Lacquer sap is a water-in-oil natural emulsion with high viscosity. in nature, it exudes from the phloem of lacquer tree to repair its wounds in the presence of o 2. So far, it is unclear how rapid and smooth polymerization of urushiol is achieved in such a viscous sap. Here, we find that there is a diffuse interface layer with 2.43 nm of thickness between two phases. The interface layer consists of urushiol, urushiol-laccase complex, urushiol-stellacyanin complex and water-insoluble glycoprotein. Polymerization of urushiol is realized by multicomponent synergistic effect. Radicals are first formed by laccase-catalyzed oxidation of urushiol at the interface layer, then are transferred to the urushiol oil phase via wate-insoluble glycoprotein and initiate the polymerization of urushiol there. Stellacyanin inhibits the formation of certain radicals and controls the concentration of phenoxy radicals at the interface layer. Through the inhibition of radicals by stellacyanin and the electron transfer mediated by water-insoluble glycoprotein, the polymerization of urushiol at the interface layer is inhibited. This ensures that o 2 can continuously penetrate into the aqueous phase to oxidize the reduced laccase so that the urushiol polymerization can continue smoothly. this polymerization mechanism provides an idea for developing new chemical reaction systems.
PURPOSE: Heart Failure (HF) is more prevalent in African Americans (AAs) than in Non Hispanic whites and imposes a higher rate of morbidity, mortality and 30-day readmissions. In general cohorts, AAs have also been shown to have a higher prevalence of concomitant comorbidities including chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH) and others. However, there is paucity of data looking at the impact of these conditions in AAs with acute decompensated heart failure (ADHF). The purpose of this study is to describe clinical characteristics, comorbidities, indices of cardiac structure and function, and their impact on 30-day readmission rates in an urban AA population admitted with ADHF. METHODS: A retrospective cohort analysis was conducted using data from AA patients admitted to our facility with a diagnosis of ADHF from 1/1/14 to 3/31/14. 30-day readmission incidence was documented if a patient was admitted for any cause, within 30 days of their index admission, to one of our 4 affiliate hospitals in Chicago, including ours. Chi-square, t-test, Fishers exact and multivariate regression models were applied to determine predictors of readmission including patient demographics, comorbidities, laboratory data and Doppler echocardiographic indices. RESULTS: 140 AA patients were admitted with a diagnosis of ADHF during the study period of which 84 (60%) comprised of heart failure with preserved ejection fraction (HFpEF) and 56 (40%) of heart failure with reduced ejection fraction (HFrEF). Overall, 31 (22.1%) patients were readmitted within 30 days of which 22 (71%) were of HFpEF and 9 (29%) of HFrEF variety. Patients who were readmitted were significantly older (73.03 AE 2.7, p<0.02), more likely to have COPD (40.5%, p<0.002), higher pulmonary artery systolic pressure (PASP) (45.82 AE 2.1, p<0.001) and higher tricuspid regurgitant velocity (TRV) (3.08 AE 0.13, p<0.001) on Doppler echocardiography along with elevated serum N-terminal pro-brain natriuretic peptide (NT-proBNP) (31.3%, p<0.001), compared to those who were not readmitted. Multivariate regression model revealed significant independent predictors of 30-day readmission including a prior diagnosis of COPD (OR: 3.62, p<0.01), a combination of PASP greater than 36 mmHg and TRV greater than 2.8 m/s (OR: 5.27, p<0.001), elevated NT-proBNP (OR: 4.24, p<0.02), and age greater than 70 years (OR: 3.08, p<0.02). CONCLUSIONS: Advanced age, COPD, PH and elevated NT-proBNP are associated with higher incidence of 30-day readmission among AA patients with ADHF. CLINICAL IMPLICATIONS: Identification and optimization of characteristics associated with HF readmissions prior to discharge can potentially reduce HF related morbidity, mortality and overall healthcare expenditure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.