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BACKGROUND: Nintedanib is a primary antifibrosing medication available for idiopathic pulmonary fibrosis, systemic sclerosis-interstitial lung disease, and progressive pulmonary fibrosis, with scattered report of drug-induced thrombocytopenia. CASE REPORT: A 60-year-old Asian male with no history of thrombocytopenia was administered with nintedanib to treat progressive pulmonary fibrosis. The platelet count dropped rapidly after introduction of nintedanib and resolved gradually by withdrawal of the medication along with thrombopoietin receptor agonist. CONCLUSION: Based on experience from the limited reports, nintedanib-induced thrombocytopenia is typically reversible and manageable. Close monitoring of platelet counts in patients receiving this medication should be warranted.

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Liver failure (LF) is prevalent in China and is characterized by complex pathogenesis, challenging clinical management, poor prognosis, and rising incidence and mortality rates. The immune status is an important factor affecting LF prognosis. Interleukins (Ils) are a type of cytokine that act and interact with multiple cells, including immune cells. These signaling molecules play important roles in intercellular information transmission, including the regulation of immune cells; mediation of the activation, proliferation, and differentiation of T and B cells; and orchestration of the inflammatory response. To date, many studies have explored the correlation between IL expression and liver disease prognosis, but few studies have evaluated Ils as the prognostic biomarkers of LF. This article reviews the potential use of Ils as the prognostic biomarkers of LF. Particularly, it evaluates the predictive values of IL-21, IL-22, and IL-31, the three often overlooked yet promising prognostic biomarkers, in predicting susceptibility to LF. Harnessing biomarkers for early prognostic insights can facilitate tailored treatment strategies and enhance patient survival. Thus, this article focuses on the identification of IL-21, IL-22, and IL-33 as biomarkers in preclinical and clinical studies on LF and reviews their role as biomarkers in the pathogenesis and diagnosis of LF.

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The development of epoxy resins is mainly dependent on non-renewable petroleum resources, commonly diglycidyl ether bisphenol A (DGEBA)-type epoxy monomers. Most raw materials of these thermoset resins are toxic to the health of human beings. To alleviate concerns about the environment and health, the design and synthesis of bio-based epoxy resins using biomass as raw materials have been widely studied in recent decades to replace petroleum-based epoxy resins. With the improvement in the requirements for the performance of bio-based epoxy resins, the design of bio-based epoxy resins with unique functions has attracted a lot of attention, and bio-based epoxy resins with flame-retardant, recyclable/degradable/reprocessable, antibacterial, and other functional bio-based epoxy resins have been developed to expand the applications of epoxy resins and improve their competitiveness. This review summarizes the research progress of functional bio-based epoxy resins in recent years. First, bio-based epoxy resins were classified according to their unique function, and synthesis strategies of functional bio-based epoxy resins were discussed, then the relationship between structure and performance was revealed to guide the synthesis of functional bio-based epoxy resins and stimulate the development of more types of functional bio-based epoxy resins. Finally, the challenges and opportunities in the development of functional bio-based epoxy resins are presented.

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Bismuth vanadate (BiVO4) is regarded as a promising photoanode candidate for photoelectrochemical (PEC) water splitting, but is limited by low efficiency of charge carrier transport and short carrier diffusion length. In this work, we report a strategy comprised of the gradient doping of W and back-to-back stacking of transparent photoelectrodes, where the 3-2 wt.% W gradient doping enhances charge carrier transport by optimizing the band bending degree and back-to-back stack configuration shortens carrier diffusion length without much sacrifice of photons. As a result, the photocurrent density of 3-2% W:BiVO4 photoanode reaches 2.20 mA cm-2 at 1.23 V vs. hydrogen electrode (RHE) with a charge transport efficiency of 76.1% under AM 1.5G illumination, and the back-to-back stacked 3-2% W:BiVO4 photoanodes achieves a photocurrent of 4.63 mA cm-2 after loading Co-Pi catalyst and anti-reflective coating under AM 1.5G illumination, with long-term stability of 10 hours.

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Building a polarization center is an effective avenue to boost charge separation and molecular activation in photocatalysis. However, a limited number of polarization centers are usually created. Here, a polarization plane based on two-dimensional (2D) atomic layers is designed to maximize the surface polarization centers. The Mn in a 2D crystal lattice is etched from the MnIn2S4 atomic layers to build a consecutive symmetry-breaking structure of isolated InO1S5 sites. More charges aggregate around O, making the isolated InO1S5 sites highly polarized. Due to the formation of the InO1S5 polarization plane, an enormous polarized electric field is formed perpendicular to the 2D atomic layers and the carrier lifetime can be prolonged from 93.2 ps in MnIn2S4 to 1130 ps in amorphous MnxIn2Sy. Meantime, the formed large charge density gradient favors coupling and activation of small molecules. Benefiting from these features, a good NH3 photosynthesis performance (515.8 µmol g-1 h-1) can be realized over amorphous MnxIn2Sy, roughly 2.5 and 48.9 times higher than those of MnIn2S4 atomic layers and bulk MnIn2S4, respectively. The apparent quantum yields reach 5.4 and 3.3% at 380 and 400 nm, respectively. Meanwhile, a greatly improved CO2 reduction activity is also achieved over MnxIn2Sy. This strategy provides an accessible pathway for designing an asymmetrical polarization plane to motivate photocatalysis optimization.

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Photoelectrochemical (PEC) organic transformation at the anode coupled with cathodic H2 generation is a potentially rewarding strategy for efficient solar energy utilization. Nevertheless, achieving the full conversion of organic substrates with exceptional product selectivity remains a formidable hurdle in the context of heterogeneous catalysis at the solid/liquid interface. Here, we put forward a quasi-homogeneous catalysis concept by using the reactive oxygen species (ROS), such as ·OH, H2O2 and SO4•-, as a charge transfer mediator instead of direct heterogeneous catalysis at the solid/liquid interface. In the context of glycerol oxidation, all ROS exhibited a preference for first-order reaction kinetics. These ROS, however, showcased distinct oxidation mechanisms, offering a range of advantages such as âˆ¼ 100 % conversion ratios and the flexibility to tune the resulting products. Glycerol oxidative formic acid with Faradaic efficiency (FE) of 81.2 % was realized by the H2O2 and ·OH, while SO4•- was preferably for glycerol conversion to C3 products like glyceraldehyde and dihydroxyacetone with a total FE of about 80 %. Strikingly, the oxidative coupling of methane to ethanol was successfully achieved in our quasi-homogeneous system, yielding a remarkable production rate of 12.27 µmol h-1 and an impressive selectivity of 92.7 %. This study is anticipated to pave the way for novel approaches in steering solar-driven organic conversions by manipulating ROS to attain desired products and conversion ratios.

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The synthesis of stable polynitrogen compounds with high-energy density has long been a major challenge. The cyclo-pentazolate anion (cyclo-N5 -) is successfully converted into aromatic and structurally symmetric bipentazole (N10) via electrochemical synthesis using highly conductive multi-walled carbon nanotubes (MWCNTs) as the substrate and sodium pentazolate hydrate ([Na(H2O)(N5)]·2H2O) as the raw material. Attenuated total refraction Fourier transform infrared spectroscopy, Raman spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy, transmission electron microscopy, and density functional theory calculations confirmed the structure and homogeneous distribution of N10 in the sidewalls of the MWCNTs (named MWCNT-N10-n m). The MWCNT-N10-2.0 m is further used as a catalyst for electrochemical oxygen reduction to synthesize hydrogen peroxide from oxygen with a two-electron selectivity of up to 95%.

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Digital fabrication of miniaturized micro-supercapacitors (MSCs) holds immense promise for advancing customized, integrated microelectronic systems. As potential electrode materials, carbonaceous nanomaterials, such as carbon nanotubes (CNTs), stand out due to their excellent conductivity and mechanical robustness yet suffer from low ionic storage sites, which restrict further applications. Herein, we introduce a sulfur-assisted in situ activating strategy for obtaining sulfur-functionalized carbon nanotube frameworks integrated with inlaid graphene nanosheets (S-CNT/GNS). Specifically, sulfur functionality enriches the surface charge density with improved interfacial hydrophilicity, while the inlaid nanographene sheets provide abundant ionic adsorption sites. By direct 3D printing of the S-CNT/GNS ink, planar MSCs were fabricated with desirable functionality and outstanding electrochemical performance. Notably, the developed MSCs exhibit a high areal capacitance of 0.47 F cm-2, an exceptional energy density of 64.6 µWh cm-2, and a high-power density of 34.2 mW cm-2. Furthermore, an all-flexible self-powered sensing system with photovoltaic cells and a stretchable sensor was built upon the customized S-CNT/GNS MSCs, demonstrating a highly effective capability for real-time monitoring of human physiological signals and body movements. This work not only presents a promising approach for the development of high-performance MSCs but also lays the groundwork for the creation of advanced wearable/flexible microelectronics systems.

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OBJECTIVE: The current work was designed to compare the effects of ciprofol and propofol on left ventricular systolic function and myocardial work by noninvasive speckle-tracking echocardiography in children undergoing surgical repair of atrial septal or ventricular septal defects. DESIGN: A single-center double-blind randomized noninferiority study was conducted. SETTING: The research occurred at a tertiary care center affiliated with Shanghai Jiao Tong University, China. PARTICIPANTS: One hundred and twelve children aged 1 month to 16 years undergoing atrial septal or ventricular septal defect surgery with cardiopulmonary bypass were included. INTERVENTIONS: One hundred and twelve children were allocated randomly to receive ciprofol (n = 67) or propofol (n = 45) in a 1.5:1 ratio. Ciprofol or propofol were intravenously infused at loading doses of 0.4 mg/kg or 2.0 mg/kg, respectively, over 30 seconds, depending on the physical condition of each patient. When the bispectral index was maintained between 45 and 55 after induction, transthoracic echocardiography, including apical two-chamber, three-chamber, and four-chamber views, were collected bedside. MEASUREMENTS AND MAIN RESULTS: Of the 112 patients enrolled, 104 completed the study. Global longitudinal strain in the ciprofol and propofol groups after anesthesia was -17.3% (95% confidence interval [CI] -18.0% to -16.6%) and -17.8% (95% CI -18.7 to -17.0%) in the full analysis set and -17.5% (95% CI -18.2% to -16.9%) and -17.8% (95% CI -18.7% to -17.0%) in the per-protocol set, respectively. The noninferiority margin was set at 2% and confirmed with a lower limit of two-sided 95% CI for the intergroup difference of 1.58% in the full analysis set and 1.34% in the per-protocol set. There were no significant differences between the groups in left ventricular systolic and diastolic function and myocardial work indices. Postoperative vasoactive-inotropic score, NT-proBNP, duration of mechanical ventilation, and the length of stay in the cardiac intensive care unit and hospital were also comparable between the two groups (all p > 0.05). CONCLUSIONS: Ciprofol did not show different effects on myocardial function and postoperative outcomes from propofol. Further, on the sensitive cardiac systole marker global longitudinal strain, ciprofol demonstrated noninferiority to propofol. Ciprofol might be an alternative solution for cardiac anesthesia in children with congestive heart disease with mild lesion.

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OBJECTIVE: To explore the influence of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation. METHODS: This retrospective observational cohort study included 196 patients, 75-102-years-old, with nonvalvular atrial fibrillation, hospitalized in our hospital. The nutritional status was assessed using Mini-Nutritional Assessment-Short Form (MNA-SF). Patients with MNA-SF scores of 0-11 and 12-14 were included in the malnutrition and nonmalnutrition groups, respectively. RESULTS: The average age of the malnutrition group was higher than that of the nonmalnutrition group, and the levels of body mass index (BMI), hemoglobin (HGB), and albumin (ALB) were significantly lower than those of the nonmalnutrition group, with statistical significance (p < .05). The incidence of all-cause death in the malnutrition group was higher than that in the nonmalnutrition group (p = .007). Kaplan-Meier curve indicated that malnutrition patients have a higher risk of all-cause death (log-rank test, p = .001) and major bleeding events (p = .017). Multivariate Cox proportional hazard regression analysis corrected for confounders showed that malnutrition was an independent risk factor of all-cause death (HR = 1.780, 95%CI:1.039-3.050, p = .036). The malnutrition group had a significantly high incidence of major bleeding than the nonmalnutrition group (p = .026), and there was no significant difference in the proportion of anticoagulation therapy (p = .082) and the incidence of ischemic stroke/systemic embolism (p = .310) between the two groups. CONCLUSIONS: Malnutrition is an independent risk factor of all-cause death in elderly patients with atrial fibrillation. The incidence of major bleeding in malnourished elderly patients with atrial fibrillation is high, and the benefit of anticoagulation therapy is not obvious.

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Dihydroxyacetone is the most desired product in glycerol oxidation reaction because of its highest added value and large market demand among all possible oxidation products. However, selectively oxidative secondary hydroxyl groups of glycerol for highly efficient dihydroxyacetone production still poses a challenge. In this study, we engineer the surface of BiVO4 by introducing bismuth-rich domains and oxygen vacancies (Bi-rich BiVO4-x) to systematically modulate the surface adsorption of secondary hydroxyl groups and enhance photo-induced charge separation for photoelectrochemical glycerol oxidation into dihydroxyacetone conversion. As a result, the Bi-rich BiVO4-x increases the glycerol oxidation photocurrent density of BiVO4 from 1.42 to 4.26 mA cm-2 at 1.23 V vs. reversible hydrogen electrode under AM 1.5 G illumination, as well as the dihydroxyacetone selectivity from 54.0% to 80.3%, finally achieving a dihydroxyacetone production rate of 361.9 mmol m-2 h-1 that outperforms all reported values. The surface atom customization opens a way to regulate the solar-driven organic transformation pathway toward a carbon chain-balanced product.

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A novel polycyclic naphthoxazine resin (NSA-thiq) is synthesized via N, O-acetal forming reaction between o-hydroxyl naphthaldehyde and 1,2,3,4-tetrahydroisoquinoline. The chemical structure of the monomer is investigated and confirmed by 1H and 13C NMR, Fourier-transform infrared (FT-IR) spectroscopy, and high-resolution mass spectrometry. Besides, the ring-opening polymerization behavior similar to ordinary benzoxazine resins is observed by differential scanning calorimetry (DSC) and in situ FT-IR analyses, leading to the formation of the phenolic cross-linked network. Notably, DSC thermograms indicate that the newly obtained polycyclic naphthoxazine resin exhibits much lower polymerization temperatures compared to many other reported benzoxazine or naphthoxazine resins. Moreover, the corresponding polybenzoxazine (poly(NSA-thiq)) shows comparable thermal stability in comparison with thermosets derived from monobenzoxazine resins. As a consequence of these unique performances, NSA-thiq is applied as a property modifier for a commercialized benzoxazine resin (BA-a). The glass transition temperature of copolymeric thermosets is enhanced without sacrificing too much thermal stability and heat resistance. Here, another series of naphthoxazine thermosetting resin is explored, which can provide more examples for constructing composites based on thermoset polymers.

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Lithium-carbon dioxide (Li-CO2) batteries offer the possibility of synchronous implementation of carbon neutrality and the development of advanced energy storage devices. The exploration of low-cost and efficient cathode catalysts is key to the improvement of Li-CO2 batteries. Herein, high-entropy alloys (HEAs)@C hierarchical nanosheet is synthesized from the simulation of the recycling solution of waste batteries to construct a cathode for the first time. Owing to the excellent electrical conductivity of the carbon material, the unique high-entropy effect of the HEAs, and the large number of catalytically active sites exposed by the hierarchical structure, the FeCoNiMnCuAl@C-based battery exhibits a superior discharge capability of 27664 mAh g-1 and outstanding durability of 134 cycles as well as low overpotential with 1.05 V at a discharge/recharge rate of 100 mA g-1. The adsorption capacity of different sites on the HEAs is deeply understood through density functional theory calculations combined with experiments. This work opens up the application of HEAs in Li-CO2 batteries catalytic cathodes and provides unique insights into the study of adsorption active sites in HEAs.

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The glycerol oxidation reaction (GOR) run with photoelectrochemical cells (PECs) is one of the most promising ways to upgrade biomass because it is thermodynamically favorable, while irreversible overoxidation leads to unsatisfactory product selectivities. Herein, a tunable one-dimensional nanoconfined environment was introduced into the GOR process, which accelerated mass transfer of glycerol via the microscale fluid effect and changed the main oxidation product from formic acid (FA) to glyceraldehyde (GLD), which led to retention of the heavier multicarbon products. The rate of glycerol diffusion in the nanochannels increased by a factor of 4.92 with decreasing inner diameters. The main product from the PEC-selective oxidation of glycerol changed from the C1 product FA to the C3 product GLD with a great selectivity of 60.7%. This work provides a favorable approach for inhibiting further oxidation of multicarbon products and illustrates the importance of microenvironmental regulation in biomass oxidation.

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Propelled by the structure of water oxidation co-catalysts in natural photosynthesis, molecular co-catalysts have long been believed to possess the developable potential in artificial photosynthesis. However, the interfacial complexity between light absorber and molecular co-catalyst limits its structural stability and charge transfer efficiency. To overcome the challenge, a supramolecular scaffold with the [FeCl4] catalytic units is reported, which undergo a water-nucleophilic attack of the water oxidation reaction, while the supramolecular matrix can be in-situ grown on the surface of photoelectrode through a simple chemical polymerization to be a strongly coupled interface. A well-defined BiVO4 photoanode hybridized with [FeCl4] units in polythiophene reaches 4.72 mA cm-2 at 1.23 VRHE, which also exhibits great stability for photoelectrochemical seawater splitting due to the restraint on chlorine evolution reaction by [FeCl4] units and polythiophene. This work provides a novel solution to the challenge of the interface charge transfer of molecular co-catalyst hybridized photoelectrode.

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The well-known integration of physical, chemical, and mechanical properties enables high-entropy alloys (HEAs) to be applied in various fields; however, refractory HEAs are brittle and susceptible to abrasive wear at high coefficients of friction (COF), resulting in insufficient mechanical durability against abrasion. Herein, curved MoS2 nanosheets are periodically introduced into the TiNbMoTaCr film for triggering the self-assembly mixed metal oxides @MoS2 nanoscrolls, which contain hard mixed metal oxides cores and the low-shearing lubricant MoS2 shells, during the friction in the air environment; such mixed metal oxides@MoS2 nanoscrolls in the friction interfaces can contribute to the robust low friction and low wear. Compared to the pure TiNbMoTaCr film (with high COF of ∼0.78, low abrasive durability identified by worn-out event), the periodic incorporation of 10 nm thickness curved MoS2 sheets can successfully achieve a low COF of ∼0.08 and low wear rate of ∼9.561 × 10-8 mm3/ Nm, much lower than the pure MoS2 film (COF = ∼ 0.21, wear rate = ∼ 1.03 × 10-6 mm3/ Nm). Such superior tribological properties originate from the cooperative interaction of TiNbMoTaCr nanolayers and curved MoS2 nanosheets, accompanied by the self-assembly of mixed metal oxides@MoS2 nanoscrolls. In these nanoscrolls, TiNbMoTaCr can act as an 'air-absorbing agent' to form high-loading mixed metal oxide cores and serve as an 'oxygen sacrificer,' preventing the low-shearing lubricant curved MoS2 nanosheets from oxidation. In addition, even with the soft MoS2, the hardness of the TiNbMoTaCr/MoS2 nanomultilayers can still be well maintained and increased above the calculated values by mixing law, further favoring superior mechanical durability. The synergetic effect of TiNbMoTaCr and curved MoS2 nanosheets during the friction in air can provide a route to design HEA films with enhanced tribological properties for better mechanical durability and broader application prospects.

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Objective: This study explored whether anticoagulation is safe for frail and non-frail elderly patients who have nonvalvular atrial fibrillation (NVAF). Methods: At hospital discharge, the anticoagulant regimen and frailty status were recorded for 361 elderly patients (aged ≥75 y) with NVAF. The patients were followed for 12 months. The endpoints included occurrence of thrombosis; bleeding; all-cause death; and cardiovascular events. Results: At hospital discharge, frailty affected 50.42% of the population and the anticoagulation rate was 44.04%. At discharge, age (OR 0.948, P = 0.006), paroxysmal NVAF (OR 0.384, P < 0.001), and bleeding history (OR 0.396, P = 0.001) were associated with a decrease in rate of receiving anticoagulation, while thrombotic events during hospitalization (OR 2.281, P = 0.021) were associated with an increase. Relative to non-frail patients, those with frailty showed a higher rate of ischemic stroke (5.33% cf. 3.01%), bleeding (P = 0.006) events, and all-cause mortality (P = 0.001). Relative to the group without anticoagulation, in those with anticoagulation the rate of thrombotic events was lower (6.99 cf. 10.98%) and bleeding events were higher (20.98 cf. 12.72%), but the risk of major bleeding was comparable. Conclusion: In the elderly patients with NVAF, the decision toward anticoagulation therapy at hospital discharge was influenced by age, bleeding history, paroxysmal atrial fibrillation diagnosis, and absence of thrombosis. Frail patients were at greater risk of bleeding and all-cause mortality. Anticoagulation tended to reduce the risk of thrombotic events.

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Photocatalytic oxygen reductive H2O2 production is a promising approach to alternative industrial anthraquinone processes while suffering from the requirement of pure O2 feedstock for practical application. Herein, we report a spaced double hydrogen bond (IC-H-bond) through multi-component Radziszewski reaction in an imidazole poly-ionic-liquid composite (SI-PIL-TiO2) and levofloxacin hydrochloride (LEV) electron donor for highly efficient and selective photocatalytic air reductive H2O2 production. It is found that the IC-H-bond formed by spaced imino (-NH-) group of SI-PIL-TiO2 and carbonyl (-C=O) group of LEV can switch the imidazole active sites characteristic from a covered state to a fully exposed one to shield the strong adsorption of electron donor and N2 in the air, and propel an intenser positive potential and more efficient orbitals binding patterns of SI-PIL-TiO2 surface to establish competitive active sites for selectivity O2 chemisorption. Moreover, the high electron enrichment of imidazole as an active site for the 2e- oxygen reduction ensures the rapid reduction of O2. Therefore, the IC-H-bond enables a total O2 utilization and conversion efficiency of 94.8 % from direct photocatalytic air reduction, achieving a H2O2 production rate of 1518 µmol/g/h that is 16 and 23 times compared to poly-ionic-liquid composite without spaced imino groups (PIL-TiO2) and TiO2, respectively.

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The topological diversity of covalent organic frameworks (COFs) enables considerable space for exploring their structure-performance relationships. In this study, we report a sequence of novel 1D COFs (EO, ES, and ESe-COF) with typical 4-c sql topology that can be interconnected with VIA group elements (O, S, and Se) via a modular design strategy. It is found that the electronic structures, charge delivery property, light harvesting ability, and hydrophilicity of these 1D COFs can be profoundly influenced by the bridge-linked atom ordinal. Finally, EO-COF, possessing the highest quantity of active sites, the longest lifetime of the active electron, the strongest interaction with O2 , and the lowest energy barrier of O2 reduction, exhibits exceptional photocatalytic O2 -to-H2 O2 activity under visible light, with a production rate of 2675 µmol g-1 h-1 and a high apparent quantum yield of 6.57 % at 450 nm. This is the first systematic report on 1D COFs for H2 O2 photosynthesis, which enriches the topological database in reticular chemistry and promotes the exploration of structure-catalysis correlation.