Heatstroke: a multicenter study in Southwestern China.

Background: An increase in Heatstroke cases occurred in southwest China in 2022 due to factors like global warming, abnormal temperature rise, insufficient power supply, and other contributing factors. This resulted in a notable rise in Heatstroke patients experiencing varying degrees of organ dysfunction. This descriptive study aims to analyze the epidemiology and clinical outcomes of Heatstroke patients in the ICU, providing support for standardized diagnosis and treatment, ultimately enhancing the prognosis of Heatstroke. Methods: A retrospective, multicenter, descriptive analysis was conducted on Heatstroke patients admitted to ICUs across 83 hospitals in southwest China. Electronic medical records were utilized for data collection, encompassing various aspects such as epidemiological factors, onset symptoms, complications, laboratory data, concurrent infections, treatments, and patient outcomes. Results: The dataset primarily comprised classic heatstroke, with 477 males (55% of total). The patient population had a median age of 72 years (range: 63-80 years). The most common initial symptoms were fever, mental or behavioral abnormalities, and fainting. ICU treatment involved respiratory support, antibiotics, sedatives, and other interventions. Among the 700 ICU admissions, 213 patients had no infection, while 487 were diagnosed with infection, predominantly lower respiratory tract infection. Patients presenting with neurological symptoms initially (n = 715) exhibited higher ICU mortality risk compared to those without neurological symptoms (n = 104), with an odds ratio of 2.382 (95% CI 1.665, 4.870) (p = 0.017). Conclusion: In 2022, the majority of Heatstroke patients in southwest China experienced classical Heatstroke, with many acquiring infections upon admission to the ICU. Moreover, Heatstroke can result in diverse complications.

Association of medical care capacity and the patient mortality of septic shock: a cross-sectional study.

BACKGROUND: Hospitals with higher septic shock case volume demonstrated lower hospital mortality. We conducted this study to investigate whether this phenomenon was only caused by the increase in the number of admissions or the need to improve the medical care capacity in septic shock at the same time. METHODS: Seven-hundred and eighty-seven hospitals from China collected in a survey from January 1, 2021 to December 31, 2021. Medical care capacity for septic shock was explored by patients with septic shock in intensive care units (ICU) divided into beds, intensivists, and nurses respectively. MAIN RESULTS: The proportion of ICU patients with septic shock was negatively associated with the patient mortality of septic shock (Estimate [95%CI], -0.2532 [-0.5038, -0.0026]) (p-value 0.048). The ratios of patients with septic shock to beds, intensivists, and nurses were negatively associated with mortality of septic shock (Estimate [95%CI], -0.370 [-0.591, -0.150], -0.136 [-0.241, -0.031], and -0.774 [-1.158, -0.389]) (p-value 0.001, 0.011 and < 0.001). Severe pneumonia, the most common infection that caused a septic shock, correlated positively with its mortality (Estimate [95%CI], 0.1002 [0.0617, 0.1387]) (p-value < 0.001). CONCLUSIONS: Hospitals with higher medical care capacity for septic shock were associated with lower hospital mortality.

Bioinspired Hierarchical Carbon Structures as Potential Scaffolds for Wound Healing and Tissue Regeneration Applications.

Engineered bio-scaffolds for wound healing provide an attractive treatment option for tissue engineering and traumatic skin injuries since they can reduce dependence on donors and promote faster repair through strategic surface engineering. Current scaffolds present limitations in handling, preparation, shelf life, and sterilization options. In this study, bio-inspired hierarchical all-carbon structures comprising carbon nanotube (CNT) carpets covalently bonded to flexible carbon fabric have been investigated as a platform for cell growth and future tissue regeneration applications. CNTs are known to provide guidance for cell growth, but loose CNTs are susceptible to intracellular uptake and are suspected to cause in vitro and in vivo cytotoxicity. This risk is suppressed in these materials due to the covalent attachment of CNTs on a larger fabric, and the synergistic benefits of nanoscale and micro-macro scale architectures, as seen in natural biological materials, can be obtained. The structural durability, biocompatibility, tunable surface architecture, and ultra-high specific surface area of these materials make them attractive candidates for wound healing. In this study, investigations of cytotoxicity, skin cell proliferation, and cell migration were performed, and results indicate promise in both biocompatibility and directed cell growth. Moreover, these scaffolds provided cytoprotection against environmental stressors such as Ultraviolet B (UVB) rays. It was seen that cell growth could also be tailored through the control of CNT carpet height and surface wettability. These results support future promise in the design of hierarchical carbon scaffolds for strategic wound healing and tissue regeneration applications.

Evaluation of ICUs and weight of quality control indicators: an exploratory study based on Chinese ICU quality data from 2015 to 2020.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.

Response of soil microbial compositional and functional heterogeneity to grazing exclusion in alpine shrub and meadows in the Qinghai-Tibet Plateau.

Soil microorganisms found in shrub-meadow ecosystems are highly heterogeneous and extremely sensitive to grazing, but changes in microbial compositional and functional heterogeneity during grazing exclusion (GE) have been largely overlooked compared to community diversity. We collected soil samples from heavily grazed plots (6.0 sheep/ha) and GE plots (matrix and patch areas in both), and used a combination of next-generation sequencing, vegetation features, and the associated soil property data to investigate the effect of GE on the composition and function of microbial communities (bacteria fungi, and archaea) in 0-10 cm soils. Regarding community composition, the proportions of species in bacteria, fungi, and archaea were 97.3, 2.3, and 0.4%, respectively. GE significantly affected the species diversity of fungi and archaea but not that of bacteria. GE decreased the heterogeneity of bacteria (2.9% in matrix and 6.2% in patch) and archaea (31.1% in matrix and 19.7% in patch) but increased that of fungi by 1.4% in patch. Regarding community function, enzyme diversity and heterogeneity were increased by 10.4 and 9.4%, respectively, in patch after 6 years of fencing, exemplifying a high level of microbial functional redundancy. The Kyoto Encyclopedia of Genes and Genome pathways-cell growth and death, translation, digestive system, and nucleotide metabolism-were functional biomarkers (linear discriminant analysis effect size method) in matrix-non-grazed plots, whereas lipid metabolism, xenobiotics biodegradation and metabolism, and metabolism of terpenoids and polyketides, cell motility, cancer: overview, endocrine system, and membrane transport were biomarkers in patch-non-grazed plots. Additionally, GE improved the capacity for fatty acid metabolism but decreased the abundance of methane-producing archaea by 42.9%. Redundancy analysis revealed that the factors that affected microbial composition the most were soil aggregates, soil moisture, and the number of plant species, whereas those that affected microbial function the most were soil available phosphorus, soil temperature, and shrub canopy diameter. Our results quantified soil microbial heterogeneity, emphasizing the different responses of the composition and function of bacteria, fungi, and archaea to GE in alpine shrubs and meadows.

Advances in Matrix-Supported Palladium Nanocatalysts for Water Treatment.

Advanced catalysts are crucial for a wide range of chemical, pharmaceutical, energy, and environmental applications. They can reduce energy barriers and increase reaction rates for desirable transformations, making many critical large-scale processes feasible, eco-friendly, energy-efficient, and affordable. Advances in nanotechnology have ushered in a new era for heterogeneous catalysis. Nanoscale catalytic materials are known to surpass their conventional macro-sized counterparts in performance and precision, owing it to their ultra-high surface activities and unique size-dependent quantum properties. In water treatment, nanocatalysts can offer significant promise for novel and ecofriendly pollutant degradation technologies that can be tailored for customer-specific needs. In particular, nano-palladium catalysts have shown promise in degrading larger molecules, making them attractive for mitigating emerging contaminants. However, the applicability of nanomaterials, including nanocatalysts, in practical deployable and ecofriendly devices, is severely limited due to their easy proliferation into the service environment, which raises concerns of toxicity, material retrieval, reusability, and related cost and safety issues. To overcome this limitation, matrix-supported hybrid nanostructures, where nanocatalysts are integrated with other solids for stability and durability, can be employed. The interaction between the support and nanocatalysts becomes important in these materials and needs to be well investigated to better understand their physical, chemical, and catalytic behavior. This review paper presents an overview of recent studies on matrix-supported Pd-nanocatalysts and highlights some of the novel emerging concepts. The focus is on suitable approaches to integrate nanocatalysts in water treatment applications to mitigate emerging contaminants including halogenated molecules. The state-of-the-art supports for palladium nanocatalysts that can be deployed in water treatment systems are reviewed. In addition, research opportunities are emphasized to design robust, reusable, and ecofriendly nanocatalyst architecture.

On Trees with Greatest F-Invariant Using Edge Swapping Operations.

The F-index of a graph Q is defined as F(Q)=∑ t∈V(Q)(d t )3. In this paper, we use edge swapping transformations to find the extremal value of the F-index among the class of trees with given order, pendent vertices, and diameter. We determine the trees with given order, pendent vertices, and diameter having the greatest F-index value. Also, the first five maximum values of F index among the class of trees with given diameter are determined.

Flexible reusable hierarchical hybrid catalyst for rapid and complete degradation of triclosan in water.

A flexible, durable, and reusable nanocatalyst system was fabricated by anchoring palladium nanoparticles on carbon nanotube (CNT) carpets covalently attached to carbon cloth. These hierarchical hybrid materials were tested for catalytic degradation of triclosan (TCS), an emerging contaminant. Materials were characterized using scanning & transmission electron microscopy techniques (SEM and TEM), X-Ray Diffraction (XRD), and X-Ray Photoelectron Spectroscopy (XPS). The reaction kinetics was studied using HPLC and reaction pathways proposed based on LC-MS/GC-MS analyses. In the presence of hydrogen, complete step-wise chlorine removal was seen until complete dechlorination was accomplished. The pseudo-first-order rate constant was measured to be orders of magnitude higher than earlier reported values. Moreover, the same material was usable for multiple cycles in flowing water. This study demonstrates that robustness and reusability of larger structural materials can be combined with the ultra-high surface activity of nanocatalysts to provide practical and eco-friendly solutions for water sustainability.

Multi-walled carbon nanotube carpets as scaffolds for U87MG glioblastoma multiforme cell growth.

Carbon Nanotubes (CNTs) are known for effective adhesion, growth, and differentiation of bone, muscle, and cardiac cells. CNTs can provide excellent mechanical and electrical properties for cell scaffolding; however, loose CNTs can cause in-vivo toxicity. To suppress this risk, our team has developed biomimetic scaffolds with multiscale hierarchy where carpet-like CNT arrays are covalently bonded to larger biocompatible substrates. In this study, we investigated the interaction between glioblastoma multiforme (GBM) cells (U87MG) and our unique hierarchical CNT-coated scaffolds upon brain tumor cell proliferation. U87MG cells grown on un-modified carbon scaffolds grew in a bi-phasic fashion. Initially, the scaffolds prevented GBM cell growth; however, prolonged growth on such scaffolds significantly increased GBM cell proliferation. We further defined the importance of the hydrophobicity/hydrophilicity of the CNT-coated scaffolds in this cellular response by utilizing sodium-hypochlorite based bleach treatment prior to cellular exposure. This surface modification increased the hydrophilicity of the CNT-coated scaffolds and ameliorated the biphasic response of U87MG cells allowing for a normal growth curve. Findings highlight the importance of surface modification and wettability of the CNT-coated scaffolds for cell growth applications. The focus for this study was to determine whether scaffold surface features could modulate tumor-scaffold interactions, and thus to improve our understanding of and optimize successful development of future scaffold-based chemotherapy applications. Overall, it appears that the wettability of carbon scaffolds coated with CNTs is an important regulator of U87MG cellular growth. These findings will be important to consider when developing a potential chemotherapy-attached implant to be used post-surgical resection for GBM patient treatment.

Thermo⁻Mechanical Behavior and Constitutive Modeling of In Situ TiB2/7050 Al Metal Matrix Composites Over Wide Temperature and Strain Rate Ranges.

The thermo-mechanical behavior of in situ TiB2/7050 Al metal matrix composites is investigated by quasi-static and Split Hopkinson Pressure Bar compression tests over a wide range of temperature (20~30 °C) and strain rate (0.001~5000 s-1). Johnson-Cook and Khan-Liu constitutive models determined from curve fitting and constrained optimization are used to predict the flow stress during deformation. In addition, another Johnson-Cook model calculated from an orthogonal cutting experiment and finite element simulation is also compared in this study. The prediction capability of these models is compared in terms of correlation coefficient and average absolute error. Due to the assumptions in orthogonal cutting theory, the determined Johnson-Cook model from cutting cannot describe the material deformation behavior accurately. The results also show that the Khan-Liu model has better performance in characterizing the material's thermo-mechanical behavior.

A Clustering Approach for Motif Discovery in ChIP-Seq Dataset.

Chromatin immunoprecipitation combined with next-generation sequencing (ChIP-Seq) technology has enabled the identification of transcription factor binding sites (TFBSs) on a genome-wide scale. To effectively and efficiently discover TFBSs in the thousand or more DNA sequences generated by a ChIP-Seq data set, we propose a new algorithm named AP-ChIP. First, we set two thresholds based on probabilistic analysis to construct and further filter the cluster subsets. Then, we use Affinity Propagation (AP) clustering on the candidate cluster subsets to find the potential motifs. Experimental results on simulated data show that the AP-ChIP algorithm is able to make an almost accurate prediction of TFBSs in a reasonable time. Also, the validity of the AP-ChIP algorithm is tested on a real ChIP-Seq data set.

Prognostic value of pretreatment serum lactate dehydrogenase level in pancreatic cancer patients: A meta-analysis of 18 observational studies.

BACKGROUND: Several studies were conducted to investigate the prognostic value of pretreatment serum lactate dehydrogenase (LDH) level in pancreatic cancer (PC), but the results were inconsistent. This study aims to comprehensively assess the prognostic value of pretreatment serum LDH level in PC patients by combining the data of the published literatures on this topic. METHODS: Embase, PubMed, and Web of Science were completely retrieved until June, 2018. The observational studies focusing on the prognostic value of pretreatment serum LDH level in PC patients were eligible. STATA version 12.0 was used to undertake the statistical analysis. RESULTS: Eighteen studies with a total of 3345 patients were included in this meta-analysis. The meta-analysis was conducted to generate pooled hazard ratios (HRs) and 95% confidence interval (CI) for overall survival (OS). Our analysis results suggested that high serum LDH level predicted worse OS (HR 1.57, 95% CI 1.30-1.90, P < .001) in PC patients. Moreover, for patients with advanced PC, the prognostic relevance of pretreatment serum LDH level not only existed in those receiving palliative chemotherapy (HR 1.72, 95% CI 1.35-2.18, P < .001), but also in those who were precluded from chemotherapy (HR 1.91, 95% CI 1.4219-2.58, P < .001). CONCLUSION: The meta-analysis results demonstrated that pretreatment serum LDH level is closely associated with OS, and it may be a useful biomarker for assessing the prognosis of PC patients.

Evaluation of Residual Stress Distribution and Relaxation on In Situ TiB2/7050 Al Composites.

Interior residual stresses induced by quenching may cause distortion during subsequent machining processes. Hence, various strategies have been employed to relieve the interior residual stress, such as stretching, post treatment, and other techniques. In this study, the stress distribution inside TiB2/7050 Al composite extrusions was investigated and the effects of different methods on relieving the quenching-induced stress were compared. Firstly, three TiB2/7050 Al composite extrusions were treated by stretching, stretching and heat treatment, and stretching and cold treatment processes, respectively. Then, the multiple-cut contour method was employed to assess the residual stresses in the three workpieces. Experimental results indicate that the interior stress of TiB2/7050 Al composite extrusions after stretching ranges from −89 MPa to +55 MPa, which is larger than that in 7050 aluminum alloy, which ranges from −25 Pa to +25 MPa. The heat treatment performs better than the cold treatment to reduce the post-stretching residual stress, with a reduction of 23.2⁻46.4% compared to 11.3⁻40.8%, respectively. From the stress map, it is found that the stress distribution after the heat treatment is more uniform compared with that after the cold treatment.

Mechanisms and FEM Simulation of Chip Formation in Orthogonal Cutting In-Situ TiB2/7050Al MMC.

The in-situ TiB2/7050Al composite is a new kind of Al-based metal matrix composite (MMC) with super properties, such as low density, improved strength, and wear resistance. This paper, for a deep insight into its cutting performance, involves a study of the chip formation process and finite element simulation during orthogonal cutting in-situ TiB2/7050Al MMC. With chips, material properties, cutting forces, and tool geometry parameters, the Johnson-Cook (J-C) constitutive equation of in-situ TiB2/7050Al composite was established. Then, the cutting simulation model was established by applying the Abaqus-Explicit method, and the serrated chip, shear plane, strain rate, and temperature were analyzed. The experimental and simulation results showed that the obtained material's constitutive equation was of high reliability, and the saw-tooth chips occurred commonly under either low or high cutting speed and small or large feed rate. From result analysis, it was found that the mechanisms of chip formation included plastic deformation, adiabatic shear, shearing slip, and crack extension. In addition, it was found that the existence of small, hard particles reduced the ductility of the MMC and resulted in segmental chips.

On the evaporation kinetics of [60] fullerene in aromatic organic solvents.

We investigate the effect of C60 fullerene nanospheres on the evaporation kinetics of a number of aromatic solvents with different levels of molecular association, namely, benzene, toluene, and chlorobenzene. The dependence of the evaporation rate on the fullerene concentration is not monotonic but rather exhibits maxima and minima. The results strongly support the notion of molecular structuring within the liquid solvent controlled by the nature of the fullerene/solvent interaction and the level of molecular association within the solvent itself.

Phosphate recovery from water using cellulose enhanced magnesium carbonate pellets: Kinetics, isotherms, and desorption.

Phosphorus is an essential and limited nutrient that is supplied by a depleting resource, mineral phosphate rock. Eutrophication is occurring in many water bodies which provides an opportunity to recover this nutrient from the water. One method of recovery is through adsorption; this study focused on fabricating a porous and granular adsorptive material for the removal and recovery of phosphate. Magnesium carbonate was combined with cellulose in varying weight ratios (0, 5, 10, 15, 20%) to synthesize pellets, which were then calcined to increase internal surface area. Physiochemical properties such as surface area, surface morphology, elemental composition, and crystal structure of the materials were characterized using Brunauer, Emmett, and Teller (BET) surface area analysis, X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). The pellet proved to be uniform in composition and an increase in BET surface area correlated with an increase in cellulose content until pellet stability was lost. Phosphate adsorption using the pellets was studied via batch kinetics and sorption isotherms. The pseudo-second-order kinetics model fits best suggesting that the adsorption occurring was chemisorption. The isotherm model that fit best was the Langmuir isotherm, which showed that the maximum equilibrium adsorption capacity increased with an increase in cellulose content between 10% and 20%. The average adsorption capacity achieved in the triplicate isotherm study was 96.4 mg g-1 for pellets synthesized with 15% cellulose. Overall, using cellulose and subsequent calcination created an additional internal surface area for adsorption of phosphate and suggested that granular materials can be modified for efficient removal and recovery of phosphate from water.

Carbon-based hierarchical scaffolds for myoblast differentiation: Synergy between nano-functionalization and alignment.

While several scaffolds have been proposed for skeletal muscle regeneration, multiscale hierarchical scaffolds with the complexity of extracellular matrix (ECM) haven't been engineered successfully. By precise control over nano- and microscale features, comprehensive understanding of the effect of multiple factors on skeletal muscle regeneration can be derived. In this study, we engineered carbon-based scaffolds with hierarchical nano- and microscale architecture with controlled physico-chemical properties. More specifically, we built multiscale hierarchy by growing carbon nanotube (CNT) carpets on two types of scaffolds, namely, interconnected microporous carbon foams and aligned carbon fiber mats. Nanostructured CNT carpets offered fine control over nano-roughness and wettability facilitating myoblast adhesion, growth and differentiation into myocytes. However, microporous foam architecture failed to promote their fusion into multinucleated myotubes. On the other hand, aligned fibrous architecture stimulated formation of multinucleated myotubes. Most importantly, nanostructured CNT carpets interfaced with microscale aligned fibrous architecture significantly enhanced myocyte fusion into multinucleated mature myotubes highlighting synergy between nanoscale surface features and micro-/macroscale aligned fibrous architecture in the process of myogenesis. STATEMENT OF SIGNIFICANCE: Due to limited regenerative potential of skeletal muscle, strategies stimulating regeneration of functional muscles are important. These strategies are aimed at promoting differentiation of progenitor cells (myoblasts) into multinucleated myotubes, a key initial step in functional muscle regeneration. Recent tissue engineering approaches utilize various scaffolds ranging from decellularized matrices to aligned biomaterial scaffolds. Although, majority of them have focused on nano- or microscale organization, a systematic approach to build the multiscale hierarchy into these scaffolds is lacking. Here, we engineered multiscale hierarchy into carbon-based materials and demonstrated that the nanoscale features govern the differentiation of individual myoblasts into myocytes whereas microscale alignment cues orchestrate fusion of multiple myocytes into multinucleated myotubes underlining the importance of multiscale hierarchy in enhancing coordinated tissue regeneration.

Alterations of signaling pathways in muscle tissues of patients with amyotrophic lateral sclerosis.

INTRODUCTION: Amyotrophic lateral sclerosis (ALS), a degenerative disorder of the central nervous system, manifests as progressive weakening of muscles. The diagnosis and prognosis of ALS are often unclear, so useful biomarkers are needed. METHODS: Total proteins were extracted from muscle samples from 36 ALS, 17 spinal muscular atrophy (SMA), and 36 normal individuals. The expression levels of 134 proteins and phosphoproteins were assessed using protein pathway array analysis. RESULTS: Seventeen proteins were differentially expressed between ALS and normal muscle, and 9 proteins were differentially expressed between ALS and SMA muscle. The low-level expression of Akt and Factor XIIIB correlates with unfavorable survival, and the risk score calculated based on these proteins predicts the survival of each individual patient. CONCLUSIONS: Some proteins could be selected as clinically useful biomarkers. Specifically, Akt and Factor XIIIB were found to be promising biomarkers for estimating prognosis in ALS.

Interaction between protein 4.1R and spectrin heterodimers.

Defects or deficiencies in red cell membrane skeletal proteins often undermine the integrity and stability of the plasma membrane, and consequently cause hereditary hemolytic anemias. Genetic and biochemical studies have revealed a complicated picture of the organization of the membrane skeleton, within which α-/ß-spectrin heterodimers form a protein lattice. By stabilizing the red cell membrane skeleton, the erythroid protein 4.1R greatly contributes to connecting and regulating the interaction among spectrins, actin filaments and integral proteins on the plasma membrane. In this study, we demonstrated the direct interaction between 4.1R and α-/ß-spectrin. The results provide novel insights into the stoichiometry of 4.1R with spectrin, and demonstrate for the first time that the binding ratio of 4.1R to spectrin heterodimers is approximately 5.