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ABSTRACT: Objectives: Proteus mirabilis is an important opportunistic Gram-negative pathogen. This study reports the whole genome sequence of multidrug-resistant (MDR) P. mirabilis PM1162 and explores its antibiotic resistance genes (ARGs) and their genetic environments. Methods: P. mirabilis PM1162 was isolated from a urinary tract infection in China. Antimicrobial susceptibility was determined, and whole genome sequencing (WGS) was performed. ARGs, insertion sequence (IS) elements, and prophages were identified using ResFinder, ISfinder, and PHASTER software, respectively. Sequence comparisons and map generation were performed using BLAST and Easyfig, respectively. Results: On its chromosome, P. mirabilis PM1162 harboured 15 ARGs, including cat, tet(J), blaCTX-M-14 (three copies), aph(3′)-Ia, qnrB4, blaDHA-1, qacE, sul1, armA, msr(E), mph(E), aadA1, and dfrA1. We focused our analysis on the four related MDR regions: (1) genetic contexts associated with blaCTX-M-14; (2) the prophage containing blaDHA-1, qnrB4, and aph(3′)-Ia; (3) genetic environments associated with mph(E), msr(E), armA, sul, and qacE; and (4) the class II integron harbouring dfrA1, sat2, and aadA1. Conclusion: This study reported the whole genome sequence of MDR P. mirabilis PM1162 and the genetic context of its ARGs. This comprehensive genomic analysis of MDR P. mirabilis PM1162 provides a deeper understanding of its MDR mechanism and elucidates the horizontal spread of its ARGs, thus providing a basis for the containment and treatment of the bacteria.

PurposeThe study aims to develop a finite element model of the pelvic floor and thighs of elderly men to quantitatively assess the impact of different pelvic floor muscle trainings and the urinary and defecation control ability.MethodsA finite element model of the pelvic floor and thighs of elderly men was constructed based on MRI and CT. Material properties of pelvic floor tissues were assigned through literature review, and the relative changes in waistline, retrovesical angle (RVA) and anorectad angulation (ARA) to quantitatively verify the effectiveness of the model. By changing the material properties of muscles, the study analyzed the muscle strengthening or impairment effects of the five types of rehabilitation training for four types of urination and defecation dysfunction. The changes in four outcome indicators, including the retrovesical angle, anorectad angulation, stress, and strain, were compared.ResultsThis study indicates that ARA and RVA approached their normal ranges as material properties changed, indicating an enhancement in the urinary and defecation control ability, particularly through targeted exercises for the levator ani muscle, external anal sphincter, and pelvic floor muscles. This study also emphasizes the effectiveness of personalized rehabilitation programs including biofeedback, exercise training, electrical stimulation, magnetic stimulation, and vibration training and advocates for providing optimized rehabilitation training methods for elderly patients.DiscussionBased on the results of computational biomechanics, this study provides foundational scientific insights and practical recommendations for rehabilitation training of the elderly’s urinary and defecation control ability, thereby improving their quality of life. In addition, this study also provides new perspectives and potential applications of finite element analysis in elderly men, particularly in evaluating and designing targeted rehabilitation training.

BackgroundThe population is constantly aging, and most older adults will experience many potential physiological changes as they age, leading to functional decline. Urinary and bowel dysfunction is the most common obstacle in older people. At present, the analysis of pelvic floor histological changes related to aging has not been fully elucidated, and the mechanism of improving intestinal control ability in older people is still unclear. ObjectiveThe purpose of this study is to describe how the finite element method will be used to understand the mechanical characteristics of and physiological changes in the pelvic cavity during the rehabilitation process, providing theoretical support for the mechanism for improving urination and defecation dysfunction in older individuals. MethodsWe will collect magnetic resonance imaging (MRI) and computed tomography (CT) data of the pelvic cavity of one male and one female volunteer older than 60 years and use the finite element method to construct a 3D computer simulation model of the pelvic cavity. By simulating different physiological states, such as the Valsalva maneuver and bowel movement, we will verify the accuracy of the constructed model, investigate the effects of different neuromuscular functional changes, and quantify the impact proportions of the pelvic floor muscle group, core muscle group, and sacral nerve. ResultsAt present, we have registered the study in the Chinese Clinical Trial Registry and collected MRI and CT data for an older male and an older female patient. Next, the construction and analysis of the finite element model will be accomplished according to the study plan. We expect to complete the construction and analysis of the finite element model by July 2024 and publish the research results by October 2025. ConclusionsOur study will build finite element models of the pelvic floor of older men and older women, and we shall elucidate the relationship between the muscles of the pelvic floor, back, abdomen, and hips and the ability of older adults to control bowel movements. The results of this study will provide theoretical support for elucidating the mechanism for improving urination and defecation dysfunction through rehabilitation. Trial RegistrationChinese Clinical Trial Registry ChiCTR2400080749; https://www.chictr.org.cn/showproj.html?proj=193428 International Registered Report Identifier (IRRID)DERR1-10.2196/56333

ObjectiveHuman brucellosis causes serious public health concerns in Ningxia, China.MethodsThis study employed epidemiological, bacteriological, and multiple-locus variable-number tandem repeat analysis (MLVA) methods to conduct an epidemiological investigation, which is necessary for devising tailored control strategies.ResultsBetween 1958 and 2022, 29,892 cases were reported, with an average annual number of cases and incidence of 467 and 7.1/100,000, respectively. The epidemic situation gradually worsened, with cases escalating from 26 cases in 2005 to 6,292 in 2022, with the incidence rate rising from 0.441 in 2005 to 86.83 in 2022. Geographically, the disease spread from a single affected county in 2004 to encompass all 22 counties in 2022. Yanchi County had the highest incidence, followed by the Hongsibao and Tongxin counties. These data suggest that Brucella infection has become a rampant regional concern in human brucellosis. Between 1958 and 2019, a total of 230 Brucella strains were identified across four studied hosts. These strains comprised four species with 12 biovars, including B. melitensis bv. 1, bv. 2, bv. 3, B. abortus bv. 1, bv. 3, bv. 4, bv. 5, bv. 6, bv. 7, B. suis bv. 1 and bv. 3, and B. canis. These data highlight the high species/biovars and host diversity of the Brucella population, posing a substantial challenge to brucellosis surveillance. There was an apparent transition from multiple species/biovars historically to the current dominance of a single species, B. melitensis, emphasizing the requirement for strengthening surveillance of B. melitensis. Genotypes 42 and 116, constituting 96.2% of the total number of genotypes, predominated in panel 1 and MLVA-11, indicating that all strains belong to the East Mediterranean lineage. MLVA cluster analysis revealed persistent transmission of dominant circulating genotypes, presenting an epidemic pattern characterized primarily by epidemiologically related cases with a few sporadic cases. Strains in this study exhibited high genetic homogeneity with strains from the Northwest, and those from Kazakhstan and Mongolia.ConclusionThe epidemic situation of human brucellosis has gradually worsened; the rampant epidemic of the disease has become a regional concern. The present study highlights that implementing the of targeted surveillance and intervention strategies is urge.

IntroductionEpidemiological and clinical analyses of brucellosis are vital for public health leaders to reinforce disease surveillance and case management strategies.MethodsIn this study, we aimed to analyse the epidemiology and clinical features of 1,590 cases of human brucellosis.ResultsApproximately 72.08% (1,146) of the patients were male and 27.92% (444) were female. At least 88.18% (1,402/1,590) of the patients had a history of contact with sheep/goats and cattle, which was identified as the main risk factor for infection. The most common age group affected was 30–69 years, comprising 83.90% of all cases, with a median age of 47.3 years. Meanwhile, 75.03% (1,193/1,590) of the patients were farmers, followed by workers (10.50%, 167/1,590). The spectrum of clinical manifestations varied, and the major symptoms were fatigue (42.96%), joint pain (37.30%), and fever (23.33%). Arthritis was diagnosed in 989 patients, spondylitis was diagnosed in 469 patients, and external genital complications were found in at least 53.96% (858/1,590) of patients. In addition, approximately 41.25% (625/1,515) and 24.53% (390/1,590) of cases exhibited elevated CRP and D-dimer levels, respectively. Conversely, a significant decrease was observed in fibrinogen, total protein, and albumin levels, affecting 48.36% (769/1,590), 77.30% (1,226/1,586), and 91.80% (1,456/1,586) of the patients, respectively. These data demonstrate that brucellosis is a severe wasting disease that leads to an imbalance in nutritional metabolism and a decline in immunity. In total, 86.73% (1,379/1,590) of patients showed improvement with antibiotic therapy, while 13.27% (211/1,590) of patients experienced relapses or treatment failure.ConclusionBrucellosis often presents with non-specific symptoms and laboratory findings, accompanied by multiple organ invasions, as well as being a vital challenge for diagnosis and treatment; thus, it is essential for a high degree of suspicion to be placed on brucellosis for a timely diagnosis and treatment. This study provides basic data and resources for developing tailored countermeasures to curb its further spread.

Corn starch was plasticized by glycerol suspension in a twin-screw extruder, in which the glycerol suspension was the pre-dispersion mixture of glycerol with nano-SiO2. Polylactide (PLA)/thermoplastic starch/SiO2 composites were obtained through melt-blending of PLA with thermoplastic starch/SiO2 in a twin-screw extruder. The nonisothermal crystallization behavior of PLA in the composites was investigated by differential scanning calorimetry. An interface of PLA with thermoplastic starch was proven to exist in the composites, and its interfacial bonding characteristics were analyzed. The interfacial binding energy stemming from PLA with thermoplastic starch exerts a significant influence on the segmental mobility of PLA at the interface. The segmental mobility of PLA is gradually improved by increasing interfacial binding energy, and consequently, the relative crystallinity on the interface exhibits progressive promotion. The Jeziorny model could well describe the primary crystallization of PLA in the composites. The extracted Avrami exponents based on the Jeziorny model indicate that the primary crystallization of PLA follows heterogeneous nucleation and three-dimensional growth. This study has revealed the intrinsic effect of the interfacial segmental mobility on the nonisothermal crystallization behavior of PLA in composites, which is of technological significance for its blow molding.

Adsorption is considered the most favorable method for heavy metal removal. In this paper, a low-cost, high-efficiency heavy metal adsorbent, mannitol-modified loofah (MML) was prepared. Some characterization methods are used to characterize the structure of MML, such as Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM). The adsorption behavior of MML for Cu(II) ions was explored under different conditions, such as the amount of adsorbent, pH, initial concentration of Cu(II) ions, and adsorption time. The results indicated that the adsorption capacity of MML for Cu(II) ions was greatly improved. When the initial concentration of Cu(II) ions was 900 mg/L and the pH is 5.0, the adsorption capacity (Qe) was 888.9 mg/g at 298K, which was significantly higher than that of some other modified cellulose adsorbents. Isothermal adsorption results showed that the adsorption process was consistent with the Freundlich model. The adsorption kinetics conformed to the pseudo-second-order equation. Furthermore, the regeneration capability of MML indicates that MML is a cheap and excellent adsorbent for Cu(II) ions removal in wastewater treatment.

Silicone rubber (SR)/vinyl-graphene oxide (vinyl-GO) nanocomposites were prepared through the hydrosilylation reaction of silicon hydrogen polydimethylsiloxane (H-PDMS) with vinyl polydimethylsiloxane (vinyl-PDMS), in which vinyl-GO was used as a nano filler. The thermally conductive and antistatic properties of the nanocomposites, and their tensile strength and thermal stability were evaluated. The thermally conductive and antistatic properties increased naturally when the nanocomposites had eight to nine parts of vinyl-GO. The addition of 9 parts of vinyl-GO increased the thermal conductivity to 0.44 from 0.17 W/m−1·K−1 of neat SR and the surface resistance value to 108 from 1014 Ω of neat SR. Vinyl-GO is effective in improving the tensile strength and toughness of the nanocomposites. The tensile strength and elongation at break of the nanocomposites were much higher than that of neat SR, especially for 10 parts of vinyl-GO in the nanocomposite, and the tensile strength was 1.84 MPa and the elongation at break was 314.1%. Additionally, compared with neat SR, the nanocomposites had a much higher thermal stability. For eight parts of vinyl-GO in the nanocomposites, H-PDMS with the selected silicon hydrogen content and vinyl-PDMS with the selected vinyl content could offer an appropriate cross-linking degree that suits the character of GO. When the nanocomposite had eight parts of vinyl-GO, its scanning electron microscope exhibited a monolayer GO with folded, twisted, and local surface folds. However, there was a certain amount of multilayer aggregation of GO for 10 parts of vinyl-GO in the nanocomposite.

Background: To contain the pandemic of COVID-19, China has implemented a series of public health interventions that impacted the tuberculosis control substantially, but these impacts may vary greatly depending on the severity of the local COVID-19 epidemic. The impact of COVID-19 on TB control in Ningxia Hui Autonomous Region is little known.Methods: Based on the national TB Information Management System (TBIMS), this study accessed the actual impact of COVID-19 on TB by comparing TB notifications, pre-treatment delays, and clinical characteristics of TB cases between 2020 COVID-19 period and 2017–2019 baseline. The data were divided into three periods based on the response started to fight against COVID-19 in Ningxia Hui Autonomous Region, including the control period (10 weeks before the pandemic), intensive period (10 weeks during the Ningxia Hui Autonomous Region lockdown), and regular (10 additional weeks after Ningxia Hui Autonomous Region reopen).Results: TB notification dropped sharply in the first week of the intensive period but took significantly longer to return to the previous level in 2020 compared with the 2017–2019 baseline. Totally, the TB notification rates decreased by more than 60% in the intensive period of COVID-19 compared with the average level of 2017–2019. The sputum smear-positive rate of TB patients diagnosed in intensive period of COVID-19 was significantly higher than that in the corresponding periods of 2017–2019 (P < 0.001). The rate of cavity on X-ray inspection of TB cases diagnosed in the intensive period of COVID-19 was significantly higher than that in period 2 of 2017–2019 (23.5 vs. 15.4%, P = 0.004). The patients' delay in the intensive period was significantly longer than that before the pandemic (P = 0.047).Conclusions: The TB notification in Ningxia was impacted dramatically by the pandemic of COVID-19. To compensate for the large numbers of missed diagnosis as well as delayed diagnosis during the intensive period of COVID-19, an urgent restoration of normal TB services, and further emphasis on enhanced active case finding and scale-up of household contact tracing and screening for TB-related symptoms or manifestation, will be essential.

Grafting polymerization was a valuable method for the modification of the chemical and physical properties of polymer surfaces. In this paper, the grafting of cationic vinyl monomer with quaternary ammonium groups, methacryloxyethyltrimethyl ammonium chloride (DMC), onto the isotactic polypropylene (iPP) granule was performed by suspension solid-state grafting process. The technique offers new opportunities in modification of polyolefins, which had the advantages of solventless, lower process temperature. The grafted PP was systematically characterized by using various analytic tools including FT-IR, DSC and TGA. The FT-IR spectra of the grafted iPP confirmed that DMC was successfully grafted onto the iPP backbone. The influences of the reaction parameters such as the concentration of DMC, the dose of styrene, initiator concentration, swelling time, reaction time, reaction temperature were investigated. The optimum condition for the grafting of DMC onto the iPP granules was obtained within the range studied. Furthermore, the results of TGA and the hydrophilicity measurement indicated that the thermal stability of the grafted iPP was enhanced remarkably, and the hydrophilicity was also enhanced due to the addition of hydrophilic quaternary ammonium groups. This research is worthwhile and it can be foreseen with a great prospect in the developing of anti-static and antiseptic materials.