FSLens: A Visual Analytics Approach to Evaluating and Optimizing the Spatial Layout of Fire Stations.

The provision of fire services plays a vital role in ensuring the safety of residents' lives and property. The spatial layout of fire stations is closely linked to the efficiency of fire rescue operations. Traditional approaches have primarily relied on mathematical planning models to generate appropriate layouts by summarizing relevant evaluation criteria. However, this optimization process presents significant challenges due to the extensive decision space, inherent conflicts among criteria, and decision-makers' preferences. To address these challenges, we propose FSLens, an interactive visual analytics system that enables in-depth evaluation and rational optimization of fire station layout. Our approach integrates fire records and correlation features to reveal fire occurrence patterns and influencing factors using spatiotemporal sequence forecasting. We design an interactive visualization method to explore areas within the city that are potentially under-resourced for fire service based on the fire distribution and existing fire station layout. Moreover, we develop a collaborative human-computer multi-criteria decision model that generates multiple candidate solutions for optimizing firefighting resources within these areas. We simulate and compare the impact of different solutions on the original layout through well-designed visualizations, providing decision-makers with the most satisfactory solution. We demonstrate the effectiveness of our approach through one case study with real-world datasets. The feedback from domain experts indicates that our system helps them to better identify and improve potential gaps in the current fire station layout.

Resilience patterns of urban road networks under the worst-case localized disruptions.

Recent events, including COVID-19, extreme floods, and explosion accidents, commonly induced localized closures and disruptions of urban road networks (URNs), resulting in significant impacts on human mobility and socio-economic activities. Existing studies on URN resilience to those events mainly took few cases for empirical studies, limiting our understanding on the URN resilience patterns across different cities. By conducting a large-scale nationwide resilience analysis of URNs in 363 cities in mainland China, this study attempts to uncover the resilience patterns of URNs against the worst-case single (SLDs) and multiple localized disruptions (MLDs). Results show that the distance from the worst-case SLD to the city center would be less than 5 km in 62.3% cities, as opposed to more than 15 km in 14.3% cities. Moreover, the average road network resilience of cities in western China could be 7% and 13% smaller than that of the eastern cities under the worst-case SLDs and MLDs, respectively. This inequality in the worst-case resilience is partly attributable to variations in urban socio-economic, infrastructure-related, and topographic factors. These findings could inspire nationwide pre-disaster mitigation strategies to cope with localized disruptions and help transfer insights for mitigation strategies against disruptive events across cities.

Boundary effects on topological characteristics of urban road networks.

Urban road networks (URNs), as simplified views and important components of cities, have different structures, resulting in varying levels of transport efficiency, accessibility, resilience, and many socio-economic indicators. Thus, topological characteristics of URNs have received great attention in the literature, while existing studies have used various boundaries to extract URNs for analysis. This naturally leads to the question of whether topological patterns concluded using small-size boundaries keep consistent with those uncovered using commonly adopted administrative boundaries or daily travel range-based boundaries. This paper conducts a large-scale empirical analysis to reveal the boundary effects on 22 topological metrics of URNs across 363 cities in mainland China. Statistical results show that boundaries have negligible effects on the average node degree, edge density, orientation entropy of road segments, and the eccentricity for the shortest or fastest routes, while other metrics including the clustering coefficient, proportion of high-level road segments, and average edge length together with route-related metrics such as average angular deviation show significant differences between road networks extracted using different boundaries. In addition, the high-centrality components identified using varied boundaries show significant differences in terms of their locations, with only 21%-28% of high-centrality nodes overlapping between the road networks extracted using administrative and daily travel range-based boundaries. These findings provide useful insights to assist urban planning and better predict the influence of a road network structure on the movement of people and the flow of socio-economic activities, particularly in the context of rapid urbanization and the ever-increasing sprawl of road networks.

The restricted mass transfer inside the anode pore channel affects the electroactive biofilms formation, community composition and the power production in microbial electrochemical systems.

Porous anodes improve system performance in microbial electrochemical systems by increasing the specific surface area for electroactive bacteria. In this study, multilayer anodes with different pore diameters were constructed to assess the impact of pore size and depth on anode performance. This layered structure makes detecting electroactive biofilms more accessible layer by layer, which is the first study to examine electroactive biofilms' molecular biology and electrochemical properties at different depths in pores with varied pore sizes. The millimeter-scale pores inside the bioanode have a limited effect in increasing power. The larger the pore diameter, the higher the maximum power density (Pmax) obtained. The Pmax of anodes with 4 mm pore (1.91 ± 0.15 W m-2) was 1.4 times higher than that of the non-perforated (1.37 ± 0.07 W m-2) and 0.5 mm pore anodes (1.39 ± 0.04 W m-2). Electricigens can colonize into pore channels for at least 10 mm with a pore diameter ≥3 mm and current densities >0.05 A m-2. However, in the pores channel with 0.5 mm diameter, electricigens can only colonize to a depth of 2 mm. The biofilm thickness, electricity output, metabolic activity, and biocommunity changed with pore depth and were restricted by the limited mass transfer. The Geobacter sp. was the dominant species in inter-pore biofilms, with 43.8 %-78.6 % in abundance and decreased in quantity as pore depth increased. The inter-pore biofilms on the outer layer contributed a current density of 0.17 ± 0.003 A m-2, while that of the inner layer was only 0.02 ± 0.01 A m-2. Further studies found that the pore edge mass transfer effect can contribute up to 75 % of the current. The mass transfer process at the pore edge region could be a multidirectional mass transfer rather than a pore channel mass transfer.

Liquid-gas phase transition enables microbial electrolysis and H2-based membrane biofilm hybrid system to degrade organic pollution and achieve effective hydrogenotrophic denitrification of groundwater.

Electron-donor Lacking was the limiting factor for the denitrification of oligotrophic groundwater and hydrogenotrophic denitrification provided an efficient approach without secondary pollution. In this study, a hybrid system with microbial electrolysis cell (MEC) assisted hydrogen-based membrane biofilm reactor (MBfR) was established for advanced groundwater denitrification. The liquid-gas phase transition prevented the potential pollution from organic wastes in MEC to groundwater, while the bubble-free diffusion of MBfR promoted hydrogen utilization efficiency. The negative-pressure extraction from MEC and the positive pressure for gas supply into MBfR increased the hydrogen proportion and current density of MEC, and improved the kinetic constant K of the denitrification reaction in MBfR. With actual groundwater, the MEC-MBfR hybrid system achieved a nitrate reduction of 97.8% with an effluent NO3--N of 2.2 ± 1.0 mg L-1. The hydrogenotrophic denitrifiers of Thauera, Pannonibacter, and Azonexus, dominated the denitrification biofilm on the membrane and elastic filler in MBfR.

Optimization of Processing Technology for Tiebangchui with Zanba Based on CRITIC Combined with Box-Behnken Response Surface Method.

The dried root of Aconitum pendulum Busch., called Tiebangchui (TBC) in Chinese, is one of the most famous Tibetan medicines. It is a widely used herb in northwest China. However, many cases of poisoning have occurred because of TBC's intense toxicity and because its therapeutic and toxic doses are similar. Therefore, finding a safe and effective method to reduce its toxicity is an urgent task. A search through the Tibetan medicine classics shows that the processing method of TBC stir-fried with Zanba was recorded in the "Processing specification of Tibetan medicine of Qinghai Province (2010)". However, the specific processing parameters are not yet clear. Thus, this study aims to optimize and standardize the processing technology of Zanba-stir-fried TBC. First, a single-factor experiment was conducted on four factors: the slice thickness of TBC, amount of Zanba, processing temperature, and time. With monoester and diester alkaloid contents in Zanba-stir-fried TBC as indexes, CRITIC combined with the Box-Behnken response surface method was used to optimize the processing technology of Zanba-stir-fried TBC. The optimized processing conditions of Zanba-stir-fried TBC were a TBC slice thickness of 2 cm, three times more Zanba than TBC, a processing temperature of 125 °C, and 60 min of stir-frying. This study determined the optimized and standard processing conditions for the usage of Zanba-stir-fried TBC, thus providing an experimental basis for the safe clinical use and industrial production of Zanba-stir-fried TBC.

A three-dimensional phenolic-based carbon anode for microbial electrochemical system with customized macroscopic pore structure to promote interior bacteria colonization.

Microbial electrochemical system (MES) is an emerging wastewater treatment technology that compensates the energy demands of containments removal by in situ converting the chemical energy of organic pollutants. As the structure for exoelectrogens and the reaction site of extracellular electron transfer (EET), the anode is essential for MES. The future commercial application of MES requires efficiency and large-scale fabrication available anode. In this study, a 3D anode with millimeter-scale pores (3D-MPA) was successfully constructed by sacrificial template method, with low-cost phenolic resin as carbon precursor and polymethyl methacrylate (PMMA) pellets as template. With customized and ordered pore of 1 mm, the 3D-MPAs allowed the microorganisms to colonize inside, improving anodic space utilization efficiency. Different carbonization temperature in tested range from 700 °C to 1000 °C regulated the micrometer-scale convex structures and surface roughness of 3D-MPAs, causing electrochemical performance changes. The 3D-MPA-900 obtained the largest electroactive surface area (102 ± 4.1 cm2) and smallest ohmic resistance (1.8 ± 0.09 Ω). Equipped with MES, 3D-MPA-900 reached the highest power density and current density (2590 ± 25 mW m-2 and 5.20 ± 0.07 A m-2). Among tested 3D-MPA, the excellent performance of 3D-MPA-900 might be attributed by its convex structures with suitable size and surface coverage. The surface roughness of 3D-MPA-900 enhanced the microorganism adherence, which then promoted EET on anode surface. Generally, phenolic-based 3D-MPA made of sacrificial-template method had controllable porous structure, large-scale fabrication availability, high chemical stability and excellent mechanical property, which could be promising for the commercial application of MES.

High concentration of ammonia sensitizes the response of microbial electrolysis cells to tetracycline.

Microbial electrolysis cell (MEC) is a promising technology for effective energy conversion of wastewater organics to biogas. Yet, in swine wastewater treatment, the complex contaminants including antibiotics may affect MEC performance, while the high ammonia concentration might increase this risk by increasing cell membrane permeability. In this work, the responses of MECs on tetracycline (TC) with low and high ammonia loadings (80 and 1000 mg L-1) were fully investigated. The TC of 0 to 1 mg L-1 slightly improved MEC performance in current production and electrochemical characteristics with low ammonia loading, while TC ≥ 4 mg L-1 started to show negative effects. Generally, the high ammonia loading sensitized MECs to TC concentration, inducing the current and COD removal of MECs to sharply decline with TC ≥ 0.5 mg L-1. The positive effect of high ammonia loading on MEC due to conductivity increase was counteracted with TC ≥ 1 mg L-1. The co-contamination of TC and ammonia significantly decreased the bioactivity and biomass of anode biofilm. Although the high concentration of co-existing TC and ammonia inhibited MEC performance, the reactors still obtained positive energy feedback. The network analyses indicated that the effluent suspension contributed much to antibiotic resistance gene (ARG) transmission, while the microplastics (MPs) in wastewater greatly raised the risks of ARGs spreading. This work systematically examined the synergetic effects of TC and ammonia and the transmission of ARGs in MEC operation, which is conducive to expediting the application of MECs in swine wastewater treatment.

NaCl Micro-Crystal as a Molecular Mold for Enhanced Synthesis of Planar Phenazines and Their Applications on Chemosensing and a Full-Color Fluorescent Material.

NaCl has been successfully used as a template for the synthesis of 2D nanomaterials, but it is seldom used for the construction of flat small organic molecules. Herein, a simple, low-cost, and highly efficient synthesis of phenazines with planar main frames, such as 5-phenyl-5,14-dihydro-5,7,12,14-tetraazapentacene, in the presence of NaCl micro-crystal as a kind of molecular mold is described. The reactants were mixed with NaCl powder and heated to 320 °C for 5 min. Yields >90% were readily achieved after a simple precipitation in water. The effectiveness of NaCl crystal as a mold with HCl was confirmed by comparison with common inorganic salts, SiO2, and γ-Al2O3 with HCl together with combinations including NaNO3 + HNO3, Na2SO4 + H2SO4, NaH2PO4 + H3PO4, and NaH2PO4 + polyphosphoric acid. The mechanism was deduced with the aid of computer simulation, which confirms the stabilization of 5,14-dihydro-5,7,12,14-tetraazapentacene by the NaCl surface. DMSO solution of a product, 1,3-dihydro-imidazo[4,5-b]phenazin-2-one, showed enhanced fluorescence in H2O, and it was used as a fluorescent probe for pH and Hg2+. A full-color material was prepared by mixing precursors of epoxy resin and phenazines, and its fluorescent color could be adjusted by the ratio of phenazines.

Transcriptome Analysis Reveals Candidate Lignin-Related Genes and Transcription Factors during Fruit Development in Pomelo (Citrus maxima).

Juice sac granulation (a physiological disorder) leads to large postharvest losses of pomelo (Citrus maxima). Previous studies have shown that juice sac granulation is closely related to lignin accumulation, while the molecular mechanisms underlying this disorder remain elusive in pomelo. Our results showed that the lignin content in NC (near the core) and FC (far away from the core) juice sacs overall increased from 157 DPA (days post anthesis) to 212 DPA and reached a maximum at 212 DPA. Additionally, the lignin content of NC juice sacs was higher than that of FC juice sacs. In this study, we used transcriptome-based weighted gene co-expression network analysis (WGCNA) to address how lignin formation in NC and FC juice sacs is generated during the development of pomelo. After data assembly and bioinformatic analysis, we found a most correlated module (black module) to the lignin content, then we used the 11 DEGs in this module as hub genes for lignin biosynthesis. Among these DEGs, PAL (phenylalanine ammonia lyase), HCT (hydroxycinnamoyl-CoA shikimate/quinate hydroxycinnamoyl transferase), 4CL2 (4-coumarate: CoA ligase), C4H (cinnamate 4-hydroxylase), C3'H (p-coumarate 3-hydroxylase), and CCoAOMT1 (caffeoyl CoA 3-Omethyltransferase) were the most distinct DEGs in granulated juice sacs. Co-expression analysis revealed that the expression patterns of several transcription factors such as MYB, NAC, OFP6, and bHLH130 are highly correlated with lignin formation. In addition, the expression patterns of the DEGs related to lignin biosynthesis and transcription factors were validated by qRT-PCR, and the results were highly concordant with the RNA-seq results. These results would be beneficial for further studies on the molecular mechanism of lignin accumulation in pomelo juice sacs and would help with citrus breeding.

Effects of ammonia on electrochemical active biofilm in microbial electrolysis cells for synthetic swine wastewater treatment.

When facing wastewater with high organic and ammonia, e. g. swine wastewater, microbial electrolysis cell (MEC) is emerging for energy extraction as hydrogen and methane. However, the effects of highly concentrated ammonia on MEC haven't been fully evaluated. In this study, single-chamber MECs were operated with acetate and sucrose as substrates under various ammonia concentrations. The current generally increased with ammonia loading from 80 to 3000 mg L-1. Yet, the substrate consumption in MECs was inhibited with ammonia concentrations above 1000 mg L-1. As a combined result, the energy recovery efficiency of MECs was stable. The electrochemical activity of anode biofilm reached the peak under 1000 mg L-1 ammonia and was restricted under higher ammonia loadings. Under neutral pH, the NH4+ increases the cell membrane permeability, which benefited the electrochemical activity of exoelectrogens to a proper extent. Nevertheless, the toxic ammonia also accelerated the anode biomass loss and stimulated the extracellular polymeric substance (EPS) secretion. Due to the current increase, the abundance of exoelectrogens generally raised with ammonia loading from 80 to 3000 mg L-1. However, except for anode biomass loss, the carbon and methane metabolism pathways were inhibited in acetate-fed MEC, while the glycolysis acted as the rate-limiting step for substrate degradation in sucrose-fed conditions. This study systematically examined the influences of high ammonia loading on MEC performances, bio-community and anode electrochemical activities, and evaluated practical feasibility and application inch of MECs for the energy recovery and pollutant removal of high concentration organic and ammonia wastewater.

Aconitum pendulum and Aconitum flavum: A narrative review on traditional uses, phytochemistry, bioactivities and processing methods.

ETHNOPHARMACOLOGICAL RELEVANCE: Composed of dried Aconitum pendulum and Aconitum flavum roots, Tiebangchui, is an important Tibetan medicine and has been traditionally and widely used as a remedy for cold and pain for thousands of years because of its extraordinary pharmacological activities. The toxicity and efficacy of Tiebangchui as a typical toxic traditional Tibetan medicine, are interdependent, and thus to make sure its safe use in clinics is also noteworthy. AIM OF THE STUDY: This review aims to document and summarize critical and comprehensive information about traditional uses, phytochemistry, pharmacology, toxicology and processing methods of Tiebangchui. Perspectives for possible future investigations have been discussed. MATERIALS AND METHODS: Relevant information about Tiebangchui (A. pendulum and A. flavum) was collected from internationally recognized electronic scientific databases, such as Web of Science, PubMed, Science Direct, Springer Link, ACS, and CNKI. Then, classic Tibetan medical books, such as Four Medical Tantra, and Jing Zhu Materia Medica, and official drug standards were reviewed. RESULTS: A total of 95 chemical constituents have been isolated and identified from Tiebangchui, and most of them were diterpenoid alkaloids. These phytochemicals showed a wide range of pharmacological properties, such as anti-inflammation, anti-rheumatoid arthritis, analgesic, local anesthetic, anti-cancer and anti-bacterial activities. Hence, Tiebangchui is broadly used in hundreds of preparations to treat fever, arthritis, rheumatic arthralgia, traumatic injury, furuncle and swelling. Cardiotoxicity, neurotoxicity and gastrointestinal toxicity are the main toxic effects caused by the Aconitum alkaloids of Tiebangchui. Various processing methods, including steaming, decocting and sand-frying, and traditional Tibetan medicine processing methods, such as processing with Hezi decoction, Qingke wine and Zanba, are effective in attenuating toxicity while retaining efficacy. CONCLUSIONS: The present review provides primary information of Tiebangchui, particularly for its traditional uses, botanical characteristics, phytochemicals, outstanding bioactivities and processing methods. However, studies that explored the in vivo pharmacokinetics and mechanism of Tiebangchui, as well as its quality markers, qualitative and quantitative analysis are still insufficient. Processing methods that attenuate toxicities, evaluations of efficacy, in vivo processes and biological effects, the mechanisms of processed products should be further explored.

Identification and Functional Analysis of the CgNAC043 Gene Involved in Lignin Synthesis from Citrusgrandis "San Hong".

Overaccumulation of lignin (a physiological disorder known as granulation) often occurs during fruit ripening and postharvest storage in pomelo (Citrus grandis). It causes an unpleasant fruit texture and taste. Previous studies have shown that lignin metabolism is closely associated with the process of juice sacs granulation. At present, the underlying transcriptional regulatory mechanisms remain unclear. In this study, we identified and isolated a candidate NAC transcription factor, CgNAC043, that is involved in the regulation of lignin biosynthesis in Citrus grandis, which has homologs in Arabidopsis and other plants. We used the fruit juice sacs of 'San hong' as the material, the staining for lignin with HCl-phloroglucinol of fruit juice sacs became dark red from the various developmental stages at 172 to 212 days post anthesis (DPA). The RT-qPCR was used to analyze the gene expression of CgNAC043 and its target gene CgMYB46 in fruit sacs, it was found that the expression trend of CgNAC043 was basically same as CgMYB46, which increased gradually and peaked at 212 DPA. The expression level of CgNAC043 in juice sacs obtained away from the core was the lowest, while those near the core and granulated area were highly expressed. The transcriptional activation activity of CgNAC043 and CgMYB46 was analyzed by a yeast two-hybrid system, with only CgNAC043 showing transcriptional activation activity in Y2H Gold yeast. A transformation vector, p1301- CgNAC043, was transformed into the mesocarp of 'San hong' by Agrobacterium-mediated transformation. Results showed that the expression of transcription factors CgMYB58 and CgMYB46 are all upregulated. Further experiments proved that CgNAC043 not only can directly trans-activate the promoter of CgMYB46 but also trans-activate the promoters for the lignin biosynthesis-related genes CgCCoAOMT and CgC3H by dual luciferase assay. We isolated the CgNAC043 gene in pomelo and found CgNAC043 regulates target genes conferring the regulation of juice sacs granulation.

Amplifying anti-flooding electrode to fabricate modular electro-fenton system for degradation of antiviral drug lamivudine in wastewater.

The advanced oxidation based on in-situ hydrogen peroxide production using carbon air cathode is very potential for wastewater treatment. However, catalyst flooding and complex assembly patterns are the bottleneck limiting the air cathode to the long-term and large-scale application. In this work, a novel anti-flooding air-breathing cathode (ABC) was prepared by a simple rolling-spraying method with relatively low price commercial materials. The novel method changed the morphology of gas diffusion layer as well as adjusted the hydrophobicity of air side of the catalyst layer. As a result, water-air distribution management was achieved and TPI disequilibrium was prevented. Compare with traditional ABC, the H2O2 yield and current efficiency (CE) of optimized anti-flooding ABC (ABC0.9) increased by 13.5% (941 ± 10 mg·L-1·h-1 with CE of 84% at 30 mA·cm-2), the material cost and fabrication time decreased by 10.1% (2.32 ¥·dm-2, ~0.36 $·dm-2) and 40%. Amplified ABC coupled with Ti/IrO2 anodes were integrated into a modular electrode used for H2O2generation. When the current density (j) increased from 10 to 30 mA·cm-2, the energy cost increased from 0.19 to 0.43 ¥·mol-1 H2O2 (from 0.03 to 0.07 $·mol-1 H2O2). The modular electrode was utilized in a 2 L pre-pilot scale reactor for antiviral drug lamivudine degradation by electro-Fenton (EF) process. 100% of lamivudine and 78.1% of total organic carbon (TOC) were removed within 60 min at 20 mA·cm-2. The susceptible sites on the lamivudine toward hydroxyl radicals were investigated and transformation products (TP) as well as degradation pathway were studied.

Multimodal Assessments of Altered Sensation after Transoral Endoscopic Thyroidectomy.

BACKGROUND: Transoral endoscopic thyroidectomy, a novel technique, uses oral vestibule as the entry point and leaves no scar on the body surface. However, because the incisions are close to the mental nerve, nerve damage and the associated sensory impairment are concerning. Herein, we evaluated sensory alteration after transoral endoscopic thyroidectomy and determined factors associated with the prolonged sensory alteration. METHODS: Patients who underwent transoral endoscopic thyroidectomy were enrolled. Sensation over the lower lip, chin, and neck was evaluated before and after the surgery. A self-assessment questionnaire, Semmes-Weinstein monofilament test, and two-point discrimination test were used to subjectively and objectively evaluate sensory changes. RESULTS: Fifty-one patients were enrolled; most of them reported altered sensation, with chin (72.5%) being the most common site, followed by lower lip (52.9%), upper neck (33.3%), and lower neck (5.9%) on postoperative day 2. The sensory disturbance resolved within 3 months. Factors associated with prolonged sensory alteration are male sex and old age. Fourteen patients (27.5%) experienced mild drooling from the mouth, which was usually self-limiting in 1 month. Sensory impairments in light touch pressure threshold and two-point discrimination were significant in the chin and neck on postoperative day 2 and at 1 week. The ability to discern two-point was also compromised in the lower lip on postoperative day 2. All these significant changes normalized to preoperative baseline at 1 month. CONCLUSIONS: There was an altered sensation after transoral endoscopic thyroidectomy with the most common and disturbed in the chin. Sensory impairment was usually transient and recovered in 3 months.

Economic affordable carbonized phenolic foam anode with controlled structure for microbial fuel cells.

In microbial fuel cells (MFCs), the anode electrode is a core structure as the catalytic area of exoelectrogens. The anode material for large-scale MFCs needs excellent bioelectrochemical performance and low fabrication costs. Herein, carbonized phenolic foam with controllable porous structures was developed as the bio-capacitor of MFCs. The proportion of sodium dodecylbenzene sulfonate (SDBS), which improved mixing and dissolution between the resin liquid and the foaming agent, was adjusted to form open pores on the foam film and skeletons, which promoted both the capacitance and biocompatibility of the anode. Within SDBS proportion from 0 to 1.2 wt%, the anode SPF-9 (0.9 wt%) obtained the best capacitance (37 ±â€¯0.13 F g-1), electrochemical active surface area (87 ±â€¯0.38 cm2) and hydrophilia (contact angle 79 ±â€¯0.2°). The MFCs with SPF-9 obtained the highest power density of 3980 ±â€¯178 mW m-2, while those of carbon-cloth anodes were 1600 ±â€¯28 mW m-2. The biofilm of SPF-9 also demonstrated higher activity and obtained larger abundance of exoelectrogens (68 ±â€¯0.38%). The increased capacitance and biocompatibility mainly resulted in the good performance of SPF-9. The carbonized phenolic foam anode material was worth considering for the future application of MFCs due to its superior electrochemical performance and large-quantity fabrication capability.

Clinical and molecular characteristics and risk factors for patients acquiring carbapenemase-producing and non-carbapenemase-producing carbapenem-nonsusceptible-Enterobacterales bacteremia.

BACKGROUND/PURPOSE: Carbapenem-nonsusceptible Enterobacterales (CNSE) are a growing global threat. Carbapenemases are often produced by plasmids, which allow rapid transmission. This study aimed to investigate (1) the bacterial type (2) resistant genes (3) antimicrobial susceptibility and (4) risk factors for acquisition of carbapenemase-producing carbapenem-nonsusceptible Enterobacterales (CP-CNSE) and non-carbapenemase-producing carbapenem-nonsusceptible Enterobacterales (non-CP-CNSE) bacteremia. METHODS: There were a total of 113 isolates of Enterobacterales from 2013 to 2018. After excluding nonblood isolates and including only one sample from each patient, 99 isolates were analyzed and the medical charts of these patients were reviewed. Carbapenemase genes, ß-lactamase genes and antimicrobial susceptibility of the isolates were determined. Multilocus sequence typing (MLST) was performed on CP-CNSE isolates. RESULTS: CP-CNSE carried more blaSHV (P = 0.004) and were more resistant to imipenem than non-CP-CNSE (P < 0.001). In the univariate analyses, we found that CP-CNSE bloodstream infection was associated with patient <65 years of age (odds ratio, 3.90; 95% confidence interval [CI], 1.16 to 13.10; P = 0.027), mechanical ventilation at the time of bloodstream infection (BSI) (odds ratio, 3.85; 95% CI, 1.16-12.78; P = 0.028) and exposure to piperacillin/tazobactam (odds ratio, 3.96; 95% CI, 1.09-14.38; P = 0.037). However, on multivariate analyses, no independent predictor for CP-CNSE was identified in this study. CONCLUSION: CP-CNSE carried more blaSHV and were more resistant to imipenem when compared to non-CP-CNSE. No independent predictor for CP-CNSE was identified after multivariate analysis. This is the first study conducted in Taiwan comparing risk factors between CP-CNSE and non-CP-CNSE from both clinical and molecular aspects.

Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy.

Indocyanine green (ICG) angiography, a real-time intraoperative imaging technique, is associated with better parathyroid identification and functional evaluation during open thyroidectomy. However, the benefits of ICG fluorescence imaging application in transoral endoscopic thyroidectomy are not well-documented. Consecutive patients who underwent transoral endoscopic thyroidectomy were retrospectively reviewed. Parathyroid glands were assessed with visual inspection followed by ICG angiography. The fluorescence intensity of all parathyroid glands was recorded. In total, 158 parathyroid glands from 60 patients (41 underwent lobectomy and 19 underwent total thyroidectomy) were eligible for evaluation. A total of 135 parathyroid glands (85.4%) were identified, including nine glands (5.7%) that were solely localized because of ICG angiography. Incidental parathyroidectomy occurred in 12 patients with predominant inferior gland (83.3%) and associated with central neck dissection (66.7%). Among patients receiving total thyroidectomy, patients who retained at least one well-perfused parathyroid gland had higher parathyroid hormone (PTH) level and were less likely to develop hypoparathyroidism on postoperative day one than those without any well-perfused ICG-enhanced parathyroid gland (p = 0.038). In addition, the duration of calcium supplementation to maintain normocalcemia was also shorter. ICG angiography is a feasible adjunct procedure for parathyroid identification and postoperative functional prediction in transoral endoscopic thyroidectomy.

Inhibition of Cancer Cell Adhesion, Migration and Proliferation by a Bispecific Antibody that Targets two Distinct Epitopes on αv Integrins.

Members of the αv family of integrins regulate activation of transforming growth factor beta (TGFß) and are directly involved in pro-tumorigenic phenotypes. Thus, αv integrins may be therapeutic targets for fibrosis and cancer, yet the isolation of selective inhibitors is currently a challenge. We generated synthetic antibodies selective for αv integrins by phage display selections on cell lines that displayed integrin heterodimers. We identified antibodies that targeted two distinct epitopes on cell-surface αv integrins and partially inhibited cell adhesion mediated by interactions between integrins and the latency-associated peptide, part of the pro-form of TGFß. Using the isolated antibody paratope sequences we engineered a bispecific antibody capable of binding to both epitopes simultaneously; this antibody potently and completely inhibited cell adhesion mediated by integrins αvß1, αvß3 and αvß5. In addition, the bispecific antibody inhibited proliferation and migration of lung carcinoma lines, where the highest and lowest potencies observed correlated with integrin-αv cell surface expression levels. Taken together, our results demonstrate that phage display selections with live cells can yield high quality anti-integrin antibodies, which we used as biparatopic building blocks to construct a bispecific antibody that strongly inhibited integrin function and may be a therapeutic candidate for cancer and fibrosis.

Vocal cord granuloma after transoral thyroidectomy using oral endotracheal intubation: two case reports.

BACKGROUND: Transoral thyroidectomy can be performed using nasal or oral intubation. Recently, we encountered two cases of vocal cord granuloma that were suspected to result from intraoperative compression by the oral endotracheal tube. CASES PRESENTATION: Two women underwent transoral endoscopic thyroidectomy with oral endotracheal tubes fixed at the mouth angle. Their initial postoperative recovery was uneventful, but they developed hoarseness 2 months after the surgery. Subsequent strobolaryngoscopy revealed vocal cord granulomas at the side of contact of the endotracheal tube. One patient received medication and voice therapy, and her granuloma shrank significantly one month later. The other patient underwent granuloma resection. Thereafter, the symptoms improved in both the patients. CONCLUSIONS: Oral intubation with tube placement at the mouth angle might result in the formation of vocal cord granulomas. Therefore, we suggest positioning the tube at the midline to avoid excessive irritation on one side of the vocal cord.