Lanthanum-calcium bimetallic-modified attapulgite- chitosan hydrogel beads for efficient phosphate removal from water: Performance evaluation, mechanistic and life cycle assessment.

Phosphorus is a critical factor in the control of eutrophication. We developed a three-dimensional porous, bimetallic-modified adsorbent La-Ca-CS/ATP to remove excess phosphate from water. Langmuir model showed that the theoretical adsorption capacity of La-Ca-CS/ATP was up to 123 mg P/g. The amount of La and Ca leached by La-Ca-CS/ATP was small, and the adsorption of 36.08 mg P/g was maintained during the five cycles of La-Ca-CS/ATP. The La-Ca-CS/ATP adsorption mechanism mainly involved surface precipitation, ligand exchange, electrostatic attraction, and inner-sphere complexation. Molecular dynamics demonstrated that La and Ca had complementary effects on binding sites and energy barriers within the range of 0.5-0.7 nm and 1.2-2 nm, enhancing the adsorption effect of La-Ca-CS/ATP. The life cycle assessment results showed that adding calcium could help reduce the environmental impact of lanthanum and chitosan. The production of La-Ca-CS/ATP adsorbed 73.88 P mg/g and emitted 24.73 kg CO2 eq, which was less than other adsorbents.

CircCamsap1 is dispensable for male fertility in mice.

Background: Circular RNAs (circRNAs) are a large class of RNAs present in mammals. Among these, circCamsap1 is a well-acknowledged circRNA with significant implications, particularly in the development and progression of diverse tumors. However, the potential consequences of circCamsap1 depletion in vivo on male reproduction are yet to be thoroughly investigated. Methods: The presence of circCamsap1 in the mouse testes was confirmed, and gene expression analysis was performed using reverse transcription quantitative polymerase chain reaction. CircCamsap1 knockout mice were generated utilizing the CRISPR/Cas9 system. Phenotypic analysis of both the testes and epididymis was conducted using histological and immunofluorescence staining. Additionally, fertility and sperm motility were assessed. Results: Here, we successfully established a circCamsap1 knockout mouse model without affecting the expression of parental gene. Surprisingly, male mice lacking circCamsap1 (circCamsap1-/-) exhibited normal fertility, with no discernible differences in testicular and epididymal histology, spermatogenesis, sperm counts or sperm motility compared to circCamsap1+/+ mice. These findings suggest that circCamsap1 may not play an essential role in physiological spermatogenesis. Nonetheless, this result also underscores the complexity of circRNA function in male reproductive biology. Therefore, further research is necessary to elucidate the precise roles of other circRNAs in regulating male fertility.

Anti-Solvent-Free Fabrication of Stable FA0.9Cs0.1PbI3 Perovskite Solar Cells with Efficiency Exceeding 24.0% through a Naphthalene-Based Passivator.

The anti-solvent-free fabrication of high-efficiency perovskite solar cells (PSCs) holds immense significance for the transition from laboratory-scale to large-scale commercial applications. However, the device performance is severely hindered by the increased occurrence of surface defects resulting from the lack of control over nucleation and crystallization of perovskite using anti-solvent methods. In this study, 2-(naphthalen-2-yl)ethylamine hydriodide (NEAI) is employed as the surface passivator for perovskite films without using any anti-solvent. Naphthalene demonstrates strong π-π conjugation, which aids in the efficient extraction of charge carriers. Additionally, the naphthalene-ring moieties form a tight attachment to the perovskite surface. After NEAI treatment, FA and I vacancies are selectively occupied by NEA+ and I- in NEAI respectively, thus effectively passivating the surface defects and isolating the surface from moisture. Ultimately, the optimized NEAI-treated device achieves a promising power conversion efficiency (PCE) of 24.19% (with a certified efficiency of 23.94%), featuring a high fill factor of 83.53%. It stands out as one of the reported high PCEs achieved for PSCs using the spin-coating technique without the need for any anti-solvent so far. Furthermore, the NEAI-treated device can maintain ≈87% of its initial PCE after 2000 h in ambient air with a relative humidity of 30% ± 5%.

Erector spinae plane block versus quadratus lumborum block for postoperative analgesia after laparoscopic nephrectomy: A randomized controlled trial.

STUDY OBJECTIVE: We compared the analgesic effects of erector spinae plane block versus quadratus lumborum block following laparoscopic nephrectomy. DESIGN: A randomized controlled trial. SETTING: A tertiary hospital in Beijing, China. PATIENTS: Patients scheduled for elective laparoscopic nephrectomy. INTERVENTIONS: A total of 110 patients were enrolled and randomized to receive either erector spinae plane block (n = 55) or quadratus lumborum block (n = 55) under ultrasound guidance. Patient-controlled sufentanil analgesia was provided after surgery. MEASUREMENTS: Our primary outcome was cumulative opioid consumption within 24 h after surgery. Secondary outcomes included postoperative pain intensity, subjective sleep quality, and quality of recovery. MAIN RESULTS: All 110 patients (mean 53 years, 57.3% female) were included in the intention-to-treat analysis. Cumulative sufentanil equivalent within 24 h was lower in patients given erector spinae plane block (median 13 µg, interquartile range 4 to 33) than in those given quadratus lumborum block (median 25 µg, interquartile range 13 to 39; median difference - 8 µg, 95% CI -15 to 0, P = 0.041). Pain intensity (0-10 range where 0 = no pain and 10 = the worst pain) at 2, 6, 12, and 24 h after surgery was lower with erector spinae plane block (at rest: median differences -1 point, all P ≤ 0.009; with movement: median differences -2 to -1 points, all P < 0.001). Subjective sleep quality on the night of surgery (the Richards-Campbell Sleep Questionnaire: 0-100 range, higher score better; median difference 12, 95% CI 2 to 23, P = 0.018) and quality of recovery at 24 h (the Quality of Recovery-15: 0-150 range, higher score better; median difference 8, 95% CI 2 to 15, P = 0.012) were better with erector spinae plane block. No procedure-related adverse events occurred. CONCLUSIONS: Compared with quadratus lumborum block, erector spinae plane block provided better analgesia as manifested by lower opioid consumption and pain intensity for up to 24 h after laparoscopic nephrectomy.

Methacrylic acid in situ modified steel converter slag/natural rubber composites: Resourceful utilization of steelmaking solid wastes.

As a by-product of the steelmaking industry, the large-volume production and accumulation of steel converter slag cause environmental issues such as land occupation and dust pollution. Since metal salts of unsaturated carboxylic acid can be used to reinforce rubber, this study explores the innovative application of in-situ modified steel slag, mainly comprising metal oxides, with methacrylic acid (MAA) as a rubber filler partially replacing carbon black. By etching the surface of steel slag particles with MAA, their surface roughness was increased, and the chemical bonding of metal methacrylate salt was introduced to enhance their interaction with the molecular chain of natural rubber (NR). The results showed that using the steel slag filler effectively shortened the vulcanization molding cycle of NR composites. The MAA in-situ modification effectively improved the interaction between steel slag and NR molecular chains. Meanwhile, the physical and mechanical properties, fatigue properties, and dynamic mechanical properties of the experimental group with MAA in-situ modified steel slag (MAA-in-situ-m-SS) were significantly enhanced compared with those of NR composites partially filled with unmodified slag. With the dosage of 7.5 phr or 10 phr, the above properties matched or even exceeded those of NR composites purely filled with carbon black. More importantly, partially replacing carbon black with modified steel slag reduced fossil fuel consumption and greenhouse gas emission from carbon black production. This study pioneered an effective path for the resourceful utilization of steel slag and the green development of the steelmaking and rubber industries.

Site-Selective Tyrosine Reaction for Antibody-Cell Conjugation and Targeted Immunotherapy.

Targeted immunotherapies capitalize on the exceptional binding capabilities of antibodies to stimulate a host response that effectuates long-lived tumor destruction. One example is the conjugation of immunoglobulins (IgGs) to immune effector cells, which equips the cells with the ability to recognize and accurately kill malignant cells through a process called antibody-dependent cellular cytotoxicity (ADCC). In this study, a chemoenzymatic reaction is developed that specifically functionalizes a single tyrosine (Tyr, Y) residue, Y296, in the Fc domain of therapeutic IgGs. A one-pot reaction that combines the tyrosinase-catalyzed oxidation of tyrosine to o-quinone with a subsequent [3+2] photoaddition with vinyl ether is employed. This reaction installs fluorescent molecules or bioorthogonal groups at Y296 of IgGs or the C-terminal Y-tag of an engineered nanobody. The Tyr-specific reaction is utilized in constructing monofunctionalized antibody-drug conjugates (ADCs) and antibody/nanobody-conjugated effector cells, such as natural killer cells or macrophages. These results demonstrate the potential of site-selective antibody reactions for enhancing targeted cancer immunotherapy.

Receptor-interacting Protein Kinase 2 Is an Immunotherapy Target in Pancreatic Cancer.

Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy because of its aggressive nature and the paucity of effective treatment options. Almost all registered drugs have proven ineffective in addressing the needs of patients with PDAC. This is the result of a poor understanding of the unique tumor-immune microenvironment (TME) in PDAC. To identify druggable regulators of immunosuppressive TME, we performed a kinome- and membranome-focused CRISPR screening using orthotopic PDAC models. Our data showed that receptor-interacting protein kinase 2 (RIPK2) is a crucial driver of immune evasion of cytotoxic T-cell killing and that genetic or pharmacologic targeting of RIPK2 sensitizes PDAC to anti-programmed cell death protein 1 (anti-PD-1) immunotherapy, leading to prolonged survival or complete regression. Mechanistic studies revealed that tumor-intrinsic RIPK2 ablation disrupts desmoplastic TME and restores MHC class I (MHC-I) surface levels through eliminating NBR1-mediated autophagy-lysosomal degradation. Our results provide a rationale for a novel combination therapy consisting of RIPK2 inhibition and anti-PD-1 immunotherapy for PDAC. SIGNIFICANCE: PDAC is resistant to almost all available therapies, including immune checkpoint blockade. Through in vivo CRISPR screen, we identified that RIPK2 plays a crucial role in facilitating immune evasion by impeding antigen presentation and cytotoxic T-cell killing. Targeting tumor-intrinsic RIPK2 either genetically or pharmacologically improves PDAC to anti-PD-1 immunotherapy. See related commentary by Liu et al., p. 208 . This article is featured in Selected Articles from This Issue, p. 201.

The Properties and Microstructure of Na2CO3 and Al-10Sr Alloy Hybrid Modified LM6 Using Ladle Metallurgy Method.

In this work, Al-10Sr alloy and Na2CO3 were added to LM6 (reference alloy) as hybrid modifiers through ladle metallurgy. The microstructure enhancement was analyzed using an optical microscope (OM). The results were further confirmed with Scanning Electron Microscope (SEM) and Energy Dispersive X-ray (EDX) spectroscopy. The results showed that Na2CO3 and Al-10Sr alloy successfully hybrid modified the sharp needle-like eutectic Si into fibrous eutectic Si. Soft primary Al dendrites were also discovered after the hybrid modification. The formation of ß-Fe flakes was suppressed, and α-Fe sludge was transformed into Chinese script morphology. A 2.13% density reduction was recorded. A hardness test was also performed to investigate the mechanical improvement of the hybrid-modified LM6. 2.3% of hardness reduction was recorded in the hybrid-modified LM6 through ladle metallurgy. Brittle cracks were not observed, while ductile pile-ups were the main features that appeared on the indentations of hybrid-modified LM6, indicating a brittle to ductile transformation after hybrid modification of LM6 by Na2CO3 and Al-10Sr alloy through ladle metallurgy.

Flavivirus genome recoding by codon optimisation confers genetically stable in vivo attenuation in both mice and mosquitoes.

Virus genome recoding is an attenuation method that confers genetically stable attenuation by rewriting a virus genome with numerous silent mutations. Prior flavivirus genome recoding attempts utilised codon deoptimisation approaches. However, these codon deoptimisation approaches act in a species dependent manner and were unable to confer flavivirus attenuation in mosquito cells or in mosquito animal models. To overcome these limitations, we performed flavivirus genome recoding using the contrary approach of codon optimisation. The genomes of flaviviruses such as dengue virus type 2 (DENV2) and Zika virus (ZIKV) contain functional RNA elements that regulate viral replication. We hypothesised that flavivirus genome recoding by codon optimisation would introduce silent mutations that disrupt these RNA elements, leading to decreased replication efficiency and attenuation. We chose DENV2 and ZIKV as representative flaviviruses and recoded them by codon optimising their genomes for human expression. Our study confirms that this recoding approach of codon optimisation does translate into reduced replication efficiency in mammalian, human, and mosquito cells as well as in vivo attenuation in both mice and mosquitoes. In silico modelling and RNA SHAPE analysis confirmed that DENV2 recoding resulted in the extensive disruption of genomic structural elements. Serial passaging of recoded DENV2 resulted in the emergence of rescue or adaptation mutations, but no reversion mutations. These rescue mutations were unable to rescue the delayed replication kinetics and in vivo attenuation of recoded DENV2, demonstrating that recoding confers genetically stable attenuation. Therefore, our recoding approach is a reliable attenuation method with potential applications for developing flavivirus vaccines.

Supreme laryngeal mask airway for cesarean section under general anesthesia: a 10-year retrospective cohort study.

Background: Previous research showed the use of supraglottic airways in obstetric anesthesia. The relevant evidence of laryngeal mask airway (LMA) on maternal and neonatal outcomes is still limited. We aimed to assess the maternal and neonatal outcomes when the LMA Supreme was used for cesarean section under general anesthesia. Methods: We included all patients who underwent general anesthesia for cesarean section between January 2010 and December 2019. Propensity score matching was used to reduce potential bias from non-random selection of airway intervention. The primary outcome was adverse maternal and neonatal outcomes defined as maternal regurgitation, aspiration, hypoxemia, and low neonatal Apgar scores. Secondary outcomes included patient admission to the intensive care unit, neonate required tracheal intubation, external cardiac massage, and admission to the neonatal intensive care unit. Results: A total of 723 patients were included in the analysis; of whom, 221 received Supreme laryngeal mask airway (LMA group) and 502 were intubated with an endotracheal tube (ETT group). After propensity score matching, 189 patients remained in each group. No episode of regurgitation and aspiration occurred in both groups. There was no difference in the rates of Apgar score below 7 at 1 min (14.3% LMA group vs. 15.3% ETT group, OR 0.931, 95% CI 0.574 to 1.510, P = 0.772) and 5 min (3.7% vs. 4.2%, OR 0.875, 95% CI 0.324 to 2.365, P = 0.792). No difference was observed in the secondary outcomes between the two groups. Conclusion: The LMA Supreme was not associated with higher adverse maternal and neonatal outcomes when compared to an endotracheal tube for cesarean section under general anesthesia. It might be considered an alternative to tracheal intubation in obstetric practice.

Perceived usefulness of, engagement with, and effectiveness of virtual reality environments in learning industrial operations: the moderating role of openness to experience.

The development of virtual reality (VR) in enhancing the effectiveness of the learning process, with its interactive, immersive, and intuitive pedagogical environment, has become a necessity for corporations with increasingly complex operations. However, VR users' perceptions, openness and learning effectiveness are seldom comprehensively evaluated, particularly in learning complex industrial operations. In this study, grounded in the technology acceptance model, a moderated mediation model of perceived usefulness, ease of use, openness to experience, and engagement in VR-based learning was developed. The model was empirically validated using responses collected from 321 users who were trained on aircraft and cargo terminal operations powered by a novel VR-based learning platform. A survey to measure openness to experience and a pre-training performance test were carried out, followed by a post-training survey of learners' intrinsic factors, including the influence of perceived usefulness, openness to experience, and attitude towards learning. The study revealed that learners with an open attitude towards experiencing new technology tend to perceive VR technology as a useful platform for training. In addition, the learners with more positive views of VR technology-supported training were more engaged in learning.

Inter-regional environmental inequality under lasting pandemic exacerbated by residential response.

Pandemics greatly affect transportation, economic and household activities and their associated air pollutant emissions. In less affluent regions, household energy use is often the dominant pollution source and is sensitive to the affluence change caused by a persisting pandemic. Air quality studies on COVID-19 have shown declines in pollution levels over industrialized regions as an immediate response to pandemic-caused lockdown and weakened economy. Yet few have considered the response of residential emissions to altered household affluence and energy choice supplemented by social distancing. Here we quantify the potential effects of long-term pandemics on ambient fine particulate matter pollution (PM2.5) and resulting premature mortality worldwide, by comprehensively considering the changes in transportation, economic production and household energy use. We find that a persisting COVID-like pandemic would reduce the global gross domestic product by 10.9 % and premature mortality related to black carbon, primary organic aerosols and secondary inorganic aerosols by 9.5 %. The global mortality decline would reach 13.0 % had the response of residential emissions been excluded. Among the 13 aggregated regions worldwide, the least affluent regions exhibit the greatest fractional economic losses with no comparable magnitudes of mortality reduction. This is because their weakened affluence would cause switch to more polluting household energy types on top of longer stay-at-home time, largely offsetting the effect of reduced transportation and economic production. International financial, technological and vaccine aids could reduce such environmental inequality.

Comparison of two frailty indices in predicting life-threatening morbidity and mortality among older patients undergoing elective high-risk abdominal surgery.

Background: Frailty predicts an increased risk of postoperative morbidity and mortality. Comparison of the predictive performance between two deficit accumulation models of frailty, the modified frailty index (mFI) and the revised-Risk Analysis Index (RAI-rev), is poorly understood. This study compared the predictive abilities of the above two frailty indices in predicting life-threatening morbidity and mortality among older patients following elective high-risk abdominal surgery. Methods: This retrospective cohort study extracted perioperative data of older patients (age ≥65 years) undergoing elective high-risk abdominal surgery at a single institution between January 2018 and December 2020. Preoperative frailty was screened by mFI and RAI-rev scoring systems. The primary outcome was the composite of postoperative life-threatening morbidity and mortality during hospitalization. Multivariable logistic regression analyses were performed to investigate the association of the two frailty indices with the primary outcome. Receiver-operating characteristic (ROC) curve was employed to test the predictive performances of the two frailty instruments in predicting the composite primary outcome. The difference between the area under the curves (AUCs) was assessed by DeLong's test. Results: 1,132 older patients (mean age, 73.4 ± 6.2 years; 63.9% male) were included. Of these, 107 (9.5%) developed postoperative life-threatening morbidity and mortality. In multivariable logistic regression analyses, rising continuous frailty scores (mFI: adjusted OR 1.319 per 0.09-point increase in score, 95% CI 1.151-1.511, p < 0.001; RAI-rev: adjusted OR 1.052 per 1-point increase in score, 95% CI 1.018-1.087, p = 0.002) as well as dichotomized frailty measures (mFI ≥0.27: adjusted OR 2.059, 95% CI 1.328-3.193, p = 0.001; RAI-rev ≥45: adjusted OR 1.862, 95% CI 1.188-2.919, p = 0.007) were associated with increased odds of the primary outcome separately. ROC curve analysis showed that the discrimination of mFI and RAI-rev scores for the life-threatening morbidity and mortality was poor and comparable (AUC: 0.598 [95% CI 0.569-0.627] vs. 0.613 [95% CI 0.583-0.641]; DeLong's test: Z = 0.375, p = 0.7075). Conclusion: High mFI and RAI-rev scores were associated with an increased risk of life-threatening morbidity and mortality in older patients undergoing elective high-risk abdominal surgery. However, both frailty indices displayed poor discrimination for postoperative life-threatening morbidity and mortality.

Two-dimensional peptide nanosheets functionalized with gold nanorods for photothermal therapy of tumors.

Self-assembled peptide nanomaterials exhibit great potential for applications in materials science, energy storage, nanodevices, analytical science, biomedicine, tissue engineering, and others due to their tailorable ordered nanostructures and unique physical, chemical, and biological properties. Although one-dimensional peptide nanofibers and nanotubes have been widely used for biomedical applications, the design and synthesis of two-dimensional (2D) peptide nanostructures for cancer therapy remain challenging. In this work, we describe the creation of 2D biocompatible peptide nanosheets (PNSs) through molecular self-assembly, which can provide support matrixes for conjugating gold nanorods (AuNRs) to form high-performance 2D nanomaterials for photothermal conversion. After molecular modification, AuNRs can be chemically conjugated onto the surface of 2D PNSs, and the created PNS-AuNR nanohybrids serve as a potential nanoplatform for photothermal therapy of tumor cells. The obtained results indicate that both PNSs and AuNRs contribute to the improved efficiency of photothermal therapy (PTT) of tumors, in which 2D PNSs provide high biocompatibility and a large surface area for binding AuNRs, and AuNRs show a high PTT ability towards tumors. The strategies of molecular design and functional tailoring of self-assembled peptide nanomaterials shown in this study are valuable and inspire the synthesis of biomimetic nanomaterials for biomedicine and tissue engineering applications.

Study on the resourceful reuse in SBS-modified asphalt of waste bagasse fibers based on green modification with tannic acid and FeOOH.

Hydrophobic modification of bagasse fibers (BFs) through a green approach can promote its reuse in asphalt and enhance the utilization value of agricultural and forestry waste in road engineering. In contrast to traditional chemical modification, this study reports a new method for the hydrophobic modification of BFs using tannic acid (TA) and the in situ growth of FeOOH nanoparticles (NPs), resulting in FeOOH-TA-BF, which is used to prepare styrene-butadiene styrene (SBS)-modified asphalt. The experimental results show that the surface roughness, specific surface area, thermal stability, and hydrophobicity of the modified BF are improved, which is beneficial for enhancing the interface compatibility with asphalt. Specifically, compared with BF/SBS-modified asphalt, FeOOH-TA-BF/SBS-modified asphalt exhibits 39.21% and 23.26% increase in the elastic modulus G' and viscous modulus G″, respectively, at the optimal dosage of 2.5%, corresponding to 6.15-fold and 7.13-fold increase in the fatigue life at 2.5% and 5.0% strain respectively, and 22.0% improvement in shear resistance performance. In the meantime, 2.5-fold enhancement of the storage stability. Therefore, this study provides a simple, environmentally friendly, and efficient hydrophobic modification method that is of great significance for promoting the resource utilization of solid waste BF.

A comprehensive overview of clinical research on dexmedetomidine in the past 2 decades: A bibliometric analysis.

Introduction: Dexmedetomidine is a potent, highly selective α-2 adrenoceptor agonist with sedative, analgesic, anxiolytic, and opioid-sparing properties. A large number of dexmedetomidine-related publications have sprung out in the last 2 decades. However, no bibliometric analysis for clinical research on dexmedetomidine has been published to analyze hot spots, trends, and frontiers in this field. Methods: The clinical articles and reviews related to dexmedetomidine, published from 2002 to 2021 in the Web of Science Core Collection, were retrieved on 19 May 2022, using relevant search terms. VOSviewer and CiteSpace were used to conduct this bibliometric study. Results: The results showed that a total of 2,299 publications were retrieved from 656 academic journals with 48,549 co-cited references by 2,335 institutions from 65 countries/regions. The United States had the most publications among all the countries (n = 870, 37.8%) and the Harvard University contributed the most among all institutions (n = 57, 2.48%). The most productive academic journal on dexmedetomidine was Pediatric Anesthesia and the first co-cited journal was Anesthesiology. Mika Scheinin is the most productive author and Pratik P Pandharipande is the most co-cited author. Co-cited reference analysis and keyword analysis illustrated hot spots in the dexmedetomidine field including pharmacokinetics and pharmacodynamics, intensive care unit sedation and outcome, pain management and nerve block, and premedication and use in children. The effect of dexmedetomidine sedation on the outcomes of critically ill patients, the analgesic effect of dexmedetomidine, and its organ protective property are the frontiers in future research. Conclusion: This bibliometric analysis provided us with concise information about the development trend and provided an important reference for researchers to guide future research.

Recent advance in biomass membranes: Fabrication, functional regulation, and antimicrobial applications.

Both inorganic and polymeric membranes have been widely applied for antimicrobial applications. However, these membranes exhibit low biocompatibility, weak biodegradability, and potential toxicity to human being and environment. Biomass materials serve as excellent candidates for fabricating functional membranes to address these problems due to their unique physical, chemical, and biological properties. Here we present recent progress in the fabrication, functional regulation, and antimicrobial applications of various biomass-based membranes. We first introduce the types of biomass membranes and their fabrication methods, including the phase inversion, vacuum filtration, electrospinning, layer-by-layer self-assembly, and coating. Then, the strategies on functional regulation of biomass membranes by adding 0D, 1D, and 2D nanomaterials are presented and analyzed. In addition, antibacterial, antifungal, and antiviral applications of biomass-based functional membranes are summarized. Finally, potential development aspects of biomass membranes are discussed and prospected. This comprehensive review is valuable for guiding the design, synthesis, structural/functional tailoring, and sustainable utilization of biomass membranes.

Bilateral ultrasound-guided erector spinae plane block versus wound infiltration for postoperative analgesia in lumbar spinal fusion surgery: a randomized controlled trial.

PURPOSE: Both erector spinae plane block and wound infiltration are used to improve analgesia following spinal fusion surgery. Herein, we compared the analgesic effect of bilateral erector spinae plane block with wound infiltration in this patient population. METHODS: In this randomized trial, 60 patients scheduled for elective open posterior lumbar interbody fusion surgery were randomized to receive either ultrasound-guided bilateral erector spinae plane block before incision (n = 30) or wound infiltration at the end of surgery (n = 30). Both groups received standardized general anesthesia and postoperative analgesia, including patient-controlled analgesia with sufentanil and no background infusion. Opioid consumption and pain intensity were assessed at 2, 6, 12, 24, and 48 h after surgery. The primary outcome was cumulative opioid consumption within 24 h after surgery. RESULTS: All 60 patients were included in the intention-to-treat analysis. The equivalent dose of sufentanil consumption within 24 h was significantly lower in patients given erector spinae plane block (median 11 µg, interquartile range 5-16) than in those given wound infiltration (20 µg, 10 to 43; median difference - 10 µg, 95% CI - 18 to - 3, P = 0.007). The cumulative number of demanded PCA boluses was significantly lower with erector spinae plane block at 6 h (median difference - 2, 95% CI - 3 to 0, P = 0.006), 12 h (- 3, 95% CI - 6 to - 1, P = 0.002), and 24 h (- 5, 95% CI - 8 to - 2, P = 0.005) postoperatively. The proportion given rescue analgesia was also significantly lower in patients given erector spinae plane block group within 48 h (relative risk 0.27, 95% CI 0.07 to 0.96, P = 0.037). There were no statistical differences in pain intensity at any timepoints between groups. No procedure-related adverse events occurred. CONCLUSIONS: Compared with wound infiltration, bilateral ultrasound-guided erector spinae plane block decreases short-term opioid consumption while providing similar analgesia in patients following lumbar spinal fusion surgery. Chinese Clinical Trial Registry: ChiCTR2100053008.

Lanthanum modified chitosan-attapulgite composite for phosphate removal from water: Performance, mechanisms and applicability.

A novel lanthanum-modified-chitosan-attapulgite (La-CTS-ATP) composite with efficient adsorption of phosphate in water was prepared and characterized. The adsorption properties were investigated by adsorption kinetics, adsorption isotherms and thermodynamics. An orthogonal design test was used to explore the optimal preparation conditions of La-CTS-ATP. Various characterizations exhibited the successful modification of lanthanum and the effective adsorption of phosphate. The batch experiments showed that La-CTS-ATP exhibited excellent stability within pH range of 4-10 and the disturbance of co-existing substances (Cl-, NO3-, HCO3-, SO42-). Chemisorption played the main role in phosphate adsorption from kinetic studies. Isotherm studies illustrated monolayer uptake of adsorbents onto the adsorbent, and the maximum adsorption capacity was 102.90 mg/g, much higher than other La-based adsorbents. The reaction process was spontaneous (ΔG < 0), exothermic (ΔH < 0) and disordered (ΔS > 0) from thermodynamic analysis. The excellent reusability of La-CTS-ATP was investigated, after five cycles, the phosphate removal rate and desorption rates were 72.93 % and 77.44 %, respectively. The dynamic adsorption experiments showed that the faster the flow rate, the shorter the time for La-CTS-ATP to get saturation, and the maximum adsorption capacity was slightly reduced. The surface precipitation, electrostatic attraction, and ligand exchange were the main mechanisms affecting its adsorption behavior. The adsorbent exhibited excellent effectiveness in real wastewater (breeding wastewater and domestic wastewater). In this study, a novel and effective adsorbent for phosphorus removal was produced in contaminated water, and the analysis of the adsorption process of the system provides new insights for related research.

Self-Assembled Peptide-Based Nanodrugs: Molecular Design, Synthesis, Functionalization, and Targeted Tumor Bioimaging and Biotherapy.

Functional nanomaterials as nanodrugs based on the self-assembly of inorganics, polymers, and biomolecules have showed wide applications in biomedicine and tissue engineering. Ascribing to the unique biological, chemical, and physical properties of peptide molecules, peptide is used as an excellent precursor material for the synthesis of functional nanodrugs for highly effective cancer therapy. Herein, recent progress on the design, synthesis, functional regulation, and cancer bioimaging and biotherapy of peptide-based nanodrugs is summarized. For this aim, first molecular design and controllable synthesis of peptide nanodrugs with 0D to 3D structures are presented, and then the functional customization strategies for peptide nanodrugs are presented. Then, the applications of peptide-based nanodrugs in bioimaging, chemotherapy, photothermal therapy (PTT), and photodynamic therapy (PDT) are demonstrated and discussed in detail. Furthermore, peptide-based drugs in preclinical, clinical trials, and approved are briefly described. Finally, the challenges and potential solutions are pointed out on addressing the questions of this promising research topic. This comprehensive review can guide the motif design and functional regulation of peptide nanomaterials for facile synthesis of nanodrugs, and further promote their practical applications for diagnostics and therapy of diseases.