Social support and the burden of physical and psychiatric comorbidities in the patients with late-onset epilepsy in China: A cross-sectional study.

INTRODUCTION: Epilepsy is the third most common neurological disorder in elderly people. Patients with epilepsy (PWEs) are more likely to have comorbidities. Social support is very important for PWEs. However, there are many gaps in the research on social support in older PWEs, especially the correlation between social support and comorbidities. METHODS: A cross-sectional study was conducted in three hospitals in China. Social support was assessed using the Social Support Rate Scale. The burden of physical comorbidities was assessed using the CCI, and global disability was assessed using the mRS. The NDDIE was used to assess depression, the GAD7 was used for anxiety, the CDR was used for cognitive status, and the NPI was used for psychotic symptoms. RESULTS: A total of 154 older PWEs participated in the study. There were 97 patients with at least one physical comorbidities. The burden of physical comorbidities was negatively correlated with overall social support (Adj. r = -0.35, P < 0.001) and global disability (Adj. r = -0.45, P < 0.001). In terms of psychiatric comorbidities, anxiety, depression, and cognitive status were not correlated with overall social support (Adj. r = -0.03, -0.02, and -0.11, P > 0.05). Psychotic symptoms were correlated with overall social support (Adj. r = -0.20, P < 0.05). The overall burden of psychiatric comorbidities was associated with overall social support (r = 0.30, P < 0.01). DISCUSSION: Neurologists and social workers should consider more personalized biopsychosocial care to improve the quality of life of older PWEs.

Diverse thermal desorption combined with self-aspirating corona discharge ionization for direct mass spectrometry analysis of complex samples.

The thermal desorption (TD) technique is widely employed in modern mass spectrometry to facilitate the detection of non-volatile analytes. In this study, we developed a compact TD device based on a small resistance wire and coupled it with a self-aspirating corona discharge ionization (CDI) source to conduct direct MS analysis of various liquid and solid samples. Due to its small size and low heat capacity, the temperature of the TD module can be flexibly and rapidly modulated by controlling the power sequence. Multiple heating modes, including pulse heating (PH), isothermal heating, and step heating (SH), are realized and characterized, and then applied for the detection of different real samples. In particular, the PH mode is suitable for the simultaneous detection of multiple components in samples with relatively simple matrices, while the SH mode is capable of component separation. In addition, the sensitivity and quantitative capability of the TD-CDI system for DEP solutions were tested, showing acceptable stability with a relative standard deviation of about 6.7% and a detection limit of 0.088 ng. Overall, the developed TD-CDI system provides a simple, convenient, and versatile tool for direct mass spectrometry analysis of real samples.

Performance of assessment tools in predicting neural autoantibody positivity in patients with seizures.

BACKGROUND: The identification of patients with seizures of unknown etiology who would benefit from neural antibody testing necessitates effective assessment tools. The study aimed to compare the performance of the Antibody Prevalence in Epilepsy and Encephalopathy (APE2) score and the "Obvious" Indications for Neural Antibody Testing in Epilepsy or Seizures (ONES) checklist. We also intended to evaluate whether the performance of the tools varied by types of antibody. METHODS: Patients diagnosed with epilepsy, seizures, or status epilepticus of unknown etiology at West China Hospital from January 2019 to December 2021 were included. Paired serum/cerebrospinal fluid samples were analyzed for antineuronal and antiglial antibodies. The APE2 score and ONES checklist were applied, and their outcomes were compared to laboratory antibody test results. Possible false positive neuronal antibody results were excluded in sensitivity/specificity analysis reasonably. RESULTS: A total of 113 antibody-positive and 159 antibody-negative patients were enrolled in sensitivity/specificity analysis. The ONES checklist showed superior sensitivity than APE2 score (95.6 % vs.79.6 %, P < 0.001). Specificity was not statistically different (60.4 % vs. 57.9 %, P = 0.557). The negative predictive value (NPV) of ONES checklist was higher than that of APE2 score (94.8 % vs 80.7 %, P < 0.001). The positive predictive value of them was not statistically different (61.7 % vs 58.8 %, P = 0.557). APE2 score exhibited lower sensitivity for predicting LGI-Abs (52.9 % vs. 80.3 %, P = 0.022) compared to NMDAR-Abs. Similarly, ONES checklist showed lower sensitivity for LGI1-Abs than NMDAR-Abs (82.4 % vs. 100.0 %, P = 0.009). CONCLUSIONS: The ONES checklist demonstrates superior sensitivity for neural antibody positivity than APE2 score. Specificity of the two assessment tools was similar. ONES checklist performed better NPV than the APE2 score. Both assessment tools performed less well in predicting the presence of LGI1- Abs when compared to NMDAR-Abs.

A highly efficient lanthanide coordination polymer luminescent material for the multi-task detection of environmental pollutants.

It is challenging to explore novel-structure lanthanide coordination polymers (Ln-CPs) for sensing environmental pollutants. Herein, we designed and synthesized an organic bridging linker 3-(carboxymethoxy)-1-(carboxymethyl) pyrazole-4-carboxylic acid (H3ccpc), and then successfully prepared and characterized a novel Ln-CP, namely [Tb2(ccpc)2(H2O)6]·1.5H2O (ccpcTb). Structural analysis indicates that ccpcTb exhibits a two-dimensional structure, in which Tb ions are in an eight-coordinated environment. The photoluminescence performance of ccpcTb was discussed in detail. The ccpcTb displays bright green luminescence and behaves as a multi-responsive luminescent sensor toward Fe3+ ions, Cr2O72- ions and 2,4,6-trinitrophenol with high selectivity and low detection limits. Furthermore, the possible luminescence sensing mechanisms have been addressed in detail. The luminescence quenching mechanism of sensing Fe3+ and Cr2O72- is attributed to the energy competitive absorption, while that of sensing TNP is due to the synergistic effect of energy competitive absorption and photo-induced electron transfer.

Prevalence and risk factors of anxiety and depression in adult patients with epilepsy: a multicenter survey-based study.

Background: Depression and anxiety are the most common psychiatric comorbidities in patients with epilepsy (PWE). However, they are often unrecognized and consequently untreated. Objective: The study was conducted to evaluate the prevalence and risk factors of anxiety and depression among Chinese adult PWE. Design: Cross-sectional study. Methods: Adult PWE were recruited from 13 tertiary epilepsy centers from February to September 2022. Generalized Anxiety Disorder-7 and Neurological Disorders Depression Inventory for Epilepsy were applied to evaluate anxiety and depression, respectively. Both univariate and multivariate logistic regression analyses models were performed to explore the risk factors of anxiety and depression. Results: A total of 1326 PWE were enrolled in this study. The prevalence of anxiety and depression was 31.45% and 27.30%, respectively. Being female [odds ratio (OR) = 1.467, 95% CI: 1.134-1.899; p = 0.004], focal and focal to bilateral tonic-clonic seizures (TCSZ) (OR = 1.409, 95% CI: 1.021-1.939; p = 0.036), and seizure occurrence in the last 3 months (OR = 1.445, 95% CI: 1.026-2.044; p = 0.036) were the risk factors for anxiety. Focal and focal to bilateral TCSZ (OR = 1.531, 95% CI: 1.094-2.138; p = 0.013) and seizure occurrence in the last 3 months (OR = 1.644, 95% CI: 1.130-2.411; p = 0.010) were the risk factors for depression. In addition, for every 1-year increment of age, the odds of developing depression were decreased by 3.8% (p = 4.12e-5). Nevertheless, up to 70% of PWE did not receive any treatment for comorbidity. Conclusion: There were approximately 30% of PWE screened positive for anxiety or depression. Both focal and focal to bilateral TCSZ and seizure occurrence in the last 3 months were estimated as risk factors for anxiety and depression. However, the current status of treatment was not optimal.

Natural and biocompatible dressing unit based on tea carbon dots modified core-shell electrospun fiber for diabetic wound disinfection and healing.

Wound infection and healing in patients with diabetes is one of the complex problems in trauma treatment. Therefore, designing and preparing an advanced dressing membrane for treating the wounds of such patients is essential. In this study, a zein film with biological tea carbon dots (TCDs) and calcium peroxide (CaO2) as the main components for promoting diabetic wound healing was prepared by an electrospinning technique, which combines the advantages of natural degradability and biosafety. CaO2 is a biocompatible material with a microsphere structure that reacts with water to release hydrogen peroxide and calcium ions. TCDs with a small diameter were doped in the membrane to mitigate its properties while improving the antibacterial and healing effects of the membrane. TCDs/CaO2 was mixed with ethyl cellulose-modified zein (ZE) to prepare the dressing membrane. The antibacterial properties, biocompatibility and wound-healing properties of the composite membrane were investigated by antibacterial experiment, cell experiment and a full-thickness skin defect. TCDs/CaO2 @ZE exhibited significant anti-inflammatory and wound healing-promoting properties in diabetic rats, without any cytotoxicity. This study is meaningful in developing a natural and biocompatible dressing membrane for diabetic wound healing, which shows a promising application in wound disinfection and recovery in patients with chronic diseases.

Synthesis of Castor Oil-Based Quaternary Ammonium Salt and Modification of Attapulgite for Treating Industrial Wastewaters.

In order to develop multifunctional quaternary ammonium salts and explore their advantages as modifiers for wastewater treatment, castor oil-based quaternary ammonium salts were synthesised and subsequently used as modifiers for attapulgite treatment. The structures of untreated and treated attapulgite were compared by Fourier transform infrared spectra and X-ray diffraction. The mechanism of modification was speculated. Various factors such as the amount of modified attapulgite, temperature and pH were also investigated in the batch experiments on the removal rates of acetone and phenol from wastewaters. The synthesis conditions were set as follows: the reaction temperature was 80 °C, the reaction time was 8 h, the molar ratio of castor oil to N,N-dimethyl-1,3-propanediamine was 1:5, the catalyst was 6% NaOH and the product yield was about 64.72%. The grafting rate of the castor oil-based quaternary ammonium salt was about 99.6% when the amount of modifier was 0.69 g per 5 g of attapulgite, the ultrasound treatment time was 11 min and the pH was 5. The quaternary ammonium salt was only associated with the surface of attapulgite and did not change the rod-like crystal structure of the silicate. The modified attapulgite is much more fibrous and exhibits a good distribution of crystal bundles. The removal rates were found to be less favourable under strongly acidic and strongly alkaline conditions. Under suitable conditions, for 50 mL industrial wastewaters (phenol: 100-160 mg/L; acetone: 680-800 mg/L), the amount of modified attapulgite was 1 g, the temperature was 80 °C and the pH was 7, and the maximum removal rates of acetone and phenol after 80 min reached about 65.71% and 78.72%, respectively, which were higher than those of ATP.

Dopamine D1-receptor-expressing pathway from the nucleus accumbens to ventral pallidum-mediated sevoflurane anesthesia in mice.

BACKGROUND: General anesthesia has long been used in clinical practice, but its precise pharmacological effects on neural circuits are not fully understood. Recent investigations suggest that the sleep-wake system may play a role in the reversible loss of consciousness induced by general anesthetics. Studies in mice have shown that microinjection of dopamine receptor 1 (D1R) agonists into the nucleus accumbens (NAc) promotes recovery from isoflurane anesthesia, while microinjection of D1R antagonists has the opposite effect. Furthermore, during the induction and maintenance of sevoflurane anesthesia, there is a significant decrease in extracellular dopamine levels in the NAc, which subsequently increases during the recovery period. These findings suggest the involvement of the NAc in the regulation of general anesthesia. However, the specific role of D1R-expressing neurons in the NAc during general anesthesia and the downstream effect pathways are still not well understood. METHODS: In order to analyze the impact of sevoflurane anesthesia on NAcD1R neurons and the NAcD1R -VP pathway, this study employed calcium fiber photometry to investigate alterations in the fluorescence intensity of calcium signals in dopamine D1-receptor-expressing neurons located in the nucleus accumbens (NAcD1R neurons) and the NAcD1R -VP pathway during sevoflurane anesthesia. Subsequently, optogenetic techniques were utilized to activate or inhibit NAcD1R neurons and their synaptic terminals in the ventral pallidum (VP), aiming to elucidate the role of NAcD1R neurons and the NAcD1R -VP pathway in sevoflurane anesthesia. These experiments were supplemented with electroencephalogram (EEG) recordings and behavioral tests. Lastly, a genetically-encoded fluorescent sensor was employed to observe changes in extracellular GABA neurotransmitters in the VP during sevoflurane anesthesia. RESULTS: Our findings revealed that sevoflurane administration led to the inhibition of NAcD1R neuron population activity, as well as their connections within the ventral pallidum (VP). We also observed a reversible reduction in extracellular GABA levels in the VP during both the induction and emergence phases of sevoflurane anesthesia. Additionally, the optogenetic activation of NAcD1R neurons and their synaptic terminals in the VP resulted in a promotion of wakefulness during sevoflurane anesthesia, accompanied by a decrease in EEG slow wave activity and burst suppression rate. Conversely, the optogenetic inhibition of the NAcD1R -VP pathway exerted opposite effects. CONCLUSION: The NAcD1R -VP pathway serves as a crucial downstream pathway of NAcD1R neurons, playing a significant role in regulating arousal during sevoflurane anesthesia. Importantly, this pathway appears to be associated with the release of GABA neurotransmitters from VP cells.

[Rapid health technology assessment of four oral Chinese patent medicines in treatment of functional gastrointestinal disorders].

To provide proof of the evidence-based medicine and decision-making information for the clinical decision of functional gastrointestinal disorders(FGIDs), this study evaluated and compared the efficacy, safety, and economy of four oral Chinese patent medicines(CPMs) in the treatment of FGIDs using the method of rapid health technology assessment. The literature was systematically retrieved from CNKI, Wanfang, VIP, SinoMed, EMbase, PubMed, Cochrane Library and ClinicalTrials.gov from the establishment of the databases to May 1, 2022. Two evaluators screened out the literature, extracted data, evaluated the quality of the literature, and descriptively analyzed the results according to the prepared standard. Eventually, 16 studies were included, all of which was rando-mized controlled trial(RCT). The results showed that Renshen Jianpi Tablets, Renshen Jianpi Pills, Shenling Baizhu Granules, and Buzhong Yiqi Granules all had certain effects on the treatment of FGIDs. Renshen Jianpi Tablets treated FGIDs and persistent diarrhea. Shenling Baizhu Granules treated diarrhea with irritable bowel syndrome and FGIDs. Buzhong Yiqi Granules treated diarrhea with irritable bowel syndrome, FGIDs, and chronic diarrhea in children. Renshen Jianpi Pills treated chronic diarrhea. The four oral CPMs all have certain effects on the treatment of FGIDs and have specific advantages for specific patients. Compared with other CPMs, Renshen Jianpi Tablets have higher clinical universality. However, there are problems such as insufficient clinical research evidence, generally low quality of evidence, lack of comparative analysis among medicines, and lack of academic evaluation. More high-quality clinical research and the economic research should be carried out in the future, so as to provide more evidence for the evaluation of the four CPMs.

Electronic Modulation of the 3D Architectured Ni/Fe Oxyhydroxide Anchored N-Doped Carbon Aerogel with Much Improved OER Activity.

It remains a big challenge to develop non-precious metal catalysts for oxygen evolution reaction (OER) in energy storage and conversion systems. Herein, a facile and cost-effective strategy is employed to in situ prepare the Ni/Fe oxyhydroxide anchored on nitrogen-doped carbon aerogel (NiFeOx(OH)y@NCA) for OER electrocatalysis. The as-prepared electrocatalyst displays a typical aerogel porous structure composed of interconnected nanoparticles with a large BET specific surface area of 231.16 m2·g-1. In addition, the resulting NiFeOx(OH)y@NCA exhibits excellent OER performance with a low overpotential of 304 mV at 10 mA·cm-2, a small Tafel slope of 72 mV·dec-1, and excellent stability after 2000 CV cycles, which is superior to the commercial RuO2 catalyst. The much enhanced OER performance is mainly derived from the abundant active sites, the high electrical conductivity of the Ni/Fe oxyhydroxide, and the efficient electronic transfer of the NCA structure. Density functional theory (DFT) calculations reveal that the introduction of the NCA regulates the surface electronic structure of Ni/Fe oxyhydroxide and increases the binding energy of intermediates as indicated by the d-band center theory. This work provides a new method for the construction of advanced aerogel-based materials for energy conversion and storage.

Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study.

Background: Remimazolam tosilate (RT) is a new type of γ-aminobutyric acid subtype A (GABAA) receptor agonist, having the possibility to be an ideal sedative drug for procedural sedation. At present, there are few studies on the effect of RT on respiratory depression in elderly patients. We aimed to evaluate the effect of RT on respiratory depression in elderly patients undergoing gastroscopy. Methods: This prospective, randomized, single-blinded trial recruited patients from eight centers in China between May 2022 and July 2022. A total of 346 elderly patients undergoing gastroscopy were randomly divided into RT group (0.2 mg/kg) or propofol group (1.5 mg/kg), respectively. The primary outcome was the incidence of respiratory depression. Secondary outcomes include the incidence of sedative-related adverse events, the success rate of sedation, time to fully alert, time to loss of consciousness (LOC), time to ready for discharge, as well as the the patients, endoscopists and anethetists' satisfaction. Results: The incidence of respiratory depression was significantly reduced in the RT group compared with the propofol group (9.8% vs 17.9%, P=0.042). The time of LOC and fully alert in the RT group were longer than that in the propofol group (P < 0.05). The incidences of hypotention (50.9% vs 32.4%, P=0.001) and hypotension requiring treatment (5.8% vs 1.7%, P=0.031) were significantly higher in the propofol group than that in the RT group. The incidence and severity of injection pain were more frequently recorded in the propofol group than that in the RT group (40.5% vs 12.1%, P<0.05). There were no statistically significant differences between the two groups in terms of sedation success rates, time to ready for discharge, endoscopists and anethetists' satisfaction and other sedative-related adverse events. Conclusion: RT may be a suitable alternative sedative agent for elderly patients undergoing gastroscopy due to its safety profile.

Antibacterial Z-scheme ZnIn2S4/Ag2MoO4 composite photocatalytic nanofibers with enhanced photocatalytic performance under visible light.

Considering the biocompatibility of natural proteins and the strong photo-redox capability of Z-scheme heterojunctions, we fabricated Z-scheme ZnIn2S4/Ag2MoO4@Zein (Z ZA) photocatalytic membranes via electrospinning and in-situ precipitation for enrofloxacin (ENR) degradation. Z ZA exhibit a fiber structure wrapped with ZnIn2S4/Ag2MoO4 heterojunctions. Photocatalytic studies and various characterization results certified that the Z-scheme structure between ZnIn2S4 and Ag2MoO4 significantly increases the lifetime and separation efficiency of photogenerated carriers, which in turn enhances the photodegradation of ENR. The degradation rate of Z ZA-10 (ZnIn2S4/10 wt% Ag2MoO4@Zein) with the highest catalytic activity could reach 100% within 120 min compared with other samples. For ENR degradation, •O2- radicals were certified to be the primary active species by trapping experiments, and several possible conversion pathways of ENR in photocatalytic reactions were proposed. Furthermore, the antibacterial rates of Z ZA-20 (ZnIn2S4/20 wt% Ag2MoO4@Zein) against B. subtilis, P. aeruginosa, S. aureus, and E. coli could reach 90.09%, 89.78%, 84.34%, and 95.31%, respectively. Antibacterial evaluations and cytotoxicity assays demonstrated that Z ZA photocatalytic films had desirable antibacterial properties and low cytotoxicity, rendering them safe and effective for use in the treatment of antibiotic wastewater.

Inhibition of KIR2.1 decreases pulmonary artery smooth muscle cell proliferation and migration.

The investigation of effective therapeutic drugs for pulmonary hypertension (PH) is critical. KIR2.1 plays crucial roles in regulating cell proliferation and migration, and vascular remodeling. However, researchers have not yet clearly determined whether KIR2.1 participates in the proliferation and migration of pulmonary artery smooth muscle cells (PASMCs) and its role in pulmonary vascular remodeling (PVR) also remains elusive. The present study aimed to examine whether KIR2.1 alters PASMC proliferation and migration, and participates in PVR, as well as to explore its mechanisms of action. For the in vivo experiment, a PH model was established by intraperitoneally injecting Sprague­Dawley rats monocrotaline (MCT). Hematoxylin and eosin staining revealed evidence of PVR in the rats with PH. Immunofluorescence staining and western blot analysis revealed increased levels of the KIR2.1, osteopontin (OPN) and proliferating cell nuclear antigen (PCNA) proteins in pulmonary blood vessels and lung tissues following exposure to MCT, and the TGF­ß1/SMAD2/3 signaling pathway was activated. For the in vitro experiments, the KIR2.1 inhibitor, ML133, or the TGF­ß1/SMAD2/3 signaling pathway blocker, SB431542, were used to pre­treat human PASMCs (HPASMCs) for 24 h, and the cells were then treated with platelet­derived growth factor (PDGF)­BB for 24 h. Scratch and Transwell assays revealed that PDGF­BB promoted cell proliferation and migration. Immunofluorescence staining and western blot analysis demonstrated that PDGF­BB upregulated OPN and PCNA expression, and activated the TGF­ß1/SMAD2/3 signaling pathway. ML133 reversed the proliferation and migration induced by PDGF­BB, inhibited the expression of OPN and PCNA, inhibited the TGF­ß1/SMAD2/3 signaling pathway, and reduced the proliferation and migration of HPASMCs. SB431542 pre­treatment also reduced cell proliferation and migration; however, it did not affect KIR2.1 expression. On the whole, the results of the present study demonstrate that KIR2.1 regulates the TGF­ß1/SMAD2/3 signaling pathway and the expression of OPN and PCNA proteins, thereby regulating the proliferation and migration of PASMCs and participating in PVR.

Modulation of the lipophilicity and molecular size of thiosemicarbazone inhibitors to regulate tyrosinase activity.

A group of 5-methylsalicylaldehyde thiosemicarbazone derivatives (HMTs) bearing different lipophilic and steric substituents attached at the 3-position of cresol ring were synthesized and investigated as mushroom tyrosinase (TYR) inhibitors. The ability of HMTs to inhibit the diphenolase activity of TYR was evaluated with L-DOPA as substrate by determining IC50 values in relation to their structure modifications. HMTs displayed distinct inhibitory competencies towards TYR activity with IC50 values in the range of 1.02-143.56 µM. A close correlation between their inhibition potency and both lipophilicity and molecular size was observed. The inhibitory effect of the hydroxyethyl-containing derivatives was much higher than the hydroxyethyl-free ones overall. Among them, HMT-NBO exhibited the most potent effect with IC50 of 5.85 µM, which was nearly 25-fold and 3.8-fold lower than its parent HMT-NBE and the control kojic acid, respectively. The hydroxyethyl clearly benefited the improvement of the inhibitory competences and acted as a regulating group of lipophilicity of the inhibitors. The kinetic analyses showed that HMTs were reversible and mixed type inhibitors against mushroom TYR. The inhibition mechanism was studied by means of fluorescence spectroscopy, FT-IR, ESI-MS and molecular docking analysis. The results indicated that the observed inhibitory effect of HMTs was accomplished by acting on the amino acid residues rather than by chelating the centre copper ions of TYR. Each of HMTs can insert the hydrophobic pocket and interact with the residues of TYR through Van der Waals forces and hydrogen bonds, with additional electrostatic interactions for HMT-NEE and HMT-NEO further strengthening the affinity. Meanwhile, the inhibitors were observed to bind with L-DOPA or/and L-DOPAquinone forming 1:1 stoichiometric complexes, probably exerting indirect inhibition against TYR activity.

Rapid screening of illegally added drugs in functional food using a miniature ion trap mass spectrometer.

With the expansion of the functional food market, the qualification assessment of these products has become a major challenge, and efficient analytical tools are urgently needed. Here, a miniature mass spectrometer (MS) with self-aspiration capillary electrospray ionization (SACESI) source and ion trap analyzer was developed for rapid screening of various illegally added drugs in functional foods. No chromatographic separation was required, but a simplified two-step pretreatment method was developed to reduce the operational procedures and time consumption of the entire analysis. SACESI source uses capillary action to drive solution injection, which utilizes a simple structure and convenient operation to constitute a kind of disposable MS detection solution. To achieve accurate and automatic identification, an intelligent recognition algorithm with steps of spectrum preprocessing, characteristic peak matching, and support vector machine learning was constructed. The relative accuracy of rapid screening of 31 suspicious drugs in various samples is up to 99.78%. It achieves 100% correct identification for the 55 batches of actual samples captured by on-site inspection, which demonstrates the feasibility of the proposed analytical system and strategy in food safety applications.

Ibuprofen degradation by a synergism of facet-controlled MIL-88B(Fe) and persulfate under simulated visible light.

The photocatalysis/persulfate (PS) hybrid system has proven to be a promising method for degrading organic pollutants from aqueous solutions. In this study, three MIL-88B(Fe) iron-based metal-organic framework (MOF) phases with different facet content were prepared and used both as photocatalysts and catalysts for PS activation to remove ibuprofen (IBP). The results showed that there was a close correlation between the exposed facets and the catalytic activity. MIL-88B(Fe)-1 (M88B1) with exposed {100} facets and proportionally more {101} facets showed the best catalytic activity. The optimum PS dosage used in this study was 60 mg/L. The presence of Cl-, SO42-, and NO3- all inhibited the degradation of IBP. X-ray photoelectron spectroscopy (XPS) showed that M88B1 possessed more Fe2+ than the other two MIL-88B(Fe) MOF phases, making it easier to generate active radicals through PS activation. The UV-vis diffuse reflectance spectra (DRS), photoluminescence (PL), and electrochemical analysis indicated that M88B1 possessed the highest light absorption, most active sites, and fastest charge transfer ability. Radical scavenging and electron spin resonance (ESR) experiments demonstrated that SO4-•, •OH, O2-•, and 1O2 species participated in the IBP degradation process. Furthermore, density functional theory (DFT) calculations were performed to identify the crystallographic facets, band structure, and total density of states of MIL-88B(Fe) to further confirm the mechanism of MIL-88B(Fe) as a photocatalyst and a PS activator. This work provides new insights into the synergism between photocatalysis and persulfate activation by facet-controlled MOFs for environmental remediation.

Efficacy and Safety of the Remimazolam-Alfentanil Combination for Sedation During Gastroscopy: A Randomized, Double-blind, Single-center Controlled Trial.

PURPOSE: Propofol infusion is a popular single drug of choice for sedation in the gastrointestinal endoscopy suite. Drug combinations are more beneficial than single-drug regimens in gastroscopy sedation. However, the cardiopulmonary complications of propofol sedation raise concern. Remimazolam is a novel, ultra-short-acting benzodiazepine sedative, and alfentanil is a weak opioid. During endoscopic procedures, remimazolam is an effective and safe sedative procedure. No synergistic effect has been reported when remimazolam was combined with alfentanil in gastroscopy sedation. Here, we evaluated the effective dose, sedative efficacy, and safety of the remimazolam-alfentanil combination in gastroscopy sedation and compared the results with those of the propofol-alfentanil combination. METHODS: This study was conducted in two parts. In Part 1, Dixon's up-and-down method (sequential distribution) was adopted for determining the 95% effective dose (ED95) (95% CI) and 95% CI of remimazolam combined with 5 µg/kg alfentanil. In Part 2, after obtaining the predictive remimazolam ED95, 161 patients were randomized into the remimazolam group (remimazolam-alfentanil) and the propofol group (propofol-alfentanil). The effectiveness of the drug combinations was measured according to successful sedation parameters. Changes in vital signs and the appearance of adverse events were used to assess the safety of drug combinations. Evaluation of patient and physician satisfaction was included as quality indicators of treatment. RESULTS: Baseline demographic and clinical characteristics were comparable between the 2 parts of the study. The ED95 of remimazolam in inhibiting a positive response to gastroscopy placement into the pharyngeal cavity was 0.33 mg/kg (95% CI, 0.289 to 1.023). The procedure success rate was 97.53% in the remimazolam group and 97.50% in the propofol group. The difference in the success rate of the procedure between the remimazolam and propofol groups was 0.03% (95% CI, -2.5 to 2.4). However, the incidence of injection pain, hypotension, respiratory depression, and dizziness was lower in the remimazolam group compared with the propofol group (P < 0.05). Furthermore, patients from the propofol group were more likely to be drowsy, and their work efficiency was reduced the day after leaving the hospital, whereas patients in the remimazolam group were less affected (P < 0.05). IMPLICATIONS: The ED95 of remimazolam was 0.33 mg/kg when it was combined with alfentanil (5 µg/kg) for gastroscopy sedation. The sedation strategy of remimazolam-alfentanil has noninferior efficacy, fewer adverse effects, and a better postoperative recovery process than propofol-alfentanil for patients undergoing gastroscopy. Chinese Clinical Trials Registry identifier: ChiCTR2100051565.

Electron beam induced degradation of indomethacin in aqueous solution: kinetics, degradation mechanism, and toxicity assessment.

Pharmaceutical compounds were emerging contaminants, and the accumulation of pharmaceutical compounds in the environment increased the risk to humans and ecosystems. In this study, electron beam irradiation was applied to degrade indomethacin (IDM) in aqueous solution. IDM degradation followed pseudo-first-order kinetics and 300 µM IDM could be completely degraded at only 2 kGy. According to the quenching experiment, the dose constant ratios of oxidative radicals (•OH) and reductive radicals (e-aq and •H) could be calculated as k•OH: ke aq and •H=4.79:1. As the concentration of H2O2 increased from 0 to 10 mM, the dose constant increased from 1.883 to 2.582 kGy-1. However, degradation effect would be restrained in the existence of NO-3, NO-2, CO2-3, HCO-3, SO2-, and humic acid due to their competition for the active species. Theoretical calculation revealed the radical attacking sites of IDM molecule and the most probable pathways were proposed with identification of intermediates. The attack of •OH mainly resulted in the cleavage of amide bond, indole ring opening, demethoxylation, and •OH addition. Dechlorination and the reduction of the carbonyl group occurred on IDM molecular through the reduction of e-aq and •H. The intermediates could continue to be degraded to small molecule acid, such as formic acid, acetic acid, and oxalic acid. Furthermore, highly toxic IDM transformed into less toxic products during the irradiation process.