Association between stress hyperglycemia ratio with short-term and long-term mortality in critically ill patients with ischemic stroke.

AIMS: Hyperglycemia on admission is associated with poor prognosis in ischemic stroke (IS) patients. We aimed to investigate the relationship between stress hyperglycemia ratio (SHR) and short-term or long-term mortality in IS patients in the ICU and to explore whether this relationship is influenced by diabetes status. MATERIALS AND METHODS: We collected patients with severe IS requiring ICU admission in the Medical Information Mart for Intensive Care (MIMIC-IV) database and calculated SHR. Outcomes included 30-day, 90-day, and 1-year mortality. The association between SHR and mortality in patients with critical IS was elucidated using Multivariate Cox regression and subgroup analysis for diabetes. RESULTS: A total of 1376 patients were recruited. After adjusting for potential confounders, patients in the third and fourth quartiles had a significantly increased risk of death at 30 days, 90 days, and 1 year compared to the first quartile of SHR (Q3 vs. Q1: HR 1.56-1.80, all p < 0.02; Q4 vs. Q1: HR 1.75-2.15, all p < 0.001; all p for trend < 0.001). In addition, the highest quartile of SHR was significantly associated with short-term or long-term mortality compared with the first quartile, regardless of diabetes status. CONCLUSIONS: Our results suggest that stress hyperglycemia, defined by the glucose/HbA1c ratio, is associated with increased short-term and long-term mortality in patients with ischemic stroke, independent of the patient's diabetes status.

Selective pressure of arsenic and antimony co-contamination on microbial community in alkaline sediments.

Although response of microbial community to arsenic (As) and antimony (Sb) co-contamination has been investigated in neutral and acidic environments, little is known in alkaline environment. Herein, the microbial response and survival strategies under the stress of As and Sb co-contamination were determined in the alkaline sediments. Elevated concentrations of As (13700 ± 5012 mg/kg) and Sb (10222 ± 1619 mg/kg) were introduced into the alkaline sediments by the mine drainage, which was partially adopted in the aquatic environment and resulted in a relatively lower contamination (As, 6633 ± 1707 mg/kg; Sb, 6108 ± 1095 mg/kg) in the downstream sediments. The microbial richness was significantly damaged and the microbial compositions were dramatically shifted by the As and Sb co-contamination. Metagenomic analysis shed light on the survival strategies of the microbes under the pressure of As and Sb co-contamination including metal oxidation coupled with denitrification, metal reduction, and metal resistance. The representative microbes were revealed in the sediments with higher (Halomonas) and lower (Thiobacillus, Hydrogenophaga and Flavihumibacter) As and Sb concentration, respectively. In addition, antibiotic resistance genes were found to co-occur with metal resistance genes in the assembled bins. These findings might provide theoretical guidance for bioremediation of As and Sb co-contamination in alkaline environment.

Removal of toilet paper fibers from residential wastewater: a life cycle assessment.

Toilet paper has been reported as one of the major insoluble pollutant components in the influent of wastewater treatment plants. Toilet paper fibers contribute to a large production of sewage sludge, resulting in a high treatment cost and high energy consumption. To find energy-efficient, cost-effective, and environment-friendly technologies for fiber removal and resource recovery from wastewater, a life-cycle assessment (LCA) was performed to analyze the wastewater treatment processes, including a sieving process for removing and recovering suspended solids before the biodegradation units. Based on the LCA results, it was estimated that the sieve screening process saved 8.57% of energy consumption. The construction phase of sieving consumed 1.31% energy cost compared with the operation phase. Environmental impact analysis showed that sieving reduced the impacts of climate change, human toxicity, fossil depletion, and particulate matter formation, which reduced the total normalized environmental impacts by 9.46%. The life-cycle analysis of the removal of toilet paper fibers from wastewater revealed the need to use more efficient methods to enhance the recovery of cellulose fibers.

Distribution and characteristics of heavy metals in a first-generation monofill site for incinerator residue.

This study investigated core samples from a landfill site for incinerator residue. The landfill site is one of the first monofill sites for municipal solid waste incinerator residue in the world. The concentrations of the heavy metals Cd, Cr, Cu, Pb, Zn, and Ni in the landfilled incinerator residues were 1-108, 41-926, 40-5498, 35-9806, 103-11453, and 25-719 mg/kg, respectively. Based on comparisons of heavy metal contents between raw incinerator fly ash and bottom ash reported in the literature, our samples comprised a mixture of incinerator fly ash and bottom ash. Rainfall had removed the dissolvable salts from the incinerator residues. The compositions of incinerator residues from different locations varied markedly. The vertical distribution showed a high heavy metal content in the waste layers, suggesting no vertical movement of heavy metals in this landfill site. A comparison between the experimental data and data calculated from historic records of the original metal compositions of the incinerator residues suggested high mobility of Zn, Cu, and Pb and low mobility of Cr and Cd. This trend was supported by a leaching test of waste layer samples. Zn and Cu were leached more readily at pH 9.0-10.0 and 10.5-11.5, respectively.

Heavy metal behavior in "Washing-Calcination-Changing with Bottom Ash" system for recycling of four types of fly ashes.

The Washing-Calcination-Changing with Bottom Ash (WCCB) system, effective at reducing chloride, was proposed to treat fly ash (FA) from a municipal solid waste incinerator (MSWI) before recycling FA in cement kiln as raw material. This study analyzed the behavior of heavy metals in four types of FA during WCCB treatment via Tessier and X-ray absorption fine structure (XANES) method. One FA was from the bag filter of a typical MSWI in Beijing, China (CFA), and the other three were from Japan (RFA, CaFA, and NaFA). All the metals were reduced especially Pb, Cd, and Hg (38.4-82.4%, 21.8-34.7%, and 100%, respectively). Besides Cr almost all heavy metals were stabilized according to Tessier analysis. Cr should be given more attention in WCCB as the formation of exchangeable Cr in the final residue. XANES result indicated that PbCl2 could be the main species of Pb in FA, while CaFA contains some PbO. The treated FAs contain PbCO3 and PbO besides PbCl2. The Tessier results of Ni, Pb, Cd, Cr, and Cu showed that NaFA was better at heavy metal stabilization than the other FA, so NaHCO3 is a more suitable neutralizer in WCCB.

Sarcolemmal ATP-sensitive potassium channel protects cardiac myocytes against lipopolysaccharide-induced apoptosis.

The sarcolemmal ATP-sensitive K+ (sarcKATP) channel plays a cardioprotective role during stress. However, the role of the sarcKATP channel in the apoptosis of cardiomyocytes and association with mitochondrial calcium remains unclear. For this purpose, we developed a model of LPS-induced sepsis in neonatal rat cardiomyocytes (NRCs). The TUNEL assay was performed in order to detect the apoptosis of cardiac myocytes and the MTT assay was performed to determine cellular viability. Exposure to LPS significantly decreased the viability of the NRCs as well as the expression of Bcl-2, whereas it enhanced the activity and expression of the apoptosis-related proteins caspase-3 and Bax, respectively. The sarcKATP channel blocker, HMR-1098, increased the apoptosis of NRCs, whereas the specific sarcKATP channel opener, P-1075, reduced the apoptosis of NRCs. The mitochondrial calcium uniporter inhibitor ruthenium red (RR) partially inhibited the pro-apoptotic effect of HMR-1098. In order to confirm the role of the sarcKATP channel, we constructed a recombinant adenovirus vector carrying the sarcKATP channel mutant subunit Kir6.2AAA to inhibit the channel activity. Kir6.2AAA adenovirus infection in NRCs significantly aggravated the apoptosis of myocytes induced by LPS. Elucidating the regulatory mechanisms of the sarcKATP channel in apoptosis may facilitate the development of novel therapeutic targets and strategies for the management of sepsis and cardiac dysfunction.

Comparison of biodiesel production from sewage sludge obtained from the A²/O and MBR processes by in situ transesterification.

The potential of two types of sludge obtained from the anaerobic-anoxic-oxic (A(2)/O) and membrane bioreactor (MBR) processes as lipid feedstock for biodiesel production via in situ transesterification was investigated. Experiments were conducted to determine the optimum conditions for biodiesel yield using three-factor and four-level orthogonal and single-factor tests. Several factors, namely, methanol-to-sludge mass ratio, acid concentration, and temperature, were examined. The optimum yield of biodiesel (16.6% with a fatty acid methyl ester purity of 96.7%) from A(2)/O sludge was obtained at a methanol-to-sludge mass ratio of 10:1, a temperature of 60°C, and a H2SO4 concentration of 5% (v/v). Meanwhile, the optimum yield of biodiesel (4.2% with a fatty acid methyl ester purity of 92.7%) from MBR sludge was obtained at a methanol-to-sludge mass ratio of 8:1, a temperature of 50°C, and a H2SO4 concentration of 5% (v/v). In this research, A(2)/O technology with a primary sedimentation tank is more favorable for obtaining energy from wastewater than MBR technology.

[The expression of KATP; channel mutant subunit Kir6.2AAA in rat cardiomyocytes].

OBJECTIVE: To construct a recombinant adenovirus vector carrying KATP; channel mutant subunit Kir6.2AAA and express it in rat cardiomyocytes. METHODS: Based on the primers for Kir6.2 subunits, Kir6.2 GFG amino acids were site-directed mutated into AAA by means of overlap PCR. PCR products were cloned into pShuttle vector for sequence analysis. After Pme I linearization, it was transformed into adenovirus expression vector pAdEasy-1. Then the pAdEasy-1 was packaged into liposome and transfected into primary cultured rat cardiomyocytes. The expression of Kir6.2AAA was confirmed by reverse transcription PCR(RT-PCR) and Western blotting. RESULTS: The recombinant adenovirus carrying the gene fragment Kir6.2AAA and EGFP was constructed successfully, and the virus titer was 2.64×10(11); VP/mL. After infected by the recombinant adenovirus expressing Kir6.2AAA, rat cardiomyocytes expressed EGFP and emitted green fluorescence under a fluorescence microscope. RT-PCR demonstrated that the expression of Kir6.2AAA was significantly up-regulated in the infected cardiomyocytes, and Western blotting also proved the over-expression of Kir6.2AAA in the cardiomyocytes. CONCLUSION: The recombinant adenovirus carrying the gene fragment Kir6.2AAA and EGFP was constructed successfully and expressed correctly in rat cardiomyocytes.

Efficacy and safety of a chinese herbal formula (invigorating kidney and strengthening spleen) in chronic hepatitis B virus carrier: results from a multicenter, randomized, double-blind, and placebo-controlled trial.

A Chinese Herbal Formula (CHF) has acquired a certain therapeutic effect on chronic HBV infection. To assess the efficacy and safety of CHF on HBV replication in chronic HBV carriers, we performed a randomized, double-blind, and placebo-controlled trial involving patients from 16 centers. A total of 300 confirmed chronic HBV carriers were randomized at baseline in a ratio of 2 : 1 to receive either CHF or placebo for 52 weeks. The results showed that a greater proportion of CHF than placebo treated patients achieved virological response at week 52; the mean decline of serum HBsAg levels in the CHF group dropped more obviously than that in the control group at all stages of the treatment; however, the rates of HBeAg loss and seroconversion had no difference between the two groups. Meanwhile, were presented significant increases in IFN- γ ; IL-2 levels and reductions in IL-4 and IL-10 levels in the treatment group compared to the control group at week 52. There were no drug-related serious adverse events. In conclusion, the treatment with 52-week CHF is safe and effective in inhibiting HBV replication in chronic HBV carriers. The ability of the compound to modulate host immune function probably contributed to this effect.

Removal and recovery of Zn2+ and Pb2+ by imine-functionalized magnetic nanoparticles with tunable selectivity.

This research investigated the adsorption of zinc and lead from binary metal solution with tunable selectivity. A nano adsorbent was prepared by introducing imine groups onto the surface of stability enhanced magnetic nanoparticles and then characterized by TEM and FTIR. Binary metal components adsorption was carried out in different concentration of metal and EDTA solution. Due to the interaction between metals and adsorbent in the presence of EDTA, the selective adsorption of zinc and lead could be achieved with 100% selectivity. To only remove zinc from binary metals, the solution condition was [EDTA]/[M(2+)] = 0.7 with pH of 6, and its saturated adsorption capacity was 1.25 mmol/g. For selective adsorption of lead, an equilibrium adsorption capacity of 0.81 mmol/g was obtained under the condition of [EDTA]/[M(2+)] = 0.7 and pH of 2. The exhausted adsorbent could be regenerated by simple acid or alkali wash, and high purity lead and zinc salt solutions were recovered and concentrated.