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Purpose: Infections cause high rates of illness and death in children worldwide. However, studies on the clinical value of metagenomic next-generation sequencing (mNGS) for immunocompromised children are still limited. Patients and Methods: From June 2021 to December 2023, 119 samples were collected at Pediatric Intensive Care Unit (PICU) of a single-center pediatric hospital and classified into two groups based on their immune states. We compared the diagnostic performance of mNGS and conventional microbiological test (CMT) for pathogen identification, and assessed the clinical impacts of mNGS. Results: Among the 119 samples, 48 (40.34%) belonged to the immunocompromised children. mNGS had a higher positivity rate than CMT (76.47% vs 55.46%, P = 0.0006). The positive percent agreement (PPA) of mNGS for immunocompromised children was higher compared to immunocompetent children (95.24% vs 77.78%). The most common pathogens for immunocompromised patients were gram-negative bacteria and herpesvirus. However, immunocompetent children showed a higher detection rate for gram-positive bacteria and respiratory viruses. Furthermore, the proportions of the positive impact of mNGS results were significantly higher in immunocompromised patients compared to immunocompetent patients for both diagnosis (91.67% vs 57.75%) and treatment (95.83% vs 64.79%) (P < 0.0001). Immunocompromised state, length of hospital stays, times stay in ICU, Pediatric Risk of Mortality (PRISM) score, neutrophil percentage (NEUT%) and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) were considered independent factors for poor prognosis in critically ill pediatric patients. Conclusion: In patients from PICU, mNGS had a greater clinical significance in immunocompromised children compared to immunocompetent children. mNGS technology is an important auxiliary method for achieving accurate diagnosis and treatment of critically ill pediatric patients.
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The liver receives blood from both the hepatic artery and portal vein. Hepatic infarction is rare in clinical practice as both the hepatic artery and portal vein can supply blood to the liver. Here, we reported a case of a 75-year-old man who underwent radical laparoscopic surgery for rectal cancer and subsequently developed hepatic infarction. The patient experienced severe infection, as well as circulatory and respiratory failure on the third day after surgery. The patient presented with high fever, chest tightness, shortness of breath, decreased blood oxygen saturation and blood pressure. The leukocyte count decreased from 8.10 × 10^9/L to 1.75 × 10^9/L. Procalcitonin (PCT) levels increased from 1.02 ng/mL to 67.14 ng/mL, and eventually reaching levels over 200 ng/mL. Enhanced abdominal computed tomography (CT) confirmed the presence of hepatic infarction, but no thrombosis was observed in the hepatic artery or portal vein. Metagenomic next-generation sequencing (mNGS) identified hypervirulent Klebsiella pneumoniae (hvKp) in the patient's blood and ascites, one day earlier than the detection results using traditional culture methods. The patient was diagnosed with hepatic infarction combined with septic shock caused by hvKp. This case emphasizes that in the high-risk group of thrombosis, infection can trigger exacerbated hepatic infarction events, particularly in cases after surgical procedures. For severely ill patients with infectious diseases who are admitted to the ICU with worsening symptoms, it is important to collect appropriate samples and send them for pathogen detection using mNGS in a timely manner. This may aid in early intervention and improve clinical outcomes.
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Background: Investigations assessing the value of metagenomic next-generation sequencing (mNGS) for distinguish Aspergillus infection from colonization are currently insufficient. Methods: The performance of mNGS in distinguishing Aspergillus infection from colonization, along with the differences in patients' characteristics, antibiotic adjustment, and lung microbiota, were analyzed. Results: The abundance of Aspergillus significantly differed between patients with Aspergillus infection (n=36) and colonization (n=32) (P < 0.0001). Receiver operating characteristic (ROC) curve result for bronchoalveolar lavage fluid (BALF) mNGS indicated an area under the curve of 0.894 (95%CI: 0.811-0.976), with an optimal threshold value of 23 for discriminating between Aspergillus infection and colonization. The infection group exhibited a higher proportion of antibiotic adjustments in comparison to the colonization group (50% vs. 12.5%, P = 0.001), with antibiotic escalation being more dominant. Age, length of hospital stay, hemoglobin, cough and chest distress were significantly positively correlated with Aspergillus infection. The abundance of A. fumigatus and Epstein-Barr virus (EBV) significantly increased in the infection group, whereas the colonization group exhibited higher abundance of A. niger. Conclusion: BALF mNGS is a valuable tool for differentiating between colonization and infection of Aspergillus. Variations in patients' age, length of hospital stay, hemoglobin, cough and chest distress are observable between patients with Aspergillus infection and colonization.
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Aspergilose , Infecções por Vírus Epstein-Barr , Pneumonia , Humanos , Herpesvirus Humano 4 , Aspergillus/genética , Tosse , Líquido da Lavagem Broncoalveolar , Sequenciamento de Nucleotídeos em Larga Escala , Antibacterianos , Pulmão , Hemoglobinas , Sensibilidade e Especificidade , Estudos RetrospectivosRESUMO
Online fitness training, with its affordability and flexibility, offers a convenient way for individuals to engage in regular workouts that promote physical and mental health. Yet, learning fitness motions in this way presents various challenges and may not always be as effective as in-person training. To address the practical demands of motion learning, we conducted a systematic survey and accordingly proposed a four-stage self-learning genre that integrates immersive virtual reality (VR) environments with motion skill learning theories, strategies, and expert experience. Herein, we merged progressive structures and multi-level visual cues to enhance instruction, and proposed a fine-grained motion analysis method to provide adaptive correction feedback during training. Utilizing a Taichi training platform with the genre embedded, we systematically validated the effectiveness of the genre, and examined the potential impact of VR content presentation form on motion learning among different age groups, as well as their preferences and focus on VR fitness training genre design. Results from the quantitative analysis, qualitative evaluation, and case study showed that the 360° video-based VR content brought more positive motion learning performance and user experiences than the fully-simulated VR used in many previous studies. The proposed genre demonstrated outstandingly performance, experience, and usability, with each stage and design playing an effective role. Moreover, we offer several design considerations for VR fitness systems targeting diverse age groups, providing beneficial insights for VR development in the sports and health-related fields.
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Realidade Virtual , Humanos , Adulto , Masculino , Feminino , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Aprendizagem/fisiologia , IdosoRESUMO
Histoplasmosis is an endemic disease caused by Histoplasma capsulatum. This systemic disease can affect various organs beyond the lungs, such as the liver, spleen, adrenal gland, and lymph nodes. The clinical symptoms can range from asymptomatic to severe, life-threatening conditions, depending on the state of the patient's immune system. This report describes a 40-year-old male who presented with reports of weight loss, low back pain, and progressively worsening movement disorder of the bilateral lower extremities for months. Computed tomography (CT) examination showed multiple lytic lesions of vertebral bodies, bilateral ribs, and pelvic bone, histopathological examination and tumor-related serum markers exclude tumors. mNGS was employed to identify H. capsulatum var. capsulatum as the etiological agent of the lesions in the bone biopsy. Through phylogenetic tree analysis, Histoplasma capsulatum var. Capsulatum (Hcc) was the main responsible pathogen, rarely reported in bone lesions. The patient underwent spinal surgery and was successfully treated with liposomal amphotericin B and itraconazole. Based on the diagnosis and treatment of this case, we discuss the epidemiologic status, clinical presentations, diagnostic criteria, and treatment guidelines of histoplasmosis to provide additional information about this disease. mNGS is utilized in this case, and it appears to be a reliable method for early and accurate diagnosis of this disease.
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BACKGROUND: The potential protective effects of dietary fiber against all-cause mortality, cardiovascular mortality, and cardiovascular disease in patients with chronic kidney disease have not been definitively established. To verify this relationship, a systematic review and a meta-analysis were undertaken. METHODS: PubMed, The Cochrane Library, Web of Science, Embase, ProQuest, and CINAHL were used to systematically search for prospective cohort studies that investigate the association between dietary fiber and all-cause mortality, cardiovascular mortality, and cardiovascular disease in individuals with chronic kidney disease (CKD). This search was conducted up to and including March 2023. RESULTS: The analysis included 10 cohort studies, with a total of 19,843 patients who were followed up for 1.5-10.1 y. The results indicated a significant negative correlation between dietary fiber and all-cause mortality among patients with CKD (HR 0.80, 95% CI 0.58-0.97, P < 0.001). Subgroup analysis further revealed that the study population and exposure factors were significantly associated with all-cause mortality (P < 0.001). Increased dietary fiber intake was associated with a reduced risk of cardiovascular mortality (HR 0.78; 95% CI 0.67-0.90) and a reduced incidence of cardiovascular disease (HR 0.87; 95% CI 0.80-0.95) among patients with CKD. CONCLUSIONS: The pooled results of our meta-analysis indicated an inverse association between dietary fiber intake and all-cause mortality, cardiovascular mortality, and cardiovascular disease.
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Doenças Cardiovasculares , Fibras na Dieta , Mortalidade , Insuficiência Renal Crônica , Humanos , Doenças Cardiovasculares/mortalidade , Estudos Prospectivos , Insuficiência Renal Crônica/complicaçõesRESUMO
Medical image segmentation faces challenges because of the small sample size of the dataset and the fact that images often have noise and artifacts. In recent years, diffusion models have proven very effective in image generation and have been used widely in computer vision. This paper presents a new feature map denoising module (FMD) based on the diffusion model for feature refinement, which is plug-and-play, allowing flexible integration into popular used segmentation networks for seamless end-to-end training. We evaluate the performance of the FMD module on four models, UNet, UNeXt, TransUNet, and IB-TransUNet, by conducting experiments on four datasets. The experimental data analysis shows that adding the FMD module significantly positively impacts the model performance. Furthermore, especially for small lesion areas and minor organs, adding the FMD module allows users to obtain more accurate segmentation results than the original model.
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Artefatos , Análise de Dados , Difusão , Tamanho da Amostra , Processamento de Imagem Assistida por ComputadorRESUMO
INTRODUCTION: Previous studies have evaluated metagenomic next-generation sequencing (mNGS) of cell-free DNA (cfDNA) for pathogen detection in blood and body fluid samples. However, no study has assessed the diagnostic efficacy of mNGS using cellular DNA. OBJECTIVES: This is the first study to systematically evaluate the efficacy of cfDNA and cellular DNA mNGS for pathogen detection. METHODS: A panel of seven microorganisms was used to compare cfDNA and cellular DNA mNGS assays concerning limits of detection (LoD), linearity, robustness to interference, and precision. In total, 248 specimens were collected between December 2020 and December 2021. The medical records of all the patients were reviewed. These specimens were analysed using cfDNA and cellular DNA mNGS assays, and the mNGS results were confirmed using viral qPCR, 16S rRNA, and internal transcribed spacer (ITS) amplicon next-generation sequencing. RESULTS: The LoD of cfDNA and cellular DNA mNGS was 9.3 to 149 genome equivalents (GE)/mL and 27 to 466 colony-forming units (CFU)/mL, respectively. The intra- and inter-assay reproducibility of cfDNA and cellular DNA mNGS was 100%. Clinical evaluation revealed that cfDNA mNGS was good at detecting the virus in blood samples (receiver operating characteristic (ROC) area under the curve (AUC), 0.9814). In contrast, the performance of cellular DNA mNGS was better than that of cfDNA mNGS in high host background samples. Overall, the diagnostic efficacy of cfDNA combined with cellular DNA mNGS (ROC AUC, 0.8583) was higher than that of cfDNA (ROC AUC, 0.8041) or cellular DNA alone (ROC AUC, 0.7545). CONCLUSION: Overall, cfDNA mNGS is good for detecting viruses, and cellular DNA mNGS is suitable for high host background samples. The diagnostic efficacy was higher when cfDNA and cellular DNA mNGS were combined.
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Líquidos Corporais , Ácidos Nucleicos Livres , Humanos , RNA Ribossômico 16S/genética , Reprodutibilidade dos Testes , Sequenciamento de Nucleotídeos em Larga Escala , Ácidos Nucleicos Livres/genética , DNARESUMO
BACKGROUND: Several studies have investigated the detection of plasma cell-free DNA (cfDNA) using metagenomic next-generation sequencing (mNGS). However, to our knowledge, no study has evaluated the diagnostic value of mNGS detection using blood cells. In this study, we aimed to evaluate the performance of a whole blood mNGS assay which includes the results of plasma and blood cells mNGS detection. METHODS: We selected a panel of seven microorganisms to validate both the plasma and blood cells assay for their limits of detection (LoD), linearity, precision, and robustness to interference. In a multicentered prospective study conducted from January 2021 to April 2022, we tested 253 septic patients with plasma and blood cells mNGS and compared it with blood cultures (BCs). The performance of pathogen detection was compared between mNGS and BCs. RESULTS: The LoD for plasma and blood cells mNGS was 8.3-140 genome equivalents (GE)/mL and 26 to 534 colony-forming units (CFU) or copies/mL, respectively. The inter- and intra-assay reproducibility of both plasma and blood cells mNGS was 100%. Compared to plasma mNGS alone, the sensitivity of whole blood mNGS was increased by 18.04% when using BCs as the standard (67.21% vs 85.25%). Furthermore, the sensitivity of whole blood mNGS in diagnosing bloodstream infections (BSIs) was 85.21%, which was significantly higher than that of BCs (36.09%, Pï¼0.0001) and plasma mNGS (69.82%; P = 0.0007). Additional analysis showed that blood cells mNGS was able to detect bacteria missed by plasma mNGS, while plasma mNGS was effective at detecting viruses. CONCLUSIONS: Our findings indicate that whole blood mNGS shows great potential as a promising diagnostic technique for BSIs owing to its ability to identify pathogens with higher sensitivity.
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Sepse , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Sepse/diagnóstico , Células Sanguíneas , Sequenciamento de Nucleotídeos em Larga Escala , Metagenômica , Sensibilidade e EspecificidadeRESUMO
Nitrate is a contaminant widely found in surface water, and a high concentration of nitrate can pose a serious threat to human health. Zero-valent iron is widely used to reduce nitrate in aqueous solution, but an acidic condition is required. Zero-valent aluminum has a much lower redox potential (E0(Al3+/Al0) = -1.662 V) than zero-valent iron (E0(Fe2+/Fe0) = -0.44 V), making it a better choice for reduction of nitrate. However, a passive oxide film covering on Al surfaces inhibits its electron transfer. In this work, metal Al powder was activated by a soaking procedure in deionized water. It was found that nitrate in neutral solution can be efficiently and completely reduced by soaked Al, even if the concentration of nitrate-N was up to 100 mg L-1. Using an optimal soaking time, the soaked Al can remove >90% of nitrate in aqueous solution within â¼2 h at 50 °C. Furthermore, the nitrate reduction efficiency increased with increasing reaction temperature and dosage of Al powder. After reaction, only â¼50% of pristine N content was left in the form of ammonia ions (NH4+) in aqueous solution. Mechanism analyses showed that after soaking, Al particle surfaces were covered by a layer of loose and fine Al(OH)3 grains, which can shorten the induction time for the beginning of the reaction between inner Al and outside ions or molecules. This is the reason why soaked Al has a high efficiency for nitrate removal. The present results indicate that soaking is an effective way to activate Al to remove nitrate in water.
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Membrane-enclosed transport carriers sort biological molecules between stations in the cell in a dynamic process that is fundamental to the physiology of eukaryotic organisms. While much is known about the formation and release of carriers from specific intracellular membranes, the mechanism of carrier formation from the recycling endosome, a compartment central to cellular signaling, remains to be resolved. In Caenorhabditis elegans, formation of transport carriers from the recycling endosome requires the dynamin-like, Eps15-homology domain (EHD) protein, RME-1, functioning with the Bin/Amphiphysin/Rvs (N-BAR) domain protein, AMPH-1. Here we show, using a free-solution single-particle technique known as burst analysis spectroscopy (BAS), that AMPH-1 alone creates small, tubular-vesicular products from large, unilamellar vesicles by membrane fission. Membrane fission requires the amphipathic H0 helix of AMPH-1 and is slowed in the presence of RME-1. Unexpectedly, AMPH-1-induced membrane fission is stimulated in the presence of GTP. Furthermore, the GTP-stimulated membrane fission activity seen for AMPH-1 is recapitulated by the heterodimeric N-BAR amphiphysin protein from yeast, Rvs161/167p, strongly suggesting that GTP-stimulated membrane fission is a general property of this important class of N-BAR proteins.
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Endocitose , Endossomos , Animais , Membrana Celular/metabolismo , Endocitose/fisiologia , Endossomos/metabolismo , Membranas Intracelulares , Caenorhabditis elegans , Guanosina Trifosfato/metabolismoRESUMO
A precise and efficient microbiological diagnosis is essential for sepsis. Metagenomic next-generation sequencing (mNGS) is a novel technique for the diagnosis of infectious diseases, but its current application in multisite sampling and interpretation remains controversial. Therefore, this study was undertaken to evaluate the reliability of multisite mNGS tests and the efficiency of plasma mNGS based on lymphocyte subset counts. A prospective observational study was performed on the intubated patients with sepsis-associated lymphopenia from January 2020 to February 2022. During the study period, data on 71 patients with sepsis-induced lymphopenia were collected. Among the 125 mNGS tests, 95 were positive for pathogens, whereas of the 166 conventional microbiological tests (CMTs), 91 were positive. The comparison showed that 38 patients (53.5%) had at least one matched pair of plasma mNGS and CMT results, while for multisite sampling, 47 patients (66.2%) had at least one. Lymphocyte subset analysis showed that T lymphocyte (577 ± 317 versus 395 ± 207, P = 0.005) and CD4+ T lymphocyte (333 ± 199 versus 230 ± 120, P = 0.009) counts were lower in the matched group. According to receiver operating characteristic (ROC) analysis, a CD4+ T lymphocyte count lower than 266 cells/mm3 was predictive of a match result. For sepsis-associated lymphopenia patients, we found that multisite mNGS tests showed a higher positivity rate. With plasma mNGS, a lower CD4+ T lymphocyte count predicted a better match result with CMT. The lymphocyte subset analysis may promote the clinical interpretation of mNGS results. IMPORTANCE This study was undertaken to evaluate the reliability of pathogenic diagnoses based on multisite mNGS detection at the clinically suspected sites and to analyze the efficiency of plasma mNGS detection based on lymphocyte subset counts in patients with sepsis-associated lymphopenia.
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Linfopenia , Sepse , Humanos , Reprodutibilidade dos Testes , Linfopenia/diagnóstico , Sepse/complicações , Sepse/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala , Metagenoma , MetagenômicaRESUMO
Ultrasound can accelerate and change the reaction process and is widely used in the field of hydrogen production and storage. In this study, ultrasound (US) and AlOOH suspension (AH) are used to promote hydrogen production from Al hydrolysis. The results indicate that both US and AH greatly shorten the induction time and enhance the hydrogen production rate and yield. The promoting effect of US and AH on Al hydrolysis originates from the acoustic cavitation effect and catalytic effect, respectively. When AH is used in combination with US, Al hydrolysis has the best hydrogen production performance and the hydrogen yield can reach 96.6 % within 1.2 h, because there is a synergistic effect on Al hydrolysis between AH and US. Mechanism analyses reveal that the micro-jets and local high temperature environment arising from acoustic cavitation improve the catalytic activity of AlOOH, while the suspended AlOOH particles enhance the cavitation effect of US. This work provides a novel and feasible method to promote hydrogen production from Al hydrolysis.
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Hidróxido de Alumínio , Óxido de Alumínio , Hidrólise , HidrogênioRESUMO
BACKGROUND: Noncoding RNAs (ncRNAs), pyroptosis and tumours are all hot topics in current research, but there are very limited studies on pyroptosis and its regulated ncRNAs in colon adenocarcinoma (COAD). METHODS: The COAD transcription profile dataset from TCGA was used for differential expression analysis. Pyroptosis-related genes (PRGs), the top 200 long noncoding RNAs (lncRNAs) and circular RNA (circRNAs) were selected from the results to construct an endogenous competitive RNA (ceRNA) network. Moreover, the expression of the ceRNAs was used for consensus cluster analysis of COAD and developing a risk model after combining clinical follow-up data by the least absolute shrinkage and selection operator method. The stability and independent prognostic ability of the risk model were evaluated. Finally, gene set enrichment analysis (GSEA) and immune score comparisons between the high-risk and low-risk groups were performed. RESULTS: There were 87 PRGs with significant differences, among which casp3/8, NLRP1/3, and IL-1α/1ß were at the core of the interactions. The ceRNA network consisted of 58 lncRNAs, 6 circRNAs, 25 PRGs, and 55 microRNAs. We speculated that KCNQ1OT1-miRNAs-SQSTM1 and HSA_CIRC_0001495-miRNAs-PTEN have great potential and value in the pyroptosis mechanism of COAD. Nine RNAs were involved in the risk score, which had excellent independent prognostic ability. Survival analyses were significant between the high-risk (HR) and low-risk (LR) groups (training cohort: P < 0.001; test cohort: P = 0.037). GSEA was mainly enriched in tumour proliferation and metastasis related pathways, while differences in immune activity showed a bipolar distribution between the HR and LR groups. CONCLUSIONS: The overall mechanism of pyroptosis in COAD was revealed. CeRNAs most closely related to the pyroptosis mechanism of COAD were selected and used to develop a prognostic model. The results may present new regulatory sites and potential targets for COAD pyroptosis mechanisms.
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Adenocarcinoma , Neoplasias do Colo , MicroRNAs , RNA Longo não Codificante , Adenocarcinoma/genética , Caspase 3/genética , Caspase 3/metabolismo , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Regulação Neoplásica da Expressão Gênica , Redes Reguladoras de Genes , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Prognóstico , Piroptose/genética , RNA Circular/genética , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , RNA Mensageiro/genética , Proteína Sequestossoma-1/genética , Proteína Sequestossoma-1/metabolismoRESUMO
Extracellular ß-amyloid (Aß) deposition and intraneuronal phosphorylated-tau (pTau) accumulation are the hallmark lesions of Alzheimer's disease (AD). Recently, "sorfra" plaques, named for the extracellular deposition of sortilin c-terminal fragments, are reported as a new AD-related proteopathy, which develop in the human cerebrum resembling the spatiotemporal trajectory of tauopathy. Here, we identified intraneuronal sortilin aggregation as a change related to the development of granulovacuolar degeneration (GVD), tauopathy, and sorfra plaques in the human hippocampal formation. Intraneuronal sortilin aggregation occurred as cytoplasmic inclusions among the pyramidal neurons, co-labeled by antibodies to the extracellular domain and intracellular C-terminal of sortilin. They existed infrequently in the brains of adults, while their density as quantified in the subiculum/CA1 areas increased in the brains from elderly lacking Aß/pTau, with pTau (i.e., primary age-related tauopathy, PART cases), and with Aß/pTau (probably/definitive AD, pAD/AD cases) pathologies. In PART and pAD/AD cases, the intraneuronal sortilin aggregates colocalized partially with various GVD markers including casein kinase 1 delta (Ck1δ) and charged multivesicular body protein 2B (CHMP2B). Single-cell densitometry established an inverse correlation between sortilin immunoreactivity and that of Ck1δ, CHMP2B, p62, and pTau among pyramidal neurons. In pAD/AD cases, the sortilin aggregates were reduced in density as moving from the subiculum to CA subregions, wherein sorfra plaques became fewer and absent. Taken together, we consider intraneuronal sortilin aggregation an aging/stress-related change implicating protein sorting deficit, which can activate protein clearance responses including via enhanced phosphorylation and hydrolysis, thereby promoting GVD, sorfra, and Tau pathogenesis, and ultimately, neuronal destruction and death.
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OBJECTIVES: For patients with intra-abdominal infection (IAI), the rapid and accurate identification of pathogens remains a challenge. Metagenomic next-generation sequencing (mNGS) is a novel technique for infectious diseases, but its application in IAI is limited. In this study, we compared the microbiological diagnostic ability of plasma mNGS with that of conventional peritoneal drainage (PD) culture in critical care settings. METHODS: From January 2018 to December 2020, a prospective observational study was performed at a tertiary teaching hospital in China and data on 109 abdominal sepsis patients were collected. The pathogen detection performance of plasma mNGS and PD culture method were compared. MEASUREMENTS AND RESULTS: Ninety-two positive cases detected on PD culture, while plasma mNGS detected 61 positive cases. Forty-five patients (44.0%) had at least one matched pair of plasma mNGS and PD culture results. Compared with PD culture, the plasma mNGS was more rapid (27.1 ± 4.0 vs. 68.9 ± 22.3 h, p < 0.05). The patients received initial antibiotic treatment matched with mNGS detection showed better clinical outcomes. CONCLUSION: For abdominal sepsis patients, plasma mNGS can provide early, noninvasive, and rapid microbiological diagnosis. Compared with conventional PD smear, culture, and blood culture methods, plasma mNGS promote the rapid detection of pathogenic bacteria.
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BACKGROUND: Shotgun metagenomics has been used clinically for diagnosing infectious diseases. However, most technical assessments have been limited to individual sets of reference standards, experimental workflows, and laboratories. METHODS: A reference panel and performance metrics were designed and used to examine the performance of shotgun metagenomics at 17 laboratories in a coordinated collaborative study. We comprehensively assessed the reliability, key performance determinants, reproducibility, and quantitative potential. FINDINGS: Assay performance varied significantly across sites and microbial classes, with a read depth of 20 millions as a generally cost-efficient assay setting. Results of mapped reads by shotgun metagenomics could indicate relative and intra-site (but not absolute or inter-site) microbial abundance. INTERPRETATION: Assay performance was significantly impacted by the microbial type, the host context, and read depth, which emphasizes the importance of these factors when designing reference reagents and benchmarking studies. Across sites, workflows and platforms, false positive reporting and considerable site/library effects were common challenges to the assay's accuracy and quantifiability. Our study also suggested that laboratory-developed shotgun metagenomics tests for pathogen detection should aim to detect microbes at 500 CFU/mL (or copies/mL) in a clinically relevant host context (10^5 human cells/mL) within a 24h turn-around time, and with an efficient read depth of 20M. FUNDING: This work was supported by National Science and Technology Major Project of China (2018ZX10102001).
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Bactérias/isolamento & purificação , Doenças Transmissíveis/diagnóstico , Fungos/isolamento & purificação , Metagenômica/instrumentação , Metagenômica/métodos , Bactérias/classificação , Bactérias/genética , Benchmarking , China , Fungos/classificação , Fungos/genética , Células HeLa , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Laboratórios , Metagenômica/normas , Reprodutibilidade dos Testes , Análise de Sequência de DNA , Fluxo de TrabalhoRESUMO
We describe 3 similar cases of rickettsial disease that occurred after tick bites in a mountainous rural area of Shandong Province, China. Next-generation sequencing indicated the etiologic agent of 1 patient was Rickettsia conorii subspecies indica. This agent may be more widely distributed across China than previously thought.
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Febre Botonosa , Infecções por Rickettsia , Rickettsia conorii , Rickettsia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Rickettsia/genética , Infecções por Rickettsia/diagnóstico , Rickettsia conorii/genéticaRESUMO
Bromate, a toxic by-product of bromide-containing drinking water after disinfecting with ozone, has attracted much attention in the past two decades. Traditional methods to activate zero-valent metals for reducing bromate are to eliminate their surface oxide layer by acid washing. In this work, for the first time, zero-valent Al (ZVAl) was surface treated by the following procedures including soaking, soaking and freeze-drying, soaking and heat-treating, and γ-Al2O3 covering Al particle surfaces (GCAP). It was found that all of above surface treated ZVAls have an obvious high efficiency for bromate reduction relative to pristine ZVAl. The bromate reduction rate is GCAP > soaking Al > freeze-drying Al > soaking and heat-treating Al > pristine Al, and using GCAP just 30 min is taken to completely reduce bromate to bromide in neutral solution. Mechanism analyses revealed that Al surface treating or covered by fine γ-Al2O3 phase can promote the hydration and breakage of Al surface passive oxide layer, resulting in a fast contact of inner Al with outside ions, leading to a high reduction rate of bromate in neutral solution. XPS analyses indicated that there are no bromate or bromide ions adsorbed on Al particle surfaces, implying that there is a high direct donating efficiency of electrons from inner Al to bromate ions in solution. Furthermore, GCAP has a good reusability and >90% bromate can be reduced even it was reused up to 4 cycles.
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Poluentes Químicos da Água , Purificação da Água , Alumínio , Bromatos , Brometos , OxirreduçãoRESUMO
Aluminum hydroxide is an effective defluoridation adsorbent; however, the poor defluoridation performance limits its wide application. In this work, amorphous and crystalline AlOOH adsorbents are synthesized through hydrolysis of Al salts, and their defluoridation performances are evaluated in terms of adsorption capacity and rate, sensitivity to pH value, and water quality after defluoridation. The defluoridation performance of AlOOH is closely related to the hydrolysis pH value, but hardly to the type of Al salts. The adsorbent can remove >95% fluoride in the first 2 min and reach adsorption equilibrium within 2 h, and the maximum defluoridation capacity is 41.9 mg/g. Furthermore, the adsorbent exhibits an excellent defluoridation efficiency at a wide pH range of 4.5-10.5. After fluoride removal, the adsorbents prepared at pH values of 6 and 7 exhibit low residual Al concentration. The Fourier transform infrared (FTIR) and X-ray photoelectron spectroscopy (XPS) results confirm that the fluoride removal mechanism is the ligand exchange between fluoride and hydroxyl groups. The excellent defluoridation capacity and low residual Al demonstrate that AlOOH is a potential adsorbent for fluoride separation from water.