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Introduction: Hypoglycemia is an acute complication that can appear in people with type 2 diabetes treated with drugs which are associated with a risk of hypoglycemia, and it may lead to individual's fear of hypoglycemia (FoH). FoH adversely affects diabetic self-management, psychological well-being, and quality of life, and it is associated with sleep quality. Nevertheless, this problem is often underestimated. The purpose of this study was to explore the heterogeneous characteristics of FoH in middle-aged and elderly hospitalized patients with type 2 diabetes and assess its relationship with the sleeping quality.Patients and Methods: A cross-sectional study was performed on 263 middle-aged and elderly patients with type 2 diabetes hospitalized at the Zhejiang Veteran Hospital in Jiaxing, China, from May to August 2022, selected by a convenient sampling method. A questionnaire containing general information, fear of hypoglycemia scale-15 (FH-15) and the Pittsburgh sleep quality index (PSQI) was provided to the participants. Latent profile analysis was performed to examine the potential latent groups in the distribution of answers on the individual FoH items.Results: The results identified three latent classes: Class 1 – Low FoH group (33%); Class 2 – No FoH group (61%); Class 3 – High FoH group (6%). The latent FoH class was the influencing factor of sleep quality, which was better in the No FoH group than in the Low FoH group, while the sleep quality of the Low FoH group was better than that in the High FoH group.Conclusion: A heterogeneity was found in the FoH of middle-aged and elderly hospitalized patients with type 2 diabetes. Health-care providers should pay more attention to these patients with high FoH and develop intervention strategies to mitigate it and improve their sleep quality. [ABSTRACT FROM AUTHOR]

Mucosal‐associated invariant T (MAIT) cells are important in antibacterial immune responses; however, during sepsis, they are few in number and exhibit highly activated phenotypes. The relationship between MAIT cells in peripheral blood and the prognosis of sepsis is not well understood. Thus, this study aimed to examine the levels and phenotypes of MAIT cells in early sepsis, evaluate their clinical relevance, and investigate their association with patient prognosis. This prospective observational study enrolled 72 septic patients defined according to the Sepsis 3.0 criteria and 21 healthy controls matched for age and sex. Their peripheral blood samples were used to assay the expression of immune activation (CD69 and HLA‐DR) and immune checkpoint (PD‐1 and PD‐L1) markers on MAIT cells. The systemic inflammatory response syndrome, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment scores were recorded. Subsequently, the association between MAIT cell characteristics and clinical indicators was assessed using Spearman's rank correlation analysis, and binary logistic regression analysis with a forward stepwise approach assessed independent risk factors for 28‐day mortality. We noted a decrease in the percentage of MAIT cells in the patients' peripheral blood, which exhibited an activated phenotype. Besides, HLA‐DR+ MAIT cell percentage and the APACHE II score were independently associated with the 28‐day mortality and, in combination, were the best indicators of mortality. Thus, the percentage of HLA‐DR+ MAIT cells in early sepsis serves as a novel prognostic biomarker for predicting mortality and improves the predictive capacity of the APACHE II score. [ABSTRACT FROM AUTHOR]

A new type of polyhedral oligomeric silsesquioxanes bisDOPO-NH2-POSS flame retardant consisting of one polyhedral oligomeric silsesquioxane (POSS), two units of 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO) and reactive –NH2 groups, was synthesized and characterized by FTIR, 1H NMR, and 31P NMR. It was applied to modified conventional environmentally friendly E0 grade urea formaldehyde (UF) resin to prepare flame-retardant plywood. Two other POSS structure flame retardants were used for comparison. The results showed that the addition of bisDOPO-NH2-POSS flame retardant to E0 UF resin improved bonding strength while lowering formaldehyde emission owing to the increase in cross-linking of the UF molecule chain in condensation. TGA curves showed that bisDOPO-NH2-POSS-E0 UF exhibited the highest thermal stability. The flammability characteristics of the plywood were evaluated by a cone calorimeter test (CCT), and the results indicated that the heat release and smoke production of flame-retardant plywood were lower than those of the control E0-UF plywood. Moreover, compared to E0-UF plywood, the char residue remaining after the CCT test of the flame-retardant plywood with POSS structure increased. In particular, bisDOPO-NH2-POSS-E0-plywood had a continual compact outer carbon layer, which was conducive to effectively forming a physical barrier to hinder the penetration of oxygen and heat and exhibiting the outstanding synergistic effect of phosphorous, silicon and nitrogen. [ABSTRACT FROM AUTHOR]

Wood-based materials are multifunctional green and environmentally friendly natural construction materials, and are widely used in decorative building materials. For this reason, a lot of research has been carried out to develop new and innovative wood surface improvements and make wood more appealing through features such as fire-retardancy, hydrophobicity, and antibacterial properties. To improve the performance of wood, more and more attention is being paid to the functioning of the surface. Understanding and mastering technology to improve the surface functionality of wood opens up new possibilities for developing multifunctional and high-performance materials. Examples of these techniques are ion crosslinking modification and coating modification. Researchers have been trying to make wooden surfaces more practical for the past century. This study has gradually gained popularity in the field of wood material science over the last 10 years. This paper provides an experimental reference for research on wood surface functionalization and summarizes the most current advancements in hydrophobic, antibacterial, and flame-retardant research on wood surfaces. [ABSTRACT FROM AUTHOR]

Wood is widely used as a construction material due to its many advantages, such as good mechanical properties, low production costs, and renewability. However, its flammability limits its use in construction. To solve the problem of wood flammability, the most common method to improve the fire safety of wood is to modify the wood by deep impregnation or surface coating with flame retardants. Therefore, many researchers have found that environmentally friendly and low-cost biomass materials can be used as a source of green flame retardants. Two aspects of biomass-based intumescent flame retardants are summarized in this paper. On the one hand, biomass is used as one of the three sources or as a flame-retardant synergist in combination with other flame retardants, which are called composite biomass intumescent flame retardants. On the other hand, biomass is used alone as a feedstock to produce all-biomass intumescent flame retardants. In addition, the potential of biomass-based materials as an environmentally friendly and low-cost FR source to produce high-performance biomass-based flame retardants with improved technology was also discussed in detail. The development of biomass-based intumescent flame retardants represents a viable and promising approach for the efficient and environmentally friendly production of biomass-based flame retardants. [ABSTRACT FROM AUTHOR]

Background: This study was designed to evaluate the efficacy of exchange transfusion in patients with severe imported falciparum malaria. Twelve patients who met the diagnostic criteria for severe malaria were treated with exchange transfusion 14 times according to a conventional anti-malarial treatment. This study evaluated the efficacy of exchange transfusion for severe imported falciparum malaria. Methods: Clinical data of severe imported falciparum malaria patients admitted to the intensive care unit (ICU) of Nantong Third People's Hospital from January 2007 to December 2016 were investigated in this retrospective study. Patients were divided into the intervention group, which received exchange transfusion, and the control group. This study assessed parasite clearance and outcomes of the two groups, and levels of erythrocytes, haemoglobin, platelets, coagulation, liver function, lactate, C-reactive protein, and procalcitonin, before and after exchange transfusion in the intervention group. Results: There was no significant difference in the severity of admitted patients. Exchange transfusion was successfully applied 14 times in the intervention group. Differences in the levels of erythrocytes, haemoglobin and platelets did not reach statistical significance. Exchange transfusion improved coagulation, liver function, lactic acid, C-reactive protein, and procalcitonin. No differences were observed in parasite clearance, ICU and hospital length of stay, inhospital mortality, and costs of hospitalization between the two groups. Conclusion: Exchange transfusion as adjunctive therapy for severe malaria was observed to be safe in this setting. Exchange transfusion can improve liver function and coagulation and reduce inflammation, but it failed to improve parasite clearance and the outcomes of severe imported falciparum malaria in this case series. [ABSTRACT FROM AUTHOR]

Mucosal-associated invariant T (MAIT) cells are important in antibacterial immune responses; however, during sepsis, they are few in number and exhibit highly activated phenotypes. The relationship between MAIT cells in peripheral blood and the prognosis of sepsis is not well understood. Thus, this study aimed to examine the levels and phenotypes of MAIT cells in early sepsis, evaluate their clinical relevance, and investigate their association with patient prognosis. This prospective observational study enrolled 72 septic patients defined according to the Sepsis 3.0 criteria and 21 healthy controls matched for age and sex. Their peripheral blood samples were used to assay the expression of immune activation (CD69 and HLA-DR) and immune checkpoint (PD-1 and PD-L1) markers on MAIT cells. The systemic inflammatory response syndrome, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment scores were recorded. Subsequently, the association between MAIT cell characteristics and clinical indicators was assessed using Spearman's rank correlation analysis, and binary logistic regression analysis with a forward stepwise approach assessed independent risk factors for 28-day mortality. We noted a decrease in the percentage of MAIT cells in the patients' peripheral blood, which exhibited an activated phenotype. Besides, HLA-DR + MAIT cell percentage and the APACHE II score were independently associated with the 28-day mortality and, in combination, were the best indicators of mortality. Thus, the percentage of HLA-DR + MAIT cells in early sepsis serves as a novel prognostic biomarker for predicting mortality and improves the predictive capacity of the APACHE II score., (© 2023 The Scandinavian Foundation for Immunology.)

A 63-year-old man was admitted for acute left heart failure after doing farm work. He rapidly developed refractory cardiogenic shock due to a large left atrial myxoma which was found by bedside echocardiography. Venoarteriovenous extracorporeal membrane oxygenation (ECMO) was performed immediately, and the patient was transferred for further surgery with a good outcome. Therefore, timely echocardiographic evaluation and surgical removal of myxomas is recommended, and ECMO could be used as a bridge between the transfer and perioperative period., (© 2021 Forum Multimedia Publishing, LLC)

Rationale: Extensive thrombosis in the portal venous system caused by hypereosinophilic syndrome (HES) is rare, and there is no consensus on anticoagulant and thrombolytic treatments for arteriovenous thrombosis caused by HES., Patient Concerns: The clinical data of a patient with extensive thrombosis in his portal venous system (superior mesenteric, splenic, hepatic, and portal veins), renal artery thrombosis, and mesenteric thrombosis caused by HES with secondary gastrointestinal bleeding and intestinal necrosis were retrospectively analyzed. Before admission, his eosinophil count increased to 7.47 × 10/L, and HES had been confirmed via bone marrow cytology. The patient experienced fever, cough, abdominal pain, massive hematemesis, and hematochezia that developed in succession. Abdominal computed tomography showed portal vein and superior mesenteric vein thromboses., Diagnosis: Hypereosinophilic syndrome; extensive thrombosis in the portal venous system; acute eosinophil-associated pneumonia; gastrointestinal bleeding; intestinal necrosis., Interventions: The patient was first treated with methylprednisolone, plasma exchange/hemofiltration, and single or combined use of unfractionated heparin and argatroban for anticoagulation. He was also administered alteplase and urokinase, successively, for thrombolytic treatment. Once the thromboses finally disappeared, the patient underwent surgery to excise a necrotic intestinal canal., Outcomes: The thromboses disappeared with these treatments, and the patient recovered after the necrotic intestinal canal was excised., Lessons: The clinical manifestations of HES are complex and varied, and this condition can cause severe and extensive arteriovenous thrombosis. Anticoagulation therapy and thrombolysis are necessary interventions, and appear to be safe and effective.

Three new species of earthworms belonging to the genus Amynthas are described from Hainan Island, China. They are named Amynthas wenchangensis sp. nov., Amynthas accessorius sp. nov., and Amynthas eumorphus sp. nov. A. wenchangensis sp. nov. keys to the Amynthas morrisi-group; it has several small genital papillae in the male pore region and a degenerated prostate. A. accessorius sp. nov. keys to the Amynthas hawayanus-group and has completely degenerated prostates and two large accessory glands. A. eumorphus sp. nov. keys to the Amynthas sieboldi-group.