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Abstract Sodium oligomannate (GV-971), an oligosaccharide drug approved in China for treating mild-to-moderate Alzheimer’s disease (AD), was previously found to recondition the gut microbiota and limit altered peripheral Th1 immunity in AD transgenic mice. As a follow-up study, we here made advances by pinpointing a Lactobacillus murinus (L.m.) strain that highly expressed a gene encoding a putative adhesin containing Rib repeats (Ribhigh-L.m.) particularly enriched in 5XFAD transgenic mice. Mechanistically, Ribhigh-L.m. adherence to the gut epithelia upregulated fecal metabolites, among which lactate ranked as the top candidate. Excess lactate stimulated the epithelial production of serum amyloid A (SAA) in the gut via the GPR81-NFκB axis, contributing to peripheral Th1 activation. Moreover, GV-971 disrupted the adherence of Ribhigh-L.m. to gut epithelia via direct binding to Rib, which corrected the excess lactate, reduced SAA, and alleviated Th1-skewed inflammation. Together, we gained further insights into the molecular link between gut bacteria and AD progression and the mechanism of GV-971 in treating AD.

Background and Importance: The surgical management of intracerebral hemorrhage (ICH) remains controversial due to unfavorable outcomes reported in several influential clinical trials. There is a pressing need for novel instrumentation and approaches that optimize evacuation efficiency while minimizing invasiveness. Among the emerging techniques, endoscopic surgery and robot-assisted minimally invasive catheterization (robotic MISTIE) show potential. However, the former still results in brain damage at a centimeter level, while the latter exhibits low evacuation efficiency due to its non-visualized nature. Methods: We have developed a novel technique called robot-assisted visualized minimally invasive aspiration (RAVMIA) for the evacuation of ICH. This technique integrates neurosurgical robot navigation, contact-visible endoscopy, and minimally invasive catheterization. The efficacy of RAVMIA was evaluated using robotic MISTIE as a historical control. Results: The RAVMIA technique was successfully implemented in three cases of ICH without complications. Brain damage was limited to 5mm. Compared to robotic MISTIE, RAVMIA did not prolong operative time (20.67 ± 4.04 minutes vs. 20.87 ± 5.74 minutes, p = 0.946) but significantly increased the intraoperative hematoma evacuation rate from 80.8 ± 4.1 % to 86.6 ± 1.3 % (p = 0.003). Consequently, the end-of-treatment residual ICH volume decreased from 5.3 ± 2.95 ml to 1.3 ± 1.05 ml (p = 0.004), and the hospital stay was reduced from 12.87 ± 4.55 days to 10.67 ± 4.04 days (p = 0.029). Conclusion: The preliminary application of the RAVMIA technique demonstrates its safety and feasibility in treating long, oval-shaped basal ganglia hematoma and brain stem hematoma. This method achieves high evacuation efficiency while minimizing invasiveness. Further technical optimization and clinical trials are warranted to fully explore its potential.

Abstract Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common cause for dementia. There are many hypotheses about AD, including abnormal deposit of amyloid β (Aβ) protein in the extracellular spaces of neurons, formation of twisted fibers of tau proteins inside neurons, cholinergic neuron damage, inflammation, oxidative stress, etc., and many anti-AD drugs based on these hypotheses have been developed. In this review, we will discuss the existing and emerging hypothesis and related therapies.

Abstract High-entropy alloy nanoparticles (HEA-NPs) exhibit favorable properties in catalytic processes, as their multi-metallic sites ensure both high intrinsic activity and atomic efficiency. However, controlled synthesis of uniform multi-metallic ensembles at the atomic level remains challenging. This study successfully loads HEA-NPs onto a nitrogen-doped carbon carrier (HEAs) and pioneers the application in peroxymonosulfate (PMS) activation to drive Fenton-like oxidation. The HEAs-PMS system achieves ultrafast pollutant removal across a wide pH range with strong resistance to real-world water interferences. Furthermore, the nonradical HEAs-PMS system selectively transforms phenolics into high-molecular-weight products via a polymerization pathway. The unique non-mineralization regime remarkably reduces PMS consumption and achieves a high electron utilization efficiency of up to 213.4%. Further DFT calculations and experimental analysis reveal that Fe and Co in HEA-NPs act as the primary catalytic sites to complex with PMS for activation, while Ni, Cu, and Pd serve as charge mediators to facilitate electron transfer. The resulting PMS* complexes on HEAs possess a high redox potential, which drives spatially separated phenol oxidation on nitrogen-doped graphene support to form phenoxyl radicals, subsequently triggering the formation of high-molecule polymeric products via polymerization reactions. This study offers engineered HEAs catalysts for water treatment with low oxidant consumption and emissions.

Abstract Advanced Oxidation Processes (AOPs) are promising for treating persistent pollutants, yet challenges arise due to the step-wise oxidants activation process, which traditional single-active-center catalysts struggle to facilitate effectively. Recently, dual-active-center catalysts have emerged as a solution by enabling synergistic reactions. This review covers advances in these catalysts, their co-catalytic mechanisms, and applications in electro-Fenton, photocatalytic, peroxymonosulfate-, and pollutant-as-electron-donor based Fenton-like processes, along with active site design considerations and future challenges.

Abstract Microplastic pollution, an emerging environmental issue, poses significant threats to aquatic ecosystems and human health. In tackling microplastic pollution and advancing green hydrogen production, this study reveals a tandem catalytic microplastic degradation-hydrogen evolution reaction (MPD-HER) process using hierarchical porous carbon nitride-supported single-atom iron catalysts (FeSA-hCN). Through hydrothermal-assisted Fenton-like reactions, we accomplish near-total ultrahigh-molecular-weight-polyethylene degradation into C3-C20 organics with 64% selectivity of carboxylic acid under neutral pH, a leap beyond current capabilities in efficiency, selectivity, eco-friendliness, and stability over six cycles. The system demonstrates versatility by degrading various daily-use plastics across different aquatic settings. The mixture of FeSA-hCN and plastic degradation products further achieves a hydrogen evolution of 42 μmol h‒1 under illumination, outperforming most existing plastic photoreforming methods. This tandem MPD-HER process not only provides a scalable and economically feasible strategy to combat plastic pollution but also contributes to the hydrogen economy, with far-reaching implications for global sustainability initiatives.

Bisphenol A, a hazardous endocrine disruptor, poses significant environmental and human health threats, demanding efficient removal approaches. Traditional biological methods struggle to treat BPA wastewater with high chloride (Cl−) levels due to the toxicity of high Cl− to microorganisms. While persulfate-based advanced oxidation processes (PS-AOPs) have shown promise in removing BPA from high Cl− wastewater, their widespread application is always limited by the high energy and chemical usage costs. Here we show that peroxymonosulfate (PMS) degrades BPA in situ under high Cl− concentrations. BPA was completely removed in 30 min with 0.3 mM PMS and 60 mM Cl−. Non-radical reactive species, notably free chlorine species, including dissolved Cl2(l), HClO, and ClO− dominate the removal of BPA at temperatures ranging from 15 to 60 °C. Besides, free radicals, including •OH and Cl2•−, contribute minimally to BPA removal at 60 °C. Based on the elementary kinetic models, the production rate constant of Cl2(l) (32.5 M−1 s−1) is much higher than HClO (6.5 × 10−4 M−1 s−1), and its degradation rate with BPA (2 × 107 M−1 s−1) is also much faster than HClO (18 M−1 s−1). Furthermore, the degradation of BPA by Cl2(l) and HClO were enlarged by 10- and 18-fold at 60 °C compared to room temperature, suggesting waste heat utilization can enhance treatment performance. Overall, this research provides valuable insights into the effectiveness of direct PMS introduction for removing organic micropollutants from high Cl− wastewater. It further underscores the critical kinetics and mechanisms within the PMS/Cl⁻ system, presenting a cost-effective and environmentally sustainable alternative for wastewater treatment.

Abstract Solar desalination is a promising solution for alleviating water scarcity due to its low‐cost, environmentally friendly, and off‐grid capabilities. However, simultaneous salt rejection and heat localization remain challenging, as the rapid salt convection often results in considerable heat loss. Herein, this challenge is overcome via a facile design: i) isolating high‐temperature and high‐salt zones by rationally designing morning glory‐shaped wick structures and ii) bridging high‐salt zones and bulk water with low‐tortuosity macrochannels across low‐temperature surfaces. The salinity gradient in the macrochannels passively triggers convective flow, facilitating the rapid transfer of salt ions from the high‐salt zone to the bulk water. Meanwhile, the macrochannels are spatially isolated from the high‐temperature zone, preventing heat loss during salt convection and thereby achieving a high evaporation rate (≈3 kg m−2 h−1) and superior salt rejection even in highly concentrated real seawater. This work provides new insights into salt rejection strategies and advances practical applications for sustainable seawater desalination.

Solar steam generation (SSG) is widely regarded as one of the most sustainable technologies for seawater desalination. However, salt fouling severely compromises the evaporation performance and lifetime of evaporators, limiting their practical applications. Herein, we propose a hierarchical salt-rejection (HSR) strategy to prevent salt precipitation during long-term evaporation while maintaining a rapid evaporation rate, even in high-salinity brine. The salt diffusion process is segmented into three steps—insulation, branching diffusion, and arterial transport—that significantly enhance the salt-resistance properties of the evaporator. Moreover, the HSR strategy overcomes the tradeoff between salt resistance and evaporation rate. Consequently, a high evaporation rate of 2.84 ​kg ​m−2 ​h−1, stable evaporation for 7 days cyclic tests in 20 ​wt% NaCl solution, and continuous operation for 170 ​h in natural seawater under 1 sun illumination were achieved. Compared with control evaporators, the HSR evaporator exhibited a >54% enhancement in total water evaporation mass during 24 ​h continuous evaporation in 20 ​wt% salt water. Furthermore, a water collection device equipped with the HSR evaporator realized a high water purification rate (1.1 ​kg ​m−2 ​h−1), highlighting its potential for agricultural applications.

Highlights Sn-based MAX/MXene hybrids with abundant Sn vacancies, Sn@Ti2CT X /Ti2SnC–V, fabricated by controlled etching method, are demonstrated to be an excellent electrocatalyst for N2 electroreduction. An economic “NH3 farm” has been developed based on Sn@Ti2CT X /Ti2SnC–V electrode, demonstrated by a commercial electrochemical photovoltaic cell, which may open a novel avenue for solar energy-driven synthesis of ammonia directly from air and water. The potential of the “NH3 farm” was demonstrated by a systematic technical economic analysis.

Two−dimensional (2D) supports confined single−atom catalysts (2D SACs) with unique geometric and electronic structures have been attractive candidates in different catalytic applications, such as energy conversion and storage, value−added chemical synthesis and environmental remediation. However, their environmental applications lack of a comprehensive summary and in−depth discussion. In this review, recent progresses in synthesis routes and advanced characterization techniques for 2D SACs are introduced, and a comprehensive discussion on their applications in environmental remediation is presented. Generally, 2D SACs can be effective in catalytic elimination of aqueous and gaseous pollutants via radical or non−radical routes and transformation of toxic pollutants into less poisonous species or highly value−added products, opening a new horizon for the contaminant treatment. In addition, in−depth reaction mechanisms and potential pathways are systematically discussed, and the relationship between the structure−performance is highlighted. Finally, several critical challenges within this field are presented, and possible directions for further explorations of 2D SACs in environmental remediation are suggested. Although the research of 2D SACs in the environmental application is still in its infancy, this review will provide a timely summary on the emerging field, and would stimulate tremendous interest for designing more attractive 2D SACs and promoting their wide applications.

Abstract. Background:. Sepsis is a serious disease caused by infection. Aminophylline has anti-asthma and anti-inflammatory effects. We aimed to explore the safety and effect of aminophylline in sepsis. Methods:. We conducted a clinical randomized controlled trial involving 100 patients diagnosed with sepsis within 48 h after intensive care unit (ICU) admission in two sites. All patients were randomized in a 1:1 ratio to receive standard therapy with or without aminophylline. The primary clinical outcome was all-cause mortality at 28 days. Results:. From September 27, 2018 to February 12, 2020, we screened 277 septic patients and eventually enrolled 100 patients, with 50 assigned to the aminophylline group and 50 to the usual-care group. At 28 days, 7 of 50 patients (14.0%) in the aminophylline group had died, compared with 16 of 50 (32.0%) in the usual-care group (P = 0.032). Cox regression showed that the aminophylline group had a lower hazard of death (hazard ratio = 0.312, 95% confidence interval: 0.129–0.753). Compared with the usual-care group, patients in the aminophylline group had a longer survival time (P = 0.039 by the log-rank test). The effects of aminophylline on vasopressor dose, oxygenation index, and sequential organ failure assessment score were time-dependent with treatment. There were no significant differences in total hospitalization days, ICU hospitalization days, and rates of serious adverse events (all P > 0.05). No adverse events were observed in the trial. Conclusions:. Aminophylline as an adjunct therapy could significantly reduce the risk of death and prolong the survival time of patients with sepsis. Trial registration:. ChiCTR.org.cn, ChiCTR1800019173.

Increased evidence shows that gut microbiota acts as the primary regulator of the liver; however, their role in sepsis-related liver injury (SLI) in the elderly is unclear. This study assessed whether metformin could attenuate SLI by modulating gut microbiota in septic aged rats. Cecal ligation and puncture (CLP) was used to induce SLI in aged rats. Fecal microbiota transplantation (FMT) was used to validate the roles of gut microbiota in these pathologies. The composition of gut microbiota was analyzed by 16S rRNA sequencing. Moreover, the liver and colon tissues were analyzed by histopathology, immunofluorescence, immunohistochemistry,and reverse transcription polymerase chain reaction (RT-PCR). Metformin improved liver damage, colon barrier dysfunction in aged SLI rats. Moreover, metformin improved sepsis-induced liver inflammation and damage under the presence of gut microbiota. Importantly, FMT assay showed that rats gavaged with feces from metformin-treated SLI rats displayed fewer-severe liver damage and colon barrier dysfunction than did rats gavaged with feces from SLI rats.The gut microbiota composition among the sham-operated, CLP-operated and metformin-treated SLI rats were different. In particular, the proportion of Klebsiella and Escherichia_Shigella was higher in SLI rats than sham-operated and metformin-treated SLI rats;while metformin could increased the proportion of Bifidobacterium, Muribaculaceae, Parabacteroides_distasonis and Alloprevitella in aged SLI rats. Additionally, Klebsiella and Escherichia_Shigella correlated positively with the inflammatory factors in the liver. Our findings suggest that metformin may improve the liver injury by regulating the gut microbiota and alleviating colon barrier dysfunction in septic aged rats, which may be an effective therapy for SLI.

Abstract Purpose Current knowledge of Lymphoma Associated Hemophagocytic Syndrome (LAHS) mainly relies on T/NK-cell LAHS cases, while B-cell lymphoma associated hemophagocytic syndrome (B-LAHS) variant are rare. We aimed at identifying a single-center cohort of patients with B-LAHS to shed light on relevant clinical and laboratory features, diagnosis, treatment and prognosis. Methods The clinical data of 36 patients with B-LAHS, admitted to the First Affiliated Hospital of Zhengzhou University in the time period ranging from January 2011 to May 2021 were analyzed retrospectively. Survival analysis was performed using the Kaplan–Meier method and groups were compared using the log-rank test. Results The 36 patients included 17 males and 19 females with a median age of 53.5 years (range: 28–74 years). Among these, the most common histopathological type diagnosed was diffuse large B-cell lymphoma (69%). The initial symptoms included fever (100%), splenomegaly (97%), multicavity effusion (83%), abnormal liver function (58%), and jaundice (44%). Patients treated with dexamethasone only seemed to have an inferior prognosis compared to those treated with etoposide-involving regimens (χ2 = 20.037, p < 0.001). Patients received based on the Hemophagocytic Lymphohistocytosis (HLH)-2004 protocol combined with multidrug chemotherapy had a significantly improved Overall Survival (OS) compared to patients who only underwent treatment according to the HLH-2004 regimen (χ2 = 30.744, p < 0.001). The 2-week mortality rate was 13.9% and the 1-year OS rate was 19.4%. Compared with the median survival time of 34 patients without Epstein-Barr virus (EBV) infection, 97 days (range: 24–322 days), two patients with EBV infection died within 8 days. Conclusion B-LAHS is relatively rare and has a high early mortality rate, mostly in middle-aged and elderly patients. The HLH-2004 regimen combined with multidrug chemotherapy is a reasonable choice for the treatment of B-LAHS, and EBV infection may be used as a reference indicator of a poor prognosis.

Abstract Background High morbidity and mortality due to carbapenem-resistant Gram-negative bacilli (CR-GNB) has led to the resurgence of polymyxin B (PMB) use in the last decade. The aim of our multicenter, real-world study was to evaluate the effectiveness and safety of PMB in the treatment of CR-GNB infections. Methods The real-world study included patients treated with intravenous PMB for at least 7 days during the period of October 2018 through June 2019. Associations between these clinical features and 28-day mortality or all-cause hospital mortality were explored through univariate analyses and multivariable logistic regression. Results The study included 100 patients. Many patients presented with combined chronic conditions, septic shock, mechanical ventilation, and the presence of Klebsiella pneumoniae. The mean duration of PMB therapy was 11 days (range 7–38 days). Temperature (38 °C vs 37.1 °C), white blood cells (14.13 × 109/l vs 9.28 × 109/l), C-reactive protein (103.55 ug/l vs 47.60 ug/l), procalcitonin (3.89 ng/ml vs 1.70 ng/ml) and APACHE II levels (17.75 ± 7.69 vs 15.98 ± 7.95) were significantly decreased after PMB treatment. The bacteria eradication rate was 77.65%. The overall mortality at discharge was 15%, and 28-day mortality was 40%. Major adverse reactions occurred in 16 patients. Nephrotoxicity was observed in 7 patients (7%). Conclusions Our results provide positive clinical and safety outcomes for PMB in the treatment of CR-GNB. Timely and appropriate use of PMB may be particularly useful in treating patients with sepsis in CR-GNB infections.

The aim of the study was to investigate dynamic changes in α-melanocyte-stimulating hormone (α-MSH) levels in the serum of patients with craniocerebral trauma. Forty-eight patients with acute craniocerebral injury were selected between January 2015 and October 2016. The patients were divided into three groups: severe (18 cases), moderate (16 cases) and mild (14 cases), according to the Glasgow Coma Scale (GCS) score at the time of admission. At the same time, 10 adults with a similar age distribution to the patients were also selected as a control group. Venous blood was extracted from patients at 1, 3, 5 and 7 days after injury. Serum α-MSH and tumor necrosis factor (TNF)-α levels were measured using an enzyme-linked immunosorbent assay (ELISA). The correlation between α-MSH and TNF-α was analyzed using Pearson's correlation analysis. Serum α-MSH levels in patients with craniocerebral injury were lower than those in the healthy control group (P<0.05). Decreased serum α-MSH levels were usually accompanied with higher degrees of craniocerebral injury. Serum α-MSH levels initially decreased and then later increased, with the lowest α-MSH levels in the mild at 5 days, moderate at 5 days, and severe groups at 3 days after injury (P<0.05). Serum TNF-α levels in all the patient groups were higher than those in the control group at different time points after injury, with higher TNF-α serum levels accompanying higher degrees of brain injury. In all three groups, serum TNF-α levels initially increased and then decreased post-injury, with peak serum TNF-α levels found at 3-day postinjury in all the patient groups (P<0.05). A negative correlation between serum α-MSH content and serum TNF-α levels in patients with craniocerebral trauma at different time points, was noted (P<0.05). Serum α-MSH content in the survival group was higher than that in the death group (P<0.05). Serum α-MSH levels in patients with non-systemic inflammatory response syndrome (SIRS) were higher than in patients with SIRS (P<0.05). Serum α-MSH levels during the early stages after craniocerebral trauma can be used as a factor for the prediction of secondary SIRS, with constant low levels of serum α-MSH suggest poor prognosis. [ABSTRACT FROM AUTHOR]

The sluggish kinetics of Fe(Ⅱ) recovery in Fenton/Fenton-like reactions significantly limits the oxidation efficiency. In this study, we for the first time use boron carbide (BC) as a green and stable promotor to enhance the reaction of Fe(Ⅲ)/H2O2 for degradation of diverse organic pollutants. Electron paramagnetic resonance analysis and chemical quenching/capturing experiments demonstrate that hydroxyl radicals (•OH) are the primary reactive species in the BC/Fe(Ⅲ)/H2O2 system. In situ electrochemical analysis indicates that BC remarkably boosts the Fe(Ⅲ)/Fe(Ⅱ) redox cycles, where the adsorbed Fe(Ⅲ) cations were transformed to more active Fe(Ⅲ) species with a higher oxidative potential to react with H2O2 to produce Fe(Ⅱ). Thus, the recovery of Fe(Ⅱ) from Fe(Ⅲ) is facilitated over BC surface, which enhances •OH generation via Fenton reactions. Moreover, BC exhibits outstanding reusability and stability in successive cycles and avoids the secondary pollution caused by conventional organic and metalliferous promotors. Therefore, metal-free BC boosting Fe(Ⅲ)/H2O2 oxidation of organics provides a green and advanced strategy for water decontamination.

Heteroatom-doping of carbocatalysts has been a powerful strategy to remarkably enhance the catalytic performance. Herein, the underlying nature of N promotional effects on peroxymonosulfate (PMS) activation for phenol removal is understood by combining kinetics analysis with multiple techniques. A strategy using mixed acid oxidation of carbon nanotube (CNT) followed by NH3 treatment is employed to yield a series of catalysts with different N-doping contents but similar fraction of sp2-hybridized carbon and defective degree, endowing with a chance to discriminate the dominant N-containing active sites. The multi-sites kinetics analysis suggests the graphitic N-containing sites as the dominant active sites. The mechanism of the surface-bound reactive species is also discriminated as the dominant reaction mechanism. The insights reported here could provide the methodology to fundamentally understand the heteroatom-doping effects of carbocatalysis.

Abstract Background We hypothesized that adipose-derived mesenchymal stem cells (ADMSCs) may ameliorate sepsis-induced acute lung injury (ALI) and change microorganism populations in the gut microbiota, such as that of Firmicutes and Bacteroidetes. Methods A total of 60 male adult Sprague-Dawley (SD) rats were separated into three groups: the sham control (SC) group, the sepsis induced by cecal ligation and puncture (CLP) group, and the ADMSC treatment (CLP-ADMSCs) group, in which rats underwent the CLP procedure and then received 1 × 106 ADMSCs. Rats were sacrificed 24 h after the SC or CLP procedures. To study the role of ADMSCs during ALI caused by sepsis and examine the impact of ADMSCs on the gut microbiome composition, rat lungs were histologically evaluated using hematoxylin and eosin (H&E) staining, serum levels of pro-inflammatory factors were detected using enzyme-linked immunosorbent assay (ELISA), and fecal samples were collected and analyzed using 16S rDNA sequencing. Results The serum levels of inflammatory cytokines, tumor necrosis factor (TNF)-α and interleukin (IL)-6, were significantly increased in rats after the CLP procedure, but were significantly decreased in rats treated with ADMSCs. Histological evaluation of the rat lungs yielded results consistent with the changes in IL-6 levels among all groups. Treatment with ADMSCs significantly increased the diversity of the gut microbiota in rats with sepsis. The principal coordinates analysis (PCoA) results showed that there was a significant difference between the gut microbiota of the CLP-ADMSCs group and that of the CLP group. In rats with sepsis, the proportion of Escherichia–Shigella (P = 0.01) related to lipopolysaccharide production increased, and the proportion of Akkermansia (P = 0.02) related to the regulation of intestinal mucosal thickness and the maintenance of intestinal barrier function decreased. These changes in the gut microbiota break the energy balance, aggravate inflammatory reactions, reduce intestinal barrier functions, and promote the translocation of intestinal bacteria. Intervention with ADMSCs increased the proportion of beneficial bacteria, reduced the proportion of harmful bacteria, and normalized the gut microbiota. Conclusions Therapeutically administered ADMSCs ameliorate CLP-induced ALI and improves gut microbiota, which provides a potential therapeutic mechanism for ADMSCs in the treatment of sepsis.

AimThe purpose of this study was to explore prognostic factors of bloodstream infections (BSIs), a common severe infection and a major cause of mortality worldwide, so as to construct a prognosis model of patients with BSI.Materials and MethodsClinical and biochemical test data were obtained retrospectively from the medical records of 562 patients with BSI who had been treated at a single center; the end point was 60 days of all-cause death. The chi-square test was used to compare the mortality of patients grouped by the types of antibiotic treatment. The logistic regression analysis was adopted to identify prognostic factors; the Kaplan–Meier survival curve and log-rank test were conducted to compare the survival rate of patients with different prognostic factors; the receiver operating characteristic (ROC) curve was used to estimate the predictive value of different prognostic factors.ResultsOf the 562 patients, 455 survived (80.96%), and 107 died (19.04%). The mortality rate of patients treated with a combination of antibiotics (25.40%) was higher than that treated with a single antibiotic (15.82%). Univariate analysis identified 19 prognostic factors for patients with BSI, including gender, age, diabetes, malignant tumor (non-blood system), total hospitalization time, alanine aminotransferase, aspartate aminotransferase, total protein, albumin, total bilirubin, direct bilirubin, creatinine, ratio of granulocytes, fibrinogen, D-dimer, platelet, C-reactive protein, shock, and respiratory failure (P < 0.05). Multivariate analysis indicated that albumin (odds ratio [OR] = 0.94, 95% confidence interval [CI]: 0.89–0.99), fibrinogen (OR = 0.61, 95%CI: 0.46–0.82), shock (OR = 16.61, 95%CI: 7.00–39.41), and respiratory failure (OR = 47.53, 95%CI: 19.93–133.64) were independent factors. The combination of four indicators demonstrated a favorable predictive value for the 60-day outcome of patients with BSI, with an area under the ROC of 0.96 (95%CI: 0.94–0.99), sensitivity of 90.65%, specificity of 94.95%, and accuracy of 94.13%.ConclusionsShock, respiratory failure, albumin, and fibrinogen are potential independent prognostic factors for 60-day mortality.

Background: Patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) may require intensive care unit (ICU) admission due to different reasons, and the in-ICU mortality is high among AAV patients. The aim of this study was to explore the clinical features and risk factors of mortality of patients with AAV in the ICU.Methods: A retrospective study was conducted based on 83 AAV patients admitted to the ICU in a tertiary medical institution in China. Data on clinical characteristics, laboratory tests, treatment in ICU and outcomes were collected. The data were analyzed using univariate and multivariate logistic regression analysis to explore the variables that were independently related to mortality. Kaplan–Meier method was used to assess the long-term survival.Results: Among the 83 patients, 41 (49.4%) were female. The mean age of patients was 66 ± 13 years. Forty-four patients deceased, with the in-ICU mortality of 53%. The most common cause for ICU admission was active vasculitis (40/83, 48.2%). The main cause of death was infection (27/44, 61.4%) followed by active vasculitis (15/44, 34.1%). A multivariate analysis revealed that the Acute Physiology and Chronic Health Evaluation II (APACHE II) at ICU admission (OR = 1.333, 95% CI: 1.031–1.722) and respiratory failure (OR = 620.452, 95% CI: 11.495–33490.306) were independent risk factors of in-ICU death. However, hemoglobin (OR = 0.919, 95% CI: 0.849–0.995) was an independent protective factor. The nomogram established in this study was practical in predicting the risk of in-ICU mortality for AAV patients. Moreover, for 39 patients survived to the ICU stay, the cumulative survival rates at 0.5, 1, and 5 years were 58.3%, 54.2%, and 33.9%, respectively, and the median survival time was 14 months.Conclusion: In our study, active vasculitis was the most frequent reason for ICU admission, and the main cause of death was infection. APACHE II and respiratory failure were independent risk factors while hemoglobin was an independent protective factor of in-ICU mortality for AAV patients admitted to the ICU. The risk prediction model developed in this study may be a useful tool for clinicians in early recognition of high-risk patients and applying appropriate management.

Background: Although numerous studies are conducted every year on how to reduce the fatality rate associated with sepsis, it is still a major challenge faced by patients, clinicians, and medical systems worldwide. Early identification and prediction of patients at risk of sepsis and adverse outcomes associated with sepsis are critical. We aimed to develop an artificial intelligence algorithm that can predict sepsis early.Methods: This was a secondary analysis of an observational cohort study from the Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University. A total of 4,449 infected patients were randomly assigned to the development and validation data set at a ratio of 4:1. After extracting electronic medical record data, a set of 55 features (variables) was calculated and passed to the random forest algorithm to predict the onset of sepsis.Results: The pre-procedure clinical variables were used to build a prediction model from the training data set using the random forest machine learning method; a 5-fold cross-validation was used to evaluate the prediction accuracy of the model. Finally, we tested the model using the validation data set. The area obtained by the model under the receiver operating characteristic (ROC) curve (AUC) was 0.91, the sensitivity was 87%, and the specificity was 89%.Conclusions: This newly established machine learning-based model has shown good predictive ability in Chinese sepsis patients. External validation studies are necessary to confirm the universality of our method in the population and treatment practice.

Iron nanoparticles encapsulated within boron and nitrogen co-doped carbon nanoshell (B/N-C@Fe) were synthesized through a novel and green pyrolysis process using melamine, boric acid, and ferric nitrate as the precursors. The surface morphology, structure, and composition of the B/N-C@Fe materials were thoroughly investigated. The materials were employed as novel catalysts for the activation of potassium monopersulfate triple salt (PMS) for the degradation of levofloxacin (LFX). Linear sweep voltammograms and quenching experiments were used to identify the mechanisms of PMS activation and LFX oxidation by B/N-C@Fe, where SO4− as well as HO were proved to be the main radicals for the reaction processes. This study also discussed how the fluvic acid and inorganic anions in the aqueous solutions affected the degradation of LFX and use this method to simulate the degradation in the real wastewater. The synthesized materials showed a high efficiency (85.5% of LFX was degraded), outstanding stability, and excellent reusability (77.7% of LFX was degraded in the 5th run) in the Fenton-like reaction of LFX. In view of these advantages, B/N-C@Fe have great potentials as novel strategic materials for environmental catalysis. Keywords: Iron-based nanomaterials, Potassium monopersulfate, Fenton-like reaction, Antibiotics degradation, Green/sustainable remediation, Environmental catalysts

Regulated disposal or re-utilization of dewatered sludge is of economic benefits and can avoid secondary contamination to the environment; however, feasible and effective management strategies are still lacking. In this study, a peroxydisulfate/zero-valent iron (PDS-ZVI) system is proposed to destroy proteins in soluble extracellular polymeric substances (S-EPS) and loosely bound EPS (LB-EPS) in anaerobic digested sludge (ADS) to improve the dewaterability. Moreover, ADS derived biochars supported via iron oxides (Fe-ADSBC) were generated by dewatering and thermal annealing. Intriguingly, the iron species was discovered to gradually transform from Fe3O4 to FeO with increased pyrolysis temperatures from 600 to 1000 °C. The manipulated iron species on the biochar can remarkably impact the catalytic activity in PDS activation and degradation of sulfamethazine (SMT). The in situ radical scavenging and capturing tests revealed that the principal reactive oxygen species (ROS) in Fe-ADSBC/PDS system experienced a variation from OH into SO4− at higher annealing temperature (1000 °C). In addition, the carbonaceous ADSBC can promote the catalytic activity of iron oxides by synergistically facilitating the adsorption of reactants and charge transfer through COFe bonds at the interfaces. This study enables the first insights into the properties and catalytic performance of Fe-ADSBC, meanwhile unveils the mechanism, reaction pathways, and environmental impacts of the ultimate transformation products (TPs) from SMT degradation in the Fe-ADSBC/PDS system. The study also contributes to developing value-added green biochar catalysts from bio-wastes towards environmental purification. Keywords: Anaerobic digested sludge, Biochar, Peroxydisulfate, Sulfamethazine

Recovery of rare earth ions from wastewater holds an important strategy for the use of the precious resources. In this study, we found that a metal-organic framework (MOF), HKUST-1, exhibited a high affinity and selectivity towards adsorptive recovery of rare earth ions (Ce3+ and La3+) in aqueous solutions. The adsorbent showed a remarkable adsorption capacity of 234 mg/g and 203 mg/g for Ce3+ and La3+ at pH = 6, respectively. More importantly, its adsorption selectivity of the rare earth ions was about 87% against other metal ions. The adsorption isotherm, kinetics, and mechanism in the process were also investigated. The adsorption process can be better fit by the Freundlich model in isotherm and the pseudo-second-order model in kinetics. A plausible mechanism for the adsorption of metal ions on the HKUST-1 was proposed by considering ion exchange and the covalent bonding between the adsorbent and metal ions. The selectivity can be attributed to the different bonding abilities to metal ions.

Given the high mortality associated with sepsis, there is an urgent need for a full understanding of sepsis pathophysiology and finding new therapeutic regimens. Adipose-derived mesenchymal stem cells (ADMSCs) has been proven to have anti-inflammatory effects and could be used to treat cecal ligation and puncture (CLP) induced lung and liver injury in septic rat models. In this study, we used metabolomics to investigate small molecule metabolites between CLP and ADMSCs treatment groups. Sixty SD rats were randomly assigned to the sham operation group (SC group), the CLP group, and the CLP+ADMSCs group (CLP-ADMSCs group). We used liquid mass spectrometry-chromatography to detect metabolic changes in plasma and lung tissues. Compared with the SC group, the metabolic profile of plasma and lung tissues changed significantly 24 h after CLP. Moreover, 22 and 11 main differential metabolites involved in amino acid and glycerophospholipid metabolism were found in plasma and lung tissues, respectively. After the rats were injected with ADMSCs, these differential metabolites were reverse-regulated both in plasma and lung tissues. Besides, ADMSCs improved the survival rate and down-regulated the concentration of TNF-α and IL-6 at 24 h after CLP. The correlational analysis between plasma of IL-6/TNF-α and metabolites suggested that acetylcholine, spermine, phenylalanine, threonine of plasma and phosphatidylcholine (36:4) of lung tissues were significantly associated with IL-6/TNF-α in CLP and CLP-ADMSCs groups. ADMSCs might reverse abnormal metabolic pathways by reducing anti-inflammatory factors in sepsis-induced ALI. Our findings may provide novel metabolic mechanism of ADMSCs therapy for sepsis.

An imaging system based on a polycapillary half-focusing X-ray lens (PHFXRL) and synchrotron radiation source has been designed. The focal spot size and the gain in power density of the PITIFXRL were 22 μm (FWHM) and 4648, respectively, at 14.0 keV. The spatial resolution of this new imaging system was better than 5 μm when an X-ray charge coupled device with a pixel size of 10.9 x 10.9 μm was used. A fossil of an ancient biological specimen was imaged using this system. [ABSTRACT FROM AUTHOR]

Three-dimensional flower-like BiOI/BiOX (X = Br or Cl) hybrids were synthesized via a facile one-pot solvothermal approach. With systematic characterizations by X-ray diffraction (XRD), scanning electron microscopy (SEM), Transmission electron microscopy (TEM), the Brunauer-Emmett-Teller (BET)specific surface area, X-ray photoelectron spectroscopy (XPS), and the UV-Vis diffuse reflectance spectra (DRS), the BiOI/BiOCl composites showed a fluffy and porous 3-D architecture with a large specific surface area (SSA) and high capability for light absorption. Among all the BiOX (X = Cl, Br, I) and BiOI/BiOX (X = Cl or Br) composites, BiOI/BiOCl stands out as the most efficient photocatalyst under both visible and UV light irradiations for methyl orange (MO) oxidation. The reaction rate of MO degradation on BiOI/BiOCl was 2.1 times higher than that on pure BiOI under visible light. Moreover, BiOI/BiOCl exhibited enhanced water oxidation efficiency for O2 evolution which was 1.5 times higher than BiOI. The enhancement of photocatalytic activity could be attributed to the formation of a heterojunction between BiOI and BiOCl, with a nanoporous structure, a larger SSA, and a stronger light absorbance capacity especially in the visible-light region. The in situ electron paramagnetic resonance (EPR) revealed that BiOI/BiOCl composites could effectively evolve superoxide radicals and hydroxyl radicals for photodegradation, and the superoxide radicals are the dominant reactive species. The superb photocatalytic activity of BiOI/BiOCl could be utilized for the degradation of various industrial dyes under natural sunlight irradiation which is of high significance for the remediation of industrial wastewater in the future.