Sustainable development pathways for energies in Yangtze River Delta urban agglomeration.

The sustainable development of urban agglomerations plays a pivotal role in national and global efforts to reduce emissions. By focusing on the efficient exchange and optimization of energy consumption across various sectors, the sustainable development of energy systems within urban agglomerations can be achieved. However, the overall impact of the cross-sector energy optimization and complementarity has not been quantitatively analyzed. Here, we focused on the Yangtze River Delta (YRD) urban agglomeration in China and proposed an optimization framework for energy, environment, and economy. The framework considered four sectors: transportation sector, power sector, industry sector, and building sector, in order to determine the most sustainable development pathway for the urban agglomeration. The optimization model considers total costs and greenhouse gas emissions reduction as the objectives and utilizes technologies as constraints to optimize the pathway. We found that this optimization strategy resulted in a 53.1 billion tons increase in CO2 emissions reduction in the region. The results of emission reduction varied across sectors, ranging from 4.5 to 22.2 billion tons CO2 equivalent, and across cities, ranging from 7.1 to 4688.1 Mt. The results suggest that the core cities in the urban agglomeration can take on a leadership role. By promoting cross-sector collaboration and implementing energy recycling, the energy efficiency of surrounding cities can be greatly improved, leading to the sustainable development of the urban agglomeration.

Epidemiology, antifungal susceptibility, risk factors, and mortality of persistent candidemia in adult patients in China: a 6-year multicenter retrospective study.

BACKGROUND: Data on persistent candidemia (PC), a recognized complication of candidemia, are lacking in China. This study aimed to investigate the clinical characteristics and risk factors for the mortality of PC among adults in China. METHODS: This 6-year retrospective study analyzed the prevalence, species distribution, antifungal susceptibility, risk factors, and patient mortality of PC among adults in three regional tertiary teaching hospitals in China from 2016 to 2021. We collected electronic laboratory records data of PC and non-PC patients and used the Student test or Mann-Whitney U test for a retrospective study. Logistic regression was used to identify risk factors associated with persistent candidemia. RESULTS: The definition of PC was fulfilled by 36 patients (13.7%, 36/263). The mean age of the patients was 59.9 years (60 years for patients with PC; 59.8 years for those with non-PC; P > 0.05) and 131 (60.1%) were men [16 with PC (44.4%), 115 with non-PC (63.2%), P < 0.05]. The mean annual incidence was 0.15/1000 admissions (including PC 0.03/1000 admissions vs. non-PC 0.12/1000 admissions, P < 0.05). Candida parapsilosis (14/36, 38.9%) and Candida albicans (81/182, 44.5%) were the predominant pathogens in patients with PC and non-PC, respectively. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.5%), and the activity of antifungal agents against Candida species was not statistically significantly different between patients with PC and non-PC (P > 0.05). The 30-day mortality rate was 20.2% (16.7% with PC vs. 20.9% with non-PC, P > 0.05). Multivariable regression analysis showed that use of broad-spectrum antibiotics (odds ratio (OR), 5.925; 95% confidence interval (CI), 1.886-18.616, P = 0.002), fluconazole (OR, 3.389; 95% CI, 1.302-8.820, P = 0.012) and C. parapsilosis infection (OR, 6.143; 95% CI, 2.093-18.031, P = 0.001) were independent predictors of PC, sex (male) (OR, 0.199; 95% CI, 0.077-0.518, P = 0.001) was the protective factor for PC. Respiratory dysfunction (OR, 5.763; 95% CI, 1.592-20.864, P = 0.008) and length of hospital stay(OR, 0.925; 95% CI, 0.880-0.973, P = 0.002) were independent predictors of 30-day mortality in patients with non-PC. C. tropicalis bloodstream infection (OR, 12.642; 95% CI, 1.059-150.951; P = 0.045) was an independent predictor of 30-day mortality in patients with PC. CONCLUSIONS: The epidemiological data of patients with PC and non-PC were different in the distribution of Candida species, the mean annual incidence and independent predictors of 30-day mortality. Flucytosine and amphotericin B could be used as first-choice drugs in the presence of PC infections.

In situ self-assembly of polydopamine inside injectable hydrogels: antibacterial activity and photothermal therapy for superbug-infected wound healing.

Inspired by the mussel foot proteins, polydopamine nanoparticles (PDA NPs) are often used to design hydrogel wound dressings due to their strong wet adhesion. However, additional antibiotics or nanometal bactericides are always required to enhance their poor antibacterial activity, which will cause drug resistance and toxic side effects. Herein, self-assembly confined PDA NPs (SC-PDA NPs, <50 nm) are employed as a freestanding antibacterial ingredient for constructing an ideal hydrogel wound dressing, which maintains relatively strong reducibility and size effect. Through a rapid gelation (within 10 s) strategy triggered by electrostatic complexation, an antibacterial hydrogel system is obtained, in which the in situ self-assembly of the SC-PDA NPs continues, endowing the gel with outstanding antibacterial activity, especially against methicillin-resistant Staphylococcus aureus (MRSA, >99.9%). With the continuous in situ self-assembly, the size of the PDA NPs increases (>200 nm), eventually giving the gel an efficient photothermal therapy effect. Moreover, the gel presents a relatively strong wet adhesion (63 kPa), superior biocompatibility and non-immunogenicity. This work offers innovative insights into the antibacterial mechanism of SC-PDA NPs and provides a novel design for constructing safe antibacterial hydrogel wound dressings, demonstrating great potential applications in superbug-infected wound healing.