Epidemiology and staphylococcal cassette chromosome mec typing of methicillin-resistant Staphylococcus aureus isolates in Taiwan: A multicenter study.

BACKGROUND/PURPOSE: After community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified, new community-onset, healthcare-associated MRSA (HA-MRSA-CO) infections have been noticed as MRSA infection in patients with community-onset infection who have underlying conditions resulting in frequent exposure to the healthcare system. However, previous studies have not thoroughly investigated whether HA-MRSA-CO has characteristics resembling those of CA-MRSA or hospital-onset, healthcare-associated MRSA (HA-MRSA-HO) infection. METHODS: A multicenter, retrospective study was conducted to analyze the clinical and microbiological data of patients with clinical isolates of MRSA from nine hospitals in Taiwan. RESULTS: In total, 203 patients with MRSA isolates, including 27 patients with CA-MRSA (13.3%), 59 with HA-MRSA-CO (29.1%), and 117 with HA-MRSA-HO (57.6%), were studied. Compared to HA-MRSA-HO isolates, the CA-MRSA and HA-MRSA-CO isolates were associated with a higher proportion of skin and soft tissue infections (81.8% and 65.3% vs. 40.5%, p=0.001 and p=0.002) as well as lesser rate of resistance to ciprofloxacin (33.3% and 50.9% vs. 74.4%, p<0.001 and p=0.002), gentamicin (44.4% and 64.4% vs. 84.6%, p<0.001 and p=0.002), and trimethoprim/sulfamethoxazole (33.3% and 42.4% vs. 58.1%, p=0.02 and p=0.048), and a lower 30-day all-cause mortality rate (7.4% and 0% vs. 20.9%, p<0.001). Most of the CA-MRSA isolates were classified as staphylococcal cassette chromosome mec (SCCmec) type VT (11/27, 40.7%), whereas most HA-MRSA-HO isolates were classified as SCCmec type III (66/117, 56.4%). CONCLUSION: The CA-MRSA, HA-MRSA-CO, and HA-MRSA-HO clinical isolates significantly differed in their clinical presentations and molecular characteristics.

Preferential deposition of buoyant small microplastics in surface sediments of the Three Gorges Reservoir, China: Insights from biomineralization.

Sediments act as sinks of microplastics (MPs) derived from terrestrial ecosystems. However, the fate and transport of MPs at the zone of sediment-overlying water in reservoir environment are poorly understood. Here, the MPs distribution patterns in surface sediments of the Three Gorges Reservoir (TGR) and dominant mechanisms responsible for the sinking of MPs at the zone of sediment-overlying water were comprehensively investigated. The predominant occurrence of small microplastics (<300 µm, SMPs) in surface sediments of the TGR was found, with buoyant polyethene (PE) was dominant polymer types. Interestingly, the high abundance of SMPs in sediments correlated well with the Ca2+/Mg2+ in overlying water, suggesting that divalent cations in overlying water may enhance the preferential deposition of SMPs. Simulation sinking experiments under the presence of Microcystis aeruginosa and two divalent cations using different-sized PE MPs demonstrated that the greater deposition of SMPs was mainly the result of the formation of biogenic calcite on the surface of MPs rather than magnesium minerals, which provides stronger ballasting effects for SMPs than for large MPs. This study first highlights that the impact of biomineralization on preferential sinking of SMPs and enhances the understanding of the transport behaviour of MPs in aquatic environment.

Fabrication of three-dimensional orthodontic force detecting brackets and preliminary clinical test for tooth movement simulation.

This study aimed to develop an ultraminiature pressure sensor array to measure the force exerted on teeth. Orthodontic force plays an important role in effective, rapid, and safe tooth movement. However, owing to the lack of an adequate tool to measure the orthodontic force in vivo, it remains challenging to determine the best orthodontic loading in clinical and basic research. In this study, a three-dimensional (3D) orthodontic force detection system based on piezoresistive absolute pressure sensors was designed. The 3D force sensing array was constructed using five pressure sensors on a single chip. The size of the sensor array was only 4.1 × 2.6 mm, which can be placed within the bracket base area. Based on the barometric calibration, conversion formulas for the output voltage and pressure of the five channels were constructed. Subsequently, a 3D linear mechanical simulation model of the voltage and stress distribution was established using 312 tests of the applied force in 13 operating modes. Finally, the output voltage was first converted to pressure and then to the resultant force. The 3D force-detection chip was then tested to verify the accuracy of force measurement on the teeth. Based on the test results, the average output force error was only 0.0025 N (0.7169%) (p = 0.958), and the average spatial positioning error was only 0.058 mm (p = 0.872) on the X-axis and 0.050 mm (p = 0.837) on the Y-axis. The simulation results were highly consistent with the actual force applied (intraclass correlation efficient (ICC): 0.997-1.000; p < 0.001). Furthermore, through in vivo measurements and a finite element analysis, the movement trends generated when the measured orthodontic forces that acted on the teeth were simulated. The results revealed that the device can accurately measure the orthodontic force, representing the first clinical test of an orthodontic-force monitoring system. Our study provides a hardware basis for clinical research on efficient, safe, and optimal orthodontic forces, and has considerable potential for application in monitoring the biomechanics of tooth movement.

Comprehensive analysis of liquid-liquid phase separation-related genes in prediction of breast cancer prognosis.

Objective: Liquid-liquid phase separation (LLPS) is a functional unit formed by specific molecules. It lacks a membrane and has been reported to play a crucial role in tumor drug resistance and growth by regulating gene expression and drug distribution. However, whether LLPS could be used to predict cancer prognosis was not clear. This study aimed to construct a prognostic model for breast cancer based on LLPS-correlated genes (LCGs). Methods: LCGs were identified using the PhaSepDB, gene expression profile and clinical characteristics of breast cancer were obtained from TCGA and cBioportal. The PanCancer Atlas (TCGA) cohort was used as the training cohort to construct the prognostic model, while the Nature 2012 and Nat Commun 2016 (TCGA) cohort and GEO data were used as test cohort to perform external verification. Data analysis was performed with R4.2.0 and SPSS20.0. Results: We identified 140 prognosis-related LCGs (pLCGs) (p< 0.01) in all cohorts, 240 pLCGs (p< 0.01) in the luminal cohort, and 28 pLCGs (p< 0.05) in the triple-negative breast cancer (TNBC) cohort. Twelve genes in all cohorts (training cohort: 5/10-year ROC values were 0.76 and 0.77; verification cohort: 5/10-year ROC values were 0.61 and 0.58), eight genes in the luminal cohort (training cohort: 5/10-year ROC values were 0.79 and 0.75; verification cohort: 5/10-year ROC values were 0.62 and 0.62), and four genes in the TNBC cohort (training cohort: 5/10-year ROC values were 0.73 and 0.79; verification cohort: 5/10-year ROC values were 0.55 and 0.54) were screened out to construct the prognostic prediction model. The 17-gene risk-score was constructed in all cohorts (1/3/5-year ROC values were 0.88, 0.83, and 0.81), and the 11-gene risk-score was constructed in the luminal cohort (1/3/5-year ROC values were 0.67, 0.85 and 0.84), and the six-gene risk-score was constructed in the TNBC cohort (1/3/5-year ROC value were 0.87, 0.88 and 0.81). Finally, the risk-score and clinical factors were applied to construct nomograms in all cohorts (1/3/5-year ROC values were 0.89, 0.79 and 0.75, C-index = 0.784), in the luminal cohort (1/3/5-year ROC values were 0.84, 0.83 and 0.85, C-index = 0.803), and in the TNBC cohort (1/3/5-year ROC values were 0.95, 0.84 and 0.77, C-index = 0.847). Discussion: This study explored the roles of LCGs in the prediction of breast cancer prognosis.

The development of a nomogram model for predicting left recurrent laryngeal nerve lymph node metastasis in esophageal cancer based on radiomics and clinical factors.

Background: The lymph node dissection for esophageal cancer is controversial. Some prediction models of lymph node metastasis (LNM) use the short diameter of lymph nodes measured by computed tomography (CT) examination as a predictor, but the size of that for judging metastasis is still controversial. However, radiomics can extract some features in tumors that cannot be obtained by naked eyes, which may have a higher value in predicting LNM. In this study, a nomogram was developed based on radiomics and clinical factors to predict left recurrent laryngeal nerve lymph node (RLNN) metastasis in patients with esophageal squamous cell carcinoma (ESCC). Methods: There were 350 patients included in this retrospective study. And the postoperative pathological results determined whether there was left RLNN metastasis. A univariate analysis was conducted of the clinical data. The least absolute shrinkage and selection operator regression analysis was conducted to filter the radiomics features extracted from CT images. The multivariate logistic regression equation was used to construct a nomogram. The area under the curve (AUC) was used to evaluate the predictive ability. Due to the small sample size, we chose to perform internal validation after the model was established by 10-fold cross-validation, Harrell's concordance index (C-index), bootstrap validation and calibration. Results: Ultimately, 3 indicators were screened out; that is, tumor location, surface volume ratio, and run-length non-uniformity. We then constructed the nomogram using these 3 indicators. The model had good accuracy and calibration performance. It has an AUC of 0.903 (95% confidence interval: 0.861-0.945), a sensitivity of 0.873, and a specificity of 0.756. Ten-fold cross-validation showed that the sensitivity and specificity of the training set were 88.08% and 75.81%, and the validation set had a sensitivity of 85.08% and a specificity of 75.49%. The Brier score was 0.074, and C-index was 0.904, which indicated good consistency between the actual and predicted results. Conclusions: A nomogram constructed based on radiomics features and clinical factors can be used to predict the metastasis of left RLNN in patients with ESCC in a non-invasive way, which provided a reference for clinicians to formulate individualized lymph node dissection plans.

Stress Corrosion Cracking Behavior of TP 439 and 690 TT under Film-Forming Amine Environment.

Film-forming amines have been widely used in thermal power plants for maintenance after shutdown, and there are more and more applications and researches in nuclear power secondary circuits for this purpose. However, in the direction of stress corrosion cracking, there is not much research on the influence of film-forming amines on metal materials. This article uses the high temperature slow strain rate test (SSRT) method to evaluate the influence of a commercial film-forming amine on the stress corrosion cracking behavior of two conventional island materials for PWR nuclear power plants. These two metal materials are the heat exchange tube materials of the high-pressure heater and steam generator in the high-temperature operation area of the secondary circuit of a nuclear power plant: TP 439 stainless steel and 690 TT alloy. The test analyzed the mechanical properties and fracture morphology. The test results show that in the test concentration range (<5 mg/kg), the film-forming amine will not affect the SCC of TP 439 stainless steel and 690 TT alloy under the condition of slow strain rate. The behavior has a significant impact. In practical applications, the general dosage of film-forming amine is 1-2 mg/kg. This data is lower than the film-forming amine concentration used in the experiment. Therefore, there is no need to worry about the obvious impact on the SCC behavior of TP 439 stainless steel and 690 TT alloy.

Social support, parental role competence and satisfaction among Chinese mothers and fathers in the early postpartum period: A cross-sectional study.

BACKGROUND: A sense of parental competence and satisfaction during the transition to parenthood can have a tremendous impact on the quality of parenting behaviors, with social support being an important facilitator. AIM: To examine parental role competence and satisfaction of Chinese mothers and fathers in the early postpartum period with regard to social support. METHODS: A cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China. The study was conducted between June 5 and November 16, 2015. One hundred and eighty parental pairs at 6-8 weeks after birth completed the Parenting Sense of Competence Scale, Perceived Social Support Scale, and socio-demographic questionnaires. RESULTS: Parental role competence and satisfaction of Chinese mothers and fathers were at a moderate level, affected each other and there were no significant differences between the mothers and the fathers. The Competence Scale scores had a significant positive correlation with social support. Multiple regression analysis revealed two variables that predicted maternal Competence Scale scores: maternal social support and the paternal Competence Scale scores. Paternal social support and maternal Competence Scale scores contributed significantly to paternal Competence Scale scores. CONCLUSION: Parental role competence and satisfaction of mothers and fathers were at a moderate level and affected by the parenting partner. To improve parental role competence and satisfaction, health care professionals should develop strategies that impact the whole family and not just a single individual. Supportive parenting programs should be implemented for both mothers and fathers.

Primary synovial sarcoma of the prostate: report of 2 cases and literature review.

Two cases of primary prostatic synovial sarcoma presenting as a prostatic mass are presented in patients aged 44 and 46 years. Histologically, both tumors were mainly composed of uniform spindle cells forming interlacing fascicles. Clusters of immature epithelioid cells were also observed among the spindle cells in case 1. Immunohistochemically, the tumor cells of both cases were strongly positive for vimentin, bcl-2, CD99, and E-cadherin, as well as focally positive for cytokeratin. However, they were negative for prostate-specific antigen, S-100 protein, CD34, CD117, muscle-specific actin, desmin, and calretinin. The presence of an SYT-SSX gene fusion resulting from t(X;18) was demonstrated from paraffin blocks by reverse transcriptase polymerase chain reaction in both cases. To the authors' knowledge, these represent the fifth and sixth reported cases of prostatic synovial sarcoma. Accurate diagnosis depends on morphologic and immunohistochemical examination and proper molecular analysis.

Opposing actions of TRPV4 channel activation in the lung vasculature.

OBJECTIVES: Transient receptor potential vanilloid 4 (TRPV4) calcium channels are known to promote endothelium-dependent relaxation of mouse mesenteric arteries but TRPV4's role in the pulmonary vasculature is uncertain. Thus, we characterized TRPV4 channel vascular tone regulation in mouse main pulmonary artery rings and in the isolated perfused pulmonary circulation and studied possible mechanisms behind these characterizations. METHODS AND RESULTS: Using myography and a TRPV4 specific agonist GSK1016790A in a C57BL/6 WT mouse model of isolated constant-flow lung perfusion, we studied vascular tone regulation in arterial rings from the main left and right pulmonary arteries and vascular resistance of the intra-pulmonary circulation beyond the second branches of the pulmonary arteries. Removal of the endothelium confirmed endothelial dependence. GSK1016790A relaxed the main pulmonary artery (EC50 4 × 10(-8)mol/L), which was inhibited by removal of the endothelium from main pulmonary artery rings. GSK1016790A significantly increased vascular resistance of the pulmonary circulation in isolated perfused lungs, but these effects were inhibited by a TRPV4 antagonist AB159908. A nitric oxide inhibitor NG-nitro-L-arginine methyl ester (L-NAME) and K(+) channel blockers apamin plus charybdotoxin (ChTx) significantly inhibited GSK1016790A in the main pulmonary artery and in an isolated perfused lung in vitro. CONCLUSIONS: Activated TRPV4 channels increase pulmonary vascular resistance and vasodilate the main pulmonary artery.

Esophageal sarcomatoid carcinoma presenting as a Fever with elevated serum leukocytes.

The study presented a case of esophageal cancer presenting as intermittent fever with markedly elevated serum leukocyte and C-reactive protein. The patient's symptoms had not improved with antibiotic treatment. However, after thoracic esophagectomy, the fever faded and leukocyte serum levels rapidly normalized.

A multicenter study of risk factors and outcome of hospitalized patients with infections due to carbapenem-resistant Acinetobacter baumannii.

BACKGROUND: Risk factors and outcome in patients who acquire nosocomial infections due to carbapenem-resistant Acinetobacter baumannii (CRAB) are rarely investigated. METHODS: A multicenter retrospective study was conducted to analyze the clinical and microbiological data of patients with nosocomial infections due to A. baumannii in 10 hospitals around Taiwan from May 2004 to December 2006. Comparisons were made between patients with infections due to CRAB and patients with infections due to carbapenem-susceptible A. baumannii (CSAB). RESULTS: One hundred and twenty-one patients carrying CRAB (infections, n=91) and 127 patients carrying CSAB (infections, n=97) were recruited for analysis. Compared with patients with CSAB infections, patients with CRAB infections had a longer duration of hospital stay before A. baumannii was isolated (median 48 vs. 21 days, p<0.001) and were more likely to have had exposure to a carbapenem (adjusted odds ratio (AOR) 2.57, 95% confidence interval (95% CI) 1.43-5.35; p=0.02) and an intensive care unit (ICU) stay (AOR 3.42, 95% CI 1.76-5.26; p=0.008). Risk factors associated with CRAB bacteremia included duration of hospital stay before onset of bacteremia (AOR 1.009 per 1-day longer, 95% CI 1.03-1.24; p=0.049), prior colonization with A. baumannii (AOR 3.27, 95% CI 1.99-5.93; p=0.002), and hospitalization in the ICU (AOR 6.12, 95% CI 1.58-13.68; p=0.009). Patients with CRAB bacteremia had a higher mortality rate than patients with CSAB bacteremia (46.0% vs. 28.3%, p=0.04). Multivariate analysis showed that carbapenem resistance (AOR 5.31, 95% CI 1.88-13.25; p=0.002), central venous catheterization (AOR 3.27, 95% CI 1.55-10.56; p=0.009), and ICU stay (AOR 2.56, 95% CI 1.15-8.85; p=0.04) were independent variables associated with mortality in patients with A. baumannii bacteremia. CONCLUSIONS: Patients with CRAB infections have a higher mortality rate than those with CSAB infections. Longer hospital stay, colonization with A. baumannii, and admission to the ICU were associated with the development of CRAB bacteremia.

Delta opioid agonist [D-Ala2, D-Leu5] enkephalin (DADLE) reduced oxygen-glucose deprivation caused neuronal injury through the MAPK pathway.

It has been demonstrated that [D-Ala2, D-Leu5] enkephalin (DADLE), a delta opioid agonist, protected neuron from hypoxic neuronal injury by activating the delta opioid receptor (DOR). However, whether DADLE can prevent neuronal injury induced by severe hypoxia like oxygen-glucose deprivation (OGD) is not clear. Here, we investigated whether DADLE has a protective effect against neuronal injury induced by oxygen-glucose deprivation. Neuron viability was measured by MTT and neuron injury was assessed by lactate dehydrogenase (LDH) release. Protein expression was examined by Western blot. The results showed that DADLE protected the cortical neuron in a dose-dependent way from OGD injury. And this neuroprotective effect could be completely blocked by delta 2 opioid antagonist Naltrindole. DADLE increased phosphorylation of ERK and prevented OGD-induced p38 phosphorylation. Neither DADLE nor Naltrindole had any appreciable effect on phosphorylation of JNK. One of the protective mechanisms of DADLE on OGD neurons may be due to the dynamic balance between the activation of ERK and the p38.