Changes in sputum microbiota during treatment for nontuberculous mycobacterial pulmonary disease.

Limited data exist on longitudinal changes in the sputum bacterial microbiome during treatment in nontuberculous mycobacterial pulmonary disease (NTM-PD) patients. We prospectively collected serial sputum samples from 14 NTM-PD patients during treatment, at the start (n = 14) and at 1 (n = 10), 3 (n = 10), 6 (n = 12), and 12 (n = 7) months. The bacterial microbiome changes were analyzed using 16S rRNA sequences (V3-V4 regions). Subgroup analysis included culture conversion (n = 9) and treatment refractory (n = 5) groups. In all patients, sputum alpha-diversity (ACE, Chao1, and Jackknife) significantly decreased during antibiotic treatment at 1, 3, 6, and 12 months compared to treatment initiation levels. Within the culture conversion group, genus/species-level beta-diversity showed differences at 1, 3, 6, and 12 months compared to treatment initiation (all p < 0.05). However, in the refractory group, there were no differences in beta-diversity at the genus/species levels in the sputum at any time point. In the linear discriminant analysis (LDA) effect sizes (LEfSe) analysis, the culture conversion group exhibited decreasing taxa at various levels (phylum/genus/species), but no significant increase in taxa was observed. LEfSe analysis of the refractory patient group revealed multiple taxa decreased during treatment. However, proportions of Veillonella dispar (LDA = 4.78), Fusobacterium periodonticum (LDA = 4.35), and Pseudomonas aeruginosa (LDA = 2.92) increased as the treatment period progressed in the refractory group. Sputum microbiota diversity decreases during NTM-PD treatment. In the culture conversion group, most taxa decrease, while some increase in the refractory group. These findings suggest that a distinct respiratory microbial community may exist in refractory NTM-PD patients compared to responsive antibiotic-treated patients.

Spontaneous Cultural Conversion Rate of Mycobacterium avium Complex Pulmonary Disease Based on BACES Severity.

BACKGROUND: Only a few clinical factors can aid in predicting spontaneous culture conversion (SCC) in patients with Mycobacterium avium complex-pulmonary disease (MAC-PD). In this study, we aimed to evaluate whether the rate of SCC varies according to the severity of the disease in MAC-PD patients. METHODS: We retrospectively classified 373 MAC-PD patients who had undergone watchful waiting without antibiotics based on the severity assessment using the 'body mass index (BMI), age, cavity, erythrocyte sedimentation rate (ESR), and sex (BACES)' criteria. We evaluated the rate of SCC in MAC-PD patients based on BACES severity and analyzed the relevant factors. Results: Of 373 patients, 153 (41%) achieved SCC without antibiotics during a median follow-up of 48.1 months. There was a trend toward a higher SCC rate in patients with lower BACES severity: 48% (87/183), 37% (58/157), and 24% (8/33) in the mild, moderate, and severe BACES groups, respectively. In addition, a favorable outcome, defined as maintaining SCC or having two consecutive negative sputum cultures until the last follow-up date, was also more common in patients with lower BACES severities of 53% (97/183), 34% (54/157), and 18% (6/33) in the mild, moderate, and severe BACES groups, respectively. In multivariate analysis, moderate BACES (hazard ratio [HR] = 0.63; 95% confidence interval [CI] 0.44-0.91; p = 0.013) and severe BACES (HR 0.37; 95% CI 0.16-0.90; p = 0.028) had a significantly negative impact on favorable outcomes compared to mild BACES. CONCLUSIONS: Lower BACES severity may be associated with SCC in MAC-PD patients.

Clinical Characteristics and Treatment Outcomes of Mycobacterium fortuitum Pulmonary Disease.

We evaluated the clinical characteristics and treatment outcomes of 35 patients diagnosed with Mycobacterium fortuitum-pulmonary disease (M. fortuitum-PD). Prior to treatment, all isolates were sensitive to amikacin and 73% and 90% were sensitive to imipenem and moxifloxacin, respectively. Approximately two-thirds of the patients (24 of 35) remained stable without antibiotic treatment. Of 11 patients requiring antibiotic treatment, the majority (81%, 9 of 11) achieved a microbiological cure with susceptible antibiotics. IMPORTANCE Mycobacterium fortuitum (M. fortuitum) is a rapidly growing mycobacterium that causes M. fortuitum-pulmonary disease (PD). It is common among individuals with preexisting lung conditions. Limited data exist regarding treatment and prognosis. Our study examined patients with M. fortuitum-PD. Two-thirds of them remained stable without antibiotics. Among those requiring treatment, 81% achieved a microbiological cure with suitable antibiotics. In many cases, M. fortuitum-PD follows a stable course without antibiotics, and when necessary, a favorable treatment response can be achieved with the appropriate antibiotics.

Ultrasensitive and Highly Stretchable Multiple-Crosslinked Ionic Hydrogel Sensors with Long-Term Stability.

Flexible hydrogels are receiving significant attention for their application in wearable sensors. However, most hydrogel materials exhibit weak and one-time adhesion, low sensitivity, ice crystallization, water evaporation, and poor self-recovery, thereby limiting their application as sensors. These issues are only partly addressed in previous studies. Herein, a multiple-crosslinked poly(2-(methacryloyloxy)ethyl)dimethyl-(3-sulfopropyl)ammonium hydroxide-co-acrylamide) (P(SBMA-co-AAm)) multifunctional hydrogel is prepared via a one-pot synthesis method to overcome the aforementioned limitations. Specifically, ions, glycerol, and 2-(methacryloyloxy)ethyl)dimethyl-(3-sulfopropyl)ammonium hydroxide are incorporated to reduce the freezing point and improve the moisture retention ability. The proposed hydrogel is superior to existing hydrogels because it exhibits good stretchability (a strain of 2900%), self-healing properties, and transparency through effective energy dissipation in its dynamic crosslinked network. Further, 2-(methacryloyloxy)ethyl)dimethyl-(3-sulfopropyl)ammonium hydroxide as a zwitterion monomer results in an excellent gauge factor of 43.4 at strains of 1300-1600% by improving the ion transportability and achieving a strong adhesion of 20.9 kPa owing to the dipole-dipole moment. The proposed hydrogel is promising for next-generation biomedical applications, such as soft robots, and health monitoring.

Clinical Safety of Expanded Hemodialysis Compared with Hemodialysis Using High-Flux Dialyzer during a Three-Year Cohort.

Expanded hemodialysis (HD) equipped with a medium cut-off (MCO) membrane provides superior removal of larger middle molecules. However, there is still little research on the long-term benefits of expanded HD. Over a three-year period, this observational study evaluated the efficacy and safety profile of expanded HD for inflammatory cytokines, including IL-6. We conducted a prospective cohort study to investigate the inflammatory cytokine changes and a retrospective observational cohort study to investigate long-term clinical efficacy and safety over a three-year period. We categorized the patients according to dialyzer used: MCO and high-flux (HF) dialyzer. The inflammatory cytokines, including IFN-γ, IL-1ß, IL-6, and TNF-α, were measured annually. The concentrations and changes of the four cytokines over time did not differ between the HF group (n = 15) and MCO group (n = 27). In both prospective and retrospective (HF group, n = 38; MCO group, n = 76) cohorts, there were no significant differences in either death, cardiovascular events, infections, or hospitalizations. Furthermore, the temporal changes in laboratory values, including serum albumin and erythropoietin prescriptions, did not differ significantly between the two groups in either the prospective or retrospective cohorts. In conclusion, clinical efficacy and safety outcomes, as well as inflammatory cytokines, did not differ with expanded HD compared with HF dialysis during a three-year treatment course, although the level of inflammatory cytokine was stable.

Black Si Photocathode with a Conformal and Amorphous MoSx Catalytic Layer Grown Using Atomic Layer Deposition for Photoelectrochemical Hydrogen Evolution.

We demonstrated how the photoelectrochemical (PEC) performance was enhanced by conformal deposition of an amorphous molybdenum sulfide (a-MoSx) thin film on a nanostructured surface of black Si using atomic layer deposition (ALD). The a-MoSx is found to predominantly consist of an octahedral structure (S-deficient metallic phase) that exhibits high electrocatalytic activity for the hydrogen evolution reaction with a Tafel slope of 41 mV/dec in an acid electrolyte. The a-MoSx has a smaller work function (4.0 eV) than that of crystalline 2H-MoS2 (4.5 eV), which induces larger energy band bending at the p-Si surface, thereby facilitating interface charge transfer. These features enabled us to achieve an outstanding kinetic overpotential of ∼0.2 V at 10 mA/cm2 and an onset potential of 0.27 V at 1 mA/cm2. Furthermore, the a-MoSx layer provides superior protection against corrosion of the Si surface, enabling long-term PEC operation of more than 50 h while maintaining 87% or more performance. This work highlights the remarkable advantages of the ALD a-MoSx layer and leads to a breakthrough in the architectural design of PEC cells to ensure both high performance and stability.

Psychological distress of patients with end-stage kidney disease undergoing dialysis during the 2019 coronavirus disease pandemic: A cross-sectional study in a University Hospital.

INTRODUCTION: Previous studies have revealed that the COVID-19 pandemic can cause psychological distress such as depression and anxiety. Patients with chronic kidney disease (CKD) might be more vulnerable to psychological distress due to the COVID-19 pandemic. Its impact could be different according to dialysis modality. The aim of this study was to investigate COVID-19-related psychological stress experienced by end-stage kidney disease (ESKD) patients and identify differences in concerns about COVID-19 between hemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: This cross-sectional study included 148 dialysis patients at Soonchunhyang University Cheonan Hospital from August 2020 to September 2020. These patients responded to a questionnaire covering mental health status and COVID-19 related concerns. Symptoms of depression, anxiety, stress, and insomnia were measured using a 9-item Patient Health Questionnaire (PHQ-9), a 7-item Generalized Anxiety Disorder (GAD-7) scale, a 22-item Impact of Event Scale-Revised (IES-R), and a 7-item Insomnia severity Index (ISI), respectively. Outcomes of HD and PD patients were compared by propensity score matching analysis. RESULTS: Dialysis patients reported psychological distress including symptoms of depression, anxiety, stress, and insomnia. HD patients showed higher scores for depression (p = 0.018), anxiety(p = 0.005), stress(p<0.001), and insomnia(p = 0.006) than the PD patients. After propensity score matching, HD was associated with depression(p = 0.0131), anxiety(p = 0.0143), and stress(p = 0.000415). CONCLUSION: Dialysis patients showed psychological distress during the COVID-19 pandemic period, with HD patients having more severe symptoms than PD patients.

Dynamic Photoelectrochemical Device with Open-Circuit Potential Insensitive to Thermodynamic Voltage Loss.

The open-circuit potential ( Voc) represents the maximum thermodynamic potential in a device, and achieving a high Voc is crucial for self-biased photoelectrochemical (PEC) devices that use only solar energy to produce chemical energy. In general, Voc is limited by the photovoltage ( Vph), which is a potential difference generated by light-induced thermodynamic processes at semiconductor photoelectrodes, such as the generation and recombination of charge carriers. Therefore, low light intensity and nanostructured semiconductor materials degrade Vph (and Voc) by inefficient carrier generation and by enhancing recombination loss, respectively. Here, we report that Voc in dynamic PEC devices employing a porous NiO x/Si photocathode is insensitive to thermodynamic losses, which was clarified by varying the carrier generation and recombination rates. The Voc values were observed to be unchanged even under a low light intensity of 0.1 sun, as well as for different morphologies such as nanostructured and polycrystalline Si. These findings shed light on the potential merit of dynamically operated PEC systems.

Dynamic Photoelectrochemical Device Using an Electrolyte-Permeable NiO x/SiO2/Si Photocathode with an Open-Circuit Potential of 0.75 V.

As a thermodynamic driving force obtained from sunlight, the open-circuit potential (OCP) in photoelectrochemical cells is typically limited by the photovoltage ( Vph). In this work, we establish that the OCP can exceed the value of Vph when an electrolyte-permeable NiO x thin film is employed as an electrocatalyst in a Si photocathode. The built-in potential developed at the NiO x/Si junction is adjusted in situ according to the progress of the NiO x hydration for the hydrogen evolution reaction (HER). As a result of decoupling of the OCP from Vph, a high OCP value of 0.75 V (vs reversible hydrogen electrode) is obtained after 1 h operation of HER in an alkaline electrolyte (pH = 14), thus outperforming the highest value (0.64 V) reported to date with conventional Si photoelectrodes. This finding might offer insight into novel photocathode designs such as those based on tandem water-splitting systems.

Hierarchically Designed 3D Holey C2N Aerogels as Bifunctional Oxygen Electrodes for Flexible and Rechargeable Zn-Air Batteries.

The future of electrochemical energy storage spotlights on the designed formation of highly efficient and robust bifunctional oxygen electrocatalysts that facilitate advanced rechargeable metal-air batteries. We introduce a scalable facile strategy for the construction of a hierarchical three-dimensional sulfur-modulated holey C2N aerogels (S-C2NA) as bifunctional catalysts for Zn-air and Li-O2 batteries. The S-C2NA exhibited ultrahigh surface area (∼1943 m2 g-1) and superb electrocatalytic activities with lowest reversible oxygen electrode index ∼0.65 V, outperforms the highly active bifunctional and commercial (Pt/C and RuO2) catalysts. Density functional theory and experimental results reveal that the favorable electronic structure and atomic coordination of holey C-N skeleton enable the reversible oxygen reactions. The resulting Zn-air batteries with liquid electrolytes and the solid-state batteries with S-C2NA air cathodes exhibit superb energy densities (958 and 862 Wh kg-1), low charge-discharge polarizations, excellent reversibility, and ultralong cycling lives (750 and 460 h) than the commercial Pt/C+RuO2 catalysts, respectively. Notably, Li-O2 batteries with S-C2NA demonstrated an outstanding specific capacity of ∼648.7 mA h g-1 and reversible charge-discharge potentials over 200 cycles, illustrating great potential for commercial next-generation rechargeable power sources of flexible electronics.

Planar n-Si/PEDOT:PSS hybrid heterojunction solar cells utilizing functionalized carbon nanoparticles synthesized via simple pyrolysis route.

Herein, we present a facile and simple strategy for in situ synthesis of functionalized carbon nanoparticles (CNPs) via direct pyrolysis of ethylenediaminetetraacetic acid (EDTA) on silicon surface. The CNPs were incorporated in hybrid planar n-Si and poly(3,4-etyhlenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) solar cells to improve device performance. We demonstrate that the CNPs-incorporated devices showed increased electrical conductivity (reduced series resistance) and minority carrier lifetime (better charge carrier collection) than those of the cells without CNPs due to the existence of electrically conductive sp 2-hybridized carbon at the heterojunction interfaces. With an optimal concentration of CNPs, the hybrid solar cells exhibited power conversion efficiency up to 11.95%, with an open-circuit voltage of 614 mV, short-circuit current density of 26.34 mA cm-2, and fill factor of 73.93%. These results indicate that our approach is promising for the development of highly efficient organic-inorganic hybrid solar cells.

Self-assembled air-stable magnesium hydride embedded in 3-D activated carbon for reversible hydrogen storage.

The rational design of stable, inexpensive catalysts with excellent hydrogen dynamics and sorption characteristics under realistic environments for reversible hydrogen storage remains a great challenge. Here, we present a simple and scalable strategy to fabricate a monodispersed, air-stable, magnesium hydride embedded in three-dimensional activated carbon with periodic synchronization of transition metals (MHCH). The high surface area, homogeneous distribution of MgH2 nanoparticles, excellent thermal stability, high energy density, steric confinement by carbon, and robust architecture of the catalyst resulted in a noticeable enhancement of the hydrogen storage performance. The resulting MHCH-5 exhibited outstanding hydrogen storage performance, better than that of most reported Mg-based hydrides, with a high storage density of 6.63 wt% H2, a rapid kinetics loading in <5 min at 180 °C, superior reversibility, and excellent long-term cycling stability over ∼435 h. The significant reduction of the enthalpy and activation energy observed in the MHCH-5 demonstrated enhancement of the kinetics of de-/hydrogenation compared to that of commercial MgH2. The origin of the intrinsic hydrogen thermodynamics was elucidated via solid state 1H NMR. This work presents a readily scaled-up strategy towards the design of realistic catalysts with superior functionality and stability for applications in reversible hydrogen storage, lithium ion batteries, and fuel cells.

Highly active and durable carbon nitride fibers as metal-free bifunctional oxygen electrodes for flexible Zn-air batteries.

The design of flexible, highly energetic, and durable bifunctional oxygen electrocatalysts is indispensable for rechargeable metal-air batteries. Herein we present a simple approach for the development of carbon nitride fibers co-doped with phosphorus and sulfur, grown in situ on carbon cloth (PS-CNFs) as a flexible electrode material, and demonstrate its outstanding bifunctional catalytic activities toward ORR and OER compared to those of precious metal-based Pt/C and IrO2 on account of the dual action of P and S, numerous active sites, high surface area, and enhanced charge transfer. Furthermore, we demonstrate the flexibility, suitability, and durability of PS-CNFs as air electrodes for primary and rechargeable Zn-air batteries. Primary Zn-air batteries using this electrode showed high peak power density (231 mW cm-2), specific capacity (698 mA h g-1; analogous energy density of 785 W h kg-1), open circuit potential (1.49 V), and outstanding durability of more than 240 h of operation followed by mechanical recharging. Significantly, three-electrode rechargeable Zn-air batteries revealed a superior charge-discharge voltage polarization of ∼0.82 V at 20 mA cm-2, exceptional reversibility, and continuous charge-discharge cycling stability during 600 cycles. This work provides a pioneering strategy for designing flexible and stretchable metal-free bifunctional catalysts as gas diffusion layers for future portable and wearable renewable energy conversion and storage devices.