Functional versatility of Zur in metal homeostasis, motility, biofilm formation, and stress resistance in Yersinia pseudotuberculosis.

Zur (zinc uptake regulator) is a significant member of the Fur (ferric uptake regulator) superfamily, which is widely distributed in bacteria. Zur plays crucial roles in zinc homeostasis and influences cell development and environmental adaptation in various species. Yersinia pseudotuberculosis is a Gram-negative enteric that pathogen usually serves as a model organism in pathogenicity studies. The regulatory effects of Zur on the zinc transporter ZnuABC and the protein secretion system T6SS have been documented in Y. pseudotuberculosis. In this study, a comparative transcriptomics analysis between a ∆zur mutant and the wild-type (WT) strain of Y. pseudotuberculosis was conducted using RNA-seq. This analysis revealed global regulation by Zur across multiple functional categories, including membrane transport, cell motility, and molecular and energy metabolism. Additionally, Zur mediates the homeostasis not only of zinc but also ferric and magnesium in vivo. There was a notable decrease in 35 flagellar biosynthesis and assembly-related genes, leading to reduced swimming motility in the ∆zur mutant strain. Furthermore, Zur upregulated multiple simple sugar and oligopeptide transport system genes by directly binding to their promoters. The absence of Zur inhibited biofilm formation as well as reduced resistance to chloramphenicol and acidic stress. This study illustrates the comprehensive regulatory functions of Zur, emphasizing its importance in stress resistance and pathogenicity in Y. pseudotuberculosis. IMPORTANCE: Bacteria encounter diverse stresses in the environment and possess essential regulators to modulate the expression of genes in responding to the stresses for better fitness and survival. Zur (zinc uptake regulator) plays a vital role in zinc homeostasis. Studies of Zur from multiple species reviewed that it influences cell development, stress resistance, and virulence of bacteria. Y. pseudotuberculosis is an enteric pathogen that serves a model organism in the study of pathogenicity, virulence factors, and mechanism of environmental adaptation. In this study, transcriptomics analysis of Zur's regulons was conducted in Y. pseudotuberculosis. The functions of Zur as a global regulator in metal homeostasis, motility, nutrient acquisition, glycan metabolism, and nucleotide metabolism, in turn, increasing the biofilm formation, stress resistance, and virulence were reviewed. The importance of Zur in environmental adaptation and pathogenicity of Y. pseudotuberculosis was emphasized.

Development and validation of a nomogram model for predicting low muscle mass in patients undergoing hemodialysis.

BACKGROUND: Muscle mass is important in determining patients' nutritional status. However, measurement of muscle mass requires special equipment that is inconvenient for clinical use. We aimed to develop and validate a nomogram model for predicting low muscle mass in patients undergoing hemodialysis (HD). METHODS: A total of 346 patients undergoing HD were enrolled and randomly divided into a 70% training set and a 30% validation set. The training set was used to develop the nomogram model, and the validation set was used to validate the developed model. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curve, a calibration curve, and the Hosmer-Lemeshow test. A decision curve analysis (DCA) was used to evaluate the clinical practicality of the nomogram model. RESULTS: Age, sex, body mass index (BMI), handgrip strength (HGS), and gait speed (GS) were included in the nomogram for predicting low skeletal muscle mass index (LSMI). The diagnostic nomogram model exhibited good discrimination with an area under the ROC curve (AUC) of 0.906 (95% CI, 0.862-0.940) in the training set and 0.917 (95% CI, 0.846-0.962) in the validation set. The calibration analysis also showed excellent results. The nomogram demonstrated a high net benefit in the clinical decision curve for both sets. CONCLUSIONS: The prediction model included age, sex, BMI, HGS, and GS, and it can successfully predict the presence of LSMI in patients undergoing HD. This nomogram provides an accurate visual tool for medical staff for prediction, early intervention, and graded management.

Low-protein diet supplemented with inulin lowers protein-bound toxin levels in patients with stage 3b-5 chronic kidney disease: a randomized controlled study.

Introduction: Objective: this study aimed to evaluate whether low-salt low-protein diet (LPD) supplemented with 10 g of inulin could lower serum toxin levels in patients with chronic kidney disease (CKD), thereby providing evidence for adjusting dietary prescriptions of inhospital patients and outpatient nutrition consultants. Methods: we randomized 54 patients with CKD into two groups. Dietary protein intake compliance was evaluated using a 3-day dietary diary and 24-h urine nitrogen levels. The primary outcomes were indoxyl sulfate (IS) and p-cresyl sulfate (PCS), and secondary outcomes included inflammation marker levels, nutritional status, and renal function. We assessed 89 patients for eligibility, and a total of 45 patients completed the study, including 23 and 22 in the inulin-added and control groups, respectively. Results: PCS values decreased in both groups after intervention: inulin-added group, ∆PCS -1.33 (-4.88, -0.63) µg/mL vs. LPD group, -4.7 (-3.78, 3.69) µg/mL (p = 0.058). PCS values reduced from 7.52 to 4.02 µg/mL (p < 0.001) in the inulin-added group (p < 0.001). Moreover, IS decreased from 3.42 (2.53, 6.01) µg/mL to 2.83 (1.67, 4.74) µg/mL after adding inulin; ∆IS was -0.64 (-1.48, 0.00) µg/mL, and a significant difference was observed compared with the control group (p = 0.004). The inflammation index decreased after intervention. Conclusion: dietary fiber supplementation may reduce serum IS and PCS levels and modulate their inflammatory status in predialysis CKD patients.

Introducción: Objetivo: este ensayo aleatorizado doble ciego comparó el efecto de una dieta baja en proteínas (LPD) con o sin suplementos orales de 10 g de inulina en los niveles de PBUT en pacientes con ERC en prediálisis durante 12 semanas. Métodos: clasificamos aleatoriamente a 54 pacientes con ERC en dos grupos. El cumplimiento de la ingesta dietética de proteínas se evaluó utilizando un diario dietético de 3 días y nitrógeno en orina de 24 horas. Los resultados primarios fueron IS y PCS y los resultados secundarios incluyeron niveles de marcadores de inflamación, estado nutricional y función renal. Evaluamos la elegibilidad de 89 pacientes y 45 completaron la intervención, incluidos 23 y 22 en los grupos de inulina añadida y de control, respectivamente. Resultados: el sodio urinario promedio de 24 horas fue de 86 mmol/día y la ingesta promedio de proteínas fue de ~0,7 g/kg/día. Los valores de PCS exhibieron una tendencia decreciente en ambos grupos después de la intervención: grupo con inulina añadida, ∆PCS -1.33 (-4.88, -0.63) µg/mL vs. grupo LPD, -4.7 (-3.78, 3.69) µg/mL) (p =0,058). Los valores de PCS se redujeron de 7,52 a 4,02 µg/mL (p < 0,001) con inulina (p < 0,001). Además, IS disminuyó de 3,42 (2,53, 6,01) µg/mL a 2,83 (1,67, 4,74) µg/mL después de agregar inulina; El ∆IS fue -0,64 (-1,48; 0,00) µg/mL y se observó una diferencia significativa en comparación con el grupo control (p =0,004). Conclusión: la suplementación con fibra dietética puede reducir las toxinas de unión a proteínas séricas en pacientes con ERC en prediálisis y modular su estado inflamatorio.

High thermo-optic tunability in PECVD silicon-rich amorphous silicon carbide.

In this work, the thermo-optic coefficient (TOC) of the silicon-rich amorphous silicon carbide (a-SiC) thin film deposited by plasma-enhanced chemical vapor deposition (PECVD) was characterized. We found that the TOC of the film increases as its silicon content increases. A more than threefold improvement in the TOC was measured, reaching a TOC as high as 1.88×10-4 ∘C-1, which is comparable to that of crystalline silicon. An efficient thermo-optic phase shifter has also been demonstrated by integrating the silicon-rich a-SiC micro-ring structure with a NiCr heater. Tunability of 0.117 nm/mW was demonstrated, and a corresponding tuning efficiency P π as low as 4.2 mW has been measured at an optical wavelength of 1550 nm. These findings make silicon-rich a-SiC a good candidate material for thermo-optic applications in photonic integrated circuits.

Association of the modified creatinine index with muscle strength and mortality in patients undergoing hemodialysis.

BACKGROUND: In the updated consensus, low muscle strength overtook the role of low muscle mass, and probable sarcopenia was diagnosed once low muscle strength was detected. Whether the modified creatinine index (mCI) could identify persons with probable sarcopenia who may be at risk of adverse outcomes remains unknown. We aimed to evaluate the association of the mCI with probable sarcopenia and mortality in patients undergoing hemodialysis. METHODS: In the cross-sectional study (n = 346), univariate and multivariable logistic regression analyses were performed to study the association of mCI with probable sarcopenia. Modified Quantitative Subjective Global Assessment (MQSGA) was used to evaluate the nutritional status. The performance of the mCI value for identifying probable sarcopenia was analyzed using receiver operating characteristic (ROC) curve analysis. The appropriate cutoff points were determined using Youden's method. In the longitudinal cohort study composed of an independent hemodialysis cohort (n = 218), cox proportional regression models were used to evaluate crude and adjusted hazard ratios and 95% confidence intervals (CIs) of death by mCI and MQSGA. RESULTS: Cross-sectional results showed that after adjusting for confounders, the association of mCI with low muscle strength remained significant. The area under the curve (AUC) of the mCI to predict probable sarcopenia was 0.804 (95% CI, 0.744-0.863; p < 0.001) for men and 0.787 (95% CI, 0.711-0.864; p < 0.001) for women. The optimal mCI cutoff values were 21.07 mg/kg/d for men and 19.57 mg/kg/d for women, respectively. Longitudinal results showed that compared with those in the high mCI group, subjects in the low mCI group had a higher risk of death for all causes (adjusted HR, 2.51; 95% CI, 1.16-5.41; p = 0.019). Adding the mCI significantly improved the predictive accuracy for death with an increase in C-index from 0.785 to 0.805 (p = 0.026) and improved the net reclassification index (38.6%, p = 0.021), while adding MQSGA did not. CONCLUSION: The mCI is a predictor of muscle strength and survival in hemodialysis patients, and is preferable to the MQSGA for predicting death. Assessment of mCI could provide additional predictive and prognostic information to sarcopenia.

The predictive value of bioimpedance-derived fluid parameters for cardiovascular events in patients undergoing hemodialysis.

BACKGROUND: It is becoming increasingly evident that the accurate assessment of fluid status is critical to ensure optimal care in patients undergoing hemodialysis (HD). Various fluid parameters, including overhydration (OH) and overhydration/extracellular water (OH/ECW%), which can be obtained using a bioimpedance spectroscopy device have been used to indicate the hydration status in such patients. This study aimed to explore the effect of these fluid parameters on cardiovascular events and determine which parameter was a better predictor of cardiovascular events (CVEs). METHODS: A total of 227 patients who underwent HD at the Hangzhou Hospital of Traditional Chinese Medicine were enrolled in this prospective study between December 2017 and August 2018. Clinical data were collected, and the fluid status of patients was assessed using a body composition monitor. The patients were followed up until December 2020. The primary outcomes were CVEs. The association between fluid parameters and CVEs was analyzed using Cox proportional hazards models. The areas under the curve (AUCs) of receiver operating characteristic analysis and improvement in the global chi-squared value were used to compare the predictive values of fluid parameters for CVEs. RESULTS: During a median follow-up of 31 months, 66 CVEs were recorded. The patients with a higher absolute hydration index (OH) and a relative hydration index (OH/ECW%) exhibited an increased risk of developing CVEs. After adjusting for confounding factors, both OH [hazard ratio (HR) 1.279 per L, 95% confidence interval (CI) 1.047-1.562; p = 0.016] and OH/ECW% (HR 1.061 per %, 95% CI 1.017-1.108; p = 0.006) were independently associated with CVEs. The predictive ability of the absolute hydration index was superior to the relative hydration index based on AUC calculations for CVEs. Furthermore, a greater change in χ2 in predicting CVEs was noted for the absolute hydration index. CONCLUSIONS: Both absolute hydration index and relative hydration index were found to be independent predictors of CVEs in univariate and multivariate analyses. Furthermore, the absolute hydration index had a better additive predictive value than the relative hydration index in predicting CVEs.

Efficacy and safety of a low-sodium diet and spironolactone in patients with stage 1-3a chronic kidney disease: a pilot study.

BACKGROUND: Excessive salt intake is associated with the deterioration of chronic kidney disease (CKD). Aldosterone is also known as an independent risk factor for kidney injury. Dietary sodium intake acts as a main stimulator in aldosterone-mediated kidney injury. Hence, this study aimed to further investigate the renal protective effects and safety of a low-sodium diet in combination with spironolactone (SPL) in stage 1-3a CKD. METHODS: This single-center, SPL-blinded randomized controlled trial recruited patients with stage 1-3a CKD, randomized into three groups, low-sodium (3 g/d salt) + placebo, medium-sodium (5 g/d salt) + SPL, and low-sodium (3 g/d salt) + SPL. Patients received 12 weeks of intervention. The primary and secondary endpoints were 24-h urine protein and estimated glomerular filtration rate (eGFR) at the end of the intervention, respectively. RESULTS: A total of 74 patients were analyzed eventually. Significantly decreased 24-h urine protein was found in all three groups, from 0.37 to 0.23 g/d (P = 0.004) in the low-sodium+placebo group, from 0.44 to 0.29 g/d (P = 0.020) in the medium-sodium+SPL group, and from 0.35 to 0.31 g/d (P = 0.013) in the low-sodium +SPL group. There were no significant differences among the three groups in 24-h urine protein amount change after intervention from pre-treatment values (P = 0.760, ITT set). The results of the 24-h urine protein by using PP set analysis was similar to the ITT set. No significant differences in eGFR, nutritional, metabolic, inflammatory, and other biomarkers were observed across all three groups (P > 0.05). No safety signal was observed. CONCLUSION: No additional benefit was observed when SPL was prescribed to patients already on a low-sodium diet (3.0 g/d). Still, small doses of SPL may benefit patients with poor sodium restriction. A combination of short-term low-dose SPL and ARB is safe for patients with stage 1-3a CKD, but blood potassium must be regularly monitored. TRIAL REGISTRATION: Name of the registry: Chinese clinical trial registry. TRIAL REGISTRATION NUMBER: ChiCTR1900026991. Date of registration: Retrospectively registered 28 October 2019. URL of trial registry record: http://www.chictr.org.cn/searchproj.aspx?title=&officialname=&subjectid=&secondaryid=&applier=&studyleader=ðicalcommitteesanction=&spo.

Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis.

OBJECTIVES: The aim of this study was to analyze the factors influencing sarcopenia in patients on maintenance hemodialysis (MHD) in mainland China and to explore the role of phase angle (PhA) in sarcopenia. METHODS: We enrolled 346 patients on MHD with regular dialysis and collected relevant data. According to the diagnostic criteria of the Asian Sarcopenia Working Group, the patients were placed into one of two groups: sarcopenia and non-sarcopenia. The differences between groups were compared and the statistically significant factors were included in binary logistic regression analysis to screen for independent factors influencing sarcopenia. Receiver operating characteristic curve and area under the curve were used to evaluate the predictive value of PhA in sarcopenia. RESULTS: The prevalence of sarcopenia was 32.66% in patients on MHD. Logistic regression analysis showed that sarcopenia was significantly associated with age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.08-1.15; P < 0.001), body mass index (OR, 0.66; 95% CI, 0.58-0.76; P < 0.001), and PhA (OR, 0.24; 95% CI, 0.15-0.40; P < 0.001). The best cutoff value of PhA on sarcopenia was 4.67° for both sexes, 4.67° and 4.60° for men and women, respectively (P < 0.001). CONCLUSION: The present study showed that PhA was an important influencing factor of sarcopenia adjusted by age and body mass index in Asian patients on MHD. PhA may have an optimistic predictive value to identify sarcopenia in these population, and it is convenient and accessible in clinical practice than the diagnostic criteria of sarcopenia.

Effects of low-dose energy spectrum scanning combined with adaptive statistical iterative reconstruction on the quality of imaging in Budd-Chiari syndrome.

OBJECTIVE: To assess the quality and diagnostic accuracy of monochromatic images combined with adaptive statistical iterative reconstruction (ASIR) performed via spectral computed tomography (CT) in patients with Budd-Chiari syndrome (BCS). METHODS: Sixty-two patients with BCS underwent pectral CT with upper abdominal two-phase contrast-enhanced scanning to generate a 60keV monochromatic energy level combined with ASIR (ranging from 0% -100%) during the portal venous phase (PVP) and the hepatic venous phase (HVP). One-way ANOVA was used to compare vessel-to-liver contrast-to-noise ratio (CNR) for the portal vein (PV), hepatic vein (HV), and inferior vena cava (IVC). Subjective evaluations of the images in the three groups were conducted by image quality assessors and compared via Kruskal-Wallis H test. RESULTS: The CNR values of the PV trunk, HV, IVC, liver parenchyma and pancreas were within ASIR (ranging from 0% - 100%) weight, and the difference were statistically significant (p <0.05). The highest overall image score was distributed at 50% ASIR weight value. Higher CNR values of HV, hepatic parenchyma and pancreas were obtained in the IVC type than in mixed and HV types (respective p values = 0.035, 0.019 and 0.042). Higher CNR values of the IVC were obtained in the HV type than in mixed and IVC types (p = 0.032). The CNR value of the IVC in the mixed type was less than that of the HV type (p = 0.028). The CNR values of the HV and liver parenchyma in mixed type were lower than those of the IVC type (p = 0.016 and 0.038, respectively). The CNR value of pancreas in IVC type was higher than that of the HV type (p = 0.037). The diagnostic value of CNR in patients with the IVC type was higher than that in patients with mixed and HV type, while the diagnostic value of CNR was found to be the lowest for the HV type (p = 0.043). CONCLUSION: A monochromatic energy level of 60 keV with 50% ASIR can significantly improve image quality in cases of BCS.

The Influence of Different Partial Pressure on the Fabrication of InGaO Ultraviolet Photodetectors.

A metal-semiconductor-metal ultraviolet photodetector has been fabricated with a radiofrequency (RF)-sputtered InGaO thin film. Results for the devices fabricated under different oxygen partial pressure are here in discussed. Under low oxygen partial pressure, the devices work in the photoconductive mode because of the large number of subgap states. Therefore, the devices exhibit internal gain. These defects in the films result in slow switching times and lower photo/dark current ratios. A higher flow ratio of oxygen during the sputtering process can effectively restrain the oxygen vacancies in the film. The responsivity of the photodetector fabricated under an oxygen flow ratio of 20% can reach 0.31 A/W. The rise time and decay time can reach 21 s and 27 s, respectively.

Drip-feed bioreactor for the treatment of concentrated wastes with minimal dilution.

Avoiding substrate inhibition is a significant challenge in designing biological treatment systems for concentrated or toxic wastes. Substrate inhibition is commonly avoided by diluting the waste before treatment, however, dilution of a waste before treatment is not always feasible. In the case of radioactive mixed wastes and chemical warfare materiel (CWM), dilution presents regulatory and safety concerns. In this study, we investigated a "drip-feed" reactor configuration as an alternative approach for the biological treatment of concentrated waste streams with minimal dilution and complete containment. In the drip-feed reactor undiluted waste is slowly fed to biomass in a reactor at a rate sufficient to maintain activity, but at a low enough rate so that bacterial degradation maintains the reactor concentration below the toxic threshold. The reactor has no effluent, but rather fills as the undiluted waste is fed to the reactor, which has the advantage of preventing the release of hazardous material into the environment during treatment. Volatile releases are prevented with the use of condensers. The drip-feed bioreactor configuration was tested under aerobic conditions, at 25 degrees C, using a 10% acetonitrile feed solution. The treatment of acetonitrile to less than 0.1 mg l(-1) was achieved with a dilution factor of only 3.4. The acetonitrile degradation reaction was pH sensitive, where the optimal pH range for the biodegradation process was approximately between 6.5 and 7.1 and the biodegradation rate declined precipitously above pH 7.2. The applicability of the drip-feed reactor configuration to the treatment of mixed wastes and CWM is discussed.

Catalytic oxidation of mixed wastes containing high organic content--emission reduction and the effect of steam.

To resolve mixed organic and radioactive waste disposal problems, Lawrence Berkeley National Laboratory (LBNL) initiated a treatability study using the catalytic chemical oxidation (CCO) system to oxidize a mixed-waste stream and to confine tritium as part of LBNL's pollution prevention program. LBNL has also adopted a legal approach by seeking an equivalent waste-treatment determination for the CCO process, and by petitioning the United States Environmental Protection Agency (EPA) to delist F-coded treatment residues. The results of this study demonstrate that (1) the CCO process can treat aqueous wastes containing a broad range of organic chemicals and achieve more than 99.999% destruction efficiency; (2) greater than 99.9% trapping efficiency for tritiated water can be achieved using an emission-reduction system that also confines the vapor of hydrochloric acid or nitric acid to the liquid residue; and (3) neutralized treatment residues can be disposed of as low-level radioactive waste at a permitted facility after EPA has approved LBNL's petitions, or the tritium in the residues can be recycled. The high oxidation efficiency of the CCO process is mainly due to the optimized operating conditions of the CCO process and the combined effect of steam reforming in the oxidation cell and the catalytic oxidation of organic mixtures and CO in the Pt/Al2O3 catalyst bed.