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Asthma remains a prevalent diagnosis among intensive care unit (ICU) admissions, frequently linked to worsened patient outcomes. Therefore, identifying simple and effective indicators to predict the mortality risk of asthma patients in the ICU is particularly important. Given the unmet need for mortality biomarkers in critical asthma, this study specifically examined neutrophil percentage-to-albumin ratio's (NPAR's) correlation with ICU and in-hospital death. We selected 1191 eligible asthma patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 3.0 database for analysis. This study applied a multivariate Cox regression model to explore the relationship between NPAR levels and the risk of mortality in the ICU and during hospitalization. Additionally, we used restricted cubic splines (RCSs) models to investigate the potential nonlinear dose-response relationship between NPAR levels and the risk of mortality in the ICU and during hospitalization. Among the 1192 enrolled asthma cases, the cohort demonstrated a mean age of 58.1 ± 18.1 years, of which 38.7% were male. Asthma patients with higher NPAR faced substantially greater mortality risks during intensive care and hospitalization (hazard ratio [HR] range 1.75-2.14, p  < 0.01). The relationship between logarithmic transformation (ln) NPAR and ICU and in-hospital mortality rates is nonlinear. Threshold effect analysis showed that when the ln NPAR level exceeded 0.5, the risk of patient mortality significantly increased (HR range 1.574-1.831, p  < 0.05). Additionally, subgroup analysis revealed no significant interactions. In ICU asthma patients, higher NPAR levels are associated with higher risks of ICU and in-hospital mortality, emphasizing the importance of these findings for early identification and timely intervention in reducing the mortality risk of ICU asthma patients.

A nanozyme based on CoFe 2 O 4 modified with MoS 2 was constructed for colorimetric determination of cysteine (Cys) and glutathione (GSH). Firstly, ferrite CoFe 2 O 4 is synthesized, and it is then modified by MoS 2 to form a flower-like polymer (MoS 2 @CoFe 2 O 4 ). In the presence of H 2 O 2 , a redox interaction takes place, and the resulting hydroxyl promoted a colorimetric conversion from colorless to blue in the presence of 3,3′,5,5′-tetramethylbenzidine (TMB). However, once Cys or GSH is added, they are capable to compete with the interaction of the hydroxyl with TMB, resulting in an inhibition of the colorimetric conversion. The colorimetric distinction is sensitive to the amount of target. The results obtained proved that the catalytic efficiency of MoS 2 @CoFe 2 O 4 is 4.4-fold and 1.8-fold to that of MoS 2 and CoFe 2 O 4 . Meanwhile, the K m values to TMB and H 2 O 2 are 0.067 and 0.048 mM, respectively, which are 6.5-fold and 77-fold, respectively smaller than those of natural peroxidase such as HPR. This indicates that the MoS 2 @CoFe 2 O 4 possesses a favorable interaction affinity. Additionally, the colorimetric distinction caused by the competition between TMB and cysteine or glutathione is obvious. The signal responses to cysteine and glutathione are linear in the range 0.5~15 μM and 0.5~35 μM, and the LODs are 0.10 and 0.21 μM, respectively. In practical assay of Cys in serum, the RSD of the sample tests is 4.6%, and the recoveries for the spiked assays are 95.3% and 96.0% with the RSD of 2.1% and 4.2%, respectively. Graphical abstract

This study aimed to investigate the relationship between unintentional weight loss and 30-day mortality in sepsis patients in the intensive care unit (ICU). A retrospective cohort study sepsis patients in the ICU was conducted using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, involving 1842 sepsis patients in the ICU. We utilized multivariate Cox regression analysis to evaluate the association between unintentional weight loss and the risk of 30-day mortality. In addition, we conducted stratified and interaction analyses to determine the consistency of this association across various demographic and clinical subgroups. Out of the 1842 patients, 19.2% (354) died within 30 days. The fully adjusted multivariate Cox regression model revealed that for every one-unit decrease in body weight, the risk of death increased by 58% (hazard ratio [HR] = 1.58; 95% confidence interval [CI] = 1.20–2.07). Unintentional weight loss was found to be positively correlated with 30-day mortality. Subgroup analysis yielded consistent results across all groups. Unintentional weight loss was positively associated with a greater risk of mortality in critically ill patients with sepsis in the ICU.

Gastrointestinal tumors are a major global health burden, with surgery as the main curative treatment. The Stress Hyperglycemia Ratio (SHR) has prognostic value in critical illnesses, but its association with postoperative intensive care unit (ICU) admission in gastrointestinal tumor patients remains unclear. This study investigates the relationship between preoperative SHR and ICU transfer risk after gastrointestinal cancer surgery. This retrospective cohort study analyzed data from 2,102 gastrointestinal tumor surgery patients in the INSPIRE database. Multivariable logistic regression examined the association between SHR and ICU admission, with models progressively adjusted for confounders. A generalized additive model explored potential nonlinearity. The model's predictive performance was assessed using receiver operating characteristic (ROC) curves and calibration plots with bootstrapping. Subgroup and sensitivity analyses were performed to evaluate the consistency of the findings. In fully adjusted models, elevated preoperative SHR was independently associated with increased ICU admission risk. Each 0.1-unit increase in SHR corresponded to an odds ratio (OR) of 1.08 (95% CI: 1.04-1.13, < 0.001). Compared to the lowest tertile, patients in the highest SHR tertile (≥1.04) had an OR of 1.43 (95% CI: 1.04-1.97, = 0.03). The dose-response relationship was linear (P for nonlinearity >0.05). The prediction model incorporating SHR demonstrated good discrimination with an AUC of 0.895 and good calibration with a mean absolute error of 0.009. Subgroup analysis indicated significant interaction effects for age and sex. Preoperative SHR is a strong and independent predictor of postoperative ICU admission in patients undergoing surgery for gastrointestinal tumors, exhibiting a linear dose-response relationship. The multivariable model incorporating SHR showed excellent predictive performance, with an AUC of 0.895 and good calibration. Integrating SHR assessment into preoperative evaluation could enhance risk stratification, guide perioperative management, and optimize critical care resource allocation for this patient population.

Tracheal intubation in intensive care unit (ICU) patients is associated with significant risks, necessitating simple mortality predictors. We investigated the relationship between neutrophil percentage-to-albumin ratio (NPAR) and in-hospital and ICU mortality in intubated patients. This retrospective cohort study analyzed 1,401 intubated ICU patients from MIMIC-IV. Multivariable Cox regression and smooth curve fitting were used to assess the association between NPAR and mortality. A two-stage linear regression model and threshold analysis evaluated nonlinear relationships. Among patients (mean age 62.7 ± 17.1 years; 43.6% female), NPAR exhibited a U-shaped relationship with mortality, with an inflection point at 2.2 observed in this cohort. Below this inflection point, hazard ratios (HRs) were 0.656 (95% CI: 0.492-0.875) for in-hospital mortality and 0.586 (95% CI: 0.413-0.831) for ICU mortality. Above 2.2, HRs increased to 1.187 (95% CI: 1.097-1.286) and 1.15 (95% CI: 1.047-1.264), respectively. NPAR demonstrates a U-shaped association with mortality in intubated ICU patients, with elevated risks above 2.2. Further large-scale studies are needed to validate these findings.

Background In the intensive care unit (ICU), the incidence of iron-deficiency anemia (IDA) is relatively high and is associated with various adverse clinical outcomes. Therefore, it is crucial to identify simple and practical indicators to assess the mortality risk in ICU patients with IDA. This study aims to investigate the relationship between the Neutrophil Percentage-to-Albumin Ratio (NPAR) levels in patients with IDA in the ICU and their all-cause mortality at 30 and 365 days. Materials and methods We analyzed data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 3.0 database spanning the years 2008–2022 and identified a cohort of 817 patients with IDA who met our inclusion criteria. Through multivariate Cox regression analysis, the relationship between NPAR levels and 30-day and 365-day mortality risks was assessed, and restricted cubic splines (RCS) models were used to explore potential nonlinear relationships. Additionally, an inflection point analysis was conducted to evaluate the potential of NPAR levels in predicting short- and long-term mortality risks. Results The study found that high NPAR levels were significantly associated with an increased risk of 30-day and 365-day mortality in patients with IDA (hazard ratio [HR] range 1.49–2.23, p  < 0.001 for all). The relationship between natural logarithmic transformation (ln) NPAR levels and 30-day and 365-day mortality risks exhibited an inverse “L” shaped pattern. Patient mortality risk increased significantly when ln-transformed NPAR levels exceeded 1.2 (HR range 3.366–4.304, p  < 0.001 for all). Additionally, subgroup analyses did not reveal any significant interactions, indicating that the predictive effect of NPAR on mortality risk is relatively consistent across different subgroups. Conclusion We found an inverse “L” shaped relationship between ln-transformed NPAR levels and 30-day and 365-day mortality risks, particularly when ln-transformed NPAR values exceed 1.2, which is significantly associated with an increased risk of death within 30 and 365 days for patients.

By using graphene quantum dots (GQDs) and o -phenylenediamine (OPD), a ratiometric fluorescence probe was designed for the highly sensitive and selective detection of AChE. GQDs with strong fluorescence were synthesized by the one-step hydrothermal method. The optimal emission wavelength of GQDs was 450 nm at the excitation wavelength of 375 nm. MnO 2 nanosheets with a wide absorption band of 300–600 nm were prepared at room temperature. Because of the extensive overlap between the absorption spectrum of MnO 2 nanosheets and the excitation and emission spectra of GQDs, the fluorescence of GQDs at 450 nm was efficiently quenched by the inner-filter effect. Meanwhile, due to the peroxidase-like activity of MnO 2 nanosheets, OPD was catalytically oxidized to 2,3-diaminophenazine (oxOPD), a yellow fluorescent substance with a new emission peak at 572 nm. When AChE was present, the substrate acetylthiocholine (ATCh) was hydrolyzed to thiocholine (TCh) that is capable of decomposing MnO 2 nanosheets. Therefore, the quench of GQDs and the oxidation of OPD by MnO 2 nanosheets were suppressed, resulting in the fluorescence recovery of GQDs at 450 nm, while the fluorescence decrease of oxOPD at 572 nm. Utilizing the fluorescence intensity ratio F 450 /F 572 as the signal readout, the ratiometric fluorescence method was established to detect AChE activity. The ratio F 450 /F 572 against the AChE concentration demonstrated two linear relationships in the range 0.1–2.0 and 2.0–4.5 mU mL −1 with a detection limit of 0.09 mU mL −1 . The method was applied to the detection of positive human serum samples and the analysis of the inhibitor neostigmine. Due to the advantages of high sensitivity, favorable selectivity, and strong anti-interference, the method possesses an application prospect in clinical diagnosis of AChE and the screening of inhibitors. Graphical abstract Schematic presentation of a ratiometric fluorescence method for the detection of acetylcholinesterase (AChE). The fluorescence of graphene quantum dots (GQDs) is quenched and o -phenylenediamine (OPD) is oxidized to generate fluorescent product 2,3-diaminophenazine (oxOPD) by MnO 2 nanosheets. When AChE is present, acetylthiocholine iodide (ATCh) is hydrolyzed to thiocholine (TCh) with reducibility for decomposing MnO 2 nanosheets. Due to the decomposition of MnO 2 nanosheets, the quenching of GQDs and oxidation of OPD are suppressed. The fluorescence of GQDs at 450 nm is enhanced, while the fluorescence of oxOPD at 572 nm is reduced. The fluorescence intensity ratio F 450 /F 572 is used to establish the ratiometric fluorescence method for AChE activity.

TAR DNA-binding protein 43 (TDP-43) has emerged as a critical player in neurodegenerative disorders, with its dysfunction implicated in a wide spectrum of diseases including amyotrophic lateral sclerosis (ALS), frontotemporal lobar degeneration (FTLD), and Alzheimer’s disease (AD). This comprehensive review explores the multifaceted roles of TDP-43 in both physiological and pathological contexts. We delve into TDP-43’s crucial functions in RNA metabolism, including splicing regulation, mRNA stability, and miRNA biogenesis. Particular emphasis is placed on recent discoveries regarding TDP-43’s involvement in DNA interactions and chromatin dynamics, highlighting its broader impact on gene expression and genome stability. The review also examines the complex pathogenesis of TDP-43-related disorders, discussing the protein’s propensity for aggregation, its effects on mitochondrial function, and its non-cell autonomous impacts on glial cells. We provide an in-depth analysis of TDP-43 pathology across various neurodegenerative conditions, from well-established associations in ALS and FTLD to emerging roles in diseases such as Huntington’s disease and Niemann-Pick C disease. The potential of TDP-43 as a therapeutic target is explored, with a focus on recent developments in targeting cryptic exon inclusion and other TDP-43-mediated processes. This review synthesizes current knowledge on TDP-43 biology and pathology, offering insights into the protein’s central role in neurodegeneration and highlighting promising avenues for future research and therapeutic interventions.

A sensitive electrochemical strategy was established for kanamycin determination. A specific aptamer was modified on the electrode as the probe, followed by a cyclic hybridization chain reaction (HCR) with methylene blue, causing an increasing signal response. In the presence of kanamycin, it can initiatively convolve the aptamer and prevent further DNA assembling, resulting in a signal distinction sensitive to the target amount. However, the signal reproducibility is low. To improve the precision, the HCR procedure was investigated. The results demonstrated that the optimal amount of assembled DNA is 12-fold to that of aptamer. This amount was then controlled in further assays. Admittedly, controlled DNA assembling commonly indicates a limited signal amplification. To further enhance the sensitivity, a nanocomposite based on MoS 2 and AuNPs was modified on the electrode. The results of the assay proved that the signal distinction sensitive to target amount increased by 50%. A linearity range is obtained from 0.01 nM to 1.0 μM of kanamycin, and the LOD is 8.4 pM. Subsequently, this strategy was employed to detect kanamycin in chicken liver and milk sample; the recovery results suggest that it possess a satisfactory application prospect in analysis of agricultural products. Graphical abstract

Lithium‐ion batteries are widely used in portable electronics and electric vehicles due to their high energy density, stable cycle life, and low self‐discharge. However, irreversible lithium loss during the formation of the solid electrolyte interface greatly impairs energy density and cyclability. To compensate for the lithium loss, introducing an external lithium source, that is, a prelithiation agent, is an effective strategy to solve the above problems. Compared with other prelithiation strategies, cathode prelithiation is more cost‐effective with simpler operation. Among various cathode prelithiation agents, we first systematically summarize the recent progress of Li2S‐based prelithiation agents, and then propose some novel strategies to tackle the current challenges. This review provides a comprehensive understanding of Li2S‐based prelithiation agents and new research directions in the future. As a prelithiation agent, Li2S irreversibly release active Li+ during the first few charging process. The delithiation potential of Li2S prelithiation agent is lower than that of cathode materials, therefore the SEI formation consumes the Li+ of the Li2S prelithiation agent, rather than cathode materials, during the first charge process. In the discharge process, the oxidized cathode material of higher redox potential holds the priority to combine with the released Li+ from the anode side. The above process implies an irreversible lithiation/delithiation process, leading to a sacrificial role for Li2S prelithiation agents.