Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive procedures.AIM To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart transplantation.METHODS This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation center.Data was collected regarding MDROs commonly encountered in critical care.RESULTS Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was noted.MDRO acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors

BACKGROUND Intensive care unit(ICU)patients are critically ill and have low immunity.They will undergo various trauma medical procedures during diagnosis and treatment.The use of high-dose hormones and broad-spectrum antibiotics will increase the incidence of nosocomial infection in ICU patients.Therefore,it is necessary to explore the causes of nosocomial infection in ICU and provide basis for the prevention and control of nosocomial infection in ICU.AIM To explore major pathogens of nosocomial infection in ICUs,methods of detection and drug resistance trends.METHODS Risk factors of multidrug-resistant infection were analyzed to provide a basis for clinical rational use of antimicrobial drugs in the ICU.These findings were used to standardize rational use of antimicrobial agents.BD PhoenixTM100 automatic bacterial identification analyzer was used to for cell identification in specimens collected from the ICU between January 2016 and December 2019.Drug sensitivity tests were carried out and drug resistance trends were analyzed using the optical disc diffusion method.Odds ratios and corresponding 95%CI of independent variables were calculated using a logistic regression model.Backward elimination(trend=0.1)was used as an inclusion criterion for multivariate analysis.All data were analyzed using SPSS version 22.0,and P<0.05 was considered statistically significant.RESULTS We collected 2070 samples from ICU patients between January 2016 and December 2019.Sample types comprised sputum(1139 strains,55.02%),blood(521 strains,25.17%),and drainage fluid(117 strains,5.65%).A total of 1051 strains of major pathogens,including Acinetobacter baumannii,Escherichia coli(E.coli),Pseudomonas aeruginosa(P.aeruginosa),Klebsiella pneumoniae(K.pneumoniae)and Staphylococcus aureus,were detected,with a detection rate of 35.97%(378/1051).Most of these strains were resistant to antibiotics.Detection rate of E.coli was 21.79%(229/1051),and it was generally sensitive to many antimicrobial drugs.Detection rate of P.aeruginosa was 24.74%(260/1051),and showed low sensitivity to most antibiotics.Detection rate of K.pneumoniae was 9.42%(99/1051),which was generally resistant to multiple antimicrobial drugs and resistant forms.K.pneumoniae was resistant to imipenem for approximate 4 years,and showed a 19.9%(19/99)and 20.20%(20/99)rate of meropenem resistance.Logistic analysis showed that mechanical ventilation and ureteral intubation were risk factors for multidrug-resistant bacterial infections.CONCLUSION This study showed a high incidence of ICU infections.Mechanical ventilation and urine tube intubation were risk factors for infection with multidrug-resistant bacteria.

Risk factors for infection with multidrug-resistant organisms in diabetic foot ulcer patients:A systematic review and meta-analysis

Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by searching the Web of Science,Embase library,PubMed,Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria,and meta-analysis was performed using revman5.3 analysis software.Results:13 literature was retrieved,involving in 1715 patients.A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95%CI[1.51,4.52],P=0.0006),Previous antibiotic use(OR=2.17,95%CI[1.24-3.78],P<0.01),Type of diabetes(OR=2.44,95%CI[1.29-4.63],P<0.01),Nature of ulcer(OR=2.16,95%CI[1.06-4.40],P=0.03),Size of ulcer(OR=2.56,95%CI[1.53-4.28],P<0.01),Osteomyelitis(OR=3.50,95%CI[2.37-5.17],P<0.01),Peripheral vascular disease(OR=2.37,95%CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95%CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients.Conclusions:The risk factors of MDROs infection in patients with DFU were previous hospitalization,previous antibiotic use,type of diabetes,nature of ulcer,size of ulcer,osteomyelitis,peripheral vascular disease,and surgical treatment.This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.

Multidrug-Resistant of Escherichia coli and Salmonella spp. Strains in Chicken Feces Intended for Consumption in Open Spaces of Ouagadougou, Burkina Faso

Resistant bacteria can be transmitted to humans through feces or contaminated meat from local chickens. Bacterial strains were isolated from the intestinal contents of 400 local chicken samples from various sales sites. These strains were then characterized using bacteriological and biochemical methods to identify resistant strains. In a study conducted in Ouagadougou, we systematically collected chicken fecal samples from 20 locations across the city, followed by isolation and identification of Salmonella spp. using specific enrichment and culture methods, as well as Escherichia coli. Bacterial strains were characterized using antibiotic resistance profiles were determined through agar diffusion tests, revealing sensitivity or resistance to a range of antibiotics based on established scientific criteria. The results showed that out of the 400 samples collected, 81.25% and 63.5% were contaminated by Escherichia coli and Salmonella spp., respectively. Among these, 86.15% of identified Escherichia coli and 50.78% of Salmonella spp. displayed resistance to at least one tested antibiotic. Among 280 Escherichia coli isolates identified resistant to at least one antibiotic, 31.07% were resistant to cefotaxime (CTX), 20.35% to ceftazidime (CAZ), 21.07% to ceftriaxone (CTR), 75% to amoxicillin clavulanic acid (AMC), 23.57% aztreoname (ATM) and 27.14% were resistant to imipenem (IMP). In the case of the 129 Salmonella spp. isolates resistant to at least one tested antibiotic, 34.88% were resistant to CTX;41.08% to CAZ;35.65% to CTR, 92% to AMC, 39.53% to ATM and finally 47.28% were resistant to IMP. Our study revealed high prevalence of resistance in bacterial strains isolated from local chickens sold outdoors in Ouagadougou. These findings raise significant public health concerns, due to the possible transmission of these resistant strains to humans through the consumption of contaminated meat, thus complicating the treatment of bacterial infections.

Screening of Polyphosphate Accumulating Organisms and Their Phosphorus Removal Performance

[Objectives]To study the phosphorus removal performance of phosphate accumulating organisms(PAOs).[Methods]Activated sludge from domestic sewage treatment plant was used as the strain source,and phosphate accumulating organisms were screened by plate streaking method and dilution coating plate method.Six kinds of excellent phosphate accumulating organisms were obtained by metachromatic granule staining experiment,total phosphorus experiment and simulated sewage phosphorus removal experiment to assist the observation of bac-terial morphology and experiment of phosphorus removal capacity.In addition,the influencing factors of phosphorus removal capacity(nitrogen source,trace metal ions)were analyzed.[Results]In the case of simulated sewage,the phosphorus removal rate of strain b was the highest,reaching 66.25%,while the phosphorus removal rate of strain e and f was about 10%lower than that of the phosphorus uptake experiment.[Conclusions]This study is expected to provide a theoretical reference for the gradual optimization of the screening method of phosphorus re-moval bacteria in domestic sewage treatment.

Clinical Efficacy and Safety Analysis of Tigecycline in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Combined with Multidrug-Resistant Acinetobacter baumannii Infection

Objective:To study the clinical efficacy and safety of tigecycline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)combined with multidrug-resistant Acinetobacter baumannii infection.Methods:113 patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection were recruited between January 2021 and January 2023,and given tigecycline treatment.The total effective rate,lung function indexes,related biochemical index levels,and the incidence rate of adverse reactions were observed after the treatment.Results:After the treatment,100 patients were cured,1 case with apparent effect,2 cases were effective,10 cases were ineffective,and the total effective rate was 91.15%.The post-treatment CRP(21.22±3.35 mg/L),PCT(3.18±1.11 ng/L),CRE(76.36±9.24μmol/L),and ALT(37.76±6.99 U/L)were significantly improved as compared to the pre-treatment(P<0.05).After treatment,10 cases of vomiting(8.85%),13 cases of nausea(11.50%),4 cases of diarrhea(3.53%),1 case of abdominal pain(0.88%),and 2 cases of allergy(1.77%)were observed in 113 patients.Conclusion:Tigecycline therapy for patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection not only has significant therapeutic efficacy but also has a high degree of safety.

Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China

Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adults with multidrug-resistant tuberculosis(MDR-TB)in China.Methods A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years.The model parameter data were synthesized from the literature,the national TB surveillance information system,and consultation with experts.The incremental cost-effectiveness ratio(ICER)of BR vs.CR was determined.Results BR(vs.CR)had a higher sputum culture conversion rate and cure rate and prevented many premature deaths(decreased by 12.8%),thereby obtaining more quality-adjusted life years(QALYs)(increased by 2.31 years).The per capita cost in BR was as high as 138,000 yuan,roughly double that of CR.The ICER for BR was 33,700 yuan/QALY,which was lower than China's 1×per capita Gross Domestic Product(GDP)in 2020(72,400 yuan).Conclusion BR is shown to be cost effective.When the unit price of Bedaquiline reaches or falls below57.21 yuan per unit,BR is expected to be the dominant strategy in China over CR.

Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline

Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health problem in developing countries such as the Democratic Republic of Congo (DRC), which continues to face the emergence of MDR-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recommended the introduction of the bedaquiline regimen. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to compare the AG-based regimen and the bedaquiline-based regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB patients, performed in Kinshasa (DRC) during the period from January 2020 to January 2021. Sociodemographic, clinical, biological and audiometric data were analyzed using Stata 17. Repeated-measures analysis of variance was used to compare changes in the degree of hearing loss over time between the two groups of patients on AG and bedaquiline regimens. The double-difference method was estimated using regression with fixed-effects. A p value < 0.05 was considered the threshold for statistical significance. Results: The degree of hearing loss was similar between the two groups at the first month [AGs (28 dB) vs BDQ (30 dB);p = 0.298]. At six months, the mean degree of hearing loss was significantly greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB);p < 0.001]. The double difference was significant, with a greater increase in hearing loss in the AGs group (diff-in-diff 18.3;p < 0.001). After adjustment for age and serum albumin, the group receiving the AG-based regimen had a 2-point greater worsening than those with bedaquiline at the sixth month (diff-in-diff 19.8;p Conclusion: Hearing loss is frequent with both treatment regimens, but more marked with the Aminoglycoside-based regimen. Thus, bedaquiline should also benefit for audiometric monitoring in future MDR-TB patients.

Prevalence of Some World Health Organization Priority Organisms from an Abattoir at Kwata, Anambra State, Nigeria

The abattoir is one of the important sectors in the food industry, therefore the need for close monitoring of everything concerning it to minimize microbial contamination. The aim of the study is to identify bacteria listed as WHO priority organisms associated with meat from Kwata abattoir in Awka, Anambra state. The study was carried out over a three (3) months period from September to December 2022. Thirteen samples were collected from the floor, table, water, meat, knife and soil in the abattoir. The samples were cultured using streak and spread plate methods on MacConkey and Cetrimide agar. The isolates were identified with the following biochemical tests: catalase, oxidase, citrate and indole tests. Ampiclox levofloxacin, gentamicin, ofloxacin impenem ceftraixone, cefixime, cefuroxime and nitrofurantoin were used for sensitivity test following Kirby Bauer disc diffusion method and biofilm formation was determined using the tube method. The 75 isolates obtained were identified as follows;29.3% E. coli, 26.7% Klebsiella spp., 16% Proteus spp., and 28% Pseudomonas spp. The result of antibiotics sensitivity test interpreted using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints showed that (98%) of the isolates were resistant to the antibiotics used. Test for biofilm formation with 52 isolates showed 31 strong, 12 moderate and 9 weak biofilm formers. The result of this study confirms the presence of bacteria contaminants within the WHO priority list in the abattoir, as such there is need for improved handling of animals. Slaughtering, cleaning and distribution of meat should be done using aseptic procedures. .

In vitro study on the transmission of multidrug-resistant bacteria from textiles to pig skin

BACKGROUND The survival of microorganisms on textiles and specifically on healthcare profes-sionals’(HCP)attire has been demonstrated in several studies.The ability of microorganisms to adhere and remain on textiles for up to hours or days raises questions as to their possible role in transmission from textile to skin via HCP to patients.AIM To evaluate the presence,survival and transmission of different multidrug-resistant bacteria(MDRB)from HCP attire onto skin.METHODS Three MDRB[methicillin-resistant Staphylococcus aureus(MRSA);vancomycin-resistant Enterococcus faecium(VRE);carbapenem-resistant Klebsiella pneumoniae,(CRKP)]were inoculated on textiles from scrubs(60%cotton-40%polyester)and white coat(100%cotton)at concentrations of 108 colony-forming units(CFU),105 CFU,and 103 CFU per mL.The inoculation of swatches was divided in time intervals of 1 min,5 min,15 min,30 min,1 h,2 h,3 h,4 h,5 h,and 6 h.At the end of each period,textiles were imprinted onto pig skins and each skin square was inverted onto three different selective chromogenic media.Growth from the pig skin squares was recorded for the 3 MDRB at the three above concentrations,for the whole length of the 6-h experiment.RESULTS MRSA was recovered from pig skins at all concentrations for the whole duration of the 6-h study.VRE was recovered from the concentration of 108 CFU/mL for 6 h and from 105 CFU/mL for up to 3 h,while showing no growth at 103 CFU/mL.CRKP was recovered from 108 CFU/mL for 6 h,up to 30 min from 105 CFU/mL and for 1 min from the concentration of 103 CFU/mL.CONCLUSION Evidence from the current study shows that MRSA can persist on textiles and transmit to skin for 6 h even at low concentrations.The fact that all MDRB can be sustained and transferred to skin even at lower concentrations,supports that textiles are implicated as vectors of bacterial spread.

Microplastics in Marine Environment: Occurrence, Distribution, and Extraction Methods in Marine Organisms

The pervasive presence of microplastics in marine environments has raised significant concerns. This review addresses the pressing issue of microplastic pollution in marine ecosystems and its potential implications for both the environment and human health. It outlines the current state of microplastic occurrence, distribution, and extraction methods within marine organisms. Microplastics have emerged as a significant environmental concern due to their harmful effects on ecosystems and their potential human health risks. These particles infiltrate marine environments through runoff and atmospheric deposition, ultimately contaminating beaches and posing threats to marine life. Despite the gravity of this issue, there has been limited research on the presence and distribution of microplastics in marine organisms. This review aims to bridge this knowledge gap by comprehensively examining the occurrence, distribution, and various extraction methods used to detect microplastics in marine organisms. It emphasizes the urgent need for targeted measures to manage microplastic pollution, highlights the significant role of human activities in contributing to this problem, and underscores the importance of reducing human-induced pollution to safeguard marine ecosystems. While this paper contributes to the understanding of microplastic pollution in marine environments and underscores the critical importance of taking action to protect marine organisms and preserve our oceans for future generations, it also emphasizes that, in effectively tackling the microplastic problem, a well-coordinated approach is essential, involving research initiatives, policy adjustments, public involvement, and innovative technologies. Crucially, prompt and resolute responses must exist to counteract the escalating peril posed by microplastics to the oceans and the global environment.

Assessing Earthworm Influence on Remediating Potentials of Soil Micro-Organisms, and Bioavailable Hydrocarbon Pollutant in the Niger Delta, Nigeria

In the Niger Delta region of Nigeria, oil explorations and exploitations abound, causing environmental pollution with serious consequences on soil ecosystem and its biodiversity. In spite of the relationship between microbes and fauna in soil ecosystem, such that both organisms can metabolize certain range of petroleum hydrocarbon substrates with the fauna influencing the remediation potentials of bacteria, yet soil fauna is still not fully considered in bioremediation. The influence of earthworm;Lumbricus terrestris on the remediating potentials of soil bacteria in petroleum hydrocarbon contaminated soils was investigated. Eighteen pots were filled with 700 g of soil each, with nine treated with mixture of 3 levels crude oil and remediated with earthworm, while the other nine had no earthworm. The total petroleum hydrocarbon (TPH), soil physical, nutrient compositions, and TPH degrading bacteria biodiversity were determined before contamination or commencement of study and thirty days after. The results showed a decrease in TPH concentration of 55.58%, 62.57% and 67.07% in 1 ml, 2 ml and 3 ml crude oil contaminated soil, respectively. Species richness and abundance of bacteria organisms increased with high relative abundance in soils remediated with earthworms, hydrocarbon utilizing bacteria increased from less than 0.1 cfu/g to 0.4 cfu/g, and total heterotrophic bacteria 1.6 cfu/g at the end of the study. Earthworms increased rate of remediation potentials of bacteria, such that within 30 days post remediation treatment, 34.14% of reduced concentration was achieved over soil samples without earthworms at 3 ml, and 25.14% at 2 ml concentration. Reduction in pH levels in remediated soils was between 6.39 to 6.17 and 6.74 to 6.72 in unremediated soils, while moisture content was 6.73% to 6.77% unremediated and 5.85% to 6.62% in earthworm remediated soils. Total organic carbon, nitrates in soils inoculated with earthworms were lower in concentration than those without earthworms. Reverse was the case with potassium, phosphate and phosphorous concentrations which were above those without earthworms. Results indicate statistically, significant difference between reduction in TPH in earthworm remediated soils and unremediated soils, pointing out that earthworm is a good candidate for facilitation of bacteria remediation-petroleum hydrocarbon contamination.

The future of artificial hibernation medicine:protection of nerves and organs after spinal cord injury

Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hibernation techniques,mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury.However,its technical defects and barriers,along with serious clinical side effects,restrict its clinical application for spinal cord injury.Artificial hibernation is a futureoriented disruptive technology for human life support.It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons,reduce the central constant temperature setting point,disrupt the normal constant body temperature,make the body adapt"to the external cold environment,and reduce the physiological resistance to cold stimulation.Thus,studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology.This review introduces artificial hibernation technologies,including mild hypothermia technology,hibernation inducers,and hibernation-related central neuromodulation technology.It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection.These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal co rd injury through inflammatory inhibition,immunosuppression,oxidative defense,and possible central protection.It also promotes the repair and protection of res pirato ry and digestive,cardiovascular,locomoto r,urinary,and endocrine systems.This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation.At present,artificial hibernation technology is not mature,and research fa ces various challenges.Neve rtheless,the effort is wo rthwhile for the future development of medicine.

Machines,Tools and Tool Transporter Concurrent Scheduling in Multi⁃machine FMS with Alternative Routing Using Symbiotic Organisms Search Algorithm

This study explored the concurrent scheduling of machines, tools, and tool transporter(TT) with alternative machines in a multi-machine flexible manufacturing system(FMS), taking into mind the tool transfer durations for minimization of the makespan(MSN). When tools are expensive, just a single copy of every tool kind is made available for use in the FMS system. Because the tools are housed in a central tool magazine(CTM), which then distributes and delivers them to many machines, because there is no longer a need to duplicate the tools in each machine, the associated costs are avoided. Choosing alternative machines for job operations(jb-ons), assigning tools to jb-ons, sequencing jb-ons on machines, and arranging allied trip activities, together with the TT’s loaded trip times and deadheading periods, are all challenges that must be overcome to achieve the goal of minimizing MSN. In addition to a mixed nonlinear integer programming(MNLIP) formulation for this simultaneous scheduling problem, this paper suggests a symbiotic organisms search algorithm(SOSA) for the problem’s solution. This algorithm relies on organisms’ symbiotic interaction strategies to keep living in an ecosystem. The findings demonstrate that SOSA is superior to the Jaya algorithm in providing solutions and that using alternative machines for operations helps bring down MSN.

Determinants of the Sensorineural Hearing Loss in Patients with Multidrug-Resistant Tuberculosis in Kinshasa (Democratic Republic of the Congo): A Prospective Cohort Study

Background: The onset of the hearing loss is a major challenge during the treatment of multidrug-resistant tuberculosis (MDR-TB). Aminoglycoside-based regimens, to a lesser extent based on bedaquiline, induce ototoxic sensorineural hearing loss. Research on risk factors is essential to enable high-risk individuals to benefit from preventive measures in settings with limited resources. Objective: This study aimed to assess the determinants of the hearing loss in patients with MDR-TB. Methods: This prospective multicenter cohort study included 337 patients with MDR-TB. It was performed in Kinshasa (Democratic Republic of the Congo) between January 2020 and January 2021. Sociodemographic, clinical, biological, therapeutic, and audiometric data were exported and analyzed using Stata 17 and MedCalc. The fixed-effect linear regression panel model was used to assess the degree of the hearing loss over time according to the following covariates: therapeutic regimen (aminoglycosides, bedaquiline, or alternate), stage of chronic kidney disease (CKD), age at inclusion, body mass index, serum albumin level, HIV status, alcohol intake, hypertension, and hemoglobin level. The Hausman test was used to select between fixed- and random-effect estimators. The threshold for statistical significance was set at p Result: A total of 236 patients (70%) received an aminoglycoside-based regimen, 61 (18%) received a bedaquiline-based regimen, and 40 (12%) received aminoglycosides relayed by bedaquiline. The frequency of the hearing loss increased from 62% to 96.3% within six months for all therapeutic regimens. The Hearing loss worsened, with moderate (72.4%) and profound (16%) deafness being predominant. An Exposure to the treatment for more than one month (β coeff: 27.695, Se: 0.793, p β coeff: 6.102, Se: 1.779, p β coeff: 5.610, Se: 1.682, p = 0.001), and an eGFR β coeff: 6.730, Se: 2.70, p = 0.013) were the independent risk factors associated with the hearing loss in patients with MDR-TB. Conclusions: The Hearing loss was more prevalent and worsened during the treatment of the patients with MDR-TB. An Exposure for more than one month, AG-based regimens, advanced age, hypoalbuminemia, and CKD have emerged as the main determinants of the worsening of the hearing loss.

Integrating Levels of Hierarchical Organization in Porous Organic Molecular Materials

Porous organic molecular materials(POMMs)are an emergent class of molecular-based materials characterized by the formation of extended porous frameworks,mainly held by non-covalent interactions.POMMs represent a variety of chemical families,such as hydrogen-bonded organic frameworks,porous organic salts,porous organic cages,C-H···πmicroporous crystals,supramolecular organic frameworks,π-organic frameworks,halogen-bonded organic framework,and intrinsically porous molecular materials.In some porous materials such as zeolites and metal organic frameworks,the integration of multiscale has been adopted to build materials with multifunctionality and optimized properties.Therefore,considering the significant role of hierarchy in porous materials and the growing importance of POMMs in the realm of synthetic porous materials,we consider it appropriate to dedicate for the first time a critical review covering both topics.Herein,we will provide a summary of literature examples showcasing hierarchical POMMs,with a focus on their main synthetic approaches,applications,and the advantages brought forth by introducing hierarchy.

Can soil organic carbon sequestration and the carbon management index be improved by changing the film mulching methods in the semiarid region?

Plastic film mulching has been widely used to increase maize yield in the semiarid area of China.However, whether long-term plastic film mulching is conducive to agricultural sustainability in this region remains controversial.A field experiment was initiated in 2013 with five different film mulching methods:(i) control method, flat planting without mulching (CK),(ii) flat planting with half film mulching (P),(iii) film mulching on ridges and planting in narrow furrows(S),(iv) full film mulching on double ridges (D), and (v) film mulching on ridges and planting in wide furrows (R).The effects on soil organic carbon (SOC) content, storage, and fractions, and on the carbon management index (CMI)were evaluated after nine consecutive years of plastic film mulching.The results showed that long-term plastic film mulching generally maintained the initial SOC level.Compared with no mulching, plastic film mulching increased the average crop yield, biomass yield, and root biomass by 48.38, 35.06, and 37.32%, respectively, which led to the improvement of SOC sequestration.Specifically, plastic film mulching significantly improved CMI, and increased the SOC content by 13.59%, SOC storage by 7.47%and easily oxidizable organic carbon (EOC) by 13.78%on average,but it reduced the other labile fractions.SOC sequestration and CMI were improved by refining the plastic film mulching methods.The S treatment had the best effect among the four mulching methods, so it can be used as a reasonable film mulching method for sustainable agricultural development in the semiarid area.

Effects of desert plant communities on soil enzyme activities and soil organic carbon in the proluvial fan in the eastern foothills of the Helan Mountain in Ningxia,China

It is of great significance to study the effects of desert plants on soil enzyme activities and soil organic carbon(SOC)for maintaining the stability of the desert ecosystem.In this study,we studied the responses of soil enzyme activities and SOC fractions(particulate organic carbon(POC)and mineral-associated organic carbon(MAOC))to five typical desert plant communities(Convolvulus tragacanthoides,Ephedra rhytidosperma,Stipa breviflora,Stipa tianschanica var.gobica,and Salsola laricifolia communities)in the proluvial fan in the eastern foothills of the Helan Mountain in Ningxia Hui Autonomous Region,China.We recorded the plant community information mainly including the plant coverage and herb and shrub species,and obtained the aboveground biomass and plant species diversity through sample surveys in late July 2023.Soil samples were also collected at depths of 0–10 cm(topsoil)and 10–20 cm(subsoil)to determine the soil physicochemical properties and enzyme activities.The results showed that the plant coverage and aboveground biomass of S.laricifolia community were significantly higher than those of C.tragacanthoides,S.breviflora,and S.tianschanica var.gobica communities(P<0.05).Soil enzyme activities varied among different plant communities.In the topsoil,the enzyme activities of alkaline phosphatase(ALP)andβ-1,4-glucosidas(βG)were significantly higher in E.rhytidosperma and S.tianschanica var.gobica communities than in other plant communities(P<0.05).The topsoil had higher POC and MAOC contents than the subsoil.Specifically,the content of POC in the topsoil was 18.17%–42.73%higher than that in the subsoil.The structural equation model(SEM)indicated that plant species diversity,soil pH,and soil water content(SWC)were the main factors influencing POC and MAOC.The soil pH inhibited the formation of POC and promoted the formation of MAOC.Conversely,SWC stimulated POC production and hindered MAOC formation.Our study aimed to gain insight into the effects of desert plant communities on soil enzyme activities and SOC fractions,as well as the drivers of SOC fractions in the proluvial fan in the eastern foothills of the Helan Mountain and other desert ecosystems.

Recent progress of hybrid cathode interface layer for organic solar cells

Organic solar cells(OSCs)have gained conspicuous progress during the past few decades due to the development of materials and upgrading of the device structure.The power conversion efficiency(PCE)of the single-junction device had surpassed 19%.The cathode interface layer(CIL),by optimizing the connection between the active layer and the cathode electrode,has become a momentous part to strengthen the performances of the OSCs.Simultaneously,CIL is also indispensable to illustrating the working mechanism of OSCs and enhancing the stability of the OSCs.In this essay,hybrid CILs in OSCs have been summarized.Firstly,the advancement and operating mechanism of OSCs,and the effects and relevant design rules of CIL are briefly concluded;secondly,the significant influence of CIL on enhancing the stability and PCE of OSCs is presented;thirdly,the characteristics of organic hybrid CIL and organic-inorganic hybrid CIL are introduced.Finally,the conclusion and outlook of CIL are summarized.

Fertilization and Soil Ploughing Practices under Changing Physical Environment Lead to Soil Organic Carbon Dynamics under Conservation Agriculture in Rice-Wheat Cropping System: A Scoping Review

Ploughing and fertilization practices in rice-wheat system have deteriorated the soil carbon (C) pools. Conservation agriculture (CA) based management approaches have proven to enhance C sequestration and reverse the loss of soil-organic-carbon (SOC), which further enhances soil fertility. Different fractions of SOC pools react to the alterations in management practices and indicate changes in SOC dynamics as compared to total C in the soil. Higher SOC levels in soil have been observed in case of reduced/no-till (NT) practices than conventional tillage (CT). However, between CT and zero tillage/NT, total SOC stocks diminished with an increase in soil depth, which demonstrated that the benefits of SOC are more pronounced in the topsoil under NT. Soil aggregation provides physical protection to C associated with different-sized particles, thus, the improvement in soil aggregation through CA is an effective way to mitigate soil C loss. Along with less soil disturbance, residual management, suitable crop rotation, rational application of manures and fertilizers, and integrated nutrient management have been found to be effective in not only improving soil C stock but also enhancing the soil health and productivity. Thus, CA can be considered as a potential method in the build-up of SOC of soil in rice-wheat system.