Calcium silicate hydrate complex konjac glucomannan-based hydrogel selectively adsorbed phosphate in low alkalinity solution.

The selective recovery of phosphate from wastewater can manage nutrients and realize the recycling of phosphorus resources. In this study, a novel konjac glucomannan/pectin/calcium silicate composite hydrogel (KP-CSH) was developed for efficient recovery of phosphate in aqueous solution. The amount of alkali released after the reaction of KP-CSH in a neutral solution was small (the pH of the solution after the reaction was < 9). In a wide initial pH range (3-10), the adsorption capacity of KP-CSH in 50 mg-P/L phosphate solution reached 39∼45 mg-P/g. Besides, even if the pH of the solution after the reaction was less than 8, it could still well adsorb phosphate. The kinetic and isothermal adsorption experiments indicated that the adsorption process of phosphate by KP-CSH was chemical adsorption, and the maximum adsorption capacity was 61.2 mg-P/g. KP-CSH preferentially adsorbed phosphate even in the presence of high concentrations of competitive ions. In the actual biogas slurry, KP-CSH also exhibited the strongest selectivity/affinity for phosphate, and its distribution coefficient (Kd) was significantly higher than that of other co-existing anions and cations. The adsorption mechanism analysis indicated that Ca was the main adsorption site of KP-CSH, and that the adsorption process of target pollutants mainly involved ligand exchange and the intra-sphere complexation. Further plant seed germination and seedling growth experiments suggested that KP-CSH after phosphate recovery did not exert a negative effect on the growth of plant seedlings, and increased the chlorophyll content of seedling leaves. These results demonstrate that KP-CSH is a potential adsorbent for efficient phosphate recovery, which can be used as a slow-release phosphate fertilizer after recovering phosphate.

Does the Angulation of the Screws in the Zero-P Implant Affect the Clinical and Radiological Outcomes of Patients?

OBJECTIVE: When implanting the Zero-P device, the screws of Zero-P form a bone wedge with a 40 ± 5° cranial and caudal angle (CCA). However, no study has been performed in the optimal CCA of the Zero-P implant. To investigate whether the cranial/caudal angles (CCA) of the screws affect the clinical and radiological outcomes in patients undergoing ACDF with the Zero-P implant. METHODS: From January 2016 to December 2023, we retrospectively analyzed 186 patients who underwent 1-level ACDF with the Zero-P device. The patients were divided into four groups: group A (cranial angle ≤40°, caudal angle ≤40°); group B (cranial angle ≤40°, caudal angle >40°); group C (cranial angle >40°, caudal angle ≤40°); and group D (cranial angle >40°, caudal angle >40°). The clinical outcomes, including Japanese Orthopaedic Association (JOA), neck disability index (NDI), and visual analogue scale (VAS) scores, the radiological parameters, including cervical lordosis (CL), cervical lordosis of operated segments (OPCL), intervertebral space height (ISH) and fusion rate (FR), and the complications, were evaluated and compared. Parametric tests, non-parametric tests, and chi-square tests were conducted to analyze the data. RESULTS: The OPCL of group A was significantly less than that of the other groups at the final follow-up (p < 0.05). The ISH of group D was significantly less than that of group A at the final follow-up (p < 0.05). The subsidence rate of group A was significantly less than that of group D at the final follow-up (p < 0.05). At the final follow-up, the upper adjacent-level degeneration (ASD) of group D was significantly less severe than that of groups A and B (p < 0.05). The clinical outcomes do not differ among groups (p > 0.05). CONCLUSION: A larger CCA of the screws (cranial angle >40°, caudal angle >40°) was better for maintaining OPCL and reducing the incidence of ASD. A smaller CCA of the screws (cranial angle ≤40°, caudal angle ≤40°) was better for maintaining ISH and reducing the rate of subsidence.

Explore the Status of Communication Between Nursing Staff and Patients on Complementary Therapy Issues.

This study investigates the state of communication between nursing staff and patients concerning complementary and alternative medicine (CAM) in a university hospital in Taiwan. The study employed a validated cross-sectional survey to gather data from 90 nurses in the internal medicine ward. The results indicate a notable need for more initiation and documentation of CAM discussions by nurses, with less than a quarter recording patients' CAM usage. Barriers such as limited time, access to evidence-based information, and workplace culture were identified as significant obstacles. Additionally, nurse characteristics like age, experience, and seniority also played a role in the extent of CAM communication. The study underscores the urgent need for health care institutions to prioritize CAM communication as a vital component of patient-centered care. It suggests the development of strategies to facilitate proactive discussions and referrals.

The Effect of Thrombin-gelatin Matrix Compared With Absorbable Gelatin Sponge on Intraoperative Hemostasis in Unilateral Open-door Laminoplasty: A Randomized Controlled Trial.

STUDY DESIGN: Prospective, randomized, parallel-controlled trial. OBJECTIVE: The primary aim of this study was to determine whether hrombin-gelatin matrix (TGM) combined with an absorbable gelatin sponge (AGS) could more greatly reduce Intraoperative blood loss (IBL) in unilateral open-door laminoplasty than the sole use of an AGS could. The secondary aims were to evaluate the hemostatic efficiency, amount of postoperative bleeding and safety of the application of TGM combined with an AGS. SUMMARY OF BACKGROUND DATA: IBL during cervical laminoplasty is substantial and is a proper indication for the application of hemostatic agents. However, we are unaware of any clinical trials on the application of TGM and an AGS in posterior cervical spine surgery. METHODS: A total of 80 consecutive patients who underwent unilateral open-door laminoplasty, were enrolled from September 2020 to March 2022. Patients were randomized into two groups, the TGM-AGS group and the AGS group, with 40 patients in each group. The primary outcome was IBL. Other outcomes included the duration of operation, duration of hemostasis, duration of drainage, maximum decrease in hemoglobin(Hb), length of hospital stay, volume of drainage, number of drainage days, occurrence of adverse events, coagulation indicators and patient-reported outcome measures (PROMs). RESULTS: The mean IBL for patients in the TGM-AGS group (75.22 mL ±21.83 mL) was significantly lower than that in the AGS group(252.43 mL ±57.39 mL)(mean difference=177.21 mL, 95% confidence interval [CI], 157.88 mL -196.53 mL, t=18.25, P<0.001); the duration of hemostasis, volume of drainage, days of drainage in the TGM group and maximum decrease in Hb were also significantly less than those in the AGS group (P<0.01). CONCLUSION: The hemostatic efficacy of TGM-AGS is better than that of an AGS alone in IBL. TGM-AGS is also superior to an AGS alone in the evaluation of hemostatic efficiency and postoperative bleeding.

Eco-friendly hydrogel based on locust bean gum for water retaining in sandy soil.

Sandy soils are suffering from water loss and desertification, which severely restrict the development of local agriculture. In this work, an eco-friendly hydrogel composed of borax and locust bean gum was synthesized to enhance the water retention capacity of sandy soil and support agricultural development in arid regions. Locust bean gum/borax hydrogel with a 3D network structure exhibited great water-absorbing capacity (130.29 g/g) within 30 min. After mixing 0.9 wt% hydrogel with sandy soil, the maximum soil water content, water retention time, soil porosity and soil organic matter were increased by 32.03 %, 14 days, 38.9 % and 8.64 g/kg respectively. Little effect on soil microorganisms revealed barely toxicity. Furthermore, the hydrogel was confirmed to be biodegradable at 43.47 % after 4 weeks. According to the study, locust bean gum/borax hydrogel possesses good water absorbing capacity, soil water retention ability, soil optimization ability and low adverse environmental impact. Together, it is inferred that the hydrogel can improve the water retention capacity of sandy soil in arid areas, promoting plant growth in arid areas.

Quantification of sources and potential risks of cadmium, chromium, lead, mercury and arsenic in agricultural soils in a rapidly urbanizing region of southwest China: the case of Chengdu.

Rapid urbanization a major factor affecting heavy metal contamination on suburban agricultural soils. In order to assess the dynamic contamination of heavy metals in soil from agricultural land bordering a rapidly urbanizing area and the transfer of human health risks from contaminants in this process, 186 and 293 soil samples from agricultural land in suburban Chengdu were collected in September 2008 and September 2017, respectively. Several indicators, such as the integrated pollution index (PI) and the potential ecological risk index (RI), were employed for analyzing the heavy metal contamination levels, and the APCS-MLR receptor model were applied for analyzing the heavy metal sources. As a result, mean concentrations for five elements did not exceed the national soil pollution risk screening values in the two periods mentioned above. Nemerow's composite contamination index revealed an increase in soil contamination of arable land after 10 years of urbanization, with 3.75 and 1.02% of light and moderate sample plots, respectively, by 2017. The assessment for potential ecological risk indicated an increased level of eco-risk to high for most of the sample plots. Based on the APCS-MLR model, the origin and contribution to the five elements varied considerably between the two periods mentioned above. Among them, soil Pb changed from "industrial source" to "transportation source," soil Cr changed from "natural source" to "transportation source," and As and Hg changed from "industrial source" to "transportation source." As and Hg were associated with agricultural activities in both periods, and Cd was derived from industrial activities in both periods. The study suggests that inhalation has become a major contributor to non-cancer health risks in urbanization, unlike intake routes in previous periods, and that the increase in cancer risk is mainly due to children's consumption of agricultural products with As residues. The change in the main source of As to "transportation" also indicates a decrease in air quality during urbanization and the development of the transportation industry. This study provides a reference for the governments of rapidly urbanizing cities to formulate relevant highway and agricultural policies to safeguard the health of the people based on the current situation.

Sodium-Glucose Co-Transporter-2 Inhibitor Empagliflozin Attenuates Sorafenib-Induced Myocardial Inflammation and Toxicity.

Environmental antineoplastics such as sorafenib may pose a risk to humans through water recycling, and the increased risk of cardiotoxicity is a clinical issue in sorafenib users. Thus, developing strategies to prevent sorafenib cardiotoxicity is an urgent work. Empagliflozin, as a sodium-glucose co-transporter-2 (SGLT2) inhibitor for type 2 diabetes control, has been approved for heart failure therapy. Still, its cardioprotective effect in the experimental model of sorafenib cardiotoxicity has not yet been reported. Real-time quantitative RT-PCR (qRT-PCR), immunoblot, and immunohistochemical analyses were applied to study the effect of sorafenib exposure on cardiac SGLT2 expression. The impact of empagliflozin on cell viability was investigated in the sorafenib-treated cardiomyocytes using Alamar blue assay. Immunoblot analysis was employed to delineate the effect of sorafenib and empagliflozin on ferroptosis/proinflammatory signaling in cardiomyocytes. Ferroptosis/DNA damage/fibrosis/inflammation of myocardial tissues was studied in mice with a 28-day sorafenib ± empagliflozin treatment using histological analyses. Sorafenib exposure significantly promoted SGLT2 upregulation in cardiomyocytes and mouse hearts. Empagliflozin treatment significantly attenuated the sorafenib-induced cytotoxicity/DNA damage/fibrosis in cardiomyocytes and mouse hearts. Moreover, GPX4/xCT-dependent ferroptosis as an inducer for releasing high mobility group box 1 (HMGB1) was also blocked by empagliflozin administration in the sorafenib-treated cardiomyocytes and myocardial tissues. Furthermore, empagliflozin treatment significantly inhibited the sorafenib-promoted NFκB/HMGB1 axis in cardiomyocytes and myocardial tissues, and sorafenib-stimulated proinflammatory signaling (TNF-α/IL-1ß/IL-6) was repressed by empagliflozin administration. Finally, empagliflozin treatment significantly attenuated the sorafenib-promoted macrophage recruitments in mouse hearts. In conclusion, empagliflozin may act as a cardioprotective agent for humans under sorafenib exposure by modulating ferroptosis/DNA damage/fibrosis/inflammation. However, further clinical evidence is required to support this preclinical finding.

Integrated biomarker profiling for enhanced heart failure management: a comprehensive study on the application of chemiluminescence detection of GDF-15 and multi-index models.

BACKGROUND: Growth differentiation factor 15 (GDF-15) holds promise as a novel marker for heart failure. However, current detection methods fall short of meeting essential clinical requirements. OBJECTIVES: The aim of this investigation was to assess the clinical significance of serum GDF-15 detection through the chemiluminescence method and to enhance its clinical application for predicting and evaluating heart failure in patients. METHODS: A total of 122 patients were included in the study. Serum GDF-15 levels were assessed using the chemiluminescence method and compared with results for NT-proBNP, N-terminal pro-brain natriuretic peptide (NT-proBNP), growth stimulation expressed gene 2 (ST2), high-sensitivity C-reactive protein (hs-CRP), and left ventricular ejection fraction (LVEF). Additionally, we conducted an analysis to evaluate the correlation between these indicators and heart failure events. RESULTS: LVEF, ST2, NT-proBNP, and GDF-15 exhibited significant associations with heart failure. In the multivariate proportional hazard analysis, subsequent to adjusting for the effects of other markers, however, only LVEF and GDF-15 retained their associations with heart failure events. Notably, GDF-15 emerged as the exclusive marker suitable for diagnosing heart failure with preserved ejection fraction. CONCLUSION: The chemiluminescence method proved efficient in the rapid and sensitive detection of GDF-15 in patients with heart failure. Additionally, GDF-15 combined with other markers created a robust multi-index model. This model is valuable for heart failure diagnosis, treatment, and monitoring, with broad clinical applicability.

Comparison between sub-chronic and chronic sleep deprivation-induced behavioral and neuroimmunological abnormalities in mice: Focusing on glial cell phenotype polarization.

BACKGROUND: Sleep disorders, depression, and Alzheimer's disease (AD) are extensively reported as comorbidity. Although neuroinflammation triggered by microglial phenotype M1 activation, leading to neurotransmitter dysfunction and Aß aggregation, is considered as the leading cause of depression and AD, whether and how sub-chronic or chronic sleep deprivation (SD) contribute to the onset and development of these diseases remains unclear. METHODS: Memory and depression-like behaviors were evaluated in both SDs, and then circadian markers, glial cell phenotype polarization, cytokines, depression-related neurotransmitters, and AD-related gene/protein expressions were measured by qRT-PCR, enzyme-linked immunosorbent assay, high-performance liquid chromatography, and western-blotting respectively. RESULTS: Both SDs induced give-up behavior and anhedonia and increased circadian marker period circadian regulator 2 (PER2) expression, which were much worse in chronic than in the sub-chronic SD group, while brain and muscle ARNT-like protein-1 only decreased in the chronic-SD. Furthermore, increased microglial M1 and astrocyte A1 expression and proinflammatory cytokines, interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α was observed in both SDs, which were more significant in chronic SD. Similarly, decreased norepinephrine and 5-hydroxytryptamine/5-hydroxyindoleacetic acid ratio were more significant, which corresponds to the worse depression-like behavior in chronic than sub-chronic-SD. With regard to AD, increased amyloid precursor protein (APP) and soluble (s)-APPß and decreased sAPPα in both SDs were more significant in the chronic. However, sAPPα/sAPPß ratio was only decreased in chronic SD. CONCLUSION: These findings suggest that both SDs induce depression-like changes by increasing PER2, leading to neuroinflammation and neurotransmitter dysfunction. However, only chronic SD induced memory impairment likely due to severer circadian disruption, higher neuroinflammation, and dysregulation of APP metabolism.

Mechanisms and emerging strategies for irinotecan-induced diarrhea.

Irinotecan (also known as CPT-11) is a topoisomerase I inhibitor first approved for clinical use as an anticancer agent in 1996. Over the past more than two decades, it has been widely used for combination regimens to treat various malignancies, especially in gastrointestinal and lung cancers. However, severe dose-limiting toxicities, especially gastrointestinal toxicity such as late-onset diarrhea, were frequently observed in irinotecan-based therapy, thus largely limiting the clinical application of this agent. Current knowledge regarding the pathogenesis of irinotecan-induced diarrhea is characterized by the complicated metabolism of irinotecan to its active metabolite SN-38 and inactive metabolite SN-38G. A series of enzymes and transporters were involved in these metabolic processes, including UGT1A1 and CYP3A4. Genetic polymorphisms of these metabolizing enzymes were significantly associated with the occurrence of irinotecan-induced diarrhea. Recent discoveries and progress made on the detailed mechanisms enable the identification of potential biomarkers for predicting diarrhea and as such guiding the proper patient selection with a better range of tolerant dosages. In this review, we introduce the metabolic process of irinotecan and describe the pathogenic mechanisms underlying irinotecan-induced diarrhea. Based on the mechanisms, we further outline the potential biomarkers for predicting the severity of diarrhea. Finally, based on the current experimental evidence in preclinical and clinical studies, we discuss and prospect the current and emerging strategies for the prevention of irinotecan-induced diarrhea.