Low Resistance Research Articles

Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya

Abstract Background To understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites. Methods In this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot). A total of 920 dried blood spot (DBS) samples collected from 121 selected primary schools within the country were used to extract genomic DNA. A nested polymerase chain reaction (PCR) was used to generate amplicons that were sequenced to determine the prevalence of known and novel polymorphisms. Results Pfk13 mutations associated with artemisinin resistance were present as mixed genotype infections for the C469Y mutation in 23 samples (4%), the A675V mutation in 2 samples (1.7%), and the P553L mutation in 7 samples (1.2%). The A578S mutation, was also identified in mixed infections, appearing in 15.2% of the 87 samples analysed. The Pfdhfr 51I and 108 N pyrimethamine-resistance mutations were at fixation (100% frequency), and the Pfmdr1 Y184F mutation, which is linked to reduced susceptibility to several antimalarial drugs, especially those used in combination therapies for malaria treatment, was detected in 97.5% of the samples as mixed-genotype infections. Conclusion The genomic surveillance of asymptomatic school children in Kenya provides an early warning signal of at least 1 of the 3 validated artemisinin resistance mutations circulating in all regions in Western Kenya sampled except Homa Bay and Kisii Counties. These signals in asymptomatic and mixed infections would have been missed without deep sequencing.

Insights from a Genome-Wide Study of Pantoea agglomerans UADEC20: A Promising Strain for Phosphate Solubilization and Exopolysaccharides Production

The genome sequence of Pantoea agglomerans UADEC20 is presented, which is a strain isolated from agricultural fields in northeast Mexico. The genome was assembled into 13 scaffolds, constituting a total chromosome size of 4.2 Mbp, with two of the scaffolds representing closed plasmids. The strain exhibits activity in phosphate solubilization and exopolysaccharide (EPS) production and secretion; therefore, we explored its biotechnological potential via its genome sequencing and annotation. Genomic analyses showed that a total of 57 and 58 coding sequences (CDSs) related to phosphate solubilization and EPS production were identified within its genome, in addition to a reduced number of CDSs related to drug resistance and phages. The comprehensive set of genes supporting phosphate solubilization, EPS synthesis, and secretion, along with its low virulence and antibiotic resistance levels, justify further research for its potential biotechnological application and possible use as a plant growth-promoting agent in the field. These findings suggest a unique genetic background in the P. agglomerans UADEC20 strain.

Controllable Synthesis and “Fast‐charging” Mechanism of Hollow‐Micropencil Co3V2O8 from Perspective of Ion Diffusion in Crystal Structure

AbstractCo3V2O8 as a bimetallic oxide with “fast‐charging” capacity presents some potential advantages, comprising decent theoretical specific capacity, favorable crystal structure, and intrinsic safety. Presently, although extensive research of Co3V2O8 as an anode material are reported, the formed Co° from Co3V2O8 after the initial discharging is not oxidized to CoO during the charging process, and the ion diffusion mechanism are not well clarified. The lithium‐storage process of Co3V2O8 and the diffusion mechanism of lithium ion in Co3V2O8 are studied in detail in this work. A hollow‐micropencil Co3V2O8 prepared through the hydrothermal method without using surfactants or templates demonstrates a high “fast‐charging” capability even at the current densities as high as 1.0–2.0 A g−1. The electrochemical kinetic results illustrate that the hollow‐micropencil Co3V2O8 presents low charge transfer resistance. The distinctive lithium ion storage sites as well as diffusion paths are predicted. The in situ X‐ray diffraction analysis is adopted to confirm that the formed Co° after the initial discharging is not oxidized to CoO during the delithiation process. The work not only helps to understand the lithium insertion mechanisms of Co3V2O8 but also offers new means to develop “fast‐charging” anode material for lithium‐ion batteries with remarkable electrochemical performance.

Favorable Contact with Low Interfacial Resistance for n-Type TiCoSb-Based Thermoelectric Devices.

In the past decade, significant efforts have been made to develop efficient half-Heusler (HH) based thermoelectric (TE) materials. However, their practical applications remain limited due to various challenges occurring during the fabrication of TE devices, particularly the development of stable contacts with low interfacial resistance. In this study, we have made an effort to explore a stable contact material with low interfacial resistance for an n-type TiCoSb-based TE material, specifically Ti0.85Nb0.15CoSb0.96Bi0.04 as a proof of concept, using a straightforward facile synthesis route of spark plasma sintering. We tested many metals with compatible coefficients of thermal expansion to TiCoSb, like Fe and Co. Still, we failed to form proper atomic bonds with the TE material. In contrast, Ti metal bonded correctly but showed very high electrical contact resistance (∼300 mΩ at one side), reducing performance due to Ti diffusion and a high potential barrier at the interface. This issue was addressed by highly doped semiconductor (HDS) contact Ti0.7Nb0.3CoSb, which matched the TE material in terms of atomic bonding, crystal structure, and stability. The leg with the HDS contact demonstrated superior electronic transport performance and low interface resistance (∼15 mΩ at one side), achieving a maximum output power of 30.7 mW at ΔT = 451 K due to the sharp interface with a low barrier height. These findings suggest that using HDS material as a contact with the same HH TE material would be an effective way to develop a TE device with low interface resistance and high thermal stability.

Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent Klebsiella pneumoniae Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan

The emergence of hypervirulent and carbapenem-resistant hypermucoviscous Klebsiella pneumoniae strains presents a significant public health challenge due to their increased virulence and resistance to multiple antibiotics. This study evaluates the antibiotic susceptibility patterns and virulence profiles of classical and hypervirulent K. pneumoniae strains isolated from various clinical samples. A total of 500 clinical samples were collected from patients at the Mardan Medical Complex and Ayub Medical Complex in KPK between July 2022 and June 2024. Among these, 64 K. pneumoniae strains were isolated and subsequently subjected to antimicrobial susceptibility testing (AST) and phenotypic virulence detection. Among the 64 isolates, 21 (32.8%) exhibited hypermucoviscosity, a characteristic associated with increased pathogenicity. Hemagglutination was observed in 35 (54.1%) of the isolates, indicating the presence of surface adhesins that facilitate bacterial adherence to host tissues. A high prevalence of biofilm formation was noted, with 54 (84%) isolates capable of forming biofilms, which are known to protect bacteria from antibiotics and the host immune response. Most isolates (59/64, 92.1%) were resistant against ampicillin, highlighting its limited efficacy against these strains. Conversely, the lowest resistance was observed for tigecycline, with only 15% (10/64) of the isolates showing resistance, indicating its potential utility as a treatment option. The study also found that 38 (59.3%) of the isolates were extended-spectrum beta-lactamase (ESBL) producers, 42 (65.6%) were multidrug-resistant (MDR), 32 (50%) were extensively drug-resistant (XDR), and 13 (20.3%) were resistant to carbapenems. The genetic study revealed biofilm producer and enhancer genes (mrkD, pgaABCD, fimH, treC, wzc, pilQ, and luxS) mainly in the hypervirulent strains. These hypervirulent strains also show a high number of resistance genes. The findings of this study underscore the critical need for the active surveillance of antimicrobial resistance and virulence determinants in K. pneumoniae. The coexistence of high levels of antibiotic resistance and virulence factors in these isolates poses a severe threat to public health, as it can lead to difficult-to-treat infections and increased morbidity and mortality.

Geopolitical Risk and Trade Reorientation Dynamics: A Comparative Study

ABSTRACT The global trade system has been experiencing major restructuring due to geopolitical risks through reshuffling different economic blocs. To this end, we conduct a comparative assessment of the response of trade to geopolitical risk, economic and trade policy uncertainty across three thriving blocs, namely, the BRICS, G7, and ASEAN countries. Given the distinct features of the sample data, we apply cross-quantilogram and partial cross-quantilogram approaches to analyze monthly data from January 2000 to June 2023. Our empirical evidence confirms the favorable impact of geopolitical events on trade integration in the BRICS bloc. However, in comparison to BRICS nations, G7 countries have demonstrated lower resistance to geopolitical uncertainty, while the ASEAN bloc exhibits a cautious approach to increased geopolitical risks in the short term, leading to a potential loss in trade integration. Overall, this study shows that comparing these blocs in the context of geopolitical risk and intraregional trade integration requires a policy that offers a balance among economic cooperation and diplomatic ties, which nevertheless are critical for economic integration and welfare.

Construction of Cu2MoS4/ZnO Heterostructures and Mechanism of Photocatalytic Hydrogen Production.

Constructing wide and narrow band gap heterogeneous semiconductors is a method to improve the activity of photocatalysts. In this paper, CMS/ZnO heterojunctions were prepared by solvothermal loading of ZnO particles on the surface of Cu2MoS4 nanosheets. The photocatalytic H2 precipitation rate is about 545 μmol·g-1·h-1, which is 6.8 times that of Cu2MoS4 and 3 times that of ZnO without any cocatalyst. After etching modification of CMS, the photocatalytic hydrogen production efficiency of the ECMS/ZnO heterojunction is further improved. Its hydrogen production efficiency reaches about 1115 μmol·g-1·h-1, which is 9 times that of ECMS and 6 times that of ZnO. The reasons are mainly attributed to the following two factors: (1) the formation of the ECMS/ZnO type-II-type heterojunction facilitates the effective separation of photogenerated electrons and holes; (2) the band structure of Cu2MoS4 was optimized by etching modification, which made the ECMS/ZnO heterojunction have lower interfacial charge transfer resistance and improved the photocatalytic hydrogen production activity of the heterojunction.

Current Concepts in Fluid Resuscitation and Vasopressor Use in Cirrhosis.

Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation. Fluid responsiveness reflects the ability of fluid bolus to increase the cardiac output and is assessed effectively by POCUS, passive leg raise manoeuvre, and dynamic tests such as pulse pressure and stroke volume variation both in spontaneously breathing and mechanically ventilated patients. Albumin has pleotropic benefits through anti-inflammatory properties besides its standard action on oncotic pressure and volume expansion in patients with cirrhosis but has potential for precipitating pulmonary edema. In conclusion, fluid therapy in critically ill patients with liver disease is a complex and dynamic process that requires individualised management protocols to optimise patient outcomes.

Decoding nature: multi-target anti-inflammatory mechanisms of natural products in the TLR4/NF-κB pathway

Natural products are valuable medicinal resources in the field of anti-inflammation due to their significant bioactivity and low antibiotic resistance. Research has demonstrated that many natural products exert notable anti-inflammatory effects by modulating the Toll-like receptor 4 (TLR4) and nuclear factor kappa B (NF-κB) signaling pathways. The research on related signal transduction mechanisms and pharmacological mechanisms is increasingly being discovered and validated. However, there is currently a lack of comprehensive reviews focusing on the pharmacological mechanisms of natural products targeting the TLR4/NF-κB pathway for anti-inflammatory effects. In light of these considerations, this review comprehensively synthesizes recent research findings concerning the TLR4/NF-κB signaling pathway, including the translocation of TLR4 activation to lysosomes within the cytoplasm, the assembly of protein complexes mediated by ubiquitin chains K63 and K48, and the deacetylation modification of p65. These discoveries are integrated into the classical TLR4/NF-κB pathway to systematically elucidate the latest mechanisms among various targets. Additionally, we summarize the pharmacological mechanisms by which natural products exert anti-inflammatory effects through the TLR4/NF-κB pathway. This aims to elucidate the multitarget advantages of natural products in the treatment of inflammation and their potential applications, thereby providing theoretical support for molecular pharmacology research on inflammation and the development of novel natural anti-inflammatory drugs.

Lattice defect engineering advances n-type PbSe thermoelectrics

Te-free thermoelectrics have garnered significant interest due to their immense thermoelectric potential and low cost. However, most Te-free thermoelectrics have relatively low performance because of the strong electrical and thermal transport conflicts and unsatisfactory compatibility of interfaces between device materials. Here, we develop lattice defect engineering through Cu doping to realize a record-high figure of merit of ~1.9 in n-type polycrystalline PbSe. Detailed micro/nanostructural characterizations and first-principles calculations demonstrate that Cu-induced interstitial defects and nanoprecipitates simultaneously optimize electron and phonon transport properties. Moreover, a robust Co/PbSe interface is designed to effectively prevent chemical reactions/diffusion; this interface exhibited a low electrical contact resistivity of ~10.9 μΩ cm2, excellent durability, and good stability in the thermoelectric module, which achieves a record-high conversion efficiency of 13.1% at a temperature difference of 460 K in segmented thermoelectric modules. This study lays the groundwork for advancing the development of Te-free selenide-based thermoelectric materials.

Anisotropic Shape‐Memory Cryogel with Oriented Macroporous Channel for Hemorrhage Control and Tissue Generation

AbstractInjectable shape‐memory materials represent a promising solution for managing severe bleeding from deep, inaccessible wounds. However, many existing expandable hemostats consist of randomly porous networks and often exhibit inadequate liquid absorption, non‐degradability, and potential cytotoxicity, which limits their effectiveness in hemostasis and wound repair. To overcome these challenges, this study introduces an anisotropic hemostatic cryogel, SALC, featuring oriented macroporous channels made from biocompatible polymers (poly(ethylene glycol), gelatin, and lignin) through a simple one‐step cryo‐structuration process. This structural alignment provides the cryogel with low water flow resistance, efficient fluid transport, and rapid shape recovery. SALC demonstrates superior liquid adsorption and retention, in vitro tamponade sealing, and pro‐coagulant properties compared to commercial gelatin sponges and XSTAT, along with favorable biocompatibility and biodegradability. The hemostatic efficacy of SALC surpasses clinically used counterparts in rat models of liver perforation and femoral artery transection. Remarkably, SALC achieves effective hemostasis in porcine models of severe hepatic, femoral artery, and cardiac injuries. Additionally, this anisotropic cryogel supports liver tissue regeneration by promoting cell migration and angiogenesis while mitigating inflammatory responses. The cryogel is also lightweight and easy to carry and implement. Overall, SALC shows promising clinical applications for treating severe hemorrhages and improving wound healing.

Diminution of surface spin disorder in a ferromagnet via proximity effect of single-molecule magnets

Abstract Field-dependent resistance of a magnetic layer is often used as the basic tunable operational entity in several spintronics applications. In this work we demonstrate that the magnetoresistance (MR) of a classic ferromagnetic Ni layer can be tuned significantly by controlling the surface spin scattering of electrons, by manipulating disordered surface spins via proximity effect. This was achieved by drop casting molecules of a well-known single molecule magnet Mn 12-ac on micro-tracks of a thin (~12 nm) Ni film. We found significant changes in the width and sign of the magnetoresistance of the Ni micro-tracks. This is explained in the light of possible locking of the disordered surface spins of the Ni layer with the high spin moment of adjacent Mn 12-ac molecules, causing reduction in the surface spin scattering. As expected, the spin moments of Mn 12-ac molecules were found to effectively pin the surface spins only below the blocking temperature of Mn 12-ac. Above the blocking temperature, the Mn 12-ac molecules had no effect on the MR behavior of Ni micro-tracks. This observation offers a simple route to achieve on-demand low or high resistance states of a magnetic layer, very relevant to the field of spintronics.

Overcoming the Conductance versus Crossover Trade-off in State-of-the-Art Proton Exchange Fuel-Cell Membranes by Incorporating Atomically Thin Chemical Vapor Deposition Graphene.

Permeance-selectivity trade-offs are inherent to polymeric membranes. In fuel cells, thinner proton exchange membranes (PEMs) could enable higher proton conductance and increased power density with lower area-specific resistance (ASR), smaller ohmic losses, and lower ionomer cost. However, reducing thickness is accompanied by an increase in undesired species crossover harming performance and long-term efficiency. Here, we show that incorporating atomically thin monolayer graphene synthesized via scalable chemical vapor deposition (CVD) and tunable defect density into PEMs (Nafion, ∼5-25 μm thick) can allow for reduced H2 crossover (∼34-78% of Nafion of a similar thickness) while maintaining adequate areal proton conductance for applications (>4 S cm-2). In contrast to most prior work using >50 μm symmetric Nafion sandwich structures, we elucidate the interplay of graphene defect density and Nafion proton transport resistance on the performance of Nafion|graphene composite membranes and find high-quality low-defect density CVD graphene (G) supported on Nafion 211 (∼25 μm); i.e., N211|G has a high areal proton conductance (∼6.1 S cm-2) and the lowest H2 crossover (∼0.7 mA cm-2). Fully functional centimeter-scale N211|G fuel-cell membranes demonstrate performance comparable to that of state-of-the-art Nafion N211 at room temperature as well as standard operating conditions (∼80 °C, ∼150-250 kPa-abs) with H2/air (power density ∼0.57-0.63 W cm-2) and H2/O2 feed (power density ∼1.4-1.62 W cm-2) and markedly reduced H2 crossover (∼53-57%).

Enhanced Tribological Performance of Laser-Textured TiN-Coated Ti6Al4V Alloy Surfaces: A Comparative Study with Untextured Surfaces

Titanium alloy is widely used as a biomaterial due to its strength, lightweight nature, and corrosion resistance. Despite its strength and lightweight nature, its low wear resistance limits its uses in prosthetic components. Laser surface texturing (LST) was used to improve the wear resistance of titanium alloys by creating textured surfaces before applying protective coatings. A biocompatible TiN composite protective coating was applied using physical vapour deposition (PVD) with a thickness of 4 µm. Response surface methodology (RSM) was used to predict the tribological properties by varying input parameters such as material type (TI, T2, T3, and T4), load in N, and sliding velocity in m/s. A pin-on-disc tribometer was used to conduct a unidirectional sliding wear test based on the RSM design. Tribological properties were studied to determine the impact of laser texturing on the bonding strength of the coating. As a result, material type T4 exhibits an improved coefficient of friction and specific wear resistance under varying sliding velocity and load conditions compared to other material types. The study was further supported by an ANSYS simulation, which revealed stress reduction affecting the coefficient of friction and, consequently, wear. The textured surface topography, wear mechanisms, and coating compositions were examined using scanning electron microscopy.

Conservation Analysis and Colorimetric Characterization of Betalain Extracts from the Peel of Red Beetroot, Golden Beetroot, and Prickly Pear Applied to Cottage Cheese

The maintenance of betalains and the color of extracts from the peel of red beetroot (RBAC), golden beetroot (YBAC), and purple prickly pear (PBAC) were evaluated, describing the capacity of their use as natural pigments and in the formulation of attractive and functional foods. Betalain extracts were prepared as juices from frozen and dehydrated peel, adding organic acids and concentrating for water reduction. Extracts were evaluated and applied on cottage cheese, measuring the capacity of betalains retention and pigmentation, during 10 days of storage of closed and opened products. Extracts of RBAC showed the highest betacyanin concentration, followed by YBAC with betaxanthins and PBAC with less betacyanin content. The pH stability for the extracts was pH4–7; RBAC and PBAC were stables at <90 °C, whereas YBAC exposed >125 °C. Extracts were constant during 10 days under oxygen and light exposure; however, YBAC exhibited low resistance in this environment. With cottage cheese, extracts exposed no changes in betalains and color on closed products (10 days of storage at 4 °C). In opened products, PBAC maintained the maximum betalains and color at 90%, PBAC at 75%, and YBAC at 60%. The obtained data contributed to use of agro-industrial residues, betalain extraction and conservation, and their potential use in food coloration and stabilization.

Assessing Design Space for the Device-Circuit Codesign of Nonvolatile Memory-Based Compute-in-Memory Accelerators.

Unprecedented penetration of artificial intelligence (AI) algorithms has brought about rapid innovations in electronic hardware, including new memory devices. Nonvolatile memory (NVM) devices offer one such attractive alternative with ∼2× density and data retention after powering off. Compute-in-memory (CIM) architectures further improve energy efficiency by fusing the computation operations with AI model storage. Electronic characteristics of NVM devices, like resistance in the two resistance states, directly affect the circuit designers' decisions and result in the varying performance of NVM-CIM chips. In this mini review, we assess the bounds on device resistances for accuracy and circuit performance to suggest recommendations to device engineers for frictionless device-circuit-system interactions. Furthermore, we review challenges in reliably programming NVM devices, followed by benchmarking recent NVM-CIM chips. Our literature review and analytical modeling reveal that a high resistance ratio and low variability are favored, and the resistance in a low resistance state is bound by accuracy and circuit performance constraints.

Positive Intraoperative Bile Culture and Antibiotic Resistance Increase the Risk of Pancreatic Fistula in Patients After Pancreatoduodenectomy

Background/Objectives: A positive intraoperative bile culture (bacterobilia) is considered to be a risk factor for increased morbidity after pancreatoduodenectomy. The aim of our study was to describe the frequency of bacterobilia with a special emphasis on antibiotic resistance and to analyze the association of these findings with postoperative complications, in particular with postoperative pancreatic fistula. Methods: From a prospective database, patients with available intraoperative bile cultures (n = 95) were selected and analyzed. Microbiological test results reported the type of bacteria as well as sensitivity and resistance patterns. Associations between culture results, antibiotic resistance, and postoperative outcomes were assessed. Results: Among 95 patients that were included in this trial, 71 (74.7%) had a positive bile culture. A total of 29.6% (21/71) of patients with positive bile cultures developed POPF grade B/C compared to 8.3% (2/24) of patients with negative bile cultures (p = 0.052). The difference in CR-POPF became statistically significant when at least one of the isolated microorganisms was resistant to ampicillin/sulbactam, the perioperative antibiotic administered for prophylaxis. CR-POPF was diagnosed in 38.5% (15/39) of patients with antibiotic resistance vs. 14.3% (8/56) of patients without resistant microorganisms (p = 0.007). We also identified the isolation of Enterococcus spp. (p = 0.006), resistant Enterobacter (p = 0.031), or resistant Escherichia coli (p = 0.027) as risk factors for pancreatic fistula. Conclusions: The isolation of antibiotic-resistant strains in a positive bile culture is a major risk factor for the development of pancreatic fistula after pancreatoduodenectomy. The most relevant bacteria in our study were Enterococcus spp., Enterobacter cloacae, and Escherichia coli. Thus, broad-spectrum antimicrobial prophylaxis with efficacy against these microorganisms and with low resistance rates should be routinely administered perioperatively.

A Four-Year Study of Antibiotic Resistance, Prevalence and Biofilm-Forming Ability of Uropathogens Isolated from Community- and Hospital-Acquired Urinary Tract Infections in Southern Italy

The aim of this study was to investigate the differences between nosocomial and community microorganisms isolated from patients with UTI by determining their bacterial profile, antibiotic resistance and ability to produce biofilms. A retrospective study, based on bacterial isolates from consecutive urine samples collected between January 2019 and December 2023, was conducted at a university hospital. The main pathogens isolated from both community and hospital samples were the same, but their frequency of isolation differed. Compared with community-associated cases, hospital-associated infections have more isolates of Acinetobacter baumanii complex. In contrast, Proteus mirabilis isolates were more prevalent in community than in hospital infections. In both hospital and community isolates, gram-positive bacteria showed a lower overall antimicrobial resistance (22%) compared to gram-negative bacteria (30%). The data demonstrated that individual strains exhibited disparate degrees of capacity for biofilm formation. Additionally, the data indicate an inverse correlation between biofilm production and antibiotic resistance. Isolates from community patients exhibited lower capacities for biofilm production in comparison to the capacities demonstrated by microorganisms isolated from nosocomial patients (29% and 35%, respectively). Area-specific surveillance studies can provide valuable information on UTI pathogens and antimicrobial resistance patterns, which can be useful in guiding empirical treatment.

Clinical Characteristics of Primary and Overlap Sjögren's Syndrome-Associated Pulmonary Arterial Hypertension: A Multicenter Retrospective Study.

To explore the clinical characteristics and risk factors for adverse outcomes in patients with Sjögren's Syndrome-associated pulmonary arterial hypertension (SS-PAH). A retrospective analysis was conducted on SS-PAH patients diagnosed by right heart catheterization (RHC) between March 2013 and March 2024 across four Chinese medical centers. Patients were categorized into primary SS-PAH (pSS-PAH) and overlap SS-PAH, based on the presence of additional autoimmune diseases. We compared clinical and demographic data, echocardiographic and hemodynamic parameters, treatment strategies, and event-free survival between the groups. Statistical analyses included t-tests, Wilcoxon rank-sum tests, χ2 tests, Fisher's exact tests, and Kaplan-Meier survival analysis. Overlap SS-PAH was most commonly associated with systemic lupus erythematosus (SLE). Compared with pSS-PAH, overlap SS-PAH patients had a lower proportion of WHO functional class III-IV, lower pulmonary vascular resistance (PVR), and higher cardiac index (CI). They also showed higher treatment success rates and better event-free survival. However, overlap SS-PAH patients with primary biliary cholangitis (PBC) or autoimmune hepatitis (AIH) had significantly lower 1-year event-free survival rates, older age, and elevated alkaline phosphatase (ALP) levels. Overlap SS-PAH generally has a better prognosis than pSS-PAH, with improved exercise capacity and milder hemodynamic abnormalities. However, overlap with PBC/AIH is associated with a poorer prognosis. These findings highlight the heterogeneity of SS-PAH and the need for tailored treatment based on underlying autoimmune conditions. NCT05980728, https://clinicaltrials.gov.

Surface wettability effects on droplet dynamics and heat transfer on heated stainless-steel foils

Abstract We report the dynamics and heat transfer characteristics of water droplets impacting on a thin stainless-steel foil maintained at different temperatures. The hydrophobic characteristics are imparted to the surface through polysiloxane coating and water droplets impact the uncoated and coated heated surfaces at different velocities. High-speed videography is utilized to capture the dynamics of the droplet upon impact, while the temperature field of the substrate, during the phenomenon, is simultaneously recorded using high-speed infrared thermography. Heat transfer to the droplet over different surfaces is determined through energy balance on the foil using the captured thermographs. The results reveal that the spreading phase and its duration are strong functions of droplet impact velocity, irrespective of the surface wettability, whereas surface wettability primarily affects the receding phase. The coated hydrophobic surfaces exhibited lower resistance to motion at the three-phase contact line, resulting in reduced spread ratios during the receding phase. It is noted that majority of heat transfer occurred during the initial spreading and receding phases, driven primarily by forced convection. The maximum heat fluxes were observed along the three-phase contact line, particularly at the onset of the receding phase. The coated surface demonstrated lower overall heat transfer rates compared to non-coated surfaces, with the difference increasing at higher surface temperatures. Additionally, an increase in surface temperature to 75°C enhanced the hydrophobicity of the coated surface, leading to prolonged receding phases and extended time to reach the sessile state.