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This meta-analysis aims to evaluate the effectiveness of the double plasma molecular adsorption system (DPMAS) in combination with plasma exchange (PE) compared to plasma exchange alone in the treatment of Acute-on-Chronic liver failure (LF) caused by hepatitis B. Until August 31, 2023, a comprehensive search of databases including Embase, Chinese Medical Journal Full-text Database, China Biomedical Literature Database, Wan Fang Medical Network, PubMed, and the Cochrane Library was carried out using keywords like "liver failure," "acute-on-chronic liver failure," "PE," "DPMAS," and related terms. The quality of the included studies was evaluated using QUADS (quality assessment of diagnostic accuracy studies). Software Revman 5.3 was used to examine the data, while Stata 15.1 was used to run Egger's test. Following thorough screening, 452 patients who received PE alone and 429 patients who received DPMAS in addition to PE were included. Every study that was included was of a high caliber. When comparing the DPMAS plus PE group to the PE alone group, the total bilirubin reduction was considerably higher (mean difference [MD] = -49.09, 95% confidence interval [CI]: -54.84 to -43.35, p < .00001). Prothrombin activity (PTA; MD = -1.53, 95% CI: -3.29 to -0.22, p = .09), albumin (ALB; MD = -0.58, 95% CI: -1.57 to 0.41, p = .25), prothrombin time (PT; MD = -0.07, 95% CI: -1.47 to 1.34, p = .92), and platelet count (PLT; MD = -0.08, 95% CI: -1.33 to 1.66, p = .90) did not differ significantly. The improvement in international standardized ratio (INR) was significantly greater in the PE group (MD = 0.07, 95% CI (0.03, 0.10), p = .0001). When combined with DPMAS, PE has been shown to be more effective in lowering total bilirubin levels. PE can also lower INR in individuals who have hepatitis B-related ACLF. This therapeutic strategy also lessens the need for plasma transfusions.
Subject(s)
Acute-On-Chronic Liver Failure , Hepatitis B , Plasma Exchange , Plasma Exchange/methods , Humans , Acute-On-Chronic Liver Failure/therapy , Hepatitis B/complications , Adsorption , Bilirubin/blood , Treatment Outcome , Female , MaleABSTRACT
This study introduces an innovative approach using highly efficient nanocomposite materials to effectively remove PFAS from water, demonstrating remarkable adsorption capabilities. The nanocomposite was synthesized by integrating a zirconium-based metal-organic framework (MOF) called UiO-66 with graphene oxide (GO) within a polyvinyl alcohol (PVA) matrix. The resulting PVA@UiO-66/GO material features flower-like UiO-66 MOF crystals embedded in the PVA and GO matrix. Various kinetic models were applied to determine the rate constants and adsorption capacities, with the Langmuir isotherm indicating an adsorption capacity of 9.904 mg/g. Thermodynamic analysis confirmed the process's spontaneity and exothermic nature. The UiO-66-NH2/GO/PVA composite also demonstrated high reusability, maintaining substantial PFOA removal efficiency across multiple cycles, with optimal reduction occurring at approximately pH 5. Overall, the PVA@UiO-66/GO composites offer an effective, sustainable, and environmentally friendly solution for PFAS removal in water purification.
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In this manuscript, we provide a general theory for how surface phonons couple to molecular adsorbates. Our theory maps the extended dynamics of a surface's atomic vibrational motions to a generalized Langevin equation, and by doing so captures these dynamics in a single quantity: the non-Markovian friction. The different frequency components of this friction are the phonon modes of the surface slab weighted by their coupling to the adsorbate degrees of freedom. Using this formalism, we demonstrate that physisorbed species couple primarily to acoustic phonons while chemisorbed species couple to dispersionless local vibrations. We subsequently derive equations for phonon-adjusted reaction rates using transition state theory and demonstrate that these corrections improve agreement with experimental results for CO desorption rates from Pt(111).
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Copper squarate is a metal-organic framework with an oxo-carbonic anion organic linker and a doubly charged metal mode. Its structure features large channels that facilitate the adsorption of relatively small molecules. This study focuses on exploring the potential of adsorbing small pollutants, primarily greenhouse gases, with additional investigations conducted on larger pollutants. The objective is to comprehend the efficacy of this new material in single and multiple molecular adsorption processes using theoretical methods based on density functional theory. Furthermore, we find that the molecular adsorption energies range from 3.4 KJâmol-1 to 63.32 KJâmol-1 depending on the size and number of adsorbed molecules. An exception is noted with an unfavorable adsorption energy value of 47.94 KJâmol-1 for 4-nitrophenol. More importantly, we demonstrate that water exerts an inhibitory effect on the adsorption of these pollutants, distinguishing copper squarate as a rare MOF with hydrophilic properties. The Connolly surface was estimated to give a more accurate idea of the volume and surface accessibility of copper squarate. Finally, using Monte Carlo simulations, we present a study of adsorption isotherms for individual molecules and molecules mixed with water. Our results point out that copper squarate is an efficient adsorbent for small molecular pollutants and greenhouse gases.
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In this report, we demonstrate that high-capacity hybrid supercapacitors can be realized by utilizing iron azaphthalocyanine (FeAzPc-4N) adsorbed activated carbons (ACs) as an electrode due to the combination of the electric double layer of activated carbon surfaces and redox reactions of FeAzPc-4N molecules. By increasing the mixing ratio of FeAzPc-4N with ACs, a maximum capacity of 907 F/gAC is achieved, also enabling rapid charging and discharging at 20 A/g. The revelation of the capacitor electrode's durability through 20â¯000 cycles of charging and discharging is realized, and the capacitor cell had sufficient output power to illuminate LEDs. This concept illustrates the potential for enhancing capacitor performance by immobilizing redox-active species.
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In the last two decades, significant efforts have been particularly invested in two-dimensional (2D) hexagonal boron carbon nitride h-BxCyNz because of its unique physical and chemical characteristics. The presence of the carbon atoms lowers the large gap of its cousin structure, boron nitride (BN), making it more suitable for various applications. Here, we use density functional theory to study the structural, electronic, and magnetic properties of Pt-doped BC6N (Pt-BC6N, as well as its adsorption potential of small molecular gases (NO, NO2, CO2, NH3). We consider all distinct locations of the Pt atom in the supercell (B, N, and two C sites). Different adsorption locations are also considered for the pristine and Pt-doped systems. The formation energies of all Pt-doped structures are close to those of the pristine system, reflecting their stability. The pristine BC6N is semiconducting, so doping with Pt at the B and N sites gives a diluted magnetic semiconductor while doping at the C1 and C2 sites results in a smaller gap semiconductor. We find that all doped structures exhibit direct band gaps. The studied molecules are very weakly physisorbed on the pristine structure. Pt doping leads to much stronger interactions, where NO, NO2, and NH3 chemisorb on the doped systems, and CO2 physiorb, illustrating the doped systems' potential for gas purification applications. We also find that the adsorption changes the electronic and magnetic properties of the doped systems, inviting their consideration for spintronics and gas sensing.
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Copper plays a crucial role in the heterogenous dissociation of chlorothiophenols (CTPs) to form chlorothiophenoxy radicals (CTPRs), which is the initial and critical step in the formation of polychlorinated thianthrenes/dibenzothiophenes (PCTA/DTs). Here, first-principles calculations were performed to investigate the activity of Cu(111) surface towards the formation of adsorbed 2-CTPR from 2-CTP. The interaction between 2-CTP and Cu(111) surface was explored to find stable adsorption configurations. Besides, the decomposition routes of 2-CTP on the Cu(111) surface were further explored. Moreover, the effects of water on the formation of absorbed 2-CTPR on the Cu(111) surface were examined. Our results demonstrate that the flat adsorption of 2-CTP on the surface with adsorption energy in the range of -33.21â¯kcal/mol to -28.37â¯kcal/mol is more stable than the vertical adsorption with adsorption energy ranging from -23.53â¯kcal/mol to -13.38â¯kcal/mol. The Cu(111) surface catalyzes the conversion of 2-CTP into the adsorbed 2-CTPR with a modest energy barrier of 9.46â¯kcal/mol. Furthermore, water molecules exhibit stronger catalytic activity in this process with a decreased energy barrier of 5.87â¯kcal/mol through "water bridge" and hydrogen bonding. Specifically, the water accepts the hydrogen atom from 2-CTP and donates another hydrogen to the surface via "water bridge". This research provides a molecular-level understanding of the heterogeneous formation of PCTA/DTs by fly ash, suggesting novel approaches for control strategy and legislation of dioxin analogues.
Subject(s)
Coal Ash , Copper , Thiophenes , Density Functional Theory , Hydrogen , WaterABSTRACT
BACKGROUND: Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are very serious skin allergies, with an etiology related to infections and medication. Since the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/TEN. CASE SUMMARY: We report the case of a woman in her thirties who took acetaminophen after contracting COVID-19. After 3 d of fever relief, she experienced high fever and presented with SJS/TEN symptoms, accompanied by intrahepatic cholestasis. Three days of corticosteroid treatment did not alleviate the skin damage; therefore, double plasma molecular adsorption system (DPMAS) therapy was initiated, with treatment intervals of 48 h. Her skin symptoms improved gradually and were resolved after seven DPMAS treatments. CONCLUSION: DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators (e.g., tumor necrosis factor-alpha and interleukin-10 and-12) speculated to be involved in the pathology of the skin conditions.
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Metal organic framework (MOF) films have attracted abundant attention due to their unique characters compared with MOF particles. But the high-temperature reaction and solvent corrosion limit the preparation of MOF films on fragile substrates, hindering further applications. Fabricating macro-sized continuous free-standing MOF films and transferring them onto fragile substrates are a promising alternative but still challenging. Here, a universal strategy to prepare transferrable macro-sized continuous free-standing MOF films with the assistance of oxide nanomembranes prepared by atomic layer deposition and studied the growth mechanism is developed. The oxide nanomembranes serve not only as reactant, but also as interfacial layer to maintain the integrality of the free-standing structure as the stacked MOF particles are supported by the oxide nanomembrane. The centimeter-scale free-standing MOF films can be transferred onto fragile substrates, and all in one device for glucose sensing is assembled. Due to the strong adsorption toward glucose molecules, the obtained devices exhibit outstanding performance in terms of high sensitivity, low limit of detection, and long durability. This work opens a new window toward the preparation of MOF films and MOF film-based biosensor chip for advantageous applications in post-Moore law period.
Subject(s)
Biosensing Techniques , Metal-Organic Frameworks , Metal-Organic Frameworks/chemistry , Biosensing Techniques/methods , Biosensing Techniques/instrumentation , Glucose , Equipment Design/methodsABSTRACT
Polyphenol oxidase (PPO) is critical due to enzymatic browning in fruits and vegetables, developing economic impact in fruits industry. Metal-Organic Frameworks (MOF) have shown interesting characteristics such as water stability, low toxicity, and good adsorption yield, making them good candidates for PPO inactivation. Al-based-MOFs, MIL-53(Al), DUT-5, and MIL-110 were tested as PPO inactivators in apple juice by enzyme-MOF interactions at r.t. through two possible mechanisms, i) substrate scavengers (substrates:catechol and 4-methylcatechol) or ii) enzyme activity modifiers. The scavenging behavior of Al-based-MOFs was moderate, in the same magnitude, being catechol adsorption better than 4-methylcatechol. PPO activity was reduced by at least 70% by MIL-53(Al)/DUT-5 in 10/30 min respectively, and MIL-110 inactivated PPO in 50 min with some structural modifications. Enzyme-MOF interactions are major responsible for PPO inactivation. This could be a new applicability of MOFs, as an alternate PPO inactivation process, easily included in juice processing, retaining sensorial/nutritional properties, developed at r.t thus energy-cost-effective.
Subject(s)
Malus , Metal-Organic Frameworks , Malus/chemistry , Fruit/chemistry , Vegetables , Metal-Organic Frameworks/analysis , Catechol Oxidase/chemistry , Catechols/analysisABSTRACT
Objective To explore the effect of low replacement plasma exchange(LPE)combined with double plasma molecular adsorption(DPMAS)in the treatment of patients with chronic acute liver failure(ACLF)and its influence on liver function,inflammatory cytokines and short-term prognosis.Methods One hundred patients with ACLF were randomly divided into the observation group and the control group by envelope method,with 50 cases in each group.On basis of routine symptomatic treatments(liver protection,removing jaundice,reducing enzymes,anti-viruses,bleeding prevention),the control group and the observation group were treated with plasma exchange(PE)and LPE plus DPMAS,respectively.The liver function,coagulation function,the levels of inflammatory cytokines,incidence of adverse reactions,and 90-day survival rate were compared between the two groups after treatment.Results After treatment,the liver function and coagulation function in the observation group were significantly improved(P<0.05)and the levels of inflammatory cytokines were significantly lowered than those in the control group(P<0.05).There was no statistically significant difference in the 90-day survival rate and the total incidence of adverse reactions between the groups(P>0.05).Conclusion LPE combined with DPMAS can effectively improve liver function and coagulation function,and reduce levels of inflammatory cyto-kines in ACLF patients,with high safety.
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【Objective】 To investigate the effect of double plasma molecular adsorption system and sequential half-dose plasma exchange (DPMAS+HPE) on the short-term survival rate of patients with hepatitis B associated acute-on-chronic liver failure (HBV-ACLF). 【Methods】 Data on HBV-ACLF cases hospitalized in our hospital from January 1, 2015 to December 31, 2022 were retrospectively collected, and were divided into standard comprehensive medical treatment group and DPMAS+HPE group according to different treatment methods. Propensity score matching (PSM) was used to eliminate inter group confounding bias. The baseline data and improvement of laboratory indicators after treatment between two groups were compared. Death related risk factors in HBV-ACLF patients were screened by logistic regression analysis, and cumulative survival rates at 30 and 90 days between the two groups were compared by Kaplan-Meier survival analysis. 【Results】 A total of 373 cases of HBV-ACLF were included in this study. Among them, 136 cases in the treatment group received DPMAS+HPE once on the basis of comprehensive internal medicine treatment, and 237 cases only received comprehensive internal medicine treatment. After PSM, 136 patients were included as the control group. The decrease in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total protein (TP) in the treatment group before and after treatment was significantly greater than that in the control group (446.5 vs 159.0, 317.0 vs 92.0,5.2 vs 0.3), with statistically significant difference (P<0.05). DPMAS+HPE treatment is an independent protective factor for mortality in HBV-ACLF patients at 30 and 90 days (30 days: OR=0.497, P<0.05; 90 days: OR= 0.436, P<0.05). The cumulative survival rates at 30 and 90 days in the treatment group were significantly higher than those in the control group (30 days: 50.71% vs 44.12%, P<0.05; 90 days: 30.15% vs 22.79%, P<0.05). 【Conclusion】 DPMAS+HPE improves the short-term prognosis of HBV-ACLF patients and can serve as an effective artificial liver model for the treatment of HBV-ACLF patients.
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ObjectiveTo investigate the clinical efficacy of double plasma molecular adsorption system (DPMAS) and sequential plasma exchange (PE) combined with continuous renal replacement therapy (CRRT) in the treatment of patients with acute-on-chronic liver failure (ACLF) and acute kidney injury (AKI). MethodsA retrospective analysis was performed for the clinical data of 90 patients with ACLF and AKI who were hospitalized in The Affiliated Hospital of Guizhou Medical University from January 2019 to December 2022, and according to the method for blood purification, they were divided into DPMAS sequential PE+CRRT group (observation group with 31 patients) and DPMAS sequential PE group (control group with 59 patients). General data on admission and laboratory markers before and after blood purification were collected from all patients, including hepatic and renal function, coagulation function, and inflammation markers, and estimated glomerular filtration rate (eGFR) and MELD combined with serum sodium concentration (MELD-Na) score were calculated. The independent-samples t test was used for comparison of normally distributed continuous data between two groups; the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data within each group before and after treatment, and the Mann-Whitney U test was used for comparison between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThe observation group had a significantly higher response rate than the control group [48.4% (15/31) vs 27.1% (16/59), χ2=4.071, P=0.044]. The methods for blood purification in both groups could effectively improve total bilirubin, alanine aminotransferase, aspartate aminotransferase (AST), prothrombin time activity, serum creatinine (Scr), procalcitonin (PCT), C-reactive protein, eGFR, and MELD-Na score (all P<0.05), and both groups had significant reductions in platelet count (PLT) and hemoglobin (Hb) after treatment (all P<0.05), while there were no significant changes in blood urea nitrogen, albumin, and international normalized ratio after treatment (all P>0.05). There were significant differences between the two groups in the changes in AST, Scr, PCT, eGFR, MELD-Na score, Hb, and PLT after treatment (all P<0.05). ConclusionDPMAS sequential PE combined with CRRT can effectively remove inflammatory mediators, improve renal function, stabilize the internal environment of human body, and achieve a relatively good clinical efficacy.
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The adsorption of CO, NO, and O2 molecules onto Cu, Ag, and Au atoms placed in the S vacancies of a WS2 monolayer was elucidated within dispersion-corrected density functional theory. The binding energies computed for embedded defects into S vacancies were 2.99 (AuS), 2.44 (AgS), 3.32 eV (CuS), 3.23 (Au2S2), 2.55 (Ag2S2), and 3.48 eV/atom (Cu2S2), respectively. The calculated diffusion energy barriers from an S vacancy to a nearby site for Cu, Ag, and Au were 2.29, 2.18, and 2.16 eV, respectively. Thus, the substitutional atoms remained firmly fixed at temperatures above 700 K. Similarly, the adsorption energies showed that nitric oxide and carbon oxide molecules exhibited stronger chemisorption than O2 molecules on any of the metal atoms (Au, Cu, or Ag) placed in the S vacancies of the WS2 monolayer. Therefore, the adsorption of O2 did not compete with NO or CO adsorption and did not displace them. The density of states showed that a WS2 monolayer modified with a Cu, Au, or Ag atom could be used to design sensing devices, based on electronic or magnetic properties, for atmospheric pollutants. More interestingly, the adsorption of CO changed only the electronic properties of the MoS2-AuS monolayer, which could be used for sensing applications. In contrast, the O2 molecule was chemisorbed more strongly than CO or NO on Au2S2, Cu2S2, or Ag2S2 placed into di-S vacancies. Thus, if the experimental system is exposed to air, the low quantities of O2 molecules present should result in the oxidation of the metallic atoms. Furthermore, the O2 molecules adsorbed on WS2-Au2S2 and WS2-CuS introduced a half-metallic behavior, making the system suitable for applications in spintronics.
Subject(s)
Carbon , Nitric Oxide , Adsorption , Diffusion , Electronics , MetalsABSTRACT
BACKGROUND AND AIMS: Different modes of artificial liver support (ALS) therapy can improve the survival of patients with acute-on-chronic liver failure (ACLF). This study aimed to compare the effects of mixed using different modes of ALS (MALS) and single using one mode of ALS (SALS) on 28- and 90-day survival rates of ACLF. METHODS: Clinical data and survival times of patients with ACLF treated for ALS between January 1, 2018 and December 30, 2021 were retrospectively collected. Cox regression analysis was performed to identify risk factors of 28- and 90-day mortalities. RESULTS: Of the 462 eligible ACLF patients, 388 belonged to the SALS group (76.3% male, 74.2% cirrhosis) and 74 to the MALS group (86.5% male, 71.6% cirrhosis). Comparison of 28-day and 90-day crude mortality between the SALS and MALS groups showed no significant differences (28-day: 20.4% vs. 14.9%, p = 0.27; 90-day: 44.6% vs. 52.7%, p = 0.20). After adjusting for confounders, the 28-day mortality (adjusted hazard ratio [aHR]: 0.32, 95% confidence interval [CI] 0.16-0.65) and 90-day mortality (aHR: 0.65, 95% CI 0.44-0.95) in the MALS group were significantly lower than those in the SALS group. These associations were consistently observed across pre-specified subgroups according to age, sex, etiology, and Child-Pugh grade. However, positive interactions between MALS and 90-day mortality were found between MALS and 90-day mortality in those with MELD score ≥ 22 and international normalized ratio ≥ 1.9 (p for interaction < 0.05). CONCLUSION: MALS therapy significantly decreased 28- and 90-day mortalities of ACLF than SALS did, especially in advanced stages.
Subject(s)
Acute-On-Chronic Liver Failure , Liver, Artificial , Female , Humans , Male , Acute-On-Chronic Liver Failure/mortality , Liver Cirrhosis/complications , Liver, Artificial/adverse effects , Prognosis , Retrospective StudiesABSTRACT
Background and Aims: To investigate the safety and efficacy of double plasma molecular adsorption system (DPMAS) with sequential low-dose plasma exchange (LPE) in treating early hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods: Clinical data of patients with HBV-ACLF were prospectively collected, including patients in a DPMAS with sequential LPE (DPMAS+LPE) group and those in a standard medical treatment (SMT) group. The primary endpoint was death or liver transplantation (LT) at 12 weeks of follow-up. Propensity-score matching was performed to control the effects of confounding factors on prognosis between the two groups. Results: After 2 weeks, total bilirubin, alanine aminotransferase, blood urea nitrogen levels, and Chinese Group on the Study of Severe Hepatitis B score, were significantly lower in the DPMAS+LPE group than those in the SMT group (p<0.05). After 4 weeks, laboratory parameters of the two groups were similar. The cumulative survival rate of the DPMAS+LPE group was significantly higher than that of the SMT group at 4 weeks (97.9% vs. 85.4%, p=0.027), but not at 12 weeks (85.4% vs. 83.3%, p=0.687). Cytokine levels were significantly lower in 12-week survival group than in the death-or-LT group (p<0.05). Functional enrichment analysis showed that downregulated cytokines were mainly involved in positive regulation of proliferation and activation of lymphocytes and monocytes, regulation of immune effect response, regulation of endotoxin response, and glial cell proliferation. Conclusion: DPMAS+LPE significantly improved the 4-week cumulative survival rate, and ameliorated the inflammatory response in patients. DPMAS+LPE may be a promising modality for patients with early HBV-ACLF.
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Defective molybdenum disulfide (MoS2) monolayers (MLs) modified with coinage metal atoms (Cu, Ag and Au) embedded in sulfur vacancies are studied at a dispersion-corrected density functional level. Atmospheric constituents (H2, O2 and N2) and air pollutants (CO and NO), known as secondary greenhouse gases, are adsorbed on up to two atoms embedded into sulfur vacancies in MoS2 MLs. The adsorption energies suggest that the NO (1.44 eV) and CO (1.24 eV) are chemisorbed more strongly than O2 (1.07 eV) and N2 (0.66 eV) on the ML with a cooper atom substituting for a sulfur atom. Therefore, the adsorption of N2 and O2 does not compete with NO or CO adsorption. Besides, NO adsorbed on embedded Cu creates a new level in the band gap. In addition, it was found that the CO molecule could directly react with the pre-adsorbed O2 molecule on a Cu atom, forming the complex OOCO, via the Eley-Rideal reaction mechanism. The adsorption energies of CO, NO and O2 on Au2S2, Cu2S2 and Ag2S2 embedded into two sulfur vacancies were competitive. Charge transference occurs from the defective MoS2 ML to the adsorbed molecules, oxidizing the later ones (NO, CO and O2) since they act as acceptors. The total and projected density of states reveal that a MoS2 ML modified with copper, gold and silver dimers could be used to design electronic or magnetic devices for sensing applications in the adsorption of NO, CO and O2 molecules. Moreover, NO and O2 molecules adsorbed on MoS2-Au2s2 and MoS2-Cu2s2 introduce a transition from metallic to half-metallic behavior for applications in spintronics. These modified monolayers are expected to exhibit chemiresistive behavior, meaning their electrical resistance changes in response to the presence of NO molecules. This property makes them suitable for detecting and measuring NO concentrations. Also, modified materials with half-metal behavior could be beneficial for spintronic devices, particularly those that require spin-polarized currents.
Subject(s)
Copper , Gases , Adsorption , Molybdenum , Gold , SulfurABSTRACT
Current evidence suggests that the mortality rate of intermediate-stage hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) remains high. We aimed to investigate the safety and efficacy of double plasma molecular adsorption system (DPMAS) with sequential low-volume plasma exchange (LPE) treatment in intermediate-stage HBV-related ACLF. This prospective study recruited intermediate-stage HBV-related ACLF patients and was registered on ClinicalTrials.gov (NCT04597164). Eligible patients were randomly divided into a trial group and a control group. Patients in both groups received comprehensive medical treatment. Patients in the trial group further received DPMAS with sequential LPE. Data were recorded from baseline to Week 12. Fifty patients with intermediate-stage HBV-related ACLF were included in this study. The incidence of bleeding events and allergic reactions in the trial group was 12% and 4%, respectively, with no other treatment-related adverse events. The levels of total bilirubin and prothrombin time-international normalized ratio, and model for end-stage liver disease scores after each session of DPMAS with sequential LPE were significantly lower than those before treatment (all p < 0.05). The 12-week cumulative liver transplantation-free survival rates in the trial and control groups were 52% and 24%, respectively (p = 0.041). The 12-week cumulative overall survival rates in the trial and control groups were 64% and 36%, respectively (p = 0.048). The Kaplan-Meier survival analysis revealed significant differences in liver transplantation-free survival (p = 0.047) and overall survival (p = 0.038) between the trial and control groups. Cox regression analysis indicated that blood urea nitrogen (p = 0.038), DPMAS with sequential LPE (p = 0.048), and Chinese Group on the Study of Severe Hepatitis B-ACLF II score (p < 0.001) were significant risk factors for mortality. DPMAS with sequential LPE treatment is safe and effective for patients with intermediate-stage HBV-related ACLF.
Subject(s)
Acute-On-Chronic Liver Failure , End Stage Liver Disease , Hepatitis B, Chronic , Hepatitis B , Humans , Hepatitis B virus , Plasma Exchange/adverse effects , Acute-On-Chronic Liver Failure/therapy , Prospective Studies , End Stage Liver Disease/complications , Adsorption , Severity of Illness Index , Hepatitis B/complications , Hepatitis B/therapy , Prognosis , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/therapy , Retrospective StudiesABSTRACT
Developing highly efficient gas sensors with excellent performance for rapid and sensitive detection of volatile organic compounds (VOCs) is of critical importance for the protection of human health, ecological environment, and other factors. Here, a robust gas sensor based on Raman technology was constructed by an in situ grown 2D covalent organic framework (COF) on Au nanoparticles' surface in the microchannel. Dual enhancement effects are included for the as-prepared microfluidic sensor. First, acting as a gas confinement chamber, the 2D COF could effectively capture gas molecules with high adsorption capacity and fast adsorption kinetics, resulting in VOCs' preconcentration at a high level in the COF layer. At the same time, after being stacked in the microchannel, abundant hot spots were generated among the nanogaps of Au@COF NPs. The local surface plasmon resonance effect could effectively enhance the Raman intensity. Both factors contribute to the improved detection sensitivity of VOCs. As a demonstration, several representative VOCs with different functional groups were tested. The resultant Raman spectra were subjected to the statistical principal component analysis. Varied VOCs can be successfully detected with a detection limit as low as ppb level and distinguished with 95% confidence interval. The present microfluidic platform provides a simple, sensitive, and fast method for VOCs' sensing and distinguishing, which is expected to hold potential applications in the fields of health, agricultural, and environmental research.
Subject(s)
Metal Nanoparticles , Volatile Organic Compounds , Humans , Volatile Organic Compounds/analysis , Adsorption , Gold , Spectrum Analysis, Raman/methodsABSTRACT
Background and Aims: Nonbiological artificial liver (NBAL) is frequently used as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). This study aimed to compare the therapeutic efficacy and cost-effectiveness ratio (CER) of comprehensive medical treatment, plasma exchange (PE), and double plasma molecular adsorption system (DPMAS) plus half-dose PE (DPMAS+PE) in patients with HBV-ACLF. Methods: A total of 186 patients with HBV-ACLF randomly received comprehensive medical treatment, PE, or DPMAS+PE and were prospectively evaluated. Patients were divided into four subgroups based on the pretreatment prothrombin activity (PTA): Group I (PTA>40%), group II (PTA 30-40%), group III (PTA 20-30%), and group IV (PTA<20%). The main outcome measures were 28 day effectiveness; 90 day liver transplantation-free survival; change of biochemical parameters; and CER. Results: DPMAS+PE treatment was associated with significantly higher 28 day effectiveness and 90 day liver transplantation-free survival compared with PE treatment in patients with group I liver failure. Clearance of serum total bilirubin (TBIL), AST, and creatinine (Cr) were significantly higher in the DPMAS+PE group than in the PE group. For subjects with group I liver failure, DPMAS+PE treatment had advantages of lower CER values and better cost-effectiveness. Conclusions: Compared with comprehensive medical treatment and PE alone, DPMAS with half-dose sequential PE treatment more effectively improved TBIL, AST, and Cr in HBV-ACLF patients, improved 28 day effectiveness and 90 day survival rates in patients with group I liver failure, and was more cost effective. DPMAS+PE is a viable NBAL approach for treatment of HBV-ACLF.