A retrospective study of uropathogen and its antibiotic resistance among children with urinary tract infection from a single center in China.

Urinary tract infection (UTI) is a well-known bacterial infection posing serious health problem in children. A retrospective study was conducted to explore the uropathogen and its antibiotic resistance in children with UTI. Data of urine culture and antimicrobial susceptibility test was collected. Consequently, 840 children were included. The overall culture-positive UTI was 458 (54.52 %) with Escherichia coli 166 (36.24 %), followed by Enterococcus faecalis 59 (12.88 %), Enterococcus faecium 70 (15.28 %) and others. They were highly resistant to the most commonly used antibiotics. In 694 children with complicated UTI, there were 8 children with fungal infection. Multiple drug resistance (MDR) was recorded in 315 (80.98 %). The overall proportion of Extended Spectrum ß-Lactamase (ESßL) production was 25 (6.43 %). In 146 children with simple UTI, MDR were also detected in 47 (77.05 %). There were 6 (9.84 %) positive for ESßL production. Our study found that complicated UTI was relatively common. Escherichia coli was the most prevalent isolate, followed by Enterococcus faecium and Enterococcus faecalis. These organisms were highly resistant to the most commonly used antibiotics. Relatively high prevalence of MDR and low ESßL-producing organisms were observed.

Effect of Lactobacillus helveticus IMAUJBH1 on fat and volatile flavor substances in fermented mutton sausages.

The decomposition and oxidation of fat is essential for the formation and quality of the unique flavor of sausage. To explore the effect of lactic acid bacteria on fat decomposition and oxidation in fermented sausage, free fatty acids and volatile flavor compounds were determined by gas chromatography (GC) and headspace solid-phase microextraction (HS-SPME)-GC-MS, respectively. The results showed that the addition of Lactobacillus helveticus IMAUJBH1 inhibited fat peroxidation and relatively increased the proportion of monounsaturated fatty acids. A total of 47 volatile flavor compounds were detected, including aldehydes, esters, alcohols, and ketones. The content of substances such as hexanal, heptanal, nonanal and 1-octene-3-ol related to lipid oxidation was significantly reduced. The results obtained in this study show that the strain can further affect the flavor of the product by inhibiting the formation of lipid oxidation or peroxide flavor substances to a certain extent.

Effect of agricultural management practices on rice yield and greenhouse gas emissions in the rice-wheat rotation system in China.

Agricultural management practices (AMPs) have the potential to significantly enhance crop yield, albeit with the possible side effect of escalating greenhouse gas emissions. Few studies have undertaken a comprehensive quantification of the impact of AMPs on crop production and soil GHG, particularly in identifying the optimal AMPs for rice cultivation within rice-wheat rotation system. Here, we combined data analysis and keyword search methods on 1433 individual experimental observations from 172 studies on diverse soil types in the subtropical monsoon climate zone of China to assess the impact of AMPs on rice yield, CH4 and N2O emissions, total greenhouse gas emissions (TGHGE). We focused on four key AMPs: mineral N fertilizer management (including ordinary N fertilizer and slow-/controlled-release fertilizer (SCRF)), organic material management (incorporating organic fertilizer, biochar amendment, and straw return), water-saving irrigation, and no-tillage. Our result showed the rice yield ranged from 2525 to 31,196 kg ha-1, and mineral N fertilizer and organic material management boosted rice yield by 2.84-16.19 % and 2.47-8.52 %, respectively. In terms of N2O emissions, biochar amendment resulted in a decrease of 13.05 %, while ordinary N fertilizer, organic fertilizer, and water-saving irrigation led to increases of 63.16 %, 136.66 %, and 37.41 %, respectively. The implementation of SCRF, water-saving irrigation, and no-tillage significantly curtailed CH4 (6.83 %-35.91 %) and TGHGE (6.22 %-20.59 %). Conversely, organic fertilizer and straw return significantly escalated CH4 emissions by 102.20 % and 33.64 % and TGHGE by 85.03 % and 32.40 %. Rice yield and GHG emissions are mainly influenced by variables such as soil bulk density, pH, soil organic carbon, soil texture, mean annual temperature, and total nitrogen. Our study demonstrates that the application of SCRF, water-saving irrigation, and no-tillage can effectively reduce GHG without compromising yield. These practices are particularly effective under climatic and soil conditions of rice-wheat rotation systems in China, thereby contributing to the sustainable rice farming.

In Situ Rapid Fabrication of Graphene-Copper Heterojunctions Using Fiber Laser Direct Writing.

Multifunctional three-dimensional heterostructures for flexible electronics have gained significant attention due to their distinctive structural formability and superior electronic and optoelectronic properties. Nevertheless, conventional fabrication techniques have yet to be optimized for flexible substrates. In this study, a straightforward fiber laser direct writing (FLDW) process is demonstrated for the simultaneous fabrication of diodes (PN junctions) and bipolar junction transistors (BJTs) on flexible polyimide substrates, which is realized through the deposition of multifunctional p- or n-type copper oxide films (CuOx) and p- or n-type porous laser-reduced graphene oxide films (LrGO) using fiber laser ablation and deposition. The presence of both p- and n-type semiconductor films is confirmed through material characterization. The fabricated PN junctions exhibit reasonable diode rectification ratios, ranging from 20 to 220, and perform reliably under numerous operating conditions such as light-dark illumination and elevated temperatures. Furthermore, I-V curve analysis indicates that the current gain and electrical performance of printed negative-positive-negative (NPN) (or positive-negative-positive, PNP) BJTs can be tailored by adjusting the laser energy density of the FLDW process and the base gap width of the BJTs. As a proof of concept, the FLDW process is successfully employed to deposit both NPN (or PNP) BJTs composed of LrGO/CuOx heterostructures with controlled current gains. Its ease of operation, versatility, and cost-effectiveness make FLDW promising for large-scale flexible electronics fabrication.

Complete revascularization based on angiography derived fractional flow reserve versus incomplete revascularization in patients with ST-segment elevation myocardial infarction.

BACKGROUND: Nearly half of ST-segment elevation myocardial infarction (STEMI) patients present with significant multivessel coronary artery disease, they are at high risk of subsequent adverse events. Whether complete revascularization guided by coronary angiography-derived fractional flow reserve (caFFR) further reduces such events risk is not fully investigated. METHODS: In this study, 367 consecutive STEMI patients who underwent successful primary percutaneous coronary intervention (PCI) were enrolled. caFFR of all three coronary vessels were measured, including 367 culprit vessels and 703 non-culprit vessels. Complete revascularization was defined as post-PCI caFFR > 0.8 of all three coronary vessels. The primary endpoint was major adverse cardiovascular events (MACE, a composite of cardiovascular death, non-fatal recurrent myocardial infarction, ischemia-driven revascularization and non-fatal stroke/transient ischemic attacks) during follow-up. RESULTS: At a median follow-up of 3.8 years, MACE had occurred in 39 patients of the 220 (17.7%) in the complete revascularization group as compared with 49 patients of the 131 (37.4%) in the incomplete revascularization group (hazard ratio [HR] 1.9; 95% confidence interval [CI] 1.2-3.0; p = 0.005). The incomplete revascularization in culprit vessels evaluated by caFFR showed the highest risk for MACE occurrence. CONCLUSIONS: In STEMI patients with multivessel coronary artery disease, incomplete revascularization based on caFFR might contribute to identifying patients at high-risk.

The SUPER reporting guideline suggested for reporting of surgical technique.

Background: Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical technique. The Surgical techniqUe rePorting chEcklist and standaRds (SUPER) aims to address this gap by defining reporting standards for surgical technique. The SUPER guideline intends to apply to articles that encompass surgical technique in any study design, surgical discipline, and stage of surgical innovation. Methods: Following the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach, 16 surgeons, journal editors, and methodologists reviewed existing reporting guidelines relating to surgical technique, reviewed papers from 15 top journals, and brainstormed to draft initial items for the SUPER. The initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and regions. The final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER consultants. Results: The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique reporting. The items are divided into six sections: background, rationale, and objectives (items 1 to 5); preoperative preparations and requirements (items 6 to 9); surgical technique details (items 10 to 15); postoperative considerations and tasks (items 16 to 19); summary and prospect (items 20 and 21); and other information (item 22). Conclusions: The SUPER reporting guideline has the potential to guide detailed, comprehensive, and transparent surgical technique reporting for surgeons. It may also assist journal editors, peer reviewers, systematic reviewers, and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique. Trial Registration: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#SUPER.

Prevalence, Pathogenic Bacterial Profile and Antimicrobial Susceptibility Pattern of Urinary Tract Infection Among Children with Congenital Anomalies of the Kidney and Urinary Tract.

Purpose: The study was to detect the pathogenic bacterial profile and antibiogram among children with congenital anomalies of the kidney and urinary tract (CAKUT). Patients and Methods: A retrospective analysis was performed using medical records of urine culture results and antibiotic susceptibility results in patients with UTIs from March 2017 to March 2022. Antimicrobial susceptibility pattern was determined by a standard agar disc diffusion method. Results: A total of 568 children were included. The proportion of culture-positive UTI was 59.15% (336/568). More than nine types of bacteria were isolated with most pathogens being Gram-negative species. Among Gram-negative isolates, the predominant bacteria were Escherichia coli (30.95%, 104/336) followed by Klebsiella pneumoniae (9.23%). Escherichia coli isolates were highly sensitive to amikacin (95.19%), ertapenem (94.23%), nitrofurantoin (93.27%), imipenem (91.35%), and piperacillin-tazobactam (90.38%) and high rate of resistant were also detected to ampicillin (92.31%), cephazolin (73.08%), ceftriaxone (70.19%), trimethoprim-sulfamethoxazole (61.54%) and ampicillin-sulbactam (57.69%). Klebsiella pneumoniae isolates showed sensitive to ertapenem (96.77%), amikacin (96.77%), imipenem (93.55%), piperacillin-tazobactam (90.32%) and gentamicin (83.87%), while highly resistant were observed to ampicillin (96.77%), cephazolin (74.19%), ceftazidime (61.29%), ceftriaxone (61.29%), and aztreonam (61.29%). The isolated Gram-positive bacteria mainly contained Enterococcus faecalis and Enterococcus faecium (each 15.77%). Enterococcus faecalis were sensitive to vancomycin, penicillin-G, tigecycline, nitrofurantoin and linezolid (100%, 94.34%, 88.68%, 88.68%, 86.79, respectively) and resistant to tetracycline (86.79%), quinupristi (83.02%), erythromycin (73.58%). Enterococcus faecium also showed a similar result. Multiple drug resistance (MDR) was observed in 264 (80.00%) of the 360 bacterial isolates. Only age was significantly associated with a culture-positive UTI. Conclusion: A higher prevalence of culture-positive UTI was detected. Escherichia coli was the most prevalent uropathogen followed by Enterococcus faecalis and Enterococcus faecium. These uropathogens showed highly resistant to the commonly used antibiotics. Moreover, MDR was commonly observed. Thus, empiric therapy is unsatisfactory as drug sensitivity always varies over time.

Clinical outcomes and risk factor analysis of early endoscopic puncture decompression for ureterocele associated with duplex kidney in children: a single-center retrospective study.

PURPOSE: The aims of this study were to analyze the clinical outcomes of treating duplex system ureteroceles with early endoscopic puncture decompression and to identify the risk factors related to outcomes to help guide future work. MATERIALS AND METHODS: We retrospectively reviewed the clinical records of patients with ureteroceles with duplex kidney that were treated with early endoscopic puncture decompression. Charts were reviewed for demographics, preoperative imaging, surgical indications, and follow-up data. Recurrent febrile urinary tract infections (fUTIs), de novo vesicoureteral reflux (VUR), persistent high-grade VUR, unrelieved hydroureteronephrosis, and the need for further intervention were considered unfavorable outcomes. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), type of ureterocele, ipsilateral VUR diagnosed before surgery, simultaneously upper-pole moiety (UM) and lower-pole moiety (LM) obstruction, the width of ureter affiliated to UM, and maximum diameter of ureterocele were all considered potential risk factors. A binary logistic regression model was used to identify the risk factors of unfavorable outcomes. RESULTS: A total of 36 patients with ureteroceles related to duplex kidney underwent endoscopic holmium laser puncture from 2015 to 2023 at our institution. After a median follow-up of 21.6 months, unfavorable outcomes developed in 17 patients (47.2%). Three patients underwent ipsilateral common-sheath ureter reimplantation and one patient underwent laparoscopic ipsilateral upper to lower ureteroureterostomy combined with recipient ureter reimplantation. Three patients underwent laparoscopic upper-pole nephrectomy. Fifteen patients suffered from recurrent UTIs were treated with oral antibiotics and eight of them were diagnosed de novo VUR according to voiding cystourethrography (VCUG). In univariate analysis, patients with simultaneously UM and LM obstruction (P = 0.003), fUTIs before surgery (P = 0.044), and ectopic ureterocele (P = 0.031) were more likely to have unfavorable outcomes. Binary logistic regression analysis showed that ectopic ureterocele (OR = 10.793, 95% CI 1.248-93.312, P = 0.031) and simultaneously UM and LM obstruction (OR = 8.304, 95% CI 1.311-52.589, P = 0.025) were identified as independent factors for unfavorable outcomes. CONCLUSIONS: Our study suggested that early endoscopic puncture decompression is not a preferred but an available treatment option to release BOO or to cure refractory UTIs. It was easier to fail if the ureterocele was ectopic or simultaneously UM and LM obstruction existed. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), ipsilateral VUR diagnosed before surgery, the width of ureter affiliated to UM, and maximum diameter of ureterocele were not significantly related to the success rate of early endoscopic punctures.

The SUPER reporting guideline suggested for reporting of surgical technique: explanation and elaboration.

Background: Surgical technique plays an essential role in achieving good health outcomes. However, the quality of surgical technique reporting remains heterogeneous. Reporting checklists could help authors to describe the surgical technique more transparently and effectively, as well as to assist reviewers and editors evaluate it more informatively, and promote readers to better understand the technique. We previously developed SUPER (surgical technique reporting checklist and standards) to assist authors in reporting their research that contains surgical technique more transparently. However, further explanation and elaboration of each item are needed for better understanding and reporting practice. Methods: We searched surgical literature in PubMed, Google Scholar and journal websites published up to January 2023 to find multidiscipline examples in various article types for each SUPER item. Results: We explain the 22 items of the SUPER and provide rationales item by item alongside. We provide 69 examples from 53 literature that present optimal reporting of the 22 items. Article types of examples include pure surgical technique, and case reports, observational studies and clinical trials that contain surgical technique. Examples are multidisciplinary, including general surgery, orthopaedical surgery, cardiac surgery, thoracic surgery, gastrointestinal surgery, neurological surgery, oncogenic surgery, and emergency surgery etc. Conclusions: Along with SUPER article, this explanation and elaboration file can promote deeper understanding on the SUPER items. We hope that the article could further guide surgeons and researchers in reporting, and assist editors and peer reviewers in reviewing manuscripts related to surgical technique.

A retrospective analysis of the clinical characteristics of 207 hospitalized children with adrenal masses.

Objective: The detection rates of adrenal masses (AMs) have recently increased. The present study aimed to examine the clinical characteristics of these adrenal masses for guiding the clinical diagnosis and treatment among hospitalized children. Methods: The clinical data of AM cases admitted to our hospital from January 2014 to March 2023 were collected and analyzed retrospectively. The data included composition, sex, age, initial presentation, size and site of mass, functional tumor, intervention or surgery, pathological or clinical diagnosis, and imaging data. Results: A total of 207 hospitalized children were included. Among them, adrenal hematoma was the most common finding (53.6%), followed by adrenal neuroblastoma (36.2%). Most masses were larger-sized (51.2%) and non-functional (94.7%). We found that adrenal hematoma commonly occurred in a neonate or child with abdominal trauma. Most adrenal hematoma cases were found in male patients (63.1%), on the right side (71.2%), and with sizes <4 cm (73.9%). Adrenal neuroblastoma was commonly detected in male patients (56.0%), on the right side (66.7%), and with sizes ≥4 cm (85.3%). Moreover, the metastases were frequently explored at the time of diagnosis. In addition, there was no significant difference between ultrasound and computed tomography (CT) scans under suspicion of hematoma (P > 0.05). However, CT showed a priority over ultrasound in the diagnosis of neuroblastoma (P < 0.05). Conclusion: Most masses were non-functional and benign. Of these, adrenal hematoma was the most common type of pediatric AM, followed by adrenal neuroblastoma. They were both commonly found in male patients and on the right side. Neuroblastoma revealed a larger tumor size. Compared to cases of adrenal hematoma, cases of adrenal neuroblastoma required CT scans for further assessment.

Control of Halogen Atom in Inorganic Metal-Halide Perovskites Enables Large Piezoelectricity for Electromechanical Energy Generation.

Regulating the strain of inorganic perovskites has emerged as a critical approach to control their electronic and optical properties. Here, an alternative strategy to further control the piezoelectric properties by substituting the halogen atom (I/Br) in the CsPbX3 perovskite (X = Cl, Br) structure is adopted. A series of piezoelectric materials with excellent piezoelectric coefficients (d33 ) are unveiled. Iodine-incorporated CsPbBr2 I demonstrates the record intrinsic piezoelectric response (d33 ≈47 pC N-1 ) among all inorganic metal halide perovskites. This leads to an excellent electrical output power of ≈ 0.375 mW (24.8 µW cm-2 N-1 ) in the piezoelectric energy generator (PEG) which is higher than those of the pristine/mixed perovskite references with CsPbX3 (X = I, Br, Cl). With its structural phase remaining unchanged, the strained CsPbBr2 I retains its superior piezoelectricity in both thin film and nanocrystal powder forms, further demonstrating its repeatability and versatility of applications. The origin of high piezoelectricity is found to be due to halogen-induced anisotropic lattice strain in the unit-cell along the c-axis, and octahedral distortion. This study reveals an avenue to design new piezoelectric materials by modifying their halide constituents and paves the way to design efficient PEGs for improved electromechanical energy conversion.

Surface modification of ureteral stents: development history, classification, function, and future developments.

INTRODUCTION: Ureteral stents are commonly used in urology but are frequently associated with hematuria, abdominal discomfort, urinary tract infection, stent displacement, and stent encrustation. Surface modification of ureteral stents is beneficial to solve the problem, and these can be divided into coated stents and drug-eluting stents according to the modification method. Coated stents can be divided into hydrophilic coatings, antibacterial coatings, and anti-encrustation coatings. Drug-eluting stents can be divided into antimicrobial drug-eluting, antispasmodic analgesic drug-eluting, anti-ureteral stricture drug-eluting, and anti-tumor drug-eluting. Surface modification of ureteral stents can not only reduce complications related to ureteral stents but also strengthen the treatment of certain urologic diseases, which has a high clinical application value. AREAS COVERED: This review focuses on highlighting and summarizing the latest research progress about surface modification of ureteral stents, ureteral stent development history, classification, functions, and future development prospects. EXPERT OPINION: The purpose of this article is to discuss surface modification of ureteral stents to reduce stent-related complications and potential research directions for the treatment of urinary tract tumors are also briefly discussed, to help guide further innovation in ureteral stent coatings, which contribute to the future progress of ureteral stents surface modification.

High-Performance Integrated Iontronic Circuits Based on Single Nano/Microchannels.

Recently, artificial channel-based ionic diodes and transistors are extensively studied to mimic biological systems. Most of them are constructed vertically and are challenging to be further integrated. Several examples of ionic circuits with horizontal ionic diodes are reported. However, they generally require nanoscale channel sizes to meet the demand for ion-selectivity, resulting in low current output and restricting potential applications. In this paper, a novel ionic diode is developed based on multiple-layer polyelectrolyte nanochannel network membranes. Both bipolar and unipolar ionic diodes can be achieved by simply switching the modification solution. Ionic diodes with a high rectification ratio of ≈226 are achieved in single channels with the largest channel size of 2.5 µm. This design can significantly reduce the channel size requirement and improve the output current level of ionic devices. The high-performance ionic diode with a horizontal structure enables the integration of advanced iontronic circuits. Ionic transistors, logic gates, and rectifiers are fabricated on a single chip and demonstrated for current rectification. Furthermore, the excellent current rectification ratio and the high output current of the on-chip ionic devices highlight the promise of the ionic diode as a component of complex iontronic systems for practical applications.

Astragaloside IV induces the protective effect of bone marrow mesenchymal stem cells derived exosomes in acute myocardial infarction by inducing angiogenesis and inhibiting apoptosis.

Bone marrow mesenchymal stem cells (BMECs)-derived exosomes (MSC-Exo) can improve acute myocardial infarction (AMI). Astragaloside IV (AS-IV) has also been reported to have cardioprotective pharmacological effects. However, it is not entirely clear whether AS-IV can improve AMI by inducing MSC-Exo. BMSCs and MSC-Exo were isolated and identified, and we also established the AMI rat model and the OGD/R model with H9c2 cells. After MSC-Exo or AS-IV-mediated MSC-Exo treatment, cell angiogenesis, migration, and apoptosis were evaluated by tube formation, wound healing, and TUNEL staining. The cardiac function of the rats was measured by echocardiography. The pathological changes and collagen deposition in rats were also assessed with Masson and Sirius red staining. The levels of α-SMA, CD31 and inflammatory factors were determined by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). In vitro, AS-IV-mediated MSC-Exo can significantly enhance the angiogenesis and migration of H9c2 cells induced by OGD/R, and significantly reduce their apoptosis. In vivo, AS-IV-mediated MSC-Exo can improve the cardiac function of rats, and attenuate pathological damage and collagen deposition in AMI model rats. In addition, AS-IV-mediated MSC-Exo can also promote angiogenesis and reduce inflammatory factors in rats with AMI. AS-IV-stimulated MSC-Exo can improve myocardial contractile function, myocardial fibrosis and angiogenesis, reduce inflammatory factors and induce apoptosis in rats after AMI.

Reporting guidelines for surgical technique could be improved: a scoping review and a call for action.

OBJECTIVES: To identify reporting guidelines related to surgical technique and propose recommendations for areas that require improvement. STUDY DESIGN AND SETTING: A protocol-guided scoping review was conducted. A literature search of MEDLINE, the EQUATOR Network Library, Google Scholar, and Networked Digital Library of Theses and Dissertations was conducted to identify surgical technique reporting guidelines published up to December 31, 2021. RESULTS: We finally included 55 surgical technique reporting guidelines, vascular surgery (n = 18, 32.7%) was the most common among the clinical specialties covered. The included guidelines generally showed a low degree of international and multidisciplinary cooperation. Few guidelines provided a detailed development process (n = 14, 25.5%), conducted a systematic literature review (n = 13, 23.6%), used the Delphi method (n = 4, 7.3%), or described post-publication strategy (n = 6, 10.9%). The vast majority guidelines focused on the reporting of intraoperative period (n = 50, 90.9%). However, of the guidelines requiring detailed descriptions of surgical technique methodology (n = 43, 78.2%), most failed to provide guidance on what constitutes an adequate description. CONCLUSION: Our study demonstrates significant deficiencies in the development methodology and practicality of reporting guidelines for surgical technique. A standardized reporting guideline that is developed rigorously and focuses on details of surgical technique may serve as a necessary impetus for change.