Protein disulfide isomerase 1 is required for RodA assembling-based conidial hydrophobicity of Aspergillus fumigatus.

The hydrophobic layer of Aspergillus conidia, composed of RodA, plays a crucial role in conidia transfer and immune evasion. It self-assembles into hydrophobic rodlets through intramolecular disulfide bonds. However, the secretory process of RodA and its regulatory elements remain unknown. Since protein disulfide isomerase (PDI) is essential for the secretion of many disulfide-bonded proteins, we investigated whether PDI is also involved in RodA secretion and assembly. By gene knockout and phenotypic analysis, we found that Pdi1, one of the four PDI-related proteins of Aspergillus fumigatus, determines the hydrophobicity and integrity of the rodlet layer of the conidia. Preservation of the thioredoxin-active domain of Pdi1 was sufficient to maintain conidial hydrophobicity, suggesting that Pdi1 mediates RodA assembly through its disulfide isomerase activity. In the absence of Pdi1, the disulfide mismatch of RodA in conidia may prevent its delivery from the inner to the outer layer of the cell wall for rodlet assembly. This was demonstrated using a strain expressing a key cysteine-mutated RodA. The dormant conidia of the Pdi1-deficient strain (Δpdi) elicited an immune response, suggesting that the defective conidia surface in the absence of Pdi1 exposes internal immunogenic sources. In conclusion, Pdi1 ensures the correct folding of RodA in the inner layer of conidia, facilitating its secretion into the outer layer of the cell wall and allowing self-assembly of the hydrophobic layer. This study has identified a regulatory element for conidia rodlet assembly.IMPORTANCEAspergillus fumigatus is the major cause of invasive aspergillosis, which is mainly transmitted by the inhalation of conidia. The spread of conidia is largely dependent on their hydrophobicity, which is primarily attributed to the self-assembly of the hydrophobic protein RodA on the cell wall. However, the mechanisms underlying RodA secretion and transport to the outermost layer of the cell wall are still unclear. Our study identified a critical role for Pdi1, a fungal protein disulfide isomerase found in regulating RodA secretion and assembly. Inhibition of Pdi1 prevents the formation of correct S-S bonds in the inner RodA, creating a barrier to RodA delivery and resulting in a defective hydrophobic layer. Our findings provided insight into the formation of the conidial hydrophobic layer and suggested potential drug targets to inhibit A. fumigatus infections by limiting conidial dispersal and altering their immune inertia.

Longitudinal Study on Changes of Cancer-Related Fatigue in Elderly Patients with Postoperative Chemotherapy for Non-Small Cell Lung Cancer.

BACKGROUND: Cancer-related fatigue (CRF) stands out as one of the most prevalent subjective adverse reactions experienced by patients following chemotherapy, often resulting in unfavorable symptoms for elderly non-small cell lung cancer (NSCLC) patients during chemotherapy. Hence, the aim of this study was to explore the fluctuations in CRF levels among elderly NSCLC patients undergoing chemotherapy. METHODS: This retrospective study involved 400 elderly patients diagnosed with NSCLC. Standardized guidelines were employed to direct patient care following lung cancer surgery (T0), subsequent to the first (T1), second (T2), third (T3), and fourth (T4) cycles of chemotherapy. At various intervals, all patients underwent assessments utilizing the Piper Fatigue Scale, Karnofsky Performance Status (KPS) Scale, Pittsburgh Sleep Quality Index (PSQI) Scale, and Connor-Davidson Resilience Scale. Additionally, serum levels of IL-6 and TNF-α were quantified using enzyme-linked immunosorbent assay (ELISA). RESULTS: Throughout the treatment regimen, patients exhibited a declining trend in CRF, CD-RISC, and KPS scores (p < 0.05, T0 vs T4), whereas the PSQI score demonstrated a notable increase (p < 0.05, T0 vs T4). Furthermore, ELISA results revealed that as treatment advanced, the average levels of inflammatory markers interleukin 6 (IL-6) and tumor necrosis factor (TNF)-α during the T4 period significantly decreased compared to those at T0 (p < 0.05). CONCLUSION: As the number of chemotherapy treatments for elderly NSCLC patients increased, the severity of CRF and the manifestations of sleep disorders were escalated. Additionally, physical function, psychological resilience, as well as IL-6 and TNF-α levels, exhibited a downward trend.

Identification of ammonium source for groundwater in the piedmont zone with strong runoff of the Hohhot Basin based on nitrogen isotope.

Groundwater with high ammonium concentration (HANC groundwater), mostly caused by anthropogenic pollution, is widely distributed in China, which could also result from natural geological genesis. Groundwater in the piedmont zone with strong runoff in the central Hohhot Basin has featured its excessive ammonium concentration since the 1970s. Currently, chemical factories also serve as potential pollution sources. In this study, based on the nitrogen isotopic technique and combined with hydrochemical methods, the sources of high concentration ammonium in the groundwater was identified. The HANC groundwater is mainly distributed in the alluvial-proluvial fan and the interfan depression in the western and central parts of the study area, and a maximum ammonium concentration of 529.32 mg/L was observed in the groundwater in the mid-fan of the Baishitou Gully (BSTG) alluvial-proluvial fan. Although the BSTG mid-fan is part of the piedmont zone with strong runoff, some of the HANC groundwater in this area still presents the typical hydrochemical characteristics in the discharge area. Moreover, an extremely high concentration of volatile organic compounds was observed in groundwater in the BSTG alluvial-proluvial fan, which indicated significant anthropogenic pollution. Besides, 15N-NH4+ is enriched in groundwater in the BSTG root-fan and the interfan depression, which is consistent with the situation of organic nitrogen and exchangeable ammonium in natural sediments, as well as the natural HANC groundwater in other regions of China. These δ15N-NH4+ values indicate that the ammonium of the groundwater in the BSTG root-fan and the interfan depression is derived from natural sediments. The 15N-NH4+ in groundwater is depleted in the BSTG mid-fan, and the δ15N-NH4+ values are similar with those of the pollution sources from the chemical factories in the mid-fan. Both hydrochemical and nitrogen isotopic characteristics indicate significant pollution in the mid-fan, but the ammonium pollution is limited to the area near the chemical factories.

Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering.

There have been significant advancements in medical techniques in the present epoch, with the emergence of some novel operative substitutes. However, the treatment of tracheal defects still faces tremendous challenges and there is, as yet, no consensus on tracheal and carinal reconstruction. In addition, surgical outcomes vary in different individuals, which results in an ambiguous future for tracheal surgery. Although transplantation was once an effective and promising method, it is limited by a shortage of donors and immune rejection. The development of bioengineering has provided an alternative for the treatment of tracheal defects, but this discipline is full of ethical controversy and hindered by limited cognition in this area. Meanwhile, progression of this technique is blocked by a deficiency in ideal materials. The trachea together with the carina is still the last unpaired organ in thoracic surgery and propososal of a favorable scheme to remove this dilemma is urgently required. In this review, four main tracheal reconstruction methods, especially surgical techniques, are evaluated, and a thorough interpretation conducted.

Sustainability evaluation of microalgae biodiesel production process integrated with nutrient close-loop pathway based on emergy analysis method.

To make comprehensive assessment on sustainability of microalgae biofuel production process integrated with nutrient close-loop pathways, Emergy Analysis methodology was adopted based on case studies: microalgae biodiesel production integrated with Nutrient Recycling Pathway in Case A and microalgae biodiesel production integrated with Protein Production as By-Product Pathway in Case B. Emergy results show that microalgae biodiesel system integrated with Nutrient Recycling Pathway is more sustainable, and factor analysis shows that water source with higher unit emergy value and electricity with lower one are more favorable to improve sustainability performance of the integrated process. Besides, different generations of biofuel are also assessed by Emergy Analysis method, and the third-generation biodiesel shows the most sustainable potentials than the previous.

Life cycle and techno-economic assessment of source-separated wastewater-integrated microalgae biofuel production plant: A nutrient organization approach.

Microalgae cultivating in wastewater enabling nutrient uptake for biomass and biofuel generation is regarded as a promising pathway to increase sustainability of microalgae biofuel production process. A source-separated nutrient organization approach for the process of wastewater-based microalgae biofuel is proposed in this study. Comparative life cycle assessment (LCA) method and Techno-economic analysis (TEA) approach are employed to assess sustainability and economic performance of the proposed nutrient approach. Two scenarios are used to validate our study. Scenario 1 is based on the source-separated nutrient delivery approach with microalgae integrated wastewater in tertiary treatment. Scenario 2 is based on non-separated-point nutrient delivery policy and microalgae integrated with secondary wastewater treatment. The results show that the source-separated nutrient approach is effective for reducing the environmental impacts and increasing commercial potential of microalgae biofuel.

Early enhanced recovery after lung surgery: early ambulation 1 hour after extubation.

BACKGROUND: In this study, we describe our experience regarding the implementation of early enhanced recovery after lung surgery. We achieved early ambulation within 1 hour after extubation mainly by minimally invasive surgery combined with fast-track thoracic anesthesia. METHODS: We retrospectively analyzed the clinical outcomes of early enhanced recovery in 211 patients who underwent lung resection using miniport video-assisted thoracic surgery (VATS) by a multidisciplinary team in a single institution in the period from August 2018 to August 2019. RESULTS: Out of the 211 patients, 178 achieved early ambulation 1 hour after extubation. The mean age of patients in the early ambulation group was 58.6±10.8 years, and 69 men and 109 women were included. The anesthesia time (100.8±26.6 minutes), extubation time (10±2.1 minutes), and operating time (71.1±25.3 minutes) were lower in the early ambulation group (P=0.001, P<0.001, and P=0.002, respectively). Segmentectomy was performed in 48.9% of patients in the early ambulation group. The mean length of postoperative hospital stay was 4.1±3.1 days, and the 30-day morbidity was 13.7% (29/211). Prolonged air leak was the main complication, which accounted for 75.9% (22/29). No reinsertion of chest tubes, no 30-day readmissions, and no reoperations in the postoperative 30-day period occurred in any of the patients. CONCLUSIONS: Early enhanced recovery after lung surgery is feasible and safe, and may facilitate early ambulation and lay the foundation for the implementation of day surgery.

Simulation in disaster nursing education: A scoping review.

OBJECTIVES: Disasters are gradually increasing in type and frequency throughout the globe. Simulation is being used in disaster nursing teaching and training. The aim of this scoping review was to systematically map the extent and application of simulation in disaster nursing education. DESIGN, DATA SOURCES AND METHODS: A scoping review was conducted using the model of Arksey and O'Malley as the methodological framework, extended by Levac. The following databases were systematically searched to identify relevant literature: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO from the launch of the databases to June 14, 2020, with a supplemental search on October 12, 2020. Two researchers independently screened the relevant articles selected and extracted the data. RESULTS: Twenty-four studies were included in the scoping review. The research purpose varied widely. The 24 included studies examined nine disaster simulation scenarios. Eight types of simulation methods were identified, of which simulated patients and a mixed-simulation approach were the main methods. Only two studies used a randomized controlled trial design, and none of the rest studies were set up with control groups. Only 10 studies reported validated questionnaires with reliability tests being used. Debriefing was performed in 19 studies, and in 4 of those studies, the debriefing was structured. The reported outcomes were concentrated in Kirkpatrick's levels 1 (participants' satisfaction with the training experience) and 2 (whether participants actually benefited from the training). CONCLUSION: This review found that simulation was well-recognised in disaster nursing education and training. However, insufficient designs and methods indicated that there was a lack of strong evidence, and high-level research on the application of simulation is needed in the field of disaster care.

Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study.

Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.

The Evaluation of the Distance Learning Combining Webinars and Virtual Simulations for Senior Nursing Students during the COVID-19 Period.

Background: The outbreak of COVID-19 has forced many schools to adopt distance teaching. This study developed a distance learning program that combines webinars and virtual simulations to meet students' learning needs. Methods: A descriptive and quasi-experimental design was used. Thirty-five students participated in this distance learning program. Toward the middle and the end of the webinars, computer-based examinations were conducted to assess students' theoretical knowledge. The Clinical Thinking Ability Scale was administered before and after virtual simulation. Academic Self-efficacy, Student Engagement, and Students' Satisfaction Scales were administered after completing the learning program. Results: The students obtained high scores on the theoretical knowledge examinations and virtual simulation scenarios. The virtual simulation led to an improvement in clinical thinking ability. Students displayed high levels of academic self-efficacy and student engagement and expressed high satisfaction with this program. Moreover, there were significant differences between genders in learning behavior self-efficacy, and learning effectiveness. Conclusion: This distance learning program could meet the learning requirements of senior nursing students, in a flexible manner, in a safe environment during the COVID-19 outbreak.

Nano-Brick Wall Architectures Account for Super Oxygen Barrier PET Film by Quadlayer Assembly of Polyelectrolytes and α-ZrP Nanoplatelets.

Nanobrick wall hybrid coating with super oxygen barrier properties were fabricated on polyethylene terephthalate (PET) film using a quadlayer (QL) assembly of polyelectrolytes and nanoplateles. A quadlayer assembly consists of three repeat units of polyacrylic acid (PAA), poly (dimethyl diallyl ammonium chloride) (PDDA) and layered α-zirconium phosphate (α-ZrP). PDDA with positive charges can assemble alternatively with both α-ZrP and PAA with negative charges to form nanobrick wall architectures on the surface of PET film via the electrostatic interaction. The lamellar structure of α-ZrP platelets and the dense QL assembly coating can greatly reduce the oxygen transmission rate (OTR) of PET film. Compared to pristine PET film, the OTR of PET (QL)19 is reduced from 57 to 0.87 cc/m²/day. Moreover, even with 19 QLs coating, PET (QL)19 composite film is still with an optical transparency higher than 90% and a haze lower than 10%. Therefore, the transparent PET (QL)n composite films with super oxygen barrier properties show great potential application in food packaging and flexible electronic packaging.

Inhibition on hepatitis B virus in vitro of lectin from Musca domestica pupa via the activation of NF-κB.

The present study reported that the secretions of HBsAg and HBeAg in HepG2.2.15 cells were significantly decreased under the treatment of lectin from Musca domestica pupa (MPL). Both the replication of hepatitis B virus (HBV) DNA and HBV cccDNA in cells, and the copies of extracellular HBV DNA were inhibited by MPL. The mRNA expressions of interleukin-2 (IL-2), gamma interferon (INF-γ) and MxA were up-regulated by MPL treatments, but down-regulated when nuclear factor-κB (NF-κB) signal pathway was blocked by pyrrolidine dithiocarbamate (PDTC). Subsequent investigation revealed that nuclear factor-κB inhibitory κB (IκB) in endochylema was inhibited and NF-κB was translocated into the nucleus. These findings indicate that MPL could inhibit HBV replication via the induction of the expression of IL-2, INF-γ and MxA through the activation of NF-κB.