Chronic infectious unilateral giant thyroid cyst related to diabetes mellitus: A case report.

BACKGROUND: Patients rarely develop complicated infections in thyroid cysts. Here, we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus (DM). CASE SUMMARY: A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM. Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe. He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications. Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles, the nodule and glandular tissue. Fortunately, inflammatory lesions did not affect major neck vessels. Finally, a left partial thyroidectomy was performed. Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter. Postoperative pathology confirmed benign thyroid cyst with chronic infection. CONCLUSION: The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM, and identifying blood vessels involvement can prevent serious complications during operation.

Relationship between medication burden and medication experience in stable patients with schizophrenia: the mediating effect of medication belief.

BACKGROUND: Individuals with schizophrenia require prolonged antipsychotic medication treatment. But more than 50% of individuals with schizophrenia experience adverse medication experiences during their antipsychotic treatments. Such individuals often adjust or discontinue medication, leading to disease relapse and impaired social functioning. Psychiatric nurses should pay close attention to the medication experiences of individuals with schizophrenia. This research explore the relationship between medication burden and medication experience, as well as the mediating effect of medication belief in stable patients with schizophrenia. METHODS: A convenience sample of hospitalized stable patients with schizophrenia were selected from Daqing Third Hospital and Baiyupao Hospital from September 2023 to December 2023. A survey was conducted with them using a questionnaire consisting of general information questionnaire, The Subjective Well-being Under Neuroleptic Treatment Scale(SWN), The Living with Medicines Questionnaire(LMQ), Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). Pearson correlation analysis was used to explore the correlation between LMQ, BMQ-Specific and SWN scores, and multiple linear regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia. AMOS 24.0 was used to construct the structural equation modeling(SEM), and the mediation effect of the SEM was tested using Bootstrap method. RESULTS: According to the sample size calculation requirements of structural equation model, a total of 300 samples were required in this study, and 400 effective questionnaires were actually collected in this study, which met the sample size requirements for constructing structural equation models. Bootstrap test showed that the mediation effect was significant. The total effect of medication burden on medication experience was significant (Z=-12.146, 95%CI (-0.577, -0.417), P < 0.001). The indirect effect of medication burden on medication experience, that is, the mediating effect of medication belief was significant (Z=-4.839, 95%CI (-0.217, -0.096), P < 0.001). The direct effect of medication burden on medication experience was significant (Z=-7.565, 95%CI (-0.437, -0.257), P < 0.001). This model belongs to partial mediation model. CONCLUSIONS: Psychiatric nurses can enhance the patients' medication experience by reducing medication burden and strengthening medication beliefs. Therefore, the results also provide theoretical references and decision-making foundations for psychiatric nursing professionals to develop appropriate management strategies for individuals with schizophrenia.

Highly Thermally Conductive Triple-Level Ordered CNT/PVA Nanofibrous Films.

The escalating thermal power density in electronic devices necessitates advanced thermal management technologies. Polymer-based materials, prized for their electrical insulation, flexibility, light weight, and strength, are extensively used in this field. However, the inherent low thermal conductivity of polymers requires enhancement for effective heat dissipation. This work proposes a novel paradigm, emphasizing ordered structures with functional units, to create triple-level, ordered, low-filler loading of multi-walled carbon nanotube (MWCNT)/poly(vinyl alcohol)(PVA) nanofibrous films. By addressing interfacial thermal resistance through -OH groups, the coupling between polymer and MWCNT is strengthened. The triple-level ordered structure comprises aligned PVA chains, aligned MWCNTs, and aligned MWCNT/PVA composite fibers. Focusing on the filler's impact on thermal conductivity and chain orientation, the thermal transport mechanisms have been elucidated level by level. Our MWCNT/PVA composite, with lower filler loadings (10 wt.%), achieves a remarkable TC exceeding 35.4 W/(m·K), surpassing other PVA composites with filler loading below 50 wt.%.

Asymmetric Cyclodextrin-Dimer-Involved Nanoassemblies by Selective Host-Guest Interactions: Concentration-Dependent Morphology Evolution and Light-Regulated Biomedical Applications.

Supramolecular assembly has attracted significant attention and has been applied to various applications. Herein, a ß-γ-CD dimer was synthesized to complex different guest molecules, including single-strand polyethylene glycol (PEG)-modified C60 (PEG-C60), photothermal conversion reagent (IR780), and dexamethasone (Dexa), according to the complexation constant-dependent specific selectivity. Spherical or cylindrical nanoparticles, monolayer or bilayer vesicles, and bilayer fusion vesicles were discovered in succession if the concentration of PEG-C60 was varied. Moreover, if near-infrared light was employed to irradiate these nanoassemblies, the thermo-induced morphological evolution, subsequent cargo release, photothermal effect, and singlet oxygen (1O2) generation were successfully achieved. The in vitro cell experiments confirmed that these nanoparticles possessed excellent biocompatibility in a normal environment and achieved superior cytotoxicity by light regulation. Such proposed strategies for the construction of multilevel structures with different morphologies can open a new window to obtain various host-guest functional materials and achieve further use for disease treatment.

Study on the behavior of clusters in the physical recovery of GaAs scrap.

Gallium arsenide (GaAs) is the most widely used second-generation semiconductor material. However, a large amount of GaAs scrap is generated at various stages of the GaAs wafer production process. Volatile GaAs clusters are inevitably generated during the process of GaAs vacuum thermal decomposition, resulting in lower purity of the recovered arsenic and the loss of gallium. In this study, thermodynamic analysis and dynamics simulation were combined to discuss the possibility of separating GaAs clusters and arsenic from a microscopic perspective. A vacuum thermal decomposition-directional condensation recovery process for GaAs scrap was proposed. By properly adjusting the separation parameters such as heating temperature, holding time and raw material size, high purity of gallium (99.99%) and arsenic (99.5%) were directly recovered under a system pressure of 1 Pa, heating temperature of 1323 K, holding time of 3 h, and GaAs scrap size of 2.5 cm. GaAs clusters were also recovered in powder form. The problem of difficult separation of GaAs clusters from arsenic was effectively solved by this method, and the purity of recovered arsenic was greatly improved. No additives are required and no waste liquid or gas emission in the whole process. The complexity of subsequent arsenic purification operations and the threat of arsenic containing waste to the environment were reduced as well.

The experimental approach for the interleaved joint modulation of PHIP and NMR.

Nuclear spin hyperpolarization derived from parahydrogen is a technique for enhancing nuclear magnetic resonance (NMR) sensitivity. The key to hyperpolarization experiments is to achieve rapid transfer and detection to minimize relaxation losses, while also avoiding bubbles or turbulence to guarantee high spectral resolution. In this article, we describe an experimental approach for the interleaved joint modulation of parahydrogen-induced polarization and NMR. We provide schematic diagrams of parahydrogen-based polarizer with in situ high-pressure detection capability and low-field polarization transfer. This approach can help to control the experimental process and acquire experimental information, one example of which is the attainment of the highest hyperpolarization signal intensity at 3.6 s after closing the valve. The polarizer demonstrates in situ detection capability, allowing sample to be restabilized within 0.3 ± 0.1 s and high-resolution NMR sampling under a pressure of 3 bars. Moreover, it can transfer polarized samples from the polarization transfer field to the detection region of NMR within 1 ± 0.3 s for completing signal amplification by reversible exchange experiments.

Construction and verification of aggressive behavior risk prediction model in stable patients with schizophrenia.

BACKGROUND: Among all types of mental disorders, individuals with schizophrenia exhibit the highest frequency of aggressive behavior. This disrupts the healthcare environment and poses threats to family life and social harmony. Present approaches fail to identify individuals with schizophrenia who are predisposed to aggressive behavior. In this study, we aimed to construct a risk prediction model for aggressive behavior in stable patients with schizophrenia, which may facilitate early identification of patients who are predisposed to aggression by assessing relevant factors, enabling the management of high-risk groups to mitigate and prevent aggressive behavior. METHODS: A convenience sample of stable inpatients with schizophrenia were selected from Daqing Municipal Third Hospital and Chifeng Municipal Anding Hospital from March 2021 to July 2023. A total of 429 patients with stable schizophrenia who met the inclusion criteria were included. A survey was conducted with them using a questionnaire consisting of general information questionnaire, Positive and Negative Symptom Scale, Childhood Trauma Questionnaire-Short Form, Connor-Davidson Resilience Scale and Self-esteem Scale. Patients enrolled in this study were divided into aggressive and non-aggressive groups based on whether there was at least one obvious and recorded personal attack episode (including obvious wounding and self-injurious behavior) following diagnosis. Binary Logistic regression was used to determine the influencing factors, and R software was used to establish a nomogram model for predicting the risk of aggressive behavior. Bootstrap method was used for internal validation of the model, and the validation group was used for external validation. C statistic and calibration curve were used to evaluate the prediction performance of the model. RESULTS: The model variables included Age, Duration of disease, Positive symptom, Childhood Trauma, Self-esteem and Resilience. The AUROC of the model was 0.790 (95% CI:0.729-0.851), the best cutoff value was 0.308; the sensitivity was 70.0%; the specificity was 81.4%; The C statistics of internal and external validation were 0.759 (95%CI:0.725-0.814) and 0.819 (95%CI:0.733-0.904), respectively; calibration curve and Brier score showed good fit. CONCLUSIONS: The prediction model has a good degree of discrimination and calibration, which can intuitively and easily screen the high risk of aggressive behavior in stable patients with schizophrenia, and provide references for early screening and intervention.

Efficacy and safety of blonanserin versus risperidone in the treatment of schizophrenia: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of blonanserin and risperidone for the treatment of schizophrenia and to provide reliable pharmacotherapeutic evidence for in the clinical treatment of schizophrenia. METHODS: We systematically searched the PubMed, Cochrane Library, Embase, Chinese Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) databases for head-to-head randomized controlled trials that compared blonanserin with risperidone for the treatment of schizophrenia. We extracted the following data: author, year, country, diagnostic criteria, sample size, course of treatment, dosage and outcomes. Our main endpoint was the changes in the Positive and Negative Syndrome Scale (PANSS) total scores. Meta-analysis of the included data was conducted by RevMan 5.3 software. We used the GRADE criteria to evaluate the certainty of the evidence. RESULTS: A total of 411 studies were initially; 8 trials were eligible and were included in our analysis (N = 1386 participants). Regarding efficacy, there was no difference in changes in the PANSS total scores between the two groups (P > 0.05). In terms of safety, compared to risperidone, the incidence of serum prolactin increases and weight gain in the blonanserin group was lower (P<0.05), but the incidence of extrapyramidal symptoms (EPS) was higher (P<0.05). CONCLUSION: The efficacy of blonanserin is similar to that of risperidone, but it is unclear whether blonanserin is more effective than risperidone at improving cognitive and social function. More high-quality studies are needed to verify the efficacy and safety of blonanserin in the future.

A Case of Strange Arterial Embolism After Uterine Curettage.

Hysteroscopic local endometrial resection and curettage are common surgical procedures. Postoperative arterial thromboembolism is rare. However, coronary and renal embolism after the procedure has never been reported in the literature, so far. We report a 50-year-old woman who developed arterial thromboembolism 4 hours after local endometrial resection and curettage. Thrombus disappeared after anticoagulant therapy was started as soon as possible. How do strange clots form and by what route do they occur in the arterial system?

Adjunctive repetitive transcranial magnetic stimulation for adolescents with first-episode major depressive disorder: a meta-analysis.

Objective: This meta-analysis of randomized clinical trials (RCTs) was conducted to explore the therapeutic effects, tolerability and safety of repetitive transcranial magnetic stimulation (rTMS) as an adjunct treatment in adolescents with first-episode major depressive disorder (FE-MDD). Methods: RCTs examining the efficacy, tolerability and safety of adjunctive rTMS for adolescents with FE-MDD were included. Data were extracted by three independent authors and synthesized using RevMan 5.3 software with a random effects model. Results: A total of six RCTs involving 562 adolescents with FE-MDD were included. Adjunctive rTMS was superior in improving depressive symptoms over the control group [standardized mean difference (SMD) = -1.50, 95% confidence interval (CI): -2.16, -0.84; I2 = 89%, p < 0.00001] in adolescents with FE-MDD. A sensitivity analysis and two subgroup analyses also confirmed the significant findings. Adolescents with FE-MDD treated with rTMS had significantly greater response [risk ratio (RR) = 1.35, 95% CI: 1.04, 1.76; I2 = 56%, p = 0.03] and remission (RR = 1.35, 95% CI: 1.03, 1.77; I2 = 0%, p = 0.03) over the control group. All-cause discontinuations were similar between the two groups (RR = 0.79, 95% CI: 0.32, 1.93; I2 = 0%, p = 0.60). No significant differences were found regarding adverse events, including headache, loss of appetite, dizziness and nausea (p = 0.14-0.82). Four out of six RCTs (66.7%), showed that adjunctive rTMS was more efficacious over the control group in improving neurocognitive function (all p < 0.05). Conclusion: Adjunctive rTMS appears to be a beneficial strategy in improving depressive symptoms and neurocognitive function in adolescents with FE-MDD. Higher quality RCTs with larger sample sizes and longer follow-up periods are warranted in the future.

Synergistic chemo-photo anticancer therapy by using reversible Diels-Alder dynamic covalent bond mediated polyprodrug amphiphiles and immunoactivation investigation.

Highly efficient endocytosis and multi-approach integrated therapeutic tactics are important factors in oncotherapy. With the aid of thermally reversible furan-maleimide dynamic covalent bonds and the "polyprodrug amphiphiles" concept, thermo- and reduction-responsive PEG(-COOH)Fu/MI(-SS-)CPT copolymers were fabricated by the Diels-Alder (D-A) coupling of hydrophilic Fu(-COOH)-PEG and hydrophobic MI(-SS-)-CPT building blocks. The copolymers could self-assemble to form composite nanoparticles with a photothermal conversion reagent (IR780) and maintain excellent stability. In the in vitro simulated environments, the composite nanoparticles could detach Fu(-COOH)-PEG chains by a retro-D-A reaction upon near-infrared light (NIR) irradiation and reduce the size to facilitate endocytosis. Once in the intracellular environment, glutathione (GSH) could trigger a cascade reaction to release active CPT drugs to achieve chemotherapy, which could be further promoted by NIR light induced photothermal therapy. The in vivo mouse tumor model experiments demonstrated that these nanoparticles had an excellent therapeutic effect on solid tumors and inhibited their recurrence. Not only that, the synergistic chemical and optical therapy induced body immune response was also systematically evaluated; the maturation of dendritic cells, the proliferation of T cells, the increase of high mobility group box protein 1, and the decrease of immunosuppressive regulatory T cells confirmed that such synergistic therapy could effectively provide immune protection to the body. We believe such in situ generation of small-sized therapeutic units brought by a dynamically reversible D-A reaction could expand the pathway to design next generation drug delivery systems possessing superior design philosophy and excellent practice effects compared to currently available ones.

Necrotic cardiac myocytes skew macrophage polarization towards a classically activated phenotype.

Necrotic and dying cells release damage-associated molecular patterns (DAMPs) that can initiate sterile inflammatory responses in the heart. Although macrophages are essential for myocardial repair and regeneration, the effect of DAMPs on macrophage activation remains unclear. To address this gap in knowledge we studied the effect of necrotic cardiac myocyte extracts on primary peritoneal macrophage (PPM) cultures in vitro. We first performed unbiased transcriptomic profiling with RNA-sequencing of PPMs cultured for up to 72 hours in the presence and absence of: 1) necrotic cell extracts (NCEs) from necrotic cardiac myocytes in order to mimic the release of DAMPs; 2) lipopolysaccharide (LPS), which is known to polarize macrophages towards a classically activated phenotype and 3) Interleukin-4 (IL-4), which is known to promote polarization of macrophages towards an alternatively activated phenotype. NCEs provoke changes in differential gene expression (DEGs) that had considerable overlap with LPS-induced changes, suggesting that NCEs promote macrophage polarization towards a classically activated phenotype. Treating NCEs with proteinase-K abolished the effects of NCEs on macrophage activation, whereas NCE treatment with DNase and RNase did not affect macrophage activation. Stimulation of macrophage cultures with NCEs and LPS resulted in a significant increase in macrophage phagocytosis and interleukin-1ß secretion, whereas treatment with IL-4 had no significant effect on phagocytosis and interleukin-1ß. Taken together, our findings suggest that proteins released from necrotic cardiac myocytes are sufficient to skew the polarization of macrophages towards a classically activated phenotype.

Elevated serum FGF21 levels predict heart failure during hospitalization of STEMI patients after emergency percutaneous coronary intervention.

Background: Fibroblast growth factor 21 (FGF21) has multiple cardioprotective effects including modulation of glucolipid metabolism, anti-inflammation, and anti-oxidative stress, but its association with the heart failure during hospitalization in patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) has not been reported. Methods: A total of 348 STEMI patients treated with emergency PCI were included from January 2016 to December 2018. Relevant biochemical indicators were measured by central laboratory. Serum FGF21 levels were measured by ELISA. The occurrence of heart failure during hospitalization was recorded. Patients' cardiac function was assessed by echocardiography. Results: Serum FGF21 levels were significantly higher in the STEMI group with heart failure than in the group without heart failure (249.95 ± 25.52 vs. 209.98 ± 36.35, P < 0.001). Serum FGF21 levels showed a strong positive correlation with N-terminal precursor B-type natriuretic peptide (NT-proBNP) in STEMI patients (r = 0.749, P < 0.001). FGF21 was found to be an independent risk factor for the development of heart failure during hospitalization in STEMI patients by binary logistic regression analysis. The area under curve (AUC) for FGF21 to predict the development of heart failure during hospitalization in STEMI patients was 0.816 (95% CI [0.770-0.863]) according to the receiver operating characteristic (ROC) curve analysis. Conclusion: Elevated serum FGF21 levels have been shown to be a strong predictor of heart failure during hospitalization in patients with STEMI after emergency PCI.

A wearable platform for closed-loop stimulation and recording of single-neuron and local field potential activity in freely moving humans.

Advances in technologies that can record and stimulate deep brain activity in humans have led to impactful discoveries within the field of neuroscience and contributed to the development of novel therapies for neurological and psychiatric disorders. Further progress, however, has been hindered by device limitations in that recording of single-neuron activity during freely moving behaviors in humans has not been possible. Additionally, implantable neurostimulation devices, currently approved for human use, have limited stimulation programmability and restricted full-duplex bidirectional capability. In this study, we developed a wearable bidirectional closed-loop neuromodulation system (Neuro-stack) and used it to record single-neuron and local field potential activity during stationary and ambulatory behavior in humans. Together with a highly flexible and customizable stimulation capability, the Neuro-stack provides an opportunity to investigate the neurophysiological basis of disease, develop improved responsive neuromodulation therapies, explore brain function during naturalistic behaviors in humans and, consequently, bridge decades of neuroscientific findings across species.

Efficacy and safety of liraglutide in patients with type 2 diabetes mellitus and severe obstructive sleep apnea.

OBJECTIVES: To observe the efficacy and side effects of liraglutide in the treatment of type 2 diabetes mellitus (T2DM) patients with severe obstructive sleep apnea (OSA). METHODS: The study conducted in an outpatient setting was a two-center, prospective randomized controlled study. T2DM patients with severe OSA were randomized to the control group (continuous positive airway pressure [CPAP] and drug treatment without liraglutide) or the liraglutide group (CPAP and drug treatment including liraglutide). Demographic and clinical characteristics, sleep-disordered breathing indices, cardiac function indices, and side effects were evaluated and compared between the two groups before and after 3 months. RESULTS: Of 90 patients, 45 were randomized to the intervention arm (with liraglutide) and 45 to the control arm (without liraglutide). One patient in the liraglutide group dropped out of the study on day 8 after enrollment due to obvious gastrointestinal symptoms. No significant differences were found between the two groups in baseline demographics, clinical characteristics, cardiac function indicators, or sleep disorder respiratory indices (P > 0.05). After 3 months, the body mass index (BMI), apnea hypopnea index (AHI), and mean systolic blood pressure in the liraglutide treatment group were significantly lower than those in the control group (P < 0.05). The minimum oxygen saturation was significantly higher in the liraglutide group compared with that in the control group after 3 months of follow-up (P < 0.05). No difference was found between the two groups in the summary of side effects (P > 0.05). CONCLUSIONS: Liraglutide combined with CPAP can effectively reduce BMI, lower mean systolic blood pressure, and improve AHI scores and hypoxia in T2DM patients with severe OSA. Liraglutide did not increase side effects.

Synergy of directional oxidation and vacuum gasification for green recovery of As2O3 from arsenic-containing hazardous secondary resources.

Arsenic, a hazardous material that is toxic for humans, enters the human body through soil, water, and air. Furthermore, metal smelting is known to produce arsenic-containing hazardous secondary resources (AHSRs), which cause irreversible damage to the total environment. Therefore, a novel, clean, and efficient arsenic fixation technology has been developed in this study for arsenic removal, which involves directional oxidation and vacuum gasification of AHSRs. Oxidation results revealed that physical phases containing arsenic (As, As2O3, As2Te3 and Cu3As) are selectively oxidized to As2O3 completely and thus classified as oxidative modulation products (OMPs). Meanwhile, approximately 98.82% As2O3 of OMPs convert into volatiles in the following gasification. Characterization results showed that As2O3 with 96.72% purity and uniform microscopic distribution was obtained in the form of monoclinic crystalline needle-like crystals. The proposed approach organically combines oxidation and volatilization properties of each element to facilitate clean and efficient separation as well as recovery of As2O3. No hazardous gas or wastewater is discharged during the entire process, thereby ensuring that arsenic is recycled in a sustainable and clean manner. Overall, this study provides a clean and low-carbon approach for recycling secondary resources containing arsenic.

Template-Free Synthesis of Magnetic La-Mn-Fe Tri-Metal Oxide Nanofibers for Efficient Fluoride Remediation: Kinetics, Isotherms, Thermodynamics and Reusability.

The occurrence of fluoride contamination in drinking water has gained substantial concern owing to its serious threat to human health. Traditional adsorbents have shortcomings such as low adsorption capacity and poor selectivity, so it is urgent to develop new adsorbents with high adsorption capacity, renewable and no secondary pollution. In this work, magnetic electrospun La-Mn-Fe tri-metal oxide nanofibers (LMF NFs) for fluoride recovery were developed via electrospinning and heat treatment, and its defluoridation property was evaluated in batch trials. Modern analytical tools (SEM, BET, XRD, FTIR) were adopted to characterize the properties of the optimized adsorbent, i.e., LMF11 NFs with a La:Mn molar ratio of 1:1. The surface area calculated via BET method and pHpzc assessed using pH drift method of LMF11 NFs were 55.81 m2 g-1 and 6.47, respectively. The results indicated that the adsorption amount was highly dependent on the pH of the solution, and reached the highest value at pH = 3. The kinetic behavior of defluoridation on LMF11 NFs was dominated by the PSO model with the highest fitted determination coefficients of 0.9999. Compared with the other three isotherm models, the Langmuir model described defluoridation characteristics well with larger correlation coefficients of 0.9997, 0.9990, 0.9987 and 0.9976 at 15 °C, 25 °C, 35 °C and 45 °C, respectively. The optimized LMF11 NFs exhibited superior monolayer defluoridation capacities for 173.30-199.60 mg F-/g at pH 3 at 15-45 °C according to the Langmuir isotherm model. A thermodynamic study proved that the defluoridation by LMF11 NFs is a spontaneous, endothermic along with entropy increase process. In addition, the LMF11 NFs still showed high defluoridation performance after three reused cycles. These findings unveil that the synthesized LMF11 NFs adsorbent is a good adsorbent for fluoride remediation from wastewater owing to its low cost, high defluoridation performance and easy operation.

Outstanding fluoride removal from aqueous solution by a La-based adsorbent.

A La-based adsorbent was prepared with La(NO3)3·6H2O, 2-methylimidazole and DMF via amide-hydrolysis and used for fluoride decontamination from aqueous water. The obtained adsorbent was lanthanum methanoate (La(COOH)3). The effects of pH value, initial F- concentration and interfering ions on defluoridation properties of as-prepared La(COOH)3 were assessed through batch adsorption tests. The adsorption kinetics, isotherm models and thermodynamics were employed to verify the order, nature and feasibility of La(COOH)3 towards fluoride removal. The results imply that La(COOH)3 is preferable for defluoridation over a wide pH range of 2 to 9 without interference. Simultaneously, the defluoridation process of La(HCOO)3 accords to the pseudo-second order model and Langmuir isotherm, revealing chemical adsorption is the main control step. The maximum fluoride capture capacities of La(COOH)3 at 30, 40 and 50 °C are 245.02, 260.40 and 268.99 mg g-1, respectively. The mechanism for defluoridation by La(COOH)3 was revealed by PXRD and XPS. To summarize, the as-synthesized La based adsorbent could serve as a promising adsorbent for defluoridation from complex fluoride-rich water.

Predictive value of two different definitions of contrast-associated acute kidney injury for long-term major adverse kidney events in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

BACKGROUND: It remains controversial whether contrast-associated acute kidney injury (CA-AKI) is associated with long-term major adverse kidney events (MAKE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: By the Acute Kidney Injury Network (AKIN) criteria, CA-AKI was defined as an increase in serum creatinine ≥ 0.3 mg/dL or 50% from baseline within 48 h after PCI; or an increase in serum creatinine ≥ 0.5 mg/dL or 25% within 72 h by the contrast-induced nephropathy (CIN) criteria. The primary endpoint was 1-year MAKE, defined as a composite of all-cause mortality and persistent renal dysfunction. RESULTS: A total of 402 patients were finally included in this study. The primary endpoint occurred in 29 (7.2%) patients. There was a significant association between CA-AKI and 1-year MAKE assessed by both the AKIN (hazard ratios [HR]: 11.58, 95% confidence interval [CI]: 4.29-31.24, p = 0.000) and CIN (HR: 6.45, 95% CI: 2.56-16.25, p = 0.000) definitions. However, the AKIN definition (HR: 4.95, 95% CI: 1.17-21.02, p = 0.030) was more reliable in the prediction of persistent renal dysfunction than CIN definition (HR: 4.08, 95% CI: 0.99-16.87, p = 0.052). Additionally, the area under receiver operating characteristic curve was larger for predicting 1-year MAKE with the AKIN definition than CIN definition (0.742 vs. 0.727). CONCLUSIONS: In patients with STEMI undergoing primary PCI, CA-AKI was significantly associated with 1-year MAKE. Moreover, the AKIN definition might be more reliable in the prediction of long-term prognosis.