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Vancomycin (Van) remains one of the first-line drugs for the treatment of wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA). However, the unsatisfactory bioavailability of vancomycin alone has greatly limited its potential health benefits. Here a responsive chitosan-based hydrogel was developed as the delivery system which not only would reduce this side effect but also increase efficacy of vancomycin. The hydrogel was prepared by grafting chitosan and cinnamaldehyde-based thioacetal (CTA) together with ginipin (G) as the crosslinker. Upon exposure to reactive oxygen species which were enriched in the bacterial wound, the hydrogel can locally degrade and sustainably release the loaded vancomycin near the lesion to compete with the troubling MRSA. Compared with vancomycin alone, the chitosan-based hydrogel loaded with vancomycin demonstrated accelerated acute wound healing. This achievement reveals that this multi-functional hydrogel may be a promising drug-delivery device for improving the efficacy of local antibiotic therapy.Textile/Dyeing industries have been considered as one of the intense water-consuming units, resulting in the generation of a large volume of dye(s) contaminated effluent posing a heavy burden on the receiving water bodies. Therefore, the identification of methods to synthesize bulk quantity of adsorbent(s) and further their evaluation for the efficient treatment of effluent is one of the most prominent topics. Hence, microwave-assisted method was proposed for the rapid synthesis of nanocomposite (C-CS@ZnO) from natural biomolecule (chitosan-CS), a well-known crosslinker (tripolyphosphate) and metal-oxide (ZnO) nanoparticles. Detailed characterization was performed to identify the structure (SEM, XRD) and composition (FT-IR, XPS) of the sorbent. Sorption experiments with methyl orange (MO) dye solution were carried out under different pH (2.0-12.0), dye concentrations (150-350 mg L-1), reaction times (0-210 min) and temperature (25-45 °C) to establish the adsorbent at the lab-scale. The maximum sorption capacity (185.2 mg g-1) was obtained because of the ligand-exchange, Yoshida H-bonding and electrostatic interactions and was best elucidated by Freundlich (R2 ≥ 0.99) and pseudo-second-order (R2 ≥ 1) models. To simulate the field conditions, the effects of co-existing ions (anions/cations), cocktail dyes/ions mixture and regenerant were also studied. The obtained results suggest its promising applicability at a large scale for textile effluent treatment.Zinc(II) phthalocyanine (ZnPc) is a promising photosensitizer in photodynamic therapy (PDT) for melanoma treatment. However, the poor solubility of ZnPc limits its application. To overcome this limitation, heparosan (HP)-based nanoparticles were prepared by anchoring the l-lysine-linked α-linolenic acid branch to the carboxylic acid group to produce amphiphilic conjugates named heparosan with an l-lysine-linked α-linolenic acid branch (HLA). HLA conjugates could self-assemble into spherical nanoparticles in aqueous media and encapsulate ZnPc to form HLA-ZnPc nanoparticles. The cellular uptake of ZnPc could be improved by HLA carriers. These nanoparticles presented excellent photodynamic-mediated toxicity against mouse melanoma cells (B16) by markedly upregulating the intracellular reactive oxygen species (ROS) levels while showing no cytotoxicity to either B16 or normal cells (L02 and HK-2 cells) in the dark. Furthermore, HLA-ZnPc displayed excellent stability in both powder and Roswell Park Memorial Institute (RPMI) 1640 medium, indicating its promise for application in drug delivery and PDT. These results revealed a strategy for HP-based enhancement of ZnPc in PDT efficacy.Heat stimulation can promote osteoblast differentiation and bone formation. Combining photothermal therapy and chemotherapy is an effective strategy for treating rheumatoid arthritis (RA). Herein, we prepared chitosan/gelatin/β-glycerophosphate-melanin-methotrexate (CMM) hydrogel that could be used to perform simultaneous chemotherapy and photothermal therapy for patients with RA. The CMM solution was successfully converted to a gel state at body temperature. Due to intrinsic photothermal properties of melanin, CMM hydrogel exhibited effective temperature increase both in vitro and in vivo with increasing time of near-infrared (NIR) laser irradiation. After NIR laser irradiation, 50 % of methotrexate was rapidly released from the hydrogel within 3 h. Its release rate showed an instantaneous increase with additional NIR laser irradiation. After CMM hydrogel was injected directly into the paw joint of each collagen-induced arthritis (CIA) mouse followed by irradiation with a NIR laser (808 nm, 0.5 W/cm2, 3 min), swelling and redness at the inflamed area were significantly alleviated at 14 days after treatment. Micro-CT analysis confirmed that treated joints of mice were similar to normal joints. Cell Cycle inhibitor Hence, CMM hydrogel could be used as an attractive RA therapeutic agent for simultaneous chemo-photothermal therapy.In this study, chitosan (CS) with different molecular weights was functionalized with protocatechuic acid (PA) by free-radical grafting reaction, and used for the inhibition of lipid oxidation and the enhancement of stability of β-carotene in Pickering emulsions. The order of grafting ratio of PA in CS-PA conjugates was CS400 (400 kDa CS) > CS200 (200 kDa CS) > CS100 (100 kDa CS). UV-vis, FT-IR and 1H NMR spectra proved that PA was covalently bonded to CS through amino and ester linkages. Compared with native CS, three CS-PA conjugates exhibited reduced crystallinity and thermal stability and improved antioxidant activity, with a molecular weight-dependent relationship. Besides, CS-PA-conjugate particles formed by ionic gelling procedure were spherically shaped and homogeneously dispersed, which substantially improved the stability of β-carotene in Pickering emulsions than CS particles under ultraviolet irradiation, natural light exposure and heat treatment, and the retention rates of β-carotene were in the following order CS200-PA- > CS400-PA- > CS100-PA-conjugate particles. Furthermore, the oxidation stability of Pickering emulsions fabricated by CS-PA-conjugate particles was also higher than that of CS particles. These results will provide valuable information for the application of CS-PA conjugates to protect bioactive components and inhibit lipid oxidation in emulsion systems.The preparation of low-cost adsorbents using naturally available biomaterials to realize the efficient removal of Cu(II) is urgently needed. Herein, low-cost and recyclable calcium crosslinked alginate electrospun nanofibres (SA-Ca) were prepared using low-cost materials via a low-energy-consumption process. The prepared SA-Ca possesses a porous network structure, and its average diameter, specific surface area, and tensile strength are approximately 129.6 nm, 3.409 m2 g-1, and 2.73MPa, respectively. The maximum adsorption capacity of SA-Ca for Cu(II) in aqueous solution is 285.5 mg g-1, and the adsorption can be completed in 0.5 h. The adsorption kinetics were well described by the general-order kinetic model, and the adsorption isotherm fitted to the Liu model. The study of the adsorption mechanism suggested that electrostatic attraction, ion exchange, and complexation cooperated to exert effects. More important, SA-Ca can be regenerated using CaCl2/HCl solutions based on the ion-exchange mechanism without destroying the morphology of the nanofibres. Furthermore, a low concentration of Cu(II) (10 mg L-1) and other heavy metal ions [Pb(II) and Cd(II), each 10 mg L-1] were successfully removed from water, demonstrating that economical biocarbohydrate polymer-based nanofibres have great application prospects in the removal of heavy metal ions.

Diabetic foot ulcers (DFU) have a complex multifactorial pathophysiology. It is crucial to identify essential prognostic variables to streamline therapeutic actions and quality-of-care audits. Although SINBAD and University of Texas (UT), the most frequently used prognostic classification systems, were prospectively validated, not all individual parameters were shown to have consistent associations with healing. In this study, we used a bottom-up approach relying on robust methods to identify independent predictors of DFU healing.

1,664 DFU patients were included by 34 Belgian diabetic foot clinics (DFCs). Twenty-one patient- and foot-related characteristics were recorded at presentation. Predictors of healing were identified using multivariable Cox proportional hazard regression. Multivariable models were built using backward regression with multiple imputation of missing values and bootstrapping.

Five essential independent variables were identified presentation delay, history of minor amputation, ulcer location, surface area and ischemia. This 5 variable-model showed a better performance compared to models based on existing classification systems.

A bottom-up approach was used to build a prognostic classification for DFU healing based on large databases. It offers new insights and allows to tailor the classification to certain clinical settings. These 5 parameters could be used as a 'precision classification' for specialized DFCs.

A bottom-up approach was used to build a prognostic classification for DFU healing based on large databases. It offers new insights and allows to tailor the classification to certain clinical settings. These 5 parameters could be used as a 'precision classification' for specialized DFCs.

Surgical site infection (SSI) following hip or knee arthroplasty poses a serious health and economic burden.

To evaluate SSI management strategies and outcomes to help address this problem.

A retrospective cohort study was undertaken of adults undergoing primary total hip or knee arthroplasty who were identified to have a complex SSI by infection prevention and control surveillance audit. Audits identified SSI within 90 days of arthroplasty. Patients at two tertiary referral centres in Edmonton, Alberta, Canada from 2012 to 2019 were included, and SSI cases were followed for 2 years.

In total, 240 SSIs were identified. Of these, 202 (84%) cases were managed with debridement with antibiotics and implant retention (DAIR), of which 71% achieved cure. The use of any topical intra-operative antibiotic in DAIR was not associated with improved outcome (odds ratio 1.68, 95% confidence interval 0.91-3.10; P=0.097). DAIR performed 31-90 days after arthroplasty had a lower chance of cure compared with DAIR perfo, and may be used to plan interventions to optimize SSI management.Colorectal cancer (CRC) is the third most common cancer in both sexes and the second in terms of mortality. Apart from genetic predisposition, dietary and lifestyle factors have been implicated in the development of CRC. Several studies suggested that vitamin D (VitD) might be a promising strategy in CRC prevention, while other studies did not confirm this finding. The aim of our study was to examine the role of Vit-D supplementation in the prevention of colorectal neoplasms (CRC and polyps). We conducted a systematic search in Pubmed, Embase and Web of Science databases for Randomized Controlled Trials (RCTs) examining the incidence of colorectal neoplasms in patients taking Vit-D supplementation compared to placebo. We synthetized results using Risk Ratio along with 95% Confidence Intervals (CIs). Nine RCTs (N = 71,386) were included. Non-significant correlations were observed between Vit-D supplementation and CRC incidence (RR1.06, p = 0.52). Similarly, non-significant associations were observed between the use of Vit-D supplements and colorectal adenoma incidence (RR1.

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