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Abstract This report describes the case of a 41-year-old male patient complaining of a hacking cough. The patient was treated with a Janus kinase (JAK) inhibitor for psoriasis. Blood tests revealed mild lymphopenia and high levels of serum cryptococcal antigen. Chest computed tomography revealed infection in the lower lobe of the left lung. Metagenomic next-generation sequencing of bronchoalveolar lavage fluid revealed Tropheryma whipplei. Tropheryma whipplei and Cryptococcus antimicrobial therapies were sequentially administered. During follow-up, the patient showed clinical and radiographic improvement. Tropheryma whipplei is an opportunistic Gram-positive rod-shaped bacterium belonging to the family Actinomycetes. Lung involvement is an unusual but classic manifestation of Whipple’s disease. This is the first report of pneumonia caused by infection with Tropheryma whipplei complicated by Cryptococcus. To our knowledge, this is the first case report of Tropheryma whipplei infection following the use of JAK inhibitors. Clinicians should be aware of opportunistic infections that can occur during treatment with JAK inhibitors.

Abstract Bloodstream infections are globally occurring life-threatening diseases that impose significant societal and economic burdens. This study explored the red cell distribution width (RDW) to albumin ratio (RAR), a novel index derived from RDW, to investigate its relationship with prognosis of bacteremia using propensity score matching (PSM). This retrospective observational cohort study included patients with bacteremia admitted to Yantai Yuhuangding Hospital’s intensive care units from June 2019 to December 2022. PSM was performed to adjust for confounding factors. The relationship between RAR and mortality was assessed using receiver operating characteristic curves, multivariate, and Kaplan–Meier analyses. A total of 411 patients were included. The RAR threshold of 5.824% /g/dL was determined by maximizing the Youden index; the study population was divided into two groups based on this cutoff value. After PSM, 125 pairs of score-matched patients were generated. Using logistic regression analysis, patients with RAR ≥ 5.824% /g/dL exhibited significantly higher mortality than did those with RAR ＜ 5.824% /g/dL in the entire cohort (OR = 3.926, 95% confidence interval (CI): 2.408–6.400, p

Abstract Background Patients with sepsis with low albumin levels and high red blood cell distribution width levels have poor prognoses. Red blood cell distribution width to albumin ratio (RAR) has recently attracted attention as an innovative inflammation biomarker. We aimed to explore the association between RAR and the prognosis of patients with sepsis. Methods This retrospective observational study included 402 patients meeting the sepsis-3 standards admitted to Yantai Yuhuangding Hospital’s intensive care units (ICUs) between January 2020 and December 2022. The relationship between RAR and mortality in patients with sepsis was examined using regression analysis, Kaplan–Meier analyses, and a receiver operating characteristic curve. Subgroup and sensitivity analyses were conducted to assess the results’ robustness. Results RAR, when considered as a continuous variable, was a significant independent in-hospital mortality risk factor (adjusted odds ratio [OR]: 1.383; 95% confidence interval [CI]: 1.164–1.645; P

In recent years, many studies have reported that microRNAs play an important role in the pathogenesis of a variety of diseases, and the aim of this paper is to explore the role and mechanism of miR-346 in acute respiratory distress syndrome (ARDS). A mouse model of ARDS was constructed by LPS induction, and RT-qPCR assay was used to verify that the expression level of miR-346 in lung tissue was significantly increased, and was negatively correlated with oxygenation index. Inhibiting the expression of miR-346 in mice and HPMECs by miR-346 inhibitor confirmed that decreased miR-346 expression could lead to increased oxygenation index, decreased lung index, lung water content and NO content to reduce lung injury in mice, while lung inflammation was alleviated and apoptosis was reduced in mice. The same results were obtained in cells. BCL6 was predicted to be a target of miR-346 by targetscan and miRDB; when miR-346 was inhibited, BCL6 expression was increased, and if miR-346 and BCL6 expression were inhibited at the same time, it could aggravate lung injury and reduce the proliferation of HPMECs and increase their apoptosis and inflammation in mice. This shows that miR-346 inhibits the migration of HPMECs by regulating BCL6 expression, which in turn promotes the apoptosis of HPMECs, leading to inflammation and inducing ARDS.

Currently, the metaverse points to the human "world" in the context of a "multiverse". Historically, large-scale multiplayer online games, the iteratively developed internet, and virtual reality have constructed the metaverse from different dimensions, but none of them alone can be equated with the metaverse. Based on the arguments of predecessors, this paper proposes the "four worlds" paradigm, which implies a synchronic structure and diachronic development for the metaverse. One of the four elements of literature and art proposed by theorists such as M. H. Abrams (1912–2015) and James J. Y. Liu (1926–1986) is the universe; after encountering the metaverse, this universal element has been rewritten, forming the "metaversal elements" of literature and art. Digital space enables the virtual potential of the "metaversal elements" to be fully released in the form of information, and potential information about reality is extracted to constitute a self-sustaining digital system. [ABSTRACT FROM AUTHOR]

Introduction Pulmonary embolism (PE) has a high morbidity and mortality. Hence it is important to recognize factors associated with higher risk of adverse outcomes in hemodynamically stable patients. Heart-type fatty acid binding protein (H-FABP) is a novel marker evaluated in recent years for prognosis in acute PE. Our aim was to evaluate the available evidence on the accuracy of H-FABP for predicting the prognosis of adverse clinical outcomes (defined as the occurrence of any of the following: death, cardiopulmonary resuscitation, endotracheal intubation, use of vasopressors, thrombolysis, surgical embolectomy, or admission to the intensive care unit) or mortality in patients with acute PE. Methods Unrestricted searches of PubMed, the Cochrane Library, Web of Science and Science Direct were performed using the terms of "H-FABP" or "heart-type fatty acid binding protein" and ("pulmonary embolism" or "pulmonary thromboembolism"). A random-effect model was used to pool study results; χ2 and I2 testing was used to test for heterogeneity. Data of six studies were included in this analysis. Results 34 of 119(28.57%; 95%CI, 20.42%--36.72%) patients with elevated H-FABP levels had adverse events during follow-up compared with 24 of 475 (5.05%; 95%CI, 3.08%--7.02%) patients with normal levels. High H-FABP levels were associated with a high risk of occurrence of adverse clinical outcome (pooled OR, 10.81; 95%CI, 3.92--29.83). Conclusion The results of this meta-analysis indicate that H-FABP is a good predictor for adverse outcomes in patients with acute PE. [ABSTRACT FROM AUTHOR]