Tumor-associated macrophages trigger MAIT cell dysfunction at the HCC invasive margin.

Mucosal-associated invariant T (MAIT) cells represent an abundant innate-like T cell subtype in the human liver. MAIT cells are assigned crucial roles in regulating immunity and inflammation, yet their role in liver cancer remains elusive. Here, we present a MAIT cell-centered profiling of hepatocellular carcinoma (HCC) using scRNA-seq, flow cytometry, and co-detection by indexing (CODEX) imaging of paired patient samples. These analyses highlight the heterogeneity and dysfunctionality of MAIT cells in HCC and their defective capacity to infiltrate liver tumors. Machine-learning tools were used to dissect the spatial cellular interaction network within the MAIT cell neighborhood. Co-localization in the adjacent liver and interaction between niche-occupying CSF1R+PD-L1+ tumor-associated macrophages (TAMs) and MAIT cells was identified as a key regulatory element of MAIT cell dysfunction. Perturbation of this cell-cell interaction in ex vivo co-culture studies using patient samples and murine models reinvigorated MAIT cell cytotoxicity. These studies suggest that aPD-1/aPD-L1 therapies target MAIT cells in HCC patients.

High-Active Surface of Centimeter-Scale ß-In2S3 for Attomolar-Level Hg2+ Sensing.

Recognition layer materials play a crucial role in the functionality of chemical sensors. Although advancements in two-dimensional (2D) materials have promoted sensor development, the controlled fabrication of large-scale recognition layers with highly active sites remains crucial for enhancing sensor sensitivity, especially for trace detection applications. Herein, we propose a strategy for the controlled preparation of centimeter-scale non-layered ultrathin ß-In2S3 materials with tailored high-active sites to design ultrasensitive Hg2+ sensors. Our results reveal that the highly active sites of non-layered ß-In2S3 materials are pivotal for achieving superior sensing performance. Selective detection of Hg2+ at the 1 aM level is achieved via selective Hg-S bonding. Additionally, we evaluate that this sensor exhibits excellent performance in detecting Hg2+ in the tap water matrix. This work provides a proof-of-concept for utilizing non-layered 2D films in high-performance sensors and highlights their potential for diverse analyte sensing applications.

Coexistence of Ferroelectricity and Ferromagnetism in Atomically Thin Two-Dimensional Cr2S3/WS2 Vertical Heterostructures.

Two-dimensional (2D) heterostructures with ferromagnetism and ferroelectricity provide a promising avenue to miniaturize the device size, increase computational power, and reduce energy consumption. However, the direct synthesis of such eye-catching heterostructures has yet to be realized up to now. Here, we design a two-step chemical vapor deposition strategy to growth of Cr2S3/WS2 vertical heterostructures with atomically sharp and clean interfaces on sapphire. The interlayer charge transfer and periodic moiré superlattice result in the emergence of room-temperature ferroelectricity in atomically thin Cr2S3/WS2 vertical heterostructures. In parallel, long-range ferromagnetic order is discovered in 2D Cr2S3 via the magneto-optical Kerr effect technique with the Curie temperature approaching 170 K. The charge distribution variation induced by the moiré superlattice changes the ferromagnetic coupling strength and enhances the Curie temperature. The coexistence of ferroelectricity and ferromagnetism in 2D Cr2S3/WS2 vertical heterostructures provides a cornerstone for the further design of logic-in-memory devices to build new computing architectures.

Inhibition of STAT3 by S3I-201 suppress peritoneal fibroblast phenotype conversion and alleviate peritoneal fibrosis.

Peritoneal fibrosis is a common pathological response to long-term peritoneal dialysis (PD) and a major cause for PD discontinuation. Understanding the cellular and molecular mechanisms underlying the induction and progression of peritoneal fibrosis is of great interest. In our study, in vitro study revealed that signal transducer and activator of transcription 3 (STAT3) is a key factor in fibroblast activation and extracellular matrix (ECM) synthesis. Furthermore, STAT3 induced by IL-6 trans-signalling pathway mediate the fibroblasts of the peritoneal stroma contributed to peritoneal fibrosis. Inhibition of STAT3 exerts an antifibrotic effect by attenuating fibroblast activation and ECM production with an in vitro co-culture model. Moreover, STAT3 plays an important role in the peritoneal fibrosis in an animal model of peritoneal fibrosis developed in mice. Blocking STAT3 can reduce the peritoneal morphological changes induced by chlorhexidine gluconate. In conclusion, our findings suggested STAT3 signalling played an important role in peritoneal fibrosis. Therefore, blocking STAT3 might become a potential treatment strategy in peritoneal fibrosis.

Methionine gamma lyase fused with S3 domain VGF forms octamers and adheres to tumor cells via binding to EGFR.

Methods for targeting enzymes exhibiting anticancer properties, such as methionine γ-lyase (MGL), have not yet been sufficiently developed. Here, we present the data describing the physico-chemical properties and cytotoxic effect of fusion protein MGL-S3 - MGL from Clostridium sporogenes translationally fused to S3 domain of the viral growth factor of smallpox. MGL-S3 has methioninase activity comparable to native MGL. In solution, MGL-S3 protein primarily forms octamers, whereas native MGL, on the contrary, usually forms tetramers. MGL-S3 binds to the surface of the neuroblastoma SH-SY5Y and epidermoid carcinoma A431 cells and, unlike native MGL, remains there and retains its cytotoxic effect after media removal. In HEK293T cells lacking EGFRs, no adhesion was recorded. Confocal fluorescence microscopy confirms the preferential adhesion of MGL-S3 to tumor cells, while it avoids getting into lysosomes. Both MGL and MGL-S3 arrest cell cycle of SH-SY5Y cells mainly in the G1 phase, while only MGL-S3 retains this ability after washing the cells.

Realizing High Thermoelectric Properties in Bi2S3 Bulk via Band Engineering and Nanorods Compositing.

Bismuth sulfide is a promising thermoelectric material because of its low cost and toxicity; however, its low electrical conductivity limits its thermoelectric properties. In this study, Bi2S3+x wt% HfCl4 (x = 0, 0.25, 0.5, 0.75, and 1.0) bulk samples are fabricated using a combination of melting and spark plasma sintering. The microstructures, electronic structures, and thermoelectric properties of the composites are characterized. The results of electronic structure calculations show that doping with HfCl4 produces an impurity energy level that narrows the bandgap and allows the Fermi energy level to enter the conduction band, leading to a favorable increase in carrier concentration. By regulating the HfCl4 doping concentration, the electrical conductivity of the 0.75 wt% doped sample reaches 253 Scm-1 at 423 K and its maximum ZT value is 0.47 at 673 K. Moreover, the sample is compounded with Bi2S3 nanorods prepared by the hydrothermal method, reducing thermal conductivity by 30% due to the introduction of additional interfaces and pores. This resulted in a final ZT value of 0.61 at 673 K, which is approximately eight times higher than that of pure Bi2S3. This step-by-step optimization approach provides a valuable methodology for enhancing the performance of other thermoelectric material systems.

Precursor Engineering of Solution-Processed Sb2 S3 Solar Cells.

Antimony-based chalcogenides have emerged as promising candidates for next-generation thin film photovoltaics. Particularly, binary Sb2 S3 thin films have exhibited great potential for optoelectronic applications, due to the facile and low-cost fabrication, simple composition, decent charge transport and superior stability. However, most of the reported efficient Sb2 S3 solar cells are realized based on chemical bath deposition and hydrothermal methods, which require large amount of solution and are normally very time-consuming. In this work, Ag ions are introduced within the Sb2 S3 sol-gel precursors, and effectively modulated the crystallization and charge transport properties of Sb2 S3 . The crystallinity of the Sb2 S3 crystal grains are enhanced and the charge carrier mobility is increased, which resulted improved charge collection efficiency and reduced charge recombination losses, reflected by the greatly improved fill factor and open-circuit voltage of the Ag incorporated Sb2 S3 solar cells. The champion devices reached a record high power conversion efficiency of 7.73% (with antireflection coating), which is comparable with the best photovoltaic performance of Sb2 S3 solar cells achieved based on chemical bath deposition and hydrothermal techniques, and pave the great avenue for next-generation solution-processed photovoltaics.

Tuning the D-Band Center of Bi2S3─MoS2 Heterostructure Towards Superior Lithium-Sulfur Batteries.

Lithium-sulfur (Li-S) batteries are one of the most promising energy storage devices due to their environmental friendliness, low cost, and high specific capacity. However, the slow electrochemical kinetics and the "shuttle effect" have seriously hindered their commercialization. Herein, the nanoflower Bi2S3─MoS2 (BMS) heterostructure is synthesized by a two-step hydrothermal method, and then the Bi2S3─MoS2-Polypropylene (BMS-PP) interlayer is constructed. The heterostructure is rich in active sites, in which BMS has strong adsorption to lithium polysulfides (LiPSs) and can effectively anchor LiPSs while catalyzing LiPSs and promote the redox of Li2S at the same time, which can improve the utilization of active substances. More importantly, the d-band center can be tuned by the formation of Bi2S3─MoS2 heterostructure. Thus, Li-S batteries containing the BMS-PP interlayer show excellent rate performance (841.6 mAh g-1 at 5 C) and cycling performance (70.3% capacity retention after 500 cycles at 3 C). This work provides a new route for high-performance lithium-sulfur batteries.

Large-Scale Vertically Interconnected Complementary Field-Effect Transistors Based on Thermal Evaporation.

With the rapid development of integrated circuits, there is an increasing need to boost transistor density. In addition to shrinking the device size to the atomic scale, vertically stacked interlayer interconnection technology is also an effective solution. However, realizing large-scale vertically interconnected complementary field-effect transistors (CFETs) has never been easy. Currently-used semiconductor channel synthesis and doping technologies often suffer from complex fabrication processes, poor vertical integration, low device yield, and inability to large-scale production. Here, a method to prepare large-scale vertically interconnected CFETs based on a thermal evaporation process is reported. Thermally-evaporated etching-free Te and Bi2S3 serve as p-type and n-type semiconductor channels and exhibit FET on-off ratios of 103 and 105, respectively. The vertically interconnected CFET inverter exhibits a clear switching behavior with a voltage gain of 17 at a 4 V supply voltage and a device yield of 100%. Based on the ability of thermal evaporation to prepare large-scale uniform semiconductor channels on arbitrary surfaces, repeated upward manufacturing can realize multi-level interlayer interconnection integrated circuits.

Introducing Bi2S3 Interlayer to Synergistically Modify Mo Back Contact and Regulate Bulk Defects in Kesterite Solar Cells.

A suitable interlayer between the Mo back electrode and kesterite absorber layer has been proven to have a positive effect on limiting the bulk defects of the absorber by the constitute diffusion. Here, a thin Bi2S3 layer is used as the back-interface intermediate layer for the first time, this innovative approach allows for simultaneous modification of the back contact and reduction of bulk defects, resulting in improving the power conversion efficiency of the kesterite device from 9.66% to 11.8%. The evaporated Bi2O3 thin films turn into the Bi2S3 interlayers after sintering the Cu2ZnSnS4 precursor thin films. The Bi2S3 interlayer can inhibit the decomposition reaction of back contact and suppress the formation of the secondary phases. It can also optimize the Fermi level offset and promote the separation of the photoinduced carriers, resulting from its characteristic of high work function. Besides, a small part of the Bi element can diffuse into Cu2ZnSn(S, Se)4 film and induce the crystal growth and restrain Zn-related defects, which is attributed to forming the low melting-point liquid BiSex phase during the high-temperature selenization process. The conclusions highlight the bifunction of the thin Bi2S3 intermediate layer, which can provide a new approach to improve the photoelectric conversion efficiency of kesterite solar cells.

Designing Atomic Interface in Sb2S3/CdS Heterojunction for Efficient Solar Water Splitting.

In the emerging Sb2S3-based solar energy conversion devices, a CdS buffer layer prepared by chemical bath deposition is commonly used to improve the separation of photogenerated electron-hole pairs. However, the cation diffusion at the Sb2S3/CdS interface induces detrimental defects but is often overlooked. Designing a stable interface in the Sb2S3/CdS heterojunction is essential to achieve high solar energy conversion efficiency. As a proof of concept, this study reports that the modification of the Sb2S3/CdS heterojunction with an ultrathin Al2O3 interlayer effectively suppresses the interfacial defects by preventing the diffusion of Cd2+ cations into the Sb2S3 layer. As a result, a water-splitting photocathode based on Ag:Sb2S3/Al2O3/CdS heterojunction achieves a significantly improved half-cell solar-to-hydrogen efficiency of 2.78% in a neutral electrolyte, as compared to 1.66% for the control Ag:Sb2S3/CdS device. This work demonstrates the importance of designing atomic interfaces and may provide a guideline for the fabrication of high-performance stibnite-type semiconductor-based solar energy conversion devices.

Unleashing the Power of Sn2S3 Quantum Dots: Advancing Ultrafast and Ultrastable Sodium/Potassium-Ion Batteries with N, S Co-Doped Carbon Fiber Network.

Tin sulfide (Sn2S3) has been recognized as a potential anode material for sodium-ion batteries (SIBs) and potassium-ion batteries (PIBs) due to its high theoretical capacities. However, the sluggish ion diffusion kinetics, low conductivity, and severe volume changes during cycling have limited its practical application. In this study, Sn2S3 quantum dots (QDs) (≈1.6 nm) homogeneously embedded in an N, S co-doped carbon fiber network (Sn2S3-CFN) are successfully fabricated by sequential freeze-drying, carbonization, and sulfidation strategies. As anode materials, the Sn2S3-CFN delivers high reversible capacities and excellent rate capability (300.0 mAh g-1 at 10 A g-1 and 250.0 mAh g-1 at 20 A g-1 for SIBs; 165.3 mAh g-1 at 5 A g-1 and 100.0 mAh g-1 at 10 A g-1 for PIBs) and superior long-life cycling capability (279.6 mAh g-1 after 10 000 cycles at 5 A g-1 for SIBs; 166.3 mAh g-1 after 5 000 cycles at 2 A g-1 for PIBs). According to experimental analysis and theoretical calculations, the exceptional performance of the Sn2S3-CFN composite can be attributed to the synergistic effect of the conductive carbon fiber network and the Sn2S3 quantum dots, which contribute to the structural stability, reversible electrochemical reactions, and superior electron transportation and ions diffusion.

An aldolase-dependent phloroglucinol degradation pathway in Collinsella sp. zg1085.

Phloroglucinol (1,3,5-trihydroxybenzene) is a key intermediate in the degradation of polyphenols such as flavonoids and hydrolysable tannins and can be used by certain bacteria as a carbon and energy source for growth. The identification of enzymes that participate in the fermentation of phloroglucinol to acetate and butyrate in Clostridia was recently reported. In this study, we present the discovery and characterization of a novel metabolic pathway for phloroglucinol degradation in the bacterium Collinsella sp. zg1085, from marmot respiratory tract. In both the Clostridial and Collinsella pathways, phloroglucinol is first reduced to dihydrophoroglucinol by the NADPH-dependent phloroglucinol reductase (PGR), followed by ring opening to form (S)-3-hydroxy-5-oxohexanoate by a Mn2+-dependent dihydrophloroglucinol cyclohydrolase (DPGC). In the Collinsella pathway, (S)-3-hydroxy-5-oxohexanoate is then cleaved to form malonate semialdehyde and acetone by a newly identified aldolase (HOHA). Finally, a NADP+-dependent malonate-semialdehyde dehydrogenase converts malonate semialdehyde to CO2 and acetyl-CoA, an intermediate in carbon and energy metabolism. Recombinant expression of the Collinsella PGR, DPGC, and HOHA in E. coli enabled the conversion of phloroglucinol into acetone, providing support for the proposed pathway. Experiments with Olsenella profusa, another bacterium containing the gene cluster of interest, show that the PGR, DPGC, HOHA, and MSDH are induced by phloroglucinol. Our findings add to the variety of metabolic pathways for the degradation of phloroglucinol, a widely distributed phenolic compound, in the anaerobic microbiome.IMPORTANCEPhloroglucinol is an important intermediate in the bacterial degradation of polyphenols, a highly abundant class of plant natural products. Recent research has identified key enzymes of the phloroglucinol degradation pathway in butyrate-producing anaerobic bacteria, which involves cleavage of a linear triketide intermediate by a beta ketoacid cleavage enzyme, requiring acetyl-CoA as a co-substrate. This paper reports a variant of the pathway in the lactic acid bacterium Collinsella sp. zg1085, which involves cleavage of the triketide intermediate by a homolog of deoxyribose-5-phosphate aldolase, highlighting the variety of mechanisms for phloroglucinol degradation by different anaerobic bacterial taxa.

CoPS/Co4S3 Heterojunction with Highly Exposed Active Sites and Dual-site Synergy for Effective Hydrogen Evolution Reactions.

Cobalt phosphosulphide (CoPS) has recently been recognized as a potentially effective electrocatalyst for the hydrogen evolution reaction (HER). However, there have been no research on the design of CoPS-based heterojunctions to boost their HER performance. Herein, CoPS/Co4S3 heterojunction was prepared by phosphating treatment based on defect-rich flower-like Co1-xS precursors. The high specific surface area of nanopetals, together with the heterojunction structure with inhomogeneous strain, exposes more active sites in the catalyst. The electronic structure of the catalyst is reconfigured as a result of the interfacial interactions, which promote the catalyst's ability to adsorb hydrogen and conduct electricity. The synergistic effect of the Co and S dual-site further enhance the catalytic activity. The catalyst has overpotentials of 61 and 70 mV to attain a current density of 10 mA cm-2 in acidic and alkaline media, respectively, which renders it competitive with previously reported analogous catalysts. This work proposes an effective technique for constructing transition metal phosphosulfide heterojunctions, as well as the development of an efficient HER electrocatalyst.

S-induced Phase Change Forming In2 O3 /In2 S3 Heterostructure for Photoelectrochemical Glucose Sensor.

In the past several decades, Photoelectrochemical (PEC) sensing still remains a great challenge to design highly-efficient semiconductor photocatalysts via a facile method. It is of much importance to design and synthesize various novel nanostructured sensing materials for further improving the response performance. Herein, we present an In2 O3 /In2 S3 heterostructure obtained by combining microwave assisted hydrothermal method with S-induced phase change, whose energy band and electronic structure could be adjusted by changing the S content. Combining theoretical calculation and spectroscopic techniques, the introduction of sulfur was proved to produce multifunctional interfaces, inducing the change of phase, oxygen vacancies and band gap, which accelerates the separation of photoexcited carriers and reduces their recombination, improving the electronic injection efficiency around the interface of In2 O3 /In2 S3 . As anticipated, an enhanced glucose response performance with a photocurrent of 0.6 mA cm-2 , a linear range of 0.1-1 mM and a detection limit as low as 14.5 µM has been achieved based on the In2 O3 /In2 S3 heterostructure, which is significant superior over its pure In2 O3 and S-doped In2 O3 counterparts. This efficient interfacial strategy may open a new route to manipulate the electrical structure, and energy band structure regulation of sensing material to improve the performance of photoelectrodes for PEC.

Catalytic Oxidation of Methanol to Formaldehyde Catalyzed by Iron Complex with N3S3-type Tripodal Ligand.

A Fe3+ complex with N3S3-type tripod ligand, 1, reacts with O2 in CH3OH to generate formaldehyde, which has been studied structurally, spectroscopically, and electrochemically. Complex 1 crystallizes as an octahedral structure with crystallographic C3 symmetry around the metal, with Fe-N=2.2917(17) Å and Fe-S=2.3574(6) Å. UV-vis spectrum of 1 in CH3OH under Ar shows an intense band at 572 nm (ϵ 4,100 M-1cm-1), which shifts to 590 nm (ϵ 2,860 M-1cm-1) by the addition of O2, and a new peak appeared at 781 nm (ϵ 790 M-1cm-1). Such a spectral change is not observed in CH2Cl2. Cyclic voltammogram (CV) of 1 in CH2Cl2 under Ar gives reversible redox waves assigned to Fe2+/Fe3+ and Fe3+/Fe4+ couples at -1.60 V (ΔE=69 mV) and -0.53 V (ΔE=71 mV) vs Fc/Fc+, respectively. In contrast, in CH3OH, the reversible redox waves, albeit accompanied by a positive shift of the Fe2+/Fe3+ couple, are observed at -1.20 V (ΔE=85 mV) and -0.53 V (ΔE=64 mV) vs Fc/Fc+ under Ar. Interestingly, a catalytic current was observed for the CV of 1 in CH3OH in the presence of CH3ONa under Ar, when the sweep rate was slowed down.

Expression analysis and mapping of Viral-Host Protein interactions of Poxviridae suggests a lead candidate molecule targeting Mpox.

BACKGROUND: Monkeypox (Mpox) is an important human pathogen without etiological treatment. A viral-host interactome study may advance our understanding of molecular pathogenesis and lead to the discovery of suitable therapeutic targets. METHODS: GEO Expression datasets characterizing mRNA profile changes in different host responses to poxviruses were analyzed for shared pathway identification, and then, the Protein-protein interaction (PPI) maps were built. The viral gene expression datasets of Monkeypox virus (MPXV) and Vaccinia virus (VACV) were used to identify the significant viral genes and further investigated for their binding to the library of targeting molecules. RESULTS: Infection with MPXV interferes with various cellular pathways, including interleukin and MAPK signaling. While most host differentially expressed genes (DEGs) are predominantly downregulated upon infection, marked enrichments in histone modifiers and immune-related genes were observed. PPI analysis revealed a set of novel virus-specific protein interactions for the genes in the above functional clusters. The viral DEGs exhibited variable expression patterns in three studied cell types: primary human monocytes, primary human fibroblast, and HeLa, resulting in 118 commonly deregulated proteins. Poxvirus proteins C6R derived protein K7 and K7R of MPXV and VACV were prioritized as targets for potential therapeutic interventions based on their histone-regulating and immunosuppressive properties. In the computational docking and Molecular Dynamics (MD) experiments, these proteins were shown to bind the candidate small molecule S3I-201, which was further prioritized for lead development. RESULTS: MPXV circumvents cellular antiviral defenses by engaging histone modification and immune evasion strategies. C6R-derived protein K7 binding candidate molecule S3I-201 is a priority promising candidate for treating Mpox.

FeOCl/MOF-derived In2S3 photocatalysts with high H2O2 adsorption: Degradation mechanism, H2O2 activation process.

The FeOCl-based photo-Fenton heterojunction catalyst holds great promise for effective water pollution treatment. A novel heterojunction FeOCl/MOF-In2S3 (F/M-I) was fabricated by coating hollow MOF-In2S3 nanoflowers onto the surface of FeOCl. Under the optimal conditions, the maximum photo-Fenton degradation rate constants of FeOCl/MOF-In2S3 for oxytetracycline (OTC) within 20 min is 0.88192 L mg-1·min-1, which are 3.2 and 2.5 times that of pure FeOCl (0.27357 L mg-1·min-1) and MOF-In2S3 (0.35222 L mg-1·min-1). Density functional theory (DFT) results confirm that the electron-rich nature of MOF-In2S3 accelerates the cycle between Fe (III)/Fe (II)of FeOCl, promoting H2O2 adsorption by FeOCl/MOF-In2S3 and generating more hydroxyl radicals (·OH) for pollutant degradation. Based on the results of DFT, combined with the results of the reactive oxidation species scavenger (ROSs), electron paramagnetic resonance (EPR) and Mott-Schottky curves, the separation and transfer behavior of photoexcited charges in FeOCl/MOF-In2S3 heterojunction and the possible photocatalytic degradation mechanism were investigated. Finally, a Z-scheme heterostructure is proposed to elucidate the catalytic mechanism. This study provides a new perspective on designing and synthesizing semiconductor materials for water treatment by photo-Fenton catalysis.

Decision-making on systemic antibiotics in the management of periodontitis: A retrospective comparison of two concepts.

AIM: To retrospectively compare two approaches for the adjunctive use of systemic antibiotics in non-surgical periodontal therapy: one based on the detection of Aggregatibacter actinomycetemcomitans (Aa) and the other on age and severity of periodontitis (Age & PPD). We also assessed the additional benefit of antibiotics in reducing the need for further surgical therapy in each group. MATERIALS AND METHODS: Patients of the Department of Periodontology, Goethe University Frankfurt, Germany, were screened for microbiological testing between 2008 and 2018. Patients were categorized by their microbiological result (Aa+/-) and demographic/clinical data (Age & PPD+/-). Agreement on antibiotic indication was tested. The clinical evaluation focussed on teeth with probing pocket depths (PPDs) ≥ 6 mm. RESULTS: Analysis of 425 patients revealed 30% categorized as Age & PPD+ and 34% as Aa+. Sixty-three percent had consistent antibiotic recommendations (phi coefficient 0.14, p = .004). Patients in the Age & PPD+ group receiving antibiotics showed the most substantial reduction in the number of teeth with PPD ≥ 6 mm after non-surgical periodontal therapy. CONCLUSIONS: Both strategies resulted in a significant clinical improvement compared with those without antibiotic treatment and restricted antibiotic use similarly, but targeted different patient groups. Younger individuals with severe periodontitis benefited most from antibiotics, reducing the need for additional surgeries. The study was registered in an international trial register (German Clinical Trial Register number DRKS00028768, registration date 27 April 2022, https://drks.de/search/en/trial/DRKS00028768).

Early diastolic heart sounds caused by the atrial kick.

An 81-year-old male with a history of coronary artery disease, hypertension, paroxysmal atrial fibrillation and chronic kidney disease presents with asymptomatic bradycardia. Examination was notable for an early diastolic heart sound. 12-lead electrocardiogram revealed sinus bradycardia with a markedly prolonged PR interval and second-degree atrioventricular block, type I Mobitz. We review the differential diagnosis of early diastolic heart sounds and present a case of Wenckebach associated with a variable early diastolic sound on physical exam.