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Chronic heart failure (CHF) poses a significant threat to human health. The stress hyperglycemia ratio (SHR) is a novel metric for accurately assessing stress hyperglycemia, which has been correlated with adverse outcomes in various major diseases. However, it remains unclear whether SHR is associated with 28-day mortality in patients with pre-existing CHF who were admitted to intensive care units (ICUs). This study retrospectively recruited patients who were admitted to ICUs with both acute critical illness and pre-existing CHF from the Medical Information Mart for Intensive Care (MIMIC) database. Characteristics were compared between the survival and non-survival groups. The relationship between SHR and 28-day all-cause mortality was analyzed using restricted cubic splines, receiver operating characteristic (ROC) curves, Kaplan–Meier survival analysis, and Cox proportional hazards regression analysis. The importance of the potential risk factors was assessed using the Boruta algorithm. Prediction models were constructed using machine learning algorithms. A total of 913 patients were enrolled. The risk of 28-day mortality increased with higher SHR levels (P < 0.001). SHR was independently associated with 28-day all-cause mortality, with an unadjusted hazard ratio (HR) of 1.45 (P < 0.001) and an adjusted HR of 1.43 (P < 0.001). Subgroup analysis found that none of the potential risk factors, such as demographics, comorbidities, and drugs, affected the relationship (P for interaction > 0.05). The area under the ROC (AUC) curve for SHR was larger than those for admission blood glucose and HbA1c; the cut-off for SHR was 0.57. Patients with SHR higher than the cut-off had a significantly lower 28-day survival probability (P < 0.001). SHR was identified as one of the key factors for 28-day mortality by the Boruta algorithm. The predictive performance was verified through four machine learning algorithms, with the neural network algorithm being the best (AUC 0.801). For patients with both acute critical illness and pre-existing CHF, SHR was an independent predictor of 28-day all-cause mortality. Its prognostic performance surpasses those of HbA1c and blood glucose, and prognostic models based on SHR provide clinicians with an effective tool to make therapeutic decisions.

Stimuli-responsive hydrogel actuators have promising applications in various fields. However, the typical hydrogel actuation relies on the swelling and de-swelling process caused by osmotic-pressure changes, which is slow and normally requires the presence of water environment. Herein, we report a light-powered in-air hydrogel actuator with remarkable performances, including ultrafast motion speed (up to 1.6 m/s), rapid response (as fast as 800 ms) and high jumping height (~15 cm). The hydrogel is operated based on a fundamentally different mechanism that harnesses the synergetic interactions between the binary constituent parts, i.e. the elasticity of the poly(sodium acrylate) hydrogel, and the bubble caused by the photothermal effect of the embedded magnetic iron oxide nanoparticles. The current hydrogel actuator exhibits controlled motion velocity and direction, making it promising for a wide range of mobile robotics, soft robotics, sensors, controlled drug delivery and other miniature device applications. Actuation of hydrogel actuators relies on slow swelling and de-swelling process which hampers its application in many fields. Here the authors report a light-powered in-air hydrogel actuator with remarkable performances including fast motion, speed and rapid response time.

The second near-infrared (NIR II) response photon up-conversion (UC) materials show great application prospects in the fields of biology and optical communication. However, it is still an enormous challenge to obtain efficient NIR II response materials. Herein, we develop a series of Er 3+ doped ternary sulfides phosphors with highly efficient UC emissions under 1532 nm irradiation. β-NaYS 2 :Er 3+ achieves a visible UC efficiency as high as 2.6%, along with high brightness, spectral stability of lights illumination and temperature. Such efficient UC is dominated by excited state absorption, accompanied by the advantage of long lifetimes ( 4 I 9/2 , 9.24 ms; 4 I 13/2 , 30.27 ms) of excited state levels of Er 3+ , instead of the well-recognized energy transfer UC between sensitizer and activator. NaYS 2 :Er 3+ phosphors are further developed for high-performance underwater communication and narrowband NIR photodetectors. Our findings suggest a novel approach for developing NIR II response UC materials, and simulate new applications, eg., simultaneous NIR and visible optical communication. Development of efficient upconversion (UC) phosphors that emit under irradiation in the NIR II region is challenging - most UC materials rely on the presence of sensitizers absorbing at shorter wavelengths. Here, authors synthesize Er 3+ doped ternary sulfides phosphors with visible UC efficiency up to 2.6% and long emission lifetimes under 1532 nm irradiation, via an excited state absorption mechanism.

The pathogenetic mechanisms of ventilator-induced lung injury (VILI) still need to be elucidated. The mechanical forces during mechanical ventilation are continually sensed and transmitted by mechanosensitive ion channels (MSICs) in pulmonary endothelial, epithelial, and immune cells. In recent years, MSICs have been shown to be involved in VILI. A systematic search across PubMed, the Cochrane Library, Web of Science, and ScienceDirect was performed from inception to March 2024, and the review was conducted in accordance with PRISMA guidelines. The potential eligible studies were evaluated by two authors independently. Study characteristics, quality assessment, and potential mechanisms were analyzed. We included 23 eligible studies, most of which were performed with murine animals . At the level, 52% and 48% of the experiments were conducted with human or animal cells, respectively. No clinical studies were found. The most reported MSICs include Piezo channels, transient receptor potential channels, potassium channels, and stretch-activated sodium channels. Piezo1 has been the most concerned channel in the recent five years. This study found that signal pathways, such as RhoA/ROCK1, could be enhanced by cyclic stretch-activated MSICs, which contribute to VILI through dysregulated inflammation and immune responses mediated by ion transport. The review indicates the emerging role of MSICs in the pathogenesis of VILI, especially as a signal-transmitting link between mechanical stretch and pathogenesis such as inflammation, disruption of cell junctions, and edema formation. Mechanical stretch stimulates MSICs to increase transcellular ion exchange and subsequently generates VILI through inflammation and other pathogeneses mediated by MSICs signal-transmitting pathways. These findings make it possible to identify potential therapeutic targets for the prevention of lung injury through further exploration and more studies. https://inplasy.com/inplasy-2024-10-0115/, identifier INPLASY2024100115.

For seeking high enantiopurity, the previously reported thermal asymmetric catalysis is usually carried out at low temperature sometimes with limited yield, that is, the high enantiomeric excess (ee) usually at the cost of high yield. Thus, the achieving both high stereoselectivity and yield is an enormous challenge. We report herein two metal nanoparticle (M NP)-loaded and porphyrin-containing homochiral covalent organic framework (CCOF)-based composite catalysts, and their application in the thermally-driven asymmetric one-pot Henry and A 3 -coupling reactions. All the reactions are conducted at elevated temperatures with both excellent stereoselectivity and yield which resulted from the synergy of CCOF confinement effect and M NP catalytic activation. Notably, the needed thermal energy for the asymmetric reactions herein is derived from the photothermal conversion via porphyrin-based CCOF upon irradiation with visible light. Remarkably, the CCOF confinement effect can be effectively maintained up to 100 °C for the asymmetric one-pot Henry and A 3 -coupling reactions herein. Achieving both high stereoselectivity and yield is a challenge for conventional asymmetric catalysis. Here, the authors report two metal nanoparticle-loaded and porphyrin-containing homochiral covalent organic framework-based composite catalysts that exhibit high stereoselectivity and yield in the thermally-driven asymmetric reactions.

The total solids content of feedstocks affects the performances of anaerobic digestion and the change of total solids content will lead the change of microbial morphology in systems. In order to increase the efficiency of anaerobic digestion, it is necessary to understand the role of the total solids content on the behavior of the microbial communities involved in anaerobic digestion of organic matter from wet to dry technology. The performances of mesophilic anaerobic digestion of food waste with different total solids contents from 5% to 20% were compared and the microbial communities in reactors were investigated using 454 pyrosequencing technology. Three stable anaerobic digestion processes were achieved for food waste biodegradation and methane generation. Better performances mainly including volatile solids reduction and methane yield were obtained in the reactors with higher total solids content. Pyrosequencing results revealed significant shifts in bacterial community with increasing total solids contents. The proportion of phylum Chloroflexi decreased obviously with increasing total solids contents while other functional bacteria showed increasing trend. Methanosarcina absolutely dominated in archaeal communities in three reactors and the relative abundance of this group showed increasing trend with increasing total solids contents. These results revealed the effects of the total solids content on the performance parameters and the behavior of the microbial communities involved in the anaerobic digestion of food waste from wet to dry technologies.

Integrated photonic devices based on Si 3 N 4 waveguides allow for the exploitation of nonlinear frequency conversion, exhibit low propagation loss, and have led to advances in compact atomic clocks, ultrafast ranging, and spectroscopy. Yet, the lack of Pockels effect presents a major challenge to achieve high-speed modulation of Si 3 N 4 . Here, microwave-frequency acousto-optic modulation is realized by exciting high-overtone bulk acoustic wave resonances (HBAR) in the photonic stack. Although HBAR is ubiquitously used in modern communication and superconducting circuits, this is the first time it has been incorporated on a photonic integrated chip. The tight vertical acoustic confinement releases the lateral design of freedom, and enables negligible cross-talk and preserving low optical loss. This hybrid HBAR nanophotonic platform can find immediate applications in topological photonics with synthetic dimensions, compact opto-electronic oscillators, and microwave-to-optical converters. As an application, a Si 3 N 4 -based optical isolator is demonstrated by spatiotemporal modulation, with over 17 dB isolation achieved. Here, the authors demonstrate acousto-optic modulation of silicon nitride microring resonators using high-overtone bulk acoustic wave resonances, allowing modulation in the GHz range via acoustic waves. As an application, an optical isolator is demonstrated with 17 dB non-reciprocity.

The new Version 2.3 of the Global Precipitation Climatology Project (GPCP) Monthly analysis is described in terms of changes made to improve the homogeneity of the product, especially after 2002. These changes include corrections to cross-calibration of satellite data inputs and updates to the gauge analysis. Over-ocean changes starting in 2003 resulted in an overall precipitation increase of 1.8% after 2009. Updating the gauge analysis to its final, high-quality version increases the global land total by 1.8% for the post-2002 period. These changes correct a small, incorrect dip in the estimated global precipitation over the last decade given by the earlier Version 2.2. The GPCP analysis is also used to describe global precipitation in 2017. The general La Niña pattern for 2017 is noted and the evolution from the early 2016 El Niño pattern is described. The 2017 global value is one of the highest for the 1979–2017 period, exceeded only by 2016 and 1998 (both El Niño years), and reinforces the small positive trend. Results for 2017 also reinforce significant trends in precipitation intensity (on a monthly scale) in the tropics. These results for 2017 indicate the value of the GPCP analysis, in addition to research, for climate monitoring.

In patients with acute myocardial infarction receiving potent antiplatelet therapy, the bleeding risk remains high during the maintenance phase. We sought data on a uniform unguided de-escalation strategy of dual antiplatelet therapy (DAPT) from ticagrelor to clopidogrel after acute myocardial infarction. In this open-label, assessor-masked, multicentre, non-inferiority, randomised trial (TALOS-AMI), patients at 32 institutes in South Korea with acute myocardial infarction receiving aspirin and ticagrelor without major ischaemic or bleeding events during the first month after index percutaneous coronary intervention (PCI) were randomly assigned in a 1:1 ratio to a de-escalation (clopidogrel plus aspirin) or active control (ticagrelor plus aspirin) group. Unguided de-escalation without a loading dose of clopidogrel was adopted when switching from ticagrelor to clopidogrel. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, or bleeding type 2, 3, or 5 according to Bleeding Academic Research Consortium (BARC) criteria from 1 to 12 months. A non-inferiority test was done to assess the safety and efficacy of de-escalation DAPT compared with standard treatment. The hazard ratio (HR) for de-escalation versus active control group in a stratified Cox proportional hazards model was assessed for non-inferiority by means of an HR margin of 1·34, which equates to an absolute difference of 3·0% in the intention-to-treat population and, if significant, a superiority test was done subsequently. To ensure statistical robustness, additional analyses were also done in the per-protocol population. This trial is registered at ClinicalTrials.gov, NCT02018055. From Feb 26, 2014, to Dec 31, 2018, from 2901 patients screened, 2697 patients were randomly assigned: 1349 patients to de-escalation and 1348 to active control groups. At 12 months, the primary endpoints occurred in 59 (4·6%) in the de-escalation group and 104 (8·2%) patients in the active control group (pnon-inferiority<0·001; HR 0·55 [95% CI 0·40–0·76], psuperiority=0·0001). There was no significant difference in composite of cardiovascular death, myocardial infarction, or stroke between de-escalation (2·1%) and the active control group (3·1%; HR 0·69; 95% CI 0·42–1·14, p=0·15). Composite of BARC 2, 3, or 5 bleeding occurred less frequently in the de-escalation group (3·0% vs 5·6%, HR 0·52; 95% CI 0·35–0·77, p=0·0012). In stabilised patients with acute myocardial infarction after index PCI, a uniform unguided de-escalation strategy significantly reduced the risk of net clinical events up to 12 months, mainly by reducing the bleeding events. ChongKunDang Pharm, Medtronic, Abbott, and Boston Scientific.

HighlightsAnalyzed the function of internal polarization field in Ni2P/FeP2 via hydroxyl spillover effect.From theoretical design to experimental verification, to optimize adsorption energy of oxygen intermediates on Ni active site, and further boost the xygen evolution reaction process.A hydroxyl spillover effect driven by internal polarization field in Ni2P/FeP2 can be amplified in low concentration alkaline electrolyte environment, and facilitate the application in anion exchange membrane water electrolyzer systems.The formation of multiple oxygen intermediates supporting efficient oxygen evolution reaction (OER) are affinitive with hydroxyl adsorption. However, ability of the catalyst to capture hydroxyl and maintain the continuous supply at active sits remains a tremendous challenge. Herein, an affordable Ni2P/FeP2 heterostructure is presented to form the internal polarization field (IPF), arising hydroxyl spillover (HOSo) during OER. Facilitated by IPF, the oriented HOSo from FeP2 to Ni2P can activate the Ni site with a new hydroxyl transmission channel and build the optimized reaction path of oxygen intermediates for lower adsorption energy, boosting the OER activity (242 mV vs. RHE at 100 mA cm–2) for least 100 h. More interestingly, for the anion exchange membrane water electrolyzer (AEMWE) with low concentration electrolyte, the advantage of HOSo effect is significantly amplified, delivering 1 A cm–2 at a low cell voltage of 1.88 V with excellent stability for over 50 h.