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Qi Xin,1 Tonghui Xie,1 Rui Chen,1 Xing Zhang,1 Yingmu Tong,1 Hai Wang,1 Shufeng Wang,2 Chang Liu,1,3 Jingyao Zhang1,3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China; 2Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China; 3Department of SICU, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of ChinaCorrespondence: Chang Liu; Jingyao Zhang, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China, Tel +86-29-85323900, Fax +86-29-85324642, Email liuchangdoctor@163.com; you12ouy@163.comBackground: Sepsis-induced acute kidney injury (S-AKI) is associated with systemic inflammatory responses and coagulation system dysfunction, and it is associated with an increased risk of mortality. However, there was no study to explore the predictive value of inflammatory and coagulation indicators for S-AKI.Methods: In this retrospective study, 1051 sepsis patients were identified and divided into a training cohort (75%, n = 787) and a validation cohort (25%, n = 264) in chronological order according to the date they were admitted. Univariate analyses and multivariate logistic regression analyses were performed to identify the independent predictors of S-AKI. The logistic regression analyses (enter methods) were used to conducted the prediction models. The ROC curves were used to determine the predictive value of the constructed models on S-AKI. To test whether the increase in the AUC is significant, we used a two-sided test for ROC curves available online (http://vassarstats.net/roc_comp.html). The secondary outcome was different AKI stages and major adverse kidney events within 30 days (MAKE30). Stage 3B of S-AKI was defined as both meeting the stage 3 criteria [increase of Cr level by > 300% (≥ 4.0 mg/dL with an acute increase of ≥ 0.5 mg/dL) and/or UO < 0.3 mL/kg/h for > 24 h or anuria for > 12 h and/or acute kidney replacement therapy] and having cystatin C positive. MAKE30 were a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD).Results: We discovered that cardiovascular disease, white blood cell (WBC), mean arterial pressure (MAP), platelet (PLT), serum procalcitonin (PCT), prothrombin time activity (PTA), and thrombin time (TT) were independent predictors for S-AKI. The predictive value (AUC = 0.855) of the simplest model 3 (constructed with PLT, PCT, and PTA), with a sensitivity of 77.6% and a specificity of 82.4%, had a similar predictive value comparing with the model 1 (AUC = 0.872) and the model 2 (AUC = 0.864) in the training cohort (P > 0.05). Compared with the model 1 (AUC = 0.888) and the model 2 (AUC = 0.887), the model 3 (AUC = 0.887) had a similar predictive value in the validation cohort. Moreover, model 3 had the best predictive power for predicting S-AKI in the stage 3 (AUC = 0.777), especially in stage 3B (AUC = 0.771). Finally, the model 3 (AUC = 0.843) had perfect predictive power for predicting MAKE30 in sepsis patients.Conclusion: Within 24 hours after admission, the simplest model 3 (constructed with PLT, PCT, and PTA) might be a robust predictor of the S-AKI in sepsis patients, providing information for timely and efficient intervention.Keywords: inflammation, coagulation, prediction model, sepsis, acute kidney injury

Background. Sepsis-related acute kidney injury (S-AKI) is a frequent complication of hospitalized patients and is linked to increased morbidity and mortality. Early prediction and detection remain conducive to optimizing treatment strategies and limiting further insults. This study was aimed at evaluating the potential predictive value of the combined prognostic nutrition index (PNI) and neutrophil-to-lymphocyte ratio (NLR) to predict the risk of AKI in septic patients. Methods. In this retrospective study, 1238 adult patients with sepsis who were admitted to the First Affiliated Hospital of Xi’an Jiaotong University from January 2015 to June 2021 were enrolled. Patients were divided into two groups: the non-AKI group ( n = 731 ) and the S-AKI group ( n = 507 ). Univariate and multivariate logistic regression analyses were performed to screen the independent predictive factors of S-AKI. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of PNI and NLR. Results. Multivariate logistic regression analysis indicated that age, chronic liver disease, cardiovascular disease, respiratory rate (RR), white blood cells (WBC), blood urea nitrogen (BUN), creatinine (CRE), international normalized ratio (INR), neutrophil-to-lymphocyte ratio (NLR), and prognostic nutrition index (PNI) were independent prognostic factors of S-AKI. In the three models, the adjusted OR of PNI for S-AKI was 0.802 (0.776-0.829), 0.801 (0.775-0.829), and 0.717 (0.666-0.772), while that of NLR was 1.094 (1.078-1.111), 1.097 (1.080-1.114), and 1.044 (1.016-1.072), respectively. In addition, the area under the ROC curve of the PNI plus NLR group was significantly greater than that of the CRE plus BUN group (0.801, 95% CI: 0.775-0.827 vs. 0.750, 95% CI: 0.722-0.778, respectively; P < 0.001 ). Conclusions. PNI and NLR have been identified as readily available and independent predictors in septic patients with S-AKI. PNI, in combination with NLR, is of vital significance for early warning and efficient intervention of S-AKI and is superior to combined BUN and CRE.

The performance of microalgae-based wastewater treatment processes for ammonium-N (NH4+-N) removal depends on the maintenance of a favorable pH that is critical for minimizing nitrogen escape in the form of free ammonia (NH3) and preventing high-NH3 or extreme-pH stress. This study developed a CO2-inorganic carbon (CO2-IC) buffering system that automatically stabilized pH with the supply of a carbon source for efficient photosynthetic reclamation of NH4+-N by a euryhaline microalga Tetraselmis subcordiformis. The soluble (NaHCO3) and insoluble (CaCO3 and MgCO3) ICs were compared for this purpose. The pH was well controlled in the range of 6.5~8.5 in the CO2-IC system, which was suitable for the photosynthetic growth of T. subcordiformis. The NH4+-N (100 mg/L) was almost completely removed in three days, with the maximum removal rate of 60.13 mg N/L/day and minimal N escape of 19.65% obtained in the CO2-NaHCO3 system. The CO2-IC system also restricted the release of extracellular organic matter by preventing stress conditions. The CO2-NaHCO3 system enabled the highest “normal” starch production suitable for fermentation, while the CO2-CaCO3/MgCO3 system facilitated high-amylose starch accumulation that was conducive to producing bio-based materials and health-promoting ingredients. The proteins accumulated in T. subcordiformis were of good quality for animal feeds.

Sepsis-related liver injury (SRLI) is a common condition in critically ill patients, and it is associated with poor outcomes. Early identification of liver injury in sepsis can provide clinicians withthe abundance of information for optimizing treatment strategies and improve quality of life. Therefore, the purpose of this study was to establish a predictive model to assess the early predictive value of liver injury in sepsis.In this retrospective study, a total of 1116 patients with sepsis enrolled from the Biobank of First Affiliated Hospital of Xi'an Jiaotong University were included. According to the diagnosis of SRLI, all patients were divided into SRLI group and sepsis group. Multivariable analysis was performed using stepwise logistic regression to identify the independent risk factors of SRLI. Based on the results of multivariate regression analysis, we constructed a prediction model. The receiver operating characteristic curve (ROC) was used to determine the predictive value of the model on SRLI.From December 2015 to December 2021,1116 cases met the inclusion criteria and were included in this study. The median age was 58 years, of which 458 (41.04 %) were female. We discoveredthat procalcitonin (PCT), AST-to-platelet ratio index (APRI), alanine aminotransferase (ALT), lactate (Lac), blood urea nitrogen (BUN), Neutrophil and Cardiovascular disease were independent predictors for SRLI. We used to enter methods for constructing the predictive model and finally found that the indicators of model 2 (AUC = 0.832) were readily available and had good predictive value for SRLI. Furthermore, we also found that model 2 (AUC = 0.763), with a sensitivity of 81.4 %, demonstrated excellent predictive value for predicting 28-day mortality in patients with septic liver injury.This study explored the risk factors of SRLI, and established a prediction model that can accurately and effectively predict the occurrence of SRLI. Furthermore, model 2 is easy to obtain and has the highest sensitivity, which can contribute to early warning and appropriate clinical decision-making.

Background Sepsis-induced acute kidney injury (S-AKI) is a significant complication and is associated with an increased risk of mortality, especially in elderly patients with sepsis. However, there are no reliable and robust predictive models to identify high-risk patients likely to develop S-AKI. We aimed to develop a nomogram to predict S-AKI in elderly sepsis patients and help physicians make personalized management within 24 h of admission. Methods A total of 849 elderly sepsis patients from the First Affiliated Hospital of Xi’an Jiaotong University were identified and randomly divided into a training set (75%, n = 637) and a validation set (25%, n = 212). Univariate and multivariate logistic regression analyses were performed to identify the independent predictors of S-AKI. The corresponding nomogram was constructed based on those predictors. The calibration curve, receiver operating characteristics (ROC)curve, and decision curve analysis were performed to evaluate the nomogram. The secondary outcome was 30-day mortality and major adverse kidney events within 30 days (MAKE30). MAKE30 were a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD). Results The independent predictors for nomogram construction were mean arterial pressure (MAP), serum procalcitonin (PCT), and platelet (PLT), prothrombin time activity (PTA), albumin globulin ratio (AGR), and creatinine (Cr). The predictive model had satisfactory discrimination with an area under the curve (AUC) of 0.852–0.858 in the training and validation cohorts, respectively. The nomogram showed good calibration and clinical application according to the calibration curve and decision curve analysis. Furthermore, the prediction model had perfect predictive power for predicting 30-day mortality (AUC = 0.813) and MAKE30 (AUC = 0.823) in elderly sepsis patients. Conclusion The proposed nomogram can quickly and effectively predict S-AKI risk in elderly sepsis patients within 24 h after admission, providing information for clinicians to make personalized interventions.

A novel anion exchange resin, quaternary ammonium– Chlorella vulgaris (QACV), was prepared by introducing quaternary ammonium groups onto dried Chlorella vulgaris as base material. Degrees of epoxy, amine and quaternary ammonium groups of QACV were measured. Water retention, optical microscopy, and Fourier transform infrared spectrometry were used to characterize QAVC. The adsorption behavior of QACV towards Ag(CN) 2 − in different conditions was studied carefully. The results showed that QAVC was efficient to adsorb Ag(CN) 2 − at pH 9–11, and adsorption equilibrium was almost reached in 30 min. Both kinetics and isotherm parameters in the adsorption process were obtained. The data indicated that the pseudo-second-order model provided a good correlation for adsorption of Ag(CN) 2 − on QACV and the calculated rate constant of the adsorption was 3.51 g/(mmol min). The equilibrium data fitted well in the Langmuir isotherm and the estimated maximum adsorption capacity q m was 1.96 mmol/g. The dimensionless separation factor R L was between 0 and 1, suggesting that the adsorption process of Ag(CN) 2 − using QACV was favorable. The QACV could be used successively three times without significantly affecting its adsorption efficiency. Chlorella vulgaris was a potential base material to be modified with quaternary ammonium groups to prepare an adsorbent for adsorption of Ag(CN) 2 − .

Nanostructured manganese oxide materials were prepared from manganese-contained wastewater (MW) using a facile hydrothermal method and adopted as a catalyst to degrade phenol via activation of peroxymonosulphate (PMS). In the WM environment, δ-MnO2 (flower-like Mn-2 with nanosheets) was transformed to α-MnO2 (needle-like Mn-4 with nanowires). Catalytic evaluation experiments demonstrated that the needle-like MnO2 was highly efficient for phenol removal, with a degradation efficiency of 100% within 15 min at the optimal conditions of catalyst dosage 0.2 g/L, PMS dosage 1.5 g/L, initial phenol concentration 0.025 g/L, initial pH 3 and temperature 25°C. Moreover, the needle-like MnO2 catalyst could be recycled and the regenerated material after calcination remained excellent catalytic activity. On the surface of catalysts, PMS was activated by MnIV to generate SO4−∙ which was the major reactive species attacking phenol. Overall, the needle-like MnO2 prepared from MW was an efficient catalyst with low cost for organic wastewater treatment, realizing both Mn resource recycle and organic wastewater treatment.

Nanostructured manganese oxide materials were prepared from manganese-contained wastewater (MW) using a facile hydrothermal method and adopted as catalyst to degrade phenol via activation of peroxymonosulfate (PMS). In the WM environment, δ-MnO2 (flower-like Mn-2 with nanosheets) was transformed to α-MnO2 (needle-like Mn-4 with nanowires). Catalytic evaluation experiments demonstrated that the needle-like MnO2 was highly efficient for phenol removal, with a degradation efficiency of 100% within 15 min at the optimal conditions of catalyst dosage 0.2 g/L, PMS dosage 1.5 g/L, initial phenol concentration 0.025 g/L, initial pH 3 and temperature 25°C. Moreover, the needle-like MnO2 catalyst could be recycled and the regenerated material after calcination remained excellent catalytic activity. On the surface of catalysts, PMS was activated by MnIV to generate SO4¯• which was the major reactive species attacking phenol. Overall, the needle-like MnO2 prepared from MW was an efficient catalyst with low cost for organic wastewater treatment, realizing both Mn resource recycle and organic wastewater treatment.

Herein, the feasibility to fabricate nitrogen-containing biocarbon material from kitchen waste hydrolysis residue by a molten salt-air -assisted synthetic strategy is investigated. Hierarchical porosity and graphitic carbon nanosheet structure are found for the developed biocarbon. The porosity is mainly induced by O2 and the specific surface area of biocarbon (fabricated in air) reaches 818.65 m2 g−1, much higher than that of O2-free sample (11.84 m2 g−1). Meanwhile, the heteroatom (e.g. N) is also retained and introduced into carbon structure even in air atmosphere. It is also suggested that O2 may accelerate a destructive effect on the order of graphitic structure, while the molten salts of NaCl and KCl play the roles of graphitization catalyst and sealing agent, promoting the graphitization of biocarbon. When the developed biocarbon is applied as electrode material, the as-assembled symmetric supercapacitor exhibits a high energy density of 11.7 Wh kg−1 in 1 M Na2SO4. Forthermore, the applicability of current strategy for industrial biocarbon fabrication is verified by salt recycling test and ten times scale-up trail experiment, which shows great potential for green and large-scale production of advanced carbon materials from biomass precursors, for exmple, kitchen waste hydrolysis residue.

Microalgal biofuel production from wastewater has economic and environmental advantages. This article investigates the lipid production from high chemical oxygen demand (COD) bioethanol wastewater without dilution or additional nutrients, using a newly isolated heterotrophic microalga, Chlorella vulgaris LAM-Q. To enhance lipid accumulation, the combined effects of important operational parameters were studied via response surface methodology. The optimal conditions were found to be temperature of 22.8℃, initial pH of 6.7, and inoculum density of 1.2 × 10(8) cells/ml. Under these conditions, the lipid productivity reached 195.96 mg/l/d, which was markedly higher than previously reported values in similar systems. According to the fatty acid composition, the obtained lipids were suitable feedstock for biodiesel production. Meanwhile, 61.40% of COD, 51.24% of total nitrogen, and 58.76% of total phosphorus were removed from the bioethanol wastewater during microalgal growth. In addition, 19.17% of the energy contained in the wastewater was transferred to the microalgal biomass in the fermentation process. These findings suggest that C. vulgaris LAMQ can efficiently produce lipids from high-concentration bioethanol wastewater, and simultaneously performs wastewater treatment.