Atomic-scale strain engineering of atomically resolved Pt clusters transcending natural enzymes.

Strain engineering plays an important role in tuning electronic structure and improving catalytic capability of biocatalyst, but it is still challenging to modify the atomic-scale strain for specific enzyme-like reactions. Here, we systematically design Pt single atom (Pt1), several Pt atoms (Ptn) and atomically-resolved Pt clusters (Ptc) on PdAu biocatalysts to investigate the correlation between atomic strain and enzyme-like catalytic activity by experimental technology and in-depth Density Functional Theory calculations. It is found that Ptc on PdAu (Ptc-PA) with reasonable atomic strain upshifts the d-band center and exposes high potential surface, indicating the sufficient active sites to achieve superior biocatalytic performances. Besides, the Pd shell and Au core serve as storage layers providing abundant energetic charge carriers. The Ptc-PA exhibits a prominent peroxidase (POD)-like activity with the catalytic efficiency (Kcat/Km) of 1.50 × 109 mM-1 min-1, about four orders of magnitude higher than natural horseradish peroxidase (HRP), while catalase (CAT)-like and superoxide dismutase (SOD)-like activities of Ptc-PA are also comparable to those of natural enzymes. Biological experiments demonstrate that the detection limit of the Ptc-PA-based catalytic detection system exceeds that of visual inspection by 132-fold in clinical cancer diagnosis. Besides, Ptc-PA can reduce multi-organ acute inflammatory damage and mitigate oxidative stress disorder.

Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Cardiopulmonary Arrest in the Emergency Department: The First Case With Successful Return of Spontaneous Circulation in Taiwan.

Exsanguinating torso hemorrhage is a leading cause of death in trauma patients. Bleeding leads to hypothermia, acidosis, and coagulopathy, the so-called "lethal triad," and creates a vicious cycle. Therefore, bleeding control tops the priority list in the management of trauma patients. Placement of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with traumatic non-compressible torso hemorrhage is a developing technique in the emergency departments (EDs) in Taiwan, and it is a possible solution for abdominal and pelvic trauma patients with hemodynamic instability. It not only temporarily controls bleeding below the inflation site but also increases cerebral and coronary circulation. It can create a bridge for definitive care such as an operation or an embolization, possibly preventing death. Compared to thoracotomy followed by an aortic cross clamp, REBOA is a less invasive and possibly, a more efficient way to control the hemorrhage and may lead to better overall survival. The use of REBOA has been proven to be associated with improved survival-to-discharge in severely injured trauma patients. We report a case of out-of-hospital cardiac arrest caused by penetrating injury wherein return of spontaneous circulation was successfully achieved after 39-minute cardiopulmonary resuscitation and REBOA placement in the ED. The REBOA balloon was deflated after bleeding was stopped during the laparotomy operation. The patient was then transferred to the intensive care unit for postoperative care. Unfortunately, the patient passed away approximately 12 hours after the surgery.