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A 55-year-old man sought treatment for an uncomplicated febrile illness after returning to Canada from the Philippines. A suspected diagnosis of Plasmodium knowlesi infection was confirmed by PCR, and treatment with atovaquone/proguanil brought successful recovery. We review the evolving epidemiology of P. knowlesi malaria in the Philippines, specifically within Palawan Island.
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Malária , Plasmodium knowlesi , Masculino , Humanos , Pessoa de Meia-Idade , Filipinas/epidemiologia , Plasmodium knowlesi/genética , Malária/diagnóstico , Malária/tratamento farmacológico , Malária/epidemiologia , Canadá/epidemiologia , Reação em Cadeia da PolimeraseRESUMO
PURPOSE OF REVIEW: Nucleic acid sequence-based organism identification plays an important role in the diagnosis and management of transplant and cancer-associated infectious diseases. Here, we provide a high-level overview of advanced sequencing technologies, discuss test performance, and highlight unmet research needs with a focus on immunocompromised hosts. RECENT FINDINGS: Next-generation sequencing (NGS) technologies are powerful tools with a growing role in managing immunocompromised patients with suspected infection. Targeted NGS (tNGS) can identify pathogens directly from patient specimens, especially for mixed samples, and has been used to detect resistance mutations in transplant-related viruses (e.g. CMV). Whole-genome sequencing (WGS) is increasingly used for outbreak investigations and infection control. Metagenomic NGS (mNGS) is useful for hypothesis-free testing and can simultaneously assess pathogens and host response to infection. SUMMARY: NGS testing increases diagnostic yield relative to standard culture and Sanger sequencing but may be limited by high cost, turnaround times, and detection of unexpected organisms or commensals of uncertain significance. Close collaboration with the clinical microbiology laboratory and infectious diseases is recommended when NGS testing is considered. Additional research is required to understand which immunocompromised patients are most likely to benefit from NGS testing, and when testing should ideally be performed.
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Serviços de Laboratório Clínico , Doenças Transmissíveis , Viroses , Humanos , Medicina de Precisão , Viroses/diagnóstico , Sequenciamento de Nucleotídeos em Larga EscalaRESUMO
Central nervous system (CNS) infections carry a substantial burden of morbidity and mortality worldwide, and accurate and timely diagnosis is required to optimize management. Metagenomic next-generation sequencing (mNGS) has proven to be a valuable tool in detecting pathogens in patients with suspected CNS infection. By sequencing microbial nucleic acids present in a patient's cerebrospinal fluid, brain tissue, or samples collected outside of the CNS, such as plasma, mNGS can detect a wide range of pathogens, including rare, unexpected, and/or fastidious organisms. Furthermore, its target-agnostic approach allows for the identification of both known and novel pathogens. This is particularly useful in cases where conventional diagnostic methods fail to provide an answer. In addition, mNGS can detect multiple microorganisms simultaneously, which is crucial in cases of mixed infections without a clear predominant pathogen. Overall, clinical mNGS testing can help expedite the diagnostic process for CNS infections, guide appropriate management decisions, and ultimately improve clinical outcomes. However, there are key challenges surrounding its use that need to be considered to fully leverage its clinical impact. For example, only a few specialized laboratories offer clinical mNGS due to the complexity of both the laboratory methods and analysis pipelines. Clinicians interpreting mNGS results must be aware of both false negatives-as mNGS is a direct detection modality and requires a sufficient amount of microbial nucleic acid to be present in the sample tested-and false positives-as mNGS detects environmental microbes and their nucleic acids, despite best practices to minimize contamination. Additionally, current costs and turnaround times limit broader implementation of clinical mNGS. Finally, there is uncertainty regarding the best practices for clinical utilization of mNGS, and further work is needed to define the optimal patient population(s), syndrome(s), and time of testing to implement clinical mNGS.
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Structural reconstruction of electrocatalysts to generate metal hydroxide/oxyhydroxide species is critical for an efficient oxygen evolution reaction (OER), but the controllable regulation of the reconstruction process still remains a challenge. Given the designable nature of metal-organic frameworks (MOFs), herein, we have reported a localized structure disordering strategy to accelerate the structural reconstruction of Ni-BDC to generate NiOOH for boosting the OER. The Ni-BDC nanosheets were modified by Fe3+ and urea to form cracks, which could promote the accessibility of the Ni sites by the electrolyte and thus promote the reconstruction to form NiOOH. In addition, the interaction between Ni2+ and Fe3+ allows the electron flow from Ni2+ to Fe3+, further enhancing the NiOOH generation. As a result, the optimized sample exhibits excellent OER activity with a small overpotential of 251 mV at 10 mA cm-2, which is superior to most of the MOF-based OER catalysts reported previously. This work provides a controllable strategy to regulate the structural reconstruction for promoting the OER, which could provide important guidance for the development of more efficient OER electrocatalysts.
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Donor-acceptor two-dimensional covalent-organic frameworks (COFs) have great potential as photocatalysts for hydrogen evolution because of their tunable structures, ordered and strong stacking, high crystallinity, and porosity. Herein, an acceptor unit, namely phthalimide, has been employed for the first time to construct COFs. Two donor-acceptor COFs (TAPFy-PhI and TAPB-PhI) have been successfully synthesized via a Schiff base reaction using phthalimide as the acceptor and 1,3,6,8-tetrakis(4-aminophenyl)pyrene (TAPFy) and 1,3,5-tris(4-aminophenyl)benzene (TAPB) as donors. The synthesized COFs exhibited high crystallinity, permanent porosity, excellent chemical stability, suitable band gaps, and broad visible-light absorption. In the presence of ascorbic acid (sacrificial reagent), the TAPFy-PhI COF exhibited an efficient photocatalytic performance with a hydrogen evolution rate of 1763 µmol g-1 h-1. Moreover, the photocatalytic performance was further improved by the addition of Pt (1 wt %) as a cocatalyst, and the hydrogen evolution rate reached 2718 µmol g-1 h-1.
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A nitrogen/oxygen codoped carbon derived from sweet potato (SPC) with interconnected micro-mesopores is applied to encapsulate selenium composite (SPC/Se) with a high Se loading (74.3%). As a cathode for advanced Li-Se and Na-Se batteries, the SPC/Se exhibits superior electrochemical behavior in low-cost carbonate electrolyte. Including the hierarchically porous structure of SPC and the chemical bonding between Se and carbon, the strong binding energy between SPC and Li2Se/Na2Se is also proved by DFT method, which results in the effective mitigation of shuttle reaction and volume change for SPC/Se cathode. For Li-Se batteries, the SPC/Se composite shows the initial specific charge capacity of 668 mAh g-1 with a high initial coulombic efficiency of 78%, and maintains a stable reversible capacity of 587 mAh g-1 after 1000 cycles with a weak capacity decay of 0.082% at 0.2C. It still retains a reversible specific capacity of 375 mAh g-1 even at 20C. For Na-Se battery, the SPC/Se composite displays the initial specific charge capacity of 671 mAh g-1 at 0.2C and maintains a reversible specific capacity of 412 mAh g-1 after 500 cycles with a capacity retention of 61.4%. When the current density increases to 20C, it still delivers a high reversible specific capacity of 420 mAh g-1. Finally, the transformation mechanism of Se molecule is illustrated detailedly in (de)lithi/sodiation process.
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Single-atom Fe catalysts have shown great potential for Fenton-like technology in organic pollutant decomposition. However, the underlying reaction pathway and the identification of Fe active sites capable of activating peroxymonosulfate (PMS) across a wide pH range remain unknown. We presented a novel strategy for deciphering the production of singlet oxygen (1O2) by regulating the Fe active sites in this study. Fe single atoms loaded on nitrogen-doped porous carbon (FeSA-CN) catalysts were synthesized using a cage encapsulation method and compared to Fe-nanoparticle-loaded catalysts. It was discovered that FeSA-CN catalysts served as efficient PMS activators for pollutant decomposition over a wide pH range. Several analytical measurements and density functional theory calculations revealed that the pyridinic N-ligated Fe single atom (Fe-pyridine N4) was involved in the production of 1O2 by the binding of two PMS ions, resulting in an excellent catalytic performance for PMS adsorption/activation. This work has the potential to not only improve the understanding of nonradical reaction pathway but to also provide a generalizable method for producing highly stable PMS activators with high activity for practical wastewater treatment.