Characterization of a Novel Antimicrobial Peptide Bacipeptin against Foodborne Pathogens.

The increasing emergence of multidrug-resistant pathogens and development of biopreservatives in food industries has increased the demand of novel and safe antimicrobial agents. In this study, a marine bacterial strain Bacillus licheniformis M1 was isolated and exhibited obvious antimicrobial activities against foodborne pathogens, especially against methicillin-resistant Staphylococcus aureus. The antimicrobial agent was purified and identified as a novel antimicrobial peptide, which was designated as bacipeptin, and the corresponding mechanism was further investigated by electron microscopy observation and transcriptomic analysis with biochemical validation. The results showed that bacipeptin could reduce the virulence of methicillin-resistant Staphylococcus aureus and exerted its antimicrobial activity by interfering with histidine metabolism, inducing the accumulation of reactive oxygen species and down-regulating genes related to Na+/H+ antiporter and the cell wall, thus causing damage to the cell wall and membrane. Overall, our study provides a novel natural product against foodborne pathogens and discloses the corresponding action mechanism.

Leaf Spot Disease of Michelia alba caused by Alternaria alternata in China.

The perennial deciduous tree Michelia alba is a widely cultivated street plant in China. In June 2021 and March 2022, M. alba trees with leaf spots were found in the green belt of the approximately 200,000 m2 community (32.62°N, 116.98°E) of Tianjia'an District, Huainan, Anhui, China, where approximately half of the M. alba trees had brown leaf spots surrounded with irregular yellow halos ranging from 2 to 6 mm in diameter (Fig S1A). The leaves of M. alba trees with multiple lesions became blighted. To isolate the potential pathogens causing leaf spot symptoms in M. alba trees, twenty fragments (2 cm2) were excised from the margin of the necrosis on symptomatic leaves, immersed in 1% sodium hypochlorite for 45 s, and then washed three times in sterile water. The fragments were plated and incubated on potato dextrose agar (PDA) at 25 °C and 15 dark green fungal colonies were obtained 5 days later. Single-spore isolates of the fungal colonies plated on potato carrot agar (PCA, Simmons 2007) produced gray, floccose colonies, which reached 71 mm after 7 days at 25 °C were obtained 5 days later (Fig S1C). Optical microscopy analysis showed that single-spore isolates formed sparsely branched chains with pale brown conidiophores on PCA after incubation at 25 °C in darkness for 7 days. The conidia were ellipsoidal, inverted rod, or ovoid, light brown, and 10.0 to 52.5 × 4.5 to 22.7 µm, with zero to four longitudinal or oblique and zero to eight transverse septa (n = 50). Partial conidia are 2.5 to 27.5 × 0.6 to 3.7 µm with cylindrical light brown beaks (n = 50) (Fig S1D, E). The cultural and morphological characteristics of the isolated fungi were consistent with the description of Alternaria alternata (Woudenberg et al. 2015). To further characterize the isolated fungi, the genomic DNA of three representative strains (BYL-1, BYL-2 and BYL-3) were extracted from their mycelia, respectively. ITS region and housekeeping genes GPD, and TEF, were amplified and sequenced using ITS4/ITS5 (White et al. 1990), Gpd1/Gpd2 (Berbee et al. 1999), and EF1-728F/EF1-986R (Carbone and Kohn 1999), primer pairs, respectively. BLAST analysis showed that the isolates BYL-1 (GenBank accession nos. OP325693, OP405008, and OP405009), BYL-2 (GenBank accession nos. PP057859, PP138442, and PP138444), and BYL-3 (GenBank accession nos. PP057860, PP138443, and PP138445) shared 99 to 100% identity with Alternaria alternata (GenBank accession nos. AF347032.1, AY278809.1, KC584693.1), which suggested that all the three isolates belong to A. alternata. The identifications were further confirmed by phylogenetic analysis based on combined DNA sequences data of ITS, GPD, and TEF. As showed in Fig S2, the strains of BYL-1 , BYL-2 and BYL-3 formed a robust clade with A. alternata CBS918.96. Taken together, the morphology and molecular assays suggest that strain BYL-1 is A. alternata. To test pathogenicity, the isolate BYL-1 was cultured on PCA for 7 days to prepare conidial suspensions, and the spore concentration was adjust to a final concentration of 105 spores/ml. The leaves of 3-5-leaf stage of six 5-years-old natural planting M. alba plants were sprayed with conidial suspensions and sterile distilled water, respectively. The petiole of each inoculated leaves of M. alba were secured with sterile wet cotton, and covered with plastic bags to prevent moisture evaporation after incubation. After a 3- to 5- day of inoculation, necrotic lesions appeared on the leaves inoculated with conidial suspensions, whereas no necrotic lesion was observed in the control leaves inoculated with sterile distilled water (Fig S1B). To fulfill the Koch,s postulates, fungi were re-isolated from the margin of necrotic lesions and identified as A. alternata by DNA sequencing the ITS gene. To our knowledge, this is the first report of A. alternata causing leaf spot on M. alba. Because the disease could cause damage to the foliage influencing the greening and ornamental effects of these trees, control measures may need to be implemented during daily management.

Primary adrenal epithelioid sarcoma (proximal type): a case report and literature review.

Primary adrenal epithelioid sarcoma is a rare lesion of the adrenal gland, and only seven cases have been reported in the domestic and international literature to date. We herein report a case involving a 65-year-old man with primary adrenal epithelioid sarcoma. After being admitted to the hospital with an adrenal mass found on physical examination, the patient underwent laparoscopic right adrenalectomy. Postoperative pathological findings indicated an epithelioid sarcoma (proximal type). Primary adrenal epithelioid sarcoma is a rare malignancy. Diagnosis is challenging and relies on histopathology and immunohistochemical staining.

Recurrence complicated with peritoneal dissemination after single-port gasless myomectomy for cellular uterine leiomyoma: A case report and literature review.

RATIONALE: Cellular uterine leiomyomas (CL) represent the prevailing subtype among uterine leiomyomas. In this study, we report a case of recurrent peritoneal disseminated uterine fibroids 2 years after single-port laparoscopic gasless myomectomy. This article endeavors to examine the potential limitations of the aforementioned surgical procedure and outline the distinguishing features of recurrent cases with primary postoperative pathology as CL. Additionally, it aims to provide a summary of previous retrospective studies on CL and propose the existence of immunohistochemical molecules that may serve as predictors for the postoperative recurrence of cellular uterine fibroids. The ultimate objective is to enhance clinicians' comprehension of the disease. PATIENT CONCERNS: Two years ago, the patient underwent a single-port gasless laparoscopic myomectomy for uterine fibroids. Gynecological color Doppler ultrasound conducted 3 months ago revealed recurrence of uterine fibroids, and the patient experienced abdominal distension, mild urinary frequency, and constipation for the past month. DIAGNOSES: After the second surgical procedure, a comprehensive pathological examination and immunohistochemical analysis of both the uterine mass and metastatic lesions revealed that the definitive diagnosis was CLs. INTERVENTIONS: The patient underwent the total hysterectomy, bilateral salpingectomy, pelvic adhesiolysis, omental mass resection, mesenteric mass resection, and pelvic peritoneal mass resection. All specimens were sent for rapid frozen examination and showed to be leiomyomas. OUTCOMES: The patient was discharged from the hospital on the 10th day after the operation. At the date of writing the article, the patient had no recurrence for 1 year and 5 months. LESSONS: The single-port gasless approach did not achieve the desired reduction in fibroid recurrence, as anticipated by the surgeon. The act of pulling the tumor towards the abdominal incision for resection, on the contrary, may serve as an iatrogenic factor contributing to postoperative recurrence of CL into peritoneal dissemination leiomyomatosis. The single-port gasless assisted bag may be a more suitable option for myomectomy. The utmost effort should be made to prevent the potential recurrence of myoma caused by iatrogenic factors.

A Transpiration-Driven Electrokinetic Power Generator with a Salt Pathway for Extended Service Life in Saltwater.

To ensure prolonged functionality of transpiration-driven electrokinetic power generators (TEPGs) in saltwater environments, it is imperative to mitigate salt accumulation. This study presents a salt pathway transpiration-driven electrokinetic power generator (SPTEPG), incorporating MXene, graphene oxide (GO), and carbon nanotubes (CNTs) as active materials, along with cellulose nanofibers (CNF) and poly(vinyl alcohol) (PVA) as aqueous binders and nonwoven fabrics. This unique combination confers exceptional hydrophilicity and enhances the energy generation performance. When tested with deionized water, the SPTEPG achieved a maximum voltage of 0.6 V and a current of 4.2 µA. In simulated seawater conditions, the presence of conductive ions in the solution boosted these values to 0.64 V and 42 µA. The incorporation of the salt pathway mechanism facilitates the return of excess salt deposits to the bulk solution, thus extending the SPTEPG's service life in saltwater environments. This research offers a straightforward yet effective strategy for designing transpiration-driven power generators suitable for saline water applications.

Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening.

BACKGROUND: Early screening and accurate staging of diabetic retinopathy (DR) can reduce blindness risk in type 2 diabetes patients. DR's complex pathogenesis involves many factors, making ophthalmologist screening alone insufficient for prevention and treatment. Often, endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention. AIM: To explore the efficacy of non-mydriatic fundus photography (NMFP)-enhanced telemedicine in assessing DR and its various stages. METHODS: This retrospective study incorporated findings from an analysis of 93 diabetic patients, examining both NMFP-assisted telemedicine and fundus fluorescein angiography (FFA). It focused on assessing the concordance in DR detection between these two methodologies. Additionally, receiver operating characteristic (ROC) curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine, using FFA outcomes as the standard benchmark. RESULTS: In the context of DR diagnosis and staging, the kappa coefficients for NMFP-assisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively, indicating substantial intermethod agreement. Moreover, the NMFP-assisted telemedicine's predictive accuracy for positive FFA outcomes, as denoted by the area under the ROC curve, was remarkably high at 0.955, within a confidence interval of 0.914 to 0.995 and a statistically significant P-value of less than 0.001. This predictive model exhibited a specificity of 100%, a sensitivity of 90.9%, and a Youden index of 0.909. CONCLUSION: NMFP-assisted telemedicine represents a pragmatic, objective, and precise modality for fundus examination, particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients. Its implementation in these scenarios is of paramount significance, enhancing the clinical accuracy in the diagnosis and therapeutic management of DR. This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.

Cross-layer transmission realized by light-emitting memristor for constructing ultra-deep neural network with transfer learning ability.

Deep neural networks have revolutionized several domains, including autonomous driving, cancer detection, and drug design, and are the foundation for massive artificial intelligence models. However, hardware neural network reports still mainly focus on shallow networks (2 to 5 layers). Implementing deep neural networks in hardware is challenging due to the layer-by-layer structure, resulting in long training times, signal interference, and low accuracy due to gradient explosion/vanishing. Here, we utilize negative ultraviolet photoconductive light-emitting memristors with intrinsic parallelism and hardware-software co-design to achieve electrical information's optical cross-layer transmission. We propose a hybrid ultra-deep photoelectric neural network and an ultra-deep super-resolution reconstruction neural network using light-emitting memristors and cross-layer block, expanding the networks to 54 and 135 layers, respectively. Further, two networks enable transfer learning, approaching or surpassing software-designed networks in multi-dataset recognition and high-resolution restoration tasks. These proposed strategies show great potential for high-precision multifunctional hardware neural networks and edge artificial intelligence.

Interfacial Properties of Three-Dimensional-Printed Permanent Formwork with Cast-in-Place Concrete.

The rapid construction of prefabricated components of reinforced-concrete structures using three-dimensional (3D) printing of concrete as a permanent formwork is a promising way to combine 3D printing organically with traditional construction technology. The bonding property of the contact interface between the 3D-printed permanent formwork and internal postcast concrete is crucial for maintaining the overall mechanical performance of the 3D-printed structure. In this study, the roughness of contour formworks was quantified by using 3D scanning. A large-scale formwork was fabricated by using a robotic 3D printer, and four types of cast-in-place concrete were poured into the formwork to form solid components. The interfacial bonding properties between the formwork and cast material were evaluated by splitting tensile tests and antisymmetric four-point bending shear tests. The interfacial microstructure was analyzed by using computed tomography and scanning electron microscopy. The bond performance can mainly be attributed to the mechanical interlock at the interface between the contour formwork and cast aggregated concrete. The self-compacting concrete with the expansion agent contributes the most to the interface bonding.

Shrinkage and Cracking Properties of Cellulose Fiber-Concrete Composites for 3D Printing by Leveraging Internal Curing.

Compared with conventional formwork casting materials, 3D printed concrete (3DPC) is characterized by large amounts of cementitious materials, a low aggregate-binder ratio, and a large water evaporation area, which make the printed materials and structures highly prone to plastic shrinkage and cracking. In this study, cellulose fibers were incorporated into concrete to improve its moisture distribution and increase its early-age strength. The effects of both dry and prewet cellulose fibers on properties of 3DPC were experimentally investigated. To ensure consistency in the amounts of dry fibers used, 0.5-2% dry cellulose fibers and 1-4% prewet cellulose fibers were adopted. The effects of the added cellulose fibers on printability, mechanical strength, shrinkage, and cracking performance of the 3DPC were experimentally studied. Particularly, a constraint method was developed to access the cracking behavior of 3DPC. Favorable shrinkage resistance was achieved, and the 120-day shrinkage decreased by 17.9% and 23.3% by addition of 2% dry fibers and 4% prewet fibers, respectively. Cracking was eliminated with addition of 4% prewet fibers, without influencing the printability and mechanical properties.

Decreased PDLIM1 expression in endothelial cells contributes to the development of intracranial aneurysm.

INTRODUCTION: Intracranial aneurysm (IA) is a common vascular enlargement that occurs in the wall of cerebral vessels and frequently leads to fatal subarachnoid hemorrhage. PDZ and LIM domain protein 1 (PDLIM1) is a cytoskeletal protein that functions as a platform for multiple protein complex formation. However, whether PDLIM is involved in the pathogenesis of IA remains poorly understood. METHODS: Loss-of-function and gain-of-function strategies were employed to determine the in vitro roles of PDLIM1 in vascular endothelial cells (VECs). A rat model of IA was generated to study the role of PDLIM1 in vivo. Gene expression profiling, Western blotting, and dual luciferase reporter assays were performed to uncover the underlying cellular mechanism. Clinical IA samples were used to determine the expression of PDLIM1 and its downstream signaling molecules. RESULTS: PDLIM1 expression was reduced in the endothelial cells of IA and was regulated by Yes-associated protein 1 (YAP1). Genetic silencing of PDLIM1 inhibited the viability, migratory ability, and tube formation ability of VECs. Opposite results were obtained by ectopic expression of PDLIM1. Additionally, PDLIM1 overexpression mitigated IA in vivo. Mechanistic investigations revealed that PDLIM1 promoted the transcriptional activity of ß-catenin and induced the expression of v-myc myelocytomatosis viral oncogene homolog (MYC) and cyclin D1 (CCND1). In clinical settings, reduced expression of PDLIM1 and ß-catenin downstream target genes was observed in human IA samples. CONCLUSION: Our study indicates that YAP1-dependent expression of PDLIM1 can inhibit IA development by modulating the activity of the Wnt/ß-catenin signaling pathway and that PDLIM1 deficiency in VECs may represent a potential marker of aggressive disease.

Efficacy and Safety of Oral Propranolol or Topical Timolol for the Treatment of Superficial Infantile Hemangiomas.

Infantile hemangiomas (IHs) are the most common benign soft tissue tumors of infancy. Oral propranolol has become a first-line treatment option since the unexpected discovery of its surprising efficacy in the treatment of IHs in 2008. However, oral propranolol causes systemic complications, including hypotension, bradycardia, and hypoglycemia. To minimize systemic adverse effects of oral propranolol, timolol maleate, a nonselective ß-blocker similar to propranolol, has been used as a topical agent to treat superficial IHs. The authors evaluated the efficacy and safety of oral propranolol or topical timolol in 60 patients with IHs. Of the 60 patients recruited, 30 patients were treated using orally administrated propranolol and an additional 30 patients received topical timolol. The efficacy rate of the oral propranolol and topical timolol was 96.7% and 93.3%, respectively. There were no significant differences between the two treatment patterns for the efficacy rate. The incidence of systemic adverse effects for patients treated with oral propranolol was significantly higher than that for cases received topically timolol treatment. Topical timolol maleate is effective and well-tolerated in the treatment of IHs. It could be considered as the first-line treatment choice, especially for superficial IHs.

Remediation of crude oil contaminated soil through an integrated biological-chemical-biological strategy.

A plausible approach to remediating petroleum contaminated soil is the integration of chemical and biological treatments. Using appropriate chemical oxidation, the integrated remediation can be effectively achieved to stimulate the biodegradation process, consequently bolstering the overall remediation effect. In this study, an integrated biological-chemical-biological strategy was proposed. Both conventional microbial degradation techniques and a modified Fenton method were employed, and the efficacy of this strategy on crude oil contaminated soil, as well as its impact on pollutant composition, soil environment, and soil microorganism, was assessed. The results showed that this integrated remediation realized an overall 68.3 % removal rate, a performance 1.7 times superior to bioremediation alone and 2.1 times more effective than chemical oxidation alone, elucidating that the biodegradation which had become sluggish was invigorated by the judicious application of chemical oxidation. By optimizing the positioning of chemical treatment, the oxidization was allowed to act predominantly on refractory substances like resins, thus effectively enhancing pollutant biodegradability. Concurrently, this oxidating maneuver contributed to a significant increase in concentrations of dissolvable nutrients while maintaining appropriate soil pH levels, thereby generating favorable growth conditions for microorganism. Moreover, attributed to the proliferation and accumulation of degrading bacteria during the initial bioremediation phase, the microbial growth subsequent to oxidation showed rapid resurgence and the relative abundance of typical petroleum-degrading bacteria, particularly Proteobacteria, was substantially increased, which played a significant role in enhancing overall remediation effect. Our research validated the feasibility of biological-chemical-biological strategy and elucidated its correlating mechanisms, presenting a salient reference for the further studies concerning the integrated remediation of petroleum contaminated soil.

The peripheral immune cell counts and mouth ulcers: A two-sample Mendelian randomization study.

Objective: This study explored the causal association of peripheral immune cell counts with mouth ulcers (MUs) by two-sample Mendelian Randomization. Design: The counts of 12 circulating immune cell types (leukocytes, lymphocytes, monocytes, eosinophils, neutrophils, basophils, CD4+ cells, CD8+ cells, unswitched memory B cells, NK cells, B cells and a derived ratio (CD4+/CD8+)) were determined as the exposure. MUs were the outcome. The analysis was conducted mostly using the inverse-variance weighted (IVW) approach. MR Egger, weighted median, weighted mode and simple mode were used to detect the horizontal pleiotropy. Results: The IVW results for leukocytes and lymphocyte counts were OR = 0.93, 95 % CI = 0.88-0.98, p = 0.0115 and OR = 0.91, 95 % CI: 0.84-0.98, p = 0.0150, respectively. The Wald ratio result for CD4+ cell and CD8+ cell counts were OR = 0.70, 95 % CI: 0.65-0.75, p = 1.05 × 10-20 and OR = 1.25, 95 % CI: 1.19-1.31, p = 9.99 × 10-21, respectively. Conclusions: This study supports a causal effect of peripheral immune cell counts on MUs. Higher leukocyte, lymphocyte and CD4+ cell counts can protect against MUs, but higher CD8+ cell counts enhance the risk of MUs. This finding confirms host immune factors play a crucial role in the aetiology of MUs.

Charge transfer in superbase n-type doping of PCBM induced by deprotonation.

N-type electronic doping of organic semiconductors (OSCs) by using superbase compounds shows high doping efficiency (H. Wei, Z. Cheng, T. Wu, Y. Liu, J. Guo, P.-A. Chen, J. Xia, H. Xie, X. Qiu, T. Liu, B. Zhang, J. Hui, Z. Zeng, Y. Bai and Y. Hu, Adv. Mater. 2023, 35, 2300084). While a deprotonation reaction is believed to trigger the doping process, the detailed mechanism therein is not yet fully understood. In the present work we theoretically study the electronic structure of the deprotonated Phenyl-C61-butyric acid methyl ester (PCBM) molecule, as well as the charge transfer (CT) between PCBM and its deprotonated species. We find that deprotonated PCBM without formation of a new bond between the deprotonated side chain and fullerene induces electronic structure with broken spin symmetry, where an in-gap state is singly occupied by an unpaired electron. A second scenario that we find to be possible is the formation of a new bond between the deprotonated side chain and a fullerene. This leads to a spin symmetric electronic structure with partially localized in-gap state, which is expected to contribute less to the effective doping. These results show that the deprotonated PCBM species without new bond formation predominantly accounts for the effective n-type doping of PCBM, an insight that will be useful for optimization of this recently discovered doping method.

Active Diluent-Anion Synergy Strategy Regulating Nonflammable Electrolytes for High-Efficiency Li Metal Batteries.

High-energy Li metal batteries (LMBs) consisting of Li metal anodes and high-voltage cathodes are promising candidates of the next generation energy-storage systems owing to their ultrahigh energy density. However, it is still challenging to develop high-voltage nonflammable electrolytes with superior anode and cathode compatibility for LMBs. Here, we propose an active diluent-anion synergy strategy to achieve outstanding compatibility with Li metal anodes and high-voltage cathodes by using 1,2-difluorobenzene (DFB) with high activity for yielding LiF as an active diluent to regulate nonflammable dimethylacetamide (DMAC)-based localized high concentration electrolyte (LHCE-DFB). DFB and bis(fluorosulfonyl)imide (FSI- ) anion cooperate to construct robust LiF-rich solid electrolyte interphase (SEI) and cathode electrolyte interphase (CEI), which effectively stabilize DMAC from intrinsic reactions with Li metal anode and enhance the interfacial stability of the Li metal anodes and LiNi0.8 Co0.1 Mn0.1 O2 (NCM811) cathodes. LHCE-DFB enables ultrahigh Coulombic efficiency (98.7 %), dendrite-free, extremely stable and long-term cycling of Li metal anodes in Li || Cu cells and Li || Li cells. The fabricated NCM811 || Li cells with LHCE-DFB display remarkably enhanced long-term cycling stability and excellent rate capability. This work provides a promising active diluent-anion synergy strategy for designing high-voltage electrolytes for high-energy batteries.

Toward grouped-reservoir computing: organic neuromorphic vertical transistor with distributed reservoir states for efficient recognition and prediction.

Reservoir computing has attracted considerable attention due to its low training cost. However, existing neuromorphic hardware, focusing mainly on shallow-reservoir computing, faces challenges in providing adequate spatial and temporal scales characteristic for effective computing. Here, we report an ultra-short channel organic neuromorphic vertical transistor with distributed reservoir states. The carrier dynamics used to map signals are enriched by coupled multivariate physics mechanisms, while the vertical architecture employed greatly increases the feedback intensity of the device. Consequently, the device as a reservoir, effectively mapping sequential signals into distributed reservoir state space with 1152 reservoir states, and the range ratio of temporal and spatial characteristics can simultaneously reach 2640 and 650, respectively. The grouped-reservoir computing based on the device can simultaneously adapt to different spatiotemporal task, achieving recognition accuracy over 94% and prediction correlation over 95%. This work proposes a new strategy for developing high-performance reservoir computing networks.

Unlocking the Potential of Tin-Based Perovskites: Properties, Progress, and Applications in New-Era Electronics.

Electronics have greatly promoted the development of modern society and the exploration of new semiconducting materials with low cost and high mobility continues to attract interest in the advance of next-generation electronic devices. Among emerging semiconductors, the metal-halide perovskite, especially the nontoxic tin (Sn)-based candidates, has recently made breakthroughs in the field of diverse electronic devices due to its excellent charge transport properties and cost-effective large-area deposition capability at low temperatures. To enable a more comprehensive understanding of this emerging research field and promote the development of new-generation perovskite electronics, this review aims to provide an in-depth understanding with the discussion of unique physical properties of Sn-based perovskites and the summarization of recent research progress of Sn-based perovskite field-effect transistors (FETs) and diverse electronic devices. The unique character of negligible ion migration is also discussed, which is fundamentally different from the lead-based counterparts and provides a great prerequisite for device application. The following section highlights the potential broad applications of Sn-perovskite FETs as a competitive and feasible technology. Finally, an outlook and remaining challenges are given to advance the progression of Sn-based perovskite FETs, especially on the origin and solution of stability problems toward high-performance Sn-based perovskite electronics.

Recency of Cannabis Vaping in Sexual Minorities in Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study.

BACKGROUND: Cannabis vaping is increasing in the United States. Among populations at-risk are sexual minorities (SM) who are more likely to vape cannabis compared to their heterosexual counterparts. Cannabis vaping has been associated with negative health outcomes and concomitant use of other substances with increased risk with more recent use. OBJECTIVES: This study examined the association between SM identification and recency of cannabis vaping (the last occasion that a participant used their vape device with cannabis) and number of puffs (the count of puffs that the participant took during their most recent use of their vape device with cannabis) using Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study. RESULTS: In a weighted sample of participants who reported ever vaping cannabis (N = 5,331), 15% identified as SM, about 60% vaped cannabis in the past 3 or more days, and the mean number of puffs was 2 (SE = 0.17). Using multinomial logistic regression and zero-inflated negative binomial regression, the results showed that compared to heterosexual adults who reported not recently vaping cannabis, SM had higher probabilities of vaping cannabis in the past 3 or more days, 1-2 days, and the day of interview. CONCLUSION: SM individuals were more likely to recently vape cannabis, placing them at higher risk for respiratory diseases and use of other substances. Public health researchers and practitioners need to identify reasons for cannabis vaping in this population and implement targeted public health messaging to inform SM communities of the potential health effects of cannabis vaping.

Barriers to Health Information Exchange Among Ambulatory Physicians: Results From a Nationally Representative Sample.

PURPOSE: Health information exchange (HIE) improves healthcare quality, but is underutilized by providers. This study used a nationally representative survey of ambulatory physicians to examine barriers to HIE, and identify which barriers have the greatest impact on providers' use of HIE. METHODS: A pooled sample of 1,292 physicians from the 2018-2019 National Electronic Health Record Survey was used. Univariate statistics described rates and patterns of eight common barriers to HIE. Multivariate logistic regression examined the relationship between each barrier and the use of HIE. RESULTS: Barriers to HIE were common and diverse. Negative attitudes toward HIE's ability to improve clinical quality significantly decreased HIE use (OR = .44, p < .01). CONCLUSIONS: To increase adoption of HIE, efforts should focus on addressing providers' negative attitudes toward HIE. These findings can guide targeted implementation strategies to improve HIE adoption.

Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study.

We aimed to investigate the diagnostic value of urinary Tamm-Horsfall protein (THP) and 24 h urine osmolality for recurrent calcium oxalate (CaOx) stones. Clinical data of 120 patients with upper urinary tract stones admitted to our hospital between January 2020 and January 2022 were retrospectively reviewed. Patients were divided into recurrence (53 patients) and non-recurrence (67 patients) groups based on postoperative stone recurrence. Meanwhile, 50 healthy patients were selected as the control group. Urinary THP levels, 24 h urine osmolality, and biochemical indices were compared between the three groups; their diagnostic values for stone recurrence were evaluated using receiver operating characteristic (ROC) curves. Urinary THP, 24 h urine osmolality, and biochemical indices were significantly higher in the recurrence group than in the non-recurrence and control groups (P < 0.05). The 24 h urine osmolality was positively correlated with urinary oxalic acid and calcium excretion. ROC curve analysis showed that optimal cutoff values of urinary THP and 24 h urine osmolality for the diagnosis of stone development were ≥27.01 mg/L and ≥577.69 mOsm/(kg H2O), respectively. Furthermore, these indices combined significantly improved the accuracy of diagnosis. Urinary THP and 24 h urine osmolality were higher in patients with recurrent CaOx stones. Detection of both parameters combined can accurately diagnose stone recurrence.