A study at the wildlife-livestock interface unveils the potential of feral swine as a reservoir for extended-spectrum ß-lactamase-producing Escherichia coli.

Wildlife is known to serve as carriers and sources of antimicrobial resistance (AMR). Due to their unrestricted movements and behaviors, they can spread antimicrobial resistant bacteria among livestock, humans, and the environment, thereby accelerating the dissemination of AMR. Extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae is one of major concerns threatening human and animal health, yet transmission mechanisms at the wildlife-livestock interface are not well understood. Here, we investigated the mechanisms of ESBL-producing bacteria spreading across various hosts, including cattle, feral swine, and coyotes in the same habitat range, as well as from environmental samples over a two-year period. We report a notable prevalence and clonal dissemination of ESBL-producing E. coli in feral swine and coyotes, suggesting their persistence and adaptation within wildlife hosts. In addition, in silico studies showed that horizontal gene transfer, mediated by conjugative plasmids and insertion sequences elements, may play a key role in spreading the ESBL genes among these bacteria. Furthermore, the shared gut resistome of cattle and feral swine suggests the dissemination of antibiotic resistance genes at the wildlife-livestock interface. Taken together, our results suggest that feral swine may serve as a reservoir of ESBL-producing E. coli.

All-solution-processed ultraflexible wearable sensor enabled with universal trilayer structure for organic optoelectronic devices.

All-solution-processed organic optoelectronic devices can enable the large-scale manufacture of ultrathin wearable electronics with integrated diverse functions. However, the complex multilayer-stacking device structure of organic optoelectronics poses challenges for scalable production. Here, we establish all-solution processes to fabricate a wearable, self-powered photoplethysmogram (PPG) sensor. We achieve comparable performance and improved stability compared to complex reference devices with evaporated electrodes by using a trilayer device structure applicable to organic photovoltaics, photodetectors, and light-emitting diodes. The PPG sensor array based on all-solution-processed organic light-emitting diodes and photodetectors can be fabricated on a large-area ultrathin substrate to achieve long storage stability. We integrate it with a large-area, all-solution-processed organic solar module to realize a self-powered health monitoring system. We fabricate high-throughput wearable electronic devices with complex functions on large-area ultrathin substrates based on organic optoelectronics. Our findings can advance the high-throughput manufacture of ultrathin electronic devices integrating complex functions.

Functional soft robotic composites based on organic photovoltaic and dielectric elastomer actuator.

Improving the energy efficiency of robots remains a crucial challenge in soft robotics, with energy harvesting emerging as a promising approach to address it. This study presents a functional soft robotic composite called OPV-DEA, which integrates flexible organic photovoltaic (OPV) and dielectric elastomer actuator (DEA). The composite can simultaneously generate electrostatic bending actuation and harvest energy from external lights. Owing to its simplicity and inherent flexibility, the OPV-DEA is poised to function as a fundamental building block for soft robots. This study aimed to validate this concept by initially establishing the fabrication process of OPV-DEA. Subsequently, experimental samples are fabricated and characterized. The results show that the samples exhibit a voltage-controllable bending actuation of up to 15.6° and harvested power output of 1.35 mW under an incident power irradiance of 11.7 mW/cm2. These performances remain consistent even after 1000 actuation cycles. Finally, to demonstrate the feasibility of soft robotic applications, an untethered swimming robot equipped with two OPV-DEAs is fabricated and tested. The robot demonstrates swimming at a speed of 21.7 mm/s. The power consumption of the robot is dominated by a high-voltage DC-DC converter, with a value approximately 1.5 W. As a result, the on-board OPVs cannot supply the necessary energy during locomotion simultaneously. Instead, they contribute to the overall system by charging a battery used for the controller on board. Nevertheless, these findings suggest that the OPV-DEA could pave the way for the development of an unprecedented range of functional soft robots.

Waterproof and ultraflexible organic photovoltaics with improved interface adhesion.

Ultraflexible organic photovoltaics have emerged as a potential power source for wearable electronics owing to their stretchability and lightweight nature. However, waterproofing ultraflexible organic photovoltaics without compromising mechanical flexibility and conformability remains challenging. Here, we demonstrate waterproof and ultraflexible organic photovoltaics through the in-situ growth of a hole-transporting layer to strengthen interface adhesion between the active layer and anode. Specifically, a silver electrode is deposited directly on top of the active layers, followed by thermal annealing treatment. Compared with conventional sequentially-deposited hole-transporting layers, the in-situ grown hole-transporting layer exhibits higher thermodynamic adhesion between the active layers, resulting in better waterproofness. The fabricated 3 µm-thick organic photovoltaics retain 89% and 96% of their pristine performance after immersion in water for 4 h and 300 stretching/releasing cycles at 30% strain under water, respectively. Moreover, the ultraflexible devices withstand a machine-washing test with such a thin encapsulation layer, which has never been reported. Finally, we demonstrate the universality of the strategy for achieving waterproof solar cells.

Widespread Household Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant from Children, South Korea, 2022.

The role that children play in the transmission of the omicron variant is unclear. Here we report an outbreak that started in young children attending various pediatric facilities, leading to extensive household transmission that affected 75 families with 88 confirmed case-patients in 3 weeks. Tailored social and public health measures directed towards children and pediatric facilities are warranted with the emergence of highly transmissible omicron variant to mitigate the impact of coronavirus diseases 2019 (COVID-19).

Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in Korea.

OBJECTIVES: As few mpox cases have been reported in Korea, we aimed to identify the characteristics of mpox infection by describing our epidemiologic investigation of a woman patient (index patient, the third case in Korea) and a physician who was infected by a needlestick injury (the fourth case). METHODS: We conducted contact tracing and exposure risk evaluation through interviews with these 2 patients and their physicians and contacts, as well as field investigations at each facility visited by the patients during their symptomatic periods. We then classified contacts into 3 levels according to their exposure risk and managed them to minimize further transmission by recommending quarantine and vaccination for post-exposure prophylaxis and monitoring their symptoms. RESULTS: The index patient had sexual contact with a man foreigner during a trip to Dubai, which was considered the probable route of transmission. In total, 27 healthcare-associated contacts across 7 healthcare facilities and 9 community contacts were identified. These contacts were classified into high (7 contacts), medium (9 contacts), and low (20 contacts) exposure risk groups. One high-risk contact was identified as a secondary patient: a physician who was injured while collecting specimens from the index patient. CONCLUSIONS: The index patient visited several medical facilities due to progressive symptoms prior to isolation. Although the 2022 mpox epidemic mainly affected young men, especially men who have sex with men, physicians should also consider mpox transmission in the general population for the timely detection of mpox-infected patients.

Surface-Energy-Mediated Interfacial Adhesion for Mechanically Robust Ultraflexible Organic Photovoltaics.

Insufficient interfacial adhesion is a widespread problem across multilayered devices that undermines their reliability. In flexible organic photovoltaics (OPVs), poor interfacial adhesion can accelerate degradation and failure under mechanical deformations due to the intrinsic brittleness and mismatching mechanical properties between functional layers. We introduce an argon plasma treatment for OPV devices, which yields 58% strengthening in interfacial adhesion between an active layer and a MoOX hole transport layer, thus contributing to mechanical reliability. The improved adhesion is attributed to the increased surface energy of the active layer that occurred after the mild argon plasma treatment. The mechanically stabilized interface retards the flexible device degradation induced by mechanical stress and maintains a power conversion efficiency of 94.8% after 10,000 cycles of bending with a radius of 2.5 mm. In addition, a fabricated 3 µm thick ultraflexible OPV device shows excellent mechanical robustness, retaining 91.0% of the initial efficiency after 1000 compressing-stretching cycles with a 40% compression ratio. The developed ultraflexible OPV devices can operate stably at the maximum power point under continuous 1 sun illumination for 500 min with an 89.3% efficiency retention. Overall, we validate a simple interfacial linking strategy for efficient and mechanically robust flexible and ultraflexible OPVs.

Non-pharmacological interventions on anxiety and depression in lung cancer patients' informal caregivers: A systematic review and meta-analysis.

BACKGROUND: Lung cancer is one of the common cancers and the leading cause of death. Tremendous caregiving burden of informal caregivers of lung cancer causes psychological disorders, such as anxiety and depression. Interventions for informal caregivers of patients with lung cancer to improve their psychological health, which ultimately leads to patients' positive health outcomes, are crucial. A systematic review and meta-analysis was conducted to: 1) evaluate the effect of non-pharmacological interventions on the outcomes of depression and anxiety for lung cancer patients' informal caregivers; and 2) compare the effects of interventions with differing characteristics (i.e. intervention types, mode of contact, and group versus individual delivery). METHODS: Four databases were searched to identify relevant studies. Inclusion criteria for the articles were peer-reviewed non-pharmacological intervention studies on depression and anxiety in lung cancer patients' informal caregivers published between January 2010 and April 2022. Systematic review procedures were followed. Data analysis of related studies was conducted using the Review Manager Version 5.4 software. Intervention effect sizes and studies' heterogeneity were calculated. RESULTS: Eight studies from our search were eligible for inclusion. Regarding total effect for the caregivers' levels of anxiety and depression, results revealed evidence for significant moderate effects of intervention on anxiety (SMD -0.44; 95% CI, -0.67, -0.21; p = 0.0002) and depression (SMD -0.46; 95% CI, -0.74, -0.18; p = 0.001). Subgroup analyses for both anxiety and depression of informal caregivers revealed moderate to high significant effects for specific intervention types (cognitive behavioral and mindfulness combined with psycho-education interventions), mode of contact (telephone-based interventions), and group versus individual delivery. CONCLUSION: This review provides evidence that cognitive behavioral and mindfulness-based, telephone-based, individual or group-based interventions were effective for informal caregivers of lung cancer patients. Further research is needed to develop the most effective intervention contents and delivery methods across informal caregivers with larger sample size in randomized controlled trials.

Recent Advances in the Development of Antidepressants Targeting the Purinergic P2X7 Receptor.

The purinergic P2X7 receptor (P2X7R) is an adenosine triphosphate (ATP)- gated cation channel protein. Although extracellular ATP (eATP) is maintained at the nanomolar concentration range under normal conditions, it is elevated to micromolar levels in response to cell stress or damage, resulting in activation of P2X7R in the brain. The binding of eATP to P2X7R in glial cells in the brain activates the NLRP3 inflammasome and releases pro-inflammatory cytokines, such as IL-1ß, IL-6, IL-18, and TNFα. Depression has been demonstrated to be strongly associated with neuroinflammation activated by P2X7R. Therefore, P2X7R is an attractive therapeutic target for depression. Multinational pharmaceutical companies, including AstraZeneca, GlaxoSmithKline, Janssen, Lundbeck, and Pfizer, have developed CNS-penetrating P2RX7 antagonists. Several of these have been evaluated in clinical trials. This review summarizes the recent development of P2X7R antagonists as novel antidepressant agents in terms of structural optimization, as well as in vitro/in vivo evaluation and physicochemical properties of representative compounds.

Radical-Scavenging Activatable and Robust Polymeric Binder Based on Poly(acrylic acid) Cross-Linked with Tannic Acid for Silicon Anode of Lithium Storage System.

The design of a novel binder is required for high-capacity silicon anodes, which typically undergo significant changes during charge/discharge cycling. Hence, in this study, a stable network structure was formed by combining tannic acid (TAc), which can be cross-linked, and poly(acrylic acid)(PAA) as an effective binder for a silicon (Si) anode. TAc is a phenolic compound and representative substance with antioxidant properties. Owing to the antioxidant ability of the C-PAA/TAc binder, side reactions during the cycling were suppressed during the formation of an appropriate solid-electrolyte interface layer. The results showed that the expansion of a silicon anode was suppressed compared with that of a conventional PAA binder. This study demonstrates that cross-linking and antioxidant capability facilitate binding and provides insights into the behavior of binders for silicon anodes. The Si anode with the C-PAA/TAc binder exhibited significantly improved cycle stability and higher Coulombic efficiency in comparison to the Si anode with well-established PAA binders. The C-PAA/TAc binder demonstrated a capacity of 1833 mA h g-1Si for 100 cycles, which is higher than that of electrodes fabricated using the conventional PAA binder. Therefore, the C-PAA/TAc binder offers better electrochemical performance.

Transmission of antibiotic resistance at the wildlife-livestock interface.

Antibiotic-resistant microorganisms (ARMs) are widespread in natural environments, animals (wildlife and livestock), and humans, which has reduced our capacity to control life threatening infectious disease. Yet, little is known about their transmission pathways, especially at the wildlife-livestock interface. This study investigated the potential transmission of ARMs and antibiotic resistance genes (ARGs) between cattle and wildlife by comparing gut microbiota and ARG profiles of feral swine (Sus scrofa), coyotes (Canis latrans), cattle (Bos taurus), and environmental microbiota. Unexpectedly, wild animals harbored more abundant ARMs and ARGs compared to grazing cattle. Gut microbiota of cattle was significantly more similar to that of feral swine captured within the cattle grazing area where the home range of both species overlapped substantially. In addition, ARMs against medically important antibiotics were more prevalent in wildlife than grazing cattle, suggesting that wildlife could be a source of ARMs colonization in livestock.

Experiences of Korean patients with thyroid cancer receiving radioactive iodine therapy after total thyroidectomy.

Objective: South Korea has a high incidence of thyroid cancer. This study aimed to describe and understand the nature of the experience of Korean patients with thyroid cancer undergoing radioactive iodine treatment after total thyroidectomy through an in-depth investigation of their experience. Methods: Individual interviews using open questions were conducted with 22 participants living in South Korea. All were audio-recorded and transcribed verbatim. This study used the phenomenological analysis method proposed by Colaizzi to determine the essential subjects verified according to the four reliability criteria proposed by Guba and Lincoln. Results: Three categories, 6 theme clusters, and 13 themes emerged from the study. The three categories identified were "broken life," "solitude in a crowd," and "positive changes in values." The six theme clusters were "anxiety about death," "an imperfect being," "feeling social isolation," "struggling alone," "an active attitude toward life," and "life support." The themes that emerged the most were related to physical and psychological difficulties. Of the 13 themes, four themes were related to family-oriented values and culture. Conclusions: This study suggests that nursing interventions are required to reduce the physical and psychological symptoms of Korean patients with thyroid cancer. It is necessary to build a support system with the patient's family members to consider family-oriented values and culture.

Tracing the source and route of uterine colonization by exploring the genetic relationship of Escherichia coli isolated from the reproductive and gastrointestinal tract of dairy cows.

The source and route of bacterial colonization of the uterus are still not established. The objective was to investigate the source and route of bacterial colonization of the uterus by exploring the genetic relationship among E. coli strains isolated from the gastrointestinal and the reproductive tract of dairy cows pre- and postpartum. Secondarily, uterine health status (metritis vs. healthy) was evaluated. Cows (n = 34) had the rectoanal junction (RAJ), vulva, and vagina swabbed every three days starting six days before expected calving until nine days postpartum. The uterus was swabbed postpartum. A blood sample was collected at all time points, but cultures were negative. Whole-genome sequencing was performed on 44 isolates recovered from eight cows (four metritic and four healthy) with growth on selective E. coli media from the RAJ, vulva and/or vagina and uterus. Clonal isolates were found in the RAJ or the vulva prepartum and in the vulva, vagina or uterus postpartum. Clonal isolates were also found in the RAJ, the vulva, the vagina and the uterus postpartum. Clonal isolates were found in individual cows and different cows. Absence of clustering based on virulence factor genes and all genes indicate no strain specificity to body site or uterine health status. These findings indicate that the gastrointestinal tract is the likely source of bacteria that colonize the reproductive tract via ascending colonization of the uterus through the lower genital tract. Additionally, cow to cow transmission occurs, and strains are not specific to body site or to health status.

Ultrathin and Efficient Organic Photovoltaics with Enhanced Air Stability by Suppression of Zinc Element Diffusion.

Ultrathin (thickness less than 10 µm) organic photovoltaics (OPVs) can be applied to power soft robotics and wearable electronics. In addition to high power conversion efficiency, stability under various environmental stresses is crucial for the application of ultrathin OPVs. In this study, the authors realize highly air-stable and ultrathin (≈3 µm) OPVs that possess high efficiency (15.8%) and an outstanding power-per-weight ratio of 33.8 W g-1 . Dynamic secondary-ion mass spectrometry is used to identify Zn diffusion from the electron transport layer zinc oxide (ZnO) to the interface of photoactive layer; this diffusion results in the degradation of the ultrathin OPVs in air. The suppression of the Zn diffusion by a chelating strategy results in stable ultrathin OPVs that maintain 89.6% of their initial efficiency after storage for 1574 h in air at room temperature under dark conditions and 92.4% of their initial efficiency after annealing for 172 h at 85 °C in air under dark conditions. The lightweight and stable OPVs also possess excellent deformability with 87.3% retention of the initial performance after 5000 cycles of a compressing-stretching test with 33% compression.

Developing the Nondevelopable: Creating Curved-Surface Electronics from Nonstretchable Devices.

The incorporation of electronics onto curved surfaces promises to bring new levels of intelligence to the ergonomic, aesthetic, aerodynamic, and optical surfaces that are ever-present in our lives. However, since many of these surfaces have 2D (i.e., nondevelopable) curvature, they cannot be formed from the deformation of a flat, nonstretchable sheet. This means that curved electronics cannot capitalize on the rapid technological advances taking place in the field of ultrathin electronics, since ultrathin devices, though ultraflexible, are not stretchable. In this work, a shrink-based paradigm is presented to apply such thin-film electronics to nondevelopable surfaces, expanding the capabilities of current nondevelopable electronics, and linking future developments in thin-film technology to similar developments in curved devices. The wrinkling of parylene-based devices and the effects of shrinkage on common electrical components are examined, culminating in shrinkable touch sensors and organic photovoltaics, laminated to various nondevelopable surfaces without loss of performance.

A Multiplex PCR Assay Combined with Capillary Electrophoresis for the Simultaneous Identification of Atlantic Cod, Pacific Cod, Blue Whiting, Haddock, and Alaska Pollock.

With an increased consumption of seafood products, food fraud with fish resources has been continuously reported. In particular, codfish has been exploited worldwide as a processed product in fresh, frozen, smoked, canned, or ready-to-eat dish forms. However, it is challenging to identify processed fish products after processing because of their similar morphological characteristics. Substitution and mislabeling of codfish among different species are also happening deliberately or unintentionally. Thus, it is necessary to distinguish cod species to prevent fish adulteration and food fraud. In this study, we developed a multiplex PCR for simultaneously identifying five cod species within Gadidae using capillary electrophoresis. Then, their species-specific primer sets were designed by targeting the mitochondrial cytochrome b gene. Subsequently, the amplicon sizes obtained were 237 bp, 204 bp, 164 bp, 138 bp, and 98 bp for Atlantic cod, Pacific cod, blue whiting, haddock, and Alaska pollock, respectively. The specificity of each primer was further tested using 19 fish species, and no cross-reactivity was observed. The limit of detection of this multiplex PCR assay was 1 pg. The developed multiplex PCR assay can be applied to 40 commercial food products successfully. This detection method will be efficient for managing seafood authentication by simultaneously analyzing multiple cod species.

Dissemination mechanisms of NDM genes in hospitalized patients.

BACKGROUND: NDM-producing Enterobacteriaceae are a major clinical concern worldwide. We characterized NDM-positive pathogens isolated from patients and assessed the dissemination patterns of the bla NDM genes in a hospital setting. METHODS: Eleven NDM-positive Enterobacteriaceae (three Enterobacter hormaechei, six Klebsiella pneumoniae and two Escherichia coli) were isolated from nine patients over a 1 year period. Antimicrobial susceptibility was assessed by MICs. A combination of short- and long-read WGS was used for genome analysis. Clinical treatment history of patients was linked with genetic features of individual isolates to investigate the dissemination patterns of the bla NDM genes and NDM-positive strains. RESULTS: bla NDM in clonal K. pneumoniae were transmitted between two patients. In other instances, an identical IncC plasmid encoding NDM-1 was transmitted between E. coli and K. pneumoniae isolated from the same patient, and an IncX3 plasmid, carrying bla NDM-1 or bla NDM-5, was harboured in non-clonal E. hormaechei. Varying patterns of IS elements were identified as a critical transmission mechanism in association with bla NDM genes. CONCLUSIONS: Multiple transmission patterns were identified in hospitalized patients, including dissemination of clonal bacterial strains carrying resistance genes and horizontal transfer of resistance genes among divergent bacterial strains. Controlling spread of NDM is complex: while attention to standard infection control practices is critically important, this needs to be matched by aggressive efforts to limit unnecessary antimicrobial use, to minimize the selection for and risk of transfer of 'high mobility' resistance genes among Enterobacteriaceae.

Quality of Online Information Regarding High-Risk Pregnancies.

Health information on the Internet can have a direct effect on healthcare decision-making. However, the quality of information online has seldom been evaluated. This study aimed to assess the quality of online information on high-risk pregnancies provided by English and Korean Web sites. Through a Google search, 30 English and 30 Korean Web sites were selected on January 2 and 3, 2020, respectively, and assessed using DISCERN, a Journal of the American Medical Association, and Health On the Net Foundation code questionnaires. The data assessed were analyzed using descriptive and nonparametric statistical tests. Overall, the information provided by the English Web sites presented higher-quality information than the Korean Web sites. Most Web sites did not provide the sources of the information presented on their Web sites, meet the Journal of the American Medical Association criteria, or provide information on complementarity. Based on our results, nurses need to be competent in assessing the quality of Web sites and the health information presented there, and nursing students need to be prepared to do so as well. Nurses are responsible for educating their patients about the possibility of incorrect information provided by Internet Web sites and informing their patients about reliable Web sites, thus assisting them to make informed decisions regarding their health.

Quality Evaluation of Visual Display Terminal Syndrome Videos Shared on YouTube.

Visual display terminal syndrome is a health problem that occurs when an individual looks at a visual display terminal for a long time. This study aimed to evaluate the quality of YouTube videos on visual display terminal syndrome. YouTube was searched using the keywords "visual display terminal syndrome" and "a prolonged user of a computer or smartphone" on October 16, 2019. A total of 45 videos were evaluated using DISCERN and the Journal of the American Medical Association scoring systems. The variables extracted from the videos were the uploading agency; content; presentation format; days since upload; the number of views, likes, dislikes, and comments; and the video power index. The mean DISCERN and Journal of the American Medical Association scores were 35.64 and 3.08 points, respectively, indicating that the information on visual display terminal syndrome in YouTube videos was inaccurate and unreliable. The major reason for the low quality of the videos was that the sources of information presented in the videos were not provided. The DISCERN and Journal of the American Medical Association scores showed significant differences in the uploading agency and presentation format variables. Nurses must be familiar with evaluating the quality of videos presenting health information. Guidelines informing patients that YouTube might provide misinformation about health need to be developed.

Diverse ß-lactam antibiotic-resistant bacteria and microbial community in milk from mastitic cows.

Intramammary bacterial infection, the most common cause of mastitis, is the most costly disease in dairy cattle in the US and reason for antibiotic usage. Ceftiofur, a third-generation cephalosporin, is generally used to treat such disease, but it has a high treatment failure rate. Though the reason is not known clearly, it is hypothesized that multiple factors are associated with the treatment failure. In this study, we analyzed 169 milk samples from cows with mastitis in two independent dairy farms (Farm A and B) in which 19.4% (Farm A) and 14.3% (Farm B) of the antibiotic treated cows were not cured. The prevalence of cephalosporin-resistant bacteria (CRB) in milk was 72.0% and 42.1% in Farm A and B, respectively. Nineteen and nine bacterial genera were identified in Farm A and B respectively, with the most abundant genus being Staphylococcus (27.1%; Farm A) and Bacillus (63.5%; Farm B). However, no strong relationship between the treatment failure rate and the CRB prevalence was observed. Furthermore, the metagenomic analysis showed no significant differences in the α- and ß-diversities of microbiota in milk samples from cured and uncured cows, suggesting that antibiotic-resistant bacteria were not the sole reason for the antibiotic treatment failure. KEY POINTS: • The mastitic milk samples had high prevalence of cephalosporin-resistant bacteria (CRB). • The CRB identified belong to diversified species. • Antibiotic treatment failure was not solely caused by the abundance of CRB.