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Cyanidin has a protective effect on the nervous system and has been reported to treat tumor effectively. However, its impact on glioma stem cells (GSC) is unknown. Using seven GSC lines, the anti-tumor effect of cyanidin is tested. The effect of cyanidin on the cell viability in each cell line is evaluated. Wnt signaling pathway-related genes are checked after treatment of cyanidin. Cytoplasmic/nuclear β-catenin protein levels post cyanidin treatment is detected. Protein levels of c-Myc after cyanidin treatment are determined. Twist1 and Snail1 protein levels after cyanidin treatment are checked as well. Cyanidin significantly reduces the cell viability of all GSCs, and exhibited the most substantial effect in GBM2 but no apparent effect in 293T cells. It can regulate the Wnt signaling pathway of all GSC lines. In the GBM2, GBM7, G166, and G179 cell lines, there is upregulation of WNT1 and MYC genes, while in the G144 and GliNS2 cell line, these two genes are down-regulated after cyanidin treatment. Cytoplasmic and nuclear protein levels of β-catenin in all cell lines are down-regulated. Cyanidin treatment significantly decreases the protein level for c-Myc in the GBM2 cell line compared with untreated cells, not in G144 or GliNS2 cells. Furthermore, cyanidin strongly reduces the expression of Twist1 and Snail1 in GBM2, G179, and G144 cell lines, while the GliNS2 cells show an opposite change in the cytoplasm and no change in nuclear. Cyanidin exerts an anti-tumor effect in glioma stem cell lines, probably through the Wnt signaling pathway. [ABSTRACT FROM AUTHOR]

Farnesoid X receptor (FXR) plays critical regulatory roles in cardiovascular physiology/pathology. However, the role of FXR agonist obeticholic acid (OCA) in sepsis‐associated myocardial injury and underlying mechanisms remain unclear. C57BL/6J mice are treated with OCA before lipopolysaccharide (LPS) administration. The histopathology of the heart and assessment of FXR expression and mitochondria function are performed. To explore the underlying mechanisms, H9c2 cells, and primary cardiomyocytes are pre‐treated with OCA before LPS treatment, and extracellular signal‐regulated protein kinase (ERK) inhibitor PD98059 is used. LPS‐induced myocardial injury in mice is significantly improved by OCA pretreatment. Mechanistically, OCA pretreatment decreased reactive oxygen species (ROS) levels and blocked the loss of mitochondrial membrane potential (ΔΨm) in cardiomyocytes. The expression of glutathione peroxidase 1 (GPX1), superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), and nuclear factor erythroid 2‐related factor 2 (NRF‐2) increased in the case of OCA pretreatment. In addition, OCA improved mitochondria respiratory chain with increasing Complex I expression and decreasing cytochrome C (Cyt‐C) diffusion. Moreover, OCA pretreatment inhibited LPS‐induced mitochondria dysfunction via suppressing ERK1/2‐DRP signaling pathway. FXR agonist OCA inhibits LPS‐induced mitochondria dysfunction via suppressing ERK1/2‐DRP signaling pathway to protect mice against LPS‐induced myocardial injury. [ABSTRACT FROM AUTHOR]

Light frame walls (LFWs) serve as common partition walls in prefabricated buildings due to their lightweight nature, cost-effectiveness, energy efficiency, and adaptability for rapid on-site assembly. However, their acoustic insulation capability is hindered by issues such as sound bridges, resonance, and coincidence dips, resulting in inadequate sound insulation. This study aims to propose LFW designs with superior acoustic insulation suitable for practical engineering while meeting prevailing national standards. Nine full-scale LFW configurations were subjected to laboratory testing to evaluate the impact of staggered stud arrangements, stud types, and incorporation of compounded materials. The tests were performed between 100 and 5000 Hz, and the sound pressure level and reverberation time at 1/3 octave band were measured and used to calculate the weighted sound insulation index (Rw). Results demonstrated that the outlined design modifications significantly enhanced the sound insulation of the LFW. These modifications effectively mitigate the influence of sound bridges while addressing resonance and coincidence dips inherent in the wall system. Particularly noteworthy was the superior sound insulation achieved by staggered-stud LFWs with compounded materials, surpassing that of autoclaved lightweight concrete walls commonly used in prefabricated constructions despite having lesser thickness and surface density. Rw values increased from 43 to 54 dB compared to conventional LFWs, translating to a notable elevation in airborne sound insulation level from 4 to 7 as an internal separation component, meeting the requisite standards for most applications. [ABSTRACT FROM AUTHOR]

The research strategy of using discarded lithium manganate (LiMn2O4, LMO) and lithium iron phosphate (LiFePO4, LFP) electrode materials to obtain lithium manganese iron phosphate (LiMnxFe1−xPO4, LMFP) materials with high energy density and ionic conductivity is increasingly highlighted as powerful and effective. The study explores a new strategy to prepare high‐performance LMFP materials using high‐temperature sintering based on the successful recovery of LMO and LFP electrode wastes. X‐ray diffraction results show that the LMFP cathode materials are prepared successfully by using discarded LMO and LFP materials. LM0.4F0.6P and LM0.6F0.4P, whose manganese‐to‐iron molar ratio [MR(Mn/Fe)] 4:6 and 6:4, exhibit nano‐sized olivine spheres with lattice diagram corresponding to the (101) crystal planes. The constant current curves show that LM0.6F0.4P has a specific discharge capacity of 154.4 mAh g−1 at 0.2 C. The capacity retention rate is maintained at 96.2% after 100 cycles. The cyclic voltammetry curves show that two distinct pairs of redox potentials appeared for LM0.6F0.4P in the voltage interval located at (3.63 V/3.43 V) and (4.18 V/3.87 V). Thus, the proposed strategy predicts that the discarded LMO and LFP can be used as raw materials to prepare high‐performance LMFP cathode materials, significantly reducing energy consumption and environmental pollution. [ABSTRACT FROM AUTHOR]

Background:Data suggest that regarding completion rates and lower readmission rates, video telemedicine follow-up is as efficient as in-person consultations. However, evidence of patients' intention to adopt such service is lacking. The objective of this study was to determine the essential factors influencing Chinese patients' intention to adopt video telemedicine follow-up. Methods:The researchers extended the technology acceptance model (TAM) by incorporating trust, subjective norms (SNs), perceived risk (PR), and perceived disease threat (PDT). A survey was conducted with 793 Chinese patients, and the collected data were analyzed using the partial least-squares approach. Results:The study revealed that trust emerged as the strongest factor influencing patients' behavioral intention (BI) to use video telemedicine follow-up, followed by SNs, perceived ease of use (PEOU), and perceived usefulness (PU). PR and PDT had no significant influence on patients' intention to adopt video telemedicine follow-up. PEOU mediated the relationship between trust, SNs, and BI, and PU mediated the relationship between trust and BI. The study also found that gender, age, and usage experience moderated certain relationships in the model. Conclusions:Our findings support the use of the extended TAM in understanding individual's motivations for using video telemedicine follow-up in China. In addition, this study contributes to the existing literature on telemedicine promotion by identifying significant mediation mechanisms. These findings have practical implications for planning, creating, and implementing improved video telemedicine follow-up services. [ABSTRACT FROM AUTHOR]

A facile and highly efficient method was proposed for the separation and regeneration of LiFePO4 (LFP) cathode materials from spent lithium‐ion batteries (LIBs). The optimal separation conditions involved immersing the spent LFP materials in NaOH (0.5 mol/L) solutions at a temperature of 90 °C, with a solid‐liquid ratio of 30 g/L under stirring of 500 rpm. The high separation effect can be attributed to the synergistic action of several factors at the interface. Furthermore, the structure, composition, morphology, and electrochemical performance of the regenerated LFP (D‐LFP) materials at different temperatures were systematically investigated. Notably, the D‐LFP material generated through calcination at 650 °C for 10 h exhibited a initial discharge capacity of 154.4 mAh g−1 at 0.5 C and the capacity retention rate of 97.3 % after 100 cycles. Moreover, a detailed investigation of the kinetics of the separation and regeneration processes was carried out, along with an exploration of the underlying electrochemical mechanism. This idea not only mitigates the harmful impact of waste on both human health and the environment but also realizes the transformation of waste into valuable resource treasure, promoting a greener and more sustainable development of society. [ABSTRACT FROM AUTHOR]

Heavy metal pollution has been a problem of concern in soil ecology in recent decades. This study investigated the spatial distribution of heavy metals and their pollution levels in the soil of Xinjiang, based on the data of heavy metals published in the literature in the past five years, by using a geostatistical method, pollution index method, and geographic information system (GIS)-based spatial analysis. Additionally, the effects of five economic development indicators, such as population and industrial activities on the accumulation of heavy metals in soil, were explored by correlation analysis. The results showed that the average contents of Cd, Cr, Cu, Ni, Pb, and Zn in the soils were 2.858, 1.062, 1.194, 1.159, 1.192, and 1.086 times higher than the background values in Xinjiang, respectively. The semi-variance functions indicated that the Cd and Pb block gold coefficients of soils were greater than 25% and less than 50%, with an obvious spatial correlation. The spatial patterns showed that the high values of Cd, Cr, Cu, Ni, Pb, and Zn were mainly distributed in Karamay, Changji, Tacheng, and Kashi areas, with an overall decreasing trend from north to south, and the pollution index showed that the pollution of heavy metal Cd in soil was the most serious. Furthermore, Karamay, Changji, and Kashi areas were at heavy pollution levels. Correlation analysis showed that heavy metal Pb in the soil was significantly positively correlated with the agricultural GDP in Xinjiang, while Cd was correlated significantly and positively with comprehensive energy consumption and more significantly with industrial GDP. Thus, this study could provide a scientific basis for local evaluation of soil environmental quality and prevention and control of soil heavy metal pollution, which is of great significance for understanding the impact of human activities. [ABSTRACT FROM AUTHOR]

Asiatic short-tailed shrews (Blarinella and Parablarinella) are small insectivorous mammals distributed mainly in central and southwestern China, and adjacent Myanmar and Vietnam, currently comprising three species. In 2021, we collected five specimens of Asiatic short-tailed shrews in the Dabie Mountains, eastern China, which is geographically distant from the known distribution of the taxa. Herein, we integrated molecular and morphometric approaches to assess the taxonomy, phylogeny, and divergence of Asiatic short-tailed shrews. Our results indicate that the specimens collected from Dabie Mountains represent a new species, formally described here. The new species is morphologically distinguishable from other Asiatic short-tailed shrews by the combination of a triangular upper P4, lighter feet color, relatively broader skull, and more curved outline of tooth row of P4–M3. Phylogenetic analyses indicate the new species is sister to P. griselda , and the p -distance of Cyt b between the two species is 8.3%. The divergence between the new species and P. griselda occurred ca. 3.08 million years ago and may have been affected by East Asia's topographic and climate changes in the late Pliocene. [ABSTRACT FROM AUTHOR]

Herein, a facile method with high efficiency is proposed for the separation and regeneration of LiMn2O4 (LMO) cathode material for spent lithium‐ion batteries through a simple heat treatment method. At first, the aluminum foil is separated at 450 °C in air, with a separation efficiency as high as 97.95%. Then, separation LMO is regenerated with high crystallinity at 650 °C with an optimum calcination time of 6 h. Importantly, this method allows D‐LMO to exhibit high reversible capacity (133 mAh g−1 at 0.1C), high rate performance (101 mAh g−1 at 5C), and long lifespan (0.5C, 92.1% capacity retention ratio after 100 cycles). A positive effect of the pyrolysis of polyvinylidene fluoride on D‐LMO is also suggested by the results. Moreover, a detailed investigation of the kinetics of the separation and regeneration is done, and the electrochemical mechanism is explored. Furthermore, this method requires much less energy input and chemical consumption, which would be helpful for environmental protection and green recycling. [ABSTRACT FROM AUTHOR]

Pyrazolinone derivatives are a new class of organic photochromic materials with excellent optical color change properties in the powder crystal state, which show great potential for applications, including high-density storage, fluorescence switching, and bioimaging. Their design and synthesis with structural photoreversibility and excellent fluorescence modulation properties are areas of research focus. Rational modification of the molecular backbone with the introduction of the 5-bromopyridine group at the 4-position of the pyrazolinone ring was used to prepare three pyrazolinone condensed aminothiourea derivatives with photoreversible color change in the powder crystal state. The molecular structures of the compounds were confirmed by mass spectrometry and nuclear magnetic resonance spectroscopy. The changes in the infrared spectra indicated alcoholic to ketonic transformation in the molecular structures upon ultraviolet (UV) illumination. The ultraviolet-visible (UV–vis) absorption spectra showed significant photoreversible changes in all three derivatives, and the introduction of the electron-absorbing phenyl group resulted in the most significant fading of DP5Br3PyBP-PTSC. The fluorescence emission spectra showed that the three derivatives have prominent blue fluorescence. Their fluorescence emission intensity gradually decreased until the increase in UV illumination time produced quenching. The property of excellent fluorescence reversibility under the alternating UV and visible light was shown by all three derivatives, which are expected to be applied in fluorescent molecular switches. [ABSTRACT FROM AUTHOR]

Simple Summary: A new species of odd-scaled snake in the genus Achalinus is described from Dabie Mountains Luan City, Anhui Province, China, based on one male and two female specimens. Bayesian inference and maximum likelihood analyses based on a mitochondrial DNA fragment (CO1) indicated the new taxon is different from its congeners (p–distance ≥ 9.4%). Morphologically, the new species can be diagnosed from the other species by a combination of 12 characters. The recognition of the new species brings the number of described Achalinus species to 22. A new species of Xenodermid snake, Achalinus dabieshanensis sp. nov., was described based on three specimens (two female and one male) collected from the Dabie Mountains of western Anhui Province. It can be distinguished from known congeners by a significant genetic divergence in the mitochondrial gene fragment COI (p-distance ≥ 9.4%) and the following combination of characteristics: (1) length of the suture between the internasals being distinctly shorter than between the prefrontals; (2) a single loreal; (3) dorsal scales strongly keeled, in 23 rows throughout the body; (4) two pairs of prefrontals; (5) six supralabials; (6) five infralabials; (7) temporals 2 + 2 + 3 (or 2 + 2 + 4); (8) 141–155 ventrals; (9) 45–55 subcaudals, unpaired; (10) anal entire; (11) weakly iridescent tinged, uniform, brown to black dorsum with vertebral scales and about three adjacent dorsal scales dark brown forming a longitudinal vertebral line from posterior margin of parietals to tail tip; (12) light brown venter, ventral shields wide, visible on both sides, light brown flanks, giving the appearance of a black subcaudal streak. The recognition of the new species increases the number of described Achalinus species to 22. [ABSTRACT FROM AUTHOR]

Background: Advanced glycation end product receptor (RAGE) acts as a receptor of pro-inflammatory ligands and is highly expressed in alveolar epithelial cells (AECs). Autophagy in AECs has received much attention recently. However, the roles of autophagy and RAGE in the pathogenesis of acute lung injury remain unclear. Therefore, this study aimed to explore whether RAGE activation signals take part in the dysfunction of alveolar epithelial barrier through autophagic death. Methods: Acute lung injury animal models were established using C57BL/6 and Ager gene knockout (Ager−/− mice) mice in this study. A549 cells and primary type II alveolar epithelial (ATII) cells were treated with siRNA to reduce Ager gene expression. Autophagy was inhibited by 3-methyladenine (3-MA). Lung injury was assessed by histopathological examination. Cell viability was estimated by cell counting kit-8 (CCK-8) assay. The serum and bronchoalveolar lavage fluid (BALF) levels of interleukin (IL)-6, IL-8 and soluble RAGE (sRAGE) were evaluated by Enzyme-linked immunosorbent assay (ELISA). The involvement of RAGE signals, autophagy and apoptosis was assessed using western blots, immunohistochemistry, immunofluorescence, transmission electron microscopy and TUNEL test. Results: The expression of RAGE was promoted by lipopolysaccharide (LPS), which was associated with activation of autophagy both in mice lung tissues and A549 cells as well as primary ATII cells. sRAGE in BALF was positively correlated with IL-6 and IL-8 levels. Compared with the wild-type mice, inflammation and apoptosis in lung tissues were alleviated in Ager−/− mice. Persistently activated autophagy contributed to cell apoptosis, whereas the inhibition of autophagy by 3-MA protected lungs from damage. In addition, Ager knockdown inhibited LPS-induced autophagy activation and attenuated lung injury. In vitro, knockdown of RAGE significantly suppressed the activation of LPS-induced autophagy and apoptosis of A549 and primary ATII cells. Furthermore, RAGE activated the downstream STAT3 signaling pathway. Conclusion: RAGE plays an essential role in the pathogenesis of ATII cells injury. Our results suggested that RAGE inhibition alleviated LPS-induced lung injury by directly suppressing autophagic apoptosis of alveolar epithelial cells. [ABSTRACT FROM AUTHOR]

Background: Continuous renal replacement therapy (CRRT) has been considered as an adjuvant therapy for sepsis. However, the novel biomarker to evaluate the benefits of CRRT is limited. The aim of this study was to explore the novel biomarkers involved in the impact of CRRT in pediatric sepsis. Methods: The serum proteomic profiles on the 7th day after CRRT (CRRT 7th day) compared with before CRRT (CRRT 1st day) was determined in 3 children with sepsis as a discovery set. The screened candidates were confirmed in the validation cohort including patients received CRRT (CRRT group) and without CRRT (non-CRRT group). We defined that pediatric sequential organ failure assessment score (pSOFA) in pediatric patients with sepsis decreased by 2 points or more on the CRRT 1st day compared with CRRT initiation as CRRT responders. The changes of serum biomarkers were compared between CRRT responders and CRRT non-responders. Moreover, correlation analysis was further conducted in pediatric sepsis. Results: A total of 145 differentially expressed proteins were found according to the serum proteomics profiles. By visualizing the interaction between the differential proteins, 6 candidates (Lysozyme C [LYZ], Leucine-rich alpha-2-glycoprotein [LRG1], Fibromodulin [FMOD], Alpha-1-antichymotrypsin [SERPINA3], L-selectin [SELL], Monocyte differentiation antigen CD14 [CD14]) were screened. In the validation cohort, serum levels of LYZ and LRG1 showed a higher trend on the CRRT 7th day than that on the 1st day in the non-CRRT group. However, the changes in levels of LYZ and LRG1 on the 7th day was significant in the CRRT group (p = 0.016, p = 0.009, respectively). Moreover, the levels of LYZ and LRG1 on the CRRT 7th day in the CRRT group were significantly higher than that in the non-CRRT group (p < 0.001, p = 0.025). Decreased levels of CD14 were associated with sepsis recovery, but not associated with CRRT. There were no significantly difference in serum FMOD, SERPINA3, and SELL levels. Importantly, serum LYZ and LRG1 levels changed in CRRT responders, but not CRRT non-responders. Further analysis indicated that serum LYZ levels were correlated to total platelet counts, aspartate aminotransferase (ALT), alanine aminotransferase (AST), and albumin levels, and serum LRG1 level were correlated to total platelet count and TBIL levels on the 1st day in the CRRT group. Protein–protein interaction network analysis displayed that serum LYZ and LRG1 were involved in the process of inflammatory response, leucocytes adhesion to vascular endothelial cell, as well as complement activation. Conclusion: Elevated serum LYZ and LRG1 levels are associated with clinical benefits of CRRT during sepsis. [ABSTRACT FROM AUTHOR]

The creep life of an aeroengine recuperator is investigated in terms of continuum damage mechanics by using finite element simulations. The effects of the manifold wall thickness and creep properties of brazing filler metal on the operating life of the recuperator are analyzed. Results show that the crack initiates from the brazing filler metal located on the outer surface of the manifold with the wall thickness of 2 mm and propagates throughout the whole region of the brazing filler metal when the creep time reaches 34900 h. The creep life of the recuperator meets the requirement of 40000 h continuous operation when the wall thickness increases to 3.5 mm, but its total weight increases by 15%. Decreasing the minimum creep strain rate with the enhancement of the creep strength of the brazing filler metal presents an obvious effect on the creep life of the recuperator. At the same stress level, the creep rupture time of the recuperator is enhanced by 13 times if the mismatch between the minimum creep rate of the filler and base metal is reduced by 20%. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal therapy that included therapeutic plasma exchange (TPE) or continuous hemofiltration (CHF) for toxic epidermal necrolysis (TEN) syndrome was used in small number of patients. We aimed to describe the sequential mode of combined application of CHF and TPE in 3 TEN patients with multiple organ dysfunction (MODS) in pediatric intensive care unit. Methods: Three patients with fatal TEN received sequential CHF and TPE due to unsatisfactorily conventional treatments. CHF was initiated and performed on a daily basis with 35–50 mL/kg.h replacement fluid at the rate of 3–5 mL/kg.min blood flow. CHF was temporarily interrupted for TPE, which was performed with exchange 1–1.5-fold of one body calculated plasma volume in each section. Results: All 3 fatal TEN (with >30% involvement of body surface and MODS) following unsuccessful treatment with corticosteroids and intravenous immunoglobulin. Antibiotics were suspected in the TEN-triggered drugs. The range number of TPE sessions was 3–5 and the duration of CHF was from 120 h to 202 h. After initiation of TPE and CHF, blistering with extensive epidermal necrosis halted and the skin re-epithelialized within 2 weeks. Serum C-reactive protein, procalcitonin, tumor necrosis factor-α , and interlukin-6 decreased and percentage of natural killer cells increased in surviving children. Two patients survived to discharge and one case died due to nosocomial infection with multidrug-resistant Acinetobacter baumannii.Conclusion: After sequential TPE and CHF, skin lesions and inflammatory response improved in TEN. Our result indicates extracorporeal therapy could be used as an alternative modality for fatal pediatric TEN. [ABSTRACT FROM AUTHOR]

Introduction: Multiple organ dysfunction syndrome (MODS) with secondary hemophagocytic lymphohistiocytosis (SHLH) causes significant mortality. We aimed to identify the predictor factors for death in pediatric patients with SHLH‐associated MODS receiving continuous renal replacement therapy (CRRT). Methods: This multicentered nested case–control study was conducted from 2016 to 2020. The characteristics were compared between survivors and non‐survivors. Logistic regression was applied to identify the risk factors for death. The cutoff values were assessed by receiver operating characteristics curves. Results: Fifty two patients were enrolled in this study. Interleukin‐6 level (p = 0.018) and the number of organ dysfunction (p = 0.047) were independent risk factors for death. The cutoff value of 13.12 pg/ml interleukin‐6 and three organs dysfunction at CRRT initiation presented a high sensitivity and specificity. Conclusion: The number of organ dysfunction and interleukin‐6 at CRRT initiation are independent risk factors for death in pediatric patients with SHLH‐associated MODS. [ABSTRACT FROM AUTHOR]

The recycling of cathode materials from batteries has an impact on reducing energy consumption. In this study, a green recycling method without secondary pollution was adopted to directly reutilize spent lithium manganate materials. The stripping rate achieved for these spent materials reached 91.1%. This excellent stripping rate was attributed to the synergistic effects of stirring and sonication. The molecular formula of the stripped cathode materials was determined to be LiMn1.85O4. Infrared spectroscopy was used to demonstrate that the organic adhesive in the cathode materials was completely removed after calcination and that the asymmetric stretching peak of the MO6 groups was enhanced. Comparative experiments showed that the electrochemical properties of the re-utilized materials were dramatically improved. The discharge capacity of the sample calcined at 800 °C for 12 h was 131.7 mAh g−1 at the first cycle, and 91.7% of the capacity was maintained after 200 cycles at 0.2C (1C = 148 mAh g−1). Importantly, this recycling strategy not only requires no toxic or hazardous solvents but also has no harmful effects on the environment and reduces waste accumulation effectively, thus providing a new possibility for the recycling of similar batteries. [ABSTRACT FROM AUTHOR]

RSK1, an essential cellular kinase for Kaposi's sarcoma-associated herpesvirus (KSHV) replication, is highly phosphorylated and SUMOylated during KSHV lytic cycle, which determine the substrate phosphorylation and specificity of RSK1, respectively. However, the SUMO E3 ligase responsible for attaching SUMO to RSK1 has not yet been identified. By genome-wide screening, we found that KSHV ORF45 is necessary and sufficient to enhance RSK1 SUMOylation. Mechanistically, KSHV ORF45 binds to SUMOs via two classic SUMO-interacting motifs (SIMs) and functions as a SIM-dependent SUMO E3 ligase for RSK1. Mutations on these ORF45 SIMs resulted in much lower lytic gene expressions, viral DNA replication, and mature progeny virus production. Interestingly, KSHV ORF45 controls RSK1 SUMOylation and phosphorylation via two separated functional regions: SIMs and amino acid 17–90, respectively, which do not affect each other. Similar to KSHV ORF45, ORF45 of Rhesus Macaque Rhadinovirus has only one SIM and also increases RSK1 SUMOylation in a SIM-dependent manner, while other ORF45 homologues do not have this function. Our work characterized ORF45 as a novel virus encoded SUMO E3 ligase, which is required for ORF45-RSK1 axis-mediated KSHV lytic gene expression. Author summary: The 90-kDa ribosomal S6 kinases 1 (RSK1) is an essential cellular kinase for the lytic replication of Kaposi's sarcoma-associated herpesvirus (KSHV). Besides the phosphorylation, RSK1 is highly SUMOylated, which is required for efficient KSHV lytic replication. Here, we found that KSHV ORF45 binds to SUMO1 and SUMO2 via two classic SUMO-interacting motifs (SIMs) and functions as a SIM-dependent SUMO E3 ligase, which is necessary and sufficient to enhance RSK1 SUMOylation upon KSHV lytic replication. Interestingly, KSHV ORF45 controls RSK1 SUMOylation and phosphorylation via two separated functional regions: SIMs and amino acid 17–90, respectively, which do not affect each other. Like KSHV ORF45, ORF45 of Rhesus Macaque Rhadinovirus also enhances RSK1 SUMOylation in a SIM-dependent manner, while ORF45 of Herpesvirus saimiri, Murine γ-herpesvirus 68, and Epstein-Barr virus cannot. Our data demonstrated that ORF45 as a novel virus encoded SUMO E3 ligase, which is essential for KSHV lytic replication and progeny virus production. [ABSTRACT FROM AUTHOR]

Background: Polymyxin B has become the last choice for patient with carbapenem-resistant bacterial infection. However, the optimal dosing of polymyxin B in critically ill children receiving continuous renal replacement therapy (CRRT) remains unclear. Case Presentation: Two cases of critically ill pediatric patients (7 years old) with acute kidney injury requiring continuous renal replacement (CRRT) received polymyxin B treatment due to carbapenem-resistant organism bloodstream infections. Therapeutic drug monitoring (TDM) of polymyxin B was carried out by liquid chromatography tandem mass spectrometry (LC-MS/MS). The average steady-state plasma concentration (Css,avg) of 2–4 mg/L was set as the target level. Initial polymyxin B dose was 1 mg/kg every 12 h, and the Css,avg at 4–5th dosing were 1.76 and 1.06 mg/L for patient 1 and patient 2, respectively. TDM-guided polymyxin B dose was escalated to 2 mg/kg every 12 h for both patients, resulting in the Css,avg of 2.60 and 1.73 mg/L, and the infection was controlled subsequently. Css,avg of polymyxin B with the same dosing regimens and infusion length were different during CRRT and after termination of CRRT for both patients (2.60 mg/L vs. 4.94 mg/L with 2 mg/kg every 12 h in 2 h infusion for patient 1; and 1.73 mg/L vs. 3.53 mg/L with 2 mg/kg every 12 h in 2 h infusion for patient 2). The estimation of drug exposure (estimated by AUCss,12h at the same dose) during CRRT and cessation of CRRT showed that 45% and 51% of polymyxin B was cleared during CRRT. Conclusion: Our study showed high clearance of polymyxin B through CRRT, and supplanted dosing of polymyxin B is necessary in pediatric patients undergoing CRRT. [ABSTRACT FROM AUTHOR]

Background: To assess the outcome of extracorporeal membrane oxygenation (ECMO) for severe adenovirus (Adv) pneumonia with refractory hypoxic respiratory failure (RHRF) in paediatric patients.Methods: A retrospective observational study was performed in a tertiary paediatric intensive care unit (PICU) in China. Patients with RHRF caused by Adv pneumonia who received ECMO support after mechanical ventilation failed to achieve adequate oxygenation between 2017 and 2020 were included. The outcome variables were the in-hospital survival rate and the effects of ECMO on the survival rate.Results: In total, 18 children with RHRF received ECMO. The median age was 19 (9.5, 39.8) months, and the median ECMO duration was 196 (152, 309) h. The in-hospital survival rate was 72.2% (13/18). Thirteen patients (72.2%) required continuous renal replacement therapy (CRRT) due to fluid imbalance or acute kidney injury (AKI). At ECMO initiation, compared with survivors, nonsurvivors had a lower PaO2/FiO2 ratio [49 (34.5, 62) vs. 63 (56, 71); p = 0.04], higher oxygen index (OI) [41 (34.5, 62) vs. 30 (26.5, 35); p = 0.03], higher vasoactive inotropic score (VIS) [30 (16.3, 80) vs. 100 (60, 142.5); p = 0.04], longer duration from mechanical ventilation to ECMO support [8 (4, 14) vs. 4 (3, 5.5) h, p=0.02], and longer time from confirmed RHRF to ECMO initiation [9 (4.8, 13) vs. 5 (1.3, 5.5) h; p = 0.004]. Patients with PaO2/FiO2 <61 mmHg or an OI >43 and hypoxic respiratory failure for more than 9 days before the initiation of ECMO had worse outcomes.Conclusions: ECMO seemed to be effective, as severe paediatric Adv pneumonia patients with RHRF had a cumulative survival rate of 72.2% in our study. Our study provides insight into ECMO rescue in children with severe Adv pneumonia. [ABSTRACT FROM AUTHOR]

RSK1, a downstream kinase of the MAPK pathway, has been shown to regulate multiple cellular processes and is essential for lytic replication of a variety of viruses, including Kaposi's sarcoma-associated herpesvirus (KSHV). Besides phosphorylation, it is not known whether other post-translational modifications play an important role in regulating RSK1 function. We demonstrate that RSK1 undergoes robust SUMOylation during KSHV lytic replication at lysine residues K110, K335, and K421. SUMO modification does not alter RSK1 activation and kinase activity upon KSHV ORF45 co-expression, but affects RSK1 downstream substrate phosphorylation. Compared to wild-type RSK1, the overall phosphorylation level of RxRxxS*/T* motif is significantly declined in RSK1K110/335/421R expressing cells. Specifically, SUMOylation deficient RSK1 cannot efficiently phosphorylate eIF4B. Sequence analysis showed that eIF4B has one SUMO-interacting motif (SIM) between the amino acid position 166 and 170 (166IRVDV170), which mediates the association between eIF4B and RSK1 through SUMO-SIM interaction. These results indicate that SUMOylation regulates the phosphorylation of RSK1 downstream substrates, which is required for efficient KSHV lytic replication. Author summary: RSK1 is an essential celluar kinase for lytic replication of Kaposi's sarcoma-associated herpesvirus (KSHV). Besides phosphorylation, it is not known whether other post-translational modifications play an important role in regulating RSK1 function. Here, we found that RSK1 is SUMOylated at lysine residues K110, K335, and K421, which is enhanced by KSHV lytic replication. RSK1 SUMOylation is required for effient KSHV lytic replication and mutations on its SUMOylation sites leads to reduced lytic gene expressions and impaired progeny virus production. Interestingly, SUMO modification does not alter RSK1 activation and kinase activity upon KSHV ORF45 co-expression, but affects RSK1 downstream substrate phosphorylation. Specifically, SUMOylation deficient RSK1 cannot efficiently phosphorylate eIF4B since SUMO-SIM interaction mediates the association between eIF4B and RSK1. These results indicate that SUMOylation regulates the phosphorylation of RSK1 downstream substrates, which is required for efficient KSHV lytic replication. [ABSTRACT FROM AUTHOR]

Introduction: ATP citrate lyase (ACLY) is involved in lipid metabolism and inflammatory response in immune cells. However, the serum level of ACLY and its clinical relevance in sepsis is totally unknown. Methods: We conducted a prospective pilot study in patients with sepsis admitted to pediatric intensive care unit (PICU) from January 2018 to December 2018. Results: Higher levels of ACLY were detected in sera of pediatric patients with sepsis than that of healthy children. The area under the receiver operating characteristic curve (AUC) of ACLY for diagnosis of sepsis was 0.855 (95% confidence interval [CI]: 0757–0.952), and an AUC of ACLY for predicting PICU mortality was 0.770 (95% CI: 0.626–0.915). ACLY levels ≤21 ng/ml on PICU admission predicted an unfavorable prognosis among patients with sepsis with a sensitivity of 87.5% and a specificity of 67.6%. Moreover, serum ACLY levels were correlated to platelet count, IL‐18 levels, and monocyte counts in pediatric patients with sepsis, implying the potential roles of ACLY in immunometabolic regulation in sepsis. Conclusions: ACLY is firstly identified in sera of patients with sepsis. Serum ACLY level is an additional diagnostic and prognostic biomarker in pediatric patients with sepsis. [ABSTRACT FROM AUTHOR]

Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS.Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 h identified ARDS as the value of 1st, and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed.Results: The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (dynamic lung compliance) (1st: r = - 0.757, 2nd: r = - 0.906, 3rd: r = - 0.885, 4th: r = - 0.834), OI (oxygenation index) (1st: r = 0.678, 2nd: r = 0.689, 3rd: r = 0.486, 4th: r = 0.324) based on 1st to 4th values (all P < 0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18-25) to 15 (13-18) and OI decreased from 15.92 (14.07-17.73) to 9.49 (8.70-10.58) after CRRT for four days (both P < 0.001).Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score. Trial registration CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4 . This study adheres to CONSORT guidelines. [ABSTRACT FROM AUTHOR]

Background: Multidrug resistant (MDR) and extensively drug resistant (XDR) Acinetobacter baumannii presents challenges for clinical treatment and causes high mortality in children. We aimed to assess the risk factors and overall mortality for MDR/XDR Acinetobacter baumannii infected pediatric patients.Methods: This retrospective study included 102 pediatric patients who developed MDR/XDR Acinetobacter baumannii infection in the pediatric intensive care unit (PICU) of Shanghai Children's Hospital in China from December 2014 to May 2018. Acinetobacter baumannii clinical isolates were recovered from different specimens including blood, sputum, bronchoalveolar lavage fluid, cerebrospinal fluid, ascites, hydrothorax, and urine. Antibiotic susceptibility test was determined according to the Clinical and Laboratory Standards Institute interpretive criteria. Clinical and biological data were obtained from the patients' medical records.Results: 102 patients with Acinetobacter baumannii infection were enrolled. The median age was 36 (9.6, 98.8) months, and there were 63 male in the case group. The overall mortality rate was 29.4%, while the Acinetobacter baumannii-associated mortality rate was 16.7% (17/102, 12 bloodstream infections, 4 meningitis and 1 intra-abdominal infection). Bloodstream infections occurred in 28 patients (27.5%), and 10 patients (9.8%) among them had central line-associated bloodstream infections (6 central venous catheters, 2 PICCs, 1 venous infusion port and 1 arterial catheter). Cerebrospinal fluid (CSF) cultures were positive in 4(3.9%) patients. 14(13.7%) patients got positive cultures in ascites and hydrothorax. Lower respiratory isolates (56/102) accounted for 54.9% of all patients. Non-survival patients appeared to have a lower NK cell activity (6.2% ± 3.61% vs. 9.15% ± 6.21%, P = 0.029), higher CD4+ T cell ratio (39.67% ± 12.18% vs. 32.66% ± 11.44%, P = 0.039),and a higher serum level of interlukin-8 (IL-8, 15.25 (1.62, 47.22)pg/mL vs. 0.1 (0.1, 22.99)pg/mL, P = 0.01) when Acinetobacter baumannii infection developed. Multivariate logistic analysis indicated that high serum level of Cr (RR, 0.934, 95%CI, 0.890-0.981; P = 0.007) and high BUN/ALB level (RR, 107.893, 95%CI, 1.425-870.574; p = 0.005) were associated with high risk of mortality in MDR/XDR Acinetobacter baumannii infected patients.Conclusion: MDR/XDR Acinetobacter baumannii infection is a serious concern in pediatric patients with high mortality. Bloodstream and central nervous system infection accounted for high risk of death. Acute kidney injury is associated with high risk of mortality. [ABSTRACT FROM AUTHOR]

Background: Describe the outcome of adenovirus pneumonia in a pediatric intensive care unit (PICU) over a 3-year period, to identify the risk factors that may be associated with worse outcome.Methods: A retrospective observational study was performed in the PICU of children's hospital in Shanghai from July 2016 to June 2019. Sixty-seven children over 29 days to 14 years old with adenovirus pneumonia who were admitted to PICU with acute hypoxemic respiratory failure were included in this study. The primary outcome was hospital mortality, and secondary outcomes were hospital and PICU length of stay (LOS), and risk factors of worse outcome.Results: Of 67 children with severe adenovirus pneumonia, the hospital mortality was 16.42% (11/67) and 28-day mortality was 14.93% (10/67). Median Pediatric Risk of Mortality III (PRISM III) score at admission was 13 (interquartile range [IQR], 10-15). Median PICU LOS stay was 11 days (8-18d) and hospital LOS was 22 days (16-31d). Among children with extracorporeal membrane oxygenation (n = 9), 6 cases survived and 3 cases died. The patients who need renal replacement therapy, neuromuscular blockade, parenteral nutrition, and packed red blood cell perfusion had higher hospital mortality (p < 0.001, p = 0.041, p = < 0.001, p = 0.012, respectively). Multivariate logistic analysis indicated that liver dysfunction and nosocomial infection were associated with high risk of mortality.Conclusions: The hospital mortality of adenovirus pneumonia in our PICU was 16.42%. Patients complicated liver dysfunction and co-infection & nosocomial infection were associated with poor outcome. [ABSTRACT FROM AUTHOR]

Background: Thyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock. Methods: We performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission. Results: Ninety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children. Conclusions: Nonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality. [ABSTRACT FROM AUTHOR]

Background. Systemic inflammatory response and vascular endothelial cell injury during sepsis lead to coagulopathy. Fibrinogen has been reported as a biomarker of coagulopathy; however, the prognostic value of fibrinogen remains undefined in pediatric patients with sepsis. The aim of this study was to assess fibrinogen level on pediatric intensive care unit (PICU) admission and to elucidate the relationship between fibrinogen levels and in-hospital mortality in children with sepsis. Methods. We conducted a database study. The sepsis database was divided into a training set (between July 2014 and June 2018) and a validation set (from July 2018 to June 2019). The clinical and laboratory parameters on PICU admission and in-hospital mortality in sepsis database were collected and analyzed. Results. A total of 819 pediatric patients were included from database as a training set. The overall hospital mortality was 12.1% (99/819). The fibrinogen levels were significantly lower in nonsurvivors than survivors. Multivariate logistic regression analysis showed significant associations between fibrinogen, lactate level, and hospital mortality (fibrinogen: odds ratio (OR), 0.767 (95% CI: 0.628-0.937), P = 0.009 ; lactate: OR, 1.346 (95% CI: 1.217-1.489), P < 0.001 , respectively), which was confirmed in a validation set (0.616 [95% CI: 0.457-0.829], P = 0.001 ; 1.397 [95% CI: 1.245-1.569], P < 0.001 , respectively). The hospital mortality of patients with fibrinogen < 1 g / L , 1-2 g/L, 2-3 g/L, or over 3 g/L displayed an obvious difference (62.5% vs. 27.66% vs. 18.1% vs. 4.2%, respectively). Furthermore, the area under the receiver operating characteristic curve (ROC) for fibrinogen in predicting hospital mortality was 0.780 (95% CI: 0.711-0.850) in pediatric patients with sepsis. Conclusions. Fibrinogen is a valuable prognostic biomarker for pediatric sepsis. The level of fibrinogen lower than 2 g/L on PICU admission is closely related to the greater risk of hospital death in pediatric sepsis. [ABSTRACT FROM AUTHOR]

Background. Systemic inflammatory response and vascular endothelial cell injury during sepsis lead to coagulopathy. Fibrinogen has been reported as a biomarker of coagulopathy; however, the prognostic value of fibrinogen remains undefined in pediatric patients with sepsis. The aim of this study was to assess fibrinogen level on pediatric intensive care unit (PICU) admission and to elucidate the relationship between fibrinogen levels and in-hospital mortality in children with sepsis. Methods. We conducted a database study. The sepsis database was divided into a training set (between July 2014 and June 2018) and a validation set (from July 2018 to June 2019). The clinical and laboratory parameters on PICU admission and in-hospital mortality in sepsis database were collected and analyzed. Results. A total of 819 pediatric patients were included from database as a training set. The overall hospital mortality was 12.1% (99/819). The fibrinogen levels were significantly lower in nonsurvivors than survivors. Multivariate logistic regression analysis showed significant associations between fibrinogen, lactate level, and hospital mortality (fibrinogen: odds ratio (OR), 0.767 (95% CI: 0.628-0.937), P = 0.009 ; lactate: OR, 1.346 (95% CI: 1.217-1.489), P < 0.001 , respectively), which was confirmed in a validation set (0.616 [95% CI: 0.457-0.829], P = 0.001 ; 1.397 [95% CI: 1.245-1.569], P < 0.001 , respectively). The hospital mortality of patients with fibrinogen < 1 g / L , 1-2 g/L, 2-3 g/L, or over 3 g/L displayed an obvious difference (62.5% vs. 27.66% vs. 18.1% vs. 4.2%, respectively). Furthermore, the area under the receiver operating characteristic curve (ROC) for fibrinogen in predicting hospital mortality was 0.780 (95% CI: 0.711-0.850) in pediatric patients with sepsis. Conclusions. Fibrinogen is a valuable prognostic biomarker for pediatric sepsis. The level of fibrinogen lower than 2 g/L on PICU admission is closely related to the greater risk of hospital death in pediatric sepsis. [ABSTRACT FROM AUTHOR]

In this article, a two-stage millimeter (mm)-wave frequency synthesizer with low in-band noise and robust locking reference-sampling techniques is presented. Using a two-stage scheme allows separately dealing with the low phase noise (PN) frequency synthesis in the first stage and the mm-wave frequency multiplication in the second stage, achieving the best overall power efficiency. In the first stage, a voltage domain reference-sampling phase detector (RSPD)-locked loop (RSPLL) is adopted to achieve both low PN and robust locking without additional frequency locking loop. A reference reshaping buffer is implemented to improve the phase detector gain and in-band PN. The reference rising/falling time is programmable to achieve optimal RSPLL performance even under external disturbances. The second stage employs an injection-locked voltage-controlled oscillator (ILVCO) for 4 $\times $ frequency multiplication. A low-power digital frequency tracking loop (FTL) detecting actual frequency errors is implemented in order to achieve wide operation range for the ILVCO while using a high ${Q}$ tank with low power. The prototype synthesizer was fabricated in a 45-nm partially depleted silicon on insulator (PDSOI) CMOS technology. The first stage 9-GHz RSPLL achieves 144-fs integrated jitter with 7.2-mW power consumption, achieving a figure of merit (FoM) of −248 dB and the overall mm-wave synthesizer achieves 251-fs integrated jitter with 20.6-mW power consumption at 35.84 GHz, achieving an FoM of −238.9 dB. [ABSTRACT FROM AUTHOR]

Background. Sepsis induces the release of lipid mediators, which control both lipid metabolism and inflammation. However, the role of serum apolipoprotein A-V (ApoA5) in sepsis is poorly understood in pediatric patients. Methods. ApoA5 was screened from serum proteomics profile in lipopolysaccharide- (LPS-) treated mice for 2 h, 24 h, and controls. Then, we conducted a prospective pilot study, and patients with sepsis admitted to a pediatric intensive care unit (PICU) were enrolled from January 2018 to December 2018. Serum ApoA5 levels on PICU admission were determined using enzyme-linked immunosorbent assays (ELISA). Blood samples from 30 healthy children were used as control. The correlation of ApoA5 with the clinical and laboratory parameters was analyzed. Logistic regression analyses and receiver operating characteristic curve (ROC) analysis were used to investigate the potential role of serum ApoA5 as a prognostic predictor for PICU mortality in pediatric patients with sepsis. Results. A total of 101 patients with sepsis were enrolled in this study. The PICU mortality rate was 10.9% (11/101). Serum ApoA5 levels on PICU admission were significantly lower in nonsurvivors with sepsis compared with survivors (P = 0.009). In subgroup analysis, serum levels of ApoA5 were significantly correlated with sepsis-associated multiple organ dysfunction syndrome (MODS) (P < 0.001), shock (P = 0.002), acute kidney injury (AKI) (P < 0.001), acute liver injury (ALI) (P = 0.002), and gastrointestinal (GI) dysfunction (P = 0.012), but not respiratory failure, brain injury, and pathogenic species (all P > 0.05). Correlation analyses revealed significant correlations of serum ApoA5 with Ca2+ concentration. Remarkably, the area under ROC curve (AUC) for serum ApoA5 levels on PICU admission was 0.789 for prediction of PICU mortality with a sensitivity of 75% and a specificity of 84.5% at a threshold value of 822 ng/mL. Conclusions. Serum ApoA5 level is associated with sepsis-associated shock, AKI, ALI, GI dysfunction, or MODS in children. Moreover, the findings of the present study suggest a prognostic value of ApoA5 in children with sepsis, and lower serum ApoA5 than 822 ng/mL predicts worse outcome in pediatric sepsis. [ABSTRACT FROM AUTHOR]

Vitronectin (VTN) is a key regulator of coagulation, but clinical relevance of serum VTN in pediatric sepsis remains poorly defined. The aim of this study was to access the value of serum VTN level on pediatric intensive care unit (PICU) admission in children with sepsis. Pediatric patients with sepsis were enrolled from January 2018 to December 2018. The serum VTN levels were determined on PICU admission, and the association of serum VTN level with PICU mortality and organ dysfunction was assessed. Serum VTN levels were significantly lower in nonsurvivors compared with survivors, in patients with septic shock compared with patients with sepsis, or in patients with sepsis-associated acute liver injury (ALI) compared with patients without ALI. Serum VTN level was associated with PICU mortality (odds ratio [OR]: 0.958, 95% CI: 0.927-0.996; P =.010) or ALI (OR: 0.956, 95% CI: 0.915-0.999; P =.046), but not shock (OR: 0.996, 95% CI: 0.977-1.016; P =.716). The area under receiver operating characteristic curve for VTN in predicting the occurrence of ALI during PICU stay and PICU mortality were 0.760 (95% CI: 0.627- 0.893) and 0.737 (95% CI: 0.544-0.931), respectively. Moreover, VTN plus pediatric risk of mortality (PRISM) III had a better clinical utility according to decision curve analysis compared with VTN or PRISM III alone. These findings suggest that serum VTN level is associated with sepsis-associated ALI and PICU mortality, and VTN plus PRISM III is a powerful predictor of PICU mortality in pediatric patients with sepsis, which have a better clinical benefit compared with VTN or PRISM III alone. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 5-year-old girl was referred with a 2-day history of acute onset neurological symptoms and hypodense areas in the left cerebellar hemisphere and basal ganglia on brain computed tomography. Topics include the child had developed a high fever and dry cough 11 days prior to admission and was treated for 4 days with oral cefaclor, the past medical and family histories were unremarkable, and the neurological examination has showed diminished muscle strength.

Aims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI). Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between December 2012 and December 2015. Serum TBIL concentration was determined within 72 h after PICU admission. Results. Seventy-two patients with SALI were included in this study. The overall mortality rate was 36.1% (26/72). The serum levels of TBIL of patients were significantly higher in the nonsurvivor group than the survivor group. Cox regression analysis indicated that the elevated serum TBIL level within 72 hours after admission was an independent risk factor of mortality in patients with SALI. Furthermore, the area under the receiver-operating characteristic (ROC) curve (AUC) for TBIL was 0.736 (95% confidence interval (CI): 0.614–0.858, P=0.001), in which the optimal cut-off value was 64.5 μmol/L. The combined index named “TBIL” and “TBA” showed an AUC of 0.745 (0.626–0.865) for predicting the prognosis in patients with SALI. In addition, the Kaplan–Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher serum TBIL levels (≥64.5 μmol/L) or higher value of TBIL and TBA (≥−0.8902). Conclusions. Elevated serum TBIL level is associated with poor outcomes in pediatric SALI. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to assess the clinical benefits of high-volume hemofiltration (HVHF) in pediatric patients with severe sepsis compared with standard-volume continuous veno-venous hemofiltration (CVVH). Methods: We retrospectively analyzed the medical records of 155 pediatric patients with severe sepsis admitted to the pediatric intensive care unit of Shanghai Children's Hospital from January 2010 to June 2016. A total of 93 patients were treated with HVHF and 62 patients were treated with CVVH. Results: HVHF treatment did not significantly reduce 28-day mortality. Moreover, there was no significant difference in reducing the plasma level of inflammatory mediators and improving hemodynamic variables between HVHF and CVVH group. However, the incidence of hyperglycemia was significantly higher in HVHF group than in CVVH group. Conclusions: There is no evidence to indicate that HVHF is superior to CVVH in reducing 28-day mortality as an adjunct to the treatment of severe sepsis in pediatric patients. [ABSTRACT FROM AUTHOR]

We demonstrate a new strategy for designing reversibility, fatigue resistance and fluorescence switching materials, which are based on pyrazolone derivatives by introducing a pyridine ring. The reversible “on” and “off” modulation of fluorescence emission was up to 95% in the solid state. [ABSTRACT FROM AUTHOR]

Two novel photochromic compounds derived from pyrazolones, which undergo a photochromic reaction in the solid state, have been synthesized and their photochromic and fluorescence properties were investigated. Their fluorescence emission can be efficiently modulated by photoisomerization of pyrazolones almost up to 90% upon UV light irradiation. Importantly, the fluorescence emission of 1 can be reversibly switched “on” and “off” upon alternative UV light irradiation and heating. These compounds exhibited photochromic coloration from white E-form to yellow brown K-form. On the basis of the molecular structure determined by X-ray single crystal analysis, there are intermolecular hydrogen bonds which provide suitable proton transfer channels for the enol–keto transformation. The colored K-form isomers, which are very stable at ambient temperature, may be due to the reverse reaction occurring at a high temperature. [ABSTRACT FROM AUTHOR]

The development of a combined process of catalytic oxidation and microwave heating for treatment of toluene waste gas was described in this work. Toluene, a typical toxic volatile organic compound, was oxidized through a fixed bed reaction chamber containing zeolite-supported copper oxide (CuO/zeolite) catalyst mixed with silicon carbide (SiC), an excellent microwave-absorbing material. The target compound was efficiently degraded on the surface of the catalyst at high reaction temperature achieved by microwave-heated SiC. A set of experimental parameters, such as microwave power, air flow and the loading size of CuO etc., were investigated, respectively. The study demonstrated these parameters had critical impact on toluene degradation. Under optimal condition, 92% toluene was removed by this combined process, corresponding to an 80%-90% TOC removal rate. Furthermore, the catalyst was highly stable even after eight consecutive 6-h runs. At last, a hypothetical degradation pathway of toluene was proposed based on the experimental data obtained from gas chromatography-mass spectrum and Fourier transform infrared spectroscopy analyses. [ABSTRACT FROM AUTHOR]