Self-supporting three-dimensional CuNi-Sb-SnO2 anode with ultra-long service life for efficient removal of antibiotics in wastewater.

Electrochemical ozone production (EOP) is a promising technology for the removal of contaminants in wastewater. However, traditional two-dimensional anodes for EOP are restricted by their reliance on substrates and limited surface area, thus exhibiting poor stability and efficiency. Herein, a novel three-dimensional Sb-SnO2 with Cu and Ni co-doped (3D CuNi-ATO) was synthesized via a facile pressing-sintering method without the Ti substrate. 3D CuNi-ATO had a specific surface area two orders of magnitude higher than conventional CuNi-ATO/Ti, as well as the significant capability of EOP that differs from intrinsic 3D ATO. This endowed 3D CuNi-ATO with the capability to remove tetracycline with a pseudo-first-order rate constant of 0.033 min-1 under a low current density of 5 mA cm-2 within 120 min, which was far more efficient than that by 3D ATO and other two-dimensional anodes reported. The 3D CuNi-ATO was confirmed stable in 100 cycles and had an accelerated service lifetime of over 1100 h versus 83 h of CuNi-ATO/Ti. The degradation of tetracycline in complex matrix and flow-through reactors further revealed the promising potential of 3D CuNi-ATO to be applied in scenarios of practical application and continuous high-rate treatment.

Glioma stem cells remodel immunotolerant microenvironment in GBM and are associated with therapeutic advancements.

Glioma is the most common primary tumor of the central nervous system (CNS). Glioblastoma (GBM) is incurable with current treatment strategies. Additionally, the treatment of recurrent GBM (rGBM) is often referred to as terminal treatment, necessitating hospice-level care and management. The presence of the blood-brain barrier (BBB) gives GBM a more challenging or "cold" tumor microenvironment (TME) than that of other cancers and gloma stem cells (GSCs) play an important role in the TME remodeling, occurrence, development and recurrence of giloma. In this review, our primary focus will be on discussing the following topics: niche-associated GSCs and macrophages, new theories regarding GSC and TME involving pyroptosis and ferroptosis in GBM, metabolic adaptations of GSCs, the influence of the cold environment in GBM on immunotherapy, potential strategies to transform the cold GBM TME into a hot one, and the advancement of GBM immunotherapy and GBM models.

Copper-Catalyzed Enantioselective Dehydro-Diels-Alder Reaction: Atom-Economical Synthesis of Axially Chiral Carbazoles.

The dehydro-Diels-Alder (DDA) reaction is a powerful method for the construction of aromatic compounds. However, the enantioselective DDA reaction has been rarely developed, probably due to the competitive thermal reaction. Herein, we report a copper-catalyzed enantioselective DDA reaction through vinyl cation pathway. The reaction leads to the atom-economical synthesis of axially chiral phenyl and indolyl carbazoles in generally excellent yields with good to excellent atroposelectivities. This methodology represents the first example of non-noble metal-catalyzed enantioselective DDA reaction. Notably, new chiral ligand and organocatalyst derived from the constructed axially chiral carbazole are demonstrated to be useful in asymmetric catalysis.

A single-center study of reference intervals for TAT, PIC, TM and t-PAIC in healthy older Chinese adults.

OBJECTIVE: To explore the distribution of thrombin-antithrombin complex (TAT), plasmin-α2-antiplasmin inhibitor complex (PIC), thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex (t-PAIC) in healthy older Chinese adults, and establish the reference intervals (RIs). METHODS: The Biotech Shine i2900 chemiluminescence immune assay was used to measure the plasma concentrations of TAT, PIC, TM, and t-PAIC in 1628 adults ≥ 60 years. The RIs were established using the 2.5th and 97.5th percentiles of the distribution. RESULTS: TAT levels were lower in males than females across all ages. Differences between the ages of 60-79 and ≥ 80 in both sex groups were statistically significant, with an upward trend with age. PIC levels showed no difference between the sexes but increased with age in both groups. TM levels did not differ between the sex groups, with slight fluctuation with age. The level in females aged 60-69 was slightly higher than that in the other groups; the difference was statistically significant. T-PAIC levels were not significantly different between the sex groups, with less fluctuation with sex and age. The level in males ≥ 80 years old was slightly lower than that in the other groups; the difference was statistically significant. The RIs for all markers in healthy older Chinese adults were determined and statistically reported by age and sex. For TAT, the RIs for males aged 60-79 and ≥ 80 are 0.51-2.30 ng/mL and 0.88-3.72 ng/mL, respectively, whereas for females aged 60-79 and ≥ 80, the RIs are 0.68-2.82 ng/mL and 1.02-3.67 ng/mL, respectively. For PIC, the RIs for the age groups 60-69, 70-79, and ≥ 80 are 0.10-0.89 µg/mL, 0.12-1.00 µg/mL, and 0.21-1.04 µg/mL, respectively. The RI of TM for females aged 60-69 is 3.32-13.22 TU/mL, whereas it is 2.96-13.26 TU/mL for the other groups. The RI of t-PAIC for males aged ≥ 80 is 1.63-10.68 ng/mL, whereas it is 2.33-11.34 ng/mL for the other groups. CONCLUSIONS: Discrepancies exist in thrombus markers among different sex and age groups. The RIs of TAT, PIC, TM and t-PAIC for healthy older Chinese adults were successfully established.

Predicting survival in sepsis: The prognostic value of NLR and BAR ratios.

BACKGROUND: Due to the high-risk nature of sepsis, emergency departments urgently need a simple evaluation method to assess the degree of inflammation and prognosis in sepsis patients, providing a reference for diagnosis and treatment. OBJECTIVE: To investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) combined with the blood urea nitrogen-to-serum albumin ratio (BAR) in sepsis. METHODS: A total of 377 sepsis patients admitted to Lishui People's Hospital from June 2022 to June 2023 were selected as the study subjects. Based on their prognosis, they were divided into a survival group (255 cases) and a death group (82 cases). The clinical data of the two groups were compared. Multivariate logistic analysis was used to identify factors influencing sepsis prognosis, and ROC curve analysis was used to assess the predictive efficacy of NLR, BAR, and their combination. RESULTS: Compared with survivors, non-survivors had higher NLR and BAR, with statistically significant differences (p< 0.05). After adjusting for confounding factors, NLR (OR = 1.052) and BAR (OR = 1.095) were found to be independent prognostic factors for sepsis patients (both p< 0.05). The AUC of NLR combined with BAR was 0.798 (95% CI 0.745-0.850, p< 0.05), higher than the AUC of NLR alone (0.776) and BAR alone (0.701). CONCLUSIONS: The combination of NLR and BAR has a high predictive value for the prognosis of sepsis patients. Its simple calculation makes it particularly suitable for use in emergency departments.

Enhancing the nitrogen removal of anammox sludge by setting up novel redox mediators-mediated anammox process.

Anaerobic ammonium oxidizing (anammox) bacteria have been proven weak-electroactive. However, the impact of exogenous anthraquinone-2,6-disulfonate (AQDS) on the anammox activity, although it usually plays essential roles in the life activities of many other electroactive microorganisms, is still unknown. Therefore, this study further explored the influences of AQDS on the anammox activity and the interaction mechanism with anammox bacteria, as well as the behaviors of NH4+, NO2-, and NO3-. The results showed that exogenous AQDS increased the ammonium and total nitrogen removal rates by 12.8% and 10.7%, respectively. Interestingly, the conversion from NO2- to NO3- was significantly reduced after adding AQDS, resulting in a 40.1% reduction in NO3- production of anammox process. In this study, we found for the first time that anammox bacteria could not only carry out the conventional anammox process but also perform a weak redox mediators-mediated anammox process, which could achieve the 1:1 consumption of NH4+ and NO2-. The redox mediators-mediated anammox process was related to an endogenous redox mediator (ERM) synthesized and secreted by anammox bacteria, whose redox midpoint potential was around -0.26 V (vs. Ag/AgCl). After adding AQDS, not only the ERM-mediated anammox process was enhanced, but also two novel redox mediators-mediated anammox processes were introduced, including the AQDS-mediated anammox process and ERM-AQDS-mediated anammox process. These three redox mediators-mediated anammox processes significantly improved the nitrogen removal performance of anammox bacteria and reduced energy consumption. These findings will help reduce the dependence of anammox technology on NO2-, reduce the cost of subsequent treatment of NO3-, and provide new visions for optimizing and applying anammox technology.

One-Pot Stereoselective Synthesis of the Naphthofurano-Iminosugars via a [3 + 2] Cycloaddition Reaction.

This study presents the synthesis of novel naphthofurano-iminosugars (4) using 2,3-O-isopropylidene D-ribose tosylate (1a), anilines (2), and 1,4-benzoquinone (3a) as starting materials through key iminium ion/enamine intermediates via [3 + 2] cyclization reactions at room temperature. The reaction has unique regioselectivity and stereoselectivity with moderate to excellent yields. The adaptability of this method has been demonstrated using various substituted anilines, on which both electron-donating and electron-withdrawing groups were well employed in the reactions. Notably, the treatment of the fused multicyclic iminosugar 4 with TFA efficiently leads to an interesting unexpected pyridinium salt (8), possible via four sequential steps: deprotection of the 2,3-O-isopropylidene group, furan ring opening, dehydration condensation of the OH groups, and elimination of water.

Delirium in the ICU: how much do we know? A narrative review.

Delirium in critical ill patients is a complex and common neurological syndrome in the intensive care unit (ICU) that is caused by a range of structural or functional abnormalities. ICU Delirium is associated with reduced compliance, prolonged hospital stays, greater use or delayed withdrawal of sedatives, higher rates and durations of mechanical ventilation, and higher rates of mortality. The aetiology and pathogenesis of ICU delirium are unclear, and the lack of better prediction, prevention, and treatment measures leads to a non-standardized control of delirium. By searching the relevant literature, we aim in this narrative review to describe progress in the pathogenesis, predictive biomarkers, diagnosis, and treatment of ICU delirium.

An integrated machine learning model enhances delayed graft function prediction in pediatric renal transplantation from deceased donors.

BACKGROUND: Kidney transplantation is the optimal renal replacement therapy for children with end-stage renal disease; however, delayed graft function (DGF), a common post-operative complication, may negatively impact the long-term outcomes of both the graft and the pediatric recipient. However, there is limited research on DGF in pediatric kidney transplant recipients. This study aims to develop a predictive model for the risk of DGF occurrence after pediatric kidney transplantation by integrating donor and recipient characteristics and utilizing machine learning algorithms, ultimately providing guidance for clinical decision-making. METHODS: This single-center retrospective cohort study includes all recipients under 18 years of age who underwent single-donor kidney transplantation at our hospital between 2016 and 2023, along with their corresponding donors. Demographic, clinical, and laboratory examination data were collected from both donors and recipients. Univariate logistic regression models and differential analysis were employed to identify features associated with DGF. Subsequently, a risk score for predicting DGF occurrence (DGF-RS) was constructed based on machine learning combinations. Model performance was evaluated using the receiver operating characteristic curves, decision curve analysis (DCA), and other methods. RESULTS: The study included a total of 140 pediatric kidney transplant recipients, among whom 37 (26.4%) developed DGF. Univariate analysis revealed that high-density lipoprotein cholesterol (HDLC), donor after circulatory death (DCD), warm ischemia time (WIT), cold ischemia time (CIT), gender match, and donor creatinine were significantly associated with DGF (P < 0.05). Based on these six features, the random forest model (mtry = 5, 75%p) exhibited the best predictive performance among 97 machine learning models, with the area under the curve values reaching 0.983, 1, and 0.905 for the entire cohort, training set, and validation set, respectively. This model significantly outperformed single indicators. The DCA curve confirmed the clinical utility of this model. CONCLUSIONS: In this study, we developed a machine learning-based predictive model for DGF following pediatric kidney transplantation, termed DGF-RS, which integrates both donor and recipient characteristics. The model demonstrated excellent predictive accuracy and provides essential guidance for clinical decision-making. These findings contribute to our understanding of the pathogenesis of DGF.

Distinct Immune Homeostasis Remodeling Patterns after HLA-Matched and Haploidentical Transplantation.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a widely used treatment for a variety of hematopoietic disorders, and also provides a valuable platform for investigating the development of donor-derived immune cells in recipients post-HSCT. The immune system remodels from the donor to the recipient during allo-HSCT. However, little is known about the cell profile alterations as donor homeostasis rebalances to recipient homeostasis following HSCT. Here, multi-omics technology is applied at both the single cell and bulk sample levels, as well as spectrum flow cytometry and fluorescent transgenic mouse models, to dissect the dynamics of the rebalanced homeostatic immune system in recipients after allo-HSCT. The data reveal that all immune subpopulations observed in donors are successfully restored in recipients, though with varying levels of abundance. The remodeling of immune homeostasis exhibits different patterns in HLA-matched and haploidentical HSCT, highlighting distinct biases in T cell reconstitution from the central and peripheral pathways. Furthermore, ZNF683 is critical for maintaining the persistence and quiescence of CD8 T-cell in haploidentical HSCT. The research can serve as a foundation for developing novel strategies to induce immune tolerance.

Outcomes of radiofrequency ablation for hepatocellular carcinoma with concurrent steatotic liver disease.

BACKGROUND: Steatotic liver disease (SLD) is an emerging liver disease that has been associated with an increased risk for hepatocellular carcinoma (HCC). The impact of concurrent SLD on the prognosis of HCC remains unknown. This study investigates how concurrent SLD affects the outcomes of patients with HCC undergoing curative radiofrequency ablation (RFA) therapy. METHODS: A retrospective analysis of patients with early-stage HCC receiving curative RFA at a tertiary medical center was conducted. Laboratory data and HCC characteristics were recorded and analyzed by a Cox proportional hazards regression model to predict recurrence and all-cause mortality after RFA. RESULTS: A total of 598 patients with HCC were included between 2005 and 2015, with 139 and 459 classified in SLD and non-SLD groups, respectively. The SLD group exhibited a significantly better liver reserve and a lower cumulative incidence of HCC recurrence and liver-related and all-cause mortality after a median follow-up of 51 months. After adjusting for metabolic dysfunction, liver reserve, and HCC characteristics, the presence of SLD reduced all-cause mortality (adjusted hazard ratio [aHR], 0.67; 95% confidence interval [CI], 0.45-0.996; p = .048), which was supported by inverse probability weighting analysis (aHR, 0.65; 95% CI, 0.42-1.00; p = .049). Poor liver functional reserve (high albumin-bilirubin grades) increased all-cause mortality dose dependently. Barcelona Clinic Liver Cancer staging and a higher Fibrosis-4 index were predictors for HCC recurrence, whereas SLD was not. CONCLUSIONS: Among patients with HCC undergoing curative RFA, those with concurrent SLD had a lower risk of all-cause mortality compared to those with poor liver functional reserve. PLAIN LANGUAGE SUMMARY: The present research demonstrated that patients with both liver cancer and steatotic liver disease who received curative radiofrequency ablation for liver cancer survived longer compared to those without steatotic liver disease. Maintaining good liver function is an important prognostic factor for survival.

Recent advances in moisture-induced electricity generation based on wood lignocellulose: Preparation, properties, and applications.

Moisture-induced electricity generation (MEG), which can directly harvest electricity from moisture, is considered as an effective strategy for alleviating the growing energy crisis. Recently, tremendous efforts have been devoted to developing MEG active materials from wood lignocellulose (WLC) due to its excellent properties including environmental friendliness, sustainability, and biodegradability. This review comprehensively summarizes the recent advances in MEG based on WLC (wood, cellulose, lignin, and woody biochar), covering its principles, preparation, performances, and applications. In detail, the basic working mechanisms of MEG are discussed, and the natural features of WLC and their significant advantages in the fabrication of MEG active materials are emphasized. Furthermore, the recent advances in WLC-based MEG for harvesting electrical energy from moisture are specifically discussed, together with their potential applications (sensors and power sources). Finally, the main challenges of current WLC-based MEG are presented, as well as the potential solutions or directions to develop highly efficient MEG from WLC.

Factor structure and measurement invariance of the University Demand-Resource Questionnaire: further evidence from Hungarian university students.

Purpose: The present study aimed to further examine the factor structure and measurement invariance of the UDRQ among a sample of Hungarian university students. Methods: Firstly, the factor structure of the UDRQ was examined among 837 Hungarian university students. Specifically, two measurement models (first-order model and second-order model) were constructed and compared. Secondly, the internal consistency reliability of the UDRQ was examined. Thirdly, measurement invariance of the UDRQ was evaluated across genders. Finally, measurement invariance of the UDRQ was evaluated across two different samples. Results: It was found that the first-order model outperformed the second-order model and better represented the factor structure of the UDRQ subscales. Results of Cronbach's alpha and Composite Reliability suggested that the internal consistency reliabilities of the two UDRQ subscales were satisfactory. Measurement invariance analysis revealed that the UDRQ measurement model was strict invariant across genders and samples. Conclusion: The findings of the present study indicated that the UDRQ displayed satisfactory reliability and validity and could be used to assess demands and resources of Hungarian university students.

HaploSweep: detecting and distinguishing recent soft and hard selective sweeps through haplotype structure.

Identifying soft selective sweeps using genomic data is a challenging yet crucial task in population genetics. In this study, we present HaploSweep, a novel method for detecting and categorizing soft and hard selective sweeps based on haplotype structure. Through simulations spanning a broad range of selection intensities, softness levels, and demographic histories, we demonstrate that HaploSweep outperforms iHS, nSL, and H12 in detecting soft sweeps. HaploSweep achieves high classification accuracy-0.9247 for CHB, 0.9484 for CEU, and 0.9829 YRI-when applied to simulations in line with the human Out-of-Africa demographic model. We also observe that the classification accuracy remains consistently robust across different demographic models. Additionally, we introduce a refined method to accurately distinguish soft shoulders adjacent to hard sweeps from soft sweeps. Application of HaploSweep to genomic data of CHB, CEU, and YRI populations from the 1000 genomes project has led to the discovery of several new genes that bear strong evidence of population-specific soft sweeps (HRNR, AMBRA1, BFA2T2, DYNC2H1, and RANBP2 etc), with prevalent associations to immune functions and metabolic processes. The validated performance of HaploSweep, demonstrated through both simulated and real data, underscores its potential as a valuable tool for detecting and comprehending the role of soft sweeps in adaptive evolution.

Radiofrequency affects the decrystallization efficiency and physicochemical properties of rape honey via crystal structure modification and inactivating enzyme.

Crystallization degrades the physicochemical properties of honey and reduces consumer acceptance. To address this issue, radiofrequency was developed to investigate the decrystallization efficiency and quality impact mechanism of rape honey. The results showed that radiofrequency significantly decreased the number and size of crystals, leading to shortening the decrystallization time to less than 10 min. The response surface optimization methodology further indicated that the highest decrystallization rate (98.72 ± 0.34 %) and lower 5-Hydroxymethylfurfural (2.45 ± 0.12 mg/kg) contents were obtained. Furthermore, radiofrequency changed the honey from a pseudoplastic into a Newtonian fluid efficiently due to the volumetric heating feature. It is worth noting that the inactivation of glucose oxidase reduced the antibacterial capacity, while the increase in total phenolic and flavonoid contents improved the antioxidant capacity of rape honey. In summary, current findings indicated that radiofrequency is a potential alternative decrystallization technology for water baths.

The effect of co-regulation on English public speaking self-efficacy in collaborative oral presentations.

This study investigated the influence of co-regulation on public speaking self-efficacy in the context of collaborative oral presentations. A total of 237 students enrolled in an English course at a university in China took part in the research. The factor analysis findings revealed that learners' co-regulation in public speaking encompass five components: co-planning, co-monitoring, co-evaluation, effort regulation, and help-seeking. Public speaking self-efficacy, on the other hand, pertains to learners' confidence in aspects including the topic, language use, organization, and delivery during public speaking engagements. The path analysis demonstrated that co-planning was a significant predictor of students' self-efficacy in terms of the topic and organization. Moreover, the co-monitoring strategy exhibited direct and positive correlations with language and topic self-efficacy. Similarly, the co-evaluation strategy showed direct and positive relationships with language, delivery, and organization self-efficacy. Furthermore, both effort regulation and help-seeking strategies were found to have direct and positive impacts on organization self-efficacy. This study offers valuable implications for educators, trainers, and individuals aiming to enhance their public speaking self-efficacy in collaborative environments.

AMG 193, a Clinical Stage MTA-Cooperative PRMT5 Inhibitor, Drives Antitumor Activity Preclinically and in Patients With MTAP-Deleted Cancers.

One of the most robust synthetic lethal interactions observed in multiple functional genomic screens has been dependency on PRMT5 in cancer cells with MTAP deletion. We report the discovery of the clinical stage MTA-cooperative PRMT5 inhibitor AMG 193, which preferentially binds PRMT5 in the presence of MTA and has potent biochemical and cellular activity in MTAP-deleted cells across multiple cancer lineages. In vitro, PRMT5 inhibition induces DNA damage, cell cycle arrest, and aberrant alternative mRNA splicing in MTAP-deleted cells. In human cell line and patient-derived xenograft models, AMG 193 induces robust antitumor activity and is well tolerated with no impact on normal hematopoietic cell lineages. AMG 193 synergizes with chemotherapies or the KRAS G12C inhibitor sotorasib in vitro, and combination treatment in vivo significantly inhibits tumor growth. AMG 193 is demonstrating promising clinical activity, including confirmed partial responses in patients with MTAP-deleted solid tumors from an ongoing phase 1/2 study.

Nursing Undergraduate Students' Experiences and Perceptions of Blended Learning in Pediatric Nursing: A Mixed Methods Study.

Introduction: Blended learning is a teaching approach that integrates online self-learning and classroom teaching. It emphasizes students' self-directed learning, actively engaging, as well as communication and collaboration. Blended learning develops the qualities in nursing undergraduate students with problem-solving ability, clinical thinking, and communication skills as nurses have. Currently, learners' experience has become an important factor in determining the success of blended learning. Aim: To learn about the experiences and perceptions of undergraduate nursing students regarding blending learning in pediatric nursing. Methods: A mixed methods design beginning with a quantitative data collection and analysis phase to inform the subsequent qualitative phase was utilized. This study was conducted among undergraduate nursing students at one university in China. In the quantitative study phase, a convenience sample of 59 students completed the online survey while the qualitative study phase included nine students recruited by purposive sampling. The qualitative data were collected using individual semistructured in-depth interviews. Audio data were transcribed and subjected to thematic analysis. The findings from those two phases were integrated into the final analysis. Results: The majority (89.8%) of students reported satisfaction with blended learning. Among various teaching methods, case-based learning (CBL) was the most preferred (98.3%). Regarding the qualitative data, students reported positive experiences with blended learning including well-organized course structure, resourceful course content, and high teacher quality. They stated that blended learning improved the learning outcomes such as improving problem-solving ability and developing clinical thinking. They also provided suggestions for achieving better learning outcomes, including providing stressful learning activities, optimizing online course design, and improving the quality of group learning. Conclusions: The blended learning model of pediatric nursing based on the Community of Inquiry framework provides a positive learning experience for nursing undergraduate students. However, ongoing assessment and improvement of the blended learning process are also needed.

Effect of the Step-Jump Approach in Infected Pancreatic Necrosis: A Propensity Score-Matched Study.

Purpose: The effects of the step-jump approach on the survival and prognosis of infected pancreatic necrosis (IPN) patients have not yet been determined. Patients and Methods: Between November 2018 and June 2023, 188 patients were included in this study. There were 144 patients in the step-up group (the SU group) and 44 in the step-jump group (the SJ group). In the SU group, patients successfully treated with percutaneous catheter drainage (PCD) alone were classified into the SU-1 group (n=101), while those requiring additional surgery after PCD were categorized into the SU-2 group (n=43). In the SJ group, patients who underwent minimally invasive necrosectomy (MIN) without PCD were assigned to the SJ-1 group (n=34), whereas those who initially underwent PCD followed by immediate open surgery were placed in the SJ-2 group (n=10). Propensity score matching (PSM) was used to mitigate bias. Results: After PSM, a total of 34 pairs were successfully matched. A comparison of the SU group with the SJ-1 group (upfront MIN without PCD) revealed similar mortality rates (P=0.239); however, the incidences of multiple drug-resistant organisms (MDROs) (P=0.029) and surgical complications (P<0.001) were significantly lower in the SJ-1 group. After comparing the SU-2 and SJ-2 groups (patients who underwent direct open necrosectomy without MIN after PCD failure), the incidences of surgical complications and MDRO in the SJ-2 group were significantly lower (P<0.05). Conclusion: Compared with the step-up approach, the step-jump approach is safer and more effective and can significantly reduce the incidence of MDRO and surgical complications.