Quantitative Value of Bacteria Associated with Leukocytes in Differential Diagnosis of Lower Respiratory Tract Infection in Children, in Comparison to Sputum Culture and Procalcitonin.

BACKGROUND: The mortality and morbidity rates in children with lower respiratory tract infection (LRTI) remain high. OBJECTIVE: To describe the number of bacteria that is associated with leukocytes in differential diagnosis of bacterial, mycoplasma, and viral LRTI in children. METHODS: Sputum smears were Gram stained for counting single-morphology bacteria associated with leukocytes. The differential diagnostic values of bacterial number were assessed in children with LRTI. RESULTS: The area under the receiver operating characteristic (ROC) curve was 0.95 for bacterial number in the differential diagnosis of bacterial infection from mycoplasma and viral infections. The area under the ROC curve was 0.62 for procalcitonin and 0.94 for bacterial number in the differential diagnosis of bacterial infection from mycoplasma infection. CONCLUSION: The number of bacteria associated with leukocytes in sputum was valuable and rapid in differential diagnosis of bacterial infection in children with suspected bacterial, mycoplasma, and viral LRTI.

Distinguishing COVID-19 from seasonal influenza in patients under age 65 years-a retrospective observational cohort study comparing the 2009 influenza A (H1N1) and 2022 SARS-CoV-2 pandemics.

Introduction: This study explored the differences in clinical characteristics between the 2009 pandemic influenza A (H1N1) and SARS-CoV-2 BA.2 variant (Omicron) infections in patients younger than age 65 years, to improve identification of these diseases and better respond to the current epidemic. Methods: Data from 127 patients with the 2009 pandemic influenza A (H1N1) diagnosed between May and July of 2009 and 3,265 patients with Omicron diagnosed between March and May of 2022 were collected. Using a 1:2 match based on age (difference <2 years), sex, and underlying diseases, data from 115 patients with the 2009 pandemic influenza A (H1N1) infection (H1N1 group) and 230 patients with SARS-CoV-2 Omicron BA.2 infection (Omicron group) were analyzed. The clinical manifestations were compared between the groups, logistic regression was performed to identify possible independent risk factors for each group, and multiple linear regression was used to analyze the factors predicting time for nucleic acid negativization (NAN). Results: The median [interquartile range] age of the two groups was 21 [11, 26] years. Compared with the H1N1 group, the Omicron group had: lower white blood cell counts and C-reactive protein levels; less fever, nasal congestion, sore throat, cough, sputum, and headache; and more olfactory loss, muscle soreness, and lactate dehydrogenase (LDH) abnormalities. Patients in the Omicron group used fewer antibiotics and antiviral drugs, and the time for NAN was longer (17 [14,20] VS 4 [3,5] days, P<0.001). Logistic regression showed that fever, cough, headache, and increased white blood cell count were more strongly correlated with the H1N1 group, while muscle soreness and LDH abnormalities were more strongly correlated with the Omicron group. Fever (B 1.529, 95% confidence interval [0.149,2.909], P=0.030) significantly predicted a longer time for NAN in patients with Omicron. Discussion: There are significant differences in clinical characteristics between SARS-CoV-2 Omicron infection and the 2009 pandemic influenza A (H1N1) infection. Recognition of these differences has important implications for clinical practice.

Atomic/Molecular Layer-Deposited Laminated Li2O-Lithicone Interfaces Enabling High-Performance Silicon Anodes.

Silicon-based materials are of long-standing interest as the anodes for next-generation lithium-ion batteries, yet their low initial Coulombic efficiency and poor interfacial stability are lethal limitations. In this work, we used atomic layer deposition (ALD) and molecular layer deposition (MLD) techniques to fabricate a lithium-containing laminated Li2O-lithicone hybrid film (∼5 nm) on a silicon electrode. The laminated film provides an additional surface Li source around silicon cores, which can partially reimburse the Li loss during battery cycling. Characterization of interfacial components shows that such a laminated Li2O-lithicone interface undergoes gentle element changes and participates in a hybrid solid electrolyte interphase with Li2CO3, Li2O, LixPOFy, and LiF species. Finite element model analysis and morphology characterization demonstrate that the laminated structure design can help relieve the interfacial stress and thus retain the integrity and reactivity of the silicon composite anode during cycling. Moreover, the lithium-based laminated film leads to a fast Li+ migration kinetics on the surface of the electrode as revealed by the galvanostatic intermittent titration technique and density functional theory calculation. Benefiting from the above merits, a silicon anode with a 91.2% initial Coulombic efficiency, a rate performance of 1460 mA h g-1 at 2 A g-1, and a reversible capacity over 646 mA h g-1 after 850 cycles was achieved. This work exemplifies the advantages of lithium-based hybrid films precisely engineered by ALD/MLD techniques for improving performances of advanced silicon anode batteries and deepens understandings on the mechanism of interfacial stability and reaction kinetics.

The effects of vaccination on the disease severity and factors for viral clearance and hospitalization in Omicron-infected patients: A retrospective observational cohort study from recent regional outbreaks in China.

Object: This study attempted to explore the effects of vaccination on disease severity and the factors for viral clearance and hospitalization in omicron-infected patients. Methods: The clinical manifestations of 3,265 Omicron-infected patients (BA.2 lineage variant; the Omicron group) were compared with those of 226 Delta-infected patients (the Delta group). A Multi-class logistic regression model was employed to analyze the impacts of vaccination doses and intervals on disease severity; a logistic regression model to evaluate the risk factors for hospitalization; R 4.1.2 data analysis to investigate the factors for time for nucleic acid negativization (NAN). Results: Compared with the Delta group, the Omicron group reported a fast transmission, mild symptoms, and lower severity incidence, and a significant inverse correlation of vaccination dose with clinical severity (OR: 0.803, 95%CI: 0.742-0.868, p<0.001). Of the 7 or 5 categories of vaccination status, the risk of severity significantly decreased only at ≥21 days after three doses (OR: 0.618, 95% CI: 0.475-0.803, p<0.001; OR: 0.627, 95% CI: 0.482-0.815, p<0.001, respectively). The Omicron group also reported underlying illness as an independent factor for hospitalization, sore throat as a protective factor, and much shorter time for NAN [15 (12,19) vs. 16 (12,22), p<0.05]. NAN was associated positively with age, female gender, fever, cough, and disease severity, but negatively with vaccination doses. Conclusion: Booster vaccination should be advocated for COVID-19 pandemic-related control and prevention policies and adequate precautions should be taken for patients with underlying conditions.

Correction: Liu et al. A Predictive Model for the Risk of Posterior Circulation Stroke in Patients with Intracranial Atherosclerosis Based on High Resolution MRI. Diagnostics 2022, 12, 812.

Errors occurred in the number of patients in the posterior circulation ischemic stroke (PCIS) group and non-PCIS group described in the original publication [...].

A Predictive Model for the Risk of Posterior Circulation Stroke in Patients with Intracranial Atherosclerosis Based on High Resolution MRI.

Intracranial vertebrobasilar atherosclerosis is the main cause of posterior circulation ischemic stroke. We aimed to construct a predictive model for the risk of posterior circulation ischemic stroke in patients with posterior circulation atherosclerosis based on high-resolution MRI (HR-MRI). A total of 208 consecutive patients with posterior circulation atherosclerosis confirmed by HR-MRI, from January 2020 to July 2021, were retrospectively assessed. They were assigned to the posterior circulation stroke (49 patients) and non-posterior circulation stroke group (159 patients) based on clinical presentation and diffusion-weighted imaging (DWI). Demographic data, risk factors of atherosclerosis, laboratory findings, and imaging characteristics were extracted from electronic health records. Plaque features were investigated by HR-MRI. Fifty-three clinical or imaging features were used to derive the model. Multivariable logistic regression analysis was employed to construct the prediction model. The nomogram was evaluated for calibration, differentiation, and clinical usefulness. Plaque enhancement, plaque irregular surface morphology, artery location of plaque, and dorsal quadrant of plaque location were significant predictors for posterior circulation stroke in patients with intracranial atherosclerosis. Subsequently, these variables were selected to establish a nomogram. The model showed good distinction (C-index 0.830, 95% CI 0.766-0.895). The calibration curve also showed excellent consistency between the prediction of the nomogram and the observed curve. Decision curve analysis further demonstrated that the nomogram conferred significantly high clinical net benefit. The nomogram calculated from plaque characteristics in HR-MRI may accurately predict the posterior circulation stroke occurrence and be of great help for stratification of stroke decision making.

Unvaccinated Children Are an Important Link in the Transmission of SARS-CoV-2 Delta Variant (B1.617.2): Comparative Clinical Evidence From a Recent Community Surge.

Objective: To evaluate the necessity of Covid-19 vaccination in children aged < 12 y by comparing the clinical characteristics between unvaccinated children aged < 12 y and vaccinated patients aged ≥ 12y during the Delta surge (B.1.617.2) in Putian, Fujian, China. Methods: A total of 226 patients with SARS-Cov-2 Delta variant (B.1.167.2; confirmed by Real-time PCR positivity and sequencing) were enrolled from Sep 10th to Oct 20th, 2021, including 77 unvaccinated children (aged < 12y) and 149 people aged ≥ 12y, mostly vaccinated. The transmission route was explored and the clinical data of two groups were compared; The effect factors for the time of the nucleic acid negativization (NAN) were examined by R statistical analysis. Results: The Delta surge in Putian spread from children in schools to factories, mostly through family contact. Compared with those aged ≥ 12y, patients aged < 12y accounted for 34.07% of the total and showed milder fever, less cough and fatigue; they reported higher peripheral blood lymphocyte counts [1.84 (1.32, 2.71)×10^9/L vs. 1.31 (0.94, 1.85)×10^9/L; p<0.05), higher normal CRP rate (92.21% vs. 57.72%), lower IL-6 levels [5.28 (3.31, 8.13) vs. 9.10 (4.37, 15.14); p<0.05]. Upon admission, their COVID19 antibodies (IgM and IgG) and IgG in convalescence were lower [0.13 (0.00, 0.09) vs. 0.12 (0.03, 0.41), p<0.05; 0.02 (0.00, 0.14) vs. 1.94 (0.54, 6.40), p<0.05; 5.46 (2.41, 9.26) vs. 73.63 (54.63, 86.55), p<0.05, respectively], but longer NAN time (18 days vs. 16 days, p=0.13). Conclusion: Unvaccinated children may be an important link in the transmission of SARS-CoV-2 delta variant (B1.617.2), which indicated an urgent need of vaccination for this particular population.

In Situ Formation of Polycyclic Aromatic Hydrocarbons as an Artificial Hybrid Layer for Lithium Metal Anodes.

Nonuniform Li deposition causes dendrites and low Coulombic efficiency (CE), seriously hindering the practical applications of Li metal. Herein, we developed an artificial solid-state interphase (SEI) with planar polycyclic aromatic hydrocarbons (PAHs) on the surface of Li metal anodes by a facile in situ formation technology. The resultant dihydroxyviolanthron (DHV) layers serve as the protective layer to stabilize the SEI. In addition, the oxygen-containing functional groups in the soft and conformal SEI film can regulate the diffusion and transport of Li ions to homogenize the deposition of Li metal. The artificial SEI significantly improves the CEs and shows superior cyclability of over 1000 h at 4 mAh cm-2. The LiFePO4/Li cell (2.8 mAh cm-2) enables a long cyclability for 300 cycles and high CEs of 99.8%. This work offers a new strategy to inhibit Li dendrite growth and enlightens the design on stable SEI for metal anodes.

Micro-pin-finned Surfaces with Fractal Treelike Hydrophilic Networks for Flow Boiling Enhancement.

Due to its outstanding heat transfer performance, flow boiling has a wide range of applications in many fields, especially for cooling of electronic devices. Previous studies have shown that the liquid replenishment on the downstream of the heating surface is the critical restriction of the increase of the critical heat flux (CHF). In this work, we designed a series of heterogeneous surfaces with fractal treelike hydrophilic networks for flow boiling enhancement. The micro-pin-finned surface structures are expected to increase the CHF and reduce the superheat by its high wickability. Moreover, by virtue of the efficient transport capacity of treelike networks, the fractal hydrophilic paths are designed to serve as the liquid delivery channels for the liquid replenishment on the downstream of the heating surface. The heterogeneous surfaces improve the comprehensive boiling heat transfer performance, especially the CHF, which is 82.2% higher than that of the smooth surface and 5.4% higher than the surface homogeneously covered by the microstructure with twice of the extended surface area. This work provides reference for the design of heterogeneous surfaces with both smooth and structured parts to increase the flow boiling CHF to some extent.

Tailoring Stress and Ion-Transport Kinetics via a Molecular Layer Deposition-Induced Artificial Solid Electrolyte Interphase for Durable Silicon Composite Anodes.

Silicon is considered as a blooming candidate material for next-generation lithium-ion batteries due to its low electrochemical potential and high theoretical capacity. However, its commercialization has been impeded by the poor cycling issue associated with severe volume changes (∼380%) upon (de)lithiation. Herein, an organic-inorganic hybrid film of titanicone via molecular layer deposition (MLD) is proposed as an artificial solid electrolyte interphase (SEI) layer for Si anodes. This rigid-soft titanicone coating with Young's modulus of 21 GPa can effectively relieve stress concentration during the lithiation process, guaranteeing the stability of the mechanical structure of a Si nanoparticles (NPs)@titanicone electrode. Benefiting from the long-strand (Ti-O-benzene-O-Ti-) unit design, the optimized Si NPs@70 cycle titanicone anode delivers a high Li+ diffusion coefficient and a low Li+ diffusion barrier, as revealed by galvanostatic intermittent titration (GITT) investigations and density functional theory (DFT) simulations, respectively. Ultimately, the Si NPs@70 cycle titanicone electrode shows high initial Coulombic efficiency (84%), long cycling stability (957 mAh g-1 after 450 cycles at 1 A g-1), a stable SEI layer, and good rate performances. The molecular-scale design of the titanicone-protected Si anodes may bring in new opportunities to realize the next-generation lithium-ion batteries as well as other rechargeable batteries.

Realizing the enhanced cyclability of a cactus-like NiCo2O4 nanocrystal anode fabricated by molecular layer deposition.

Lithium-ion batteries with conversion-type anode electrodes have attracted increasing interest in providing higher energy storage density than those with commercial intercalation-type electrodes. However, conversion-type materials exhibit severe structural instability and capacity fade during cycling. In this work, a molecular layer deposition (MLD)-derived conductive Al2O3/carbon layer was employed to stabilize the structure of the cactus-like NiCo2O4 nanocrystal (NC) anode. The conductive Al2O3/carbon network and cactus-like NiCo2O4 NCs are beneficial for fast Li+/e- transport. Moreover, the Al2O3/carbon buffer-layer can prevent the NiCo2O4 NCs from agglomeration and form a steady solid electrolyte interphase (SEI), thus hampering the penetration of the electrolyte. Owing to these advantages, the assembled NiCo2O4@Al2O3/carbon half battery shows a high reversible capacity (931.2 mA h g-1 at 2 A g-1) and long-term stability of 290 mA h g-1 at 5 A g-1 over 500 cycles. Quantitative analyses further reveal the fast kinetics and the capacitance-battery dual model mechanism in the 3D core-shell structures. The design and introduction of MLD-derived hybrid coating may open a new way to conversion-type and alloy-type anode materials beyond NiCo2O4 to achieve high cyclability.

Statin on post-stroke epilepsy: A systematic review and meta-analysis.

INTRODUCTION: Recent research has shown that statins can reduce the incidence of epilepsy after stroke, especially ischemic stroke, but the results are inconsistent. In view of current stroke guidelines do not recommend the use of anti-epileptic drugs (AED) for the prevention of epilepsy after stroke, statins may be a good choice. The purpose of this study was to conduct a systematic review and meta-analysis to determine the effect of statins on the prevention of epilepsy after stroke. METHODS: Correlative cohort studies were identified through search of PubMed, Cochrane Library and Embase databases. The main outcomes included post-stroke epilepsy (PSE) and early-onset seizure (ES). Subgroup analyses and Sensitivity analysis were performed to evaluate the influences of the predefined study characteristics on the outcome. RESULTS: Seven studies were included (n = 40831). Statin use was associated with a lower risk of PSE (including 6 articles) (odds ratio [OR] 0.60, 95% confidence interval [CI] [0.42, 0.84], p = 0.003), and there is a remarkable effect in ES (including 6 articles) (OR 0.36, 95% CI [0.25, 0.54], p < 0.00001). CONCLUSION: Appropriate use of statins after stroke can reduce the risk of PSE, especially ES.

Enhanced visible light photocatalytic activity of Fe2O3 modified TiO2 prepared by atomic layer deposition.

In this work, commercial anatase TiO2 powders were modified using ultrathin Fe2O3 layer by atomic layer deposition (ALD). The ultrathin Fe2O3 coating having small bandgap of 2.20 eV can increase the visible light absorption of TiO2 supports, at the meantime, Fe2O3/TiO2 heterojunction can effectively improve the lifetime of photogenerated electron-hole pairs. Results of ALD Fe2O3 modified TiO2 catalyst, therefore, showed great visible light driven catalytic degradation of methyl orange compared to pristine TiO2. A 400 cycles of ALD Fe2O3 (~ 2.6 nm) coated TiO2 powders exhibit the highest degradation efficiency of 97.4% in 90 min, much higher than pristine TiO2 powders of only 12.5%. Moreover, an ultrathin ALD Al2O3 (~ 2 nm) was able to improve the stability of Fe2O3-TiO2 catalyst. These results demonstrate that ALD surface modification with ultrathin coating is an extremely powerful route for the applications in constructing efficient and stable photocatalysts.

Titanicone-derived TiO2 quantum dot@carbon encapsulated ZnO nanorod anodes for stable lithium storage.

To address the issues of large volume expansion and low electrical conductivity of ZnO anode nanomaterials during lithium ion battery operation, herein we engineered a rod-like ZnO anode with robust and conductive TiO2 quantum dot (QD)@carbon coating derived from molecular layer deposited titanicone, in which the TiO2 QDs are well confined inside the carbon layer. Transmission electron microscopy (TEM) and X-ray photoelectron spectroscopy (XPS) confirm the formation of TiO2 QDs and carbonization of fumaric acid in hybrid films after annealing in H2 atmosphere at 700 °C. Benefiting from a unique protective layer design, the prepared TiO2 QD@carbon@ZnO nanorod (NR) anodes display outstanding cycling performance with a discharge capacity of 1154 mA h g-1 after 100 cycles and 70% capacity retention, along with a high rate capacity of 470 mA h g-1 for 500 cycles at 2 A g-1. Moreover, our work demonstrates an innovative and promising approach toward a robust and conductive metal oxide QD@carbon nanocomposite layer for electrode materials in the future.

Successful treatment of disseminated fusariosis in a patient with acute lymphoblastic leukemia: A case report and literature review.

RATIONALE: Fusarium is the second most common cause of fungi infections in the immunocompromised patients with the mortality rate over 80%. Early identification and appropriate selection of antifungal drugs is the key to successful treatment. PATIENT CONCERNS: A 31-year-old female was diagnosed with acute lymphocytic leukemia (pro-B ALL). She developed a high fever and presented with typical painful purple nodules with central necrosis formed on the upper and lower limbs during the induction chemotherapy. DIAGNOSIS: Combining clinical manifestations with results of blood culture testing and sequencing methods, it was consistent with the diagnosis of disseminated fusariosis. INTERVENTIONS: The patient was treated with the combination of tigecycline and antifungal agents (Liposomal Amphotericin B and Voriconazole), OUTCOMES:: The skin lesions generally healed with some scar left after treating with antifungal agents for 6 weeks. The final date of follow-up was 1.5 years later, and the patient was alive with no diseases. LESSONS: This case highlights the importance of the typical cutaneous lesions for early diagnosis and proper treatment to decrease the mortality rate of this severe infection. This patient was successfully treated with the combination of tigecycline and antifungal agents, which may be the first clinical confirmation of tigecycline that improved the effectiveness of antifungal agents against fusariosis, but it requires more studies to verify. We reviewed 62 cases from literature and analyzed using logistic regression and recognized the high-risk factor for fusariosis mortality in patients with acute leukemia was non-remission of underlying disease.

Ultrasound imaging in the diagnosis of benign and suspicious adrenal lesions.

BACKGROUND: The purpose of this study was to define the ultrasound imaging characteristics of adrenal tumors and to assess the performance of ultrasound in differentiating benign 'leave-alone' lesions from suspicious lesions. MATERIAL AND METHODS: We enrolled 882 patients in this study. The nature of each lesion was determined by histopathology. Ultrasound finding of each lesion was compared with its corresponding histopathologic result. The final study group consisted of 911 adrenal masses in 882 patients. All images were reviewed by 2 experienced investigators in a double blind manner. RESULTS: There were 553 adenomas identified in the study, which constituted 60.70% of the lesions. There were 161 pheochromocytomas (17.67%), 49 myelolipomas (5.38%), 39 cysts (4.28%), 37 metastasis (4.06%), 35 ganglioneuromas (3.84%), 22 lymphomas (2.41%), and 15 cortical carcinomas (1.65%). The sensitivity, specificity, and accuracy of ultrasound-based diagnosis were 89%, 99%, and 93.9%, respectively. A positive predictive value of 90.9% and a negative predictive value of 94.2% were obtained in this study. CONCLUSIONS: This large-sample study showed that ultrasound was a reliable method in differentiating benign 'leave-alone' lesions from suspicious lesions.