Safety and Efficacy of Reteplase Versus Alteplase for Acute Ischemic Stroke: A Phase 2 Randomized Controlled Trial.

BACKGROUND: Reteplase is a more affordable new-generation thrombolytic with a prolonged half-life. We aimed to determine the safety dose range of reteplase for patients with acute ischemic stroke within 4.5 hours of onset. METHODS: This is a multicenter, prospective, randomized controlled, open-label, blinded-end point phase 2 clinical trial. Patients with acute ischemic stroke aged between 18 and 80 years who were eligible for standard intravenous thrombolysis were enrolled from 17 centers in China and randomly assigned (1:1:1) to receive intravenous reteplase 12+12 mg, intravenous reteplase 18+18 mg, or intravenous alteplase 0.9 mg/kg. The primary safety outcome was symptomatic intracranial hemorrhage (SITS definition) within 36 hours. The primary efficacy outcome was the proportion of patients with the National Institutes of Health Stroke Scale score of no more than 1 or a decrease of at least 4 points from the baseline at 14 days after thrombolysis. RESULTS: Between August 2019 and May 2021, 180 patients were randomly assigned to reteplase 12+12 mg (n=61), reteplase 18+18 mg (n=67), or alteplase (n=52). Four patients did not receive the study agent. Symptomatic intracranial hemorrhage occurred in 3 of 60 (5.0%) in the reteplase 12+12 mg group, 1 of 66 (1.5%) in the reteplase 18+18 mg group, and 1 of 50 (2.0%) in the alteplase group (P=0.53). The primary efficacy outcome in the modified intention-to-treat population occurred in 45 of 60 (75.0%) in the reteplase 12+12 mg group (odds ratio, 0.85 [95% CI, 0.35-2.06]), 48 of 66 (72.7%) in the reteplase 18+18 mg group (odds ratio, 0.75 [95% CI, 0.32-1.78]), and 39 of 50 (78.0%) in alteplase group. CONCLUSIONS: Reteplase was well tolerated in patients with acute ischemic stroke within 4.5 hours of onset in China with a similar efficacy profile to alteplase. The efficacy and appropriate dosage of reteplase for patients with acute ischemic stroke need prospective validation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04028518.

Tenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial.

BACKGROUND: There is increasing interest in replacing alteplase with tenecteplase as the preferred thrombolytic treatment for patients with acute ischaemic stroke. We aimed to establish the non-inferiority of tenecteplase to alteplase for these patients. METHODS: In this multicentre, prospective, open-label, blinded-endpoint, randomised controlled, non-inferiority trial, adults with an acute ischaemic stroke who were eligible for standard intravenous thrombolysis but ineligible for endovascular thrombectomy were enrolled from 53 centres in China and randomly assigned (1:1) to receive intravenous tenecteplase (0·25 mg/kg, maximum dose of 25 mg) or intravenous alteplase (0·9 mg/kg, maximum dose of 90 mg). Participants had to be able to receive treatment within 4·5 h of stroke, have a modified Rankin Scale (mRS) score of no more than 1 before enrolment, and have a National Institutes of Health Stroke Scale score of 5-25. Patients and treating clinicians were not masked to group assignment; clinicians evaluating outcomes were masked to treatment type. The primary efficacy outcome was the proportion of participants who had a mRS score of 0-1 at 90 days, assessed in the modified intention-to-treat population (all randomly assigned participants who received the allocated thrombolytic), with a non-inferiority margin of 0·937 for the risk ratio (RR). The primary safety outcome was symptomatic intracranial haemorrhage within 36 h, assessed in all participants who received study drug and had a safety assessment available. The trial is registered with ClinicalTrials.gov, NCT04797013, and has been completed. FINDINGS: Between June 12, 2021, and May 29, 2022, 1430 participants were enrolled and randomly assigned to tenecteplase (n=716) or alteplase (n=714). Six patients assigned to tenecteplase and seven to alteplase did not receive study product, and five participants in the tenecteplase group and 11 in the alteplase group were lost to follow-up at 90 days. The primary outcome in the modified intention-to-treat population occurred in 439 (62%) of 705 in the tenecteplase group versus 405 (58%) of 696 in the alteplase group (RR 1·07, 95% CI 0·98-1·16). The lower limit of the RR's 95% CI was greater than the non-inferiority margin. Symptomatic intracranial haemorrhage within 36 h was observed in 15 (2%) of 711 in the tenecteplase group and 13 (2%) of 706 in the alteplase group (RR 1·18, 95% CI 0·56-2·50). Mortality within 90 days occurred in 46 (7%) individuals in the tenecteplase group versus 35 (5%) in the alteplase group (RR 1·31, 95% CI 0·86-2·01). INTERPRETATION: Tenecteplase was non-inferior to alteplase in people with ischaemic stroke who were eligible for standard intravenous thrombolytic but ineligible for or refused endovascular thrombectomy. FUNDING: National Science and Technology Major Project, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Natural Science Foundation of China, and China Shijiazhuang Pharmaceutical Company Recomgen Pharmaceutical (Guangzhou).

Mycobacterium bovis BCG Given at Birth Followed by Inactivated Respiratory Syncytial Virus Vaccine Prevents Vaccine-Enhanced Disease by Promoting Trained Macrophages and Resident Memory T Cells.

Respiratory syncytial virus (RSV) infects more than 60% of infants in their first year of life. Since an experimental formalin-inactivated (FI) RSV vaccine tested in the 1960s caused enhanced respiratory disease (ERD), few attempts have been made to vaccinate infants. ERD is characterized by Th2-biased responses, lung inflammation, and poor protective immune memory. Innate immune memory displays an increased nonspecific effector function upon restimulation, a process called trained immunity, or a repressed effector function upon restimulation, a process called tolerance, which participates in host defense and inflammatory disease. Mycobacterium bovis bacillus Calmette-Guérin (BCG) given at birth can induce trained immunity as well as heterologous Th1 responses. We speculate that BCG given at birth followed by FI-RSV may alleviate ERD and enhance protection through promoting trained immunity and balanced Th immune memory. Neonatal mice were given BCG at birth and then vaccinated with FI-RSV+Al(OH)3. BCG/FI-RSV+Al(OH)3 induced trained macrophages, tissue-resident memory T cells (TRM), and specific cytotoxic T lymphocytes (CTL) in lungs and inhibited Th2 and Th17 cell immune memory, all of which contributed to inhibition of ERD and increased protection. Notably, FI-RSV+Al(OH)3 induced tolerant macrophages, while BCG/FI-RSV+Al(OH)3 prevented the innate tolerance through promoting trained macrophages. Moreover, inhibition of ERD was attributed to trained macrophages or TRM in lungs but not memory T cells in spleens. Therefore, BCG given at birth to regulate trained immunity and TRM may be a new strategy for developing safe and effective RSV killed vaccines for young infants. IMPORTANCE RSV is the leading cause of severe lower respiratory tract infection of infants. ERD, characterized by Th2-biased responses, inflammation, and poor immune memory, has been an obstacle to the development of safe and effective killed RSV vaccines. Innate immune memory participates in host defense and inflammatory disease. BCG given at birth can induce trained immunity as well as heterologous Th1 responses. Our results showed that BCG/FI-RSV+Al(OH)3 induced trained macrophages, TRM, specific CTL, and balanced Th cell immune memory, which contributed to inhibition of ERD and increased protection. Notably, FI-RSV+Al(OH)3 induced tolerant macrophages, while BCG/FI-RSV+Al(OH)3 prevented tolerance through promoting trained macrophages. Moreover, inhibition of ERD was attributed to trained macrophages or TRM in lungs but not memory T cells in spleens. BCG at birth as an adjuvant to regulate trained immunity and TRM may be a new strategy for developing safe and effective RSV killed vaccines for young infants.

Surface acoustic wave manipulation of bioparticles.

The introduction of surface acoustic waves (SAWs) into lab-on-a-chip microfluidic systems has contributed to the development of a new cutting-edge technology-SAW-based micro/nano manipulation. Recently, the SAW technology has emerged as an important tool for manipulating micro/nano particles/cell populations by virtue of its simplicity, biocompatibility, non-invasiveness, scalability, and versatility. In custom-designed acoustic fields, this technology can be used to manipulate cells, bacteria, exosomes, and even worms precisely, and it has been used in applications such as biomedical and point-of-care diagnostic systems. In this review paper, we start by providing a comprehensive overview of the fundamental working principle and numerical simulation of SAW-based manipulation. Then, we introduce the recent advancements in the manipulation of organisms based on standing and traveling SAWs, including separation, concentration, and transport. At the end of the review, we discuss the current challenges to and future prospects of SAW-based manipulation. The conclusion is that the SAW technology will open up a new frontier in the microfluidics field and contribute significantly to the development of bioengineering research and applications.

Cobalt-doped tin disulfide catalysts for high-capacity lithium-air batteries with high lifetime.

Dual electrolyte lithium-air batteries have received widespread attention for their ultra-high energy density. However, the low internal redox efficiency of these batteries results in a relatively short operating life. SnS2 is widely used in Li-S batteries, Li-ion batteries, photocatalysis, and other fields due to the high discharge capacity in batteries. However, SnS2 suffers from low electrical conductivity and slow redox kinetics. In this study, Co-doped SnS2 is prepared by hydrothermal method for application in dual-electrolyte lithium-air batteries to study its electrochemical performance and its catalytic reaction process by DFT theory. Conductivity tests show that the Co doping enhances the electrical conductivity of the material and high transmission electron microscopy (HRTEM) results demonstrate that the Co doping of SnS2 increases the grain plane spacing and the material indicates that defects are created on the surface of the material, which is more beneficial to the electrochemical performance of the cell. Co-doped SnS2 exhibits excellent good cycling stability and high discharge capacity in a dual electrolyte lithium-air battery, maintaining a 0.7 V overpotential for 120 h at a current density of 0.1 mA cm-2, with a cell life of over 500 h and an initial discharge capacity showing excellent results up to 16 065 mA h g-1. In addition, this study explores the catalytic activity of Co-doped SnS2 based on density flooding theory (DFT). The results show that Co atoms have a synergistic effect with Sn atoms to perturb the lattice parameters. The calculations show that the catalytic activity is enhanced with the increasing of Co doping content and 3Co-Sn exhibits minimal overpotential.

Label-free characterization of different kinds of cells using optoelectrokinetic-based microfluidics.

We report a novel, to the best of our knowledge, method to rapidly characterize different kinds of cells and drug-treated cancer cells using a label-free biomarker of self-rotation in an optoelectrokinetics (OEK)-based microfluidic platform. OEK incorporates optics and electrokinetics into microfluidics, thereby offering a contact-free, label-free, and rapid approach to the cellular manipulation community. Self-rotational behaviors of four different kinds of cells were experimentally investigated by the frequency-sweeping of an AC bias potential in an optically induced nonuniform and irrotational electric field. The results revealed that these kinds of cells displayed a Gaussian distribution versus the AC frequency as well as different self-rotational speeds under the same conditions. Furthermore, the peak self-rotational speed varied from one kind of cell to another, with that of cancer cells higher than that of normal cells. In addition, MCF-7 cells treated by various concentrations of drug showed remarkably different self-rotational speeds. This finding suggests a high potential of developing a new label-free biomarker to rapidly distinguish different kinds of cancer cells and quantitatively monitor the response of cancer patients to various treatments.

Recent advances in AFM-based biological characterization and applications at multiple levels.

Atomic force microscopy (AFM) has found a wide range of bio-applications in the past few decades due to its ability to measure biological samples in natural environments at a high spatial resolution. AFM has become a key platform in biomedical, bioengineering and drug research fields, enabling mechanical and morphological characterization of live biological systems. Hence, we provide a comprehensive review on recent advances in the use of AFM for characterizing the biomechanical properties of multi-scale biological samples, ranging from molecule, cell to tissue levels. First, we present the fundamental principles of AFM and two AFM-based models for the characterization of biomechanical properties of biological samples, covering key AFM devices and AFM bioimaging as well as theoretical models for characterizing the elasticity and viscosity of biomaterials. Then, we elaborate on a series of new experimental findings through analysis of biomechanics. Finally, we discuss the future directions and challenges. It is envisioned that the AFM technique will enable many remarkable discoveries, and will have far-reaching impacts on bio-related studies and applications in the future.

Synthesis of SnO2 nanoparticles for formaldehyde detection with high sensitivity and good selectivity.

During the detection of industrial hazardous gases, like formaldehyde (HCHO), the selectivity is still a challenging issue. Herein, an alternative HCHO chemosensor that based on the tin oxide nanoparticles is proposed, which was obtained through a facile hydrothermal method. Gas sensing performances showed that the optimal working temperature located at only 180 °C, the response value of 79 via 50 ppm HCHO was much higher than that of 35 at 230 °C. However, the compromised test temperature was selected as 230 °C, taking into account the faster response/recovery speeds than 180 °C, named 20/23versus 53/60 s, respectively. The response (35) of the SnO2 nanoparticles-based sensor to 50 ppm of HCHO is about 400% higher than that of bulk SnO2 sensor (9), especially when the gas concentration is 1 ppm, SnO2 nanoparticles also has a higher sensitivity which may possibly result from more exposed active sites and small size effect for nanoparticles than for bulk ones. The gas sensor based on SnO2 nanoparticles can be utilized as a promising candidate for practical low-temperature detectors of HCHO due to its higher gas response, excellent response-recovery properties, and perfect selectivity.

IFN-α affects Th17/Treg cell balance through c-Maf and associated with the progression of EBV- SLE.

OBJECTIVES: Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease, of which the pathogens is remains obscure. Viral infection, particularly Epstein Barr viru (EBV) infection, has been considered a common pathogenic factor. This study suggests that c-Maf may be an important target in T cell differentiation during SLE progression, providing a potentially new perspective on the role of viral infection in the pathogenesis of autoimmune diseases. METHODS: Cytokines of EBV-infected SLE patients were measured by ELISA and assessed in conjunction with their clinical data. IFN-α, c-Maf, and the differentiation of Th17/Treg cells in SLE patients and MRL/LPR mice were analyzed using FCM, WB, RT-PCR, etc. Following the infection of cells and mice with EBV or viral mimic poly (dA:dT), the changes of the aforementioned indicators were investigated. The relationship among IFN-α, STAT3, c-Maf and Th17 cells was determined by si-RNA technique. RESULTS: Many SLE patients are found to be complicated by viral infections; Further, studies have demonstrated that viral infection, especially EBV, is involved in SLE development. This study showed that viral infections might promote IFN-α secretion, inhibit c-Maf expression by activating STAT3, increase Th17 cell differentiation, and lead to the immune imbalance of Th17/Treg cells, thus playing a role in the onset and progression of SLE. CONCLUSION: This study demonstrates that EBV infections may contribute to SLE development by activating STAT3 through IFN-α, inhibiting c-Maf, and causing Th17/Treg immune imbalance. Our work provided a new insight into the pathogenesis and treatment of SLE.

Outcomes associated to the time to treatment with intravenous tenecteplase for acute ischaemic stroke: subgroup analysis of the TRACE-2 randomised controlled clinical trial.

BACKGROUND: The benefit of intravenous alteplase in acute ischaemic stroke (AIS) is time-dependent. Tenecteplase is non-inferior to alteplase among patients with AIS. We aimed to delineate the association of the stroke onset to treatment time (OTT) with tenecteplase compared with alteplase on therapeutic benefit and clinical risks. METHODS: This is a post hoc analysis of the Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-2 an open-label, randomised, controlled, non-inferior trial. A total of 1430 AIS within 4.5 hours onset at 53 sites in China from 12 June 2021 to 29 May 2022 were randomly assigned (1:1) to receive either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg. The primary efficacy outcome was the proportion of participants with a modified Rankin Scale score of 0-1 at 90 days. A post hoc subgroup analysis was conducted with the OTT divided into three intervals (0-90 min, 91-180 min and 181-270 min). The primary safety outcome was symptomatic intracranial haemorrhage within 36 hours post-thrombolytic treatment. RESULTS: Treatment was initiated within 270 min of stroke onset in 1412 patients who were randomly allocated to either tenecteplase (n=707) or alteplase (n=705). The OR of primary efficacy outcome was similar as OTT increased (p=0.84). Adjusted odds of an excellent functional outcome were 0.99 (95% CI 0.37 to 2.67) for 0-90 min, 1.23 (95% CI 0.88 to 1.71) for 91-180 min and 1.21 (95% CI 0.88 to 1.65) for 181-270 min. All were in favour of the tenecteplase group. Meta-analysis of 2949 patients yielded a pooled risk difference of 5.54 (95% CI -0.18 to 11.26; p=0.82) in favour of tenecteplase for more than 180 min and 1.77 (95% CI -2.66 to 6.20; p=0.58) for 0-180 min. CONCLUSIONS: In AIS patients who were treated with either tenecteplase or alteplase within 4.5 hours onset, there was no difference observed in the efficacy and safety between the two groups at the three different OTT time intervals.

Accurate and Automatic Extraction of Cell Self-Rotation Speed in an ODEP Field Using an Area Change Algorithm.

Cells are complex biological units that can sense physicochemical stimuli from their surroundings and respond positively to them through characterization of the cell behavior. Thus, understanding the motions of cells is important for investigating their intrinsic properties and reflecting their various states. Computer-vision-based methods for elucidating cell behavior offer a novel approach to accurately extract cell motions. Here, we propose an algorithm based on area change to automatically extract the self-rotation of cells in an optically induced dielectrophoresis field. To obtain a clear and complete outline of the cell structure, dark corner removal and contrast stretching techniques are used in the pre-processing stage. The self-rotation speed is calculated by determining the frequency of the cell area changes in all of the captured images. The algorithm is suitable for calculating in-plane and out-of-plane rotations, while addressing the problem of identical images at different rotation angles when dealing with rotations of spherical and flat cells. In addition, the algorithm can be used to determine the motion trajectory of cells. The experimental results show that the algorithm can efficiently and accurately calculate cell rotation speeds of up to ~155 rpm. Potential applications of the proposed algorithm include cell morphology extraction, cell classification, and characterization of the cell mechanical properties. The algorithm can be very helpful for those who are interested in using computer vision and artificial-intelligence-based ideology in single-cell studies, drug treatment, and other bio-related fields.

Proline metabolism reprogramming of trained macrophages induced by early respiratory infection combined with allergen sensitization contributes to development of allergic asthma in childhood of mice.

Background: Infants with respiratory syncytial virus (RSV)-associated bronchiolitis are at increased risk of childhood asthma. Recent studies demonstrated that certain infections induce innate immune memory (also termed trained immunity), especially in macrophages, to respond more strongly to future stimuli with broad specificity, involving in human inflammatory diseases. Metabolic reprogramming increases the capacity of the innate immune cells to respond to a secondary stimulation, is a crucial step for the induction of trained immunity. We hypothesize that specific metabolic reprogramming of lung trained macrophages induced by neonatal respiratory infection is crucial for childhood allergic asthma. Objective: To address the role of metabolic reprogramming in lung trained macrophages induced by respiratory virus infection in allergic asthma. Methods: Neonatal mice were infected and sensitized by the natural rodent pathogen Pneumonia virus of mice (PVM), a mouse equivalent strain of human RSV, combined with ovalbumin (OVA). Lung CD11b+ macrophages in the memory phase were re-stimulated to investigate trained immunity and metabonomics. Adoptive transfer, metabolic inhibitor and restore experiments were used to explore the role of specific metabolic reprogramming in childhood allergic asthma. Results: PVM infection combined with OVA sensitization in neonatal mice resulted in non-Th2 (Th1/Th17) type allergic asthma following OVA challenge in childhood of mice. Lung CD11b+ macrophages in the memory phage increased, and showed enhanced inflammatory responses following re-stimulation, suggesting trained macrophages. Adoptive transfer of the trained macrophages mediated the allergic asthma in childhood. The trained macrophages showed metabolic reprogramming after re-stimulation. Notably, proline biosynthesis remarkably increased. Inhibition of proline biosynthesis suppressed the development of the trained macrophages as well as the Th1/Th17 type allergic asthma, while supplement of proline recovered the trained macrophages as well as the allergic asthma. Conclusion: Proline metabolism reprogramming of trained macrophages induced by early respiratory infection combined with allergen sensitization contributes to development of allergic asthma in childhood. Proline metabolism could be a well target for prevention of allergic asthma in childhood.

A risk score based on baseline risk factors for predicting mortality in COVID-19 patients.

BACKGROUND: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. METHODS: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. RESULTS: Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts. CONCLUSIONS: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.

Preparation of cobalt sulfide@reduced graphene oxide nanocomposites with outstanding electrochemical behavior for lithium-ion batteries.

Cobalt sulfide@reduced graphene oxide composites were prepared through a simple solvothermal method. The cobalt sulfide@reduced graphene oxide composites are composed of cobalt sulfide nanoparticles uniformly attached on both sides of reduced graphene oxide. Some favorable electrochemical performances in specific capacity, cycling performance, and rate capability are achieved using the porous nanocomposites as an anode for lithium-ion batteries. In a half-cell, it exhibits a high specific capacity of 1253.9 mA h g-1 at 500 mA g-1 after 100 cycles. A full cell consists of the cobalt sulfide@reduced graphene oxide nanocomposite anode and a commercial LiCoO2 cathode, and is able to hold a high capacity of 574.7 mA h g-1 at 200 mA g-1 after 200 cycles. The reduced graphene oxide plays a key role in enhancing the electrical conductivity of the electrode materials; and it effectively prevents the cobalt sulfide nanoparticles from dropping off the electrode and buffers the volume variation during the discharge-charge process. The cobalt sulfide@reduced graphene oxide nanocomposites present great potential to be a promising anode material for lithium-ion batteries.

Determination of Dielectric Properties of Cells using AC Electrokinetic-based Microfluidic Platform: A Review of Recent Advances.

Cell dielectric properties, a type of intrinsic property of cells, can be used as electrophysiological biomarkers that offer a label-free way to characterize cell phenotypes and states, purify clinical samples, and identify target cancer cells. Here, we present a review of the determination of cell dielectric properties using alternating current (AC) electrokinetic-based microfluidic mechanisms, including electro-rotation (ROT) and dielectrophoresis (DEP). The review covers theoretically how ROT and DEP work to extract cell dielectric properties. We also dive into the details of differently structured ROT chips, followed by a discussion on the determination of cell dielectric properties and the use of these properties in bio-related applications. Additionally, the review offers a look at the future challenges facing the AC electrokinetic-based microfluidic platform in terms of acquiring cell dielectric parameters. Our conclusion is that this platform will bring biomedical and bioengineering sciences to the next level and ultimately achieve the shift from lab-oriented research to real-world applications.

Experimental Study on the Lubrication and Cooling Effect of Graphene in Base Oil for Si3N4/Si3N4 Sliding Pairs.

Recently, the engineering structural ceramics as friction and wear components in manufacturing technology and devices have attracted much attention due to their high strength and corrosion resistance. In this study, the tribological properties of Si3N4/Si3N4 sliding pairs were investigated by adding few-layer graphene to base lubricating oil on the lubrication and cooling under different experimental conditions. Test results showed that lubrication and cooling performance was obviously improved with the addition of graphene at high rotational speeds and low loads. For oil containing 0.1 wt% graphene at a rotational speed of 3000 r·min-1 and 40 N loads, the average friction coefficient was reduced by 76.33%. The cooling effect on Si3N4/Si3N4 sliding pairs, however, was optimal at low rotational speeds and high loads. For oil containing 0.05 wt% graphene at a lower rotational speed of 500 r·min-1 and a higher load of 140 N, the temperature rise was reduced by 19.76%. In addition, the wear mark depth would decrease when adding appropriate graphene. The mechanism behind the reduction in friction and anti-wear properties was related to the formation of a lubricating protective film.

A Review on Optoelectrokinetics-Based Manipulation and Fabrication of Micro/Nanomaterials.

Optoelectrokinetics (OEK), a fusion of optics, electrokinetics, and microfluidics, has been demonstrated to offer a series of extraordinary advantages in the manipulation and fabrication of micro/nanomaterials, such as requiring no mask, programmability, flexibility, and rapidness. In this paper, we summarize a variety of differently structured OEK chips, followed by a discussion on how they are fabricated and the ways in which they work. We also review how three differently sized polystyrene beads can be separated simultaneously, how a variety of nanoparticles can be assembled, and how micro/nanomaterials can be fabricated into functional devices. Another focus of our paper is on mask-free fabrication and assembly of hydrogel-based micro/nanostructures and its possible applications in biological fields. We provide a summary of the current challenges facing the OEK technique and its future prospects at the end of this paper.

Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes.

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.

Friction Behavior of Silver Perrhenate in Oil as Lubricating Additive for Use at Elevated Temperatures.

In this study, we use an aqueous solution synthesis method to prepare silver perrhenate powders and suspend them into a poly alpha olefin (PAO) base oil with polyoxyethylene octylphenyl ether. Four ball tests and ball-on-disk reciprocating mode are performed to determine how silver perrhenate performs tribologically as a lubricating additive over a wide range of temperatures. The physical and chemical properties, as well as the lubricating mechanisms of the silver perrhenate additive, are characterized via X-ray diffraction, scanning electron microscope, Fourier transformation infrared spectroscopy, Raman spectrum, and X-ray photoelectron spectroscopy. The four-ball test results demonstrate that the oil added with silver perrhenate additive is more effective than the base oil in reducing friction and improving wear resistance, and provides the best lubricating performance when at a concentration of 0.5 wt%. The reciprocating mode findings indicate that the hybrid lubricant exhibits distinctively better tribological properties than the base oil at high temperatures, and its low shear strength and chemical inertness allow for low friction at elevated temperatures. The resulting silver perrhenate layer that incorporates native superalloy oxides on the worn surface can provide lubrication by serving as a barrier that prevents direct contact between the rubbing surfaces at elevated temperatures.