Accuracy of cell-free Mycobacterium tuberculosis DNA testing in pleural effusion for diagnosing tuberculous pleurisy: a multicenter cross-sectional study.

BACKGROUND: The diagnosis of tuberculous pleurisy (TP) presents a significant challenge due to the low bacterial load in pleural effusion (PE) samples. Cell-free Mycobacterium tuberculosis DNA (cf-TB) in PE samples is considered an optimal biomarker for diagnosing TP. This study aimed to evaluate the applicability of cf-TB testing across diverse research sites with a relatively large sample size. METHODS: Patients suspected of TP and presenting with clinical symptoms and radiological evidence of PE were consecutively enrolled by treating physicians from 11 research sites across 6 provinces in China between April 2020 and August 2022. Following centrifugation, sediments obtained from PE were used for Xpert MTB/RIF (Xpert) and mycobacterial culture, while the supernatants were subjected to cf-TB testing. This study employed a composite reference standard to definite TP, which was characterized by any positive result for Mycobacterium tuberculosis (MTB) through either PE culture, PE Xpert, or pleural biopsy. RESULTS: A total of 1412 participants underwent screening, and 1344 (95.2%) were subsequently enrolled in this study. Data from 1241 (92.3%) participants were included, comprising 284 with definite TP, 677 with clinically diagnosed TP, and 280 without TP. The sensitivity of cf-TB testing in definite TP was 73.6% (95% CI 68.2-78.4), significantly higher than both Xpert (40.8%, 95% CI 35.3-46.7, P < 0.001) and mycobacterial culture (54.2%, 95% CI 48.4-59.9, P < 0.001). When clinically diagnosed TP was incorporated into the composite reference standard for sensitivity analysis, cf-TB testing showed a sensitivity of 46.8% (450/961, 95% CI 43.7-50.0), significantly higher than both Xpert (116/961, 12.1%, 95% CI 10.2-14.3, P < 0.001) and mycobacterial culture (154/961, 16.0%, 95% CI 13.8-18.5, P < 0.001). The specificities of cf-TB testing, Xpert, and mycobacterial culture were all 100.0%. CONCLUSIONS: The performance of cf-TB testing is significantly superior to that of Xpert and mycobacterial culture methods, indicating that it can be considered as the primary diagnostic approach for improving TP detection. Trial registration The trial was registered on Chictr.org.cn (ChiCTR2000031680, https://www.chictr.org.cn/showproj.html?proj=49316 ).

Machine Learning Assisted Self-Powered Identity Recognition Based on Thermogalvanic Hydrogel for Intelligent Security.

Identity recognition as the first barrier of intelligent security plays a vital role, which is facing new challenges that are unable to meet the need of intelligent era due to low accuracy, complex configuration and dependence on power supply. Here, a finger temperature-driven intelligent identity recognition strategy is presented based on a thermogalvanic hydrogel (TGH) by actively discerning biometric characteristics of fingers. The TGH is a dual network PVA/Agar hydrogel in an H2O/glycerol binary solvent with [Fe(CN)6]3-/4- as a redox couple. Using a concave-arranged TGH array, the characteristics of users can be distinguished adequately even under an open environment by extracting self-existent intrinsic temperature features from five typical sites of fingers. Combined with machine learning, the TGH array can recognize different users with a high average accuracy of 97.6%. This self-powered identity recognition strategy is further applied to a smart lock, attaining a more reliable security protection from biometric characteristics than bare passwords. This work provides a promising solution for achieving better identity recognition, which has great advantages in intelligent security and human-machine interaction toward future Internet of everything.

Thermogalvanic hydrogel-based e-skin for self-powered on-body dual-modal temperature and strain sensing.

Sensing of both temperature and strain is crucial for various diagnostic and therapeutic purposes. Here, we present a novel hydrogel-based electronic skin (e-skin) capable of dual-mode sensing of temperature and strain. The thermocouple ion selected for this study is the iodine/triiodide (I-/I3-) redox couple, which is a common component in everyday disinfectants. By leveraging the thermoelectric conversion in conjunction with the inherent piezoresistive effect of a gel electrolyte, self-powered sensing is achieved by utilizing the temperature difference between the human body and the external environment. The composite hydrogels synthesized from polyvinyl alcohol (PVA) monomers using a simple freeze‒thaw method exhibit remarkable flexibility, extensibility, and adaptability to human tissue. The incorporation of zwitterions further augments the resistance of the hydrogel to dehydration and low temperatures, allowing maintenance of more than 90% of its weight after 48 h in the air. Given its robust thermal current response, the hydrogel was encapsulated and then integrated onto various areas of the human body, including the cheeks, fingers, and elbows. Furthermore, the detection of the head-down state and the monitoring of foot movements demonstrate the promising application of the hydrogel in supervising the neck posture of sedentary office workers and the activity status. The successful demonstration of self-powered on-body temperature and strain sensing opens up new possibilities for wearable intelligent electronics and robotics.

Combining WO3@AuNPs with Poly(amidoamine) Allows Sensitive Electrochemical Detection of DR1 Based on Dual Signal Amplification.

Down-regulator of transcription 1 (DR1) is considered as a biomarker of hashimoto's thyroiditis (HT), which is a risk factor for thyroid cancer. Here, a label-free electrochemical biosensor for DR1 detection was constructed based on polyamidoamine (PAMAM) polymer and the nanocomposite (WO3@AuNPs) composed of tungsten trioxide (WO3) and gold nanoparticles (AuNPs). WO3@AuNPs was obtained by combining monolayer WO3 nanosheets, which has high conductivity, and AuNPs. The modification of WO3@AuNPs can not only increase the conductivity of the electrode but also provide more active sites for signaling units, thus greatly improve the sensitivity of the sensor. The polymer PAMAM is biocompatible and non-immunogenic, and its end functional group can bind to the target molecules, providing them with more binding sites and thus improving the sensitivity of the sensor. Under optimal conditions, the label-free biosensor showed a good linear relationship between the logarithm of DR1 concentration and the impedance in the range of 10 fg ⋅ mL-1 to 100 ng ⋅ mL-1, with a detection limit as low as 0.3 fg ⋅ mL-1. Besides, this label-free electrochemical platform exhibited satisfactory selectivity and anti-interference capability in human serum samples. Therefore, this method has considerable potential in clinical detection of DR1.

Effect of ATG8 or SAC1 deficiency on the cell proliferation and lifespan of the long-lived PMT1 deficiency yeast cells.

Autophagy is pivotal in maintaining intracellular homeostasis, which involves various biological processes, including cellular senescence and lifespan modulation. Being an important member of the protein O-mannosyltransferase (PMT) family of enzymes, Pmt1p deficiency can significantly extend the replicative lifespan (RLS) of yeast cells through an endoplasmic reticulum (ER) unfolded protein response (UPR) pathway, which is participated in protein homeostasis. Nevertheless, the mechanisms that Pmt1p regulates the lifespan of yeast cells still need to be explored. In this study, we found that the long-lived PMT1 deficiency strain (pmt1Δ) elevated the expression levels of most autophagy-related genes, the expression levels of total GFP-Atg8 fusion protein and free GFP protein compared with wild-type yeast strain (BY4742). Moreover, the long-lived pmt1Δ strain showed the greater dot-signal accumulation from GFP-Atg8 fusion protein in the vacuole lumen through a confocal microscope. However, deficiency of SAC1 or ATG8, two essential components of the autophagy process, decreased the cell proliferation ability of the long-lived pmt1Δ yeast cells, and prevented the lifespan extension. In addition, our findings demonstrated that overexpression of ATG8 had no potential effect on the RLS of the pmt1Δ yeast cells, and the maintained incubation of minimal synthetic medium lacking nitrogen (SD-N medium as starvation-induced autophagy) inhibited the cell proliferation ability of the pmt1Δ yeast cells with the culture time, and blocked the lifespan extension, especially in the SD-N medium cultured for 15 days. Our results suggest that the long-lived pmt1Δ strain enhances the basal autophagy activity, while deficiency of SAC1 or ATG8 decreases the cell proliferation ability and shortens the RLS of the long-lived pmt1Δ yeast cells. Moreover, the maintained starvation-induced autophagy impairs extension of the long-lived pmt1Δ yeast cells, and even leads to the cell death.

Thermoelectric Hydrogel Electronic Skin for Passive Multimodal Physiological Perception.

Electronic skins (e-skins) are being extensively researched for their ability to recognize physiological data and deliver feedback via electrical signals. However, their wide range of applications is frequently restricted by the indispensableness of external power supplies and single sensory function. Here, we report a passive multimodal e-skin for real-time human health assessment based on a thermoelectric hydrogel. The hydrogel network consists of poly(vinyl alcohol)/low acyl gellan gum with [Fe(CN)6]4-/3- as the redox couple. The introduction of glycerol and Li+ furnishes the gel-based e-skin with antidrying and antifreezing properties, a thermopower of 2.04 mV K-1, fast self-healing in less than 10 min, and high conductivity of 2.56 S m-1. As a prospective application, the e-skin can actively perceive multimodal physiological signals without the need for decoupling, including body temperature, pulse rate, and sweat content, in real time by synergistically coupling sensing and transduction. This work offers a scientific basis and designs an approach to develop passive multimodal e-skins and promotes the application of wearable electronics in advanced intelligent medicine.

Impact of Metagenomic Next-Generation Sequencing of Bronchoalveolar Lavage Fluid on Antimicrobial Stewardship in Patients With Lower Respiratory Tract Infections: A Retrospective Cohort Study.

BACKGROUND: The impact of metagenomic next-generation sequencing (mNGS) on antimicrobial stewardship in patients with lower respiratory tract infections (LRTIs) is still unknown. METHODS: This retrospective cohort study included patients who had LRTIs diagnosed and underwent bronchoalveolar lavage between September 2019 and December 2020. Patients who underwent both mNGS and conventional microbiologic tests were classified as the mNGS group, while those with conventional tests only were included as a control group. A 1:1 propensity score match for baseline variables was conducted, after which changes in antimicrobial stewardship between the 2 groups were assessed. RESULTS: A total of 681 patients who had an initial diagnosis of LRTIs and underwent bronchoalveolar lavage were evaluated; 306 patients were finally included, with 153 in each group. mNGS was associated with lower rates of antibiotic escalation than in the control group (adjusted odds ratio, 0.466 [95% confidence interval, .237-.919]; P = .02), but there was no association with antibiotic de-escalation. Compared with the control group, more patients discontinued the use of antivirals in the mNGS group. CONCLUSIONS: The use of mNGS was associated with lower rates of antibiotic escalation and may facilitate the cessation of antivirals, but not contribute to antibiotic de-escalation in patients with LRTIs.

Integration of diagnostic ions, molecular network and chemometrics to illustrate the chemical mechanism of Radix Astragali processed with honey.

Radix Astragali (RA) is one of the most frequently used traditional Chinese medicine (TCM) in China, and honey-processed RA (HRA) is its common processing product. Thus far, their comprehensive chemical differences are not well understood. In this work, an integrated approach using Ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) combined with diagnostic ions, molecular network (MN) and chemometrics was established to profile their chemical characterizations and illustrate the chemical mechanism of RA processed with honey. A total of 226 compounds were tentatively identified including 50 flavonoid glycosides, 26 flavonoid aglycone, 56 saponins, 30 organic acids, 18 amino acids, 3 coumarins and 43 other compounds, of which 33 compounds were characterized according to MN. Their chemical differences were further investigated by integrating of multivariate statistical analysis, student's t-test analysis, linear regression analysis and MN. Consequently, multivariate statistical analysis showed that the raw and processed RA were different form each other. Besides, 33 different compounds were found to be significantly altered by student's t-test analysis. Apart from this, linear regression analysis indicated 42 and 120 compounds underwent the significant varieties. The potential chemical reactions induced by honey-processing, such as possible hydrolysis reactions and isomerization reactions, were speculated based on these variations coupled the areas changes of the nodes in MN. This study provided an efficient strategy to illustrate the chemical mechanism of TCM processing.

Self-Powered, Non-Toxic, Recyclable Thermogalvanic Hydrogel Sensor for Temperature Monitoring of Edibles.

Thermogalvanic hydrogel, an environmentally friendly power source, enable the conversion of low-grade thermal energy to electrical energy and powers microelectronic devices in a variety of scenarios without the need for additional batteries. Its toxicity, mechanical fragility and low output performance are a hindrance to its wide application. Here, we demonstrate thermoelectric gels with safe non-toxic, recyclable, highly transparent and flexible stretchable properties by introducing gelatin as a polymer network and SO3/42- as a redox electric pair. When the temperature difference is 10 K, the gel-based thermogalvanic cell achieves an open-circuit voltage of about 16.2 mV with a maximum short-circuit current of 39 µA. Furthermore, we extended the application of the Gel-SO3/42- gel to monitor the temperature of hot or cold food, enabling self-powered sensing for food temperature detection. This research provides a novel concept for harvesting low-grade thermal energy and achieving safe and harmless self-driven temperature monitoring.

Rapid chemical characterization of Danggui Buxue decoction using processed Astragali Radix and Angelicae Sinensis Radix based on diagnostic ion and molecular network.

Danggui Buxue decoction (DBD), a classic prescription of traditional Chinese medicine (TCM) for invigorating qi and generating blood, contains honey-processed Astragali Radix (HAR) and wine-processed Angelicae Sinensis Radix (WDG) in its original prescription. In this study, the compositions of DBD, WDG, and HAR were characterized using ultra-high-performance liquid chromatography coupled with the quadrupole-time-of-flight tandem mass spectrometry technique in combination with molecular network and diagnostic ion strategies. Finally, 200 compounds were identified in DBD, 114 compounds were identified in WDG, and 180 compounds were identified in HAR; there were 48 common compounds in total. The results demonstrated that compatibility led to changes in the chemical composition of TCM, and the qualitative method used in this study provided an effective data processing strategy for the characterization of components and the database for the study of the compounding mechanism of TCM.

Latexin regulates sex dimorphism in hematopoiesis via gender-specific differential expression of microRNA 98-3p and thrombospondin 1.

Hematopoietic stem cells (HSCs) have the ability to self-renew and differentiate to all blood cell types. HSCs and their differentiated progeny show sex/gender differences. The fundamental mechanisms remain largely unexplored. We previously reported that latexin (Lxn) deletion increased HSC survival and repopulation capacity in female mice. Here, we find no differences in HSC function and hematopoiesis in Lxn knockout (Lxn-/-) male mice under physiologic and myelosuppressive conditions. We further find that Thbs1, a downstream target gene of Lxn in female HSCs, is repressed in male HSCs. Male-specific high expression of microRNA 98-3p (miR98-3p) contributes to Thbs1 suppression in male HSCs, thus abrogating the functional effect of Lxn in male HSCs and hematopoiesis. These findings uncover a regulatory mechanism involving a sex-chromosome-related microRNA and its differential control of Lxn-Thbs1 signaling in hematopoiesis and shed light on the process underlying sex dimorphism in both normal and malignant hematopoiesis.

Low-Grade Thermal Energy Harvesting and Self-Powered Sensing Based on Thermogalvanic Hydrogels.

Thermoelectric cells (TEC) directly convert heat into electricity via the Seebeck effect. Known as one TEC, thermogalvanic hydrogels are promising for harvesting low-grade thermal energy for sustainable energy production. In recent years, research on thermogalvanic hydrogels has increased dramatically due to their capacity to continuously convert heat into electricity with or without consuming the material. Until recently, the commercial viability of thermogalvanic hydrogels was limited by their low power output and the difficulty of packaging. In this review, we summarize the advances in electrode materials, redox pairs, polymer network integration approaches, and applications of thermogalvanic hydrogels. Then, we highlight the key challenges, that is, low-cost preparation, high thermoelectric power, long-time stable operation of thermogalvanic hydrogels, and broader applications in heat harvesting and thermoelectric sensing.

Degradation of vinyl ester resin and its composites via cleavage of ester bonds to recycle valuable chemicals and produce polyurethane.

Vinyl ester resins (VER) and its composites are widely used in chemical industry and municipal engineering. However, its dense three-dimensional network structure makes its degradation and recycling a great challenge. Herein, a novel, efficient and green degradation system gamma-valerolactone (GVL)-H2O/p-toluene sulfonic (PTSA) was developed to degrade VER and its composites. VER was completely degraded in the GVL-H2O/PTSA at 210 °C and 0.6 MPa. By combing SEM-EDS, IR, NMR, GPC and MALDI-TOF-MS analysis, it was clarified that VER swelled well in GVL, allowing the transfer of PTSA and H2O through the resin matrix. The ester bonds in VER were cleaved via hydrolysis with H2O catalyzed by the sulfonic acid of PTSA, and high value-added polymer products, i.e., copolymer of styrene and methacrylic acid (SMAA) and bisphenol-A diglycidyl ether (DGEBA), were recycled, which accounted for ca. 87.0 wt% of raw VER. DGEBA can be recycled to prepare a new PU material. The GVL-H2O/PTSA system was also effective for degrading UPR and VER-containing composites. This work provides a practical strategy for chemical degradation and recovery of thermoset VER resins.

Sex differences in normal and malignant hematopoiesis.

Hematopoiesis is a continuous and well-regulated process requiring both the capacity for self-renewal and the potential for differentiation of hematopoietic stem cells. Multiple studies indicate that sex hormones exert significant effects on not only hematopoietic stem and progenitor cells, but also the development of hematopoietic lineages, resulting in sexual dimorphisms in normal hematopoiesis. Hematologic malignancies comprise a wide variety of cancers affecting the blood, bone marrow, and lymphatic system, such as leukemia, lymphoma, myeloma, myelodysplastic syndrome, and myeloproliferative diseases. Overall, males are at greater risk and have worse prognosis for most of these malignancies compared with females. A better understanding of the differences between male and female could be of substantial value in research as well as clinical management.

Triboelectric Nanogenerators for Harvesting Diverse Water Kinetic Energy.

The water covering the Earth's surface not only supports life but also contains a tremendous amount of energy. Water energy is the most important and widely used renewable energy source in the environment, and the ability to extract the mechanical energy of water is of particular interest since moving water is ubiquitous and abundant, from flowing rivers to falling rain drops. In recent years, triboelectric nanogenerators (TENGs) have been promising for applications in harvesting kinetic energy from water due to their merits of low cost, light weight, simple structure, and abundant choice of materials. Furthermore, TENGs can also be utilized as self-powered active sensors for monitoring water environments, which relies on the output signals of the TENGs caused by the movement and composition of water. Here, TENGs targeting the harvest of different water energy sources have been systematically summarized and analyzed. The TENGs for harvesting different forms of water energy are introduced and divided on the basis of their basic working principles and modes, i.e., in the cases of solid-solid and solid-liquid. A detailed review of recent important progress in TENG-based water energy harvesting is presented. At last, based on recent progresses, the existing challenges and future prospects for TENG-based water energy harvesting are also discussed.

Dynamic changes in the yak rumen eukaryotic community and metabolome characteristics in response to feed type.

With diversification of yak breeding, it is important to understand the effects of feed type on the rumen, especially microbiota and metabolites. Due to the unique characteristics of yak, research on rumen microbes and metabolites is limited. In this study, the effects of two diet types on rumen eukaryotic microflora and metabolites were evaluated using the Illumina MiSeq platform and liquid chromatography-mass spectrometry (LC-MS). All identified protozoa belonged to Trichostomatia. At the genus level, the relative abundance of Metadinium and Eudiplodinium were significantly (p < 0.05) higher in the roughage group than that of concentrate group, while the concentrate group harbored more Isotricha. Ascomycota, Basidiomycota, and Neocallimastigomycota were the main fungal phyla, and the Wallemia, Chordomyces, Chrysosporium, Cladosporium, Scopulariopsis, and Acremonium genera were significantly (p < 0.05) more abundant in the roughage group than the concentrate group, while the concentrate group harbored more Aspergillus, Neocallimastix, Thermoascus, and Cystofilobasidium (p < 0.05). Metabolomics analysis showed that feed type significantly affected the metabolites of rumen protein digestion and absorption (L-proline, L-phenylalanine, L-tryosine, L-leucine, L-tryptophan, and ß-alanine), purine metabolism (hypoxanthine, xanthine, guanine, guanosine, adenosine, and adenine), and other metabolic pathway. Correlation analysis revealed extensive associations between differential microorganisms and important metabolites. The results provide a basis for comprehensively understanding the effects of feed types on rumen microorganisms and metabolites of yaks. The findings also provide a reference and new directions for future research.

Prospective Evaluation of a Rapid Clinical Metagenomics Test for Bacterial Pneumonia.

Background: The diagnosis of bacterial pathogens in lower respiratory tract infections (LRI) using conventional culture methods remains challenging and time-consuming. Objectives: To evaluate the clinical performance of a rapid nanopore-sequencing based metagenomics test for diagnosis of bacterial pathogens in common LRIs through a large-scale prospective study. Methods: We enrolled 292 hospitalized patients suspected to have LRIs between November 2018 and June 2019 in a single-center, prospective cohort study. Rapid clinical metagenomics test was performed on-site, and the results were compared with those of routine microbiology tests. Results: 171 bronchoalveolar lavage fluid (BAL) and 121 sputum samples were collected from patients with six kinds of LRIs. The turnaround time (from sample registration to result) for the rapid metagenomics test was 6.4 ± 1.4 hours, compared to 94.8 ± 34.9 hours for routine culture. Compared with culture and real-time PCR validation tests, rapid metagenomics achieved 96.6% sensitivity and 88.0% specificity and identified pathogens in 63 out of 161 (39.1%) culture-negative samples. Correlation between enriched anaerobes and lung abscess was observed by Gene Set Enrichment Analysis. Moreover, 38 anaerobic species failed in culture was identified by metagenomics sequencing. The hypothetical impact of metagenomics test proposed antibiotic de-escalation in 34 patients compared to 1 using routine culture. Conclusions: Rapid clinical metagenomics test improved pathogen detection yield in the diagnosis of LRI. Empirical antimicrobial therapy could be de-escalated if rapid metagenomics test results were hypothetically applied to clinical management.