How to safeguard the continuous renal replacement therapy circuit: a narrative review.

The high prevalence of acute kidney injury (AKI) in ICU patients emphasizes the need to understand factors influencing continuous renal replacement therapy (CRRT) circuit lifespan for optimal outcomes. This review examines key pharmacological interventions-citrate (especially in regional citrate anticoagulation), unfractionated heparin (UFH), low molecular weight heparin (LMWH), and nafamostat mesylate (NM)-and their effects on filter longevity. Citrate shows efficacy with lower bleeding risks, while UFH remains cost-effective, particularly in COVID-19 cases. LMWH is effective but associated with higher bleeding risks. NM is promising for high-bleeding risk scenarios. The review advocates for non-tunneled, non-cuffed temporary catheters, especially bedside-inserted ones, and discusses the advantages of surface-modified dual-lumen catheters. Material composition, such as polysulfone membranes, impacts filter lifespan. The choice of treatment modality, such as Continuous Veno-Venous Hemodialysis (CVVHD) or Continuous Veno-Venous Hemofiltration with Dialysis (CVVHDF), along with the management of effluent volume, blood flow rates, and downtime, are critical in prolonging filter longevity in CRRT. Patient-specific conditions, particularly the type of underlying disease, and the implementation of early mobilization strategies during CRRT are identified as influential factors that can extend the lifespan of CRRT filters. In conclusion, this review offers insights into factors influencing CRRT circuit longevity, supporting evidence-based practices and suggesting further multicenter studies to guide ICU clinical decisions.

Complex coacervation of low methoxy pectin with three types of gelatins for the encapsulation of fish oil.

Herein, the complex coacervation of low methoxy pectin (LMP) with three types of gelatins was explored to encapsulate fish oil. The fish oil@gelatin-LMP complex coacervates with good precipitation separation could be obtained at low gelatin concentrations (Fish gelatin, FG: 10-80 mg/mL; porcine skin gelatin, PSG: 10-40 mg/mL; bovine skin gelatin, BSG: 10-80 mg/mL), high gelatin: fish oil mass ratios (4:1-1:1), appropriate gelatin: LMP mass ratios (3:1-12:1 for FG and PSG, 6:1 for BSG), and appropriate pH (FG: 4.90-5.50; PSG: 4.80-5.40; BSG: 4.10-4.50). FG induced similar loading ability, lower encapsulation ability, and comparable peroxide values to the mammalian gelatins. FG induced higher or similar free fatty acid released percentages to mammalian gelatins in the in vitro gastrointestinal model at low gelatin concentrations (10-40 mg/mL). These results provided useful information to understand the protein-polysaccharide complex coacervation to encapsulate oil-based bioactive substances.

Fish oil-loaded multicore submillimeter-sized capsules prepared with monoaxial electrospraying, chitosan-tripolyphosphate ionotropic gelation, and Tween blending.

In order to load fish oil for potential encapsulation of fat-soluble functional active substances, fish oil-loaded multicore submillimeter-sized capsules were prepared with a combination method of three strategies (monoaxial electrospraying, chitosan-tripolyphosphate ionotropic gelation, and Tween blending). The chitosan-tripolyphosphate/Tween (20, 40, 60, and 80) capsules had smaller and evener fish oil cores than the chitosan-tripolyphosphate capsules, which resulted from that Tween addition induced smaller and evener fish oil droplets in the emulsions. Tween addition decreased the water contents from 56.6 % to 35.0 %-43.4 %, increased the loading capacities from 10.4 % to 12.7 %-17.2 %, and increased encapsulation efficiencies from 97.4 % to 97.8 %-99.1 %. In addition, Tween addition also decreased the highest peroxide values from 417 meq/kg oil to 173-262 meq/kg oil. These properties' changes might result from the structural differences between the chitosan-tripolyphosphate and chitosan-tripolyphosphate/Tween capsules. All the results suggested that the obtained chitosan-tripolyphosphate/Tween capsules are promising carriers for fish oil encapsulation. This work also provided useful knowledge to understand the preparation, structural, and physicochemical properties of the chitosan-tripolyphosphate capsules.

Utilizing nanotechnology to boost the reliability and determine the vertical load capacity of pile assemblies.

Because of their high electrocatalytic activity, sensitivity, selectivity, and long-term stability in electrochemical sensors and biosensors, numerous nanomaterials are being used as suitable electrode materials thanks to developments in nanotechnology. Electrochemical sensors and biosensors are two areas where two-dimensional layered materials (2DLMs) are finding increasing utility due to their unusual structure and physicochemical features. Nanosensors, by their unprecedented sensitivity and minute scale, can probe deeper into the structural integrity of piles, capturing intricacies that traditional tools overlook. These advanced devices detect anomalies, voids, and minute defects in the pile structure with unparalleled granularity. Their effectiveness lies in detection and their capacity to provide real-time feedback on pile health, heralding a shift from reactive to proactive maintenance methodologies. Harvesting data from these nanosensors, data was incorporated into a probabilistic model, executing the reliability index calculations through Monte Carlo simulations. Preliminary outcomes show a commendable enhancement in the predictability of vertical bearing capacity, with the coefficient of variation dwindling by up to 12%. The introduction of nanosensors facilitates instantaneous monitoring and fortifies the long-term stability of pile foundations. This study accentuates the transformative potential of nanosensors in geotechnical engineering.

Determination of Eugenol Residues in Fish Tissue, Transport, and Temporary Water of Aquatic Product by Gas Chromatography-Tandem Mass Spectrometry with Application of the Electrospun Nanofibrous Membrane.

Using gas chromatography-tandem mass spectrometry and electrospun nanofibrous membrane, we developed and validated a simple, rapid, and sensitive methodology for quantifying eugenol residues in fish tissue and water samples. Fish tissue extract and water samples (315 samples) collected from three southeastern China provinces (Shanghai, Zhejiang, and Fujian), originating from eight provinces of Zhejiang, Jiangsu, Shandong, Guangdong, Fujian, Anhui, Shanghai, and Jiangxi, from April 2021 to April 2023 were filtered with an electrospun nanofiber membrane, extracted with trichloromethane/n-hexane, and directly concentrated to dry after simple purification. An internal standard of p-terphenyl in n-hexane and 5-µL injection volumes of the solutions was used to analyze eugenol via internal calibration with a minimum concentration of 0.5 µg/L in water samples and 0.1 µg/kg in aquatic product samples. The highest amount of eugenol was detected in Fujian province, possibly due to the higher temperature during transportation, while the lowest amount was found in Shanghai, which mainly uses temporary fish-culture devices. This is a fast, inexpensive, and effective method for testing large quantities of fish water and meat samples.

Functional characterization of four antenna-biased chemosensory proteins in Dioryctria abietella reveals a broadly tuned olfactory DabiCSP1 and its key residues in ligand-binding.

The orientation of the oligophagous cone-feeding moth Dioryctria abietella (Lepidoptera: Pyralidae) to host plants primarily relies on olfactory-related proteins, particularly those candidates highly expressed in antennae. Here, through a combination of expression profile, ligand-binding assay, molecular docking and site-directed mutagenesis strategies, we characterized the chemosensory protein (CSP) gene family in D. abietella. Quantitative real-time PCR (qPCR) analyses revealed the detectable expression of all 22 DabiCSPs in the antennae, of which seven genes were significantly enriched in this tissue. In addition, the majority of the genes (19/22 relatives) had the expression in at least one reproductive tissue. In the interactions of four antenna-dominant DabiCSPs and different chemical classes, DabiCSP1 was broadly tuned to 27 plant-derived odors, three man-made insecticides and one herbicide with high affinities (Ki < 6.60 µM). By contrast, three other DabiCSPs (DabiCSP4, CSP6 and CSP17) exhibited a narrow odor binding spectrum, in response to six compounds for each protein. Our mutation analyses combined with molecular docking simulations and binding assays further identified four key residues (Tyr25, Thr26, Ile65 and Val69) in the interactions of DabiCSP1 and ligands, of which binding abilities of this protein to 12, 15, 16 and three compounds were significantly decreased compared to the wildtype protein, respectively. Our study reveals different odor binding spectra of four DabiCSPs enriched in antennae and identifies key residues responsible for the binding of DabiCSP1 and potentially active compounds for the control of this pest.

Trends in sperm quality by computer-assisted sperm analysis of 49,189 men during 2015-2021 in a fertility center from China.

Background: Sperm quality, including semen volume, sperm count, concentration, and total and progressive motility (collectively, "semen parameters"), has declined in the recent decades. Computer-assisted sperm analysis (CASA) provides sperm kinematic parameters, and the temporal trends of which remain unclear. Our objective is to examine the temporal trend of both semen parameters and kinematic parameters in Shanghai, China, in the recent years. Methods: This retrospective study analyzed semen parameters and kinematic parameters of 49,819 men attending our reproductive center by using CASA during 2015-2021. The total sample was divided into two groups: samples that surpassed the WHO guideline (2010) low reference limits ("above reference limit" group, ARL; n = 24,575) and samples that did not ("below reference limit" group, BRL; n = 24,614). One-way analysis of variance, Kruskal-Wallis test, independent samples t-test, and covariance analysis were used to assess the differences among groups. Year, age, and abstinence time were included in the multiple linear regression model of the ARL group to adjust the confounders and depict the trends in sperm quality. Results: Among all the total sample and the ARL and BRL groups, the age of subjects increased in recent years. Semen volume and sperm count showed declined tendency with years in the total sample, the ARL and BRL groups, and the subgroup of age or abstinence time, whereas sperm velocities showed increased tendency with years on the contrary. The multiple linear regression model of the ARL group, adjusting for age and abstinence time, confirmed these trends. Semen volume (ß1= -0.162; CI: -0.172, -0.152), sperm count (ß1= -9.97; CI: -10.813, -9.128), sperm concentration (ß1 = -0.535; CI: -0.772, -0.299), motility (ß1 = -1.751; CI: -1.830, -1.672), and progressive motility (ß1 = -1.12; CI: -0.201, -0.145) decreased with year, whereas curvilinear line velocity (VCL) (ß1 = 3.058; CI: 2.912, 3.203), straight line velocity (VSL) (ß1 = 2.075; CI: 1.990, 2.161), and average path velocity (VAP) (ß1 = 2.305; CI: 2.224, 2.386) increased over time (all p < 0.001). In addition, VCL, VSL, and VAP significantly declined with age and abstinence time. Conclusion: The semen parameters declined, whereas the kinematic parameters increased over the recent years. We propose that, although sperm count and motility declined over time, sperm motion velocity increased, suggesting a possible compensatory mechanism of male fertility.

IKBA phosphorylation governs human sperm motility through ACC-mediated fatty acid beta-oxidation.

The nuclear factor-κB (NF-κB) signaling pathway regulates specific immunological responses and controls a wide range of physiological processes. NF-κB inhibitor alpha (IKBA) is an NF-κB inhibitory mediator in the cytoplasm that modulates the nuclear translocation and DNA binding activities of NF-κB proteins. However, whether the upstream cascade of the canonical NF-κB signaling pathway has physiological roles independent of IKBA-mediated transcriptional activation remains unclear. Herein we investigated the function of IKBA in mature sperm in which transcriptional and translational events do not occur. IKBA was highly expressed in human sperm. The repression of IKBA phosphorylation by its inhibitor Bay117082 markedly enhanced sperm motility. On the contrary, lipopolysaccharide-stimulated IKBA phosphorylation significantly decreased sperm motility. Nevertheless, Bay117082 treatment did not affect the motility of IKBA-knockout sperm. Further, untargeted metabolomic analysis and pharmacological blocking assays revealed that the Bay117082-induced increase in sperm motility was attributable to fatty acid ß-oxidation (FAO) enhancement. In addition, we found that IKBA phosphorylation inhibition resulted in a significant reduction of acetyl-CoA carboxylase levels in the FAO metabolic pathway. Our findings indicate that IKBA-mediated signaling orchestrates sperm motility program and improves our understanding of transcription-independent NF-κB signaling pathway in cells.

Expression profile and functional characterization of odorant binding proteins in a forest pest, Dioryctria abietella (Lepidoptera: Pyralidae).

In the forest ecosystem dominated by the Pinaceae plants, this boring pest Dioryctria abietella is subject to a variety of odorants derived from host and nonhost plants, in which olfactory-related proteins enriched in antennae are key behavioral modulators for the orientation of feeding and ovipositing hosts. Here, we addressed the odorant binding protein (OBP) gene family in D. abietella. Expression profiles revealed that the majority of OBPs were abundantly expressed in the antennae at a female-biased level. A male-antenna-biased DabiPBP1 was a strong candidate for detecting type I and type II pheromones of D. abitella female moths. Using a prokaryotic expression system combined with affinity chromatography, we harvested two antenna-dominant DabiOBPs. In the ligand-binding assays, the two DabiOBPs exhibited different odorant response spectra, as DabiOBP17 was tuned to most odorants with higher affinities compared to DabiOBP4. Of these, DabiOBP4 could strongly bind syringaldehyde and citral (dissociation constants (Ki) < 14 µM). A floral volatile, benzyl benzoate (Ki = 4.72 ± 0.20 µM), was the best ligand for DabiOBP17. Remarkably, several green leaf volatiles were found to strongly interact with DabiOBP17 (Ki < 8.5 µM), including Z3-hexenyl acetate, E2-hexenol, Z2-hexenal and E2-hexenal that may mediate a repellent response to D. abietella. Structural analyses of ligands revealed that the binding of the two DabiOBPs to odorants was associated with carbon-chain lengths and functional groups. Molecular simulations identified several key residues involved in the interactions of DabiOBPs and ligands, suggesting specific binding mechanisms. This study highlights olfactory roles of two antennal DabiOBPs in D. abietella, helping the identification of potentially behavioral compounds for the population control of this pest.

Two Antenna-Enriched Odorant Binding Proteins in Dioryctria abietella Tuned to General Odorants and Insecticides

The management of forest pests has become a significant challenge, particularly for wood borers, because they spend most of the time in the trunks or cones. The coneworm, Dioryctria abietella, is a representative of cone borers as its larvae feed on the cones of Pinaceae plants. The molecular mechanisms underlying the interactions between this species and host plants or habitats can assist in developing strategies for pest control. In this study, we extended the expression profiles of 32 odorant binding proteins (OBPs) in the reproductive tissues of D. abietella, revealing the detectable transcription of 29 genes. Using two DabiOBPs highly expressed in antennae (DabiOBP5 and DabiOBP14) as targets, six compounds with high affinities (dissociation constants < 13 µM) were identified through a reverse chemical ecology strategy, including insecticides widely used for the control of lepidopteran pests. Of these compounds, a floral volatile ß-ionone and a pear-produced ester ethyl-(2E,4Z)-decadienoate may serve as behaviorally active compounds in D. abietella. The strong binding of DabiOBPs to insecticides suggested their involvement in insecticide resistance, reflecting sophisticated detoxification mechanisms of this moth. In the molecular simulations, DabiOBP14 possessed stronger interactions with the six ligands compared to DabiOBP5, in which a few key residues within the binding pockets were involved in the formation of hydrogen bonds. This study provides some valuable reference active compounds for the development of lures or repellents in D. abietella and unravels the putative roles of two antenna-dominant DabiOBPs in the perception of plant-derived odorants and insecticides.

Lysophosphatidic Acid Improves Human Sperm Motility by Enhancing Glycolysis and Activating L-Type Calcium Channels.

Until now, the molecular mechanisms underlining sperm motility defect causing male infertility are still poorly understood. Safe and effective compounds or drugs that can improve sperm motility are also very limited. Lysophosphatidic acid (LPA) is a naturally occurring phospholipid and a bioactive intermediate with multiple biological activities. It has been detected in various body fluids such as serum, plasma, saliva, tears, blister fluids, hen egg white, and ascites from patients with ovarian cancer. LPA is also abundant in seminal plasma and follicular fluid. It enhances follicle stimulation, improves oocyte fertilization, and promotes early embryonic development and embryo implantation. However, the physiological role of LPA in the male reproductive system remains unknown. Here, our study showed that LPA significantly improved the motility parameters of human sperm hyperactivation in a dose-dependent manner. The LPA-induced elevation of sperm motility is dependent on bovine serum albumin (BSA) but independent of the classical BSA-induced sAC/cAMP/PKA signaling pathway. The enhancement of sperm motility by LPA could not be blocked by CCCP, a respiratory inhibitor suppressing mitochondrial ATP production. Moreover, LPA improved the activity of triosephosphate isomerase in glycolysis. Meanwhile, LPA treatment significantly increased ATP and phosphoenolpyruvate levels and decreased ADP content during sperm glycolysis. Notably, none of known or identified LPA receptors was detected in human sperm. Further investigations showed that LPA promoted sperm motility through L-type calcium channels. In summary, this study revealed the involvement of LPA in the regulation for human sperm motility by enhancing glycolysis and activating L-type calcium channels. The current findings may shed new light on the understanding of causes of asthenozoospermia, and indicate that LPA could be used as a novel therapeutic agent to improve sperm function and fertilizing capacity.

Investigating the effects of environment, corrosion degree, and distribution of corrosive microbial communities on service-life of refined oil pipelines.

Although the potential corrosive microbial communities of the refined oil pipelines can cause pipeline failure which directly threatens on soil and water environment, few studies have been published in this field. Therefore, the long-distance on-site internal corrosion detection and high-throughput sequencing techniques were employed in this study to investigate the distribution shifts of the corrosive microbial communities on the inner wall of a refined oil pipeline and its impact on the internal corrosion. The microorganisms colonizing on the inner wall of the pipeline showed significant distribution differences between the axial direction of the relative elevation and radial direction of the cross-section. On the inner wall, the high diversity and the abundance of the corrosive microbial communities induced serious microbiologically influenced corrosion (MIC), while the chemical corrosion and the synergy of the corrosive microbial communities accelerated the internal corrosion of the refined oil pipeline. A corrosion zone model has been proposed, which divides the pipeline cross-section into the sediment, the water-oil interface, the gas-oil interface, and the oil fully immersed zones. Therefore, the relationships between the environment, corrosion degree, and distribution characteristics of the corrosive microbial communities in the pipeline were analyzed. This research exhibited the importance of the distribution characteristics of the corrosive microorganisms on the inner wall of the refined oil pipelines. Its internal corrosion behavior was accurately explored, while providing a basis for controlling the corrosive microbial communities.

Reassessment of the Proteomic Composition and Function of Extracellular Vesicles in the Seminal Plasma.

Seminal plasma contains a high concentration of extracellular vesicles (EVs). The heterogeneity of small EVs or the presence of nonvesicular extracellular matter (NV) pose major obstacles in understanding the composition and function of seminal EVs. In this study, we employed high-resolution density gradient fractionation to accurately characterize the composition and function of seminal EVs and NV. We found that the seminal EVs could be divided into 3 different subtypes-namely, high-density EV (EV-H), medium-density EV (EV-M), and low-density EV (EV-L)-after purification using iodixanol, while NV was successfully isolated. EVs and NV display different features in size, shape, and expression of some classic exosome markers. Both EV-H and NV could markedly promote sperm motility and capacitation compared with EV-M and EV-L, whereas only the NV fraction induced sperm acrosome reaction. Proteomic analysis results showed that EV-H, EV-M, EV-L, and NV had different protein components and were involved in different physiological functions. Further study showed that EV-M might reduce the production of sperm intrinsic reactive oxygen species through glutathione S-transferase mu 2. This study provides novel insights into important aspects of seminal EVs constituents and sounder footing to explore their functional properties in male fertility.

Research status and development trends in the field of marine environment corrosion: a new perspective.

Corrosion had aroused extensive concern and attention because it was an unavoidable problem for marine equipment and facilities in service. However, the current status and development trend of marine environment corrosion research had seldom been systematically studied. Therefore, it was encouraged to use bibliometrics and information visualization analysis methods to conduct bibliometric analysis of related publications in the field of marine environment corrosion based on HistCite, CiteSpace, and VOSviewer software programs. Compared with the traditional comments of researchers in this field, this research provided a direction for the development of quantitative analysis and visualization of marine environment corrosion on a large scale. The results showed that the overall focus of research in the field of marine environment corrosion continued to increase from 1900 to 2019. China had the highest publication productivity, the USA had the highest h-index value and the second highest average citations per item value, Materials Science was the most popular subject category, Corrosion Science was the main journal and Melchers RE was the author with the most output contributions. This research also exhibited four hot spots in this field. In addition, this work could help new researchers to find research directions and identify research trends and frontiers in the field of marine environment corrosion by tracing the research hotspots of topic categories, countries, institutions, journals, authors, and publications in recent years.

Identification and expression profiling of chemosensory membrane protein genes in Achelura yunnanensis (Lepidoptera: Zygaenidae).

During the past decade, antennal transcriptome sequencing has been applied to at least 50 species from 16 families of the Lepidoptera order of insects, emphasizing the identification and characterization of chemosensory-related genes. However, little is known about the chemosensory genes in the Zygaenidae family of Lepidoptera. Herein, we report the transmembrane protein gene repertoires involved in chemoreception from Achelura yunnanensis (Lepidoptera: Zygaenidae) through transcriptome sequencing, bioinformatics, phylogenetics and polymerase chain reaction (PCR) approaches. Transcriptome analysis led to the generation of 555.47 million clean reads and accumulation of 83.30 gigabases of data. From this transcriptome, 132 transcripts encoding 69 odorant receptors (ORs), 33 gustatory receptors (GRs), 26 ionotropic receptors (IRs), and four sensory neuron membrane proteins (SNMPs) were identified, 69 of which were full-length sequences. Notably, the number of SNMPs in A. yunnanensis was the largest set in Lepidoptera to date. Phylogenetic analysis combined with sequence homology highlighted several conserved groups of chemoreceptors, including pheromone receptors (a so-called pheromone receptor (PR) clade: AyunOR50 and novel PR members: AyunOR39 and OR40), a phenylacetaldehyde-sensing OR (AyunOR28), carbon dioxide receptors (AyunGR1-3), and antennal IRs (13 A-IRs). In addition, a Zygaenidae-specific OR expansion was observed, including 15 A. yunnanensis members. Expression profiles revealed 99 detectable chemosensory genes in the antennae and 20 in the reproductive tissues, some of which displayed a sex-biased expression. This study identifies potential olfactory molecular candidates for sensing sex pheromones, phenylacetaldehyde or other odorants, and provides preliminary evidence for the putative reproductive function of chemosensory membrane protein genes in A. yunnanensis.

Combined transcriptomic, proteomic and genomic analysis identifies reproductive-related proteins and potential modulators of female behaviors in Spodoptera litura.

The common cutworm, Spodoptera litura, is a polyandrous moth with high reproductive ability. Sexual reproduction is a unique strategy for survival and reproduction of population in this species. However, to date available information about its reproductive genes is rare. Here, we combined transcriptomics, genomics and proteomics approaches to characterize reproductive-related proteins in S. litura. Illumina sequencing in parallel with the reference genome led to the yields of 12,161 reproductive genes, representing 47.83% of genes annotated in the genome. Further, 524 genes of 19 specific gene families annotated in the genome were detected in reproductive tissues of both sexes, some of which exhibited sex-biased and/or tissue-enriched expression. Of these, manual efforts together with the transcriptome analyses re-annotated 54 odorant binding proteins (OBPs) and 23 chemosensory proteins (CSPs) with an increase of 18 OBPs and one CSP compared to those previously annotated in the genome. Interestingly, at least 35 OBPs and 22 CSPs were transcribed in at least one reproductive tissue, suggestive of their involvement in reproduction. Further proteomic analysis revealed 2381 common proteins between virgin and mated female reproductive systems, 79 of which were differentially expressed. More importantly, 74 proteins exclusive to mated females were identified as transferred relatives, coupled with their specific or high expression in male reproductive systems. Of the transferred proteins, several conserved protein classes across insects were observed including OBPs, serpins, trypsins and juvenile hormone-binding proteins. Our current study has extensively surveyed reproductive genes in S. litura with an emphasis on the roles of OBPs and CSPs in reproduction, and identifies potentially transferred proteins serving as modulators of female post-mating behaviors.

Exploration of prognostic factors for critical COVID-19 patients using a nomogram model.

The study aimed to explore the influencing factors on critical coronavirus disease 2019 (COVID-19) patients' prognosis and to construct a nomogram model to predict the mortality risk. We retrospectively analyzed the demographic data and corresponding laboratory biomarkers of 102 critical COVID-19 patients with a residence time ≥ 24 h and divided patients into survival and death groups according to their prognosis. Multiple logistic regression analysis was performed to assess risk factors for critical COVID-19 patients and a nomogram was constructed based on the screened risk factors. Logistic regression analysis showed that advanced age, high peripheral white blood cell count (WBC), low lymphocyte count (L), low platelet count (PLT), and high-sensitivity C-reactive protein (hs-CRP) were associated with critical COVID-19 patients mortality risk (p < 0.05) and these were integrated into the nomogram model. Nomogram analysis showed that the total factor score ranged from 179 to 270 while the corresponding mortality risk ranged from 0.05 to 0.95. Findings from this study suggest advanced age, high WBC, high hs-CRP, low L, and low PLT are risk factors for death in critical COVID-19 patients. The Nomogram model is helpful for timely intervention to reduce mortality in critical COVID-19 patients.

Disinfection characteristics of an advanced rotational hydrodynamic cavitation reactor in pilot scale.

Hydrodynamic cavitation is a promising technique for water disinfection. In the present paper, the disinfection characteristics of an advanced hydrodynamic cavitation reactor (ARHCR) in pilot scale were studied. The effects of various flow rates (1.4-2.6 m3/h) and rotational speeds (2600-4200 rpm) on the removal of Escherichia coli (E. coli) were revealed and analyzed. The variation regularities of the log reduction and reaction rate constant at various cavitation numbers were established. A disinfection rate of 100% was achieved in only 4 min for 15 L of simulated effluent under 4200 rpm and 1.4 m3/h, with energy efficiency at 0.0499 kWh/L. A comprehensive comparison with previously introduced HCRs demonstrates the superior performance of the presented ARHCR system. The morphological changes in E. coli were studied by scanning electron microscopy. The results indicate that the ARHCR can lead to serious cleavage and surface damages to E. coli, which cannot be obtained by conventional HCRs. Finally, a possible damage mechanism of the ARHCR, including both the hydrodynamical and sonochemical effects, was proposed. The findings of the present study can provide strong support to the fundamental understanding and applications of ARHCRs for water disinfection.

The Effects of Dexmedetomidine Post-Conditioning on Cardiac and Neurological Outcomes After Cardiac Arrest and Resuscitation in Swine.

INTRODUCTION: One of the main contents of post-resuscitation care is to alleviate cardiac and neurological damage in cardiac arrest (CA) victims. Recently, dexmedetomidine pre- and post-conditioning have been shown to both effectively protect the heart and brain against regional ischemia reperfusion injury. In this study, we investigated the effects of dexmedetomidine post-conditioning on cardiac and neurological outcomes after CA and resuscitation in swine. METHODS: A total of 28 male domestic swine were randomized into four groups: sham, cardiopulmonary resuscitation (CPR), low-dose dexmedetomidine post-conditioning (LDP), and high-dose dexmedetomidine post-conditioning (HDP). Sham animals underwent the surgical preparation only. The animal model was established by 8 min of CA and then 5 min of CPR. After the animal was successfully resuscitated, a loading dose of 0.25 µg/kg of dexmedetomidine was intravenously injected followed by continuous infusion of 0.25 µg/kg/h for 6 h in the LDP group, and meanwhile a double dose of dexmedetomidine was similarly administered in the HDP group. The same amount of saline was given in the other two groups. All the resuscitated animals were monitored for 6 h and then returned to their cages for an additional 18 h of observation. RESULTS: After resuscitation, significantly greater cardiac, neurological dysfunction, and injuries were observed in all animals experiencing CA and resuscitation when compared with the sham group. However, the severity of cardiac and neurological damage was significantly milder in the two dexmedetomidine-treated groups than in the CPR group. Dexmedetomidine post-conditioning also significantly decreased post-resuscitation tissue inflammation, oxidative stress, and cell apoptosis and necroptosis in the heart and brain when compared with the CPR group. In addition, these protective effects produced by dexmedetomidine post-conditioning were significantly greater in the HDP group than in the LDP group. CONCLUSIONS: Dexmedetomidine post-conditioning dose-dependently improved post-resuscitation cardiac and neurological outcomes through the inhibition of tissue inflammation, oxidative stress, and cell apoptosis and necroptosis.

Differences in survival of prostate cancer Gleason 8-10 disease and the establishment of a new Gleason survival grading system.

BACKGROUND: Although the latest Gleason grading system in 2014 has distinguished between Gleason 3 + 4 and 4 + 3, Gleason 8 and Gleason 9-10 are remained systemically classified. METHODS: A total of 261,125 patients diagnosed with prostate cancer (PCa) were selected between 2005 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. We used propensity score matching to balance clinical variables and then compared overall survival (OS) and cancer-specific survival (CSS) between Gleason score subgroups. We further establish a new Gleason survival grading system based on the hazard ratio (HR) values of each Gleason subgroup. Cox proportional hazards models and Kaplan-Meier curves were used to compare patient survival. RESULTS: Among PCa patients with Gleason score 8 disease, patients with Gleason 5 + 3 had significantly worse OS and CSS than those with Gleason 3 + 5 (OS: HR = 1.26, p = 0.042; CSS: HR = 1.42, p = 0.005) and 4 + 4 (HR = 1.50 for OS and HR = 1.69 for CSS, p < 0.001 for all). PCa patients with Gleason 5 + 3 and Gleason 4 + 5 may have the similar OS and CSS (reference Gleason score <=6, 5 + 3: OS HR = 2.44, CSS HR = 7.63; 4 + 5: OS HR = 2.40, CSS HR = 8.92; p < 0.001 for all). The new Gleason survival grading system reclassified the grades 4 and 5 of the 2014 updated Gleason grading system into three hierarchical grades, which makes the classification of grades more detailed and accurate. CONCLUSION: PCa patients with Gleason 8-10 may have three different survival subgroups, Gleason 3 + 5 and 4 + 4, Gleason 5 + 3 and 4 + 5, and Gleason 5 + 4 and 5 + 5. Our results maximize risk stratification for PCa patients, provide guidance for clinicians to assess their survival and clinical management, and make a recommendation for the next Gleason grading system update.