Barriers and facilitators to guideline for the management of pediatric off-label use of drugs in China: a qualitative descriptive study.

BACKGROUND: Despite being a global public health concern, there is a research gap in analyzing implementation strategies for managing off-label drug use in children. This study aims to understand professional health managers' perspectives on implementing the Guideline in hospitals and determine the Guideline's implementation facilitators and barriers. METHODS: Pediatric directors, pharmacy directors, and medical department directors from secondary and tertiary hospitals across the country were recruited for online interviews. The interviews were performed between June 27 and August 25, 2022. The Consolidated Framework for Implementation Research (CFIR) was adopted for data collection, data analysis, and findings interpretation to implement interventions across healthcare settings. RESULTS: Individual interviews were conducted with 28 healthcare professionals from all over the Chinese mainland. Key stakeholders in implementing the Guideline for the Management of Pediatric Off-Label Use of Drugs in China (2021) were interviewed to identify 57 influencing factors, including 27 facilitators, 29 barriers, and one neutral factor, based on the CFIR framework. The study revealed the complexity of the factors influencing managing children's off-label medication use. A lack of policy incentives was the key obstacle in external settings. The communication barrier between pharmacists and physicians was the most critical internal barrier. CONCLUSION: To our knowledge, this study significantly reduces the implementation gap in managing children's off-label drug use. We provided a reference for the standardized management of children's off-label use of drugs.

Identifying the Producer and Grade of Matcha Tea through Three-Dimensional Fluorescence Spectroscopy Analysis and Distance Discrimination.

The three-dimensional fluorescence spectroscopy features the advantage of obtaining emission spectra at different excitation wavelengths and providing more detailed information. This study established a simple method to discriminate both the producer and grade of matcha tea by coupling three-dimensional fluorescence spectroscopy analysis and distance discrimination. The matcha tea was extracted three times and three-dimensional fluorescence spectroscopies of these tea infusions were scanned; then, the dimension of three-dimensional fluorescence spectroscopies was reduced by the integration at three specific areas showing local peaks of fluorescence intensity, and a series of vectors were constructed based on a combination of integrated vectors of the three tea infusions; finally, four distances were used to discriminate the producer and grade of matcha tea, and two discriminative patterns were compared. The results indicated that proper vector construction, appropriate discriminative distance, and correct steps are three key factors to ensure the high accuracy of the discrimination. The vector based on the three-dimensional fluorescence spectroscopy of all three tea infusions resulted in a higher accuracy than those only based on spectroscopy of one or two tea infusions, and the first tea infusion was more sensitive than the other tea infusion. The Mahalanobis distance had a higher accuracy that was up to 100% when the vector is appropriate, while the other three distances were about 60-90%. The two-step discriminative pattern, identifying the producer first and the grade second, showed a higher accuracy and a smaller uncertainty than the one-step pattern of identifying both directly. These key conclusions above help discriminate the producer and grade of matcha in a quick, accurate, and green method through three-dimensional fluorescence spectroscopy, as well as in quality inspections and identifying the critical parameters of the producing process.

Identification and characterization of SCCmec typing with psm-mec positivity in staphylococci from patients with coagulase-negative staphylococci peritoneal dialysis-related peritonitis.

BACKGROUND: Peritonitis is the most important complication of peritoneal dialysis (PD) and coagulase-negative staphylococci (CNS) are a frequent cause of dialysis-related infections. The association between SCCmec typing with psm-mec positivity in staphylococci and PD-related infections has not been identified. We aim to investigate the molecular epidemiology of CNS isolated from PD-peritonitis in a single Chinese center, focusing on the genetic determinants conferring methicillin resistance. METHODS: We collected 10 genetically unrelated CNS isolates from 10 patients with CNS PD-related peritonitis. The patients were divided into two groups based on the results of MIC to oxacillin: the methicillin-resistant CNS (MRCNS) and methicillin-sensitive CNS (MSCNS) groups. The biofilm formation group (BFG) and the non-biofilm formation group (NBFG) were used as the control groups. Phenotypic and molecular methods were used to analyze SCCmec types I, II and III, associated genes and biofilm formation and the existence of psm-mec. The demographic data and clinical indicators were collected. RESULTS: Ten CNS PD-related peritonitis patients were enrolled for this study. There were 6 MRCNS and 4 MRCNS isolates. SCCmec types were fully determined in 10 isolates. Seven staphylococci (70%) carried SCCmec, of which 4 isolates carried single SCCmec type I (40%) and 3 isolates had multiple SCCmec elements (I + III). Of the 6 MRCNS isolates, 3 carried SCCmec type I (50%) and 2 isolates carried SCCmec type I + III (33.3%). A high diversity of ccr types, mec complexes and ccr-mec complex combinations was identified among the 10 CNS isolates. The psm-mec gene was detected in 2/10 (20%) CNS isolates. There was no mutation in the psm-mec gene. CONCLUSIONS: The majority of isolates were hospital-associated isolates. Furthermore, 2 psm-mec positive isolates were MRCNS in the NBFG. The PD patients frequent exposure to hospital would be the main risk factor. The presence of the psm-mec signal in the spectra of the MRCNS tested here demonstrates the presence of certain SCCmec cassettes that convey methicillin resistance.

Guideline for the management of pediatric off-label use of drugs in China (2021).

BACKGROUND: The "Law on Doctors of the People's Republic of China," which was officially implemented on March 1, 2022, emphasizes the requirements for rational drug use and the necessity for appropriate management of off-label drug use. The safety and ethical considerations related to off-label drug use are different in children than in adults. There is so far no management guideline for pediatric off-label use of drugs in China, and the applicability of foreign guidelines is limited. Establishing a localized evidence-based management guideline for pediatric off-label use of drugs to support the national legislation and clinical practice is of critical importance. METHODS: We established a guideline working group, including experts from a broad range of disciplines and developed recommendations following the guidance of the World Health Organization Handbook and the Chinese Medical Association. The following themes were identified by questionnaires and expert interviews to be of great concern in the management of off-label drug use in children: general principles and characteristics of management of pediatric off-label drug use; establishment of expert committees; evidence evaluation; risk-benefit assessment; informed consent; monitoring and assessment of the risk; and monitoring and patient education. Two rounds of Delphi surveys were organized to determine the final recommendations of this guideline. We graded the recommendations based on the body of evidence, referring to the evaluation tool of the Evidence-based management (EBMgt) and the Oxford Center for Evidence-Based Medicine: Level of Evidence (March 2009). RESULTS: We developed the first guideline for the management of pediatric off-label use of drugs in China. CONCLUSIONS: The guideline is to offer guidance for pediatricians, pharmacists, medical managers, policymakers, and primary care physicians on how to manage off-label drug use in pediatrics and to provide recommendations for Chinese healthcare policy in the future.

Off-label use of drugs in pediatrics: a scoping review.

To explore the current state of research on off-label drug use in children and identify the existing research gaps in this topic. Six literature databases were searched to identify studies focusing exclusively on off-label drug use in children (aged < 18 years) published in Chinese or English between 2016 and 2021. We also searched clinicaltrials.gov for pediatric clinical trials conducted in the same period and compared the numbers of studies on off-label use and clinical trials for the most commonly reported drugs and drug types. Our search revealed 568 studies on off-label drug use. Almost half of the studies (n = 240) were cross-sectional. A total of 212 specific drugs or drug types were addressed in 361 studies, the most frequent being antipsychotic agents (n = 12), dexmedetomidine (n = 10), and rituximab (n = 8). Antipsychotic agents were also the most common type of drug examined in clinical trials in children. We identified a total of 435 different types of off-label use, the top three being unapproved indication (n = 157), population (n = 96), or age (n = 36). Only about one-third of the studies reported collecting informed consent (n = 195) or having ethics committee approval (n = 166).    Conclusions: Off-label use of antipsychotics in children is widely reported in the literature. We suggest pediatric researchers to consider the number of studies on off-label use and existing clinical trials on different drugs when selecting target drugs for new studies and systematic reviews. What is Known: • There exist a large number of studies on off-label drug use in children. What is New: • This is the first scoping review of studies on off-label drug use in children. • Off-label use of antipsychotic agents is widely reported.

Exploration of the correlation between intestinal flora and peritoneal dialysis-related peritonitis.

BACKGROUND: Peritonitis is a serious complication of peritoneal dialysis (PD). Gut microbiota alterations occur in end-stage renal disease (ESRD) patients. The relationship between the gut microbiota and PD-related peritonitis (PRP) is still poorly understood. It is unclear whether the intestinal flora is involved in the pathogenesis of PRP. METHODS: We collected fecal samples from PRP patients and normal group (NG) PD patients. 16S rRNA sequencing was used to analyze the gut microbiota of PRP and NG patients while also comparing the gram-positive peritonitis (GPP), Escherichia coli peritonitis (EP) and culture-negative peritonitis (CNP) groups in the subgroup analysis. The demographic data and clinical indicators of all patients were collected. RESULTS: Seventeen PRP patients and 28 NG patients were recruited for this study. The analysis of fecal community diversity with 16S rDNA sequencing showed an obvious change in the microbial structure of PRP patients, where Bacteroidetes and Synergistetes were upregulated at different levels, while Bacilli and Lactobacillus were downregulated at different levels compared to levels in the NG group. In the subgroup analysis, Saccharimonadaceae was significantly increased in the GPP group compared to the EP and CNP group. In addition, decreased gene function associated with metabolic pathways was observed in PRP patients. CONCLUSIONS: Bacteroidetes and Synergistetes were the dominant orders in PRP patients. The altered composition of the gut microbiota in PRP patients provided deeper insights into the pathogenesis of PRP, and these biomarkers might be established as potential therapeutic targets that deserve further exploration.

Recommendations on Off-Label Drug Use in Pediatric Guidelines.

Objective: To systematically analyze the supporting evidence, drug information, and the type of off-label drug use in recommendations on off-label drug use in pediatric guidelines. Methods: A cross-sectional study was performed by systematic search through MEDLINE (via PubMed) and Embase databases to identify literature published from 1 January 2018, to 31 December 2020. Only pediatric clinical practice guidelines that included recommendations on off-label use of drugs were included. We present descriptive information on the sources of the included guidelines, country, publication year, evidence grading system used, details on the types of off-label drug use, and the types of studies used as references to support the recommendations. Results: A total of 66 pediatric guidelines with 605 recommendations were included. Eighty-seven (14.4%) recommendations did not cite any references; and the remaining 518 recommendations were supported by 2,240 references (mean 4.3 references/recommendation). The most common types of studies cited were pediatric RCTs (n = 314, 14.0%), pediatric case series studies (n = 260, 11.6%), and reviews (n = 255, 11.4%). Twenty-one percent (n = 470) of the references were studies on adults. One hundred and forty (23.1%) recommendations were graded using the Grading of Recommendations, Assessments, Development, and Evaluations (GRADE) system, of which 37 (26.4%) were graded as strong but supported with only C or D level of evidence. The most commonly reported type of information in the recommendations was indication (n = 499, 82.5%). The most commonly addressed type of off-label drug use in the 523 positive recommendations was unapproved population (n = 255, 48.8%). Sixty-nine (11.4%) recommendations explicitly reported the drug use as off-label. Conclusion: Children may be exposed to medical risks due to gaps in reporting and evidence of off-label drug use recommendations in pediatric guidelines.

Liquid Metal Based Nano-Composites for Printable Stretchable Electronics.

Liquid metal (LM) has attracted prominent attention for stretchable and elastic electronics applications due to its exceptional fluidity and conductivity at room temperature. Despite progress in this field, a great disparity remains between material fabrication and practical applications on account of the high surface tension and unavoidable oxidation of LM. Here, the composition and nanolization of liquid metal can be envisioned as effective solutions to the processibility-performance dilemma caused by high surface tension. This review aims to summarize the strategies for the fabrication, processing, and application of LM-based nano-composites. The intrinsic mechanism and superiority of the composition method will further extend the capabilities of printable ink. Recent applications of LM-based nano-composites in printing are also provided to guide the large-scale production of stretchable electronics.

Exploration of the correlation between intestinal flora and Escherichia coli peritoneal dialysis-related peritonitis.

BACKGROUND: Escherichia coli peritonitis (EP) is a serious complication of peritoneal dialysis (PD). Gut microbiota alterations occur in end-stage renal disease (ESRD) patients. The relationship between the gut microbiota and PD-related peritonitis is still poorly understood. It is unclear whether the intestinal flora is involved in the pathogenesis of EP. METHODS: We collected fecal samples from EP patients and normal group (NG) PD patients. 16S rRNA sequencing was used to analyze the gut microbiota of EP and NG patients. The demographic data and clinical indicators of all patients were collected. RESULTS: Six EP patients and 28 NG patients were recruited for this study. The analysis of fecal community diversity with 16S rDNA sequencing showed an obvious change in the microbial structure of EP patients, where Bacteroidetes and Synergistetes were upregulated at different levels, while Bacilli and Lactobacillus were downregulated at different levels compared to the NG group. Additionally, decreased gene function associated with metabolic pathways was observed in EP patients. CONCLUSIONS: The altered composition of the gut microbiota in EP patients provided deeper insights into the pathogenesis of EP, and these biomarkers might be established as potential therapeutic targets that deserve further exploration.

Significant Decrease in Heavy Metals in Surface Sediment after Ten-Year Sustainable Development in Huaxi Reservoir Located in Guiyang, Southwestern China.

In the Karst area of southwestern China, the heavy metals in the sediment of a reservoir are determined by both human activities and the high background values. Thus, this study explores the change of heavy metals in surface sediment after ten-year sustainable development in the upstream areas of a reservoir, Huaxi Reservoir, located in Guiyang of southwestern China, then evaluates the risk of these heavy metals to water environment systematically and finally identifies the sources in both 2019 and 2009. The results reveal that all of the measured heavy metals decrease dramatically and their spatial distributions change from the increase-decrease pattern to decrease-increase pattern, implying different locations of main source input. The risk indices based on the total or average content and relative or reference values have decreased to the lowest level. However, those indices calculated from the absolute content of each metalloid still show a low or a moderate risk because of the high background value, such as As and Cr. Moreover, although only one main source of heavy metals is identified in both 2019 and 2009, the risk from human activities still cannot be neglected because agricultural production and infrastructure construction would promote the weathering of soil and then these heavy metals from the soil will be brought into the reservoir with the rainfall-runoff process. The high background value of specific heavy metals, e.g., As and Cr would still exert some challenges to the water environment protections because the non-point source input of heavy metal cannot be controlled easily by promulgating a series of bans. These results provide important reference for creating the policies of water environment protection, especially in some Karst area of southwestern China that exhibits high background value of heavy metals.

Sulfonic acid functionalized hierarchical porous covalent organic frameworks as a SALDI-TOF MS matrix for effective extraction and detection of paraquat and diquat.

Design and construction of a matrix with specific adsorption on the target compounds can effectively reduce the detection limit of surface-assisted laser desorption/ionization time-of-flight mass spectrometry (SALDI-TOF MS) analysis. Sulfonic acid functionalized hierarchical porous covalent organic frameworks (H-COF-SO3H) was synthesized by defect-structure and post-modification method, and then used as matrix and adsorbent for the determination of quaternary ammonium herbicides paraquat (PQ) and diquat (DQ). N2 adsorption-desorption experiments confirmed that H-COF-SO3H possesses hierarchical porosity with pore widths concentrated at 1.3,1.5, and 2.8 nm. The strong UV absorption at 200-450 nm and good thermal stability made H-COF-SO3H being a promising matrix without background interference. H-COF-SO3H can efficiently enrich PQ and DQ via electrostatic attraction, and the key role of -SO3H group on specific adsorption was confirmed by density functional theory (DFT) calculations. The limits of detection (LODs) for PQ and DQ with H-COF-SO3H enrichment were 0.5 and 0.1 ng·mL-1, respectively, which were 20 and 60 times higher than those without H-COF-SO3H enrichment, respectively. The spiked recoveries of PQ and DQ for the three food samples were 92.0-113.2% and 80.1-102.6% with RSDs of 2.2-9.2% and 2.0-8.7%, respectively. This work provides an analyte-oriented approach for fabricating SALDI-TOF MS matrix.

Fe3O4 nanoparticles coated with ultra-thin carbon layer for polarization-controlled microwave absorption performance.

The sufficient interface contact in the composite absorbing material is beneficial to increase the dielectric loss and promote the microwave absorption performance. In this paper, the composite nanoparticles (NPs), Fe3O4 covered with ultra-thin carbon layer (Fe3O4/C), were synthesized by simple high temperature solution-phase and subsequent high-temperature steam carbonization methods. Small size Fe3O4/C composite NPs have large heterogeneous interfaces, which can control the polarization loss of composite NPs through the method of interface regulation and achieve high microwave absorption performance. The strongest reflection loss of the composite NPs with an average particle size of 52 nm can reach -58.5 dB at 14.88 GHz with a thickness of 2 mm, and the corresponding effective absorption (RL ≤ -10 dB) bandwidth (EAB) is 5.63 GHz (12.37-18 GHz). In particular, the high-efficiency absorption (RL ≤ -20 dB) bandwidth of Fe3O4/C can reach 15.44 GHz (2-17.44 GHz) with a thickness of 1.7-10 mm. The current method for controlling polarization loss provide a meaningful reference for future microwave absorption research.

Biochar amendment effectively reduces the transport of 3,5,6-trichloro-2-pyridinol (a main degradation product of chlorpyrifos) in purple soil: Experimental and modeling.

This study investigates biochar amendment effectively reduces the transport of polar pollutant 3,5,6-trichloro-2-pyridinol, TCP, a main degradation product of chlorpyrifos, and quantitatively explores the physical and chemical mechanisms through inversion simulation. Thus, five biochar addition rates to soil, 0.0%, 0.5%, 1.0%, 2.5% and 5.0%, are tested and compared. The adsorption isotherms experiment, breakthrough curves, BTCs, in both repacked and undisturbed soil columns are also compared. And finally the non-equilibrium convection-diffusion equation, CDE, is used to uncover the change of hydraulic properties of soil and mass non-equilibrium of TCP in the soils mixed with different contents of biochar. The results show that the addition of biochar can reduce the transportation of TCP significantly in the purple soil with macro pores, and the reduction is mainly attributed to two aspects: increase of adsorption ability and decrease of diffusion coefficient and convection velocity. The former is reflected by the linear increase of Kd value with the increase of biochar addition rate and soil organic matter content. The latter is demonstrated by the dramatic reduction of TCP concentration in outflow of BTC experiment and the delayed leaching time. The inversely simulated results also reveal that the diffusion coefficient decrease from 5.35 to 3.95 when biochar addition rate increases from 0 to 5%. Compared with the repacked soil columns, the preferential flow does not disappear in the undisturbed soil columns, accompanied by a higher maximum concentration, an earlier equilibrium time and a less residual amount.

Quantifying dynamic desorption of 3,5,6-trichloro-2-pyridinol in loamy farmland soils.

Reliable estimate of the release of adsorbed pesticide from soil particles is crucial to evaluating the pesticide fate, mobility, efficacy, and remediation. In this study, the dynamics of TCP (3,5,6-trichloro-2-pyridinol) desorption, the main degradation product of chlorpyrifos and triclopyr, is explored quantitatively by the breakthrough curve (BTC) experiment with the tracer of Br- in the loamy farmland purple soil sampled from Sichuan Basin of southwestern China. TCP in the outflow originates from two sources: dissolved TCP in pore water and desorbed TCP from soil particles by infiltrating water. The dissolved TCP is considered proportional to the amount of Br- because both TCP and Br- are dissolved in water uniformly. According to the mass balance equation, the desorbed TCP are estimated and the typical patterns of dynamic TCP desorption are revealed. Characteristics of TCP desorption are compared between packed and undisturbed soil columns as well as between different planting types. The dynamics of the proportion of desorbed TCP during the breakthrough process are characterized. In particular, the high heterogeneity of the undisturbed soil may be responsible for the observed fluctuation of desorbed TCP in the outflow. Additionally, the obtained increase-decrease pattern of the desorbed rate of TCP released from the soil shows that most models proposed to simulate the desorption processes are not appropriate, because these models display a monotone decreasing trend, such as the Noyes-Whitney Rule and other release kinetic models (zero order, first order, Higuchi and Korsmeyer-Peppas model, etc.). After a comparison among linear model, Gamma distribution and Weibull distribution, the CDF of gamma distribution is identified as a better method to describe the proportion of desorbed TCP in outflow. Therefore, this study provides an alternative method to measure the dynamic desorption process of TCP in different environment of the purple soil, and their affecting factors are also identified. These results are useful in quantifying the leaching of the TCP in the field, in support of the prevention of agricultural non-point pollution of pesticides.

Halide Ion-Mediated Synthesis of L10-FePt Nanoparticles with Tunable Magnetic Properties.

L10-FePt nanoparticles (NPs) have great potential in areas of advanced magnetic and catalytic applications. Here, we present a facile control route for synthesis of hard magnetic L10-FePt NPs in which halide ions (Cl-, Br-, or I-) were added to the synthetic process to promote the phase transformation. It is confirmed that the strong ionic binding force between halide ions and Fe3+ or Pt2+ ions could facilitate the formation of L10-FePt phase due to favoring growth of FePt NPs in a more thermodynamically stable way, which enables the formation of an ordered structure. L10-FePt NPs with the highest coercivity of 8.64 kOe and saturation magnetization of 64.21 emu/g at room temperature can be directly obtained by controlling the amount of the halide ions. In comparison with conventional solution phase reduction methods, the halide ion-assisted method shows enhanced capability to tune the growth of hard magnetic bimetallic NPs, particularly Pt-based bimetallic NPs.

Hydrological interactions between oases and water vapor transportation in the Tarim Basin, northwestern China.

The spatial evolution of the oasis cold-wet effects in Tarim Basin, northwestern China, are explored quantitatively by using the China Meteorological Forcing Dataset, with spatial and temporal resolution of 0.1 degree and 3 hours, respectively, and the hydrological interactions between the oases and water vapor transfer are discussed to uncover the influence of oases on regional precipitation. The results reveal that the annual precipitation exhibits an increasing trend from desert toward oasis at all four oases. However, the cold effect is not the dominating factor increasing precipitation, since the maximum increasing rate of precipitation is accompanied by the minimum decreasing rate of temperature. Indeed, water vapor transportation is more important than the cold effect. The maximum promotion of precipitation is observed in western basin, where the water vapor transfer follows the gradients of decreasing temperature and increasing humidity. Conversely, the minimum promotion in southwestern basin results from water vapor transportation following the temperature increasing. Therefore, the transfer of water vapor and its interactions with local surface conditions determine the precipitation in oasis areas. Understanding these processes is crucial to exploring the formation and spatial layout of oases, which is helpful for preventing desertification and protecting the fragile oasis ecosystem.

High-performance asymmetric supercapacitors based on monodisperse MnO nanocrystals with high energy densities.

Monodisperse spherical MnO nanocrystals (NCs) with a size of 22.5 nm were synthesized by the thermal decomposition of manganese oleate in the presence of oleic acid and 1-octadecene. The as-synthesized MnO NCs show superior electrochemical performances with a specific capacitance of 736.4 F g-1 at a current density of 1 A g-1 and retain 93.3% of initial specific capacitance after 5000 cycles. The MnO NC electrode was successfully assembled in an asymmetric supercapacitor as the cathode with an activated carbon (AC) electrode as the anode. The as-fabricated device can demonstrate remarkable performance with an energy density of 44.2 W h kg-1, a power density of 900 W kg-1, and excellent cycling stability. This work provides a new direction for MnO nanomaterials towards high-performance energy storage devices.

A general strategy for synthesizing high-coercivity L10-FePt nanoparticles.

It is extremely desirable but challenging to develop a facile solution phase synthesis to directly prepare well-dispersed L10-FePt nanoparticles (NPs) to meet the requirements of advanced magnets in modern industry and information technology. Here, we report a novel strategy to synthesize hard magnetic L10-FePt NPs via controlled co-reduction of Fe(acac)3 and K2PtCl6 in the presence of oleylamine, in which effective control of the magnetic properties and chemical ordering of L10-FePt NPs was achieved by tuning the mole ratio of the precursors, reaction time and temperature. The highest coercivity of 10.5 kOe can be obtained for the NPs synthesized at 350 °C for 8 h, which is much higher than the coercivities reported by the previous studies on solution-synthesized FePt NPs without annealing or the third elemental additive. The reported one-pot synthesis of L10-FePt NPs may provide an ideal class of building blocks for magnetic energy applications.

High-density defects on PdAg nanowire networks as catalytic hot spots for efficient dehydrogenation of formic acid and reduction of nitrate.

Controlling the surface defects of nanocrystals is a new way of tuning/boosting their catalytic properties. Herein, we report networked PdAg nanowires (NWs) with high-density defects as catalytic hot spots for efficient catalytic dehydrogenation of formic acid (FA) and catalytic reduction of nitrates. The networked PdAg NWs exhibit composition-dependent catalytic activity for the dehydrogenation reaction of FA without any additive, with Pd5Ag5 NWs exhibiting the highest activity. They also show good durability, reflected by the retention of their initial activity during the dehydrogenation reaction of FA even after five cycles. Their initial TOF is 419 h-1 at 60 °C in water solution, much higher than those of the most Pd-based catalysts with a support. Moreover, they can efficiently reduce nitrates to alleviate nitrate pollution in water (conversion yield >99%). This strategy opens up a new green synthetic technique to design support-free heterogeneous catalysts with high-density defects as catalytic hot spots for efficient dehydrogenation catalysis of FA to meet the requirement of fuel cell applications and catalytic reduction of nitrates in water polluted with nitrates.