Uniting Synergistic Effect of Single-Ni Site and Electric Field of B- Bridged-N for Boosted Electrocatalytic Nitrate Reduction to Ammonia.

Electrochemical conversion of nitrate, a prevalent water pollutant, to ammonia (NH3) is a delocalized and green path for NH3 production. Despite the existence of different nitrate reduction pathways, selectively directing the reaction pathway on the road to NH3 is now hindered by the absence of efficient catalysts. Single-atom catalysts (SACs) are extensively investigated in a wide range of catalytic processes. However, their application in electrocatalytic nitrate reduction reaction (NO3 -RR) to NH3 is infrequent, mostly due to their pronounced inclination toward hydrogen evolution reaction (HER). Here, Ni single atoms on the electrochemically active carrier boron, nitrogen doped-graphene (BNG) matrix to modulate the atomic coordination structure through a boron-spanning strategy to enhance the performance of NO3 -RR is designed. Density functional theory (DFT) study proposes that BNG supports with ionic characteristics, offer a surplus electric field effect as compared to N-doped graphene, which can ease the nitrate adsorption. Consistent with the theoretical studies, the as-obtained NiSA@BNG shows higher catalytic activity with a maximal NH3 yield rate of 168 µg h-1 cm-2 along with Faradaic efficiency of 95% and promising electrochemical stability. This study reveals novel ways to rationally fabricate SACs' atomic coordination structure with tunable electronic properties to enhance electrocatalytic performance.

Multivalent Sulfur Vacancy-Rich NiCo2S4@MnO2 Urchin-Like Heterostructures for Ambient Electrochemical N2 Reduction to NH3.

Innovative advances in the exploitation of effective electrocatalytic materials for the reduction of nitrogen (N2) to ammonia (NH3) are highly required for the sustainable production of fertilizers and zero-carbon emission fuel. In order to achieve zero-carbon footprints and renewable NH3 production, electrochemical N2 reduction reaction (NRR) provides a favorable energy-saving alternative but it requires more active, efficient, and selective catalysts. In current work, sulfur vacancy (Sv)-rich NiCo2S4@MnO2 heterostructures are efficaciously fabricated via a facile hydrothermal approach followed by heat treatment. The urchin-like Sv-NiCo2S4@MnO2 heterostructures serve as cathodes, which demonstrate an optimal NH3 yield of 57.31 µg h-1 mgcat -1 and Faradaic efficiency of 20.55% at -0.2 V versus reversible hydrogen electrode (RHE) in basic electrolyte owing to the synergistic interactions between Sv-NiCo2S4 and MnO2. Density functional theory (DFT) simulation further verifies that Co-sites of urchin-like Sv-NiCo2S4@MnO2 heterostructures are beneficial to lowering the energy threshold for N2 adsorption and successive protonation. Distinctive micro/nano-architectures exhibit high NRR electrocatalytic activities that might motivate researchers to explore and concentrate on the development of heterostructures for ambient electrocatalytic NH3 generation.

Insight into the Formation and Transfer Process of the First Intermediate of CO2 Reduction over Ag-Decorated Dendritic Cu.

It is still poorly understood how the first intermediates of CO2 reduction are formed and converted to multi-carbon products over Cu-based electrodes. Herein, Ag is used to decorate dendritic Cu and a high Faradaic efficiency (FE) for C2 H4 (25 %) is obtained on a CuAg electrode, which is about five times higher than dendritic Cu. The intermediates including *CO2 - , OH groups, Cu-CO, C-O rotation, and CHx species are investigated by in situ Raman spectroscopy. This work provides spectroscopic evidence that the first intermediate of CO2 reduction on Ag-decorated Cu is carboxylate anion *CO2 - bonded with the catalyst surface through the C and O atom. The formation and evolution process of the *CO2 - intermediate over the applied potential are investigated in depth as well. This research contributes to a better understanding of the mechanism of CO2 reduction and multi-carbon product formation pathways over Ag-decorated Cu.

Meta-analysis of 18F-FDG PET/CT in the diagnosis of infective endocarditis.

BACKGROUND: The current diagnosis of infective endocarditis (IE) is based on the modified Duke criteria, which has approximately 80% sensitivity for the diagnosis of native valve endocarditis (NVE), with lower sensitivity for the diagnosis of prosthetic valve endocarditis (PVE) and culture-negative endocarditis. There is preliminary evidence that 18F-FDG PET/CT is an adjunctive diagnostic test with high accuracy reported in small studies to date. We therefore performed a meta-analysis of studies evaluating the use of PET/CT in the diagnosis of IE to establish a more precise estimate of accuracy. METHODS: PubMed, Embase, Cochrane library, CINAHL, Web of Knowledge, and www.clinicaltrials.gov were searched from January 1990 to April 2017 for studies evaluating the accuracy of PET/CT for the evaluation of possible IE. RESULTS: We identified 13 studies involving 537 patients that were included in the meta-analysis. The pooled sensitivity of PET/CT for diagnosis of IE was 76.8% (95% CI 71.8-81.4%; Q = 39.9, P < 0.01; I2 = 69.9%) and the pooled specificity was 77.9% (95% CI 71.9-83.2%; Q = 44.42, P < 0.01; I2 = 73.0%). Diagnostic accuracy was improved for PVE with sensitivity of 80.5% (95% CI 74.1-86.0%; Q = 25.5, P < 0.01; I2 = 72.5%) and specificity of 73.1% (95% CI 63.8-81.2%; Q = 32.1, P < 0.01; I2 = 78.2%). Additional extracardiac foci of infection were found on 17% of patients on whole body PET/CT. CONCLUSION: PET/CT is a useful adjunctive diagnostic tool in the evaluation of diagnostically challenging cases of IE, particularly in prosthetic valve endocarditis. It also has the potential to detect clinically relevant extracardiac foci of infection, malignancy, and other sources of inflammation leading to more appropriate treatment regimens and surgical intervention.

Role of 18F-FDG PET/CT in the diagnosis of cardiovascular implantable electronic device infections: A meta-analysis.

OBJECTIVE: We performed a meta-analysis evaluating the use of fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in the diagnosis of cardiovascular implantable electronic device (CIED) infections. BACKGROUND: PET/CT may be helpful in the diagnosis of CIED infection, particularly in patients with the absence of localizing signs or definitive echocardiographic findings. METHODS: PubMed, Embase, Cochrane library, CINAHL, Web of Knowledge, and www.clinicaltrials.gov from January 1990 to April 2017 were searched for studies evaluating the accuracy of PET/CT in the diagnosis of CIED infections. RESULTS: Overall, 14 studies involving 492 patients were included in the meta-analysis. The pooled sensitivity of PET/CT for diagnosis of CIED infection was 83% (95% CI 78%-86%) and the pooled specificity was 89% (95% CI 84%-94%). PET/CT demonstrated a higher sensitivity of 96% (95% CI 86%-99%) and specificity of 97% (95% CI 86%-99%) for diagnosis of pocket infections. Diagnostic accuracy for lead infections or CIED-IE was lower with pooled sensitivity of 76% (95% CI 65%-85%) and specificity of 83% (95% CI 72%-90%). CONCLUSION: Use of PET/CT in the evaluation of CIED infection has both a high sensitivity (83%) and specificity (89%) and deserves consideration in the management of selected patients with suspected CIED infections.

Invasive fungal infections associated with prior respiratory viral infections in immunocompromised hosts.

BACKGROUND: Increased risk of invasive pulmonary aspergillosis after influenza infection has been reported; however data are limited. PURPOSE: To describe Invasive fungal infections (IFI) associated with preceding respiratory viral infection at a large referral center. METHODS: We reviewed all IFI cases among patients with positive influenza and/or RSV nasopharyngeal/lower respiratory tract PCR from October 2015 to December 2016. Cases of pulmonary IFI were classified as possible, probable, and definite based on EORTC-MSG definitions. RESULTS: We identified 8 cases (4 influenza, 4 RSV); 3 with probable Aspergillosis, 1 possible Aspergillosis, 1 probable Histoplasmosis, 1 probable Mucormycosis, and 2 possible IFI (consistent clinical and imaging findings). Half of our patients were men with a mean age of 64 years (SD 8) and median Charlson Comorbidity Score of 3.5 (IQR 3-7). Most common risk factors were stem cell transplant (75%) and neutropenia (62.5%). Four patients were on antifungal prophylaxis at presentation. All patients received anti-viral therapy with oseltamivir/ribavirin and 50% received empiric antibiotics. Median duration from onset of viral infection to diagnosis of IFI was 8.5 days (IQR 2.5-14) and 75% were diagnosed during the same admission. All received antifungal therapy; 62.5% required ICU care, and 37.5% died during index hospitalization. CONCLUSIONS: Our study supports earlier observations describing IFI following respiratory viral infection in immunocompromised hosts. Secondary IFI occurred in 1.4% of our cohort and most occurred during the index admission. IFI following viral illness is associated with high mortality and early detection and therapy may improve outcomes.

A Metal Coordination Number Determined Catalytic Performance in Manganese Borides for Ambient Electrolysis of Nitrogen to Ammonia.

A new strategy that can effectively increase the nitrogen reduction reaction performance of catalysts is proposed and verified by tuning the coordination number of metal atoms. It is found that the intrinsic activity of Mn atoms in the manganese borides (MnBx) increases in tandem with their coordination number with B atoms. Electron-deficient boron atoms are capable of accepting electrons from Mn atoms, which enhances the adsorption of N2 on the Mn catalytic sites (*) and the hydrogenation of N2 to form *NNH intermediates. Furthermore, the increase in coordination number reduces the charge density of Mn atoms at the Fermi level, which facilitates the desorption of ammonia from the catalyst surface. Notably, the MnB4 compound with a Mn coordination number of up to 12 exhibits a high ammonia yield rate (74.9 ± 2.1 µg h-1 mgcat -1) and Faradaic efficiency (38.5 ± 2.7%) at -0.3 V versus reversible hydrogen electrode (RHE) in a 0.1 m Li2SO4 electrolyte, exceeding those reported for other boron-related catalysts.

Multifocal Soft Tissue Cryptococcosis in a Renal Transplant Recipient: The Importance of Suspecting Atypical Pathogens in the Immunocompromised Host.

Cryptococcal infection has been documented in 2.8% of solid-organ transplant recipients, with the median time to disease onset being 21 months. Renal transplantrecipients accountforthe majority of cases. Most patients present with central nervous system or disseminated disease, with only a minority having cutaneous manifestations. We present the case of a 47-year-old female renal transplant recipient who presented with refractory acute cellulitis 7 months after transplant. She had received thymoglobulin induction and was on a maintenance immunosuppressive regimen oftacrolimus, mycophenolic acid, and prednisone (5 mg/d). She did not respond to broad-spectrum antibacterial therapy for presumed bacterial cellulitis. Skin and soft tissue biopsies subsequently showed the presence of yeast; Cryptococcus neoformans was recovered in culture. Blood cultures, chest radiography, and cerebrospinal fluid sampling were negative, which resulted in a diagnosis of multifocal soft tissue cryptococcosis, a form of disseminated disease. Serum cryptococcal antigen testing was strongly positive (≥ 1:2560). The patient's immunosuppression was reduced, and she received treatment with liposomal-amphotericin B and flucytosine for 2 weeks, which resulted in symptomatic improvement. This was followed by 1 year of consolidation and subsequent maintenance therapy with fluconazole. This case should increase awareness of the broader differential diagnosis of soft tissue infection in immunocompromised patients. Her case mimicked bacterial cellulitis, which delayed administration of effective therapy. Although our patient was initially diagnosed via biopsy, early clinical suspicion and serum cryptococcal antigen testing can lead to the correct diagnosis more rapidly. As transplant patients return to their community providers, heightened vigilance for unusual infections and presentations is warranted.The possibility of a cryptococcal cause for acute soft tissue infection should be considered, even in the absence of pulmonary or central nervous system involvement.

Ultrasound-boosted selectivity of CO in CO2 electrochemical reduction.

Among the possible products of CO2 electrochemical reduction, CO plays a unique and vital role, which can be an ideal feedstock for further reduction to C2+ products, and also the important component of syngas that can be used as feedstock for value-added chemicals and fuels. However, it is still a challenge to tune the CO selectivity on Cu electrode. Here we newly construct an ultrasound-assisted electrochemical method for CO2 reduction, which can tune the selectivity of CO2 to CO from less than 10% to >80% at -1.18 V versus (vs.) reversible hydrogen electrode (RHE). The partial current density of CO production is significantly improved by 15 times. By in-situ Raman study, the dominating factor for the improved CO production is attributed to the accelerated desorption of *CO intermediate. This work provides a facile method to tune the product selectivity in CO2 electrochemical reduction.

In situ fabrication of Bi2MoO6/Bi2MoO6-x homojunction photocatalyst for simultaneous photocatalytic phenol degradation and Cr(VI) reduction.

In this work, we designed a novel Bi2MoO6/Bi2MoO6-x homojunction photocatalyst and successfully fabricated by a facile solvothermal-calcination approach. Experimental characterizations indicated that the formation of Bi2MoO6/Bi2MoO6-x homojunction was caused by controlling oxygen vacancies formation. Such Bi2MoO6/Bi2MoO6-x homojunction exhibits about 240 times higher photocatalytic activity towards phenol degradation as compared with pure Bi2MoO6 under visible light irradiation. Similarly, for a co-existed phenol and Cr(VI) model system, Bi2MoO6/Bi2MoO6-x-catalyzed the photodegradation of phenol and the reduction of Cr(VI) simultaneously occur, and Bi2MoO6/Bi2MoO6-x homojunction also displays a superior photocatalytic activity, that is 4 and 8 times higher than pure Bi2MoO6, respectively. The remarkably boosted photocatalytic activity could be attributed primarily to the highly efficient separation of photogenerated electrons/holes due to the homojunction and the synergistic effect between phenol oxidation and Cr(VI) reduction. Thus, the present insight provides an effective strategy for designing and preparing highly active photocatalysts with the incorporation of oxygen vacancies modulation and applying for environmental remediation.

Complete Photocatalytic Mineralization of Microplastic on TiO2 Nanoparticle Film.

Recently, the environmental impacts of microplastics have received extensive attention owing to their accumulation in the environment. However, developing efficient technology for the control and purification of microplastics is still a big challenge. Herein, we investigated the photocatalytic degradation of typical microplastics such as polystyrene (PS) microspheres and polyethylene (PE) over TiO2 nanoparticle films under UV light irradiation. TiO2 nanoparticle film made with Triton X-100 showed complete mineralization (98.40%) of 400-nm PS in 12 h, while degradation for varying sizes of PS was also studied. PE degradation experiment presented a high photodegradation rate after 36 h. CO2 was found as the main end product. The degradation mechanism and intermediates were studied by in situ DRIFTS and HPPI-TOFMS, showing the generation of hydroxyl, carbonyl, and carbon-hydrogen groups during the photodegradation of PS. This study provides a green and cost-efficient strategy for the control of microplastics contamination in the environment.

Mycobacterium genavense infections in non-HIV immunocompromised hosts: a systematic review.

BACKGROUND: Mycobacterium genavense is a non-tuberculous mycobacterium which can rarely cause disease in non-HIV immunocompromised hosts. We describe our experience with this unusual infection and perform a systematic review of the literature to describe the features of M. genavense infection in non-HIV immunocompromised hosts. METHODS: All cases of Mycobacterium genavense infection in non-HIV patients at our institution were reviewed. In addition, we conducted a systematic review of the literature to identify previously published cases of M. genavense infections in non-HIV hosts. FINDINGS: Two cases of M. genavense were identified at our center; a 51-year-old renal transplant recipient with a prosthetic knee joint infection and a 66-year-old woman with idiopathic CD4 lymphocytopenia with gastrointestinal tract disease. The systematic review identified 44 cases of M. genavense infection in non-HIV hosts. The most common underlying conditions were solid organ transplantation (40%), sarcoidosis (14%) and hematopoietic stem cell transplantation (7%). Disease most commonly involved the gastrointestinal tract, spleen, liver or bone marrow. Diagnosis was challenging with PCR required for identification in nearly all cases. Over one-third of patients died, which may reflect the combination of infection and underlying comorbidities. Overall cure was achieved in 61% with a mean duration of antimycobacterial therapy of 15.5 months (range 10-24). CONCLUSION: M. genavense infection is a rare mycobacterial infection in non-HIV immunocompromised hosts. It should be suspected in immunocompromised patients presenting with disseminated mycobacterial infection, acid fast bacilli on smear or histopathologic examination, with poor or no growth in mycobacterial cultures.

A Complicated Case of Group B Streptococcus Empyema Necessitans.

Empyema necessitans is a complication of a pleural space infection that dissects through the pleura into the soft tissues of the chest and skin. Due to the widespread availability of antibiotics, empyema necessitans is rare in modern medicine and is most commonly caused by Mycobacterium tuberculosis. A 38-year-old immunocompetent male presented with left shoulder pain and his chest radiograph revealed a mass in the upper left lung and/or pleural space. He underwent multiple debridements of the chest wall due to a left chest wall abscess and empyema necessitans. All operative samples were positive for Streptococcus agalactiae (Group B Streptococcus). The patient's clinical course was complicated by septic arthritis of the left sternoclavicular joint and first rib, vertebral osteomyelitis/discitis, and pelvic abscesses. This case report illustrates the pathogenic process of empyema necessitans and summarizes the clinical management for practicing clinicians. It also documents the second case of Streptococcus agalactiae-associated empyema necessitans, to our knowledge, with significantly greater disease extension than the first.

Successful Treatment of Human Monocytic Ehrlichiosis with Rifampin.

Currently recommended treatment regimens for human monocytic ehrlichiosis (HME) include doxycycline or tetracycline. Antibiotic susceptibility studies demonstrate that rifampin has in vitro bactericidal activity against Ehrlichia. Case reports have suggested clinical response with rifampin treatment of human granulocytic anaplasmosis (HGA). We report the first case of HME successfully treated with rifampin.

Radioactive seed localization of nonpalpable breast lesions in an academic comprehensive cancer program community hospital setting.

Wire localized excision (WLE) has been a long-standing method for localization of nonpalpable breast lesions. Disadvantages of this method include difficulty locating the wire tip in relation to borders of the lesion, imprecise placement of the wire, and the need to place the wire shortly before scheduled surgery. These shortcomings may lead to a high positive margin rate requiring re-excision to obtain clear margins for breast cancer. Radioactive seed localized excision (RSLE) of nonpalpable breast lesions has been advocated as a safe and effective alternative to WLE. The primary endpoints of the study were to compare re-excision rates between WLE and RSLE of nonpalpable breast lesions and to determine if there were any differences in volume of tissue removed. One hundred three patients were included in a retrospective review of localized breast excisions done by a single surgeon. Forty-four patients underwent WLE between April 2007 and February 2009. Fifty-nine patients underwent RSLE between September 2009 and January 2012. Margins were considered to be clear if at least 1 mm of normal tissue was obtained from the circumferential periphery of the lesion in question. RSLE resulted in a re-excision rate of 17 versus 55 per cent re-excision rate for wire localization (P < 0.001). Excision volume was greater for patients having wire localization (P = 0.074). RSLE is an effective technique for excision of nonpalpable breast lesions in the community setting. This technique allows for accurate localization and appears to allow for smaller volume of tissue to be excised.