Search

Background: For investigating the host response in Acinetobacter baumannii associated pneumonia, we analyzed the host genetic sequences obtained from metagenomic next-generation sequencing (mNGS). Methods: The samples for mNGS were bronchoalveolar lavage fluid (BALF) collected from the lungs of patients infected with A. baumannii and from patients without bacterial infections. BALF samples from patients with pneumonia were collected from the lungs of patients infected with A. baumannii with New Delhi metallo-β-lactamase (NDM, before treatment), A. baumannii with NDM (post-treatment), A. baumannii without resistant genes, and those without bacterial infection. Partek was used for investigating enriched functions and pathways related to the pulmonary host response to pneumonia caused by A. baumannii with NDM infection and A. baumannii without antimicrobial-resistant genes. The STRING was employed for identifying protein interaction pathways related to the pulmonary host response to pneumonia caused by A. baumannii without antimicrobial-resistant genes. Results: In pulmonary host response to pneumonia caused by A. baumannii with NDM, five immune system-related pathways and five pathways related to signal transduction were identified. No significant differences were observed in the immune system and signal transduction pathways in the pulmonary host response to pneumonia caused by A. baumannii without antimicrobial-resistant genes. However, significant differences were noted in the phagosome, ferroptosis, and regulation of the actin cytoskeleton in cellular processes. Conclusions: mNGS provides information not only on pathogen gene expression but also on host gene expression. In this study, we found that pneumonia with A. baumannii carrying the NDM resistance gene triggers stronger immune responses in the lung, while pneumonia with A. baumannii lacking antimicrobial resistance genes is more linked to iron-related pathways.

Background: Malposition may occur during peripherally inserted central catheter insertion. Accurately measuring the length of a peripherally inserted central catheter is crucial to preventing malposition, including “long peripherally inserted central catheter placement,” in which the tip of a peripherally inserted central catheter is deeper than the target position. The traditional method of measuring peripherally inserted central catheter length involves measuring from the insertion site to the parasternal notch and down to the third or fourth intercostal space, which may result in overestimation because of the thickness of the pectoralis major and anterior chest wall. To avoid this overestimation, the authors developed and tested a modified method for reducing long peripherally inserted central catheter placement. Methods: This study employed a retrospective design. Chest X-rays were used to examine the peripherally inserted central catheter tip positions in 48 patients in the medical intensive care unit who had undergone peripherally inserted central catheter insertion. The traditional and modified measurement methods were used to measure the peripherally inserted central catheter length in 17 and 31 patients, respectively. Fisher’s exact test was used to examine between-group differences in the incidence of different types of peripherally inserted central catheter malposition. Results: The peripherally inserted central catheter tip position was near the target position in five patients (29.41%) in the traditional measurement group and 17 patients (54.84%) in the modified measurement group ( p = 0.132), whereas long peripherally inserted central catheter placement occurred in six patients (35.29%) in the traditional measurement group and one patient (3.23%) in the modified measurement group ( p = 0.006). However, the incidence of other types of peripherally inserted central catheter malposition did not differ significantly between the groups. Conclusions: The results of this study that the proposed modified measurement method may be able to reduce the incidence of long peripherally inserted central catheter placement among medical intensive care unit patients. The method must be further evaluated in prospective studies and studies with larger sample sizes in the future.

Cancer cells harbor molecular alterations at all levels of information processing. Genomic/epigenomic and transcriptomic alterations are inter-related between genes, within and across cancer types and may affect clinical phenotypes. Despite the abundant prior studies of integrating cancer multi-omics data, none of them organizes these associations in a hierarchical structure and validates the discoveries in extensive external data. We infer this Integrated Hierarchical Association Structure (IHAS) from the complete data of The Cancer Genome Atlas (TCGA) and compile a compendium of cancer multi-omics associations. Intriguingly, diverse alterations on genomes/epigenomes from multiple cancer types impact transcriptions of 18 Gene Groups. Half of them are further reduced to three Meta Gene Groups enriched with (1) immune and inflammatory responses, (2) embryonic development and neurogenesis, (3) cell cycle process and DNA repair. Over 80% of the clinical/molecular phenotypes reported in TCGA are aligned with the combinatorial expressions of Meta Gene Groups, Gene Groups, and other IHAS subunits. Furthermore, IHAS derived from TCGA is validated in more than 300 external datasets including multi-omics measurements and cellular responses upon drug treatments and gene perturbations in tumors, cancer cell lines, and normal tissues. To sum up, IHAS stratifies patients in terms of molecular signatures of its subunits, selects targeted genes or drugs for precision cancer therapy, and demonstrates that associations between survival times and transcriptional biomarkers may vary with cancer types. These rich information is critical for diagnosis and treatments of cancers. Author summary Cancer cells harbor molecular alterations at all levels of information processing. These alterations are inter-related and affect the clinical traits in a complicated manner. We infer the associations of these molecular and clinical features and construct an Integrated Hierarchical Association Structure (IHAS) from The Cancer Genome Atlas (TCGA) data. IHAS provides a unique contribution in cancer omics as it (1) represents complicated associations in a hierarchical structure and presents varying levels-of-details views from a single gene in a specific cancer type to groups of genes across multiple cancer types, (2) performs both vertical (across multiple types of assays) and horizontal (across multiple cancer types) data integrations, (3) incorporates a large-scale biological knowledge base in the model, (4) validates the inferred associations in over 300 external datasets. In the long term, IHAS can illuminate the universal and idiosyncratic aspects of cancer omics data, give new insights about diagnosis, and provide guidance for targeted cancer therapies for precision medicine.

Interstitial pneumonia with autoimmune features (IPAF) is a new disease entity proposed in 2015. Numerous questions regarding IPAF require clarification, including diagnostic criteria, standard managements for stable disease and exacerbation, and prognosis. We report a case of a 67-year-old Asian woman who presented with progressive dyspnea. Chest computed tomography (CT) scans revealed nonspecific interstitial pneumonia. Serologic testing indicated positive anti-Jo-1 without presence of extrathoracic manifestations. An IPAF diagnosis was made after a multidisciplinary discussion. The patient experienced a severe exacerbation requiring mechanical ventilation, and she was successfully salvaged with methylprednisolone pulse therapy and single-dose cyclophosphamide. During the one-year follow-up, she reported bilateral leg muscle weakness with noticeably elevated serum creatine kinase, suggesting polymyositis. The development of malignancy was also noted 15 months after the initial presentation, and the patient eventually died. This report demonstrated successful salvage treatment with glucocorticoid pulse therapy for IPAF with acute exacerbation. However, the maintenance therapy failed to control disease progression. The treatment strategies for exacerbation and stable disease in IPAF remain unknown and need further studies. Given the high risk of evolution into a defined connective tissue disease (CTD), regular evaluation of the clinical features and biomarkers of CTDs is essential for patients with IPAF.

Objectives This study was conducted to explore the association between pneumoconiosis and pneumothorax.Design Retrospective cohort study.Setting Nationwide population-based study using the Taiwan National Health Insurance Database.Participants A total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).Primary and secondary outcome measures The incidence and the cumulative incidence of pneumothorax.Results Both incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p

In this paper, we have demonstrated an oxygen-vacancy-based bipolar RRAM on a pure logic 14-nm-node HKMG FinFET platform. A unit cell of the memory consists of a control transistor (FinFET) and a storage transistor (a second FinFET). The later performs as a bipolar RRAM. This unit cell can be integrated in an AND-type memory array. The memory cell has an ON/OFF ratio equal to 200 and 400 for the n-type and p-type FinFET RRAMs, respectively, endurance larger than 400 and 1000 times for n- and p-type devices, respectively, and the retention test for over 1 month under 125°C temperature environment. To analyze the array performance of the AND-type FinFET RRAM at the circuit level, we have further discussed the issues of the sneak path and disturbance, in which an active-fin isolation of FinFET in an AND-type array has been suggested to minimize the leakage current induced by sneak paths. The results have shown a large window with up to 103 ON/OFF ratio, 30% standby power reduction, and 90% active power reduction with reference to the conventional AND-type array. As a result, the bipolar FinFET RRAM exhibits great potential for the embedded memory applications, in particular it can be extended to 28-nm HKMG and the FinFET platform beyond 14-nm technology node, to fill the Moore's gap between the high-performance logic and the embedded memory. [ABSTRACT FROM AUTHOR]

The seismic performance of intermediate clear span-depth ratio (2.0 ≤ ln/h ≤ 4.0) coupling beams with hybrid layout were evaluated in this study. By combining the conventional ductile beam detailing and the benefit of the presence of diagonal bars, this study shows that the hybrid layout may serve as one of the possible alternatives to ease construction difficulty. Test results found out that, at the maximum considered earthquake (MCE) level, the shear strength of a coupling beam was governed by the crushing of concrete strut in the plastic hinge regions and yielding of diagonal bars. To allow a full development of concrete strut capacity and to maintain integrity of core concrete, sufficient internal support must be provided by the transverse reinforcement. Using the proposed shear-strength equation, a more rational approach can be adopted to determine the appropriate reinforcement layout and the efficient amount of diagonal bars for a coupling beam with 2.0 ≤ ln/h ≤ 4.0. [ABSTRACT FROM AUTHOR]