermatomyositis associated with interstitial lung disease.

OBJECTIVES: To investigate the clinical characteristics of subcutaneous emphysema (SE) and mediastinal emphysema (ME) occurring in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated with interstitial lung disease (anti-MDA5-positive DM-ILD). METHODS: In this retrospective study, a total of 117 anti-MDA5-positive DM-ILD patients were admitted to our hospital. All patients underwent an assessment of autoantibodies, serum ferritin levels, and lung high-resolution CT scans. RESULTS: In patients with anti-MDA5-positive DM-ILD, the incidence of SE/ME was found to be 11.1%, which was significantly higher compared to patients with anti-synthetase syndrome (p<0.01). The mortality rate among anti-MDA5-positive DM-ILD patients with SE/ME was significantly higher than those without SE/ME (p=0.0022). There was no statistically significant difference in the occurrence of SE/ME between patients with positive anti-Ro-52 antibodies and those with negative anti-Ro-52 antibodies (p=0.18). Patients with higher serum ferritin levels (1000 ng/ml ≤serum ferritin ≤1500 ng/ml) had a higher likelihood of developing SE/ME compared to patients with lower serum ferritin levels (serum ferritin <500 ng/ml) (p<0.01). Among 13 anti-MDA5-positive DM-ILD patients with SE/ME, six (46.2%) developed SE/ME within 1 month of being diagnosed and 53.8% of patients underwent positive pressure ventilation prior to the onset of SE/ME. CONCLUSIONS: We found that SE/ME is not uncommon in anti-MDA5-positive DM-ILD and is an important factor associated with poor patient prognosis. The occurrence of SE/ME is correlated with high levels of serum ferritin and is not related to anti-Ro-52 antibodies. Rheumatologists should pay close attention to SE/ME caused by positive pressure ventilation in anti-MDA5-positive DM-ILD patients.

Toxic effects of freshwater grouper (Acrossocheilus fasciatus) eggs on poultry: Morphological and transcriptomic insights into hepatic toxicity.

Fish egg poisoning is a serious and neglected public menace that kills hundreds of people and numerous poultry each year. Freshwater groupers (Acrossocheilus fasciatus) are common food fish in the southeastern regions of China. Their toxic eggs are regarded as a significant public health concern. The molecular mechanisms of egg-toxin toxicity in freshwater grouper to poisoned organisms are elusive. In this study, black-boned chicks were exposed to toxic eggs from freshwater grouper at a lethal dose. The hepatic morphology of the intoxicated chick was assessed. An analysis of the liver gene expression profile was conducted by comparing samples exposed to toxic eggs with control samples using RNA-Seq. The result revealed that an increase in vacuolation and congestion was observed in chicks with toxic eggs exposure. The transcriptome analysis revealed 5421 genes with differential expression, comprising 2810 up-regulated and 2611 down-regulated genes. The genes were primarily linked to energy metabolism, cell apoptosis, cell adhesion, exogenous microbial infection, and cell junction. The most strongly upregulated genes were cholecystokinin (CCK), cholecystokinin A receptor (CCKAR), and unc-80 homolog, NALCN activator (UNC80), and the most downregulated genes were glycine amidinotransferase (GATM), fatty acid desaturase 2 (FADS2), and hexokinase 2 (HKDC1). GO term with the highest enrichment of DEGs is nucleosome assembly. According to KEGG pathways, the three most significant metabolic pathways in the liver are DNA replication, retinol metabolism, and steroid biosynthesis. The results could be crucial for comprehending the negative biological impacts of egg-toxin and its toxic mechanisms. The outcome could provide potential biomarkers of egg-toxin exposure in hepatic, which might be useful for manufacturing an antidote to egg-toxin and providing valuable insights for ecotoxicity studies.

Synthesis of Porous Fe3 C-Based Composite Beads as Heterogeneous Oxidation Catalysts.

A series of multiscale cementite/iron/porous carbon (CIPC-T) composites with extremely low nitrogen content and millimeter-size spherical morphology were prepared by simple carbothermal pyrolysis of resin spheres exchanged with ferric oxalate anions. CIPC-T materials are composed of highly disperse core-shell-structured Fe3 C/Fe@graphitic carbon (CI@GC) nanoparticles embedded in a porous amorphous carbon framework. A mechanism for the formation of the composites is proposed on the basis of the results of XRD, SEM, TEM, and thermogravimetric analysis. The Fe3 C content can be easily controlled just by using different carbothermal temperatures. The CIPC-T materials proved to be active as heterogeneous catalysts for oxidation of ethylbenzene to acetophenone and Fenton-like oxidation of methylene blue. For the first time, the role of Fe3 C in catalytic oxidation was confirmed. The spherical morphology of the composites and magnetic property facilitate separation of the catalyst from the reaction solution. More importantly, no leaching of iron active sites occurs during the reactions and the catalyst can be reused in continuous runs without obvious loss of activity. Such high stability of iron sites in the composites is ascribed to the protecting outer graphitic carbon shell of CI@GC.

Tandem radical cyclization for the construction of 1-difluoroalkylated isoquinolines via Cu catalyzed and visible light-promoted pathways.

A Cu/B2pin2 system promoted cyclization for the synthesis of 1-difluoroalkylated isoquinolines with vinyl isocyanides and bromodifluoroacetic derivatives in moderate to good yields was reported. This method provided a mild and efficient pathway for the construction of diverse 1-difluoroalkylated isoquinolines via a proposed tandem radical cyclization process.

Doxycycline Protects Thymic Epithelial Cells from Mitomycin C-Mediated Apoptosis In Vitro via Trx2-NF-κB-Bcl-2/Bax Axis.

BACKGROUND/AIMS: Age-associated and stress-induced involution of the thymus is accompanied by reduced numbers of thymic epithelial cells (TECs) and severe reduction in peripheral T cell repertoire specificities. These events seriously affect immune function, but the mechanisms involved are unclear. Our preliminary findings showed that doxycycline (Dox) could drive the proliferation of a TEC line (MTEC1 cells) partially via the MAPK signaling pathway. Dox can also up-regulate IL-6 and GM-CSF expression via the NF-κB and MAPK/ERK pathways. Herein, we investigate the effects and mechanisms used by Dox that protect against mitomycin C (MMC)-induced MTEC1 cell apoptosis. METHODS: MTEC1 cells were treated with Dox, MMC, and Dox plus MMC for different amounts of time. The expression of Trx2, NF-κB, Bcl-2, and Bax proteins were then detected by western blotting. RESULTS: Our findings show that Dox protects MTEC1 cells from MMC-induced apoptosis. Dox up-regulated the expression of Trx2 and promoted NF-κB phosphorylation. Meanwhile, Dox also increased the expression of Bcl-2, partially reduced the expression of Bax, and normalized the ratio of Bcl-2 to Bax. CONCLUSION: Dox exerts an anti-apoptosis function via the NF-κB-Bcl-2/Bax and Trx2-ASK1/JNK pathways in vitro. Therefore, Dox may represent a drug that could be used to attenuate thymic senescence, rescue thymic function, and promote T cell reconstitution.

Cytotoxicity of Triterpenes from Green Walnut Husks of Juglans mandshurica Maxim in HepG-2 Cancer Cells.

Among the classes of identified natural products, triterpenoids, one of the largest families, have been studied extensively for their diverse structures and variety of biological activities, including antitumor effects. In the present study, a phytochemical study of the green walnut husks of Juglans mandshurica Maxim led to the isolation of a new dammarane triterpene, 12ß, 20(R), 24(R)-trihydroxydammar-25-en-3-one (6), together with sixteen known compounds, chiefly from chloroform and ethyl acetate extracts. According to their structural characteristics, these compounds were divided into dammarane-type, oleanane- and ursane-type. Dammarane-type triterpenoids were isolated for the first time from the Juglans genus. As part of our continuing search for biologically active compounds from this plant, all of these compounds were also evaluated for their cytotoxic activities against the growth of human cancer cells lines HepG-2 by the MTT assay. The results were shown that 20(S)-protopanaxadiol, 2α,3ß,23-trihydroxyolean-12-en-28-oic acid and 2α,3ß,23-trihydroxyurs-12-en-28-oic acid exhibited better cytotoxicity in vitro with IC50 values of 10.32±1.13, 16.13±3.83, 15.97±2.47 µM, respectively. Preliminary structure-activity relationships for these compounds were discussed.

Studies on Cytotoxic Activity against HepG-2 Cells of Naphthoquinones from Green Walnut Husks of Juglans mandshurica Maxim.

Twenty-seven naphthoquinones and their derivatives, including four new naphthalenyl glucosides and twenty-three known compounds, were isolated from green walnut husks, which came from Juglans mandshurica Maxim. The structures of four new naphthalenyl glucosides were elucidated based on extensive spectroscopic analyses. All of these compounds were evaluated for their cytotoxic activities against the growth of human cancer cells lines HepG-2 by MTT [3-(4,5-dimethylthiazo l-2-yl)-2,5 diphenyl tetrazolium bromide] assay. The results were shown that most naphthoquinones in an aglycone form exhibited better cytotoxicity in vitro than naphthalenyl glucosides with IC50 values in the range of 7.33-88.23 µM. Meanwhile, preliminary structure-activity relationships for these compounds were discussed.

[Study on anti-tumor chemical constituents from pericarps of Juglans mandshurica].

OBJECTIVE: To study the anti-tumor chemical components of the pericarps of Juglans mandshurica. METHODS: The chemical constituents were isolated and purified by AB-8 macroporous adsorption resin, silica gel, Sephadex LH-20 columns and recrystallization. The structures were elucidated on the basis of physicochemical properties and NMR spectral data analysis. RESULTS: From the pericarps of Juglans mandshurica, twelve compounds were separated and identified as 3-methoxy juglone(1), 3-ethoxy juglone(2), 1,8-di-hydroxy anthraquinone (3), juglone (4), 2α, 3α, 19α-trihydroxy ursolic acid (5), 1α, 3ß-dihydroxy-olean-18-ene (6), methyl gallate (7), pterocarine(8), quercetin(9), kaempferol(10), daucosterol(11), and ß-sitosterol(12). CONCLUSION: Compounds 1 - 3 and 6 are isolated from the pericarps of Juglans mandshurica for the first time. Compounds 5 and 7 are isolated from Juglans genus for the first time.

Meta-Structured Covalent Organic Framework Nanocoatings with Active and Angle-Independent Structural Coloration.

High-performance multifunctional nanocoatings not only protect and enhance substrate materials but also offer additional functionalities. This demands a sophisticated coordination of the coating's inherent properties and microstructural features. Here, a multifunctional active nanocoating via meta-structural engineering of covalent organic framework (COF) deposition materials is presented. This COF nanocoating, characterized by well-defined micropores (1-2 nm), meta-structured textures (30-300 nm), tailored thickness (100-300 nm), and good uniformness, showcases a unique combination of angle-independent structural coloration and ultrafast responsiveness to gaseous stimuli. Remarkably, it demonstrates good compatibility with a wide range of inert substrate materials, from rigid ones like glass and metal to flexible elastomers and nanomaterial films of various shapes and sizes. This versatility enables the facile development of devices that can optically report information about their environments. Examples include chemically active coatings with ultrafast (≈10 ms) color-changing behaviors and programmable actuation behaviors upon exposure to gaseous stimuli, and mechanically active coatings that can detect substrate strain up to 50% yet maintain structural robustness and consistent coloration hue. It is believed that meta-structural engineering of COF nanocoatings on inert substrates can enable them to respond to environmental stimuli, potentially indicating a new trend in developing multifunctional materials and smart devices.

Hydroxyl-modified Nb4C3Tx MXene@ZnIn2S4 sandwich structure for photocatalytic overall water splitting.

Herein, a hydroxyl-modified MXene@ZnIn2S4 (Nb4C3Tx MXene@ZIS-OH) overall water splitting photocatalyst with a sandwich structure was prepared through an in-situ growth strategy and peroxyl plasma post-treatment. The Nb4C3Tx MXene@ZIS-OH exhibits outstanding catalytic performance, which generates the release rates of hydrogen (53.8 µmol g-1h-1) and oxygen (26.7 µmol g-1h-1) from the water under visible light irradiation. After four photocatalytic cycling, the photocatalytic overall water splitting activity of Nb4C3Tx MXene@ZIS-OH is still 95.9% of the initial activity, which indicates that Nb4C3Tx MXene@ZIS-OH exhibits excellent cycling stability. Notably, the Nb4C3Tx MXene@ZIS-OH achieves an AQY of 1.2% for the overall photocatalytic water splitting at 380 nm. The sandwich structure and matched heterointerface between high work function Nb4C3Tx MXene and ZnIn2S4 nanosheets promote the electron transport, inhibit the charge recombination, and separate the generated H2 and O2 with effectiveness. Importantly, the Finite-Difference Time-Domain (FDTD) simulation suggests the hydroxyl groups on the surface of ZnIn2S4 could increase the hydrophilicity of photocatalyst and capture the holes generated by photoexcitation, thereby promoting the separation of electron-hole pairs rapidly. This work presents a successful example of constructing overall water splitting photocatalysts by energy level regulation, structure design and functional group modification.

Construction of Ag nanocluster-modified Ag3PO4 containing silver vacancies via in-situ reduction: With enhancing the photocatalytic degradation activity of sulfamethoxazole.

Photocatalytic removal of sulfonamide antibiotics is an effective strategy to solve environmental pollution. Ag3PO4 is a promising anode material for photocatalytic material with photocatalytic degradation ability under ultraviolet light or natural light. Unfortunately, due to its instability, Ag+ could be reduced to Ag0 which loaded onto the surface of Ag3PO4 during the photocatalytic process, causing self-photocorrosion and resulting in the reduction of photocatalytic activity and stability. Herein, Ag3PO4 nanoparticles loaded with Ag nanoclusters containing Ag vacancies (Ag/Ag3PO4-VAg) were constructed by an in-situ reduction strategy to achieve effectively photocatalytic degradation behavior. The Ag nanoclusters loaded on the surface of Ag3PO4 can not only effectively inhibit the self-photocorrosion but also affords a localized surface plasmon resonance (LSPR) effect in the photocatalytic process, thus leading to the efficient generation and rapid transfer of photogenerated carriers behavior. In addition, the Ag vacancies in Ag3PO4 are crucial to increasing the adsorption energy of H2O for further enhancing the capture and accumulation of electrons. In detail, according to Zeta potential analysis, the strong adsorption sites of sulfamethoxazole (SMX) molecules are generated at the interface of Ag and Ag3PO4, which promote the activation of SMX molecules. A 100 ml of 20 mg/L SMX could be completely degraded within 15 min with an apparent rate constant (Kapp) of 0.306 min-1, which far exceeds the activity of most of the photocatalysts. This work may provide an attractive strategy to address the activity, stability of Ag3PO4 and and realizing the green remediation of SMX wastewater.

Ultra-small micelles together with UTMD enhanced the therapeutic effect of docetaxel on Glioblastoma.

Owing to the difficult-to-penetrate blood-brain barrier (BBB), glioblastoma (GBM) doesn't respond well to the current chemical therapeutics. In this study, ultra-small micelles (NMs) self-assembled by RRR-a-tocopheryl succinate-grafted-ε-polylysine conjugate (VES-g-ε-PLL) as the delivery vehicle of chemical therapeutics in conjunction with ultrasound-targeted microbubble destruction (UTMD) to surmount BBB and treat GBM. Docetaxel (DTX) as a hydrophobic model drug was incorporated into NMs. DTX-loaded micelles (DTX-NMs) with 3.08% of drug loading exhibited a hydrodynamic diameter (33.2 nm) and positive Zeta potential (16.9 mV), having a remarkable tumor-permeating capacity. Furthermore, DTX-NMs presented good stability in physiologic condition. The sustained- release profile of DTX-NMs was also displayed by dynamic dialysis. Treatment of DTX-NMs together with UTMD led to more pronounced apoptosis of C6 tumor cells than DTX-NMs alone. Moreover, compared with the DTX solution or DTX-NMs alone, the combination of DTX-NMs with UTMD had a stronger inhibitory effect on tumor growth for GBM-bearing rats. The median survival period of GBM-bearing rats was extended to 75 days in the DTX-NMs+UTMD group from under 25 days in the control group. The invasive growth of glioblastoma was largely inhibited by the combination of DTX-NMs with UTMD, which was demonstrated by staining of Ki67, caspase-3, and CD31, together with TUNEL assay. In conclusion, the combination of ultra-small micelles (NMs) with UTMD may be a promising strategy to overcome the limitations of the first-line chemotherapeutics against GBM.

Loading-Driven Diffusion Pathway Selectivity in Zeolites with Continuum Intersecting Channels.

The diffusion processes in zeolites are important for heterogeneous catalysis. Herein, we show that unique zeolites with "continuum intersecting channels" (e.g., BEC, POS, and SOV), in which two intersections are proximal, are greatly significant to the diffusion process with spontaneous switching of the diffusion pathway under varied loading. At low loading, the synergy of strong adsorption sites and molecular reorientation in intersections contribute to almost exclusive molecular diffusion in smaller channels. With an increase in molecular loading, the adsorbates are transported preferentially in larger channels mainly due to the lower diffusion barrier inside continuum intersection channels. This work demonstrates the ability to adjust the prior diffusion pathway by controlling the molecular loading, which may be beneficial for the separation of the product and byproduct in heterogeneous catalysis.

Porous SiO2-Based Reactor with Self-Supply of O2 and H2O2 for Synergistic Photo-Thermal/Photodynamic Therapy.

Purpose: Although the combined photo-thermal (PTT) and photodynamic therapy (PDT) of tumors have demonstrated promise as effective cancer therapy, the hypoxic and insufficient H2O2 supply of tumors seriously limits the efficacy of PDT, and the acidic environment reduces the catalytic activity of nanomaterial in the tumor microenvironment. To develop a platform for efficiently addressing these challenges, we constructed a nanomaterial of Aptamer@dox/GOD-MnO2-SiO2@HGNs-Fc@Ce6 (AMS) for combination tumor therapy. The treatment effects of AMS were evaluated both in vitro and in vivo. Methods: In this work, Ce6 and hemin were loaded on graphene (GO) through π-π conjugation, and Fc was connected to GO via amide bond. The HGNs-Fc@Ce6 was loaded into SiO2, and coated with dopamine. Then, MnO2 was modified on the SiO2. Finally, AS1411-aptamer@dox and GOD were fixed to gain AMS. We characterized the morphology, size, and zeta potential of AMS. The oxygen and reactive oxygen species (ROS) production properties of AMS were analyzed. The cytotoxicity of AMS was detected by MTT and calcein-AM/PI assays. The apoptosis of AMS to a tumor cell was estimated with a JC-1 probe, and the ROS level was detected with a 2',7'-Dichlorodihydrofluorescein diacetate (DCFH-DA) probe. The anticancer efficacy in vivo was analyzed by the changes in the tumor size in different treatment groups. Results: AMS was targeted to the tumor cell and released doxorubicin. It decomposed glucose to produce H2O2 in the GOD-mediated reaction. The generated sufficient H2O2 was catalyzed by MnO2 and HGNs-Fc@Ce6 to produce O2 and free radicals (•OH), respectively. The increased oxygen content improved the hypoxic environment of the tumor and effectively reduced the resistance to PDT. The generated •OH enhanced the ROS treatment. Moreover, AMS depicted a good photo-thermal effect. Conclusion: The results revealed that AMS had an excellent enhanced therapy effect by combining synergistic PTT and PDT.

Aligning curved stacking bands to simultaneously strengthen and toughen lamellar materials.

A layered architecture endows structural materials like nacre and biomimetic ceramics with enhanced mechanical performance because it introduces multiple strengthening and toughening mechanisms. Yet present studies predominantly involve enhancing the alignment in planar lamellar structures, and the effects of the stacking curvature have largely remained unexplored. Here we find that ordered curved stacking bands in lamellar structures act as a new structural mechanism to simultaneously improve strength and toughness. Aligned curved bands increase interlayer frictional resistance to show a strengthening effect and suppress the crack propagation to show an extrinsic toughening effect. In prototypical graphene oxide films, rational regulation of the intervals and orientations of curved bands bring a maximum 162% improvement in strength and 183% improvement in toughness simultaneously. Our results reveal the hidden effects of the stacking curvature on the mechanical behaviors of lamellar materials, opening an extra design dimension to fabricate stronger and tougher structural materials.

Fatty Acid-Binding Protein 4 in Patients with and without Diabetic Retinopathy.

BACKGROUND: Fatty acid-binding protein 4 (FABP4) has been demonstrated to be a predictor of early diabetic nephropathy. However, little is known about the relationship between FABP4 and diabetic retinopathy (DR). This study explored the value of FABP4 as a biomarker of DR in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 238 subjects were enrolled, including 20 healthy controls and 218 T2DM patients. Serum FABP4 levels were measured using a sandwich enzyme-linked immunosorbent assay. The grade of DR was determined using fundus fluorescence angiography. Based on the international classification of DR, all T2DM patients were classified into the following three subgroups: non-DR group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. Multivariate logistic regression analyses were employed to assess the correlation between FABP4 levels and DR severity. RESULTS: FABP4 correlated positively with DR severity (r=0.225, P=0.001). Receiver operating characteristic curve analysis was used to assess the diagnostic potential of FABP4 in identifying DR, with an area under the curve of 0.624 (37% sensitivity, 83.6% specificity) and an optimum cut-off value of 76.4 µg/L. Multivariate logistic regression model including FABP4 as a categorized binary variable using the cut-off value of 76.4 µg/L showed that the concentration of FABP4 above the cut-off value increased the risk of NPDR (odds ratio [OR], 3.231; 95% confidence interval [CI], 1.574 to 6.632; P=0.001) and PDR (OR, 3.689; 95% CI, 1.306 to 10.424; P=0.014). CONCLUSION: FABP4 may be used as a serum biomarker for the diagnosis of DR.

Diffusive Skin Effect in Zeolites.

Effective contact and collision between reactants and active sites are essential for heterogeneous catalysis. Herein, we investigated molecular diffusion in more than 200 kinds of zeolites, and an intriguing "diffusive skin effect" was observed, whereby molecules migrated along the pore walls of zeolites (i.e., diffusion trajectories) because of the effect of the guest-host interaction and diffusion barrier. Furthermore, it was found that such a "diffusive skin effect" of zeolites would strongly promote the contacts and collisions between reactants and active sites in the reaction process, which might effectively promote the zeolite-catalyzed performance. These new findings will provide some new fundamental understanding of zeolite catalytic mechanisms under confinement effect.

Vertical Growth of 2D Covalent Organic Framework Nanoplatelets on a Macroporous Scaffold for High-Performance Electrodes.

Hierarchically structural engineering of electrodes is critical to achieving high energy density and high power density in electrochemical energy storage (EES). However, rational regulation of the mesoscopic structure that coordinates microscopic and macroscopic structural features simultaneously remains a significant challenge. Here, the construction of electrodes with well-defined hierarchical pores spanning multiple length scales from 1 nm to 50 µm is reported. Vertically aligned 2D covalent organic framework (COF) nanoplatelets with a thickness around 30 nm are in situ grown on macroporous graphene aerogel scaffold by a reversible polycondensation-termination strategy. The obtained electrode thus combines abundant accessible active sites and efficient transport expressways for both ions and electrons. When used for supercapacitors, a superior gravimetric capacitance of 289 F g-1  as well as outstanding capacitance retention at both high charge/discharge rates of 77% from 0.5 to 50 A g-1  and high mass loading of 74% from 1.2 to 10.4 mg cm-2  are achieved. Hierarchical engineering of mesostructured 2D COF units on the macroporous scaffold will bring unprecedented structural designability and performance enhancement for EES electrodes.

Monodomain Liquid Crystals of Two-Dimensional Sheets by Boundary-Free Sheargraphy.

Eliminating topological defects to achieve monodomain liquid crystals is highly significant for the fundamental studies of soft matter and building long-range ordered materials. However, liquid crystals are metastable and sensitive to external stimuli, such as flow, confinement, and electromagnetic fields, which cause their intrinsic polycrystallinity and topological defects. Here, we achieve the monodomain liquid crystals of graphene oxide over 30 cm through boundary-free sheargraphy. The obtained monodomain liquid crystals exhibit large-area uniform alignment of sheets, which has the same optical polarized angle and intensity. The monodomain liquid crystals provide bidirectionally ordered skeletons, which can be applied as lightweight thermal management materials with bidirectionally high thermal and electrical conductivity. Furthermore, we extend the controllable topology of two-dimensional colloids by introducing singularities and disclinations in monodomain liquid crystals. Topological structures with defect strength from - 2 to + 2 were realized. This work provides a facile methodology to study the structural order of soft matter at a macroscopic level, facilitating the fabrication of metamaterials with tunable and highly anisotropic architectures.

Mandatory Mask-Wearing and Hand Hygiene Associated With Decreased Infectious Diseases Among Patients Undergoing Regular Hemodialysis: A Historical-Control Study.

Background: Infections are the second leading cause of death among patients undergoing hemodialysis. However, preventive measures against infectious diseases are limited and have not been made mandatory for patients. Objective: To investigate the incidence of infectious diseases before and during the coronavirus disease (COVID-19) pandemic. Design: A historical comparative study of a prospective cohort. Setting(s): February 1, 2015 to January 31, 2020 was defined as the period before the mitigative confrontation of the COVID-19 pandemic in China. The period from February 1 to June 29, 2020 was defined as the period of mitigative confrontation of the COVID-19 pandemic in China. Participants: A cohort of patients undergoing hemodialysis whose infectious disease episodes were documented prospectively in the hemodialysis unit of the Third Affiliated Hospital of Guangzhou Medical University since February 1, 2015. Methods: Mandatory mask-wearing and reinforced hand-hygiene education were implemented to prevent COVID-19 from January 23, 2020 in China. The incidence of infectious episodes, including catheter-related infection, digestive tract infection, upper respiratory tract infection (UTRI), pneumonia, and infection at other sites, were documented and compared in the periods before and during the pandemic. Results: The historical control group consisted of 157 patients, with 79 patients in the COVID-19 prevention group. The mask-wearing rate of patients increased from 1.5 to 100%. Hand sanitizer consumption increased significantly during the COVID-19 pandemic. The compliance rates of hand hygiene increased from 66, 75.5, to 55% in physicians, nurses, and other employees before the pandemic to 90.5, 92.5, and 76.5%, respectively. The incidences of UTRI and pneumonia decreased during the pandemic (p < 0.001). Notably, catheter-related and digestive tract infections also decreased during the pandemic (p = 0.003 and 0.034, respectively). A matched-pair study was conducted to further analyze the 79 individual changes in the incidences of infectious disease before and during the pandemic. As a result, the incidences of UTRI, pneumonia, catheter-related infections, digestive tract infections, and infections at other sites all decreased during the pandemic. Conclusions: The present study indicated an association between mandatory mask-wearing and reinforced hand hygiene education and decreased respiratory, catheter-related, and digestive tract infection episodes in the hemodialysis unit.