Aramid nanofibers supported metal-organic framework aerogel for protection of chemical warfare agent.

Protective fabrics containing Zr-Based Metal-Organic Frameworks (Zr-MOFs) show great potential in the detoxification of chemical warfare agents (CWAs). However, the current studies still face the challenges of complicated fabrication processes, limited MOF loading mass, and insufficient protection. Herein, we developed a lightweight, flexible and mechanical robust aerogel by in situ growth of UiO-66-NH2 onto aramid nanofibers (ANFs) and assembly of UiO-66-NH2 loaded ANFs (UiO-66-NH2@ANFs) into 3D hierarchically porous architecture. The UiO-66-NH2@ANF aerogels feature high MOF loading of 261 %, high surface area of 589.349 m2 g-1, open and interconnected cellular structure, which provide efficient transfer channels and promote catalytic degradation of CWAs. As a result, the UiO-66-NH2@ANF aerogels demonstrate high 2-chloroethyl ethyl thioether (CEES) removal rate at 98.9 % and a short half-life of 8.15 min. Moreover, the aerogels present good mechanical stability (recovery rate of 93.3 % after 100 cycles under 30 % strain), low thermal conductivity (λ of 25.66 mW m-1 K-1), high flame resistance (LOI of 32 %) and good wearing comfortableness, indicating promising potential in multifunctional protection against CWAs.

Admission serum sodium and osmolarity are not associated with the occurrence or outcomes of acute respiratory distress syndrome in critically ill.

BACKGROUND: Previous studies suggested that hypernatremia or hyperosmolarity may have protective effects in lung injury. We hypothesized that hypernatremia and/or hyperosmolarity would prevent ARDS. DESIGN: Retrospective cohort study of all admissions at medical, surgical, and multidisciplinary intensive care units in Mayo Clinic, Rochester from the year of 2009 to 2019. The occurrence of ARDS was identified using a validated computerized search strategy. The association between serum sodium/osmolarity and the occurrence of ARDS was analyzed using a multivariable logistic regression model. The relationship between serum sodium/osmolarity and outcomes of ARDS was analyzed using linear and logistic regression models. RESULTS: Among 50,498 patients, the serum sodium level on admission did not have a significant association with the occurrence of ARDS, with an adjusted odds ratio of 0.95 [95% CI (0.86, 1.05)]. There was no significant association between calculated serum osmolarity and the occurrence of ARDS, with an adjusted odds ratio of 1.03 [95% CI (1.00, 1.07)]. 1560 patients developed ARDS during the ICU stay. Their serum sodium level and osmolarity level did not have a significant association with their outcomes. CONCLUSIONS: Admission serum sodium or serum osmolarity were not associated with the occurrence or outcomes of ARDS in ICU.

A novel multimodal needs assessment to inform the longitudinal education program for an international interprofessional critical care team.

BACKGROUND: The current global pandemic has caused unprecedented strain on critical care resources, creating an urgency for global critical care education programs. Learning needs assessment is a core element of designing effective, targeted educational interventions. In theory, multimodal methods are preferred to assess both perceived and unperceived learning needs in diverse, interprofessional groups, but a robust design has rarely been reported. Little is known about the best approach to determine the learning needs of international critical care professionals. METHOD: We conducted multimodal learning needs assessment in a pilot group of critical care professionals in China using combined quantitative and qualitative methods. The assessments consisted of three phases: 1) Twenty statements describing essential entrustable professional activities (EPAs) were generated by a panel of critical care education experts using a Delphi method. 2) Eleven Chinese critical care professionals participating in a planned education program were asked to rank-order the statements according to their perceived learning priority using Q methodology. By-person factor analysis was used to study the typology of the opinions, and post-ranking focus group interviews were employed to qualitatively explore participants' reasoning of their rankings. 3) To identify additional unperceived learning needs, daily practice habits were audited using information from medical and nursing records for 3 months. RESULTS: Factor analysis of the rank-ordered statements revealed three learning need patterns with consensual and divergent opinions. All participants expressed significant interest in further education on organ support and disease management, moderate interest in quality improvement topics, and relatively low interest in communication skills. Interest in learning procedure/resuscitation skills varied. The chart audit revealed suboptimal adherence to several evidence-based practices and under-perceived practice gaps in patient-centered communication, daily assessment of antimicrobial therapy discontinuation, spontaneous breathing trial, and device discontinuation. CONCLUSIONS: We described an effective mixed-methods assessment to determine the learning needs of an international, interprofessional critical care team. The Q survey and focus group interviews prioritized and categorized perceived learning needs. The chart audit identified additional practice gaps that were not identified by the learners. Multimodal methods can be employed in cross-cultural scenarios to customize and better target medical education curricula.

International Virtual Simulation Education in Critical Care During COVID-19 Pandemic: Preliminary Description of the Virtual Checklist for Early Recognition and Treatment of Acute Illness and iNjury Program.

SUMMARY STATEMENT: The Checklist for Early Recognition and Treatment of Acute Illness and iNjury program is a well-established, interactive, and simulation-based program designed to improve the quality of care delivered in intensive care units. The COVID-19 pandemic created an overwhelming surge of critically ill patients worldwide, and infection control concerns limited healthcare providers' access to in-person and hands-on simulation training when they needed it the most. Virtual simulation offers an alternative to in-person training but is often complex and expensive. We describe our successful development and initial implementation of an inexpensive, simulation-based virtual Checklist for Early Recognition and Treatment of Acute Illness and iNjury program to address the pressing need for effective critical care training in various resource-limited settings both within and outside of the United States. The overall satisfaction rate ("excellent" or "very good" responses) was 94.4% after the virtual simulation workshop. Our initial experience suggests that virtual interactions can be engaging and build strong relationships, like in-person continuing professional education, even using relatively simple technology. This knowledge-to-practice improvement platform can be readily adapted to other disciplines beyond critical care medicine.

Proton Donor-Regulated Mechanically Robust Aramid Nanofiber Aerogel Membranes for High-Temperature Thermal Insulation.

High-performance thermal insulators are urgently desired for energy-saving and thermal protection applications. However, the creation of such materials with synchronously ultralow thermal conductivity, lightweight, and mechanically robust properties still faces enormous challenges. Herein, a proton donor-regulated assembly strategy is presented to construct asymmetric aramid nanofiber (ANF) aerogel membranes with a dense skin layer and a high-porous nanofibrous body part. The asymmetric structure originates from the otherness of the structural restoration of deprotonated ANFs and the resulting ANF assembly due to the diversity of available proton concentrations. Befitting from the synergistic effect of the distinct architectures, the resulting aerogel membranes exhibit excellent overall performance in terms of a low thermal conductivity of 0.031 W·m-1·K-1, a low density of 19.2 mg·cm-3, a high porosity of 99.53%, a high tensile strength of 11.8 MPa (16.5 times enhanced), high heat resistance (>500 °C), and high flame retardancy. Furthermore, a blade-scraping process is further proposed to fabricate the aerogel membrane in a continuous and scalable manner, as it is believed to have potential applications in civil and military fields.

Dual Convolutional Neural Networks for Breast Mass Segmentation and Diagnosis in Mammography.

Deep convolutional neural networks (CNNs) have emerged as a new paradigm for Mammogram diagnosis. Contemporary CNN-based computer-aided-diagnosis systems (CADs) for breast cancer directly extract latent features from input mammogram image and ignore the importance of morphological features. In this paper, we introduce a novel end-to-end deep learning framework for mammogram image processing, which computes mass segmentation and simultaneously predicts diagnosis results. Specifically, our method is constructed in a dual-path architecture that solves the mapping in a dual-problem manner, with an additional consideration of important shape and boundary knowledge. One path, called the Locality Preserving Learner (LPL), is devoted to hierarchically extracting and exploiting intrinsic features of the input. Whereas the other path, called the Conditional Graph Learner (CGL), focuses on generating geometrical features via modeling pixel-wise image to mask correlations. By integrating the two learners, both the cancer semantics and cancer representations are well learned, and the component learning paths in return complement each other, contributing an improvement to the mass segmentation and cancer classification problem at the same time. In addition, by integrating an automatic detection set-up, the DualCoreNet achieves fully automatic breast cancer diagnosis practically. Experimental results show that in benchmark DDSM dataset, DualCoreNet has outperformed other related works in both segmentation and classification tasks, achieving 92.27% DI coefficient and 0.85 AUC score. In another benchmark INbreast dataset, DualCoreNet achieves the best mammography segmentation (93.69% DI coefficient) and competitive classification performance (0.93 AUC score).

Extracorporeal Membrane Oxygenation in Patients With COVID-19.

Coronavirus disease 2019 (COVID-19) is characterized by a clinical spectrum of diseases ranging from asymptomatic or mild cases to severe pneumonia with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in appropriate patients with COVID-19 complicated by ARDS refractory to mechanical ventilation. In this study, we review the indications, challenges, complications, and clinical outcomes of ECMO utilization in critically ill patients with COVID-19-related ARDS. Most of these patients required venovenous ECMO. Although the risk of mortality and complications is very high among patients with COVID-19 requiring ECMO, it is similar to that of non-COVID-19 patients with ARDS requiring ECMO. ECMO is a resource-intensive therapy, with an inherent risk of complications, which makes its availability limited and its use challenging in the midst of a pandemic. Well-maintained data registries, with timely reporting of outcomes and evidence-based clinical guidelines, are necessary for the careful allocation of resources and for the development of standardized utilization protocols.

Modulation of 1 MeV electron irradiation on ultraviolet response in MoS2FET.

The material, electrical and ultraviolet optoelectronic properties of few layers bottom molybdenum disulfide (MoS2) field effect transistors (FETs) device was investigated before and after 1 MeV electron irradiation. Due to the participation of SiO2in conduction, we discovered novel photoelectric properties and a relatively long photogenerated carrier lifetime (several tens of seconds). Electron irradiation causes lattice distortion, the decrease of carrier mobility, and the increase of interface state. It leads to the degradation of output characteristics, transfer characteristics and photocurrent of the MoS2FET.

FIO2 Trajectory as a Pragmatic Intermediate Marker in Acute Hypoxic Respiratory Failure.

BACKGROUND: Several markers of oxygenation are used as prognostic markers in acute hypoxemic respiratory failure. Real-world use is limited by the need for invasive measurements and unreliable availability in the electronic health record. A pragmatic, reliable, and accurate marker of acute hypoxemic respiratory failure is needed to facilitate epidemiologic studies, clinical trials, and shared decision-making with patients. [Formula: see text] is easily obtained at the bedside and from the electronic health record. The [Formula: see text] trajectory may be a valuable marker of recovery in patients with acute hypoxemic respiratory failure. METHODS: This was a historical cohort study of adult subjects admitted to an ICU with acute hypoxemic respiratory failure secondary to community-acquired pneumonia and/or ARDS. RESULTS: Our study included 2,670 subjects. [Formula: see text] and [Formula: see text] were consistently more available than was [Formula: see text] in the electronic health record: ([Formula: see text] vs [Formula: see text] vs [Formula: see text] : 100 vs 100 vs 72.8% on day 1, and 100 vs 99 vs 21% on day 5). A worsening [Formula: see text] trajectory was associated with reduced ventilator-free days. From days 2 to 5, every increase in [Formula: see text] by 10% from the previous day was associated with fewer ventilator-free days (on day 2: adjusted mean -1.25 [95% CI -1.45 to -1.05] d, P < .001). The [Formula: see text] trajectory also provided prognostic information. On days 3 - 5, an increase in [Formula: see text] from the previous day was associated with increased ventilator-free days (on day 3: adjusted mean 2.09 (95% CI 1.44-2.74) d; P < .001). [Formula: see text] models did not add predictive information compared with models with [Formula: see text] alone (on day 2: adjusted [Formula: see text] vs [Formula: see text] R2 0.122 vs 0.119; and on day 3: 0.153 vs 0.163). CONCLUSIONS: [Formula: see text] and [Formula: see text] are pragmatic and readily available intermediate prognostic markers in acute hypoxic respiratory failure. The [Formula: see text] trajectory in the first 5 d of ICU admission provided important prognostic information (ventilator-free days). Although the [Formula: see text] trajectory was also associated with ventilator-free days, it did not provide more information than the [Formula: see text] trajectory alone.

Rule-Based Cohort Definitions for Acute Respiratory Distress Syndrome: A Computable Phenotyping Strategy Based on the Berlin Definition.

Accurate identification of acute respiratory distress syndrome is essential for understanding its epidemiology, patterns of care, and outcomes. We aimed to design a computable phenotyping strategy to detect acute respiratory distress syndrome in electronic health records of critically ill patients. DESIGN: This is a retrospective cohort study. Using a near real-time copy of the electronic health record, we developed a computable phenotyping strategy to detect acute respiratory distress syndrome based on the Berlin definition. SETTING: Twenty multidisciplinary ICUs in Mayo Clinic Health System. SUBJECTS: The phenotyping strategy was applied to 196,487 consecutive admissions from year 2009 to 2019. INTERVENTIONS: The acute respiratory distress syndrome cohort generated by this novel strategy was compared with the acute respiratory distress syndrome cohort documented by clinicians during the same period. The sensitivity and specificity of the phenotyping strategy were calculated in randomly selected patient cohort (50 patients) using the results from manual medical record review as gold standard. MEASUREMENTS AND MAIN RESULTS: Among the patients who did not have acute respiratory distress syndrome documented, the computable phenotyping strategy identified 3,169 adult patients who met the Berlin definition, 676 patients (21.3%) were classified to have severe acute respiratory distress syndrome (Pao2/Fio2 ratio ≤ 100), 1,535 patients (48.4%) had moderate acute respiratory distress syndrome (100 < Pao2/Fio2 ratio ≤ 200), and 958 patients (30.2%) had mild acute respiratory distress syndrome (200 < Pao2/Fio2 ratio ≤ 300). The phenotyping strategy achieved a sensitivity of 94.4%, specificity of 96.9%, positive predictive value of 94.4%, and negative predictive value of 96.9% in a randomly selected patient cohort. The clinicians documented acute respiratory distress syndrome in 1,257 adult patients during the study period. The clinician documentation rate of acute respiratory distress syndrome was 28.4%. Compared with the clinicians' documentation, the phenotyping strategy identified a cohort that had higher acuity and complexity of illness suggested by higher Sequential Organ Failure Assessment score (9 vs 7; p < 0.0001), higher Acute Physiology and Chronic Health Evaluation score (76 vs 63; p < 0.0001), higher rate of requiring invasive mechanical ventilation (99.1% vs 71.8%; p < 0.0001), higher ICU mortality (20.6% vs 16.8%; p < 0.0001), and longer ICU length of stay (5.1 vs 4.2 d; p < 0.0001). CONCLUSIONS: Our rule-based computable phenotyping strategy can accurately detect acute respiratory distress syndrome in critically ill patients in the setting of high clinical complexity. This strategy can be applied to enhance early recognition of acute respiratory distress syndrome and to facilitate best-care delivery and clinical research in acute respiratory distress syndrome.

Inclusion of Albumin in the Initial Resuscitation of Adult Patients with Medical Sepsis or Septic Shock: a Propensity Score-Matched Analysis.

INTRODUCTION: The impact of albumin resuscitation on sepsis outcomes is debated, particularly in the initial phase of resuscitation. We aimed to investigate the association between albumin use in the initial 6 h of resuscitation and subsequent outcomes in adult septic patients. METHODS: This single-center, retrospective, propensity score-matched cohort study included adult patients admitted to intensive care units (ICUs) with sepsis or septic shock from January 1, 2006, to May 4, 2018, at a tertiary referral hospital. We compared two groups based on albumin receipt within the initial six resuscitation hours (albumin group vs. non-albumin group). We performed a 1:2 propensity score matching to assess shock-free time in ICU as the primary outcome. RESULTS: Of 2,732 patients with medical sepsis, 286 cases in the albumin group were matched with 549 individuals in the non-albumin group. Compared to the non-albumin group, the albumin group required more intravenous fluids and had higher net fluid balance, lower mean arterial pressure, and lower serum base excess level in the initial 6 and 24 h of resuscitation. Shock-free time, ICU and hospital length of stay, and 28-day mortality were not different between albumin and non-albumin groups (56 vs. 66 h, P = 0.18; 3.5 days vs. 3.7 days, P = 0.61; 9.1 days vs. 9.5 days, P = 0.27; 36% vs. 32%, P = 0.25, respectively). CONCLUSIONS: Using albumin during the initial 6 h of resuscitation was not associated with benefits in clinical outcomes of patients with medical sepsis.

Effects of LncRNA HCP5/miR-214-3p/MAPK1 Molecular Network on Renal Cell Carcinoma Cells.

BACKGROUND: Recent researches have shown that long non-coding RNA (LncRNA) is often disordered and acts in many carcinomas. Clear cell renal cell carcinoma (ccRCC) is the main reason for carcinoma-related deaths, which are mainly caused by the metastasis. HCP5 is a newly discovered LcnRNA. Early studies have found that HCP5 acts in neoplasm metastasis, but the mechanism of HCP5 in ccRCC is still unclear. METHODS: The expression of HCP5 in human renal cell carcinoma (RCC) was detected by real-time quantitative PCR. The biological effect of LncRNAs in proliferation, migration, invasion and metastasis of RCC cells was explored by gain-of-function and loss-of-function tests. The molecular mechanism of LncRNAs was explored by RNA immunoprecipitation and Western blot. RESULTS: qRT-PCR revealed that HCP5 was enhanced in neoplasm tissues of ccRCC patients and correlated with the metastatic characteristics of RCC. Over-expression of HCP5 promoted the proliferation, migration and invasion of renal carcinoma cells. The deletion of HCP5 inhibited the proliferation, migration and invasion of RCC in vitro and the metastasis of RCC in vivo. Mechanically, HCP5 inhibited the growth and metastasis of ccRCC cells by regulating miR-214-3p/MAPK1 axis. CONCLUSION: HCP5, as a key LncRNA, can promote ccRCC metastasis by regulating miR-214-3p/MAPK1 axis and may be a biomarker and be helpful for judging the prognosis of ccRCC.

Development and Verification of a Digital Twin Patient Model to Predict Specific Treatment Response During the First 24 Hours of Sepsis.

To develop and verify a digital twin model of critically ill patient using the causal artificial intelligence approach to predict the response to specific treatment during the first 24 hours of sepsis. DESIGN: Directed acyclic graphs were used to define explicitly the causal relationship among organ systems and specific treatments used. A hybrid approach of agent-based modeling, discrete-event simulation, and Bayesian network was used to simulate treatment effect across multiple stages and interactions of major organ systems (cardiovascular, neurologic, renal, respiratory, gastrointestinal, inflammatory, and hematology). Organ systems were visualized using relevant clinical markers. The application was iteratively revised and debugged by clinical experts and engineers. Agreement statistics was used to test the performance of the model by comparing the observed patient response versus the expected response (primary and secondary) predicted by digital twin. SETTING: Medical ICU of a large quaternary- care academic medical center in the United States. PATIENTS OR SUBJECTS: Adult (> 18 year yr old), medical ICU patients were included in the study. INTERVENTIONS: No additional interventions were made beyond the standard of care for this study. MEASUREMENTS AND MAIN RESULTS: During the verification phase, model performance was prospectively tested on 145 observations in a convenience sample of 29 patients. Median age was 60 years (54-66 d) with a median Sequential Organ Failure Assessment score of 9.5 (interquartile range, 5.0-14.0). The most common source of sepsis was pneumonia, followed by hepatobiliary. The observations were made during the first 24 hours of the ICU admission with one-step interventions, comparing the output in the digital twin with the real patient response. The agreement between the observed versus and the expected response ranged from fair (kappa coefficient of 0.41) for primary response to good (kappa coefficient of 0.65) for secondary response to the intervention. The most common error detected was coding error in 50 observations (35%), followed by expert rule error in 29 observations (20%) and timing error in seven observations (5%). CONCLUSIONS: We confirmed the feasibility of development and prospective testing of causal artificial intelligence model to predict the response to treatment in early stages of critical illness. The availability of qualitative and quantitative data and a relatively short turnaround time makes the ICU an ideal environment for development and testing of digital twin patient models. An accurate digital twin model will allow the effect of an intervention to be tested in a virtual environment prior to use on real patients.

Electron radiation effects on the structural and electrical properties of MoS2 field effect transistors.

The effects of space radiation on the structural and electrical properties of MoS2 field effect transistors (FETs) were investigated. The 1 MeV electronically equivalent International Space Station (ISS) track was used to apply fluence equivalent to the orbital for 10 (1.0 × 1012 cm-2) and 30 years (3.0 × 1012 cm-2) using the AP8 and AE8 models. X-ray photoelectron spectroscopy (XPS), Raman and photoluminescence (PL) spectra were recorded before and after irradiation. Electron irradiation produced strong desulfurization effects in MoS2 FETs. The PL spectra before and after irradiation did not change significantly, while the [Formula: see text] and A1g Raman modes were red- and blue-shifted, respectively. The XPS results demonstrated a strong desulfurization effect of the electron beam on MoS2. This reduction indicates a much higher amount of irradiation-induced S vacancies compared to Mo vacancies. The electrical characteristics of the device were measured before and after irradiation. The increase in the channel leakage current after irradiation was attributed to the oxide trapping positive charges. MoS2 FETs irradiated by the electron-beam demonstrated a decreased current. This phenomenon can be attributed to the combination of the states at the SiO2/MoS2 interfaces and Coulomb scattering. Our study provides a deeper understanding of the influence of 1 MeV electron-beam irradiation on MoS2-based nano-electronic devices for future space applications.

Modulation of electronic and optical properties by surface vacancies in low-dimensional ß-Ga2O3.

Calculations using the Heyd-Scuseria-Ernzerhof screened hybrid functional reveal the detailed influence that surface vacancies have on the electronic and optical properties of low-dimensional (LD) ß-Ga2O3. Vacancies manifest subtle changes to the electronic characteristics as oxygen states predominate the valence band at the surface. Dielectric functions at the surface are found to increase with vacancies and defects. A broad impact on optical properties, such as absorption coefficients, reflectivity, refractive indices, and electron loss, is seen with increased vacancy defects. Both visible and infrared regions show direct correlation with vacancies while there is a marked decrease in the deep ultraviolet (UV) region. These calculations on the ß-Ga2O3 model system may guide the rational design of two-dimensional optical devices with minimized van der Waals forces.

Statins and Incidence of Contrast-Induced Acute Kidney Injury Following Coronary Angiography - Five Year Experience at a Tertiary Care Center.

BACKGROUND: Role of statins in prevention of contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography remains controversial. We studied the use of statins in decreasing CI-AKI following coronary angiography. METHODS: We reviewed all patients who underwent coronary angiography with or without PCI and had a follow-up creatinine from January 2012 to December 2016 at a single tertiary care center in the United States. CI-AKI was defined as 0.3 mg/dL absolute rise in creatinine. Patients who were on moderate to high-intensity statins or received moderate to high-intensity statins prior to coronary angiography were included in the statin group. Crude and adjusted odds ratios (AOR) were calculated using univariate multiple logistic regression analysis. RESULTS: Out of 2055 patients (females = 30.7%, mean age 58.0 ±â€¯12.5 years, statin group = 886, non-statin group = 1169), 293 (14.3%) developed CI-AKI. Mean estimated glomerular filtration rate (eGFR) was not significantly different between the statin and the non-statin group (86.5 mL/min/1.73 m2 vs 87.1 mL/min/1.73 m2, p = 0.65). There was no significant difference in the incidence of CI-AKI between statin and non-statin group (14.4% vs 14.1%, p = 0.83). When adjusted for other risk factors, statin use was not significantly associated with decreased risk of CI-AKI (AOR) = 0.8, [95% confidence interval (CI) = 0.6-1.1, p = 0.19]. Results remained statistically non-significant on subgroup analysis of patients with acute coronary syndrome (ACS) (OR = 0.8, 95% CI = 0.6-1.2, p = 0.27), patients who had percutaneous coronary intervention (PCI) (OR = 1.1, 95% CI = 0.6-1.7, p = 0.81) and patients with eGFR < 60 mL/min/1.73 m2 (OR = 0.9, 95% CI = 0.6-1.5, p = 0.9). CONCLUSION: Statin use prior to coronary angiography is not associated with decreased incidence of CI-AKI.

Anemia (Hemoglobin ≤ 13 g/dL) as a Risk Factor for Contrast-Induced Acute Kidney Injury Following Coronary Angiography.

Contrast-induced acute kidney injury (CI-AKI) following coronary angiography is associated with increased mortality. The association between severity of anemia and CI-AKI following coronary angiography is not well-established. In this retrospective study, we aimed at assessing the association of anemia of various severity with the risk of CI-AKI in patients who underwent coronary angiography. We included all patients who underwent coronary angiography with or without percutaneous coronary intervention from January 2012 to December 2016 at a single tertiary care hospital. CI-AKI was defined as ≥0.3 mg/dL increase in creatinine from baseline and anemia was defined as baseline hemoglobin ≤13 g/dL. Patients were stratified into three subgroups-mild (11.1 to 13.0 g/dL), moderate (9.1 to 11.0 g/dL) and severe anemia (7.0 to 9.0 g/dL). Crude and adjusted odds ratios (AOR) were calculated using univariate multiple logistic regression analysis. Of 2,055 patients (females = 30.7%, mean age 58.0 ± 12.5 years) who underwent coronary angiography, 293 (14.3%) developed CI-AKI. Presence of anemia was associated with increased risk of developing CI-AKI (AOR = 5.3, 95% confidence interval [CI] = 3.8 to 7.3, p < 0.001). Risk of CI-AKI was increasingly higher with increasing severity of the anemia; mild (AOR = 3.4, 95% CI = 2.5 to 4.7, p < 0.001), moderate (AOR = 9.8, 95% CI = 6.9 to 14.2, p < 0.001) and severe (AOR = 13.7, 95% CI = 8.2 to 23.1, p < 0.001). In conclusion, severity of anemia is a strong predictor of CI-AKI following coronary angiography.

UV-assisted treatment on hydrophobic acrylic IOLs anterior surface with methacryloyloxyethyl phosphorylcholine: Reducing inflammation and maintaining low posterior capsular opacification properties.

In order to enhance the surface biocompatibility of hydrophobic acrylic intraocular lenses (IOLs), the anterior surface was modified through graft polymerization with methacryloyloxyethyl phosphorylcholine (MPC) initiated by ultraviolet radiation. Chemical changes on the IOL surface were characterised by X-ray photoelectron spectroscopy (XPS) to confirm the covalent binding of MPC. Field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM) analysis were used to characterise the morphological changes to the IOL surface. Static water contact angle (WCA) measurements showed that the hydrophilicity of the anterior surface was enhanced after grafting with MPC. The surface biocompatibility of the untreated and Anterior UV-MPC IOLs was compared with the adhesion behaviour of macrophages in vitro. The degree of posterior capsule opacification (PCO) of untreated, anterior treated, and posterior treated IOLs was evaluated by observing the behaviour of lens epithelial cells (LECs) between the IOL optic portion and type IV collagen. Results suggest that the MPC modified anterior surface resisted the attachment of macrophages. However, MPC grafted onto the posterior surface enhanced the migration of LECs between the IOL optic and type IV collagen, which may result in severe PCO. In conclusion, our Anterior UV-MPC IOLs may reduce postoperative inflammation while maintaining the low PCO rates of hydrophobic acrylic IOLs.

Particle Size-Selective Assessment of Protection of European Standard FFP Respirators and Surgical Masks against Particles-Tested with Human Subjects.

This study was conducted to investigate the protection of disposable filtering half-facepiece respirators of different grades against particles between 0.093 and 1.61 µm. A personal sampling system was used to particle size-selectively assess the protection of respirators. The results show that about 10.9% of FFP2 respirators and 28.2% of FFP3 respirators demonstrate assigned protection factors (APFs) below 10 and 20, which are the levels assigned for these respirators by the British Standard. On average, the protection factors of FFP respirators were 11.5 to 15.9 times greater than those of surgical masks. The minimum protection factors (PFs) were observed for particles between 0.263 and 0.384 µm. No significant difference in PF results was found among FFP respirator categories and particle size. A strong association between fit factors and protection factors was found. The study indicates that FFP respirators may not achieve the expected protection level and the APFs may need to be revised for these classes of respirators.

Development and application of a robust N-glycan profiling method for heightened characterization of monoclonal antibodies and related glycoproteins.

A highly robust hydrophilic interaction liquid chromatography (HILIC) method that involves both fluorescence and mass spectrometric detection was developed for profiling and characterizing enzymatically released and 2-aminobenzamide (2-AB)-derivatized mAb N-glycans. Online HILIC/mass spectrometry (MS) with a quadrupole time-of-flight mass spectrometer provides accurate mass identifications of the separated, 2-AB-labeled N-glycans. The method features a high-resolution, low-shedding HILIC column with acetonitrile and water-based mobile phases containing trifluoroacetic acid (TFA) as a modifier. This column and solvent system ensures the combination of robust chromatographic performance and full compatibility and sensitivity with online MS in addition to the baseline separation of all typical mAb N-glycans. The use of TFA provided distinct advantages over conventional ammonium formate as a mobile phase additive, such as, optimal elution order for sialylated N-glycans, reproducible chromatographic profiles, and matching total ion current chromatograms, as well as minimal signal splitting, analyte adduction, and fragmentation during HILIC/MS, maximizing sensitivity for trace-level species. The robustness and selectivity of HILIC for N-glycan analyses allowed for method qualification. The method is suitable for bioprocess development activities, heightened characterization, and clinical drug substance release. Application of this HILIC/MS method to the detailed characterization of a marketed therapeutic mAb, Rituxan(®), is described.