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Objectives Background Materials and Methods Results Conclusions We seek to describe the current practice pattern use of prothrombin complex concentrate (PCC) and fibrinogen concentrate (FC) in trauma patients.Trauma‐induced coagulopathy (TIC) and endotheliopathy of trauma (EOT) contribute significantly to mortality from traumatic haemorrhage. FC, and 4‐factor PCC are potential treatments for EOT and TIC, respectively.We obtained data from the Trauma Quality Improvement Program (TQIP) registry and identified patients who received either PCC or FC using procedural codes. We used descriptive statistics to characterise practice patterns of these products.There were 6 714 002 total encounters within the TQIP from 2017 to 2022, of which 10 589 received PCC and 3009 received FC. Of the recipients, there were 35 that received both products. There were 44 that received both. The median age of PCC recipients was 77 (69–84) with 19 patients <15 years of age with the youngest being 2 years of age. There was a general upward trend in the number of facilities with documented use of PCC: 155/744, 168/766, 189/764, 206/780, 234/795, and 235/816, respectively. The median age of FC recipients was 57 (32–75) with 48 patients <15 years of age with the youngest being 1 year of age. There was a minor downward trend in the number of facilities that had documented use of FC: 55, 44, 39, 32, 38 and 40.The administration of PCC and FC remains uncommon, although there appears to be an upward trend of PCC use. Most PCC use appeared to be for anticoagulation reversal in the setting of head trauma. Data guiding the use of these products are necessary as these products become more recognised as adjuncts to traumatic haemorrhage control. [ABSTRACT FROM AUTHOR]

Aqueous zinc‐iodine (Zn─I2) battery is a promising energy storage system due to its inherent safety, high theoretical capacity, sustainability, and cost‐effectiveness. However, the shuttle effect of polyiodide severely affects the stable loading of active iodine and even accelerates the corrosion of the Zn anode, thus impeding its further advancement. Herein, a unique trimethylsulfonium cation (TMS+) with strong adsorption is proposed to stabilize both the iodine cathode and Zn anode. Benefiting from the robust interaction between TMS+ and polyiodide, the electrolyte can effectively immobilize large‐capacity iodine in the form of oily precipitate, thus avoiding the shuttle effect of polyiodide and the Zn corrosion. Additionally, TMS+ can be preferentially adsorbed on various Zn facets, inducing an electrostatic shielding effect to inhibit Zn dendrite growth. Consequently, Zn anode can be stably cycled over 3400 h at 5 mA cm−2/5 mAh cm−2, and a large areal capacity of 2.71 mAh cm−2 as well as long‐life stability over 6400 cycles is achieved for Zn─I2 battery. Furthermore, cation adsorption engineering is practically utilized in pouch cells, realizing superior fast‐charging stability over 790 cycles. This electrolyte modification with dual stabilizations is anticipated to be applied to other metal‐iodine batteries as a cost‐effective, facile, and safe strategy. [ABSTRACT FROM AUTHOR]

An engineered tetra‐amide macrocycle is presented, and its conformation and anion recognition properties are investigated. The tetra‐amide macrocycle 1, containing the m‐amino benzoic acid, 1,3‐benzenedicarboxylic acid and m‐xylenedinediamine adopts an envelope‐like conformation in solid‐state, where the m‐xylenedinediamine ring is perpendicular with the molecular plain. The tetra‐amide macrocycle 1 is able to bind anions such as halides, sulphate and phosphate in DMSO (dimethyl sulphoxide) solution. The stabilities of the fluoride (2.6×103 M−1) and chloride (5.6×102 M−1) complexes of 1 in DMSO is higher than that of bromide (66 M−1) and iodide (52 M−1). SO42− complexes of 1 in DMSO is more stable than the HSO4−, NO3− and H2PO4− complexes. Using this information, a quantitative evaluation of the stability of the 1 : 1 complex of 1, for which overall binding energy in the order −123.98 kcal/mol for SO42−was calculated. The strong binding affinity of the tetra‐amide macrocycle 1 toward the SO42− ion can be explained on the basis of non‐covalant interaction like ion−dipole interaction, hydrogen bonding interaction and size selectivity. [ABSTRACT FROM AUTHOR]

Advances in total hip arthroplasty (THA) have resulted in evolving revision indications and intraoperative techniques, which can influence the exposure of trainees to complex cases. We report 3 decades of revision experience from a tertiary referral center that trains fellows, comparing the reasons for revision and the complexity of revisions over time. We retrospectively reviewed all revision THAs performed at our institution from 1990 to 2022. Revision diagnoses, components revised, types of revision implants used, and exposure techniques were collected. A "complex" revision was defined as a case that involved an extended trochanteric osteotomy, triflange and cup-cage construct, or acetabular augment. A total of 3,556 THA revisions were identified (108 revisions/year). Aseptic loosening was the most common indication in 1990 to 1999 (45 per year), but decreased to 28.3/year in 2010 to 2019. From 1990 to 1999 and 2010 to 2019, fracture increased from 3.1 to 7.3 per year, infection from 2.9/year to 16.9/year, and metallosis from 0.1 to 13.2 per year. Both component revision were common from 1990 to 1994 (42.6 per year), while polyethylene exchange was most common in 2010 to 2019 (43.3 per year). A decrease was observed in "complex" cases over time: 14.8 extended trochanteric osteotomies/year in 2000 to 2004 compared to 5.4 per year in 2018 to 2022, 4.5 triflange and cup-cage constructs/year in 2004 to 2007 compared to 0.8 per year in 2018 to 2022, and 4 acetabular augments per year in 2009 to 2012 compared to 1 per year in 2018 to 2022. Indications for revision have changed over the decades, while the number of "complex" revisions has gradually decreased, presumably due to advances in implants and materials. If this trend extends to other training institutions, the next generation of arthroplasty surgeons will have less exposure to complex revisions during their training. [ABSTRACT FROM AUTHOR]

Four novel lanthanide La (III), Ce (III), Nd (III), and Dy (III) complexes with (Z)‐4‐(benzo[d]thiazol‐2‐ylamino)‐3‐((benzo[d]thiazol‐2‐ylimino)methyl)‐2H‐chromen‐2‐one (L) were prepared and characterized. The novel compounds' structural compositions were elucidated by the application of analytical and spectroscopic methodologies. From physical and chemical measurements, the general formula for the [LnLCl3]2H2O complexes (C1‐C4) was proposed, which was proven by theoretical measurements. Using cisplatin, gentamicin, ampicillin, and ascorbic acid as standards, the compound's anticancer, antibacterial, and antioxidant qualities were assessed, and activities followed the order: Ce (III)L(C2) > Nd (III)L(C3) > Dy (III)L(C4) > La (III)L(C1) > L where the Ce (III) complexes exhibited the highest activity followed by Nd (III) complexes. Molecular docking studies were performed using the MOA2022 software to identify putative binding mechanisms for the methionine adenosyl‐transferases in liver cancer (PDB ID: 5A19) and the most active site of the Bacillus subtilis receptor (PDB ID: 5e6k), where the strength of the interaction increases with the negative binding energy L ˂ [LaLCl3] ˂ [DyLCl3] ˂ [NdLCl3] ˂ [CeLCl3]. [ABSTRACT FROM AUTHOR]

Upstream frameshift 1 (UPF1) is an RNA helicase involved in a number of mRNA regulatory processes including nonsense-mediated decay. Mutations in the UPF1 locus that reduce its expression have been associated with adenosquamous carcinoma of the pancreas, a particularly aggressive form of the disease. To determine the effect of Upf1 suppression in a murine model of pancreatic adenocarcinoma, we silenced with shRNA Upf1 in cells derived from an autochthonous tumor in an LSL-KrasG12D/+; Trp53R172H/+; Pdx-1Cre/+ mouse (KPC) and orthotopically implanted these cells in the pancreas of C57BL/6 mice. Tumors derived from Upf1-deficient cells were markedly larger than those derived from control cells, a difference observed only in immunocompetent mice. The immune infiltrate of Upf1-deficient tumors was enriched in myeloid-derived suppressor cells (MDSCs) and depleted of CD8+ cells compared to control KPC tumors. Upf1-deficient KPC cells secreted inflammatory cytokines including G-CSF and CXCL2, known to recruit MDSCs. Cytokine secretion from Upf1-deficient KPC cells was induced by increased levels of mitochondrial reactive oxygen species (ROS), which in turn were due to an increase in complex I activity in the electron transport chain. Thus, Upf1 helicase deficiency leads to increased mitochondrial complex I activity which produces ROS that signals for cytokine release that drives immune suppression and enhanced tumor growth. [ABSTRACT FROM AUTHOR]

Background: Current local food environments encourage poor diets, posing a significant threat to public and planetary health. Acknowledging and addressing its inherent complexity is vital to making meaningful improvements to the food environment. Using a participatory approach with local stakeholders, this study aims to gain insight into the factors and mechanisms underlying the local food environment and to identify leverage points and system-based actions to foster healthy and sustainable local food environments. Methods: A systems-thinking approach was used in a Dutch municipality in 2022. Two group model building (GMB) workshops were held with community stakeholders (e.g. local policymakers, retailers and residents). During the first workshop (June 2022), factors and mechanisms influencing the local food environment were identified and visualized through a causal loop diagram (CLD). During the second workshop, leverage points and system-based actions to improve food environments were identified by the stakeholders. Four months after (October 2022), an action-implementation meeting was organized to stimulate the implementation of selected actions. Progress was monitored through brief telephone interviews 6 and 12 months after the second workshop. Results: The CLD visualises the factors and mechanisms influencing the local food environment from the point of view of the community stakeholders. The CLD consists of 46 factors shaping the local food environment, which were categorized into four identified subsystems: societal factors, individual, socio-economic factors, commercial factors and political factors. Eight leverage points were identified within the CLD, for example, 'lobby from food industry', 'governmental food policies' and 'e-commerce and platform economy'. Stakeholders formulated 20 actions targeting the identified leverage points. During the action-implementation meeting, long-term plans were created for five actions. After 1 year, only one participant (policy advisory role) remained actively engaged in three of these actions. Conclusions: This study yields insight into the numerous factors and mechanisms underlying the local food environment and identified system-based actions as perceived by local stakeholders to improve this food environment locally. The CLD offers stakeholders valuable insights on employing a systems approach when enhancing food environments. More research is necessary, especially into the long-term processes and effects of implementing system-oriented actions to improve local food environments. [ABSTRACT FROM AUTHOR]

Potentiometry and calorimetry are used to study Ce3+–glycine–ethylenediaminedisuccinic acid and La3+–glycine–ethylenediaminedisuccinic acid systems in aqueous solutions at T = 298.15 K (KNO3). The formation of a mixed-ligand complex is revealed, and the thermodynamic characteristics (ΔrH, ΔrG, ΔrS) of the complexation reaction are determined. [ABSTRACT FROM AUTHOR]

Background: 5% of patients account for the majority of healthcare spend, but standardized interventions for this complex population struggle to generate return on investment. The aim of this study is the development and proof of concept of an adaptive intervention to reduce cost and risk of readmission for medically high-risk individuals with any behavioral health diagnosis. Methods: A behaviorally-oriented, personalized care service was delivered using a consultative, team-based approach including a physician, counselor, dietitian and social worker in collaboration with nurse care coordinators. Iterative re-conceptualizations informed tailored treatment approaches to prevent acute decompensation while retraining behaviors that impeded recovery. This service was offered to a small set of members of the employee health plan at University Hospitals Cleveland with an existing behavioral health disorder from November of 2020 to March of 2023. 26 members receiving the service were identified and matched with 26 controls using a risk algorithm. Members and controls were then classified as high utilizers (n = 14) or standard utilizers (n = 38) based on utilization claims data. Results: Primary outcomes of this study included medical expenditures (delineated as planned and unplanned spend) and readmission risk scores. Compared to risk-matched controls, both planned and unplanned health care expenditures significantly decreased (p <.05) for 7 high utilizers, and unplanned spend only significantly decreased for 19 standard utilizers (p <.05). Risk scores, which predict future spend, decreased significantly for standard utilizers (p <.05), but not for high utilizers. Discussion: The value of a behaviorally-oriented personalized care intervention for medically high-risk patients in a commercial insurance population was demonstrated through decreased spend for high utilizers and decreased risk for standard utilizers. Further expansion, refinement, evaluation and scaling are warranted. [ABSTRACT FROM AUTHOR]

The zinc boron complex formation was studied as a function of temperature (25, 50 and 70 °C) in boric acid solutions of various concentration (0.25, 0.50 and 0.68 mol·kg−1). pH was monitored during zinc ion addition by galvanostatic dissolution of a zinc metal electrode, in a solution of boric acid. The determination of the complex formation showed the importance of an accurate model of the polyborate speciation, recalculated for this work based on the previous literature data mainly potentiometric measurements completed by Raman spectroscopy and Ab Initio calculations. Modelling of our experimental results, considering various scenarios of boric acid speciation, was performed using R and PhreeqC, suggesting the formation of an aqueous triborate-zinc (II) complex, ZnB 3 O 3 (OH) 4 (aq) + , according to the reaction: Zn 2 + + 3 B (OH) 3 ⇌ ZnB 3 O 3 (OH) 4 (aq) + + 2 H 2 O + H + . The nature and structure of this aqueous complex disagrees with the results reported previously in the literature. Three formation constants of the triborate-zinc (II) complex were determined at 25, 50 and 70 °C as log 10 K ZnB = − 4.73 ± 0.10, − 4.21 ± 0.16 and − 4.94 ± 0.12, respectively. The evolution of zinc boron complex formation as a function of temperature (between 25 and 70 °C) provides information on the effect of the polyborate predominance in the solution on the complexation of zinc. [ABSTRACT FROM AUTHOR]

Introduction: Jejunoileal Atresia exhibits a fluctuating survival rate, influenced by factors such as Low Birth Weight (LBW), Small Gestational Age (SGA), and sepsis. Our objective was to compare and identify prognostic factors between Simple and Complex Jejunoileal Atresia. Methods: This retrospective study involved the analysis of medical records from neonates with Jejunoileal atresia who underwent surgery at our hospital from January 2017 to April 2021. Results: We found 25 neonates, 12 males and 13 females. We discovered 9 patients with LBW, 7 with SGA, and 15 with preoperative sepsis. In terms of type, 11 patients have a simple type and 14 have a complex type; from location, 13 patients have Jejunal atresia and 12 have Ileal atresia. overall survival rate is 40%. The survival rate for Complex type is 4 patients (28.6%), whereas survival for Simple type is 6 patients (54,5%), although not significant (p=0.241). Significant only found in a location that jejunal has a worse prognosis(p=0,008). Prognostic factors such as LBW (p=0.229) has 2 survival patients (22,2%), SGA (p=0.179) only has 1 survivor (14,3%), but 5 of 6 patients are in the complex type and all die, the survival for preoperative sepsis are 6 patients (40%) (p=1.000). The shortest median survival is LBW in 39 days, sepsis increases after surgery to 22 patients (88%) with 14 patients dying from sepsis. Conclusion: The notably low survival rate observed in our study aligns with identified prognostic factors, emphasizing the need for further exploration and in-depth investigation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Theabrownins (TBs) are one of most important quality components in dark tea, but have not been produced industrially. In this study, the aqueous extract was obtained from Pu‐erh ripe tea, one kind of dark tea. Caffeine, theaflavin, catechin and saponin were removed by trichloromethane, ethyl acetate and n‐butanol in turn to obtain a TB isolate. The TB isolate was subjected to column chromatography using a macroporous resin HPD‐750 and eluted with a gradient of 0–700 g kg−1 ethanol aqueous solution. Four fractions were obtained, and named as TBs‐FC1, TBs‐FC2, TBs‐FC3 and TBs‐FC4. RESULTS: These four fractions contained polysaccharides and no small molecules such as catechins, caffeine and theaflavins as well as average molecular weights of 123.000 kDa, 23.380 kDa, 89.870 kDa and 106.600 kDa. It was revealed that they were complexes of TBs and tea polysaccharide conjugates (TPCs). Ultraviolet‐visible (UV‐visible) and infrared (IR) spectra showed the properties of TBs and TPCs. Their zeta potentials ranged from −13.40 mV to −38.80 mV in aqueous solutions at pH 3.0–9.0. CONCLUSION: This study reveals that TBs do not exist in free state but in combined state in dark tea, which provide the theoretical basis for the industrialization of TBs. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Rock glaciers are geomorphological features often used as a visible expression of mountain permafrost. These are creeping ice-debris with distinct ridge and furrow structures on the surface with a steep frontal slope. Rock glaciers, being the valuable past permafrost indicators, also have utmost hydrological significance in near future. Therefore, mapping of rock glaciers is an important step in order to understand permafrost regimes better. The Himalayas have large occurrences of these features and this study in Himachal Himalayas complied 789 rock glaciers, covering an area of about 336.2 km2. Different labels based on genesis, location, shape, form, surface relief and activity revealed rock glaciers were mainly derived from talus slopes (239) and exhibited tongue shape (377), primarily found in cirques (531). Most of them were classified as simple units (603) with well-developed surface relief (387), and they were found to be predominantly intact (760). The topographical parameters suggest majority of the rock glaciers are located between 4000 and 4800 m with mean elevation to be 4635 m. These rock glaciers are present at gentle to steep slope gradient (0 to 45°) with curvature ranging between −3.5 and 4.5, and majority showing convex curvature. The slope aspect conducive for formation of rock glaciers in Himachal is northerly (N, NW, NE). Principal geology for these rock glaciers belongs to slate, phyllite, quartzarenite, limestone and meta basics. The climatic parameters and indices also affect the rock glaciers occurrence significantly. The mean land surface temperature (LST) for majority rock glaciers lies between 0 and −15°C. While, the mean NDSI of all the rock glaciers varies from 0.04 to 0.68 and mean NDVI varies from −0.06 to 0.08. Overall, the inventory along with labels is a valuable database for understanding the distribution and characteristics of rock glaciers in the Himachal Himalayas. [ABSTRACT FROM AUTHOR]

Complicated appendicitis is associated with a higher risk of postoperative complications, including adhesive bowel obstruction. The aim of this meta-analysis is to investigate the difference in rates of postoperative bowel obstruction in paediatric patients with complicated versus simple appendicitis and whether this is influenced by the surgical approach. A systematic literature search following PRISMA guidelines was conducted using MEDLINE, Embase and Cochrane Library for studies that analysed incidence of adhesive bowel obstruction in paediatric patients after appendicectomy. Studies from 1998 to 2022 were included in analysis. The study protocol was registered on PROSPERO (ID CRD42022309769). Pooled analysis of 6 studies with low risk of bias and adequate follow up periods, considering 58,962 cases of appendicectomy, revealed complex appendicitis was associated with a near two-fold increase in incidence of SBO (pooled odds ratio 2.02 (95% CI 1.35–2.69)). Interestingly, a similar pooled analysis of 10 studies, considering 62,433 cases of appendicectomy, revealed no significant difference between open and laparoscopic management of complex appendicitis (pooled odds ratio 0.93 (95% CI 0.24 to 1.62)). Complex appendicitis is associated with a two-fold increase in the rates of adhesive bowel obstruction. Whilst there are cosmetic advantages of a laparoscopic approach, surgical expertise should be favoured in decision making relating to surgical approach (laparoscopic versus open) as the evidence for a laparoscopic approach reducing risks of adhesive bowel obstruction is not convincing. Level II. • What is currently known about this topic? Complex appendicitis is associated with increased risk of adhesive bowel obstruction and LA is preferred to OA to reduce rates of adhesive bowel obstruction. • What new information is contained in this article? Combined synthesis of more recent literature and evaluation for study bias reveals surgical approach does not appear to increase risk of adhesive bowel obstruction. [ABSTRACT FROM AUTHOR]

Anthocyanins are important secondary metabolites in many plant fruits and are excellent natural pigments with strong biological activities.However, anthocyanins are easily influenced by environmental and processing factors, leading to poor storage and processing stability.Therefore, in-depth research on the processing stability of anthocyanins and expanding their application areas has become a hot topic of concern both domestically and internationally.This article elaborated on the composition and structure of anthocyanins, investigated their stability in food, and provided a comprehensive review of domestic and international research progress on improving their stability.The aim is to provide a theoretical basis for the development and application of anthocyanins. [ABSTRACT FROM AUTHOR]

A new polyimine polymer (PL) containing sulphone functional groups was prepared from polycondensation of Schiff base (L) with terephthaloyl chloride at a very moderate condition. The polymer metal complexes were then synthesized from the reaction of polymer with metal salts. Scanning electron microscope (SEM), Fourier‐transform infrared spectroscopy (FTIR), X‐ray diffraction analysis (XRD), thermal gravimetric analysis (TGA), derivative thermogravimetry (DTG), proton nuclear magnetic resonance (1H NMR), and CHNS elemental analysis have been used to characterize all the synthesized materials. The excellent thermal stability of PL was specified by TGA. The optical features were assessed with the UV‐visible technique. The polymer complexes represent absorbance at the same wavelength as L and PL. The synthesized polymer metal complexes have a band gap varying from 3.19 (CuPL) to 2.77 (CdPL) eV. The inherent viscosities for the synthesized polymer is 0.4490 dL/g in DMF at 25 °C, indicating their moderate molecular weight. [ABSTRACT FROM AUTHOR]

ADP-ribosylation is a ubiquitous modification of proteins and other targets, such as nucleic acids, that regulates various cellular functions in all kingdoms of life. Furthermore, these ADP-ribosyltransferases (ARTs) modify a variety of substrates and atoms. It has been almost 60 years since ADP-ribosylation was discovered. Various ART structures have been revealed with cofactors (NAD+ or NAD+ analog). However, we still do not know the molecular mechanisms of ART. It needs to be better understood how ART specifies the target amino acids or bases. For this purpose, more information is needed about the tripartite complex structures of ART, the cofactors, and the substrates. The tripartite complex is essential to understand the mechanism of ADP-ribosyltransferase. This review updates the general ADP-ribosylation mechanism based on ART tripartite complex structures. [ABSTRACT FROM AUTHOR]

An INCOSE‐wide initiative has exposed at least 600 heuristics. Previous work indicates that rationalizing and simplifying this set to make it useful and memorable is difficult, if not intractable. Difficulty Assessment Tools (DATs) have been used for years to characterize the difficulty of a problem and provide tailored advice. This paper explores using a DAT to characterize the problem, and using the outputs to provide heuristic and other forms of advice. To test this approach, 50 heuristics and 10 principles were scored and embedded into an online DAT. An experiment was conducted to determine whether the DAT discussion, recommended approach, and heuristic/principles advice were useful. All teams considered the discussion very useful. As might be expected, the results indicated that the heuristic usefulness was a function of the teams' experience and familiarity with the task. The tool prioritization of suitable heuristics met developers' expectations, but was undetected by the users. This maybe because the heuristics were a hand‐picked set of 50 Heuristics from a set of 600+, meaning all were highly useful. Further work is proposed to check this assessment. The DAT usefulness results indicate that Systems Engineers should use the DAT to inform their approach throughout the lifecycle. [ABSTRACT FROM AUTHOR]

The INCOSE Complex Systems Working Group Heuristics Team has selected 67 Principles and Heuristics that are considered to be particularly relevant to Complex Systems. These have been incorporated into a Difficulty Assessment Tool that prioritizes the list of Principles and Heuristics based on scoring of a matrix of four Difficulty Elements and six System Elements (to characterize the nature of the complexity). The purpose of this paper is to describe an initial assessment of the effectiveness and usefulness of the Difficulty Assessment Tool. The Tool has been used to assess eight Case Studies by five assessment teams — one with three people working together, one with two people and the remaining three with individual assessments. The results of these assessments have been compared using four different correlation methods, using the total weighted Heuristic score, the maximum weighted Heuristic score, a Match / Mismatch analysis of the top fifteen and bottom seven Heuristics, and a difference ranking between pairs of assessors of all 67 Principles and Heuristics. The last two assessment methods are shown to be more insightful. The assessment teams then reviewed the relevance of the highest and lowest‐ranked Principles and Heuristics to the full Case Study definitions (Problem and Outcome). There is good agreement of relevance for the highest‐ranking Principles and Heuristics, less so for the lowest‐ranking ones. Based on this initial assessment, the DAT shows promise to help people develop complex systems. The paper concludes with recommendations for further assessment of the Difficulty Assessment Tool. [ABSTRACT FROM AUTHOR]

The novel hydrosoluble silver coordination polymer [Ag(NO3)(μ-1κN;2κN′,N″-TPMOH)]n (1) (TPMOH = tris(1H-pyrazol-1-yl)ethanol) was obtained and characterized. While single crystal X-ray diffraction analysis of compound 1 disclosed an infinite 1D helical chain structure in the solid state, NMR analysis in polar solvents confirmed the mononuclear nature of compound 1 in solution. Compound 1 and the analogue [Ag(μ-1κN;2κN′,N″-TPMS)]n (2) (TPMS = tris(1H-pyrazol-1-yl)methane sulfonate) were evaluated with regard to their antimicrobial activities towards the Gram-negative Escherichia coli, Pseudomonas aeruginosa, and Burkholderia contaminans, the Gram-positive Staphylococcus aureus, and the fungal species Candida albicans and Candida glabrata. Compound 1 exhibited minimal inhibitory concentration (MIC) values ranging from 2 to 7.7 µg/mL towards the tested Gram-negative bacteria, 18 µg/mL towards the Gram-positive S. aureus, and 15 and 31 µg/mL towards C. albicans and C. glabrata, respectively. Compound 2 was less effective towards the tested bacteria, with MIC values ranging from 15 to 19.6 µg/mL towards the Gram-negative bacteria and 51 µg/mL towards S. aureus; however, it was more effective against C. albicans and C. glabrata, with MIC values of about 6 µg/mL towards these fungal species. The toxicity of compounds 1 and 2 was assessed by evaluating the survival of the Caenorhabditis elegans model organism to concentrations of up to 100 µg/mL. The value of 50% lethality (LD50) could only be estimated as 73.2 µg/mL for compound 1 at 72 h, otherwise LD50 was >100 µg/mL for both compounds 1 and 2. These results indicate compounds 1 and 2 as novel silver complexes with interesting antimicrobial properties towards bacterial and fungal pathogens. [ABSTRACT FROM AUTHOR]

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Objective: This study was to prepare solid dispersions of lidocaine (Lid) with 5-sulfosalicylic acid dihydrate (SSA) by freeze-drying (freeze-dried [FD] Lid/SSA = 1/1) and to evaluate their physical properties. Methods: Here, we evaluated the physicochemical properties and solubility of solid dispersions of Lid and SSA prepared by freeze-drying (freeze-dried [FD] Lid/SSA = 1/1). Results: Differential scanning calorimetry measurements showed that after freeze-drying, the endothermic peak due to Lid melting, the dehydration peak, and the endothermic peak due to SSA melting disappeared. Powder X-ray diffraction results showed that the characteristic Lid and SSA peaks disappeared after freeze-drying, indicating a halo pattern. The near-infrared spectroscopy results suggested that Lid-derived –NH and –CH groups and the Lid-derived –OH and –CH groups from the SSA peak shifted and broadened after freeze-drying, suggesting their involvement in complex formation through Lid/SSA intermolecular interactions. Nuclear Overhauser effect spectroscopy-nuclear magnetic resonance (NMR) measurements showed a cross-peak due to the interaction between the Lid-derived –CH group and the SSA-derived –OH group, suggesting hydrogen bonding. Diffusion-ordered spectroscopy NMR measurements showed that the diffusion coefficients of Lid and SSA aggregated in FD Lid/SSA, suggesting a change in Lid dispersibility in the solvent owing to the formation of a complex with SSA. The solubility of FD Lid/SSA was approximately 88 mg/mL (∼20-fold higher than that of Lid). Conclusions: These findings suggest that complex formation occurred in FD Lid/SSA; this enhanced the solubility of this dispersion. [ABSTRACT FROM AUTHOR]

Abstract Background Current local food environments encourage poor diets, posing a significant threat to public and planetary health. Acknowledging and addressing its inherent complexity is vital to making meaningful improvements to the food environment. Using a participatory approach with local stakeholders, this study aims to gain insight into the factors and mechanisms underlying the local food environment and to identify leverage points and system-based actions to foster healthy and sustainable local food environments. Methods A systems-thinking approach was used in a Dutch municipality in 2022. Two group model building (GMB) workshops were held with community stakeholders (e.g. local policymakers, retailers and residents). During the first workshop (June 2022), factors and mechanisms influencing the local food environment were identified and visualized through a causal loop diagram (CLD). During the second workshop, leverage points and system-based actions to improve food environments were identified by the stakeholders. Four months after (October 2022), an action-implementation meeting was organized to stimulate the implementation of selected actions. Progress was monitored through brief telephone interviews 6 and 12 months after the second workshop. Results The CLD visualises the factors and mechanisms influencing the local food environment from the point of view of the community stakeholders. The CLD consists of 46 factors shaping the local food environment, which were categorized into four identified subsystems: societal factors, individual, socio-economic factors, commercial factors and political factors. Eight leverage points were identified within the CLD, for example, ‘lobby from food industry’, ‘governmental food policies’ and ‘e-commerce and platform economy’. Stakeholders formulated 20 actions targeting the identified leverage points. During the action-implementation meeting, long-term plans were created for five actions. After 1 year, only one participant (policy advisory role) remained actively engaged in three of these actions. Conclusions This study yields insight into the numerous factors and mechanisms underlying the local food environment and identified system-based actions as perceived by local stakeholders to improve this food environment locally. The CLD offers stakeholders valuable insights on employing a systems approach when enhancing food environments. More research is necessary, especially into the long-term processes and effects of implementing system-oriented actions to improve local food environments.

Abstract Background 5% of patients account for the majority of healthcare spend, but standardized interventions for this complex population struggle to generate return on investment. The aim of this study is the development and proof of concept of an adaptive intervention to reduce cost and risk of readmission for medically high-risk individuals with any behavioral health diagnosis. Methods A behaviorally-oriented, personalized care service was delivered using a consultative, team-based approach including a physician, counselor, dietitian and social worker in collaboration with nurse care coordinators. Iterative re-conceptualizations informed tailored treatment approaches to prevent acute decompensation while retraining behaviors that impeded recovery. This service was offered to a small set of members of the employee health plan at University Hospitals Cleveland with an existing behavioral health disorder from November of 2020 to March of 2023. 26 members receiving the service were identified and matched with 26 controls using a risk algorithm. Members and controls were then classified as high utilizers (n = 14) or standard utilizers (n = 38) based on utilization claims data. Results Primary outcomes of this study included medical expenditures (delineated as planned and unplanned spend) and readmission risk scores. Compared to risk-matched controls, both planned and unplanned health care expenditures significantly decreased (p

Human cytochrome P450 3A4 (CYP3A4) is a major drug-metabolizing enzyme that shows extreme substrate promiscuity. Moreover, its large and malleable active site can simultaneously accommodate several substrate molecules of the same or different nature, which may lead to cooperative binding and allosteric behavior. Due to difficulty of crystallization of CYP3A4-substrate complexes, it remains unknown how multiple substrates can arrange in the active site. We determined crystal structures of CYP3A4 bound to three and six molecules of caffeine, a psychoactive alkaloid serving as a substrate and modulator of CYP3A4. In the ternary complex, one caffeine binds to the active site suitably for C8-hydroxylation, most preferable for CYP3A4. In the senary complex, three caffeine molecules stack parallel to the heme with the proximal ligand poised for 3-N-demethylation. However, the caffeine stack forms extensive hydrophobic interactions that could preclude product dissociation and multiple turnovers. In both complexes, caffeine is also bound in the substrate channel and on the outer surface known as a peripheral site. At all sites, aromatic stacking with the caffeine ring(s) is likely a dominant interaction, while direct and water-mediated polar contacts provide additional stabilization for the substrate-bound complexes. Protein-ligand interactions via the active site R212, intrachannel T224, and peripheral F219 were experimentally confirmed, and the latter two residues were identified as important for caffeine association. Collectively, the structural, spectral, and mutagenesis data provide valuable insights on the ligand binding mechanism and help better understand how purine-based pharmaceuticals and other aromatic compounds could interact with CYP3A4 and mediate drug-drug interactions.

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Abstract A new 3D metal–organic frameworks [Cd6(L)4(bipy)3(H2O)2·H2O] (1) was gained by employing Cd(II) and organic ligand [H3L = 4,4′,4′′-(benzene-1,3,5-triyltris(oxy))tribenzoic acid)benzene acid; bipy = 4,4′-bipyridine] in the solvothermal condition, which has been fully examined via single-X ray diffraction, FTIR and elemental analysis and so on. Using natural polysaccharides hyaluronic acid (HA) and carboxymethyl chitosan (CMCS) as raw materials, we successfully prepared HA/CMCS hydrogels and observed their internal micromorphology by scanning electron microscopy. Using doxorubicin (Dox) as a drug model, we synthesized a novel metal gel particle loaded with doxorubicin, and their encapsulation and release effects were studied using fluorescence spectroscopy, followed by further investigation of their components through thermogravimetric analysis. Based on this, the therapeutic effect on leukemia was evaluated. Finally, an enhanced learning method for automatically designing new ligand structures from host ligands was proposed. Through generative modeling and molecular docking simulations, the biological behavior of the host and predicted cadmium complexes was extensively studied.

Objective(s): Prescription of ibuprofen as a non-steroidal anti-inflammatory drug is limited by its gastrointestinal side effects and poor aqueous solubility. It was shown that phospholipid-association (PA) can lead to assembling assembly of the micellar form, thereby improving solubility of non-steroidal anti-inflammatory drugs solubility and reducing their gastrointestinal side effects. Materials and Methods: Ibuprofen in PA form was prepared and its interaction, crystallinity, and particle size were evaluated. Conventional ibuprofen and PA pellets in different drug contents were prepared by extrusion-spheronization. The mMorphology, shape factors, mechanical strength, and drug content of pellets were investigated. The dissolution test also was conducted in an intestinal-simulated medium and a gastric-simulated medium. Results: The results showed that PA micelles of ibuprofen were demonstrated to be formed, amorphous, and in an acceptable size range. Using a suitable composition of solid components and granulation fluid, pellets with desirable size, shape, and sphericity could be produced. All pellets have had plastic mechanical properties and the strength of formulations were decreased with increasing PA ratio. The PA-pellet formulation had faster drug release compared to conventional ibuprofen pellets, via increasing ibuprofen solubility by reducing crystallinity in solid state and micelle formation in dissolution media. Moreover, ibuprofen solubility in a gastric-simulated medium was decreased and might result in reduced gastrointestinal side effects.Conclusion: Due to the demonstrated bioavailability advantages of PA-pellets, they can be considered for further studies.

In the Social Housing Project in La Florida, San Diego Complex, and Townhouses Lo Recabarren, the question of collectivity is addressed in the design of the elements and spatial dynamics of accesses, both to the complex and between units. Generous circulation spaces, materialities that encourage visual interaction, the strategic placement of individual units vis-à-vis communal areas; in all these works, and in their diverse conditions, it is within the realm of access and circulation spaces where design decisions seamlessly extend the space of leisure and recreation from the confines of the dwelling unit to the heart of the common space, fostering more forms of living together.

A new iron(III) complex (Et3NH)2[Fe(L)2](ClO4)·MeOH (1) where H2L = 2-{(E)-[2-hydroxyphenyl)imino]methyl}phenol has been synthesised and characterised by single crystal XRD, elemental analysis and DC magnetic susceptibility measurements. The dianionic ligands L2− coordinate in a tridentate fashion with the Fe(III) through their deprotonated phenolic oxygens and azomethine nitrogen atoms, resulting in a trans-FeO4N2 chromophore. Variable-temperature magnetic measurements were performed between 300 and 5 K under an applied field of 0.1 T and show that 1 is in the high spin state (S = 5/2) over the whole measured temperature range. This is confirmed by Mössbauer spectroscopy at 77 and 300 K. [ABSTRACT FROM AUTHOR]

UNC-51-like kinase 1( ULK1) is an important factor involved in regulating the initiation of autophagy. ULK1 regulates inflammatory cytokines through autophagy and mitochondrial oxidative stress, and is involved in the pathological processes of various diseases. ULK1 and its complexes are regulated by rapamycin( mTOR) and AMP-activated protein kinase( AMPK) to initiate autophagy, thereby exerting differential effects on a variety of inflammatory diseases. In inflammatory diseases, mitochondrial oxidative stress can induce ULK1 into the nucleus to accelerate apoptosis. Therefore, ULK1 plays different important roles in inflammatory diseases. For example, ULK1 initiates airway epithelial mitochondrial autophagy in asthma, participates in mitochondrial oxidative stress in acute liver failure, affects related inflammatory factors in atherosclerosis, and modulates beneficial effects of autophagy in diabetes. This article reviews the biological function of ULK1, its impact on inflammatory diseases and the research progress of targeted drugs. [ABSTRACT FROM AUTHOR]

Purpose The complexity of patients with mental healthcare needs cared for by clinical pharmacists is not well delineated. We evaluated the complexity of patients with schizophrenia, bipolar disorder, and major depressive disorder (MDD) in Veterans Affairs (VA) cared for by mental health clinical pharmacist practitioners (MH CPPs). Methods Patients at 42 VA sites with schizophrenia, bipolar disorder, or MDD in 2016 through 2019 were classified by MH CPP visits into those with 2 or more visits ("ongoing MH CPP care"), those with 1 visit ("consultative MH CPP care"), and those with no visits ("no MH CPP care"). Patient complexity for each condition was defined by medication regimen and service utilization. Results For schizophrenia, more patients in ongoing MH CPP care were complex than those with no MH CPP care, based on all measures examined: the number of primary medications (15.3% vs 8.1%), inpatient (13.7% vs 9.1%) and outpatient (42.6% vs 29.7%) utilization, and receipt of long-acting injectable antipsychotics (36.7% vs 25.8%) and clozapine (20.5% vs 9.5%). For bipolar disorder, more patients receiving ongoing or consultative MH CPP care were complex than those with no MH CPP care based on the number of primary medications (27.9% vs 30.5% vs 17.7%) and overlapping mood stabilizers (10.1% vs 11.6% vs 6.2%). For MDD, more patients receiving ongoing or consultative MH CPP care were complex based on the number of primary medications (36.8% vs 35.5% vs 29.2%) and augmentation of antidepressants (56.1% vs 54.4% vs 47.0%) than patients without MH CPP care. All comparisons were significant (P < 0.01). Conclusion MH CPPs provide care for complex patients with schizophrenia, bipolar disorder, and MDD in VA. [ABSTRACT FROM AUTHOR]

Baicalin and berberine are biologically active constituents of the crude drugs Scutellaria root and Coptis rhizome/Phellodendron bark, respectively. Baicalin and berberine are reported to combine together as a 1:1 complex that forms yellow precipitates by electrostatic interaction in decoctions of Kampo formulae containing these crude drugs. However, the structural basis and mechanism for the precipitate formation of this compound–compound interaction in aqueous solution remains unclarified. Herein, we searched for berberine derivatives in the Coptis rhizome that interact with baicalin and identified the chemical structures involved in the precipitation formation. Precipitation assays showed that baicalin formed precipitates with berberine and coptisine but not with palmatine and epiberberine. Thus, the 2,3-methylenedioxy structure may be crucial to the formation of the precipitates, and electrostatic interaction is necessary but is not sufficient. In this multicomponent system experiment, palmatine formed a dissociable complex with baicalin and may competitively inhibit the formation of berberine and coptisine precipitation with baicalin. Therefore, the precipitation formed by berberine and baicalin was considered to be caused by the aggregation of the berberine–baicalin complex, and the 2,3-methylenedioxy structure is likely crucial to the aggregation of the complex. [ABSTRACT FROM AUTHOR]

In this work, A novel novel cadmium (II) co-crystal binary coordination compound with 3-FBINH ligand and nitrate anionic ligand were synthesized and characterized. The structure of co-crystal (3-FBINH is the abbreviation of 3-flouro benzylidene iso nicotine hydrazide) ([Cd (3-FBINH)2 (NO3)2 (H2O)] [Cd (3-FBINH)2 (NO3) (C2H6O) (H2O)].NO3 (1) was characterized by single-crystal X-ray analysis. The X-ray structure revealed that the compound has two Cd (II) metal centers with 7 and 6 coordination numbers. The adjacent frameworks connected by labile interactions like strong hydrogen -bonding interactions, CH ...π interactions CH ...CH interactions that the self-assembly occurs in the structure. Consequently, the labile interactions also allow the structure to form a 3D supramolecular coordination system. Cd O nanoparticles were obtained by thermolysis of 1 at 550 °C. The morphology and size of the prepared Cd O nanoparticles were further studied using SEM and XRD. [ABSTRACT FROM AUTHOR]

Soil cadmium (Cd) contamination has emerged as a significant global environmental concern, posing numerous risks to individual organisms and entire ecosystems. Concurrently, the global increase in pesticide usage has elevated the influx of chloride ions (Cl-) into the soil. Given Cl-'s robust ability to coordinate and complex with various heavy metal ions, understanding its influence on the migration and transformation of Cd in soil-rice systems is essential for the rational application of pesticides and the effective mitigation of soil heavy metal pollution. In this paper, we explained the effect of Cl- on the environmental behavior of Cd in the soil-rice system in terms of growth traits, Cd uptake and accumulation by rice, and Cd solid-solution phase interface behavior through pot experiments and sand culture experiments. The results showed that Cd concentrations in all parts of the rice treated with CaCl2 during the filling period were lower than those in the Ca(NO3)2-treated group, with Cd accumulation diminishing as Cl- concentration increased. This suggests that the filling period is critical for Cd uptake and accumulation in rice. Unlike the accompanying anion NO3 -, exogenous Cl- reduced Cd concentrations in the soil solution but increased them in rice. Notably, when the Cd/Cl ratio ranged from 0.625 to 2.5, Cl- formed predominantly CdCl+-complexes with free Cd2+ in the soil solution, enhancing the mobilization of Cd bound to soil particles and its subsequent absorption by rice. This study aims to assess Cl-'s effect on Cd migration and transformation in soil-rice systems, providing insights for safe rice production on Cd-contaminated soils and rational use of chlorine-containing pesticides. [ABSTRACT FROM AUTHOR]

A new 3D metal–organic frameworks [Cd6(L)4(bipy)3(H2O)2·H2O] (1) was gained by employing Cd(II) and organic ligand [H3L = 4,4′,4′′-(benzene-1,3,5-triyltris(oxy))tribenzoic acid)benzene acid; bipy = 4,4′-bipyridine] in the solvothermal condition, which has been fully examined via single-X ray diffraction, FTIR and elemental analysis and so on. Using natural polysaccharides hyaluronic acid (HA) and carboxymethyl chitosan (CMCS) as raw materials, we successfully prepared HA/CMCS hydrogels and observed their internal micromorphology by scanning electron microscopy. Using doxorubicin (Dox) as a drug model, we synthesized a novel metal gel particle loaded with doxorubicin, and their encapsulation and release effects were studied using fluorescence spectroscopy, followed by further investigation of their components through thermogravimetric analysis. Based on this, the therapeutic effect on leukemia was evaluated. Finally, an enhanced learning method for automatically designing new ligand structures from host ligands was proposed. Through generative modeling and molecular docking simulations, the biological behavior of the host and predicted cadmium complexes was extensively studied. [ABSTRACT FROM AUTHOR]

This review presents an overview of the biological applications of coordinative compounds based on unsaturated carboxylates accompanied by other ligands, usually N-based heterocyclic species. The interest in these compounds arises from the valuable antimicrobial and antitumor activities evidenced by some species, as well as from their ability to generate metal-containing polymers suitable for various medical purposes. Therefore, we describe the recently discovered aspects related to the synthesis, structure, and biological activity of a wide range of unsaturated carboxylate-containing species and metal ions, originating mostly from 3d series. The unsaturated carboxylates encountered in coordinative compounds are acrylate, methacrylate, fumarate, maleate, cinnamate, ferulate, coumarate, and itaconate. Regarding the properties of the investigated compounds, it is worth mentioning the good ability of some to inhibit the development of resistant strains or microbial biofilms on inert surfaces or, even more, exert antitumor activity against resistant cells. The ability of some species to intercalate into DNA strands as well as to scavenge ROS species is also addressed. [ABSTRACT FROM AUTHOR]

Oil/water (O/W) emulsions were prepared using the complex of quarternized cellulose nanofiber (QCNF) and octanoyl gelatin (OC−Gel) as an emulsifier, and the effect of pH value on their stability was investigated. OC−Gel was prepared through a condensation reaction, confirmed by 1H Nuclear Magnetic Resonance (NMR) and Fourier Transform Infrared (FT−IR) spectroscopy. It reduced air/water interfacial tension more effectively than unmodified gelatin. The complexation degree of OC−Gel and QCNF, measured by optical density, showed its maximum at a QCNF/OC−Gel mass ratio of 1/8 when the pH value of the medium was 7.4, and it increased in a saturated manner with increasing pH value. The signals of QCNF were found in the FT−IR and X−ray diffraction spectra of the complex, suggesting that the positively charged CNF were included in the OC−Gel−based complex. The complex formed a rough surface with smooth debris because the surface roughness of the complex aggregation reflected that of both QCNF and OC−Gel aggregation. QCNF could stabilize oil droplets to form a Pickering O/W emulsion. The complex of QCNF/OC−Gel was also a good emulsifier. QCNF and the complex were as potent as OC−Gel in emulsifying mineral oil in water. Most of the droplets fell within 5–25 µm, regardless of what the emulsifier was. The emulsion stabilized with OC−Gel increased in its oil droplet size more than two times in 20 days at all the pH vales tested (pH 3, 5, 7.4, 9), whereas the emulsion stabilized with QCNF remained almost constant in size during the same period regardless of the pH values. The droplet size of emulsion stabilized with the QCNF/OC−Gel complex did not change appreciably when the pH value was 5, 7.4, and 9. The complex seemed to act as a capsule wall and prevent the coalescence of the droplets. However, it increased dramatically due to the coalescence at pH 3, possibly because the complex could be dissolved under a strong acidic condition. [ABSTRACT FROM AUTHOR]

Palladium-catalyzed heterylation of monobromophenyl-substituted zinc(II) porphyrin with small heterocycles (benzothiazole, benzoxazole, and N-methylbenzimidazole) was carried out. As a result, unsymmetrical heterylphenyl-substituted zinc(II) porphyrins soluble in organic solvents were obtained. The interaction of heteryl-substituted zinc(II) porphyrins with alpha-helical proteins was studied by spectral methods using bovine serum albumin in aqueous organic solvents. It was found that the titration of the zinc(II) porphyrins with albumin in a sodium phosphate buffer involves a number of equilibria including complexation and aggregation. In the case of porphyrins containing N-methylbenzimidazole and benzoxazole residues, self-aggregation processes initiated by absorption of organic solvent molecules by the protein predominate. It was found that more hydrophobic nature of zinc(II) porphyrin with benzothiazole residue promotes the complex formation with the protein. The photochemical properties of zinc(II) porphyrin with a benzothiazole residue, capacity for the photooxidation of the alpha-helical protein, and the high affinity of protein to this porphyrin make it a promising candidate for the potential applicability for photodynamic inactivation. [ABSTRACT FROM AUTHOR]

Clinicians employ two main cognitive approaches for diagnoses, depending on their expertise. Novices typically use linear hypothetico-deductive methods, while experts rely more on intuitive pattern recognition. These closely correspond to System 1 and System 2 thinking described in behavioral economics. We propose that complex cases additionally require the cognitive skill of synthesis, to visualize and understand the connections between various elements. To illustrate the concept, we describe a 60-year-old individual with a 6 h history of chest pain, fever, cough, accompanying chronic heart failure, atrial fibrillation, COPD, thyrotoxicosis, and ischemic heart disease. Faced with such a scenario, a bedside approach adapted by clinicians is to generate a list of individual diagnoses or pathways of pathogenesis, and address them individually. For example, this cluster could include: smoking causing COPD, IHD leading to chest pain and heart failure, and thyrotoxicosis causing atrial fibrillation (AF). However, other interconnections across pathways could be considered: smoking contributing to IHD; COPD exacerbating heart failure; IHD and pneumonia triggering atrial fibrillation; thyrotoxicosis and AF, independently worsening heart failure; COPD causing hypoxemia and worsening ventricular function. The second cluster of explanation offers a richer network of relationships and connections across disorders and pathways of pathogenesis. This cognitive process of creatively identifying these relationships is synthesis, described in Bloom's taxonomy of the cognitive domain. It is a crucial skill required for visualizing a comprehensive and holistic view of a patient. The concept of synthesis as a cognitive skill in clinical reasoning warrants further exploration. [ABSTRACT FROM AUTHOR]

A 0D Cu-based complex (1) (Cu(L)2(EDA)2]n, L = 3-phenylpropylmalonic acid, EDA = ethylenediamine) is synthesized by the solvent-thermal synthesis using 3-phenylpropylmalonic acid as the ligand. It is characterized and analyzed by powder X-ray diffraction, IR and UV diffuse reflectance spectroscopy, and other techniques. Complex 1 crystallizes in the triclinic crystal system with space group , and each Cu2+ is coordinated with two ligands and a water molecule, respectively. The cyclic voltammetry curve of the electrode modified by 1 (1+CPE) is tested in the PBS buffer solution (pH = 6.5). The found pair of reversible redox peaks belonging to Cu(II)/Cu(I) prove that 1 can be used in electrochemical applications. [ABSTRACT FROM AUTHOR]