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We present the first described case of bacteremia due to Butyricimonas paravirosa, a commensal gram-negative anaerobic bacterium identified by whole-genome sequencing in an elderly patient with acute terminal ileitis, who was successfully treated with ceftriaxone and metronidazole. We reviewed eleven previous cases of infection due to other Butyricimonas spp, which can cause a range of diseases but may be treated conservatively with a short antimicrobial course in the appropriate clinical setting. Additionally, while most Butyricimonas spp are susceptible to empiric anaerobic therapy, drug resistance has been reported in some cases.

Immunocompromised patients are prone to recurrent Campylobacter infections. We report a case of recurrent multi-drug resistant Campylobactor jejuni bloodstream infections in a Bruton's X-linked agammaglobulinemia patient with prolonged ertapenem treatment. The isolate from the fifth recurrence developed carbapenem resistance, which is associated with mutations in a porin gene porA, and promoter changes and duplication of chromosomal blaOXA-61 gene. Combination therapy using cefepime and doxycycline (later switched to moxifloxacin) cleared the infection.

Pine Island Glacier (PIG), the largest glacier in the Amundsen Sea Embayment of West Antarctica, has contributed to over a quarter of the observed sea level rise around Antarctica. In recent years, multiple observations have confirmed its continuous retreat, ice flow acceleration and profound surface melt. Understanding these changes is crucial for accurately monitoring ice mass discharge and future Antarctic contributions to sea level rise. Therefore, it is essential to investigate the complex interactions between these variables to comprehend how they collectively affect the overall stability of the intricate PIG system. In this study, we utilized high-resolution remote sensing data and deep learning method to detect and analyze the spatio-temporal variations of surface melt, ice shelf calving, and ice flow velocity of the PIG from 2015 to 2023. We explored the correlations among these factors to understand their long-term impacts on the glacier's stability. Our findings reveal a retreat of 26.3 km and a mass loss of 1001.6 km2 during 2015–2023. Notably, extensive surface melting was observed, particularly in the 2016/2017 and 2019/2020 melting seasons. Satellite data vividly illustrate prolonged and intense melting periods, correlating with a significant retreat in the glacier's terminus position in 2019/2020. Furthermore, the comprehensive analysis of surface melting and the cumulative retreat of the ice shelf from 2017 to 2020 on the PIG shows a temporal relationship with subsequent significant changes in ice flow velocity, ranging from 10.9 to 12.2 m d−1, with an average acceleration rate of 12%. These empirical findings elucidate the intricate relationship among surface melt, ice flow velocity, and consequential glacier dynamics. A profound understanding of these interrelationships holds paramount importance in glacier dynamic changes and modeling, providing invaluable insights into potential glacier responses to global climate change.

Two kinds of real cutting fluid wastewater samples (i.e., sample A and sample B) and two kinds of coagulants (i.e., polymerized aluminum chloride (PAC) and polymeric iron sulfate (PFS)) were studied during coagulation experiment, and the coagulation effluent of sample B with PAC was utilized for subsequent anaerobic hydrolysis–aerobic treatment, and the molecular weight (MW) distribution and ultraviolet (UV) absorption spectroscopy were used to explore the distribution and transfer of organics of each treatment unit. The results showed that sample A and sample B both mainly contained macromolecular organics with MW > 100 kDa and small molecule organics with MW < 3 kDa, and PAC had significant coagulation performance for organics with MW > 100 kDa in both samples, while neither PAC nor PFS achieved good coagulation performance for the small molecule organics with MW < 3 kDa in both samples. It could be inferred by UV spectra that the coagulation effluent of sample A and B might both contain organics with conjugated double bonds, monocyclic aromatic hydrocarbons, and the coagulation effluent of sample B might also contain polycyclic aromatic hydrocarbons and heterocyclic compounds with low MW. MW distribution analysis and the UV spectra results showed that biological treatment could further remove organics with conjugated double bonds and aromatic compounds with MW < 3 kDa. HIGHLIGHTS Two kinds of real cutting fluid wastewater mainly contained organics with MW > 100 kDa and with MW < 3 kDa.; PAC had a significant coagulation performance for organics with MW > 100 kDa in both samples.; Neither PAC nor PFS achieved good coagulation performance for organics with MW < 3 kDa in both samples.; Biological treatment could further remove organics with conjugated double bonds and aromatic compounds with MW < 3 kDa.;

Phononic crystals (PnCs) possessing desired bandgaps find many potential applications for elastic wave manipulation. Considering the propagating essence of three-dimensional (3D) elastic waves and the interface influence of multiphase material, the bandgap design of 3D single-phase PnCs is crucial and appealing. Currently, the main approaches for designing 3D single-phase PnCs rely on less efficient trial-and-error approaches, which are heavily dependent on researchers' empirical knowledge. In comparison, topology optimization offers a dominant advantage by transcending the restriction of predefined microstructures and obtaining topologies with desired performance. This work targeted the exploration of various novel microstructures with exceptional performance by geometric-constrained topology optimization. To deal with high-dimensional design variables in topology optimization, the unit cell structure of a PnC was confined by pyramid symmetry to maximumly deduct the variable number of the unit cell. More importantly, to alleviate mesh dependence inherent in conventional topology optimization, node-to-node and edge-to-edge connection strategies were adopted, supplemented by the insertion of cylinders to ensure the stability of these connections. Finally, unstable PnC structures were filtered out using extra geometric constraints. Leveraging the proposed framework for the optimization of 3D single-phase PnCs, various novel structures were obtained. Particularly, our results demonstrate that PnC structures with only one type of mass lump exhibit significant potential to possess outstanding performance, and geometric configurations of the ultimately optimized structures are intricately linked to the particular sequence of the bandgaps.

Abstract The development of diagnostic tools for skin cancer based on artificial intelligence (AI) is increasing rapidly and will likely soon be widely implemented in clinical use. Even though the performance of these algorithms is promising in theory, there is limited evidence on the impact of AI assistance on human diagnostic decisions. Therefore, the aim of this systematic review and meta-analysis was to study the effect of AI assistance on the accuracy of skin cancer diagnosis. We searched PubMed, Embase, IEE Xplore, Scopus and conference proceedings for articles from 1/1/2017 to 11/8/2022. We included studies comparing the performance of clinicians diagnosing at least one skin cancer with and without deep learning-based AI assistance. Summary estimates of sensitivity and specificity of diagnostic accuracy with versus without AI assistance were computed using a bivariate random effects model. We identified 2983 studies, of which ten were eligible for meta-analysis. For clinicians without AI assistance, pooled sensitivity was 74.8% (95% CI 68.6–80.1) and specificity was 81.5% (95% CI 73.9–87.3). For AI-assisted clinicians, the overall sensitivity was 81.1% (95% CI 74.4–86.5) and specificity was 86.1% (95% CI 79.2–90.9). AI benefitted medical professionals of all experience levels in subgroup analyses, with the largest improvement among non-dermatologists. No publication bias was detected, and sensitivity analysis revealed that the findings were robust. AI in the hands of clinicians has the potential to improve diagnostic accuracy in skin cancer diagnosis. Given that most studies were conducted in experimental settings, we encourage future studies to further investigate these potential benefits in real-life settings.

Abstract Hypertrophic scar (HS) considerably affects the appearance and causes tissue dysfunction in patients. The low bioavailability of 5-fluorouracil poses a challenge for HS treatment. Here we show a separating microneedle (MN) consisting of photo-crosslinked GelMA and 5-FuA-Pep-MA prodrug in response to high reactive oxygen species (ROS) levels and overexpression of matrix metalloproteinases (MMPs) in the HS pathological microenvironment. In vivo experiments in female mice demonstrate that the retention of MN tips in the tissue provides a slowly sustained drug release manner. Importantly, drug-loaded MNs could remodel the pathological microenvironment of female rabbit ear HS tissues by ROS scavenging and MMPs consumption. Bulk and single cell RNA sequencing analyses confirm that drug-loaded MNs could reverse skin fibrosis through down-regulation of BCL-2-associated death promoter (BAD), insulin-like growth factor 1 receptor (IGF1R) pathways, simultaneously regulate inflammatory response and keratinocyte differentiation via up-regulation of toll-like receptors (TOLL), interleukin-1 receptor (IL1R) and keratinocyte pathways, and promote the interactions between fibroblasts and keratinocytes via ligand-receptor pair of proteoglycans 2 (HSPG2)-dystroglycan 1(DAG1). This study reveals the potential therapeutic mechanism of drug-loaded MNs in HS treatment and presents a broad prospect for clinical application.

Enterovirus G (EV-G) belongs to the Picornaviridae family and infects porcine populations worldwide. A total of 20 EV-G genotypes (EV-G1 to EV-G20) have been identified. In this study, we isolated and characterized an EV-G strain, named EV-G/YN29/2022, from the feces of diarrheic pigs. This was the first EV-G6 strain isolated in China. Comparison of the whole genome nucleotide and corresponding amino acid sequences showed that the isolate was more closely related to those of the EV-G6 genotype than other genotypes, with the complete genome sequence similarity ranging from 83.7% (Iba46442) to 84.4% (PEV-B-KOR), and corresponding amino acid homology ranged from 96% (Iba46442) to 96.8% (PEV-B-KOR). Similarly, the VP1 gene and corresponding amino acid sequences of EV-G/YN29/2022 were highly similar to those of the EV-G6 genotype (>82.9% and >94.3%, respectively). Thus, the isolated strain was classified as EV-G6 genotype. This was the first EV-G6 strain isolated in China. Pathogenicity analyses revealed that EV-G/YN29/2022 infection caused mild diarrhea, typical skin lesions, and weight reduction. The strain was mainly distributed to the intestinal tissue but was also found in the brain, mesenteric lymph nodes, spleen, and liver. Our results can be used as a reference to further elucidate the epidemiology, evolution, and pathogenicity of EV-G.

The enantioselective mechanism of the esterase QeH against the two enantiomers of quizalofop–ethyl (QE) has been primitively studied using computational and experimental approaches. However, it is still unclear how the esterase QeH adjusts its conformation to adapt to substrate binding and promote enzyme–substrate interactions in the catalytic kinetics. The equilibrium processes of enzyme–substrate interactions and catalytic dynamics were reproduced by performing independent molecular dynamics (MD) runs on the QeH-(R)/(S)-QE complexes with a newly developed residue-specific force field (RSFF2C). Our results indicated that the benzene ring of the (R)-QE structure can simultaneously form anion–π and cation–π interactions with the side-chain group of Glu328 and Arg384 in the binding cavity of the QeH-(R)-QE complex, resulting in (R)-QE being closer to its catalytic triplet system (Ser78-Lys81-Tyr189) with the distances measured for the hydroxyl oxygen atom of the catalytic Ser78 of QeH and the carbonyl carbon atom of (R)-QE of 7.39 Å, compared to the 8.87 Å for (S)-QE, whereas the (S)-QE structure can only form an anion–π interaction with the side chain of Glu328 in the QeH-(S)-QE complex, being less close to its catalytic site. The computational alanine scanning mutation (CAS) calculations further demonstrated that the π–π stacking interaction between the indole ring of Trp351 and the benzene ring of (R)/(S)-QE contributed a lot to the binding stability of the enzyme–substrate (QeH-(R)/(S)-QE). These results facilitate the understanding of their catalytic processes and provide new theoretical guidance for the directional design of other key enzymes for the initial degradation of aryloxyphenoxypropionate (AOPP) herbicides with higher catalytic efficiencies.

Hyperuricaemia (HUA) is a metabolic disorder characterised by high blood uric acid (UA) levels; moreover, HUA severity is closely related to the gut microbiota. HUA is also a risk factor for renal damage, diabetes, hypertension, and dyslipidaemia; however, current treatments are associated with detrimental side effects. Alternatively, Fangyukangsuan granules are a natural product with UA-reducing properties. To examine their efficacy in HUA, the binding of small molecules in Fangyukangsuan granules to xanthine oxidase (XOD), a key factor in UA metabolism, was investigated via molecular simulation, and the effects of oral Fangyukangsuan granule administration on serum biochemical indices and intestinal microorganisms in HUA-model rats were examined. Overall, 24 small molecules in Fangyukangsuan granules could bind to XOD. Serum UA, creatinine, blood urea nitrogen, and XOD levels were decreased in rats treated with Fangyukangsuan granules compared to those in untreated HUA-model rats. Moreover, Fangyukangsuan granules restored the intestinal microbial structure in HUA-model rats. Functional analysis of the gut microbiota revealed decreased amino acid biosynthesis and increased fermentation of pyruvate into short-chain fatty acids in Fangyukangsuan granule-treated rats. Together, these findings demonstrate that Fangyukangsuan granules have anti-hyperuricaemic and regulatory effects on the gut microbiota and may be a therapeutic candidate for HUA.

BackgroundThe COVID-19 pandemic rapidly changed the landscape of clinical practice in the United States; telehealth became an essential mode of health care delivery, yet many components of telehealth use remain unknown years after the disease’s emergence. ObjectiveWe aim to comprehensively assess telehealth use and its associated factors in the United States. MethodsThis cross-sectional study used a nationally representative survey (Health Information National Trends Survey) administered to US adults (≥18 years) from March 2022 through November 2022. To assess telehealth adoption, perceptions of telehealth, satisfaction with telehealth, and the telehealth care purpose, we conducted weighted descriptive analyses. To identify the subpopulations with low adoption of telehealth, we developed a weighted multivariable logistic regression model. ResultsAmong a total of 6252 survey participants, 39.3% (2517/6252) reported telehealth use in the past 12 months (video: 1110/6252, 17.8%; audio: 876/6252, 11.6%). The most prominent reason for not using telehealth was due to telehealth providers failing to offer this option (2200/3529, 63%). The most common reason for respondents not using offered telehealth services was a preference for in-person care (527/578, 84.4%). Primary motivations to use telehealth were providers’ recommendations (1716/2517, 72.7%) and convenience (1516/2517, 65.6%), mainly for acute minor illness (600/2397, 29.7%) and chronic condition management (583/2397, 21.4%), yet care purposes differed by age, race/ethnicity, and income. The satisfaction rate was predominately high, with no technical problems (1829/2517, 80.5%), comparable care quality to that of in-person care (1779/2517, 75%), and no privacy concerns (1958/2517, 83.7%). Younger individuals (odd ratios [ORs] 1.48-2.23; 18-64 years vs ≥75 years), women (OR 1.33, 95% CI 1.09-1.61), Hispanic individuals (OR 1.37, 95% CI 1.05-1.80; vs non-Hispanic White), those with more education (OR 1.72, 95% CI 1.03-2.87; at least a college graduate vs less than high school), unemployed individuals (OR 1.25, 95% CI 1.02-1.54), insured individuals (OR 1.83, 95% CI 1.25-2.69), or those with poor general health status (OR 1.66, 95% CI 1.30-2.13) had higher odds of using telehealth. ConclusionsTo our best knowledge, this is among the first studies to examine patient factors around telehealth use, including motivations to use, perceptions of, satisfaction with, and care purpose of telehealth, as well as sociodemographic factors associated with telehealth adoption using a nationally representative survey. The wide array of descriptive findings and identified associations will help providers and health systems understand the factors that drive patients toward or away from telehealth visits as the technology becomes more routinely available across the United States, providing future directions for telehealth use and telehealth research.

Marine wave energy exhibits significant potential as a renewable resource due to its substantial energy storage capacity and high energy density. However, conventional wave power generation technologies often suffer from drawbacks such as high maintenance costs, cumbersome structures, and suboptimal conversion efficiencies, thereby limiting their potential. The wave power generation technologies based on micro-energy technology have emerged as promising new approaches in recent years, owing to their inherent advantages of cost-effectiveness, simplistic structure, and ease of manufacturing. This paper provides a comprehensive overview of the current research status in wave energy harvesting through micro-energy technologies, including detailed descriptions of piezoelectric nanogenerators, electromagnetic generators, triboelectric nanogenerators, dielectric elastomer generators, hydrovoltaic generators, and hybrid nanogenerators. Finally, we provide a comprehensive overview of the prevailing issues and challenges associated with these technologies, while also offering insights into the future development trajectory of wave energy harvesting technology. [ABSTRACT FROM AUTHOR]

GaN is an emerging 2D material with a wide direct bandgap and high carrier concentration. By using computational methods to introduce Ga defects in GaN, we have made a structure with extremely high chemical activity. After that, Ag, Pt, and Rh are used to repair Ga defects to reasonably suppress the overactive defect sites. In this way, the Ga defect GaN repaired by metal atoms was made. We used density functional theory for dispersion correction for calculation. Specifically, the Perdew–Berke–Ernzerhof generalized gradient approximation method was used. Through the analysis of geometric structure, adsorption energy, electron transfer, deformation charge density, density of states, and band structure, it was screened that Rh@GaN could effectively adsorb SOF2 (adsorption energy −0.78 eV) and be accompanied by a high electron transfer (0.186e). Finally, through the analysis of recovery time and sensitivity, it is verified that Rh@GaN can adsorb SOF2 with high selectivity at room temperature and can generate up to 191.75% response signal to SOF2. [ABSTRACT FROM AUTHOR]

Single‐atom catalysts with precise structure and extremely high catalytic efficiency remain a fervent focus in the fields of materials chemistry and catalytic science. Herein, a nickel‐substituted polyoxometalate (POM) {NiSb6O4(H2O)3[β‐Ni(hmta)SbW8O31]3}15− (NiPOM) with one extremely exposed nickel site [NiO3(H2O)3] was synthesized using the conventional aqueous method. The uniform dispersion of single nickel center with well‐defined structure was facilely achieved by anchoring nanosized NiPOM on graphene oxide (GO). The resulting NiPOM/GO can couple with CdS photoabsorber for the construction of low‐cost and ultra‐efficient hydrogen evolution system. The H2 yield can reach to 2753.27 mmol gPOM−1 h−1, which represents a record value among all the POM‐based photocatalytic systems. Remarkablely, an extremely high hydrogen yield of 3647.28 mmol gPOM−1 h−1 was achieved with simultaneous photooxidation of commercial waste plastic, representing the first POM‐based photocatalytic system for H2 evolution and waste plastic conversion. This work highlights a straightforward strategy for constructing extremely exposed single‐metal site with precise microenvironment by facilely manipulating nanosized molecular cluster to control individual atom. [ABSTRACT FROM AUTHOR]

The enantioselective mechanism of the esterase QeH against the two enantiomers of quizalofop–ethyl (QE) has been primitively studied using computational and experimental approaches. However, it is still unclear how the esterase QeH adjusts its conformation to adapt to substrate binding and promote enzyme–substrate interactions in the catalytic kinetics. The equilibrium processes of enzyme–substrate interactions and catalytic dynamics were reproduced by performing independent molecular dynamics (MD) runs on the QeH-(R)/(S)-QE complexes with a newly developed residue-specific force field (RSFF2C). Our results indicated that the benzene ring of the (R)-QE structure can simultaneously form anion–π and cation–π interactions with the side-chain group of Glu328 and Arg384 in the binding cavity of the QeH-(R)-QE complex, resulting in (R)-QE being closer to its catalytic triplet system (Ser78-Lys81-Tyr189) with the distances measured for the hydroxyl oxygen atom of the catalytic Ser78 of QeH and the carbonyl carbon atom of (R)-QE of 7.39 Å, compared to the 8.87 Å for (S)-QE, whereas the (S)-QE structure can only form an anion–π interaction with the side chain of Glu328 in the QeH-(S)-QE complex, being less close to its catalytic site. The computational alanine scanning mutation (CAS) calculations further demonstrated that the π–π stacking interaction between the indole ring of Trp351 and the benzene ring of (R)/(S)-QE contributed a lot to the binding stability of the enzyme–substrate (QeH-(R)/(S)-QE). These results facilitate the understanding of their catalytic processes and provide new theoretical guidance for the directional design of other key enzymes for the initial degradation of aryloxyphenoxypropionate (AOPP) herbicides with higher catalytic efficiencies. [ABSTRACT FROM AUTHOR]

Point of interest (POI) recommendation is one of the most important applications of location-based social networking (LBSN). Existing studies have proposed methods that utilize POI information and spatio-temporal information for recommendation, but the relevant auxiliary information has not been fully utilized, so it can not alleviate the problems of insufficient information and less travel data caused by short track check-in of users. To solve these problems, a friends relationship and selfattention recommendation model ATFR is proposed. The prediction model consists of three parts: Firstly, the representation vector of friend relationship is obtained by graph embedding method and input into the neural network. Secondly, the user interest preference vector is obtained by GRU. Then, the self-attention mechanism is used to model the sequential and social effects of the user check-in sequence and selectively focus on the historical check-in records associated with the check-in sequence. Finally, the future interest points are recommended according to the interest points sorting list. Experimental results on two public datasets show that this model performs better than other algorithms and can be used to improve the quality of personalized interest recommendation services for websites and applications. [ABSTRACT FROM AUTHOR]