Effects of external light in the magnetic field-modulated photocatalytic reactions in a microfluidic chip reactor.

Photocatalytic reactions and their magnetic-field enhancement present significant potential for practical applications in green chemistry. This work presents the mutual enhancement of plasmonic photocatalytic reaction by externally applied magnetic field and plasmonic enhancement in a micro optofluidic chip reactor. The tiny gold (Au) nanoparticles of only a few atoms fixed on the surface of titanium dioxide (TiO2) nanoparticles lead to mutually boosted enhancement photocatalytic reactions under an external magnetic field and plasmonic effects. The dominant factor of adding green light to the photocatalytic reaction leads to the understanding that it is a plasmonic effect. The positive results of adding ethanol alcohol (EA) in the experiments further present that it is a hot electron dominant path photocatalytic reaction that is positively enhanced by both the external magnetic field and plasmonic effects. This work offers great potential for utilizing magnetic field enhancement in plasmonic photocatalytic reactions.

Discovery and Preclinical Pharmacology of NX-2127, an Orally Bioavailable Degrader of Bruton's Tyrosine Kinase with Immunomodulatory Activity for the Treatment of Patients with B Cell Malignancies.

Bruton's tyrosine kinase (BTK), a member of the TEC family of kinases, is an essential effector of B-cell receptor (BCR) signaling. Chronic activation of BTK-mediated BCR signaling is a hallmark of many hematological malignancies, which makes it an attractive therapeutic target. Pharmacological inhibition of BTK enzymatic function is now a well-proven strategy for the treatment of patients with these malignancies. We report the discovery and characterization of NX-2127, a BTK degrader with concomitant immunomodulatory activity. By design, NX-2127 mediates the degradation of transcription factors IKZF1 and IKZF3 through molecular glue interactions with the cereblon E3 ubiquitin ligase complex. NX-2127 degrades common BTK resistance mutants, including BTKC481S. NX-2127 is orally bioavailable, exhibits in vivo degradation across species, and demonstrates efficacy in preclinical oncology models. NX-2127 has advanced into first-in-human clinical trials and achieves deep and sustained degradation of BTK following daily oral dosing at 100 mg.

Current Management and Volar Locking Plate Fixation with Bone Cement Augmentation for Elderly Distal Radius Fractures-An Updated Narrative Review.

Distal radius fractures (DRFs) are the most common among all kinds of fractures with an increase in incidence due to the rapidly expanded size of the elderly population in the past decades. Both non-surgical and surgical treatments can be applied for this common injury. Nowadays, more and more elderly patients with DRFs undergo surgical treatments to restore pre-injury activity levels faster. However, optimal treatment for geriatric DRFs is still debated, and careful evaluation and selection of patients are warranted considering clinical and functional outcomes, and complications following surgical treatments. Furthermore, osteoporosis is a predominant factor in elderly DRFs mostly deriving from a low-energy trauma, so many treatment modalities are developed to enhance better bone healing. Among various options for bone augmentation, bone cement is one of the most widely used measures. Bone cement such as calcium phosphate theoretically improves fracture stability and healing, but whether the elderly patients with DRFs can significantly benefit from surgical fixation with bone cement augmentation (BCA) remains controversial. Hence, in the present review, the latest literature regarding current concepts of management and evidence about volar locking plate fixation (VLPF) with BCA for elderly DRFs was searched in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science; out of >1000 articles, full texts of 48 and 6 articles were then examined and analyzed separately for management and VLPF with BCA for elderly DRFs. We aim to provide the readers with updates concerning the above issues.

Post-Operative Greater Tuberosity Resorption or Malreduction Is Associated with Poor Prognostic Outcomes in Patients with Proximal Humeral Fractures Treated Operatively-A Single-Center Retrospective Cohort Study.

(1) Background: Proximal humerus fractures can be a debilitating condition if not properly treated. These fracture patterns are varied and differ in every patient. Functional outcomes may be determined by the integrity of the shoulder girdle involving the rotator cuff insertion. The post-operative resorption or malreduction of the greater tuberosity (GT) is an important factor contributing to the poor functional outcome of a patient. Thus, we intend to evaluate the cause-and-effect relationship between GT complications and clinical prognosis and outcomes. (2) Methods: A single-center retrospective comparative study was performed to evaluate the functional outcomes of patients undergoing operative fixation for this injury. A total of 387 consecutive cases treated operatively from 2019-2021 were included for analysis. (3) Results: 94 cases fulfilled our criteria for analysis. A matched-group comparison of 19 patients each was performed to compare demographics, post-operative fracture characteristics and clinical outcomes. (4) Conclusions: The resorption or malreduction of the GT contributes greatly to the prognostic outcome in patients treated with open reduction and internal fixation (ORIF) surgery. In our demographic study, obesity is another contributing factor affecting the parameters of post-operative reduction in proximal humerus fractures. Appropriate surgical planning and post-operative multidisciplinary care must be taken into consideration to attain a satisfactory prognostic outcome.

Matriptase-2 regulates iron homeostasis primarily by setting the basal levels of hepatic hepcidin expression through a nonproteolytic mechanism.

Matriptase-2 (MT2), encoded by TMPRSS6, is a membrane-anchored serine protease. It plays a key role in iron homeostasis by suppressing the iron-regulatory hormone, hepcidin. Lack of functional MT2 results in an inappropriately high hepcidin and iron-refractory iron-deficiency anemia. Mt2 cleaves multiple components of the hepcidin-induction pathway in vitro. It is inhibited by the membrane-anchored serine protease inhibitor, Hai-2. Earlier in vivo studies show that Mt2 can suppress hepcidin expression independently of its proteolytic activity. In this study, our data indicate that hepatic Mt2 was a limiting factor in suppressing hepcidin. Studies in Tmprss6-/- mice revealed that increases in dietary iron to ∼0.5% were sufficient to overcome the high hepcidin barrier and to correct iron-deficiency anemia. Interestingly, the increased iron in Tmprss6-/- mice was able to further upregulate hepcidin expression to a similar magnitude as in wild-type mice. These results suggest that a lack of Mt2 does not impact the iron induction of hepcidin. Additional studies of wild-type Mt2 and the proteolytic-dead form, fMt2S762A, indicated that the function of Mt2 is to lower the basal levels of hepcidin expression in a manner that primarily relies on its nonproteolytic role. This idea is supported by the studies in mice with the hepatocyte-specific ablation of Hai-2, which showed a marginal impact on iron homeostasis and no significant effects on iron regulation of hepcidin. Together, these observations suggest that the function of Mt2 is to set the basal levels of hepcidin expression and that this process is primarily accomplished through a nonproteolytic mechanism.

Impact of perioperative α1-antagonists on postoperative urinary retention in orthopaedic surgery: meta-analysis.

BACKGROUND: Postoperative urinary retention (POUR) is a common complication following orthopaedic surgery. Previous studies attempted to establish the preventative role of α1-antagonist in POUR in the general surgical population; however, there is still no consensus regarding its use in orthopaedic surgery due to limited evidence. METHODS: Electronic databases of Cochrane Library, Embase, MEDLINE, and ClinicalTrials.gov were searched by two independent investigators from inception to 1 March 2022 to identify relevant randomized clinical trials. Two reviewers independently completed a critical appraisal of included trials by using the Cochrane Risk of Bias tool version 2.0 and extracted data from included articles. Risk of POUR was summarized as risk ratio (RR) with 95 per cent confidence intervals (c.i.). Mean difference (MD) was used for meta-analysis of continuous outcomes. RESULTS: Five randomized clinical trials involving 878 patients (α1-antagonist, 434; placebo, 444) undergoing hip/knee arthroplasty and spine surgeries were included. One study was assessed as high risk of bias from the randomization process and was excluded from the final meta-analysis. There was no difference in the risk of POUR between patients taking α1-antagonist and the placebo in arthroplasty (RR, 0.64; 95 per cent c.i., 0.36 to 1.14) and in spine surgeries (RR, 1.03; 95 per cent c.i., 0.69 to 1.55). There was no difference in length of stay (MD, -0.14 days; 95 per cent c.i., -0.33 to 0.05). Use of α1-antagonist was associated with a higher risk of adverse events (RR, 1.97; 95 per cent c.i., 1.27 to 3.06), with a composite of dizziness, light-headedness, fatigue, altered mental status, and syncope being the most commonly reported symptoms. CONCLUSION: In patients undergoing spinal surgery and joint arthroplasty, routine administration of perioperative α1-antagonist does not decrease risk of POUR but does increase perioperative dizziness, light-headedness, and syncope.

The Texas Immuno-Oncology Biorepository, a statewide biospecimen collection and clinical informatics system to enable longitudinal tumor and immune profiling.

A detailed understanding of the molecular and immunological changes that occur longitudinally across tumors exposed to immune checkpoint inhibitors is a significant knowledge gap in oncology. To address this unmet need, we created a statewide biospecimen collection and clinical informatics system to enable longitudinal tumor and immune profiling and to enhance translational research. The Texas Immuno-Oncology Biorepository (TIOB) consents patients to collect, process, store, and analyze serial biospecimens of tissue, blood, urine, and stool from a diverse population of over 100,000 cancer patients treated each year across the Baylor Scott & White Health system. Here we sought to demonstrate that these samples were fit for purpose with regard to downstream multi-omic assays. Plasma, urine, peripheral blood mononuclear cells, and stool samples from 11 enrolled patients were collected from various cancer types. RNA isolated from extracellular vesicles derived from plasma and urine was sufficient for transcriptomics. Peripheral blood mononuclear cells demonstrated excellent yield and viability. Ten of 11 stool samples produced RNA quality to enable microbiome characterization. Sample acquisition and processing methods are known to impact sample quality and performance. We demonstrate that consistent acquisition methodology, sample preparation, and sample storage employed by the TIOB can produce high-quality specimens, suited for employment in a wide array of multi-omic platforms, enabling comprehensive immune and molecular profiling.

Erector Spinae Plane Block is Equivalent to Tumescent Local Anesthesia for Perioperative Pain Control with Abdominal Harvest for Fat Grafting.

There is increasing evidence that lidocaine is toxic to adipocytes and their precursors, which can contribute to the variability in fat graft resorption. Erector spinae plane (ESP) block is a new technique to provide analgesia of the trunk and would avoid lidocaine at the fat graft donor site. The aim of this study was to compare the efficacy of ESP block versus tumescent local anesthesia (TLA). Methods: A retrospective review was performed for all patients who underwent autologous fat grafting from the abdomen at the University of New Mexico Hospital between February 2016 and March 2019. These patients received either ESP block or TLA during abdominal fat harvest. The primary endpoints were intraoperative, postoperative, and total morphine equivalents. Results: There was no difference in the mean intraoperative, postoperative, and total morphine equivalents administered between the ESP and TLA groups. Conclusions: ESP block is equivalent to TLA for analgesia when using an abdominal donor site for fat harvest. ESP block should be considered in fat-grafting cases to avoid the potential toxicity of lidocaine to the viability of adipocytes and preadipocytes.

Successful Prepectoral Breast Reconstruction in a Patient With Systemic Sclerosis.

Patients with connective tissue diseases have been shown to be at higher risk for complications after surgery. In this report, we describe a case of a patient with long-standing, stable systemic sclerosis (SS), diagnosed approximately 28 years ago, who underwent nipple-sparing mastectomy and immediate reconstruction with prepectoral tissue-expander placement. She subsequently had uneventful implant-based reconstruction with adjunctive fat grafting. To our knowledge, this is the first reported case of implant-based prepectoral reconstruction after mastectomy in a patient with SS.

Global challenges in microplastics: From fundamental understanding to advanced degradations toward sustainable strategies.

Currently, the global production and usage of plastics have increased rapidly with the expansion of synthetic polymers. Since plastics' degradation processes are prolonged and thus microplastics (MPs) potentially persist for very long periods in the environment. To date, there is a need for knowledge on the relevance of different potential entry pathways and the number of MPs entering the environment via different routes. Despite the vast quantity of studies that have been undertaken, many unanswered issues remain about the environmental impacts of MPs. The real impacts on a population subjected to many MPs of different structure, dimensions, and shapes over a lifetime are still hard to elucidate. Significantly, MPs can accumulate toxic substances, such as persistent organic pollutants, on their material surface. Hence, it represents a potential concentrated source of environmental pollution or acts as a vector of toxic pollutants in the food chain's interconnection with some severe health implications. Herein, we mainly discussed the global challenges in MPs, including the current production and use status of plastics and their impact on the environment. Additionally, finding the degradation of tiny fragment plastics (MPs level) is essential to remove plastics altogether. Some of the approaches to methods, including biodegradation, physical degradation, physicochemical degradation, have been successfully reviewed. More importantly, the sustainable concepts of using microorganisms and photocatalysis for MPs' degradation have been successfully proposed and demonstrated.

Opioids and Chronic Pain: An Analytic Review of the Clinical Evidence.

We conducted an analytic review of the clinical scientific literature bearing on the use of opioids for treatment of chronic non-cancer pain in the United States. There is substantial, albeit not definitive, scientific evidence of the effectiveness of opioids in treating pain and of high variability in opioid dose requirements and side effects. The estimated risk of death from opioid treatment involving doses above 100 MMED is ~0.25%/year. Multiple large studies refute the concept that short-term use of opioids to treat acute pain predisposes to development of opioid use disorder. The prevalence of opioid use disorder associated with prescription opioids is likely <3%. Morbidity, mortality, and financial costs of inadequate treatment of the 18 million Americans with moderate to severe chronic pain are high. Because of the absence of comparative effectiveness studies, there are no scientific grounds for considering alternative non-pharmacologic treatments as an adequate substitute for opioid therapy but these treatments might serve to augment opioid therapy, thereby reducing dosage. There are reasons to question the ostensible risks of co-prescription of opioids and benzodiazepines. As the causes of the opioid crisis have come into focus, it has become clear that the crisis resides predominantly in the streets and that efforts to curtail it by constraining opioid treatment in the clinic are unlikely to succeed.

Persistent nipple discharge after nipple-sparing mastectomy secondary to unincorporated AlloDerm: a case report.

BACKGROUND: Rates of nipple-sparing mastectomies have increased over the past decade. In 2017, acellular dermal matrix was used in 56% of breast reconstructive procedures, with complication rates similar to operations without AlloDerm. Although persistent nipple discharge after nipple-sparing mastectomy is a rare event, it has been described in the literature. Other authors have described evaluation and treatment on a case-by-case basis. To the best of our knowledge, this is the first case report to describe a persistent unilateral discharge after multiple operative revisions and to provide an algorithmic approach to workup and treatment. CASE PRESENTATION: We present a case of a 29-year-old Hispanic woman with BRCA1 mutation who underwent a prophylactic bilateral nipple-sparing mastectomy with immediate reconstruction using AlloDerm. The year following her operation, the patient underwent two surgical revisions, one for implant rippling and one for asymmetry. Six months after her second revision, she presented to our hospital with a capsular contracture and unilateral clear nipple discharge. Her breast ultrasound showed dilated subareolar ducts and a suspicious mass. Magnetic resonance imaging identified a benign-appearing, rim-enhancing fluid collection. She underwent a third revision. One year later, she returned to our clinic with bloody nipple discharge, erythematous skin changes, and a palpable breast lump. Her surgical biopsy showed a fold in AlloDerm and chronic inflammatory changes. She continued experiencing discharge and opted for nipple excision. During the operation, a lacrimal probe demonstrated a direct connection between the discharging external duct and a seroma associated with an area of unincorporated AlloDerm. The section of unincorporated AlloDerm was excised, and no evidence of malignancy was identified. Ten months later, the patient remained symptom-free and had progressed to placement of final silicone implants. CONCLUSIONS: To the best of our knowledge, this is the first case report to describe a nongravid patient with persistent unilateral sanguineous nipple discharge after multiple operative revisions. A visible communication between the draining duct and a seroma associated with unincorporated AlloDerm was ultimately identified. We present a clinical algorithm for patients with nipple discharge after nipple-sparing mastectomy.

Temporary Use of Acellular Dermal Matrix in Upper Extremity Salvage.

Wound coverage of exposed vascular bypasses after acute limb revascularization may not be immediately possible, while delay may create a hostile environment for the bypass graft. The use of negative-pressure wound therapy may not be possible because of extrinsic compression. Temporary use of acellular dermal matrix can help salvage upper extremity. We present 2 patients with brachial artery transection secondary to blunt trauma, who had revascularization with interposition saphenous vein grafts. We used acellular dermal matrix as temporary coverage for the exposed arterial bypass grafts to allow for patient stabilization, serial debridement, and demarcation of the surrounding tissues before definitive coverage. Additionally, the use of negative-pressure wound therapy caused diminished pulses in the bypass graft, creating the need for reliable temporary coverage. The acellular dermal matrix dressing was left in place until definitive closure was possible. Both patients underwent successful wound coverage with fasciocutaneous flaps without disruption, thrombosis, or infection of the bypass grafts. Follow-up at 6 months demonstrated good healing and excellent function. The use of the acellular dermal matrix provides temporary coverage of vital structures until definitive reconstruction can be performed.

Direct and indirect Z-scheme heterostructure-coupled photosystem enabling cooperation of CO2 reduction and H2O oxidation.

The stoichiometric photocatalytic reaction of CO2 with H2O is one of the great challenges in photocatalysis. Here, we construct a Cu2O-Pt/SiC/IrOx composite by a controlled photodeposition and then an artificial photosynthetic system with Nafion membrane as diaphragm separating reduction and oxidation half-reactions. The artificial system exhibits excellent photocatalytic performance for CO2 reduction to HCOOH and H2O oxidation to O2 under visible light irradiation. The yields of HCOOH and O2 meet almost stoichiometric ratio and are as high as 896.7 and 440.7 µmol g-1 h-1, respectively. The high efficiencies of CO2 reduction and H2O oxidation in the artificial system are attributed to both the direct Z-scheme electronic structure of Cu2O-Pt/SiC/IrOx and the indirect Z-scheme spatially separated reduction and oxidation units, which greatly prolong lifetime of photogenerated electrons and holes and prevent the backward reaction of products. This work provides an effective and feasible strategy to increase the efficiency of artificial photosynthesis.

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures.

Anesthetic management of pediatric orthopedic patients is uniquely challenging. Approach to the pediatric patient must consider heightened preoperative anxiety and its postoperative behavioral and pain effects. Frequent respiratory infections can complicate timing of surgery and anesthetic care. Perioperative pain management usually involves a multimodal pharmacologic approach with the goal of minimizing opioid requirements. Regional anesthesia is valuable for postoperative pain control. Safety of its use in the pediatric population has been confirmed in recent studies. Included for discussion are fractures, slipped capital femoral epiphysis, club foot, and scoliosis.

Magnetic Field-Enhancing Photocatalytic Reaction in Micro Optofluidic Chip Reactor.

A small external magnetic field (100-1000 Oe) was demonstrated to enhance the photocatalytic degradation of methyl orange (MO) using TiO2 NPs in micro optofluidic chip (MOFC) reactors. The rectangular shape of the fluidic channel and TiO2 deposited only onto the lower glass substrate leads to a selectively enhancing photocatalytic reactions by magnetic field in specific directions. Utilizing ethyl alcohol as a scavenger presented the difference between generated hot-hole (hVB+) and hot-electron (eCB-) pathways of photocatalytic reactions. Effects of dissolved oxygen (DO) and hydroxyl ions (OH-) are all demonstrated in a magnetic field-enhancing photocatalytic reaction. The experimental results demonstrate great potential for practical applications utilizing low-price fixed magnets in the field of green chemistry.

Moderate-temperature catalytic incineration of cooking oil fumes using hydrophobic honeycomb supported Pt/CNT catalyst.

Catalytic incineration is one of the cost-effective technologies to deal with odor cooking oil fumes (COFs). Hydrophobic carbon nanotubes (CNT) supported Pt catalysts were prepared by incipient wetness impregnation method. The 2.0 wt.%Pt/CNT catalyst gave the highest activity with the lowest light-off temperature near 200 °C. The catalyst was further coated on the carbonized honeycomb which offered low-pressure drop and high surface area per unit volume. Toward feasibility application, hydrophobic honeycomb supported Pt/CNT catalyst achieved an excellent catalytic performance with the conversion of 88.0-91.3 % in gas hourly space velocity (GHSV) ranging from 5,700 to 17,200 h-1 at 300 °C. Importantly, the honeycomb supported Pt/CNT catalyst could remove COFs substantially under simulated cooking conditions. Only a slight amount of heptane remained after catalytic incineration. In addition, the honeycomb support used much less Pt/CNT catalyst by maintaining the same performance, compared with powder catalyst. Our research outcome provides an excellent opportunity to apply the honeycomb supported Pt/CNT catalyst for moderate-temperature catalytic incineration of odor exhaust from kitchen hood.

Defect engineering of metal-oxide interface for proximity of photooxidation and photoreduction.

Close proximity between different catalytic sites is crucial for accelerating or even enabling many important catalytic reactions. Photooxidation and photoreduction in photocatalysis are generally separated from each other, which arises from the hole-electron separation on photocatalyst surface. Here, we show with widely studied photocatalyst Pt/[Formula: see text] as a model, that concentrating abundant oxygen vacancies only at the metal-oxide interface can locate hole-driven oxidation sites in proximity to electron-driven reduction sites for triggering unusual reactions. Solar hydrogen production from aqueous-phase alcohols, whose hydrogen yield per photon is theoretically limited below 0.5 through conventional reactions, achieves an ultrahigh hydrogen yield per photon of 1.28 through the unusual reactions. We demonstrated that such defect engineering enables hole-driven CO oxidation at the Pt-[Formula: see text] interface to occur, which opens up room-temperature alcohol decomposition on Pt nanoparticles to [Formula: see text] and adsorbed CO, accompanying with electron-driven proton reduction on Pt to [Formula: see text].

Visible-Light Driven Overall Conversion of CO2 and H2O to CH4 and O2 on 3D-SiC@2D-MoS2 Heterostructure.

A marigold-like SiC@MoS2 nanoflower with a unique Z-scheme structure efficiently achieves the overall conversion of gas phase CO2 with H2O (CO2 (g) + 2H2O (g) = CH4 + 2O2) without any sacrificial reagents under visible light (λ ≥ 420 nm) irradiation. The CH4 and O2 evolution are 323 and 621 µL·g-1·h-1, and stable throughout 5 cycle reactions of total 40 h. This work demonstrates a breakthrough in artificial photosynthesis with the Z-scheme 1D heterojunction constructed by combining 2D semiconductor and 3D semiconductor based on the transfer balance of photogenerated electron and hole.

Degradation and Mineralization of Carbamazepine Using an Electro-Fenton Reaction Catalyzed by Magnetite Nanoparticles Fixed on an Electrocatalytic Carbon Fiber Textile Cathode.

Pharmaceutical wastes are considered to be important pollutants even at low concentrations. In this regard, carbamazepine has received significant attention due to its negative effect on both ecosystem and human health. However, the need for acidic conditions severely hinders the use of conventional Fenton reagent reactions for the control and elimination of carbamazepine in wastewater effluents and drinking water influents. Herein, we report of the synthesis and use of flexible bifunctional nanoelectrocatalytic textile materials, Fe3O4-NP@CNF, for the effective degradation and complete mineralization of carbamazepine in water. The nonwoven porous structure of the composite binder-free Fe3O4-NP@CNF textile is used to generate H2O2 on the carbon nanofiber (CNF) substrate by O2 reduction. In addition, ·OH radical is generated on the surface of the bonded Fe3O4 nanoparticles (NPs) at low applied potentials (-0.345 V). The Fe3O4-NPs are covalently bonded to the CNF textile support with a high degree of dispersion throughout the fiber matrix. The dispersion of the nanosized catalysts results in a higher catalytic reactivity than existing electro-Fenton systems. For example, the newly synthesized Fe3O4-NPs system uses an Fe loading that is 2 orders of magnitude less than existing electro-Fenton systems, coupled with a current efficiency that is higher than electrolysis using a boron-doped diamond electrode. Our test results show that this process can remove carbamazepine with high pseudo-first-order rate constants (e.g., 6.85 h-1) and minimal energy consumption (0.239 kW·h/g carbamazepine). This combination leads to an efficient and sustainable electro-Fenton process.