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The enzyme-hydrolysis of Acalypha hispida plant leaves for the synthesis of nanocellulose remains underexplored, yet it holds significant potential due to its biocompatibility, eco-friendliness, and the exceptional physical and biochemical properties. This innovative method employed the enzyme xylanase, produced by an indigenous strain of Bacillus pumilus, isolated from a compost pile sample and identified through 16S rRNA sequencing. The xylanolytic activity of the isolate was confirmed by the clear hydrolysis zones around bacterial colonies on xylan agar. The enzyme was purified using ammonium sulfate precipitation followed by dialysis, with a molecular weight of 45 kDa determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The purified xylanase was then utilized for enzyme-hydrolyzed nanocellulose (EHNC) synthesis. EHNC stands out for its green processing, biocompatibility, biodegradability, and low production cost. The resulting EHNC exhibited particle diameters ranging from 15 to 40 nm, with a zeta potential of -22.3 mV. The minimal enzyme concentrations and short incubation periods suggest significant potential for enzymatic applications in the production of nanofibrillated cellulose, offering an efficient and sustainable approach to manufacturing advanced nanocellulose-based materials., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The reckless use of non-replenishable fuels by the growing population for energy and the resultant incessant emissions of hazardous gases and waste products into the atmosphere have insisted that scientists fabricate materials capable of managing these global threats at once. In recent studies, photocatalysis has been employed to focus on utilizing renewable solar energy to initiate chemical processes with the aid of semiconductors and highly selective catalysts. A wide range of nanoparticles has showcased promising photocatalytic properties. Metal nanoclusters (MNCs) with sizes below 2 nm, stabilized by ligands, show discrete energy levels and exhibit unique optoelectronic properties, which are vital to photocatalysis. In this review, we intend to compile information on the synthesis, true nature, and stability of the MNCs decorated with ligands and the varying photocatalytic efficiency of metal NCs concerning changes in the aforementioned domains. The review discusses the photocatalytic activity of atomically precise ligand-protected MNCs and their hybrids in the domain of energy conversion processes such as the photodegradation of dyes, the oxygen evolution reaction (ORR), the hydrogen evolution reaction (HER), and the CO 2 reduction reaction (CO 2 RR).

Objective: To determine Inpatient Rehabilitation Facility (IRF) treatment effect on modified Rankin Scale (mRS) scores at 90 days in acute ischemic stroke (AIS) patients., Materials and Methods: This prospective cross-sectional study included 738 AIS patients admitted 1/1/2018-12/31/2020 to a Comprehensive Stroke Center with a Stroke Rehabilitation program. We compared outcomes for patients who went directly home versus went to IRF at hospital discharge: (1) acute care length of stay (LOS), (2) National Institutes of Health Stroke Scale (NIHSS) score, (3) mRS score at hospital discharge and 90 days, (4) the proportion of mRS scores ≤ 2 from hospital discharge to 90 days., Results: Among 738 patients, 499 went home, and 239 went to IRF. IRF patients were more likely to have increased acute LOS (10.7 vs 3.9 days; t-test, P<0.0001), increased mean NIHSS score (7.8 vs 4.8; t-test, P<0.0001) and higher median mRS score (3 vs 1, t-test, P<0.0001) compared to patients who went home. At 90 days, ischemic stroke patients who received IRF care were more likely to progress to a mRS ≤ 2 (18.7% increase) compared to patients discharged home from acute care (16.3% decrease). Home patients experienced a one-point decrease in mRS at 90 days compared to those who received IRF treatment (median mRS of 3 vs. 2, t-test, P<0.05)., Conclusions: In ischemic stroke patients, IRF treatment increased the likelihood of achieving mRS ≤ 2 at 90 days indicating the ability to live independently, and decreased the likelihood of mRS decrease, compared with patients discharged directly home after acute stroke care., Competing Interests: Declaration of Competing Interest None, (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Fibrous capsules (Fb) in response to cardiovascular implantable electronic devices (CIEDs), including a pacemaker (P) system, can produce patient discomfort and difficulties in revision surgery due partially to their increased compressive strength, previously linked to elevated tissue fibers., Objective: A preliminary study to quantify structural proteins, determine if biologic extracellular matrix-enveloped CIEDs (PECM) caused differential Fb properties, and to implement a realistic mechanical model., Methods: Retrieved Fb (-P and -PECM) from minipigs were subjected to biomechanical (shear oscillation and uniaxial compression) and histological (collagen I and elastin) analyses., Results: Fb-PECM showed significant decreases compared to Fb-P in: low strain-loss modulus (390 vs. 541 Pa) across angular frequencies, high strain-compressive elastic modulus (1043 vs. 2042 kPa), and elastic fiber content (1.92 vs. 3.15 μg/mg tissue). Decreases in elastin were particularly noted closer to the implant's surface (Fb-PECM = 71% vs. Fb-P = 143% relative to dermal elastin at mid-tangential sections) and verified with a solid mechanics hyperelasticity with direction-dependent fiber viscoelasticity compression simulation (r2 ≥ 98.9%)., Conclusions: The biologic envelope composed of decellularized porcine small intestine submucosa ECM for CIEDs promoted fibrous tissues with less elastic fibers. Novel compression modeling analyses directly correlated this singular reduction to more desirable subcutaneous tissue mechanics.

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer related death in the world. The early detection and removal of CRC precursor lesions has been shown to reduce the incidence of CRC and cancer-related mortality. Endoscopic resection has become the first-line treatment for the removal of most precursor benign colorectal lesions and selected malignant polyps. Detailed lesion assessment is the first critical step in the evaluation and management of colorectal polyps. Polyp size, location and both macro- and micro- features provide important information regarding histological grade and endoscopic resectability. Benign polyps and even malignant polyps with superficial submucosal invasion and favorable histological features can be adequately removed endoscopically. When compared to surgery, endoscopic resection is associated with lower morbidity, mortality, and higher patient quality of life. Conversely, malignant polyps with deep submucosal invasion and/or high risk for lymph node metastasis will require surgery. From a practical standpoint, the most appropriate strategy for each patient will need to be individualized, based not only on polyp- and patient-related characteristics, but also on local resources and expertise availability. In this review, we provide a broad overview and present a potential decision tree algorithm for the evaluation and management of colorectal polyps that can be widely adopted into clinical practice., Competing Interests: Conflict-of-interest statement: Dennis Yang: Consultant for Boston Scientific, Lumendi; Steris Peter V Draganov: Consultant for Boston Scientific, Cook Medical, Olympus America, Lumendi, Microtech, Merit, Fujifilm., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Main group metal based catalysis has been considered to be a cost-effective alternative way to the transition metal based catalysis, due to the high abundance of main group metals in the Earth's crust. Among the main group metals, aluminum is the most abundant (7-8%) in the Earth's crust, making the development of aluminum based catalysts very attractive. So far, aluminum based compounds have been popularly used as Lewis acids in a variety of organic reactions, but chemical transformation demanding a redox based process has never utilized an Al(III) complex as a catalyst. Herein, we tuned the redox noninnocence behavior of a phenalenyl ligand by coupling with Al(III) ion, which subsequently can store the electron upon reduction with K to carry out direct C-H arylation of heteroarenes/mesitylene at ambient temperature. A mechanistic investigation revealed that a three-electron reduced phenalenyl based triradical aluminum(III) complex plays the key role in such catalysis. The electronic structure of the catalytically active triradical species has been probed using EPR spectroscopy, magnetic susceptibility measurements, and electronic structure calculations using a DFT method.

Background: Children admitted to the general care floor sometimes require acute escalation of care and rapid transfer (RT) to the PICU shortly after admission. In this study, we aim to investigate the characteristics of RTs and the impact RTs have on patient outcomes, including PICU length of stay (LOS), mortality, and emergency transfer defined as critical care interventions occurring within 1 hour on either side of transfer to the PICU., Methods: We conducted a 2-year, single-center, retrospective analysis including all patients admitted to the general care floor of a tertiary children's hospital that were subsequently transferred to the PICU, with attention to those transferred within 4 hours of admission, meeting criteria as RTs. Patient-level data and outcomes were tracked. Statistical summaries were stratified by RT or non-RT strata and between-strata comparisons were performed. Significant univariate factors were entered into a multivariate logistic regression model and reduced with statistical significance required for final model inclusion., Results: Of 450 patients with an unplanned PICU transfer, 105 (23.3%) experienced RTs. Significant factors in the reduced multivariate logistic regression model associated with decreased risk for RT were increased baseline Pediatric Overall Performance Category ( P = .046) and PICU origin of admission ( P = .012). RT patients had shorter PICU LOSs (2.8 vs 5.5 days, P < .001) compared with non-RT patients despite a higher rate of emergency transfer (15.2% vs 7.5%, P = .018) and no difference in mortality ( P = .741)., Conclusions: In this study, we demonstrate RTs have an increase in emergency transfer rate but no apparent risk of increased PICU LOS or mortality., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.

Traditionally, methicillin resistant Staphylococcus aureus (MRSA) is considered as a nosocomial pathogen, but an increasing prevalence of community acquired MRSA is being reported worldwide including India, which implies a strategic change in the antibiotic of choice for treatment of community acquired Staphylococcal infections, which till now is cloxacillin. This study is aimed at identifying the prevalence and susceptibility characteristics of community acquired MRSA in our hospital. The study group consisted of 208 consecutive MRSA identified on the basis of their resistance to cefoxitin disk (30 microg) by the disc diffusion method and mecA gene detection by polymerase chain reaction (PCR). Isolates were categorized as community acquired MRSA based on criteria for inclusion and their antibiotic susceptibility was compared with that of the hospital acquired MRSA isolates. Among the 208 MRSA analyzed, 18% (n = 37) were community acquired and were from infections such as cellulitis and superficial injuries. The isolates were significantly more sensitive to ciprofloxacin than the hospital acquired MRSA isolates. The prevalence of community acquired MRSA in this study (18%) is comparable to its prevalence in other studies across India. Susceptibility to antibiotics other than glycopeptides was an important characteristic of community acquired MRSA. In the absence of other reliable phenotypic test for its identification, susceptibility to ciprofloxacin is suggested as an alternative. A prudent clinician should be aware that, cloxacillin, the drug of choice for skin infections such as carbuncle and cellulitis, will not be effective in these cases and that community acquired MRSA has a range of antibiotics to choose from, other than the glycopeptides, when compared with that of hospital acquired MRSA.

Background and Objectives: Phenotypic methods for detection of methicillin resistant Staphylococcus aureus (MRSA) have been compared with the gold standard which, as of now, is by the detection of mecA gene and femA gene by polymerase chain reaction (PCR). Discrepancies in detection have an adverse effect on patient management, thereby highlighting the importance of accuracy in detection. Our study aims to evaluate the efficacy of cefoxitin disk diffusion test to detect MRSA and compare it with other phenotypic and molecular methods., Methodology: The study was conducted from June 2006 to December 2007 and included 610 Staphylococcus aureus (S. aureus) isolates obtained from clinical samples. All isolates were tested for MRSA using oxacillin screen agar plates with 6 microg/ml of oxacillin, cefoxitin disk diffusion using 30 microg disk and MIC of oxacillin. Selected isolates (55) were tested for presence of mecA gene and Fem A gene by PCR., Results: Out of 610 isolates, MRSA was identified in 34.09% by cefoxitin disk diffusion, 34.9% by oxacillin screen agar, 34.4% by MIC and 37.3% by oxacillin disk diffusion. When selected isolates were tested with molecular methods, the cefoxitin disk diffusion and PCR tests were comparable., Discussion: Prevalence of MRSA (34.09%) is quite high as in other studies. The oxacillin disk diffusion test which was used routinely earlier is showing low specificity (56%). Among all phenotypic methods, cefoxitin disk diffusion and PCR alone have similar sensitivity and specificity., Conclusion: Results of cefoxitin disk diffusion test are in concordance with the PCR for mecA gene. Thus, the test can be an alternative to PCR for detection of MRSA in resource constraint settings.