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Abstract Purpose The risk factors for excessive blood loss and transfusion during total knee arthroplasty (TKA) remain unclear. The present study aimed to determine the risk factors for excessive blood loss and establish a predictive model for postoperative blood transfusion. Methods This retrospective study included 329 patients received TKA, who were randomly assigned to a training set (n = 229) or a test set (n = 100). Univariate and multivariate linear regression analyses were used to determine risk factors for excessive blood loss. Univariate and multivariate logistic regression analyses were used to determine risk factors for blood transfusion. R software was used to establish the prediction model. The accuracy and stability of the models were evaluated using calibration curves, consistency indices, and receiver operating characteristic (ROC) curve analysis. Results Risk factors for excessive blood loss included timing of using a tourniquet, the use of drainage, preoperative ESR, fibrinogen, HCT, ALB, and free fatty acid levels. Predictors in the nomogram included timing of using a tourniquet, the use of drainage, the use of TXA, preoperative ESR, HCT, and albumin levels. The area under the ROC curve was 0.855 (95% CI, 0.800 to 0.910) for the training set and 0.824 (95% CI, 0.740 to 0.909) for the test set. The consistency index values for the training and test sets were 0.855 and 0.824, respectively. Conclusions Risk factors for excessive blood loss during and after TKA were determined, and a satisfactory and reliable nomogram model was designed to predict the risk for postoperative blood transfusion.

Abstract Electrocatalytic conversion of organic small molecules is a promising technique for value-added chemical productions but suffers from high precious metal consumption, poor stability of electrocatalysts and tedious product separation. Here, a Pd/NiMoO4/NF electrocatalyst with much lowered Pd loading amount (3.5 wt.%) has been developed for efficient, economic, and ultra-stable glycolate synthesis, which shows high Faradaic efficiency (98.9%), yield (98.8%), and ultrahigh stability (1500 h) towards electrocatalytic ethylene glycol oxidation. Moreover, the obtained glycolic acid has been converted to value-added sodium glycolate by in-situ acid-base reaction in the NaOH electrolyte, which is atomic efficient and needs no additional acid addition for product separation. Moreover, the weak adsorption of sodium glycolate on the catalyst surface plays a significant role in avoiding excessive oxidation and achieving high selectivity. This work may provide instructions for the electrocatalyst design as well as product separation for the electrocatalytic conversions of alcohols.

AbstractAlzheimer’s disease (AD) is a chronic, progressive brain degenerative disease that is common in the elderly. So far, there is no effective treatment. The multi-target-directed ligands (MTDLs) strategy has been recognised as the most promising approach due to the complexity of the pathogenesis of AD. Herein, novel salicylic acid–donepezil–rivastigmine hybrids were designed and synthesised. The bioactivity results exhibited that 5a was a reversible and selective eqBChE inhibitor (IC50 = 0.53 μM), and the docking provided the possible mechanism. Compound 5a also displayed potential anti-inflammatory effects and significant neuroprotective effect. Moreover, 5a exhibited favourable stabilities in artificial gastrointestinal solution and plasma. Finally, 5a demonstrated potential cognitive improvement in scopolamine-induced cognitive dysfunction. Hence, 5a was a potential multifunctional lead compound against AD.

Abstract Radiodermatitis, inflammatory lesions of skin and mucosa caused by radiation, is a common adverse effect during the radiation therapy of vulvar carcinoma. The incidence of radiodermatitis is affected by various factors, and the purpose of this study was to investigate the risk factors of radiodermatitis in patients with vulvar carcinoma. Patients with vulvar tumors who received radiotherapy from January 2015 to December 2020 were included in this retrospective study. Radiodermatitis was graded according to the grading criteria of the American Center for Radiological Oncology, and then univariate analysis and logistic multivariate regression analysis were used to determine the risk factors of radiodermatitis. A total of 60 eligible patients were enrolled, including 3 (5%), 25 (41.7%), 28 (46.7%), and 4 (6.6%) patients with grade 0, 1, 2, and 3 radiodermatitis, respectively. Univariate analysis showed that the incidence of radiodermatitis was significantly correlated with age, therapeutic strategy, pathological stage and radiotherapy dose (p

Abstract Metal–air batteries, like Zn–air batteries (ZABs) are usually suffered from low energy conversion efficiency and poor cyclability caused by the sluggish OER and ORR at the air cathode. Herein, a novel bimetallic Co/CoFe nanomaterial supported on nanoflower-like N-doped graphitic carbon (NC) was prepared through a strategy of coordination construction–cation exchange-pyrolysis and used as a highly efficient bifunctional oxygen electrocatalyst. Experimental characterizations and density functional theory calculations reveal the formation of Co/CoFe heterostructure and synergistic effect between metal layer and NC support, leading to improved electric conductivity, accelerated reaction kinetics, and optimized adsorption energy for intermediates of ORR and OER. The Co/CoFe@NC exhibits high bifunctional activities with a remarkably small potential gap of 0.70 V between the half-wave potential (E 1/2) of ORR and the potential at 10 mA cm‒2 (E j=10) of OER. The aqueous ZAB constructed using this air electrode exhibits a slight voltage loss of only 60 mV after 550-cycle test (360 h, 15 days). A sodium polyacrylate (PANa)-based hydrogel electrolyte was synthesized with strong water-retention capability and high ionic conductivity. The quasi-solid-state ZAB by integrating the Co/CoFe@NC air electrode and PANa hydrogel electrolyte demonstrates excellent mechanical stability and cyclability under different bending states.

Metallic nanoparticles are emerging as an exciting class of heterogeneous catalysts with the potential advantages of exceptional activity, stability, recyclability, and easier separation than homogeneous catalysts. The traditional colloid nanoparticle syntheses usually involve strong surface binding ligands that could passivate the surface active sites and result in poor catalytic activity. The subsequent removal of surface ligands could reactivate the surface but often leads to metal ion leaching and/or severe Ostwald ripening with diminished catalytic activity or poor stability. Molecular ligand engineering represents a powerful strategy for the design of homogeneous molecular catalysts but is insufficiently explored for nanoparticle catalysts to date. We report a systematic investigation on molecular ligand modulation of palladium (Pd) nanoparticle catalysts. Our studies show that β-functional groups of butyric acid ligand on Pd nanoparticles can significantly modulate the catalytic reaction process to modify the catalytic activity and stability for important aerobic reactions. With a β-hydroxybutyric acid ligand, the Pd nanoparticle catalysts exhibit exceptional catalytic activity and stability with an unsaturated turnover number (TON) >3000 for dehydrogenative oxidation of cyclohexenone to phenol, greatly exceeding that of homogeneous Pd(II) catalysts (TON, ~30). This study presents a systematic investigation of molecular ligand modulation of nanoparticle catalysts and could open up a new pathway toward the design and construction of highly efficient and robust heterogeneous catalysts through molecular ligand engineering.

Abstract Honey is thought to act against microbes and regulates microbiota balance, and this is mainly attributed to the enzymatic production of hydrogen peroxide, high osmolarity, and nonperoxidase factors, for example, lysozyme and botanical sources of nectar, while the effect of honey's probiotic is recently considered. The study of honey as source of beneficial microbes is understudied. The purpose of this study was to screen for the beneficial microorganisms in honey with antagonistic property against important pathogens and the mechanism of antimicrobial activity and thus play a beneficial role as probiotics. The results showed that one out of the fourteen bacterial isolates had antimicrobial activity and was identified as Bacillus Sp. A2 by 16S rRNA sequence and morphology. Antimicrobial activity of the isolate against C. albicans, E. coli, and S. aureus was confirmed by Agar well diffusion and liquid coculture assays, and the propagation of those microbes was significantly inhibited after treatment with the isolate Bacillus sp. A2 (p

The integration of multiple synergistic catalytic systems can enable the creation of biocompatible enzymatic mimics for cascading reactions under physiologically relevant conditions. Here we report the design of a graphene-haemin-glucose oxidase conjugate as a tandem catalyst, in which graphene functions as a unique support to integrate molecular catalyst haemin and enzymatic catalyst glucose oxidase for biomimetic generation of antithrombotic species. Monomeric haemin can be conjugated with graphene through π-π interactions to function as an effective catalyst for the oxidation of endogenous L-arginine by hydrogen peroxide. Furthermore, glucose oxidase can be covalently linked onto graphene for local generation of hydrogen peroxide through the oxidation of blood glucose. Thus, the integrated graphene-haemin-glucose oxidase catalysts can readily enable the continuous generation of nitroxyl, an antithrombotic species, from physiologically abundant glucose and L-arginine. Finally, we demonstrate that the conjugates can be embedded within polyurethane to create a long-lasting antithrombotic coating for blood-contacting biomedical devices.

Upcycling of CO2 into fuels by virtually unlimited solar energy provides an ultimate solution for addressing the substantial challenges of energy crisis and climate change. In this work, we report an efficient nanostructured Ru/MnOx catalyst composed of well-defined Ru/MnO/Mn3O4 for photo-thermal catalytic CO2 hydrogenation to CH4, which is the result of a combination of external heating and irradiation. Remarkably, under relatively mild conditions of 200 °C, a considerable CH4 production rate of 166.7 mmol g−1 h−1 was achieved with a superior selectivity of 99.5% at CO2 conversion of 66.8%. The correlative spectroscopic and theoretical investigations suggest that the yield of CH4 is enhanced by coordinating photon energy with thermal energy to reduce the activation energy of reaction and promote formation of key intermediate COOH* species over the catalyst. This work opens up a new strategy for CO2 hydrogenation toward CH4. Reduction of CO2 with solar energy is an attractive route to new fuel sources. Here a nanostructured Ru/MnOx photo-thermal catalyst composed of well-defined Ru/MnO/Mn3O4 is reported for CO2 hydrogenation with high selectivity and a CH4 production rate at a mild temperature of 200 °C. [ABSTRACT FROM AUTHOR]