Pneumocystis jirovecii and Nocardia pneumonia in a middle-aged male with Nephrotic syndrome: a case report and literature review.

INTRODUCTION: Nephrotic syndrome (NS) is a common chronic kidney disease that is often accompanied by a state of immunodeficiency. Immunosuppression increases the risk of infections, with Pneumocystis jirovecii and Nocardia brasiliensis being two opportunistic pathogens that can cause severe infections in patients with compromised immune function. This study presents a case of a middle-aged male patient with NS concurrently infected with Pneumocystis jirovecii and Nocardia brasiliensis. It aims to synthesize the pertinent diagnostic approaches and treatment experiences. Notably, there have been no reported cases of NS occurring simultaneously with both Pneumocystis jirovecii pneumonia and Nocardia pneumonia. CASE PRESENTATION: A 58-year-old male farmer presented to the hospital with a one-week history of persistent fever, cough, and sputum production. His maximum body temperature was recorded at 39 °C, and he produced yellow viscous sputum. This patient had a one-year history of NS, managed with long-term oral corticosteroid and cyclophosphamide therapy. Admission chest computed tomography displayed interstitial changes in both lungs. After failing to detect any pathogens through routine etiological tests, we successfully identified Nocardia brasiliensis, Pneumocystis jirovecii, and Lodderomyces elongisporus using bronchoscopy-guided sputum samples through metagenomic next-generation sequencing (mNGS) technology. Subsequently, we initiated a combined treatment regimen for the patient using trimethoprim-sulfamethoxazole, meropenem, and moxifloxacin, which yielded remarkable therapeutic outcomes. CONCLUSION: The adoption and promotion of mNGS technologies have significantly resolved the difficulty in early pathogen detection, guiding clinicians from empirical to genomic diagnosis, achieving prevention before treatment, and thereby enhancing patient survival rates.

In vitro antifungal activity of Shikonin against Candida albicans by inducing cellular apoptosis and necrosis.

BACKGROUND: Our previous studies showed that Shikonin (SK) had a strong anti-Candida albican (C. albicans) activity, especially against some fluconazole-resistant strains, which is probably due to the oxidative damage of SK to C. albicans. METHODS AND RESULTS: In this study, we expanded the antifungal spectrum and evaluate the toxicity of SK. The results indicated that SK also exhibited potent invitro antifungal activities against other pathogenic fungi such as other Candida, Aspergillus, Cryptococcus, and Dermatophytes, but did not display apparent toxicity to the mammalian cells, suggesting that SK is safe to be a potential antifungal drug. Furtherly, we analyze the exact mechanism of SK against C. albicans. We found that SK could induce a series of apoptosis characteristics, including phosphatidylserine externalization, chromatin condensation and fragmentation, decreased cytochrome c oxidase activity as well as caspase activation. CONCLUSIONS: In summary, this study highlighted the antifungal activity and mechanism of SK against C. albicans, providing a potential therapeutic strategy for C. albicans infection.

Effectiveness of Kurtosis-Adjusted Cumulative Noise Exposure in Assessing Occupational Hearing Loss Associated With Complex Noise.

OBJECTIVES: Occupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases worldwide. Few studies have been reported on applying kurtosis-adjusted noise energy (e.g., kurtosis-adjusted cumulative noise exposure, CNE-K) as a joint indicator for assessing NIHL. This study aimed to analyze the effectiveness of CNE-K in assessing occupational hearing loss associated with complex noise in typical manufacturing industries. DESIGN: A cross-sectional survey of 1404 Chinese manufacturing workers from typical manufacturing industries was conducted. General demographic characteristics, noise exposure data, and noise-induced permanent threshold shifts (NIPTS) at 3, 4, and 6 kHz (NIPTS 346 ) were collected and analyzed. The role of kurtosis in high-frequency noise-induced hearing loss (HFNIHL) was also analyzed. The degree of overlap of the two logistic curves (i.e., between complex noise CNE-K and HFNIHL%, and between Gaussian noise CNE and HFNIHL%) was used to evaluate the effectiveness of CNE-K, using a stratified analysis based on age, sex, industry, or job type. RESULTS: The binary logistic regression analysis showed that in addition to age, sex, exposure duration, and Eight-hour Continuous Equivalent A-weighted Sound Pressure Level (L Aeq,8h ), kurtosis was a key factor influencing HFNIHL% in workers (odds ratio = 1.18, p < 0.05), and its odds ratio increased with an increase in kurtosis value. Multiple linear regression analysis demonstrated that the contribution of kurtosis to NIPTS 346 was second to L Aeq,8h . Complex noise led to a higher risk of NIHL than Gaussian noise at frequencies of 3, 4, 6, and 8 kHz after adjusting for age, sex, and CNE ( p < 0.05). As kurtosis increased, the notch in the audiogram became deeper, and the frequency at which the notch began to deepen shifted from 3 to 1 kHz. The logistic curve between complex noise CNE-K and HFNIHL% nearly overlapped with that between Gaussian noise CNE and HFNIHL%, and the average difference in HFNIHL% between the two curves decreased from 8.1 to 0.4%. Moreover, the decrease of average difference in HFNIHL% between the two logistic curves was evident in several subgroups, such as male workers, aged <30 and 30 to 50 years, furniture and woodworking industries and gunning and nailing job types with relatively high kurtosis values. CONCLUSIONS: Kurtosis, as an indirect metric of noise temporal structure, was an important risk factor for occupational NIHL. Kurtosis-adjusted CNE metric could be more effective than CNE alone in assessing occupational hearing loss risk associated with complex noise.

Charge Transfer Properties of Heterostructures Formed by Bi2 O2 Se and Transition Metal Dichalcogenide Monolayers.

Atomically thin bismuth oxyselenide (Bi2 O2 Se) exhibits attractive properties for electronic and optoelectronic applications, such as high charge-carrier mobility and good air stability. Recently, the development of Bi2 O2 Se-based heterostructures have attracted enormous interests with promising prospects for diverse device applications. Although the electrical properties of Bi2 O2 Se-based heterostructures have been widely studied, the interlayer charge transfer in these heterostructures remains elusive, despite its importance in harnessing their emergent functionalities. Here, a comprehensive experimental investigation on the interlayer charge transfer properties of two heterostructures formed by Bi2 O2 Se and representative transition metal dichalcogenides (namely, WS2 /Bi2 O2 Se and MoS2 /Bi2 O2 Se) is reported. Kelvin probe force microscopy is used to measure the work functions of the samples, which are further employed to establish type-II band alignment of both heterostructures. Photoluminescence quenching is observed in each heterostructure, suggesting high charge transfer efficiency. Time-resolved and layer-selective pump-probe measurements further prove the ultrafast interlayer charge transfer processes and formation of long-lived interlayer excitons. These results establish the feasibility of integrating 2D Bi2 O2 Se with other 2D semiconductors to fabricate heterostructures with novel charge transfer properties and provide insight for understanding the performance of optoelectronic devices based on such 2D heterostructures.

Associations of physical activity intensity with incident cardiovascular diseases and mortality among 366,566 UK adults.

BACKGROUND: The associations of the proportion of vigorous physical activity (VPA) to moderate to vigorous physical activity (MVPA) with incident cardiovascular disease (CVD) and all-cause mortality are unclear. METHODS: The present study included 366,566 participants (aged 40-69 years) without baseline CVD from the UK biobank during 2006 to 2010. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of outcomes. RESULTS: During a median 11.8 years of follow-up, among 366,566 participants (mean age [SD]: 56.0 [8.1]), 31,894 incident CVD and 19,823 total deaths were documented. Compared with no VPA, 0%-30% of VPA to MVPA was associated with 12% and 19% lower risks of incident CVD (HR, 0.88 [95% CI, 0.86-0.91]) and all-cause mortality (HR, 0.81 [95% CI, 0.78-0.84]), respectively. Furthermore, we found that the maximum reduction of risks of incident CVD and all-cause mortality occurred at performing approximately 30% of VPA to MVPA (P < 0.001). Compared with participants reporting the lowest levels of MVPA (moderate physical activity [MPA], 0-150 min/week; VPA, 0-75 min/week), those performing 150-300 min/week of MPA and ≥ 150 min/week of VPA experienced the lowest risk of incident CVD (HR, 0.87 [95% CI, 0.79-0.95]) and all-cause mortality (HR, 0.71 [95% CI, 0.63-0.80]). Interestingly, we found that smokers yielded more cardiovascular benefits than non-smokers by performing a higher volume of VPA. CONCLUSIONS: Comparing with UK adults reporting no VPA, engaging in 30% of VPA was associated with the lowest risk of incident CVD and all-cause mortality.

Supramolecular brush polymers prepared from 1,3,4-oxadiazole and cyanobutoxy functionalised pillar[5]arene for detecting Cu2.

A supramolecular brush polymer Poly(P5-OXD) was constructed through the self-assembly of an A1/A2 disubstituted pillar[5]arene P5-OXD with a 1,3,4-oxadiazole unit and a cyanobutoxy group, exhibiting external stimuli responsiveness towards Cu2+ ions with an ON/OFF fluorescence signal output.

Transient absorption measurements of interlayer charge transfer in a WS2/GeS van der Waals heterostructure.

We introduce germanium sulfide (GeS) as a new layered material for the fabrication of two-dimensional van der Waals materials and heterostructures. Heterostructures of WS2/GeS were fabricated using mechanical exfoliation and dry transfer techniques. Significant photoluminescence quenching of WS2 in the heterostructures indicates efficient charge transfer. Transient absorption measurements were performed to study the dynamics of charge transfer. The results show that the heterostructure forms a type-II band alignment with the conduction band minimum and valence band maximum located in the WS2 and GeS layers, respectively. The ultrafast hole transfer from WS2 to GeS is confirmed by the faster decay of the lower peak value of the differential reflection signal in the heterostructure sample, in comparison to the WS2 monolayer. These results introduce GeS as a promising semiconductor material for developing new novel heterostructures.

Thermocoagulation versus cryotherapy for the treatment of cervical precancers.

AIM: To compare thermocoagulation and cryotherapy for treatment of high-grade cervical intraepithelial neoplasia (CIN). METHODS: From May 2017 to May 2018, women with CIN2/3 were randomized to thermocoagulation or cryotherapy at Peking University Shenzhen Hospital. Follow-up at 4 and 8 months included cytology and human papillomavirus (HPV) testing. Women who were HPV-positive or had atypical squamous cells of undetermined significance or higher-grade disease underwent colposcopy/biopsy. RESULTS: Among 149 women enrolled, 74 were randomized to thermocoagulation, and 75 to cryotherapy (excluded four were immediately referred for thermocoagulation due to large lesions). At follow-up, there was no difference between the thermocoagulation and cryotherapy groups in HPV-negative (4/8 months: 72.5%/86.2% vs 68.6%/80.6%) and pathology-negative (97.1%/98.5% vs 94.3%/92.3%) rates (all P > 0.05). The cytology-negative rate was similar for thermocoagulation and cryotherapy at 4 months (79.7% vs 78.9%, P > 0.05), but higher for thermocoagulation at 8 months (100% vs 88.7%, P < 0.05). No lesions were observed among the four referral women at follow-up. As compared with cryotherapy, thermocoagulation was associated with shorter duration of treatment and less vaginal discharge, but higher pain during application and longer bleeding after treatment. CONCLUSION: Thermocoagulation was as effective and safe as cryotherapy and might be easily applied to treat high-grade cervical lesions.

Transient Absorption Microscopy of Layered Crystal AsSbS3.

We introduce getchellite as a new layered material for fabrication of two-dimensional van der Waals materials and heterostructures. Nanofilms of AsSbS3 were fabricated by mechanical exfoliation. Transient absorption spectroscopy measurements identified a direct bandgap at about 710 nm, which is close to the ideal single-junction photovoltaic bandgap. Transient absorption microscopy measurements with high spatial and temporal resolution were performed to reveal the spatiotemporal dynamics of photocarriers in AsSbS3. We obtained a photocarrier lifetime of about 200 ps, a diffusion coefficient of about 5 cm2 s-1, a diffusion length of about 320 nm, and a carrier mobility of about 200 cm2 V-1 s-1. These results establish AsSbS3 as a promising two-dimensional semiconductor for optoelectronic applications as an individual material or in heterostructures.

Ultrafast charge transfer in a type-II MoS2-ReSe2 van der Waals heterostructure.

We fabricated a van der Waals heterostructure by stacking together monolayers of MoS2 and ReSe2. Transient absorption measurements were performed to study the dynamics of charge transfer, indirect exciton formation, and indirect exciton recombination. The results show that the heterostructure form a type-II band alignment with the conduction band minimum and valance band maximum located in the MoS2 and ReSe2 layers, respectively. By using different pump-probe configurations, we found that electrons could efficiently transfer from ReSe2 to MoS2 and holes along the opposite direction. Once transferred, the electrons and holes form spatially indirect excitons, which have longer recombination lifetimes than excitons in individual monolayers. These results provide useful information for developing van der Waals heterostructure involving ReSe2 for novel electronic and optoelectronic applications.

Visible laser-assisted reduction of plasmonic Ag nanoparticles with narrow-band optical absorption for colored holographic reconstruction.

Noble metal plasmonic resonance has been utilized in optical data storage widely for its excellent photo-transformation efficiency. TiO2 nanoporous films deposited with Ag nanoparticles present outstanding polarization-response and color-modulation ability. However, the low exposure-sensitivity at single wavelength inhibits their application in optical information processing, which is urgent to be improved by innovative methods. Here, we report that Ag nanoparticles were deposited efficiently via continuous laser irradiation in the TiO2 nanoporous film treated by tannic acid, presenting high-efficient monochromic absorption property. As a result, two sets of holograms were recorded sequentially at the same point of the film with orthogonal circular polarization configurations. The colored reconstruction of the mixed holograms was achieved by utilizing laser polarization state as chrominance segmentation channel. Our method provides a distinctive route for enhancing the photo-energy conversion efficiency of plasmonic nanoparticles, and paves a way to develop advanced display device.

Nonvolatile plasmonic holographic memory based on photo-driven ion migration.

Stability of data storage is essential for optical information processing. TiO2 nanoporous films loaded with small-sized Ag nanoparticles thus attracted much attention due to their fast and polarization-sensitive photochemical response, which is able to realize optical phase modulation and high-density optical memory. However, little attention was given to the modulation of the silver ion migration, which plays a key role in anti-erasure of the recorded hologram. In this paper, the strong coupling of two phase gratings was achieved by long-term recording in the Ag-TiO2 film irradiated with a pair of coherent left- and right-hand circular polarization lights from a Blu-ray (∼405 nm) laser. The migration of Ag+ ions was enhanced by the electronic field gradient force. A stable polarization holographic grating was obtained by this method and observed by a polarizing microscope. This work provided a strategy for a nonvolatile device based on photo-driven ion migration.

Selective photo-oxidation induced bi-periodic plasmonic structures for high-density data storage.

Stable and controllable optical memory is necessary for the development of current information technology. In this context, Ag/TiO2 films have received much attention for their photosensitivity in wavelength and polarization, which can be applied to high-density optical storage. Here, we carried out dual-wavelength holographic recording using 403.4 nm and 532 nm lasers, and obtained mixed microfringes based on selective photodissolution of Ag nanoparticles of various sizes in TiO2 nanoporous films. Two recording methods of simultaneous and sequential multiplexing were investigated. It was found that using simultaneous irradiation it is easier to obtain equivalent efficiency in both spectral hole burning and multiplexed grating diffraction, compared with the sequential one. The results can be explained by the Time-accumulation effect during Ag+ ion diffusion and migration in holographic recordings. Based on such properties, multiplexed-holographic fringes with uniform contrast were reserved by simultaneous recording in Ag/TiO2 films. This work provides a new strategy for fabrication of photonic devices with complex microstructures.

Factors affecting suboptimal maturation of autogenous arteriovenous fistula in elderly patients with diabetes:A narrative review.

Autogenous arteriovenous fistula (AVF) is considered the preferred vascular access choice for individuals undergoing maintenance hemodialysis (MHD) and is widely utilized in China, as reported by the Dialysis Outcomes and Practice Patterns Study. Despite its popularity, the significant incidence of poor AVF maturation often leads to the need for central venous catheter insertion, increasing the risk of complications like superior vena cava stenosis and catheter-related infections, which in turn raises the overall mortality risk. With the prevalence of diabetes rising globally among the elderly and diabetic kidney disease being a leading cause of end-stage renal disease necessitating renal replacement therapy, our retrospective review aims to explore the various factors affecting AVF maturation in this specific patient population. While there have been numerous studies examining AVF complications in MHD patients, including issues like failure, patency loss, stenosis, thrombosis, poor maturation, and other influencing factors, there remains a gap in large-scale clinical studies focusing on the incidence and risk factors for immature AVF specifically in elderly diabetic patients. This paper delves into the pathophysiological mechanisms, diagnostic criteria, and unique considerations surrounding AVF maturation in elderly diabetic patients, distinguishing them from the general population. Our literature review reveals that elderly diabetic patients exhibit a higher risk of AVF immaturity compared to the general population. Additionally, there exists a continuing discourse regarding several aspects related to this group, including the choice of dialysis access, timing of AVF surgery, and surgical site selection. Furthermore, we delve into the management strategies for vascular access within this specific group with the goal of providing evidence-based guidance for the establishment and maintenance of functional vascular access in elderly diabetic patients.

Three novel sesquiterpene polyol esters from the root bark of Celastrus angulatus Maxim and their nitric oxide inhibitory activity.

Three new sesquiterpene polyol ester compounds angulatin V [1ß,15-diacetoxy-2ß-(α-methyl)-butanoyloxy-4α,6α-dihydroxy-8α-isobutanoyloxy-9ß-benzoxy-ß-dihydroagarofuran], angulatin W [1ß,2ß-diacetoxy-4α,6α-dihydroxy-8-carbonyl-9ß-benzoxy-15-isobutanoyloxy-ß-dihydroagarofuran], angulatin X [1ß,2ß,8α-triacetoxy-4α, 6α-dihydroxy-9ß-benzoxy-15-nicotinyl-ß-dihydroagarofuran] (1-3), together with one known compound Putterine B (4), were isolated from the root bark of Celastrus angulatus Maxim. The structures of compounds 1-3 were elucidated by NMR, HRESIMS, IR data, and comparison with the literature data. The anti-inflammatory activity of all compounds was evaluated by measuring nitric oxide production in RAW264.7 macrophages. Compounds 1-4 showed no significant nitric oxide inhibitory activity at 2.5 and 5 µM concentrations.

Causal associations between circulation ß-carotene and cardiovascular disease: A Mendelian randomization study.

The causal association between circulating ß-carotene concentrations and cardiovascular disease (CVD) remains controversial. We conducted a Mendelian randomization study to explore the effects of ß-carotene on various cardiovascular diseases, including myocardial infarction, atrial fibrillation, heart failure, and stroke. Three single nucleotide polymorphisms (SNPs) associated with the ß-carotene levels were obtained by searching published data and used as instrumental variables. Genetic association estimates for 4 CVDs (including myocardial infarction, atrial fibrillation, heart failure, and stroke) in the primary analysis, blood pressure and serum lipids (high-density lipoprotein [HDL] cholesterol, LDL cholesterol, and triglycerides) in the secondary analysis were obtained from large-scale genome-wide association studies (GWASs). We applied inverse variance-weighted as the primary analysis method, and 3 others were used to verify as sensitivity analysis. Genetically predicted circulating ß-carotene levels (natural log-transformed, µg/L) were positively associated with myocardial infarction (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.02-1.18, P = .011) after Bonferroni correction. No evidence supported the causal effect of ß-carotene on atrial fibrillation (OR 1.02, 95% CI 0.96-1.09, P = .464), heart failure (OR 1.07, 95% CI 0.97-1.19, P = .187), stroke (OR 1.03, 95% CI 0.93-1.15, P = .540), blood pressure (P > .372) and serum lipids (P > .239). Sensitivity analysis produced consistent results. This study provides evidence for a causal relationship between circulating ß-carotene and myocardial infarction. These findings have important implications for understanding the role of ß-carotene in CVD and may inform dietary recommendations and intervention strategies for preventing myocardial infarction.

Texture Feature Extraction from 1H NMR Spectra for the Geographical Origin Traceability of Chinese Yam.

Adulteration is widespread in the herbal and food industry and seriously restricts traditional Chinese medicine development. Accurate identification of geo-authentic herbs ensures drug safety and effectiveness. In this study, 1H NMR combined intelligent "rotation-invariant uniform local binary pattern" identification was implemented for the geographical origin confirmation of geo-authentic Chinese yam (grown in Jiaozuo, Henan province) from Chinese yams grown in other locations. Our results showed that the texture feature of 1H NMR image extracted with rotation-invariant uniform local binary pattern for identification is far superior compared to the original NMR data. Furthermore, data preprocessing is necessary. Moreover, the model combining a feature extraction algorithm and support vector machine (SVM) classifier demonstrated good robustness. This approach is advantageous, as it is accurate, rapid, simple, and inexpensive. It is also suitable for the geographical origin traceability of other geographical indication agricultural products.

Non-Isothermal Crystallization Kinetics of Montmorillonite/Polyamide 610 Nanocomposites.

Non-isothermal crystallization kinetics of montmorillonite (MMT)/polyamide 610 (PA610) composites were readily prepared by in situ melt polymerization followed by a full investigation in terms of their microstructure, performance, and crystallization kinetics. The kinetic models of Jeziorny, Ozawa, and Mo were used in turn to fit the experimental data, in all of which Mo's analytical method was found to be the best model for the kinetic data. Differential scanning calorimetry (DSC) and transmission electron microscopy (TEM) studies were used to investigate the isothermal crystallization behavior and MMT dispersion levels in the MMT/PA610 composites. The experiment results revealed that low MMT content can promote the PA610 crystallization, whilst high MMT content result in MMT agglomeration, and reduce the PA610 crystallization rate.