Synthesis and Assembly of Photoresponsive Colloidal Tubes.

Inspired by the sophisticated multicomponent and multistage assembly of proteins and their mixtures in living cells, this study rationally designs and fabricates photoresponsive colloidal tubes that can self-assemble and hybrid-assemble when mixed with colloidal spheres and rods. Time-resolved observation and computer simulation reveal that the assembly is driven by phoretic attraction originating from osmotic pressures. These pressures are induced by the chemical concentration gradients generated by the photochemical reaction caused by colloidal tubes in a H2O2 solution under ultraviolet (UV) irradiation. The assembled structure is dictated by the size and shape of the constituent colloids as well as the intensity of the UV irradiation. Additionally, the resulting assembly can undergo self-propelled motion originating from the broken symmetry of the surrounding concentration gradients. This motion can be steered by a magnetic field and used for microscale cargo delivery. The study demonstrates a facile synthesis method for colloidal tubes and highlights their unique potential for controlled, hierarchical self-assembly and hybrid-assembly.

Colloidal antibiotic mimics: selective capture and killing of microorganisms by shape-anisotropic colloids.

The development of targeted and efficient antimicrobials for the selective killing of pathogenic bacteria is of great importance, yet remains challenging. Here, we propose a targeted approach to selectively capture and kill microorganisms with colloidal antibiotic mimics that are readily prepared by common chemical syntheses. The mimics are shape-anisotropic colloids, which can selectively capture shape-matching microorganisms due to lock-key depletion attractions. Furthermore, after being modified with gold nanoparticles (AuNPs) and irradiated with near-infrared light, the colloidal mimics can kill the selectively captured microorganisms due to the localized photothermal effect of the AuNPs. The work demonstrates the important ability of anisotropic colloids to selectively capture and precisely kill microorganisms, which holds considerable promise for safe and adaptive antibacterial therapies without the risk of antibiotic resistance.

Comparative study of the dynamics of colloidal glass and gel.

We investigate and compare the difference in the dynamics of two arrested states: colloidal glass and colloidal gel. Real-space experiments reveal two distinct nonergodicity origins for their slow dynamics, namely, cage effects for the glass and attractive bondings for the gel. Such distinct origins lead to a faster decay of the correlation function and a smaller nonergodicity parameter of the glass than those of the gel. We also find that the gel exhibits stronger dynamical heterogeneity compared with the glass due to the greater correlated motions in the gel. Moreover, a logarithmic decay in the correlation function is observed as the two nonergodicity origins merge, consistent with the mode coupling theory.

A Versatile Method for Synthesis of Light-Activated, Magnet-Steerable Organic-Inorganic Hybrid Active Colloids.

The immense potential of active colloids in practical applications and fundamental research calls for an efficient method to synthesize active colloids of high uniformity. Herein, a facile method is reported to synthesize uniform organic-inorganic hybrid active colloids based on the wetting effect of polystyrene (PS) with photoresponsive inorganic nanoparticles in a tetrahydrofuran/water mixture. The results show that a range of dimer active colloids can be produced by using different inorganic components, such as AgCl, ZnO, TiO2, and Fe2O3 nanoparticles. Moreover, the strategy provides a simple way to prepare dual-drive active colloids by a rational selection of the starting organic materials, such as magnetic PS particles that result in light and magnet dual-drive active colloids. The motions of these active colloids are quantified, and well-controlled movements are demonstrated.

Reconfiguring Self-Assembly of Photoresponsive Hybrid Colloids.

The reconfigurable self-assembly of colloidal particles allows the bottom-up creation of adaptive materials, yet significant challenges remain. Here, we demonstrate a synthesis of photoresponsive Fe2O3/polysiloxane hybrid colloids that perform a dynamically reconfigurable self-assembly. Such self-assembly is due to chemical gradients originating from the decomposition of H2O2 by the Fe2O3 component under UV irradiation. The morphology of the self-assembly includes chains and flower-structures, where the chains can be transformed in situ into flower-like structures with decreasing UV intensity. The flower-structures can be further switched by applying an external magnetic field, leading to orientationally ordered clusters. This, interestingly, leads to an asymmetrical chemical gradient surrounding the assemblies, and transforms the cluster into a micromotor exhibiting a self-propulsion steerable by the magnetic field. Our findings demonstrate a new possibility to control and reconfigure the self-assembly of colloids, which offers an important pathway for fabrications of adaptive and smart materials at the microscale.

Synthesis of Rod-Shaped ZnO/Polysiloxane Micromotors with Patch-Dependent Motion Modes.

Inorganic particles with photocatalytic properties are excellent candidates for the fabrication of micromotors. To achieve self-propulsion, the geometric and chemical symmetries of inorganic particles should be broken. However, the synthesis of micromotors with different geometric and chemical symmetries remains challenging. In this paper, a simple synthesis method is proposed to prepare rod-shaped micromotors with different patches, leading to distinct geometric and chemical symmetries. The micromotors are composed of zinc oxide (ZnO) microrods partially patched with polysiloxanes at different positions. The patches of the micromotors can be roughly regulated by varying the amount of siloxanes used in the synthesis. These micromotors are propelled in H2O2 solution by an ionic self-diffusiophoresis mechanism, which exhibits two motion modes, including linear motion and circular motion, due to different patch positions. Moreover, the degradation of organic dyes by the micromotors depending on the patches is demonstrated.

Clinical practice guidelines for management of dual antiplatelet therapy in patients with noncardiac surgery: A critical appraisal using the AGREE II instrument.

WHAT IS KNOWN AND OBJECTIVE: Despite the availability of clinical practice guidelines (CPGs), there are considerable differences in their recommendations in the perioperative management of stented patients who need elective noncardiac surgery. Our aim was to systematically review the quality of CPGs for perioperative management of dual antiplatelet therapy (DAPT) and summarize the recommendations. METHODS: A systematic search for perioperative DAPT guidelines was conducted on PubMed, Embase and websites of guideline organizations and professional societies until 4 February 2021. Independently, two assessors appraised the quality of CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and extracted the data. Recommendations were summarized, and a comparative study was conducted to analyse the consistency among guidelines. RESULTS AND DISCUSSION: A total of 10 guidelines fulfilled our inclusion criteria. The domain of scope and purpose and clarity of presentation obtained the highest median scores, while the domain of stakeholder involvement and rigour of development obtained the lowest median scores. Three guidelines (ACCP, ESC/ESA and ACC/AHA) with a score of at least 60% in most AGREE II domains were recommended. Recommendations across perioperative management of DAPT guidelines were inconsistent. WHAT IS NEW AND CONCLUSION: The ACCP, ESC/ESA and ACC/AHA CPGs were recommended. There is a need for high-quality prospective studies assessing different management strategies on this issue. Given the lack of consensus, the results of this study will help to guide perioperative dual antiplatelet management strategies for patients with coronary stents who are undergoing noncardiac surgery.

2D Colloidal Crystals with Anisotropic Impurities.

We report a study of 2D colloidal crystals with anisotropic ellipsoid impurities using video microscopy. It is found that at low impurity densities, the impurity particles behave like floating disorder with which the quasi-long-range orientational order survives and the elasticity of the system is actually enhanced. There is a critical impurity density above which the 2D crystal loses the quasi-long-range orientational order. At high impurity densities, the 2D crystal breaks into polycrystalline domains separated by grain boundaries where the impurity particles aggregate. This transition is accompanied by a decrease in the elastic moduli, and it is associated with strong heterogeneous dynamics in the system. The correlation length vs impurity density in the disordered phase exhibits an essential singularity at the critical impurity density.

Shape-Tunable Janus Micromotors via Surfactant-Induced Dewetting.

The ability to tune shapes of micromotors is challenging yet crucial for creating intelligent and functional micromachines with shape-dependent dynamics. Here, we demonstrate a facile strategy to synthesize Janus micromotors in large quantity whose shapes can be precisely tuned by a surfactant-induced dewetting strategy. The Janus micromotor is composed of a TiO2 microparticle partially encapsulated within a polysiloxane microsphere. A range of particle shapes, from approximately spherical to snowman, is achieved, and the shape-tunable dynamics of the micromotors are quantified. Our strategy is versatile and can be applicable to other photoactive materials, such as ZnO and Fe2O3 nanoparticles, demonstrating a general approach to synthesize Janus micromotors with controllable shapes. Such shape-tunable micromotors provide colloidal model systems for fundamental research on active matter, as well as building blocks for the fabrication of micromachines.

Impact of pharmacist-led medication therapy management in ambulatory elderly patients with chronic diseases.

AIMS: This study aimed to assess the impact of pharmacist-led medication therapy management (MTM) performed on ambulatory elderly patients with chronic diseases. METHODS: Patients who came to a pharmacist-led outpatient clinic between January 2016 and June 2018 were enrolled in this study. Eligible subjects received MTM services from the pharmacists at least twice a year and the clinical data of these patients were complete. Drug-related problems (DRPs) and recommendations were evaluated using The Pharmaceutical Care Network Europe Classification for Drug related problems V8.03. RESULTS: A total of 525 DRPs were identified during the study period. Treatment effectiveness (53.71%) was the most common DRP. The most frequently recommended intervention was changing the drug (48.76%). There were 92.38% patients accepting the interventions and 90.48% patients completely implemented. The number of drugs taken was the significant associated factor for DRPs. Postintervention data collection showed lower levels in systolic blood pressure (BP) and diastolic BP compared to the preintervention data collection. There were statistically significant changes in total cholesterol, low-density lipoprotein cholesterol and triglycerides between the pre- and postintervention data collections. The average cost of medications per patient for every month decreased from 387.72 to 355.17 renminbi (P = .009). CONCLUSION: We confirmed that pharmacists had a valuable role to perform MTM services for ambulatory elderly patients, not only in identifying and solving the DRPs, but also in improving clinical outcomes (BP and lipid level) and cost-saving effect.

2D isotropic-nematic transition in colloidal suspensions of ellipsoids.

Liquid crystals are important condensed matter systems for technological applications, as well as for fundamental studies. An important unresolved issue is the nature of the phase transition in a two-dimensional (2D) liquid crystal system. In contrast to numerous computational studies reported in the last few decades, there have been no convincing experiments to verify these numerical results. Anisotropic colloids provide an excellent experimental model system to study phase transitions, such as crystallization and glass transition in condensed matter physics with single particle resolution. However, using colloids to probe the two-dimensional liquid crystal transition remains a challenge, since the condensed anisotropic colloids usually become stuck in the metastable glassy state rather than approaching their equilibrium liquid crystal phase. Here we report a method of using an external magnetic field to assist a colloidal system of super-paramagnetic anisotropic particles to overcome the local free energy barriers in the metastable states and approach the equilibrium phase. The experiments demonstrate a 2D isotropic-nematic phase transition with increasing packing density. The effects of the anisotropy of the colloidal particles on the 2D isotropic-nematic transition are explored. Our experimental results are compared with those from previous computational work, and quantitative agreements are reached.

Motor and Rotor in One: Light-Active ZnO/Au Twinned Rods of Tunable Motion Modes.

Precise control of the motion of micromachines is the key to achieving their functions for practical applications. The main challenge is that a given micromachine can typically exhibit only one motion mode, i.e., translation or rotation, while having multiple modes of motion resulting from a simple actuation is still rare. Here we designed and synthesized photochemically powered zinc oxide/gold (ZnO/Au) rods that exhibit multiple motion modes. Under homogeneous UV irradiation, these ZnO/Au rods undergo a transition from ballistic motion to persistent rotational motion upon increasing the fuel concentration or the light intensity. In addition, the rods can switch modes from a circular motion to a helical motion and then a straight-line motion by tuning the angle of incident light. We envision that such attractive colloidal micromachines with controllable motions hold considerable promise for diverse practical applications.

Profiling the pattern of human TRB/IGH-CDR3 repertoire in liver transplantation patients via high-throughput sequencing analysis.

Immune processes in liver transplantation remain poorly understood. Acute allograft rejection in liver transplantation is a kind of T cell-mediated inflammatory disease accompanied by inflammatory cell infiltration. However, the effect of acute allograft rejection on the immunological characteristics of TCRs in peripheral blood mononuclear cell is unknown. In this study, we characterized the pattern of the human T cell receptor beta chain (TRB) and immunoglobulin heavy chain (IGH) complementarity-determining region 3 (CDR3) repertoires via high-throughput sequencing in 11 acute allograft rejection (AG) cases, 23 patients with stable allograft liver function (ST) who had liver transplantation performed and 20 healthy controls (HC). The diversity of TRB-CDR3 was significantly reduced in the AG group compared with the ST group and healthy controls (HC). The CDR3 and N-addition length distribution were not significantly different between the AG and ST groups. However, N-addition length distribution was significantly changed compared to HC. It seemed that AG used more short N-additions and healthy people used more long N-additions in TRB-CDR3 repertoire. Our findings suggested that the TRB-CDR3 region of AG had distinctive V gene use compared with that of HC. The characteristics of ST seemed to be in between those of AG and HC although the difference is not significant. Cluster analysis showed that the TRB repertoire could not effectively distinguish AG from ST. This research might give to a better understanding of the immune process of liver transplantation.

Diffusion of Anisotropic Colloids in Periodic Arrays of Obstacles.

Colloidal suspensions in confined geometries exhibit rich diffusion dynamics governed by particle shapes and particle-confinement interactions. Here, we propose a colloidal system, consisting of ellipsoids in periodic array of obstacles, to investigate the confined diffusion of anisotropic colloids. From the obstacle density-dependent diffusion, we discover a decoupling of translational and rotational diffusion in which only rotational motion is localized while translational motion remains diffusive. Moreover, by evaluating the probability distributions of displacements, we found Brownian but non-Gaussian diffusion behaviors with increasing the obstacle densities, which originates from the shape anisotropy of the colloid and the multiplicity of the local configurations of the ellipsoids with respect to the obstacle. Our results suggest that the shape anisotropy and spatial confinements play a vital role in the diffusion dynamics. It is important for understanding the transportations of anisotropic objects in complex environments.

Characterization of drug-related problems and associated factors in ambulatory patients in China.

WHAT IS KNOWN AND OBJECTIVE: This study aimed to investigate the prevalence and the type of drug-related problems (DRPs) in ambulatory patients and identify factors that may be associated with risk of DRPs. METHODS: Consecutive patients were enrolled from pharmacist outpatient clinics between January 2018 and June 2019. The pharmacists performed a comprehensive assessment of the patient's drug therapy. The DRPs and recommendations were evaluated using the DOCUMENT classification system. RESULTS AND DISCUSSION: The study population consisted of 248 patients with a mean age of 72.55 ± 6.29. The patients had a mean of 7.55 ± 4.72 ongoing medications during patients' routine clinic visits. A total of 1188 DRPs were identified during the study period. An average of 4.79 DRPs per patient was detected. Sixty-two different traditional Chinese patent medicines (TCPMs) contributed to 102 DRPs. Drug selection (24.9%) was the most common DRP followed by under treated (24.2%) and monitoring needed (24.2%). The number of medications taken was the significant factor for DRPs. Pharmacists made 1092 recommendations to address the DRPs (an average 0.92 recommendations per DRP). A change in therapy was the most common recommendation (43.6%), followed by the category 'monitoring' (28.6%). The overall acceptance rate of clinical pharmacist recommendations was 88.7%. More than a half (51.6%) of all interventions were assigned a moderate level of clinical significance. WHAT IS NEW AND CONCLUSION: Drug-related problems were commonly observed among ambulatory Chinese patients. Clinical pharmacists had a valuable role to play in identifying and solving the DRPs.

Characterization of a novel multi-domain xylanase from Clostridium clariflavum with application in hydrolysis of corn cobs.

OBJECTIVES: To develop a novel multi-catalytic domain (CD) xylanase Xyn2083 from Clostridium clariflavum by expression of its truncated forms in Escherichia coli and cooperation of xylanase with cellulase in the hydrolysis of waste lignocellulosic resources. RESULTS: Xyn2083 has two glycoside hydrolase family (GH) domains GH11 and GH10. These two catalytic domains functioned synergistically in xylan hydrolysis. The recombinant protein with GH11 domain, Xyn2083GH11, had the highest xylanase activity among three constructed truncated forms. The deletion of N-terminal extra amino acid residues of Xyn2083GH11 decreased catalytic activity as well as the stability of the enzyme. The hydrolysis rates of cellulose and xylan in the pretreated corn cobs were 90.56% and 72.80% with the addition of Xyn2083GH11 and cellulase, whereas those were 67.95% and 34.45% using sole cellulase respectively. The structural analysis of substrates indicated that the addition of Xyn2083GH11 led to a looser structure and more exposure of crystal cellulose for cellulase to approach. CONCLUSIONS: Since the native multi-CDs' xylanases are rare, the thermostable Xyn2083 provides a good source for functional studies of two CDs coexisted in one xylanase and for potential applications after modification.

Stimuli-Responsive Shape Switching of Polymer Colloids by Temperature-Sensitive Absorption of Solvent.

The dynamic manipulation of colloidal particle shape offers a novel design mechanism for the creation of advanced responsive materials. To this end, we introduce a versatile new strategy for shape control of anisotropic polymeric colloidal particles. The concept utilizes temperature-sensitive absorption of a suitable solvent from a binary mixture. Specifically, increasing the temperature in the vicinity of the demixing transition of a binary mixture causes more solvent to be absorbed into the polymeric colloidal particle, which, in turn, lowers the glass transition temperature of the polymer inside the particle, with a concomitant decrease in viscosity. The balance between the internal viscosity and surface tension of the particle is thus disrupted, and the anisotropic shape of the particle shifts to become more spherical. Subsequent rapid temperature quenching can halt the process, leaving the particle with an intermediate anisotropy. The resultant shape anisotropy control provides new routes for studies of the phase transitions of anisotropic colloids and enables the fabrication of unique particles for materials applications.

Revisit to phase diagram of poly(N-isopropylacrylamide) microgel suspensions by mechanical spectroscopy.

Microgels are soft particles that can be deformed and compressed, which would induce intriguing phase behaviors at high packing fractions. Poly(N-isopropylacrylamide) (PNIPAM) microgels, with a lower critical solution temperature (LCST) of 33 °C, have attracted considerable interests as model colloids, since the volume of them and the interaction between the microgels can be tuned precisely by temperature. In this work, the linear viscoelastic properties of PNIPAM microgel suspensions have been investigated using mechanical spectroscopy. A particular attention is focused on the phase behaviors at high concentrations. With increasing concentration the system undergoes a repulsive glass-to-gel transition below the LCST, while, as temperature is raised across the LCST, the system undergoes a gel-to-attractive glass transition. A mechanism of these transitions for the microgels is proposed based on the directional interaction between the particles. In moderate concentration or de-swelling microgels the interaction is isotropic leading to the glass phase, while in concentrated and deformed microgels the interaction is directional leading to the gel phase. Our results enrich the current understanding of the phase transition in microgel systems and shed new light on the phase diagram of colloidal suspensions in general.

Comparison of the safety profiles for pirfenidone and nintedanib: a disproportionality analysis of the US food and drug administration adverse event reporting system.

Background: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease of unknown etiology. Pirfenidone (PFD) and nintedanib (NDN) were both conditionally recommended in the clinical practice guideline published in 2015. Safety and tolerability are related to the risk of treatment discontinuation. Therefore, this study evaluated and compared the adverse events (AEs) of PFD and NDN in a large real-world population by analyzing data from the FDA Adverse Event Reporting System (FAERS) to provide a reference for their rational and safe use. Methods: The AEs of PFD and NDN were extracted from the FAERS database. The pharmacovigilance online analysis tool OpenVigil 2.1 was used to retrieve data from the FAERS database from the first quarter of 2012 to the second quarter of 2022. The reporting odds ratio (ROR) and proportional reporting ratio were used to detect the risk signals. Results: The database included 26,728 and 11,720 reports for PFD and NDN, respectively. The most frequent AEs of PFD and NDN were gastrointestinal disorders. The RORs for these drugs were 5.874 and 5.899, respectively. "Cardiac disorders" was the most statistically significant system order class for NDN with an ROR of 9.382 (95% confidence interval = 8.308-10.594). Furthermore, the numbers of designated medical events of PFD and NDN were 552 and 656, respectively. Notably, liver injury was reported more frequently for NDN (11.096%) than for PFD (6.076%). Conclusion: This study revealed differences in the reporting of AEs between PFD and NDN. The findings provide reference for physicians in clinical practice. Attention should be paid to the risks of cardiac disorders and liver injury associated with NDN.

Development of a nomogram for predicting liver transplantation prognosis in hepatocellular carcinoma.

BACKGROUND: At present, liver transplantation (LT) is one of the best treatments for hepatocellular carcinoma (HCC). Accurately predicting the survival status after LT can significantly improve the survival rate after LT, and ensure the best way to make rational use of liver organs. AIM: To develop a model for predicting prognosis after LT in patients with HCC. METHODS: Clinical data and follow-up information of 160 patients with HCC who underwent LT were collected and evaluated. The expression levels of alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin, Golgi protein 73, cytokeratin-18 epitopes M30 and M65 were measured using a fully automated chemiluminescence analyzer. The best cutoff value of biomarkers was determined using the Youden index. Cox regression analysis was used to identify the independent risk factors. A forest model was constructed using the random forest method. We evaluated the accuracy of the nomogram using the area under the curve, using the calibration curve to assess consistency. A decision curve analysis (DCA) was used to evaluate the clinical utility of the nomograms. RESULTS: The total tumor diameter (TTD), vascular invasion (VI), AFP, and cytokeratin-18 epitopes M30 (CK18-M30) were identified as important risk factors for outcome after LT. The nomogram had a higher predictive accuracy than the Milan, University of California, San Francisco, and Hangzhou criteria. The calibration curve analyses indicated a good fit. The survival and recurrence-free survival (RFS) of high-risk groups were significantly lower than those of low- and middle-risk groups (P < 0.001). The DCA shows that the model has better clinical practicability. CONCLUSION: The study developed a predictive nomogram based on TTD, VI, AFP, and CK18-M30 that could accurately predict overall survival and RFS after LT. It can screen for patients with better postoperative prognosis, and improve long-term survival for LT patients.