Abstract
Skeletal muscle atrophy is prevalent and remarkably increases the risk of cardiovascular (CV) events and mortality in hemodialysis (HD) patients. However, whether diaphragm dysfunction ...predicts clinical outcomes in HD patients is unknown. This was a prospective cohort study of 103 HD patients. After assessment of diaphragm function by ultrasonography and collection of other baseline data, a 36-month follow-up was then initiated. Participants were divided into diaphragm dysfunction (DD+) group and normal diaphragm function (DD−) group, according to cutoff value of thickening ratio (i.e. the change ratio of diaphragm thickness) at force respiration. The primary endpoint was the first nonfatal CV event or all-cause mortality. A secondary endpoint was less serious CV events (LSCEs, a composite of heart failure readmission, cardiac arrhythmia or myocardial ischemia needed pharmacological intervention in hospital). 98 patients were eligible to analysis and 57 (58.16%) were men. 28 of 44 patients(63.64%) in DD+ group and 23 of 54 patients (42.59%) in DD− group had at least one nonfatal CV event or death (
p
= 0.038). Compared to DD− group, DD+ group had significantly higher incidence of LSCEs (21
vs.
14,
p
= 0.025) and shorter survival time (22.02 ± 12.98 months
vs.
26.74 ± 12.59 months,
p
= 0.046). Kaplan–Meier analysis revealed significantly higher risks of primary endpoint (
p
= 0.039), and LSCEs (
p
= 0.040) in DD+ group. Multivariate hazard analysis showed that DD+ group had significantly higher risk of primary endpoint hazard ratio (HR) 1.59; 95% confident interval (CI) 1.54–1.63, and LSCEs (HR 1.47; 95%CI 1.40–1.55). Ultrasound-assessed diaphragm dysfunction predicts clinical outcomes in HD patients.
Trial registration: This study was registered with Chinese Clinical Trials Registry (
www.chictr.org.cn
) as ChiCTR1800016500 on Jun 05, 2018.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
IgA nephropathy (IgAN) features variable renal pathology and a heterogeneous clinical course. Our aim was to search noninvasive biomarkers from urinary exosomes for IgAN patients; membrane ...nephropathy and minimal change disease were included as other glomerulopathy controls. Transmission electron microscopy and nanoparticle tracking analysis confirmed the size and morphology characteristic of urinary exosomes. Exosome markers (Alix and CD63) as well as renal cell markers aquaporin 2 (AQP2) and nephrin were detected, which indicate the renal origin of urinary exosomes. Exosome excretion was increased markedly in IgAN patients compared with controls and correlated with levels of proteinuria and tubular injury. More important, urinary exosome excretion correlated with greater histologic activity (mesangial hypercellularity, crescents, and endocapillary hypercellularity). Profiling of the inflammation-related mRNA revealed that exosomal chemokine (C-C motif) ligand 2 (CCL2) was up-regulated in IgAN patients. In a validation study, CCL2 was exclusively highly expressed in IgAN patients compared with healthy controls as well as minimal change disease and membrane nephropathy patients. Also, a correlation between exosomal CCL2 and estimated glomerular filtration rate levels was found in IgAN. Exosomal CCL2 was correlated with tubulointerstitial inflammation and C3 deposition. High CCL2 levels at the time of renal biopsy were associated with subsequent deterioration in renal function. Thus, urinary exosomes and exosomal CCL2 mRNA are promising biomarkers reflecting active renal histologic injury and renal function deterioration in IgAN.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Light-emitting materials with tunable properties may offer fascinating applications in optoelectronic devices, fluorescent sensors, and imaging agents. Herein, a new supramolecular approach based on ...host–guest interactions that greatly decreases the number of required synthetic steps and produces a system with tunable and dynamical photophysical properties was developed. Because of the novel electronic distributions of the chromophore guest within the rigid hydrophobic cavity of the cucurbit8uril host in this system, color tuning of emissions such as cyan, yellow, green, and white light with efficiency increased fluorescence lifetime, and quantum yield was easily achieved by simple addition of the host in aqueous solution. Stimulus-responsive tuning of color has long been an important area of research into light emissions. The current study distinguishes itself by its combination of simple steps using a single synthetic receptor and a single organic fluorophore guest in a single solution. Our results may provide a promising advancement of the fabrication of smart and tunable luminescent materials.
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IJS, KILJ, NUK, PNG, UL, UM
A general palladium‐catalyzed method for the direct alkynylation of unactivated alkenes via C−H activation, was successfully developed, with the assistance of 8‐aminoquinoline. It is applicable to ...both internal and terminal unactivated alkenes with a broad functionality tolerance. This method shows good regio‐ and diastereoselectivity and provides an alternative approach for directing construct of conjugated 1,3‐enynes.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The relationship between dietary total antioxidant capacity (DTAC) and death risk among CKD populations remains unclear.
Based on vitamin C equivalent antioxidant capacity (VCEAC) and the component ...dietary antioxidant index (CDAI) indices, we analyzed two cohorts to investigate the association of DTAC with all-cause and CVD mortality in CKD patients using data from National Health and Nutrition Examination Survey (2007-2018). VCEAC (n = 6330) and CDAI (n = 6300) cohorts with mortality follow-up data available through 2018 were included. Cox models with restricted cubic splines was used to model the nonlinear association between VCEAC/CDAI and outcomes in CKD patients.
Our results showed L-shaped associations of DTAC with all-cause mortality among individuals with CKD stages 1-2 in both cohorts. Compared to the lowest quartile, higher dietary total antioxidant intake was associated with lower all-cause mortality risks among CKD stages 1-2 after adjustment for covariates, with HRs (95%CI) of 1.00, 0.91 (0.71,1.17), 0.69 (0.53,0.90), and 0.70 (0.54,0.91) in VCEAC, and similar respective estimate trends in CDAI. After sensitivity and subgroup analyses, there were no benefits for patients with stage 3-5 CKD or albuminuria. Mediation analysis revealed that the proportions mediated in both cohorts were less consistent.
Moderate dietary total antioxidants intake has potential benefits for early-stage CKD patients. However, further evidence is needed to confirm whether patients with worsening CKD can benefit in the long term.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Hospice care is a multidisciplinary approach that focused on patients' quality of life, and nurses allocate more of their time with patients and patients' families than those nurses working in other ...disciplines. Nurses' knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China's hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses' willingness to practice hospice care are limited.
A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses' demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis.
Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses' willingness to practice hospice care.
This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses' knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The iridium-catalyzed enantioselective coupling reaction of vinyl azides and allylic electrophiles is presented and provides access to β-chiral carbonyl derivatives. Vinyl azides are used as ...acetamide enolate or acetonitrile carbanion surrogates, leading to γ,δ-unsaturated β-substituted amides as well as nitriles with excellent enantiomeric excess. These products are readily transformed into chiral N-containing building blocks and pharmaceuticals. A mechanism is proposed to rationalize the chemoselectivity of this coupling reaction.
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IJS, KILJ, NUK, PNG, UL, UM
Neochlorogenic acid (nCGA) is a phenolic compound isolated from mulberry leaf (
), which possesses multiple pharmacological activities containing antioxidant and anti-inflammatory effects. However, ...the role of nCGA in the treatment of acute pneumonia and the underlying molecular mechanism are still unclear. Hence, the aim of study is to investigate the anti-inflammatory properties of nCGA on LPS-stimulated inflammation in A549 cells. In the present study, results reported that nCGA without cytotoxicity significantly reduced the production of TNF-α, IL-6, and NO, and further suppressed the proteins of iNOS, COX2, TNF-α, IL-6 expression. Furthermore, nCGA also inhibited NF-κB activation and blocked MAPKs signaling pathway phosphorylation. In addition, we found nCGA significantly increased the expression of HO-1 via activating the AMPK/Nrf2 signaling pathway to attenuate the inflammatory response, whereas this protective effect of nCGA was reversed by pre-treatment with compound C (C.C, an AMPK inhibitor). Therefore, all these results indicated that nCGA might act as a natural anti-inflammatory agent for the treatment of acute pneumonia.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This is the first comprehensive review on inherent anisotropic features of transition metal diboride (MB2) and their implementation for tailoring the microstructure and properties of MB2-based ...Ultra-high temperature Ceramics (UHTCs). The emphasis is on the processing approaches, microstructures, and properties of self-reinforced and/or textured MB2-based composites with elongated MB2 grains. The crystal structure characteristics and grain growth behaviour of MB2 are also critically reviewed. Benefiting from the tailored microstructure, the MB2-based ceramics exhibit some improved properties. Considering the success of Si3N4 ceramics in the field of structural ceramics, it is expected that the potential MB2-based ceramic composites with abundant elongated MB2 grains, textured structures, and controlled grain boundaries would possess improved fracture toughness, thermal shock resistance, and reliable high-temperature properties, which are desired for their practical applications. Accordingly, microstructure designing and tailoring provide an important perspective for the future development of UHTCs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Two highly symmetrical (3,4)‐connected uranyl–organic frameworks (UOFs) were synthesized by a judicious combination of D3h‐symmetrical triangular UO2(COO)3− and Td symmetrical tetrahedral ...tetrakis(4‐carboxyphenyl)methane (H4MTB). These two as‐synthesized UOFs possess similar structural units and coordination modes but totally different topological structures, namely ctn net and bor net. Solvent‐induced interpenetration and a morphology change are observed. The two compounds exhibit crystal transformation via a dissolution–crystallization process. Adsorption experiments in CH3OH solution indicate that both of them can selectively remove positively charged dyes over negatively charged and neutral dyes. Moreover, the electronic structural and bonding properties of the two compounds were systematically explored by density functional theory (DFT) calculations.
Two uranyl–organic frameworks (UOFs) based on the MTB4− ligand, C(p‐C6H4COO−)4, were synthesized by altering solvents. They possess similar structure units and coordination modes but totally different 3D structures, featuring ctn‐type and bor‐type topology.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
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