Urgent-start peritoneal dialysis (USPD) has been identified as the efficient approach to initiate renal replacement treatment in end-stage renal disease patients. Cardiovascular mortality of urgent dialysis is an important issue. The present work focused on assessing risk factors related to cardiovascular death in USPD patients. We carried out the present multicenter retrospective cohort study in Northeast China, included adults initiating USPD between 2013 and 2019. Follow-up was conducted in every patient till the occurrence events below: technical failure, death, loss-to-follow-up, and renal transplantation. There were altogether 1549 cases enrolled into this work. Among them, 123 encountered cardiovascular death. Upon multivariate regression, predictors of cardiovascular death included advanced age (HR 1.045, 95% CI [1.031, 1.060]; p < 0.001), higher eGFR (HR 1.084, 95% CI [1.052, 1.117]; p = 0.001), combined with DM (HR 1.471, 95% CI [1.026, 2.110]; p = 0.036), and advanced HF stage (class III versus class 0-I, HR 5.262; 95% CI [3.281, 8.437]; p < 0.001; class IV versus class 0-I, HR 6.409; 95% CI [4.145, 9.912]; p < 0.001). In addition, the predictors of cardiovascular death in diabetic USPD patients included advanced age (HR 1.052, 95% CI [1.027, 1.078]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 7.843; 95% CI [4.249, 14.476]; p < 0.001; class IV versus class 0-I, HR 5.285; 95% CI [2.880, 9.698]; p < 0.001). Moreover, the predictors of cardiovascular death in elderly USPD patients were advanced age (HR 1.045, 95% CI [1.016, 1.075]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 3.407; 95% CI [1.911, 6.073]; p < 0.001; class IV versus class 0-I, HR 5.039; 95% CI [2.982, 8.516]; p < 0.001). Risk factors related to cardiovascular death included advanced age, higher eGFR, combined with diabetes, and advanced heart failure stages among USPD patients.

The Atherogenic Index of Plasma (AIP) has been reported as a strong predictor of all-cause mortality in the overall population. However, the lipid profile changes in individuals with end-stage kidney disease (ESKD) undergoing peritoneal dialysis (PD) may affect the prognostic utility of AIP for all-cause mortality. The connection between them remains unclear. This study included patients receiving PD at five hospitals in China from January 1, 2013, to December 31, 2019, with follow-up until June 30, 2020. The primary exposure variable in this investigation was the logarithm of the triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio, which was used to compute the AIP, and the outcome variable was all-cause mortality. A Cox proportional hazards regression model was employed to analyze the association between AIP and all-cause mortality. Moreover, stratified analyses were performed to investigate this association further. Kaplan-Meier curves were employed for survival analysis, assessing the prognostic implications of varying AIP levels. Nonlinear associations were examined using smooth curve fitting techniques. A total of 869 patients were included in this study, of whom 153 died during the follow-up period. An inverse association was observed between AIP and all-cause mortality risk in the highest tertile compared to the lowest tertile (HR: 0.56, 95

End-stage kidney disease (ESKD) is a growing health issue, especially among the very elderly. The optimal dialysis method for very elderly patients with ESKD remains uncertain, and there is a lack of evidence regarding the survival benefits of hemodialysis (HD) versus peritoneal dialysis (PD). This study is a multicenter cohort investigation that included 234 very elderly patients aged 75 years and older with ESKD who received HD or PD across six hospitals in China from January 2013 to December 2020. We employed Propensity Score Matching (PSM) to minimize the influence of confounding factors. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and multivariable Cox proportional hazards regression models for the matched cohorts. In the multicenter cohort study with 234 very elderly ESKD patients, PSM was employed, with each group consisting of 56 participants, averaging 79.76 ± 4.15 years in age and having a male composition of 47.44%. Kaplan-Meier survival analysis indicated with no significant difference in survival rates (log-rank p = 0.123). Further analysis, excluding participants with less than 3 months of survival, also showed no significant differences. Cox regression with multiple variables indicated a HR of 0.73 (95% CI: 0.49, 1.10) for HD versus PD, with a p-value of 0.132. This investigation did not demonstrate a statistically significant difference in survival between PD and HD among very elderly patients with ESKD.

To observe the efficacy and safety of Ripertamab in the treatment of Idiopathic Membranous Nephropathy (IMN). Clinical data from patients with IMN treated with Ripertamab or Rituximab were retrospectively collected from six tertiary hospitals in Jilin Province between January and December 2023. Patients were grouped based on treatment regimen into the Ripertamab and Rituximab groups and matched 1:1 by age and gender. Follow-ups were conducted over six months to assess baseline characteristics, laboratory parameters, and adverse reactions related to anti-CD20 monoclonal antibody therapy. A total of 112 patients with IMN were identified, including 52 treated with Ripertamab and 60 with Rituximab. After matching, 40 patients were included in each group. Baseline clinical characteristics were comparable between the groups (P > 0.05). There was no statistically significant difference in efficacy between the two groups (P > 0.05). At 6 months, the overall effectiveness rate of Ripertamab in the treatment of IMN was 65.0%, of which the partial and complete remission rates were 50.0% and 15.0%, respectively. The overall effectiveness rate of Rituximab was 60.0%, of which the partial and complete remission rates were 47.5% and 12.5%, respectively. Similarly, there were no significant differences in the incidence of infusion reactions, pulmonary infections, interstitial lung disease, HBV reactivation, neutropenia, or thrombocytopenia (P > 0.05). Ripertamab demonstrates a therapeutic efficacy comparable to Rituximab for IMN, with a similar incidence of infusion-related adverse reactions and complications.

Generative artificial intelligence (GenAI) has taken educational settings by storm in the past year due to its transformative ability to impact school education. It is crucial to investigate pre-service teachers’ viewpoints to effectively incorporate GenAI tools into their instructional practices. Data gathered from 606 pre-service teachers were analyzed to explore the predictors of behavioral intention to design Gen AI-assisted teaching. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model, this research integrates multiple variables such as Technological Pedagogical Content Knowledge (TPACK), GenAI anxiety, and technology self-efficacy. Our findings revealed that GenAI anxiety, social influence, and performance expectancy significantly predicted pre-service teachers’ behavioral intention to design GenAI-assisted teaching. However, effort expectancy and facilitating conditions were not statistically associated with pre-service teachers’ behavioral intentions. These findings offer significant insights into the intricate relationships between predictors that influence pre-service teachers’ perspectives and intentions regarding GenAI technology.

Abstract Background The first six months of therapy represents a high-risk period for peritoneal dialysis (PD) failure. The risk of death in the first six months is higher for older patients treated with urgent-start PD (USPD). However, there are still gaps in research on mortality and risk factors for death in this particular group of patients. We aimed to investigate mortality rates and risk factors for death in older patients with end-stage renal disease (ESRD) receiving USPD within and after six months of therapy. Methods We retrospectively studied the clinical information of older adults aged ≥ 65 years with ESRD who received USPD between 2013 and 2019 in five Chinese hospitals. Patients were followed up to June 30, 2020. The mortality and risk factors for death in the first six months of USPD treatment and beyond were analyzed. Results Of the 379 elderly patients in the study, 130 died over the study period. During the follow-up period, the highest number (45, 34.6%) of deaths occurred within the first six months. Cardiovascular disease was the most common cause of death. The baseline New York Heart Association (NYHA) class III–IV cardiac function [hazard ratio (HR) = 2.457, 95% confidence interval (CI): 1.200–5.030, p = 0.014] and higher white blood cell (WBC) count (HR = 1.082, 95% CI: 1.021–1.147, p = 0.008) increased the mortality risk within six months of USPD. The baseline NYHA class III–IV cardiac function (HR = 1.945, 95% CI: 1.149–3.294, p = 0.013), lower WBC count (HR = 0.917, 95% CI: 0.845–0.996, p = 0.040), lower potassium levels (HR = 0.584, 95% CI: 0.429–0.796, p = 0.001), and higher calcium levels (HR = 2.160, 95% CI: 1.025–4.554, p = 0.043) increased the mortality risk after six months of USPD. Conclusion Different risk factors correlated with mortality in older adults with ESRD within and after six months of undergoing USPD, including baseline NYHA class III–IV cardiac function, WBC count, potassium, and calcium levels.

The COVID-19 pandemic has had a significant impact on secondary school teaching and learning models and has changed the way students attend classes. This study examined the impact of teacher–student relationships on secondary school students' online learning motivation during the pandemic, using selfdetermination theory. We proposed that basic psychological needs would mediate this relationship, with affective experiences playing a moderating role. Data were collected through an online survey of 1,168 secondary school students during the outbreak containment period in China (October 14–21, 2022). The results indicated that teacher–student relationships positively influenced motivation, with basic psychological needs serving as a partial mediator, highlighting the moderating role of emotional experience in the direct association between teacher–student relationships and online learning motivation. The research enhances understanding of the dynamics between teacher support and student needs in online learning environments, and has implications for promoting student engagement and educational outcomes.

以蔗渣碱法制浆黑液为原料,采用酸析法分离提纯出碱木质素(AL),再利用3-氯-2-羟丙基三甲基氯化铵对AL改性得到季铵化木质素(QAL).以纤维素水凝胶(CEH)为基体,依次浸渍QAL和AgNO3溶液,制备出具有抗菌性能的银纳米颗粒-季铵化木质素-纤维素水凝胶(Ag NPs-QAL-CEH).通过傅里叶变换红外光谱对AL和QAL的结构进行表征,结果显示QAL制备成功.元素分析结果表明QAL中N元素由AL的0.6％增至5.9％.利用X射线衍射和扫描电子显微镜对Ag NPs-QAL-CEH进行表征,结果表明QAL还原Ag+得到Ag NPs,且Ag NPs-QAL均匀分散在CEH的三维网络结构中.水凝胶的抗菌性能结果表明:Ag NPs-QAL-CEH对金黄色葡萄球菌和大肠杆菌形成了明显的抑菌圈,且随着AgNO3用量的增加,金黄色葡萄球菌和大肠杆菌的抑菌圈直径分别由14.2 mm增至20.1 mm,16.1 mm增至18.1 mm.50 mL QAL溶液(含QAL 2.5 g)中加入AgNO3质量浓度为7.87 g/L时,制备的Ag NPs-6-QAL-CEH的抑菌效果最佳,对金黄色葡萄球菌和大肠杆菌的抑菌率均可达99.5％以上.

Background Several elderly patients with end-stage renal disease (ESRD) had to undergo urgent-start peritoneal dialysis (USPD). This study aimed to determine whether break-in period (BI) within 24 h was feasible in elderly patients undergoing USPD. Methods Patients with ESRD who underwent PD at five hospitals were screened. Patients were divided into the BI <= 24 h and >24 h groups. Complications were compared between the two groups. Multivariate logistic regression model was used to determine whether BI <= 24 h was associated with complications. Results A total of 175 elderly patients were included: BI <= 24 h group, 78; and BI >24 h group, 97. There was no significant difference in the rate of complications between the two groups (all p > 0.05). Furthermore, BI <= 24 h was not an independent risk factor for complications (all p > 0.05). Conclusions Starting PD within 24 h after PD catheter insertion was feasible in elderly ESRD patients.

Objective:To investigate the risk factors for treatment failure of enterogenous peritoneal dialysis-associated peritonitis (PDAP).Methods:Retrospective collection of clinical data on PDAP patients from four hospitals in Jilin Province from 2013 to 2019. According to the type of pathogenic bacteria from PDAP, the study subjects were divided into the enterogenous PDAP group (284 cases) and the non-enterogenous PDAP group (519 cases). The generalized estimation equation (GEE) was used to compare the two groups in clinical data, initial therapeutic effect, and current therapeutic effect of PDAP, as well as risk factors for treatment failure of enterogenous PDAP.Results:This study included a total of 803 cases of PDAP, including 284 cases in the enterogenous PDAP group, with E. coli being of the highest number of 100 cases and accounting for 35.21% of the enterogenous PDAP group. Compared with the non-enterogenous PDAP group, the enterogenous PDAP group showed higher proportion of female patients (55.99% versus 47.21%, P=0.043), and higher proportion of diabetic nephropathy as primary disease (16.96% versus 11.27%, P=0.029). There was no significant difference between the two groups in age, hemoglobin level, and serum albumin level (all P>0.05). Compared with the non-enterogenous PDAP group, the enterogenous PDAP group showed worse initial therapeutic effect and current therapeutic effect of PDAP (both P<0.001). Multivariate GEE analysis showed that long dialysis age, living in rural areas, low serum albumin, Klebsiella pneumoniae, Pseudomonas aeruginosa, fungi, and mixed bacteria were independent risk factors for the treatment failure of enterogenous PDAP (P<0.05).Conclusion:The therapeutic effect of the enterogenous PDAP was worse than that of the non-enterogenous PDAP. The independent risk factors for treatment failure of the enterogenous PDAP included long dialysis age, living in rural areas, low serum albumin levels, and related types of enterogenous microorganisms.

Objective To investigate the treatment outcomes,prognosis,and risk factors of treatment failure of peritoneal dialysis associated peritonitis (PDAP) caused by Klebsiella pneumoniae,and thus provide clinical evidence for the prevention and treatment of this disease. Methods The clinical data of PDAP patients at four peritoneal dialysis centers from January 1,2014 to December 31,2019 were collected retrospectively.The treatment outcomes and prognosis were compared between the patients with PDAP caused by Klebsiella.pneumoniae and that caused by Escherichia coli.Kaplan-Meier method was employed to establish the survival curve of technical failure,and multivariate Logistic regression to analyze the risk factors of the treatment failure of PADP caused by Klebsiella pneumoniae. Results In the 4 peritoneal dialysis centers,1034 cases of PDAP occurred in 586 patients from 2014 to 2019,including 21 cases caused by Klebsiella pneumoniae and 98 cases caused by Escherichia coli.The incidence of Klebsiella pneumoniae caused PDAP was 0.0048 times per patient per year on average,ranging from 0.0024 to 0.0124 times per patient per year during 2014-2019.According to the Kaplan-Meier survival curve,the technical failure rate of Klebsiella pneumoniae caused PDAP was higher than that of Escherichia coli caused PDAP (P=0.022).The multivariate Logistic regression model showed that long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP (OR=1.082,95%CI=1.011-1.158,P=0.023).Klebsiella pneumoniae was highly sensitive to amikacin,meropenem,imipenem,piperacillin,and cefotetan,and it was highly resistant to ampicillin (81.82%),cefazolin (53.33%),tetracycline (50.00%),cefotaxime (43.75%),and chloramphenicol (42.86%). Conclusion The PDAP caused by Klebsiella pneumoniae had worse prognosis than that caused by Escherichia coli,and long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP.

BackgroundMultidrug-resistant (MDR) bacterial infection causes difficulty in the therapy of peritoneal dialysis-associated peritonitis (PDAP); however, there are few studies on multidrug-resistant organism (MDRO)-PDAP. In view of growing concerns about MDRO-PDAP, the aim of this study was to investigate the clinical features, risk factors of treatment failure, and causative pathogens of MDRO-PDAP. MethodsIn total, 318 patients who underwent PD between 2013 and 2019 were included in this multicenter retrospective study. Clinical features, patient outcomes, factors related to treatment failure, and microbiological profiles associated with MDRO-PDAP were analyzed and risk factors for treatment failure associated with MDR-Escherichia coli (E. coli) were further discussed. ResultsOf 1,155 peritonitis episodes, 146 eligible episodes of MDRO-PDAP, which occurred in 87 patients, were screened. There was no significant difference in the composition ratio of MDRO-PDAP between 2013-2016 and 2017-2019 (p > 0.05). E. coli was the most prevalent MDRO-PDAP isolate, with high sensitivity to meropenem (96.0%) and piperacillin/tazobactam (89.1%). Staphylococcus aureus was the second most common isolate and was susceptible to vancomycin (100%) and linezolid (100%). Compared to non-multidrug-resistant organism-PDAP, MDRO-PDAP was associated with a lower cure rate (66.4% vs. 85.5%), higher relapse rate (16.4% vs. 8.0%), and higher treatment failure rate (17.1% vs.6.5%). Dialysis age [odds ratio (OR): 1.034, 95% confidence interval (CI): 1.016-1.052, p < 0.001] and >2 previous peritonitis episodes (OR: 3.400, 95% CI: 1.014-11.400, p = 0.047) were independently associated with treatment failure. Furthermore, longer dialysis age (OR: 1.033, 95% CI: 1.003-1.064, p = 0.031) and lower blood albumin level (OR: 0.834, 95% CI: 0.700-0.993, p = 0.041) increased the risk of therapeutic failure for MDR-E. coli infection. ConclusionThe proportion of MDRO-PDAP has remained high in recent years. MDRO infection is more likely to result in worse outcomes. Dialysis age and previous multiple peritonitis infections were significantly associated with treatment failure. Treatment should be promptly individualized based on local empirical antibiotic and drug sensitivity analyses.

Research progress of lignin in UV-shielding and protective area was reviewed in terms of lignin-based sunscreen production and anti-aging composite.Impact of lignin on the UV stability and mechanical property of the composite was investigated, and issues on application of lignin-based anti-aging composite were discussed.Moreover, the application of lignin-based anti-aging composite was prospected according to the UV-shielding mechanism of lignin, so as to provide references for its high-value development and utilization.

Background Assess risk factors for early death in patients who underwent urgent-start peritoneal dialysis (USPD). Methods Patients who initiated USPD in five peritoneal dialysis centers from 2013 to 2019 were screened in this multicenter retrospective cohort study. Risk factors for all-cause mortality within 3 months were explored. Results A total of 1265 USPD patients with 43 early deaths were included. Cox regression analyses showed that age older than 60 years (hazard ratio [HR], 3.054; 95% CI [1.597, 5.842]; p = 0.001), albumin less than 30 g/L (HR, 2.234; 95%CI [1.207, 4.136]; p = 0.011), blood glucose greater than 7 mmol/L (HR, 2.766; 95%CI [1.477, 5.180]; p = 0.001), higher estimated glomerular filtration rate (eGFR; HR, 1.121; 95%CI [1.071, 1.172]; p = 0.000), and poor stages of heart failure (class IV compared with class 0-I; HR, 5.165; 95%CI [2.544, 10.486]; p = 0.000) were independent predicting factors for early death. Conclusions Risk factors for early death were older age, hypoproteinemia, hyperglycemia, higher eGFR, and severe heart failure.

BackgroundThe optimal break-in period (BI) of urgent-start peritoneal dialysis (USPD) initiation for patients with end-stage renal disease (ESRD) and diabetes is unclear. We aimed to explore the safety and applicability of a BI ≤24 h in patients with ESRD and diabetes.MethodsWe used a retrospective cohort design wherein we recruited patients with ESRD and diabetes who underwent USPD at five institutions in China between January 2013 and August 2020. The enrolled patients were grouped according to BI. The primary outcomes were mechanical and infectious complication occurrences, whereas the secondary outcome was technique survival.ResultsWe enrolled 310 patients with diabetes, of whom 155 and 155 patients were in the BI ≤24 h and BI >24 h groups, respectively. The two groups showed a comparable incidence of infectious and mechanical complications within 6 months after catheter insertion (p>0.05). Logistic regression analysis revealed that a BI ≤24 h was not an independent risk factor for mechanical or infectious complications. Kaplan–Meier estimates showed no statistically significant between-group differences in technique survival rates (p>0.05). Cox multivariate regression analysis revealed that a BI ≤24 h was not an independent risk factor for technique failure.ConclusionUSPD initiation with a BI ≤24 h may be safe and feasible for patients with ESRD and diabetes.

BACKGROUND The risk of early mortality of patients who start dialysis urgently is high; however, in patients with diabetes undergoing urgent-start peritoneal dialysis (USPD), the risk of, and risk factors for, early mortality are unknown. AIM To identify risk factors for mortality during high-risk periods in patients with diabetes undergoing USPD. METHODS This retrospective cohort study enrolled 568 patients with diabetes, aged ≥ 18 years, who underwent USPD at one of five Chinese centers between 2013 and 2019. We divided the follow-up period into two survival phases: The first 6 mo of USPD therapy and the months thereafter. We compared demographic and baseline clinical data of living and deceased patients during each period. Kaplan-Meier survival curves were generated for all-cause mortality according to the New York Heart Association (NYHA) classification. A multivariate Cox proportional hazard regression model was used to identify risk factors for mortality within the first 6 mo and after 6 mo of USPD. RESULTS Forty-one patients died within the first 6 mo, accounting for the highest proportion of mortalities (26.62%) during the entire follow-up period. Cardiovascular disease was the leading cause of mortality within 6 mo (26.83%) and after 6 mo (31.86%). The risk of mortality not only within the first 6 mo but also after the first 6 mo was higher for patients with obvious baseline heart failure symptoms than for those with mild or no heart failure symptoms. Independent risk factors for mortality within the first 6 mo were advanced age [hazard ratio (HR: 1.908; 95%CI: 1.400-2.600; P < 0.001), lower baseline serum creatinine level (HR: 0.727; 95%CI: 0.614-0.860; P < 0.001), higher baseline serum phosphorus level (HR: 3.162; 95%CI: 1.848-5.409; P < 0.001), and baseline NYHA class III-IV (HR: 2.148; 95%CI: 1.063-4.340; P = 0.033). Independent risk factors for mortality after 6 mo were advanced age (HR: 1.246; 95%CI: 1.033-1.504; P = 0.022) and baseline NYHA class III-IV (HR: 2.015; 95%CI: 1.298-3.130; P = 0.002). CONCLUSION To reduce the risk of mortality within the first 6 mo of USPD in patients with diabetes, controlling the serum phosphorus level and improving cardiac function are recommended.

Objective To explore the clinical characteristics and treatment of Pseudomonas peritoneal dialysis-associated peritonitis(PsP). Methods The data of patients receiving peritoneal dialysis in four tertiary hospitals in Jilin province from 2015 to 2019 were retrospectively analyzed.According to the etiological classification,the patients with peritoneal dialysis-associated peritonitis(PDAP)were classified into PsP group and non-PsP group.The incidence of PsP was calculated,and the clinical characteristics and treatment outcomes of the two groups were compared.Kaplan-Meier method was used to draw the survival curve,and Cox regression was performed to analyze the risk factors affecting the technical failure of PsP.The treatment options of Pseudomonas aeruginosa-caused PDAP and the drug sensitivity of PsP were summarized. Results A total of 1530 peritoneal dialysis patients with complete data were included in this study,among which 439 patients had 664 times of PDAP.The incidence of PsP was 0.007 episodes/patient-year.PsP group had higher proportion of refractory peritonitis(41.38% vs.19.69%,P=0.005),lower cure rate(55.17% vs.80.79%, P=0.001),and higher extubation rate(24.14% vs.7.09%,P=0.003)than non-PsP group.The technical survival rate of PsP group was lower than that of non-PsP group(P<0.001).Multivariate Cox regression analysis showed that Pseudomonas aeruginosa was an independent risk factor for technical failure in patients with PsP(HR=9.020,95%CI=1.141-71.279,P=0.037).Pseudomonas was highly sensitive to amikacin,meropenem,and piperacillin-tazobactam while highly resistant to compound sulfamethoxazole,cefazolin,and ampicillin. Conclusion The treatment outcome of PsP is worse than that of non-PsP,and Pseudomonas aeruginosa is an independent risk factor for technical failure of PsP.

Objective:To establish and validate a predictive model for treatment failure of peritoneal dialysis-related peritonitis(PDAP)in elderly patients.Methods:Clinical data of peritoneal dialysis(PD)patients who were followed up from January 1, 2013 to December 31, 2019 at four Grade A tertiary hospitals in Jilin Province were collected.A total of 362 elderly patients with PDAP were eventually included as study subjects.Subjects recruited from 2013 to 2017 were used for model construction and the logistic regression model was used to screen risk factors for treatment failure of PDAP in elderly patients.A nomogarm was constructed to predict treatment failure of secondary PDAP using R language.The receiver operating curve(ROC)and calibration curve were used to evaluate discrimination accuracy of the model.Subjects from 2018 to 2019 were used as the cohort for validation of discrimination accuracy of the model.Results:Of 258 PDAP patients in the modeling cohort, 29 experienced treatment failure, including 15 PDAP-related deaths and 14 cases requiring catheter removal.The multivariate logistic regression model showed that types of pathogens( OR=8.849, 95% CI: 1.656-47.269, P=0.011), long dialysis age( OR=1.023, 95% CI: 1.005-1.042, P=0.013), pre-hospitalization antibiotic treatment( OR=5.123, 95% CI: 1.338-19.610, P=0.017), and dialysate white blood cell count on day 5>100×10 6/L( OR=7.085, 95% CI: 2.162-23.217, P=0.001)were independent risk factors for treatment failure of PDAP in elderly patients.For the nomogarm predictive model, the areas under the ROC curve(AUC)in the modeling cohort and the validation cohort were 0.818(95% CI: 0.735-0.902)and 0.762(95% CI: 0.656-0.889), respectively, and the calibration curves were close to a straight line with a slope of 1. Conclusions:Our nomogram predictive model based on types of pathogens, months of dialysis, pre-hospital admission antibiotic treatment, and dialysate white blood cell count on day 5 has demonstrated satisfactory discrimination accuracy for treatment failure of PDAP in elderly patients.

Carbonized wood (CW) electrodes with low-tortuosity and high conductivity have received extensive attention in the fields of energy storage and electrocatalysis. Directly carbonized wood electrodes have low specific surface area and high electrochemical impedance, and require secondary physical or chemical activation to achieve acceptable performance. Herein, we reported a facile method to prepare the CW electrode with superior surface area through self-activation using CO2 and water vapor generated during the pyrolysis which was conducted with a low inert gas flow rate. The specific surface area and electrical conductivity of the self-activated carbonized wood (SCW, 0.46 g cm(-3)) were as high as 1145 m(2) g(-1) and 20.3 S cm(-1), respectively. The SCW applied as a freestanding electrode demonstrated an impressive specific capacitance of 6.63 F cm(-2) (143.6 F g(-1)) at 1 mA cm(-2). After 10,000 cycles, the capacitance of the SCW electrode was retained as high as 101.7%. The symmetrical supercapacitor (SSC) assembled with two SCW electrodes showed an energy density of 0.27 mWh cm(-2) (8.60 Wh L-1) at a power density of 0.5 mW cm(-2) (11.8 W L-1). This work provides a simple, low-cost and green procedure for fabricating high-performance CW electrodes, which has great promotional significance and practical value on valorization of biomass.

Introduction: The impact of early-onset peritonitis (EOP) on patients with diabetes undergoing peritoneal dialysis (PD) has not been adequately addressed. We therefore sought to investigate the effects of EOP on the therapeutic response to management and long-term prognostic outcomes in patients with diabetes undergoing PD. Methods: For this retrospective cohort study, we analyzed the data for patients with end-stage renal disease, who were also suffering from diabetes mellitus and had undergone PD between January 1, 2013, and December 31, 2018. EOP was defined as the first episode of peritoneal dialysis-related peritonitis (PDAP) occurring within 12 months of PD initiation. All patients were divided into an EOP group and a later-onset peritonitis (LOP) group. Clinical data, treatment results, and outcomes were compared between groups. Results: Ultimately, 202 patients were enrolled for the analysis. Compared to the EOP group, the LOP group had more Streptococcus (p = 0.033) and Pseudomonas (p = 0.048). Patients with diabetes in the EOP group were less likely to have PDAP-related death (OR 0.13, CI: 0.02-0.82, p = 0.030). Patients with diabetes in the EOP group were more likely to have multiple episodes of PDAP and had higher rates of technical failure and poorer patient survival than those in the LOP group, as indicated by Kaplan-Meier analysis (p = 0.019, p = 0.004, and p < 0.001). In the multivariate Cox proportional hazards model, EOP was a significant predictor for multiple PDAP (HR 4.20, CI: 1.48-11.96, p = 0.007), technical failure (HR 6.37, CI: 2.21-18.38, p = 0.001), and poorer patient survival (HR 3.09, CI: 1.45-6.58, p = 0.003). Conclusions: The occurrence of EOP is significantly associated with lower rates of PDAP-related death and poorer clinical outcomes in patients with diabetes undergoing PD.