Development and validation of a nomogram for oral mucosal membrane pressure injuries in ICU patients: A prospective cohort study.

AIMS: Establishing a nomogram to estimate the probability of oral mucosal membrane pressure injury of endotracheal tube-intubated hospitalized patients in intensive care unit. DESIGN: Multicentre prospective cohort study. METHODS: Using Lasso regression and COX regression, variable selection was performed on demographic, clinical and laboratory data of 1037 ICU endotracheal tube-intubated hospitalized patients from West China Hospital, to construct a nomogram. External validation was conducted on 484 ICU endotracheal tube-intubated patients from People's Hospital of Zhongjiang County. RESULTS: Among 38 potential predictors, five variables emerged as independent predictors, integrated into the nomogram: administration of antibiotics, nutritional therapy duration, agitation, hypotension and albumin levels. CONCLUSIONS: We established a nomogram based on the hospital characteristics of ICU endotracheal tube-intubated patients, aiding in the prediction of the occurrence of oral mucosal membrane pressure injury. REPORTING METHOD: The study followed TRIPOD guidelines. RELEVANCE TO CLINICAL PRACTICE: The nomogram we developed can assist clinical worker in better identifying at-risk patients and risk factors. It enables the implementation of evidence-based nursing interventions in care to prevent the development of oral mucosal membrane pressure injury. TRIAL REGISTRATION: The study has been registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn) under registration number ChiCTR2200056615.

Systemic immune-inflammation index and all-cause and cause-specific mortality in sarcopenia: a study from National Health and Nutrition Examination Survey 1999-2018.

Background: Sarcopenia, common in the elderly, often linked to chronic diseases, correlates with inflammation.The association between SII and mortality in sarcopenia patients is underexplored, this study investigates this relationship in a U.S. adult cohort. Methods: We analyzed 1999-2018 NHANES data, focusing on 2,974 adults with sarcopenia. Mortality outcomes were determined by linking to National Death Index (NDI) records up to December 31, 2019. Using a weighted sampling design, participants were grouped into three groups by the Systemic Immune-Inflammation Index (SII). We used Cox regression models, adjusting for demographic and clinical variables, to explore SII's association with all-cause and cause-specific mortality in sarcopenia, performing sensitivity analyses for robustness. Results: Over a median follow-up of 9.2 years, 829 deaths occurred. Kaplan-Meier analysis showed significant survival differences across SII groups. The highest SII group showed higher hazard ratios (HRs) for all-cause and cause-specific mortality in both crude and adjusted models. The highest SII group had a higher HR for all-cause(1.57, 1.25-1.98), cardiovascular(1.61, 1.00-2.58), cancer(2.13, 1.32-3.44), and respiratory disease mortality(3.21, 1.66-6.19) in fully adjusted models. Subgroup analyses revealed SII's association with all-cause mortality across various demographics, including age, gender, and presence of diabetes or cardiovascular disease. Sensitivity analyses, excluding participants with cardiovascular diseases, those who died within two years of follow-up, or those under 45 years of age, largely reflected these results, with the highest SII group consistently demonstrating higher HRs for all types of mortality in both unadjusted and adjusted models. Conclusion: Our study is the first to demonstrate a significant relationship between SII and increased mortality risks in a sarcopenia population.

Prediction Model for Tight Gas Wells with Time-Dependent Mechanism and Stress Sensitivity Effect.

In the production process of tight gas wells, reservoir fluid distribution and gas-water relative permeability vary with time. However, traditional models fail to handle the time-dependent mechanism and stress sensitivity effect in the reservoir, leading to significant errors in the dynamic analysis results. To address this issue, this article presents a prediction model for fractured well production in tight gas reservoirs. It is based on a three-dimensional embedded discrete fracture model (EDFM), which considers the influences of the time-dependent mechanism and stress-dependent reservoir permeability. Transient flow equations are treated by using the finite volume method to obtain the solution of the model. The accuracy and reliability of the model are verified by comparison with the results of the commercial simulator Eclipse and the field application. Based on the model's solution, this study emphasizes the analysis of the impact of the time-dependent mechanism and reservoir stress sensitivity on gas well productivity. Simulation results show that the time-dependent relative permeability curve can decrease the level of irreducible water saturation and promote the migration of irreducible water, resulting in an increase in water permeability and a decrease in gas permeability. This effect will reduce the period of stable gas production and increase the level of water production. Besides, reservoir stress sensitivity will reduce daily water production and accelerate gas well decline. It is necessary to control the production pressure difference reasonably during the production process to effectively reduce the negative impact of stress sensitivity effects. The results indicate that when the relative permeability curve and the reservoir permeability are constant, the real gas production capacity of the reservoir will be strengthened. The application of field case studies shows that the theoretical model exhibits stronger adaptability, achieves better fitting results, and can guide the compilation and adjustment of development plans for water-bearing tight gas reservoirs. These findings provide insights into understanding the effects of the time-dependent mechanism on gas production rates in tight gas reservoirs. Furthermore, this study offers useful guidance for the prediction of field-scale gas production.

Low-Temperature Adaptive Dual-Network MXene Nanocomposite Hydrogel as Flexible Wearable Strain Sensors.

Flexible electronic devices and conductive materials can be used as wearable sensors to detect human motions. However, the existing hydrogels generally have problems of weak tensile capacity, insufficient durability, and being easy to freeze at low temperatures, which greatly affect their application in the field of wearable devices. In this paper, glycerol was partially replaced by water as the solvent, agar was thermally dissolved to initiate acrylamide polymerization, and MXene was used as a conductive filler and initiator promoter to form the double network MXene-PAM/Agar organic hydrogel. The presence of MXene makes the hydrogel produce more conductive paths and enforces the hydrogel's higher conductivity (1.02 S·m-1). The mechanical properties of hydrogels were enhanced by the double network structure, and the hydrogel had high stretchability (1300%). In addition, the hydrogel-based wearable strain sensor exhibited good sensitivity over a wide strain range (GF = 2.99, 0-200% strain). The strain sensor based on MXene-PAM/Agar hydrogel was capable of real-time monitoring of human movement signals such as fingers, wrists, arms, etc. and could maintain good working conditions even in cold environments (-26 °C). Hence, we are of the opinion that delving into this hydrogel holds the potential to broaden the scope of utilizing conductive hydrogels as flexible and wearable strain sensors, especially in chilly environments.

Dynamic Distribution Characteristics of Oil and Water during Water Flooding in a Fishbone Well with Different Branch Angles.

Lab experiments, field pilots, and numerical modeling focusing on fluid flow aspects have indicated that multi-branch wells are technically effective and promising. Several researchers have conducted some experiments for a fishbone well strategy with mixed results. Our objective in this work is to study the impact of the different fishbone well patterns, such as branch angle, on the distribution of remaining oil after water flooding. In this paper, the interference effect between branches on oil recovery is studied in three steps. First, the interferences between fishbone wells with different branch angles were measured by hydro-electric simulation experiments. Second, two-dimensional visualization water flooding experiments were carried out to clarify the remaining oil distribution at different branch angles. Third, the distribution of oil and water in fishbone wells was verified by establishing a numerical model. The modeling results agree well with the experimental phenomena. At the same time, the variation trend of water and oil production in each branch is analyzed by numerical simulation results. The results indicate that the production is strongly dependent on the branch angles, and the highest recovery was 60.2% at a 45° branch angle.

Directional Construction of New Nonlinear Optical Bifunctional Units through Molecular Engineering Design Inspired by the B3O7-Typed Configuration.

Studies on new functional structural units with both large hyperpolarizability and high anisotropy are essentially important for finding high-performance nonlinear optical (NLO) materials and enriching the material systems. Under the guidance of the "structure-analogue" strategy, the work utilizes the molecular engineering approach to direct the construction of target units, BC2N5O2 and B(C2N5)2 units. The BC2N5O2 unit with a highly analogous structure to the B3O7 group and its derivate B(C2N5)2 unit with a configuration of B5O10 group are designed as NLO-active units. Furthermore, two compounds with these new NLO-active units, BC2N5H6(OH)2·H2O (I) and B(C2N5H6.5)2(NO3)2 (II), are synthesized, successfully. These compounds exhibit excellent properties with second-harmonic generation (SHG) responses ranging from 0.5 to 5.9 times that of KDP and large birefringence (ΔnI = 0.181 @ 546.1 nm and ΔnII = 0.148 @ 546.1 nm). Theoretical calculations prove that the BC2N5O2 and B(C2N5)2 units make great contributions to the SHG effects and birefringence, which confirms that the BC2N5O2 and B(C2N5)2 units are novel NLO bifunctional units and could be excellent fundamental building blocks to construct amounts of novel NLO and birefringence crystals. Our studies would enlighten the research studies on biguanide complexes of boron.

TGFBI secreted by tumor-associated macrophages promotes glioblastoma stem cell-driven tumor growth via integrin αvß5-Src-Stat3 signaling.

Rationale: In the glioblastoma (GBM) microenvironment, tumor-associated macrophages (TAMs) are prominent components and facilitate tumor growth. The exact molecular mechanisms underlying TAMs' function in promoting glioma stem cells (GSCs) maintenance and tumor growth remain largely unknown. We found a candidate molecule, transforming growth factor beta-induced (TGFBI), that was specifically expressed by TAMs and extremely low in GBM and GSC cells, and meanwhile closely related to glioma WHO grades and patient prognosis. The exact mechanism of TGFBI linking TAM functions to GSC-driven tumor growth was explored. Methods: Western blot, quantitative real-time PCR (qRT-PCR), enzyme-linked immunosorbent assay (ELISA), immunofluorescence (IF), immunohistochemistry staining (IHC) and public datasets were used to evaluate TGFBI origin and level in GBM. The response of GSCs to recombinant human TGFBI was assessed in vitro and orthotopic xenografts were established to investigate the function and mechanism in vivo. Results: M2-like TAMs infiltration was elevated in high-grade gliomas. TGFBI was preferentially secreted by M2-like TAMs and associated with a poor prognosis for patients with GBM. TGFBI promoted the maintenance of GSCs and GBM malignant growth through integrin αvß5-Src-Stat3 signaling in vitro and in vivo. Of clinical relevance, TGFBI was enriched in the serum and CSF of GBM patients and significantly decreased after tumor resection. Conclusion: TAM-derived TGFBI promotes GSC-driven tumor growth through integrin αvß5-Src-Stat3 signaling. High serum or CSF TGFBI may serve as a potential diagnostic and prognostic bio-index for GBMs.

A space-sacrificed pyrolysis strategy for boron-doped carbon spheres with high supercapacitor performance.

Targeting the potential application of morphological carbon in electrode materials, a space-sacrificed pyrolysis strategy was applied for the preparation of boron-doped carbon spheres (B-CSs), using commercial triphenyl borate (TPB) as carbon and boron co-source. The unique structure of TPB play an important role in the sacrificed space, and has notable effect on the surface area of B-CSs. The as prepared B-CSs possess a high surface area and boron content with uniform boron atoms distribution and high surface polarity, which contributes to the improvement of pseudo-capacitance. The sizes, specific surface areas, and boron contents of B-CSs can be easily regulated by varying the experimental parameters. The optimal sample has a boron content of 1.38 at%, surface area of 560 m2 g-1 and specific capacitance of 235F g-1. We can believe that this work would provide a flexible and extensible preparation technique of B-CSs for electrochemical applications.

Headspace Characterization and Quantification of Aromatic Organosulfur Compounds in Garlic Extracts Using Surface-Enhanced Raman Scattering with a Mirror-in-a-Cap Substrate.

BACKGROUND: Surface-enhanced Raman scattering (SERS) has been deployed in the analysis of food at solid and aqueous states. However, its capability has not been fully explored in headspace profiling. OBJECTIVE: To develop an innovative SERS method for analyzing headspace volatile compounds in foods. METHODS: A volatile-capture device was developed by depositing a film of silver nanoparticles in a vial cap to capture the volatiles released from a model flavor compound (garlic). RESULTS: SERS peaks at 1632, 1400, 1291, 1191, 731, and 577 cm-1 were identified in the headspace of the garlic sample, which was representative of an organosulfur compound (diallyl disulfide), and its concentration was determined at 135 ppm, which was comparable to the value determined using GC. Preparation and analysis could be carried out in <10 min for the SERS method. The sensitivity of the SERS method (10 ppm), however, was slightly less than that of the GC method (5 pm). CONCLUSIONS: The SERS method was able to quantify the concentration of diallyl disulfide in the headspace of a raw garlic ethanolic extract. Compared to GC, the SERS method had a much shorter analysis time and simpler sample preparation procedure than GC when analyzing large numbers of samples. HIGHLIGHTS: The innovative "mirror-in-a-cap" substrate was simpler and faster than other reported SERS substrates used for this purpose. Additionally, SERS has much better portability and the potential for real-time monitoring of changes in the garlic headspace concentration during manufacturing and processing.

Association Between Serum S100A8/S100A9 Heterodimer and Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

BACKGROUND: Many studies have indicated that S100A8 and S100A9 may be involved in the development and progression of chronic obstructive pulmonary disease (COPD). However, there has been no clinical study analyzing the role of the serum S100A8/S100A9 heterodimer in COPD patients. The aim of this study was to analyze the correlation of the serum S100A8/S100A9 heterodimer with pulmonary function in COPD patients during acute exacerbation (AE-COPD) based on a cross-sectional study. METHODS: A total of 131 AE-COPD patients and matched healthy subjects were recruited. Pulmonary function, arterial blood gas values, and serum inflammatory cytokines were measured. RESULTS: Serum S100A8/S100A9 was increased in AE-COPD patients. AE-COPD patients were ranked into different grades based on FEV1%. Serum S100A8/S100A9 was higher in Grade 4 than in Grade 1-2 and Grade 3 patients with AE-COPD. Univariate regression analysis found that serum S100A8/S100A9 was negatively correlated with FEV1% in AE-COPD patients. Furthermore, serum S100A8/S100A9 was positively associated with MCP-1 in AE-COPD patients. Further stratified analysis revealed that serum S100A8/S100A9 was negatively associated with FEV1/FVC in Grade 3 (OR 0.629, P < 0.05) and in Grade 4 (OR 0.347, P < 0.05). In addition, there was a positive relationship between serum S100A8/S100A9 and PaCO2 in Grade 3 (OR 1.532, P < 0.05) and Grade 4 (OR 1.925, P < 0.01). CONCLUSION: S100A8/S100A9 was negatively associated with pulmonary function in AE-COPD patients, indicating that the serum S100A8/S100A9 heterodimer may be involved in the progression of AE-COPD, and may be a relevant serum biomarker in the diagnosis for AE-COPD.

Long Non-Coding RNA 554 Promotes Cardiac Fibrosis via TGF-ß1 Pathway in Mice Following Myocardial Infarction.

Rationale: Cardiac fibrosis is observed in nearly every form of myocardial disease. Long non-coding RNAs (lncRNAs) have been shown to play an important role in cardiac fibrosis, but the detailed molecular mechanism remains unknown. Object: We aimed at characterizing lncRNA 554 expression in murine cardiac fibroblasts (CFs) after myocardial infarction (MI) to identify CF-enriched lncRNA and investigate its function and contribution to cardiac fibrosis and function. Methods and Results: In this study, we identified lncRNA NONMMUT022554 (lncRNA 554) as a regulator of MI-induced cardiac fibrosis. We found that lncRNA 554 was significantly up-regulated in the mouse hearts following MI. Further study showed that lncRNA 554 was predominantly expressed in cardiac fibroblasts, indicating a potential role of lncRNA 554 in cardiac fibrosis. In vitro knockdown of lncRNA 554 by siRNA suppressed fibroblasts migration and expression of extracellular matrix (ECM); while overexpression of lncRNA 554 promoted expression of ECM genes. Consistently, lentivirus mediated in vivo knockdown of lncRNA 554 could inhibit cardiac fibrosis and improve cardiac function in mouse model of MI. More importantly, TGF-ß1 inhibitor (TEW-7197) could reverse the pro-fibrotic function of lncRNA 554 in CFs. This suggests that the effects of lncRNA 554 on cardiac fibrosis is TGF-ß1 dependent. Conclusion: Collectively, our study illustrated the role of lncRNA 554 in cardiac fibrosis, suggested that lncRNA 554 might be a novel target for cardiac fibrosis.

Rhodium(iii)-catalyzed indole synthesis at room temperature using the transient oxidizing directing group strategy.

Rh-catalyzed reactions of N-alkyl anilines with internal alkynes at room temperature have been developed using an in situ generated N-nitroso group as a transient oxidizing directing group. Due to mild reaction conditions, this method enabled synthesis of a broad range of N-alkyl indoles, including even two indole-based medicinal compounds. Our work disclosed the feasibility of the transient oxidizing directing group strategy in C-H functionalization reactions, which possesses the potential to enhance overall step-economy and impart new reactivity patterns to substrates.

Photo-driven redox-neutral decarboxylative carbon-hydrogen trifluoromethylation of (hetero)arenes with trifluoroacetic acid.

Catalytic oxidative C-H bond functionalization reactions that proceed without requiring stoichiometric amounts of external oxidants or pre-functionalized oxidizing reagents could maximize the atom- and step-economy in chemical syntheses. However, such a transformation remains elusive. Here, we report that a photo-driven catalytic process enables decarboxylative C-H trifluoromethylation of (hetero)arenes with trifluoroacetic acid as a trifluoromethyl source in good yields in the presence of an external oxidant in far lower than stoichiometric amounts (for example, 0.2 equivalents of Na2S2O8) using Rh-modified TiO2 nanoparticles as a photocatalyst, in which H2 release is an important driving force for the reaction. Our findings not only provide an approach to accessing valuable decarboxylative C-H trifluoromethylations via activation of abundant but inert trifluoroacetic acid towards oxidative decarboxylation and trifluoromethyl radical formation, but also demonstrate that a photo-driven catalytic process is a promising way to achieve external oxidant-free C-H functionalization reactions.

Condensation of anthranilic acids with pyridines to furnish pyridoquinazolones via pyridine dearomatization.

The unprecedented carbodiimide-mediated condensation between pyridines and anthranilic acids via pyridine dearomatization at room temperature has been developed to provide a straightforward approach to pyridoquinazolones. The value of this approach has further been demonstrated by its application to one-step, gram-scale syntheses of a series of pyridoquinazolone-based natural products and their analogues from readily available starting materials.

Silver-catalyzed arylation of (hetero)arenes by oxidative decarboxylation of aromatic carboxylic acids.

A long-standing challenge in Minisci reactions is achieving the arylation of heteroarenes by oxidative decarboxylation of aromatic carboxylic acids. To address this challenge, the silver-catalyzed intermolecular Minisci reaction of aromatic carboxylic acids was developed. With an inexpensive silver salt as a catalyst, this new reaction enables a variety of aromatic carboxylic acids to undergo decarboxylative coupling with electron-deficient arenes or heteroarenes regardless of the position of the substituents on the aromatic carboxylic acid, thus eliminating the need for ortho-substituted aromatic carboxylic acids, which were a limitation of previously reported methods.

Pd-catalyzed multidehydrogenative cross-coupling between (hetero)arenes and nitroethane to construct ß-aryl nitroethylenes.

The Pd-catalyzed multidehydrogenative cross-coupling reactions of arenes with nitroethane are described. The established methods afford ß-aryl nitroethylenes that are an important class of synthetic intermediates and biologically active compounds in an atom- and step-economical fashion. The reactions were applicable to substituted benzenes and a variety of heterocycles such as benzothiophenes, benzofurans, and indoles. Mechanistic experiments indicated that ß-nitroethylbenzene might be the intermediate in this transformation.

[The effects of multi-mode audio frequency pulse modulating laser together with electrical stimulation on blood pressure and hemorrheology of the spontaneously hypertensive rats].

In order to explore new ways in restraining the ascending blood pressure, this paper reports a research on the effects of multi-mode audio frequency pulse modulating laser irradiation with electrical stimulation on the hemorrheology and blood pressure of the spontaneously hypertensive rats (SHR). Forty male SHR were randomly divided into four groups: Group A (control), Group B (treated with electrical stimulation on stomach 36 point (ST-36)), Group C (treated with low level pulse laser irradiation on Erjian acupuncture point), Group D (low level laser irradiation together with electrical stimulation on Erjian acupuncture point and ST-36). Laser irradiation lasted for 45 min/ day, while electrical stimulation lasted for 30 min/day. After 10 days' treatment, we compared the hemorrheology and blood pressure of the rats in the four groups. The results were that values of hemorrheology in group A and group C were obviously improved compared with those in the other two groups. Meanwhile, the blood pressures in the three treated groups (B, C, and D) were lower than in the control group after the treatment, and the value of the rats in group A was the lowest. In conclusion, the treatment the laser irradiation combined with electrodes stimulation on spontaneously hypertensive rats brought better results of hemorrheology and blood pressure in the tested rats.

Autoantibody activation of beta-adrenergic and muscarinic receptors contributes to an "autoimmune" orthostatic hypotension.

BACKGROUND: Orthostatic hypotension (OH) is characterized by an abnormal autonomic response to upright posture. Activating autoantibodies to ß1/2-adrenergic (AAß1/2AR) and M2/3 muscarinic receptors (AAM2/3R) produce vasodilative changes in the vasculature that may contribute to OH. METHODS: Immunoglobulin (Ig)G from 6 patients with idiopathic OH harboring autoantibodies and from 10 healthy control subjects were examined for: 1) ß1AR and M2R activity with a perfused Purkinje fiber assay and PKA assay in H9c2 cells and 2) vasodilator ß2AR and M3R activity using a pressurized cremaster resistance arteriole assay. Changes in IgG activity with and without propranolol, atropine, and L-NAME were used to estimate AAßAR, AAM2R, and AAM3R activation of their respective functions. RESULTS: All six patients had elevated enzyme-linked immunosorbent assay titers to at least one of the receptors compared with controls. ßAR-mediated contractility activity and M2R activity were increased in five of the six patients. IgG from all six patients produced a direct vasodilator effect on cremaster arterioles. ßAR and nitric oxide synthase blockade led to near normalization of IgG-induced vasodilation. CONCLUSION: AAß1/2AR and AAM2/3R are present in some patients with idiopathic OH compatible with an in vivo effect. These autoantibodies and their cardiovascular effects provide new mechanistic insights into the pathophysiology of OH.

Construction of substituted benzene rings by palladium-catalyzed direct cross-coupling of olefins: a rapid synthetic route to 1,4-naphthoquinone and its derivatives.

Ring the changes: the direct cross-coupling of electron-deficient 1,4-benzoquinone or its derivatives with electron-rich alkyl vinyl ethers proceeds in a tandem manner to produce substituted benzene rings with good selectivity and in good to excellent yields. The reaction has the potential for the rapid synthesis of diverse substituted benzene rings as it is not limited by substituent effects.