High-valent metal-oxo species transformation and regulation by co-existing chloride: Reaction pathways and impacts on the generation of chlorinated by-products.

High-valent metal-oxo species (HMOS) have been extensively recognized in advanced oxidation processes (AOPs) owing to their high selectivity and high chemical utilization efficiency. However, the interactions between HMOS and halide ions in sewage wastewater are complicated, leading to ongoing debates on the intrinsic reactive species and impacts on remediation. Herein, we prepared three typical HMOS, including Fe(IV), Mn(V)-nitrilotriacetic acid complex (Mn(V)NTA) and Co(IV) through peroxymonosulfate (PMS) activation and comparatively studied their interactions with Cl- to reveal different reactive chlorine species (RCS) and the effects of HMOS types on RCS generation pathways. Our results show that the presence of Cl- alters the cleavage behavior of the peroxide OO bond in PMS and prohibits the generation of Fe(IV), spontaneously promoting SO4•- production and its subsequent transformation to secondary radicals like Cl• and Cl2•-. The generation and oxidation capacity of Mn(V)NTA was scarcely influenced by Cl-, while Cl- would substantially consume Co(IV) and promote HOCl generation through an oxygen-transfer reaction, evidenced by density functional theory (DFT) and deuterium oxide solvent exchange experiment. The two-electron-transfer standard redox potentials of Fe(IV), Mn(V)NTA and Co(IV) were calculated as 2.43, 2.55 and 2.85 V, respectively. Due to the different reactive species and pathways in the presence of Cl-, the amounts of chlorinated by-products followed the order of Co(II)/PMS > Fe(II)/PMS > Mn(II)NTA/PMS. Thus, this work renovates the knowledge of halide chemistry in HMOS-based systems and sheds light on the impact on the treatment of salinity-containing wastewater.

Effectiveness and safety of different catechol-o-methyl transferase inhibitors for patients with parkinson's disease: Systematic review and network meta-analysis.

BACKGROUND: Levodopa treatment requires the addition of other drugs, such as catechol-O-methyl transferase (COMT) inhibitors, to alleviate motor fluctuations in advanced parkinson's disease (PD). However, the optimal strategy, including the type and dose of COMT inhibitors remains unknown. This systematic review and network meta-analysis aimed to assess the efficacy and safety of different COMT inhibitors and for treating PD patients. METHODS: PubMed, Embase, Cochrane Library and Web of Science were screened up to November 20, 2022. Randomized controlled trials (RCTs) of COMT inhibitors (entacapone, opicapone, tolcapone) for PD patients were included. Eligible outcomes were total ON-time, rate of ON-time >1 h, total daily dose of levodopa therapy, mean change from baseline to final follow up in Unified Parkinson's Disease Rating Scale (UPDRS) part III scores, adverse events and dyskinesia. Network meta-analyses integrated direct and indirect evidence with placebo as a common comparator. RESULTS: We identified 18 studies with 7564 patients. Opicapone, entacapone, and tolcapone could increase total ON-time when compared with placebo. However, opicapone (25 mg, MD 4.0, 95%CrI: 1.1-7.5) and opicapone (50 mg, MD 5.1, 95%CrI: 2.2-8.7) statistically significant increase the total ON-time. opicapone and entacapone could increase the rate of ON-time >1 h when compared with placebo. Only opicapone (5 mg) showed no statistically significant with placebo (OR 1.4, 95%CrI: 0.74-2.4). We found that opicapone (50 mg, SURCA, 0.796) is the best option compared with other treatments. TOL (200 mg) was ranked highest in the rank probability test for total daily dose of levodopa therapy, followed by OPI (50 mg), TOL (400 mg) and TOL (100 mg) in order. SUCRA rankings identified TOL (200 mg) as the most likely therapy for increasing adverse events (SUCRA 27.19%), followed by TOL (400 mg, SUCRA 27.20%) and OPI (5 mg, SUCRA 30.81%). The SUCRA probabilities were 91.6%, 75.2%, 67.9%, 59.3%, 45.6%, 41.1%, 35.1%, 24.6% and 9.4% for PLA, TOL (400 mg), ENT (100 mg), ENT (200 mg), OPI (5 mg), TOL (100 mg), OPI (25 mg), OPI (50 mg), and TOL (200 mg) respectively. CONCLUSION: In conclusion, opicapone (50 mg) may be a better choice for treatment PD when compared with other COMT inhibitors.

Impact of microplastics on nicosulfuron accumulation and bacteria community in soil-earthworms system.

Microplastics (MPs) widely co-occur with various pollutants in soils. However, the data related to the impacts of MPs on terrestrial animal and microbial properties in pesticide-contaminated soils are few. In this study, the influence of MPs (0.01%, 0.1%, and 1%) on nicosulfuron concentrations in soil (10 µg/g) and earthworms were investigated, moreover, microbial community structure and diversity in soil and earthworm gut were also measured. After 30 days, the concentration of nicosulfuron in soil decreased to 1.27 µg/g, moreover, the residual concentration of nicosulfuron in soil (1%MPs and nicosulfuron) was only 44.8% of that in the single nicosulfuron treatment group. The accumulation of nicosulfuron in earthworms (1%MPs and nicosulfuron) was 7.37 µg/g, which was 1.82 times of that in the single nicosulfuron treatment group. In addition, 1% MPs decreased the richness and diversity of the soil and gut bacterial community in earthworms as well as altered microbial community composition, leading to the enrichment of specific microbial community. Our findings imply that MPs may change the migration of pesticides to terrestrial animal and as well as microbial diversity in earthworms and soil.

A case report of integrating Chinese and Western medicine: A new era in the treatment of stiff person syndrome.

RATIONALE: At present, there are limitations to the treatment of stiff person syndrome (SPS). Current treatments are still ineffective or financially burdensome for some patients, so it is imperative to explore more appropriate treatments for patients. This is a case report of a SPS with a more significant effect of combined Chinese and Western medicine, which may provide new treatment ideas for other patients. PATIENT CONCERNS: This patient presented with episodes of stiffness and pain in the lower back and lower extremities. His electromyography shows continued activation of normal motor units in the paraspinal and abdominal muscles. However, relevant laboratory tests including glutamic acid decarboxylase antibody and Amphiphysin antibody were negative. After a period of treatment including clonazepam, baclofen, prednisone and intravenous immunoglobulin, this patient experiences a shortened maintenance period of medication, accompanied by symptoms such as emotional anxiety and cognitive decline, which severely affects his life. DIAGNOSES: This patient was diagnosed with SPS. INTERVENTIONS: In May 2022 the patient decided to combine Chinese medicine for simultaneous treatment. OUTCOMES: During the period of simultaneous treatment with Chinese and Western medicine, the patient experienced remission of clinical symptoms, reduction of concomitant symptoms and improved quality of life. CONCLUSION: A combination of Western and Chinese medicine was effective in relieving this patient pain and stiffness and reducing the patient anxiety. Combined Chinese and Western medicine treatment may be able to bring better results to more patients with stiff person syndrome.

Aqueous-phase formation of N-containing secondary organic compounds affected by the ionic strength.

The reaction of carbonyl-to-imine/hemiaminal conversion in the atmospheric aqueous phase is a critical pathway to produce the light-absorbing N-containing secondary organic compounds (SOC). The formation mechanism of these compounds has been wildly investigated in bulk solutions with a low ionic strength. However, the ionic strength in the aqueous phase of the polluted atmosphere may be higher. It is still unclear whether and to what extent the inorganic ions can affect the SOC formation. Here we prepared the bulk solution with certain ionic strength, in which glyoxal and ammonium were mixed to mimic the aqueous-phase reaction. Molecular characterization by High-resolution Mass Spectrometry was performed to identify the N-containing products, and the light absorption of the mixtures was measured by ultraviolet-visible spectroscopy. Thirty-nine N-containing compounds were identified and divided into four categories (N-heterocyclic chromophores, high-molecular-weight compounds with N-heterocycle, aliphatic imines/hemiaminals, and the unclassified). It was observed that the longer reaction time and higher ionic strength led to the formation of more N-heterocyclic chromophores and the increasing of the light-absorbance of the mixture. The added inorganic ions were proposed to make the aqueous phase somewhat viscous so that the molecules were prone to undergo consecutive and intramolecular reactions to form the heterocycles. In general, this study revealed that the enhanced ionic strength and prolonged reaction time had the promotion effect on the light-absorbing SOC formation. It implies that the aldehyde-derived aqueous-phase SOC would contribute more light-absorbing particulate matter in the industrial or populated area where inorganic ions are abundant.

Smartphone-Based Fluorescent Profiling of Quaternary MicroRNAs in Urine for Rapid Diagnosis of Urological Cancers Using a Multiplexed Isothermal Exponential Amplification Reaction.

Urological cancers such as bladder or prostate cancer represent one of the most malignant tumors that accounts for an extremely high mortality. However, conventionally standard diagnostics for urological cancers are hardly available in low-resource settings. We developed herein a hand-held fluorescent imaging platform by integrating a multiplexed isothermal exponential amplification reaction (EXPAR) with a microgel-enriched methodology for sensitive profiling of quaternary microRNAs (miRNAs) in urine and quick diagnosis of urological cancers at the early stage. The target miRNA mixtures in the urine underwent four parallel EXPARs without cross-reactivity, followed by surface concentration and hybridization by the encoded polyacrylamide microgels. This mix-and-read strategy allowed for one-pot analysis of several key miRNAs simultaneously and provided 5-fold enhancement in fluorescent detection sensitivities compared to the individual EXPAR-based assays. Four urinary miRNAs (let-7a, miRNA-155, -223, and -143) could be quantitatively determined in a wide linear range from 50 fM to 30 nM, with the limits of detection at femtomolar levels. Using a smartphone-based imaging microreader, healthy and cancerous cohorts with prostate, bladder, and renal cell cancers could be discriminated in 30 min with the accuracy >83% using linear discriminant analysis. The developed detection platform has proven to be a portable, noninvasive, and useful complement to the toolbox for miRNA-based liquid biopsies, which holds immense potential and advantage for regular and large-scale applications in early cancer diagnosis.

Metabolism of Polyamines and Kidney Disease: A Promising Therapeutic Target.

Background: More than 850 million people worldwide suffer from acute and chronic kidney diseases (CKD) which are tremendous socioeconomic burdens for society. Currently, the treatment choices for CKD are limited. There is a great need to understand the underlying mechanisms of the development of CKD in order to develop potential therapeutic strategies. Summary: The alteration in cellular metabolism has emerged as an important common pathological mechanism in different kidney diseases. Metabolic intervening and reprogramming will yield new insights to prevent and slow the progression of kidney disease. As one essential component of cellular metabolisms in fuel-source preferences (glucose, fatty acids, or ketones), the polyamine compound metabolism comprising the metabolites (spermine, spermidine, and putrescine) and their biosynthetic and catabolic enzymes are an endogenous pathophysiological regulator that is arising as a potential therapeutic object for many diseases. Key Messages: This article aimed to review current knowledge on polyamine metabolism and physiological processes, and its potential regulatory and beneficial roles in immunoregulation, mitochondrial homeostasis, autophagy, DNA damage, and kidney diseases, and thus provide a novel therapeutic opportunity for kidney diseases.

Effect of acupuncture at neck-Jiaji (EX-B 2) and tuina on the cognitive function in the patients with subjective cognitive decline. / é’ˆåˆºé¢ˆå¤¹è„Šç©´è”åˆæŽ¨æ‹¿å¯¹ä¸»è§‚è®¤çŸ¥ä¸‹é™æ‚£è€ è®¤çŸ¥åŠŸèƒ½çš„å½±å“.

OBJECTIVES: To observe the effects on cognitive function, sleep quality and hemodynamics in the patients with subjective cognitive decline (SCD) after treated with acupuncture at neck-Jiaji (EX-B 2) and tuina on the base of healthy lifestyle education and meta-memory training. METHODS: Sixty SCD patients were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 3 cases dropped out). In the control group, the healthy lifestyle education and meta-memory training was performed, twice daily, 15 min each time; the 5-day intervention was delivered a week, lasting consecutively 4 weeks. On the base of the intervention as the control group, in the observation group, acupuncture at neck-Jiaji (EX-B 2) and tuina was conducted. First, one-finger pushing and plucking method of tuina was exerted on the neck region along the running courses of the bladder meridian of foot-taiyang and the governor vessel, for 10 min to 15 min; afterwards, acupuncture was delivered at bilateral neck-Jiaji (EX-B 2), from C1 to C7; and the needles were retained for 30 min. This intervention was given once daily, 5 times a week, for consecutive 4 weeks. Before and after treatment, the score of the mini-mental state examination (MMSE), the score of full scale memory quotient (FSMQ) were assessed by Wechsler memory scale-fourth edition (WMS-Ⅳ) and the score of the Pittsburgh sleep quality index (PSQI) was compared between the two groups. Using transcranial Doppler ultrasound, the hemodynamic indexes (the mean velocity [Vm] and pulsatility index [PI] of the left vertebral artery [LVA], the right vertebral artery [RVA] and the basilar artery [BA]) were determined in the two groups. RESULTS: After treatment, the scores of MMSE and FSMQ increased compared with those before treatment in the two groups (P<0.05, P<0.001), PSQI score was lower (P<0.05) and Vm of BA was higher (P<0.001) in the observation group when compared with those before treatment. The scores of MMSE and FSMQ, as well as Vm of BA were higher (P<0.05, P<0.001), and PSQI score was decreased (P<0.05) in the observation group when compared with the control group. CONCLUSIONS: The combined therapy of acupuncture at neck-Jiaji (EX-B 2) and tuina is more advantageous to improving cognitive function, relieving chronic emotional stress and ameliorating sleeping quality in the patients with subjective cognitive decline, which may be achieved by improving the blood supply of the basilar artery.

Genetic Susceptibility to Tardive Dyskinesia and Cognitive Impairments in Chinese Han Schizophrenia: Role of Oxidative Stress-Related and Adenosine Receptor Genes.

Objective: Tardive dyskinesia (TD) is a severe rhythmic movement disorder caused by long-term antipsychotic medication in chronic patients with schizophrenia (SCZ). We aimed to investigate the association between polymorphisms in oxidative stress-related genes (GSTM1, SOD2, NOS1, and NOS3) and adenosine receptor gene (ADORA2A), as well as their interactions, with the occurrence and severity of TD, and cognitive impairments in a Chinese Han population of SCZ patients. Methods: Two hundred and sixteen SCZ patients were recruited and divided into TD group (n=157) and non-TD group (n=59). DNA extraction was performed by a high-salt method, followed by SNP genotyping using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). The severity of TD, psychopathology and cognitive functioning were assessed using the Abnormal Involuntary Movement Scale (AIMS), the Positive and Negative Syndrome Scale (PANSS) and the Repeated Battery for Assessment of Neuropsychological Status (RBANS), respectively. Results: The combination of GSTM1-rs738491, NOS1-rs738409 and ADORA2A-rs229883 was identified as the best three-point model to predict TD occurrence (p=0.01). Additionally, GSTM-rs738491 CC or NOS3-rs1800779 AG genotypes may be protective factors for psychiatric symptoms in TD patients. TD patients carrying the NOS1-rs738409 AG or ADORA2A-rs229883 TT genotypes exhibited poorer cognitive performance. Conclusion: Our findings suggest that the interaction of oxidative stress-related genes and adenosine receptor gene may play a role in the susceptibility and severity of TD in Chinese Han SCZ patient. Furthermore, these genes may also affect the psychiatric symptoms and cognitive function of TD patients.

Dual Z-scheme BiOI/Bi2S3/MgIn2S4 composite photocatalyst for effective photocatalytic degradation of Congo red.

The demand and use of dyes in modern life are increasing, and dye pollution has become a widespread concern worldwide; therefore, it is essential to develop novel environmentally friendly materials to deal with dye wastewater. Herein, a novel visible-light-driven ternary catalyst (BiOI/Bi2S3/MgIn2S4) was fabricated by employing the hydrothermal method. Compared to BiOI, the synthesized ternary catalyst exhibited better photocatalytic performance to decompose Congo red under visible light. Congo red was completely degraded after 0.5 h (0.5 g/L photocatalyst BiOI/Bi2S3/MIS-1) in the presence of visible light, which was 16.83 and 9.94 times of that of pure BiOI and MgIn2S4, respectively. A repetitive experiment showed that the BiOI/Bi2S3/MIS-1 could be reusable to degrade Congo red, demonstrating that it has excellent mechanical properties. The enhanced photocatalytic capability was due to addition of BiOI and Bi2S3, which increased the charge separation as well as suppressed the recombination of photo-induced holes and electrons. Electron paramagnetic resonance technique and free radical trapping tests were employed to determine the radicals produced in BiOI/Bi2S3/MgIn2S4 in the presence of visible light, indicating that ·O2- and h+ were major active species to decompose Congo red under photocatalytic process. Seventeen main intermediates or reaction products were identified by UPLC-MS. The tentative degradation pathway of Congo red was also proposed.

Non-iridescent Structurally Colored Pigments Based on CB@SiO2@TiO2 Core-Bishell Nanospheres with Enhanced Color Stability and Excellent Photocatalytic Activity.

In recent years, artificial amorphous photonic structure (APS) materials with high color saturation and angle independence have been competitively reported. However, there is a lack of research into their functionalization and application in practical environments. Here, with practical applications in mind, we prepared APS pigments based on CB@SiO2@TiO2 core-bishell nanospheres and demonstrated high color saturation, enhanced color stability, and excellent photocatalytic activity. SiO2 effectively protected the carbon black particles from ablation during the calcination process. Paints composed of ethanol, ethyl cellulose (EC), and pigments could be spray-coated on any substrate to prepare a structurally colored coating without limitation. The coatings show good mechanical stability and photothermal stability. The color of the structurally colored pigments can be easily changed by adjusting the sizes of the CB@SiO2@TiO2 nanospheres. The photocatalytic activity of the pigments on formaldehyde (HCHO) and methylene blue (MB) solution and reaction kinetics of their degradation were studied by experiment. The results showed that the photocatalytic activity of the pigments increased with the increase of the TiO2 loading, and the degradation rate of HCHO reached 96.7% for 3 h and that of MB reached 97.9% for 60 min when the TiO2 shell thickness was 40 nm. The structurally colored pigments based on CB@SiO2@TiO2 nanospheres effectively solve the environmental problems caused by the application of pigments and have a promising future in the fields of color decoration, display, and painting.

Novel use of ferrous iron/peroxymonosulfate for high-performance seawater desalination pretreatment under harmful algal blooms.

Marine harmful algae bloom (HAB) is a growing threat to desalination plants worldwide. This work proposes ferrous iron/peroxymonosulfate (Fe2+/PMS) as a novel pretreatment technology for seawater reverse osmosis (SWRO) under HAB. Herein, Fe2+/PMS achieved a significantly higher reduction of negative charge of algae-laden seawater as compared to conventional coagulation (i.e., coagulant is Fe3+), which thereby facilitated improved flocculation to remove algal cells, turbidity and algal organics matters (AOMs), and marine Ca2+ (∼430 mg/L) could partially contribute to the enhanced coagulation performance. A new understanding of the improved coagulation efficiency achieved with Fe2+/PMS in seawater has been proposed as compared to freshwater: seawater matrix (e.g., 504 mM Cl-) was demonstrated to significantly enhance the generation of high-valent iron (FeO2+) as the main reactive intermediate instead of the long-recognized Fe3+ and free radicals, as revealed by methyl phenyl sulfoxide (PMSO) probe, radicals scavenging analysis and electron spin resonance (ESR) spectra. This new mechanism is expected to provide valuable insights for the development of more novel oxidative seawater treatment technologies. Of note, while trade-off between particles and AOMs played an important role in membrane fouling reduction by different dosages of Fe2+/PMS, Fe2+/PMS with an optimal dosage of 0.1 mM/0.05 mM achieved an unprecedentedly higher reduction (95.26%) of modified fouling index (MFI) as compared to conventional coagulation (13.28%-42.36% with 0.1-0.2 mM of Fe3+). Optical-photothermal infrared spectromicroscopy with sub-micron spatial resolution was employed to analyze membrane foulants for the first time, and Fe2+/PMS was found to mainly cause reduced cake layer resistance, which was attributed to the collectively reduced concentration of algae cells, micro-particles with sizes from 2 to 10 µm, humic substances and biopolymers. Moreover, Fe2+/PMS resulted in lower dissolved Fe3+ (<0.027 mg/L) in ultrafiltration (UF) permeate, which would make it more reliable for SWRO operation as compared to conventional coagulation. When energy-intensive dissolved air flotation (DAF) was employed to withstand HAB, Fe2+/PMS outperformed it and was instrumental in achieving reduced MFI with 56.4% lower operational cost. In this context, Fe2+/PMS would facilitate a high-performance and low-cost pretreatment technology for seawater desalination plants under HAB.

Interfacial Profiling of MicroRNAs at Patterned Nanogaps for an Integrated Microfluidic-SERS Liquid Biopsy.

A versatile microfluidic-SERS barcoding system is developed for sensitive and multiplexed imaging of circulating microRNAs through interfacial probing of encoded nanorod aggregates at diverse patterned nanogaps. The use of a single-layer, vertically oriented nanorod array creates a plasmonic coupling-based electromagnetic field with enormously enhanced Raman outputs. The introduction of the herringbone micromixer with circulated microflow sampling accelerates the hybridization and capture of nanorod aggregates on the plasmonic substrate. The method is able to achieve ideal sensitivities at subfemtomolar levels for four miRNAs, with multiplexed assay capability for an integrated liquid biopsy. The on-chip digital profiling of serum miRNAs in mapping and barcoding formats enable both clear discrimination of untreated cancer patients from the healthy cohort and precise classification of tumor stages, metastatic conditions, and subtypes, with an overall accuracy of 94%. The SERS-based microfluidic barcoding system therefore holds great promise in early cancer screening, diagnosis, and prognosis.

Vehicle-Mounted Pavement Health Monitoring System Based on a Spring-Guide-Assisted Triboelectric Sensor.

The present pavement health monitoring is limited by a professional staff patrol. Herein, a vehicle-mounted pavement health monitoring system (VPHMS) based on a spring-guide-assisted triboelectric sensor (S-TES) is proposed, which uses the vibration generated by vehicles passing through uneven pavements to monitor the pavement damage. The VPHMS consists of S-TES, the integration module, and the terminal display module. The designed S-TES has high stability and can achieve a high linear vibration amplitude measurement within 90 mm. Moreover, the integration module is used to process signals and transmit wireless data transmission. The terminal display module is used to receive signals and display the measurement results on the screen. When a vehicle equipped with VPHMS is driven over uneven pavements, the system can accurately monitor the potholes and upheavals on the pavement in real time. This work has significant application value in fields such as pavement health monitoring and intelligent transportation.

Model-Free Adaptive Positioning Control of the Bidirectional Stick-Slip Piezoelectric Actuator with Coupled Asymmetric Flexure-Hinge Mechanisms.

A model-free adaptive positioning control strategy for piezoelectric stick-slip actuators (PSSAs) with uncertain disturbance is proposed. The designed controller consists of a data-driven self-learning feedforward controller and a model-free adaptive feedback controller with a radial basis function neural network (RBFNN)-based observer. Unlike the traditional model-based control methods, the model-free adaptive control (MFAC) strategy avoids the complicated modeling process. First, the nonlinear system of the PSSA is dynamically linearized into a data model. Then, the model-free adaptive feedback controller based on a data model is designed to avoid the complicated modeling process and enhance the robustness of the control system. Simultaneously, the data-driven self-learning feedforward controller is improved to realize the high-precision control performance. Additionally, the convergence of the tracking error and the boundedness of the control output signal are proved. Finally, the experimentally obtained results illustrate the advantages and effectiveness of the developed control methodology on the bidirectional stick-slip piezoelectric actuator with coupled asymmetric flexure-hinge mechanisms. The positioning error through the proposed controller reaches 30 nm under the low-frequency condition and 200 nm under the high-frequency condition when the target position is set to 100 µm. In addition, the target position can be accurately tracked in less than 0.5 s in the presence of a 100 Hz frequency.

Systemic Immune-Inflammation Index Was Significantly Associated with All-Cause and Cardiovascular-Specific Mortalities in Patients Receiving Peritoneal Dialysis.

Purpose: The prognosis of patients receiving peritoneal dialysis (PD) is associated with inflammation. Systemic immune-inflammation index (SII) is one of inflammatory markers, and the role in predicting clinical outcomes in PD patients is unclear. We aimed to investigate the relationship between the SII and all-cause and cardiovascular-specific mortalities in patients undergoing PD. Patients and Methods: A total of 1419 PD patients from the First Affiliated Hospital of Sun Yat-sen University between January 1, 2007 and December 31, 2019 were retrospectively included at baseline, and the patients were followed up until November 31, 2021. SII was calculated as platelet count×neutrophil count/lymphocyte count. Kaplan-Meier curves and Cox proportional hazards regression models were used to determine the relationship between SII levels and all-cause and cardiovascular-specific mortalities. Results: During follow-up (median period was 42 months), 321 patients died (171 died of cardiovascular disease). With adjustment for the potential confounding factors, each 1-SD increase in the SII was associated with 20.2% increase in all-cause mortality (hazard ratio [HR]: 1.202, 95% confidence interval [CI]: 1.088-1.327, P<0.001) and 28.0% increase in cardiovascular-specific mortality (HR: 1.280, 95% CI: 1.126-1.456, P<0.001). High SII (vs low SII) was significantly associated with increased risks of all-cause mortality (HR: 1.391, 95% CI: 1.066-1.815, P-value: 0.015) and cardiovascular-specific mortality (HR: 1.637, 95% CI: 1.185-2.261, P-value: 0.003). Subgroups analyses showed similar results for those younger than 65-year-old only. Conclusion: Elevated SII level was independently associated with increased risks of all-cause and cardiovascular-specific mortalities in PD patients, especially for those younger than 65-year-old.

Integral back-stepping active disturbance rejection control for piezoelectric stick-slip drive nanopositioning stage.

Piezoelectric stick-slip driven nanopositioning stage (PSSNS) with nanometer resolution has been widely used in the field of micro-operation. However, it is difficult to achieve nanopositioning over large travel, and its positioning accuracy is affected by the hysteresis characteristics of the piezoelectric elements, external uncertain disturbances, and other nonlinear factors. To overcome the above-mentioned problems, a composite control strategy combining stepping mode and scanning mode is proposed in this paper, and an integral back-stepping linear active disturbance rejection control (IB-LADRC) strategy is proposed in the scanning mode control phase. First, the transfer function model of the system in the micromotion part was established, and then the unmodeled part of the system and the external disturbance were treated as the total disturbance and extended to a new system state variable. Second, a linear extended state observer was used as the core of the active disturbance rejection technique to estimate displacement, velocity, and total disturbance in real time. In addition, by introducing virtual control variables, a new control law was designed to replace the original linear control law and improve the positioning accuracy and robustness of the system. Furthermore, the effectiveness of the IB-LADRC algorithm was verified by simulation comparison experiments and experimentally validated on a PSSNS. Finally, experimental results show that the IB-LADRC is a practical solution for a controller capable of handling disturbances during the positioning of a PSSNS with a positioning accuracy of less than 20 nm, which essentially remains constant under load.

Serum cholinesterase as a new nutritional indicator for predicting weaning failure in patients.

Aim: The objective of this study is to examine the correlation between patient serum cholinesterase (SCHE) concentration and weaning failure in the context of invasive mechanical ventilation (IMV), as well as to identify predictors of ventilator weaning failure. Additionally, this study investigates the potential relationship between SCHE and nutritional risk for developing more effective weaning strategies. Method: A retrospective observational study was conducted. The sample was collected from 227 patients with IMV over 48 h who underwent SBT before weaning. Relevant experimental samples and data collection were analyzed at the time of patient admission and before the initiation of the SBT. The correlation between SCHE and weaning failure was determined by multifactorial logistic regression and propensity matching scores. Results: Weaning was successful in 127 patients and failed in 100 patients. Depending on the difficulty of weaning, 55 of these patients had difficulty in weaning and 45 had long-term weaning. In the crude cohort, experimental data collected on the day of SBT showed that SCHE concentrations were higher in patients with successful weaning than in those with failed weaning (4,514 u/l vs. 3,190 u/l p < 0.01). The critical value for predicting weaning failure was SCHE 3,228 u/l (p < 0.01). Ventilator weaning failure was predicted by multifactorial logistic regression analysis of SCHE, heart rate, and PaO2 before SBT, with SCHE predicting ventilator weaning failure (AUC 0.714; 95% CI 0.647-0.782) better than heart rate (AUC 0.618; 95% CI 0.545-0.690), PaO2 (AUC 0.59; 95% CI 0.515-0.664). After propensity-matched scores, SCHE remained an independent predictor of weaning failure (p = 0.05). And the SCHE concentration was strongly correlated with the patient's weaning difficulties (p < 0.01). The Nutrition Risk in Critically Ill (NUTRIC) score was also significantly correlated with SCHE according to Spearman's correlation analysis (p < 0.01). Conclusion: Our study revealed that the patients who experienced weaning failure exhibited lower SCHE values compared to those who successfully underwent weaning. Before spontaneous breathing trial (SBT), SCHE, heart rate, and PaO2 were identified as independent predictors of weaning failure. Following propensity score matching (PSM), SCHE and heart rate remained independent predictors. Patients with SCHE levels below 3,228 u/l should undergo careful evaluation before weaning. Our findings suggest that malnutrition may be a contributing factor to weaning failure in patients.

Polyglycerol-Amine Covered Nanosheets Target Cell-Free DNA to Attenuate Acute Kidney Injury.

Increased levels of circulating cell-free DNA (cfDNA) are associated with poor clinical outcomes in patients with acute kidney injury (AKI). Scavenging cfDNA by nanomaterials is regarded as a promising remedy for cfDNA-associated diseases, but a nanomaterial-based cfDNA scavenging strategy has not yet been reported for AKI treatment. Herein, polyglycerol-amine (PGA)-covered MoS2 nanosheets with suitable size are synthesized to bind negatively charged cfDNA in vitro, in vivo and ex vivo models. The nanosheets exhibit higher cfDNA binding capacity than polymer PGA and PGA-based nanospheres owing to the flexibility and crimpability of their 2D backbone. Moreover, with low cytotoxicity and mild protein adsorption, the nanosheets effectively reduced serum cfDNA levels and predominantly accumulated in the kidneys to inhibit the formation of neutrophil extracellular traps and renal inflammation, thereby alleviating both lipopolysaccharide and ischemia-reperfusion induced AKI in mice. Further, they decreased the serum cfDNA levels in samples from AKI patients. Thus, PGA-covered MoS2 nanosheets can serve as a potent cfDNA scavenger for treating AKI and other cfDNA-associated diseases. In addition, this work demonstrates the pivotal feature of a 2D sheet-like structure in the development of the cfDNA scavenger, which can provide a new insight into the future design of nanoplatforms for modulating inflammation.

Therapeutic mechanism of baicalein in peritoneal dialysis-associated peritoneal fibrosis based on network pharmacology and experimental validation.

Baicalein (5,6,7-trihydroxyflavone) is a traditional Chinese medicine with multiple pharmacological and biological activities including anti-inflammatory and anti-fibrotic effects. However, whether baicalein has a therapeutic impact on peritoneal fibrosis has not been reported yet. In the present study, network pharmacology and molecular docking approaches were performed to evaluate the role and the potential mechanisms of baicalein in attenuating peritoneal dialysis-associated peritoneal fibrosis. The results were validated in both animal models and the cultured human mesothelial cell line. Nine intersection genes among baicalein targets and the human peritoneum RNA-seq dataset including four encapsulating peritoneal sclerosis samples and four controls were predicted by network analysis. Among them, MMP2, BAX, ADORA3, HIF1A, PIM1, CA12, and ALOX5 exhibited higher expression in the peritoneum with encapsulating peritoneal sclerosis compared with those in the control, which might be crucial targets of baicalein against peritoneal fibrosis. Furthermore, KEGG and GO enrichment analyses suggested that baicalein played an anti-peritoneal fibrosis role through the regulating cell proliferation, inflammatory response, and AGE-RAGE signaling pathway. Moreover, molecular docking analysis revealed a strong potential binding between baicalein and MMP2, which was consistent with the predictive results. Importantly, using a mouse model of peritoneal fibrosis by intraperitoneally injecting 4.25% glucose dialysate, we found that baicalein treatment significantly attenuated peritoneal fibrosis, as evident by decreased collagen deposition, protein expression of α-SMA and fibronectin, and peritoneal thickness, at least, by reducing the expression of MMP2, suggesting that baicalein may have therapeutic potential in suppressing peritoneal dialysis-related fibrosis.