Background
Early identification of critically ill coronavirus disease (COVID-19) patients in clinical settings is crucial in reducing the mortality rate. Therefore, this study aimed to determine ...whether the saturation of peripheral oxygen (SpO
2
) to fraction of inspiratory oxygen (FiO
2
) ratio (SF ratio) at admission is useful for the early identification of severe COVID-19.
Methods
This single-center, retrospective, observational study conducted at the University Hospital, Kyoto, Japan, included 26 patients diagnosed with COVID-19 between January 24 and May 6, 2020. COVID-19 severity was classified into two groups based on the SF ratio: ≤ 235 (moderate to severe disease: low group) and > 235 (normal to mild disease: high group). The characteristics, laboratory data, and outcomes of the patients were examined retrospectively and compared between the groups.
Results
Of the 26 patients median age 51.5 years, interquartile range 35.8–67.0, 6 were in the low group (23%) and 20 in the high group (77%). The low group had a higher respiratory rate than the high group (
p
< 0.05). Blood tests immediately after admission showed that the low group had significantly lower albumin (
p
< 0.01), and higher lactate dehydrogenase (
p
< 0.01), C-reactive protein (
p
< 0.01), and
D
-dimer (
p
< 0.01) levels than the high group. Moreover, all patients received antiviral agents; four received continuous renal replacement therapy and invasive positive pressure ventilation, one received extracorporeal membrane oxygenation, and two died in the low group.
Conclusion
SF ratio measurement at admission could assist clinicians in the early identification of severe COVID-19, which in turn can lead to early therapeutic interventions.
Staphylococcus aureus is the primary cause of bacteremia, and methicillin-resistant S. aureus bacteremia is associated with a high mortality rate. Methicillin-resistant S. aureus clones are ...widespread worldwide, and molecular epidemiological studies are important. Therefore, this study aimed to determine the characteristics of patients who died due to methicillin-resistant S. aureus bacteremia and microbiological characteristics of methicillin-resistant S. aureus strains in a tertiary teaching hospital. This single-center, retrospective study included patients with methicillin-resistant S. aureus isolated from blood bacterial culture performed at Kyoto Prefectural University of Medicine Hospital, from October 2016 to May 2019. The data analyzed included patient background, clinical strain characteristics, and molecular epidemiology. Of 41 patients with methicillin-resistant S. aureus bacteremia (median age, 60 28-70 years; 24 (59%) were men), and 7 (17%) died due to methicillin-resistant S. aureus bacteremia. The median age of those who died in the methicillin-resistant S. aureus bacteremia group was predominantly higher than that of those in the alive group (p = 0.03). The most common cause of methicillin-resistant S. aureus bacteremia was endovascular devices, which occurred in 20 (49%), 18 (53%), and 2 (29%) patients in the total, alive, and died groups, respectively. Bacteriological characteristics showed that type IV Staphylococcal Cassette Chromosome mec genotype was most frequently detected in the total (n = 34 83%), alive (n = 29 85%), and died (n = 5 71%) groups. In the molecular cluster analysis, CC8, ST8, staphylococcal Cassette Chromosome mec type IV, and community-acquired-methicillin-resistant S. aureus formed the largest groups. The diversity of methicillin-resistant S. aureus clones is evident, and it is possible that clones with new virulence factors may still emerge. In the future, it will be crucial to monitor the epidemiological trends of methicillin-resistant S. aureus to respond quickly to changes in pathogenic and clonal factors, to clarify the gene expression network by identifying old and new virulence factors.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Pseudomonas aeruginosa uses a complex type III secretion system to inject the toxins ExoS, ExoT, ExoU, and ExoY into the cytosol of target eukaryotic cells. This system is regulated by the exoenzyme ...S regulon and includes the transcriptional activator ExsA. Of the four toxins, ExoU is characterized as the major virulence factor responsible for alveolar epithelial injury in patients with P. aeruginosa pneumonia. Virulent strains of P. aeruginosa possess the exoU gene, whereas non-virulent strains lack this particular gene. The mechanism of virulence for the exoU+ genotype relies on the presence of a pathogenic gene cluster (PAPI-2) encoding exoU and its chaperone, spcU. The ExoU toxin has a patatin-like phospholipase domain in its N-terminal, exhibits phospholipase A2 activity, and requires a eukaryotic cell factor for activation. The C-terminal of ExoU has a ubiquitinylation mechanism of activation. This probably induces a structural change in enzymatic active sites required for phospholipase A2 activity. In P. aeruginosa clinical isolates, the exoU+ genotype correlates with a fluoroquinolone resistance phenotype. Additionally, poor clinical outcomes have been observed in patients with pneumonia caused by exoU+-fluoroquinolone-resistant isolates. Therefore, the potential exists to improve clinical outcomes in patients with P. aeruginosa pneumonia by identifying virulent and antimicrobial drug-resistant strains through exoU genotyping or ExoU protein phenotyping or both.
The structural hot-spot stress approach is an effective method for assessing welding details when nominal stress is hard to determine due to geometric or loading complexities. Hot spots can be ...classified into two types: type “a,” which refers to a weld toe located on a plate surface, and type “b,” denoting one located on a plate edge. Previous studies on type “b” hot spots have mainly focused on in-plane gusset welded joints, and the applicability of type “b” hot-spot S-N curves proposed for in-plane gusset joints in IIW to the other details is not well understood. In this study, fatigue tests were conducted with a load-carrying attachment welded on a plate surface, where a crack occurred from a weld toe on the plate edge. The tests were also numerically simulated using finite element analysis. Upon evaluating the test results through the nominal stress, structural hot-spot stress (4, 8, and 12 mm method), and notch stress approaches, it was found that all the data lie above FAT71 for nominal stress, FAT100 for hot-spot stress, and FAT225 for effective notch stress.
Numerous studies have been conducted regarding the fatigue strength of longitudinal welded gusset joints. Most studies employed relatively small specimens. Thus, this study aims to evaluate the ...variation of fatigue life of longitudinal welded gusset joints by using the probabilistic fracture mechanics approach, particularly for larger specimens. Although some studies claimed that lower fatigue strength is found in the thicker main plate specimens, however only a limited number of fatigue test was conducted. A probabilistic approach was employed to conquer the shortfall. In this study, fatigue crack propagation analysis was performed on the main plate thicknesses of 12, 40, and 60 mm to evaluate the effect of main plate thickness on the fatigue life of the joints. Then, a probabilistic approach is given to investigate the variation of fatigue life of the joint. In addition, fatigue tests were carried out to investigate the crack propagation behavior on larger specimens. A significant decrease in fatigue life was observed by the increase of the main plate thickness from 12 to 40 mm, however, no further decrease thereafter. The fatigue strength of longitudinal welded gusset joints with the main plate thickness of 12 mm was appertained to category F in the JSSC design curve. Meanwhile, the fatigue strength of longitudinal welded gusset joints with the main plate thickness of 40 and 60 mm falls into category G in JSSC. This condition was also confirmed by the fatigue test results, where both specimens were classified as category G in JSSC.
Abstract
The bulk photovoltaic effect (BPVE) is a mechanism of recent focus for novel solar cells that exceed the power conversion efficiency of p–n junction solar cells because of the quantum ...mechanical effect to generate photocurrent known as shift current. Ferroelectrics are receiving attention again because of their high voltage generation by the BPVE and converse piezoelectric effect to realize high performance optical actuators. We have investigated the BPVE in ferroelectric BiFeO
3
(BFO) single crystal thin films, whereby the photovoltage was enhanced by Mn doping, and 852 V generation was demonstrated at 80 K. The enhancement mechanism was also investigated using soft and hard X-ray photoelectron spectroscopy (SXPES, HAXPES), and soft X-ray absorption spectroscopy with synchrotron radiation. This report reveals a way to new voltage source applications employing the BPVE for high impedance devices with ferroelectrics. Important aspects for designing ferroelectric materials by impurity doping are also discussed.
The supramolecular chirality of the hindwing of Anomala albopilosa (male) was investigated using a microscopic vibrational circular dichroism (VCD) system, denoted as MultiD-VCD. The source of ...intense infrared (IR) light for the system was a quantum cascade laser. Two-dimensional maps of IR and VCD spectra were taken by scanning the surface area (ca. 2 mm × 2 mm) of the insect hindwing tissue. The spectra ranged from 1500 to 1700 cm–1, and the maps have a spatial resolution of 100 μm. The distribution of proteins, including their supramolecular structures, was analyzed from the location-dependent spectral shape of the VCD bands assigned to amides I and II. The results revealed that the hindwing consists of segregated domains of proteins with different secondary structures: an α-helix (in one part of the membrane), a hybrid of α-helix and β-sheet (in another part of the membrane), and a coil (in a vein).
T-bet is a key transcription factor for the T helper 1 lineage and its expression level is negatively correlated to inflammation in patients with rheumatoid arthritis (RA). Our previous study using ...T-bet transgenic mice revealed over-expression of T-bet completely suppressed collagen-induced arthritis (CIA), a murine model of RA, indicating a potential suppressive role of T-bet in the pathogenesis of autoimmune arthritis. Here, we show T-bet-deficiency exacerbated CIA. T-bet in CD4 + T cells, but not in CD11c + dendritic cells, was critical for regulating the production of IL-17A, IL-17F, IL-22, and TNFα from CD4 + T cells. T-bet-deficient CD4 + T cells showed higher RORγt expression and increased IL-17A production in RORγt-positive cells after CII immunization. In addition, T-bet-deficient naïve CD4 + T cells showed accelerated Th17 differentiation in vitro. CIA induced in CD4-Cre T-bet
(cKO) mice was more severe and T-bet-deficient CD4 + T cells in the arthritic joints of cKO mice showed higher RORγt expression and increased IL-17A production. Transcriptome analysis of T-bet-deficient CD4 + T cells revealed that expression levels of Th17-related genes were selectively increased. Our results indicate that T-bet in CD4 + T cells repressed RORγt expression and function resulting in suppression of arthritogenic Th17 cells and CIA.
Root cracks initiating from U-rib to deck welded joints of orthotropic steel deck bridges have become a problem for maintenance. Some fatigue strength evaluation methods for root cracks based on ...local stress criteria have been proposed, such as the effective notch stress method, but these methods cannot evaluate fatigue strength directly from the measurable response values of the structure. In this study, the evaluation method of crack initiation by measurable stresses was investigated by fatigue tests and FE analysis for both deck and bead propagation-type cracks, which are root cracks in U-rib to deck welded joints of orthotropic steel decks. As a result of the study, the relationship between the stress of weld root and the fatigue life was obtained by using the fillet shaped notch stress as the evaluation stress, and the S-N curve for the evaluation stress was proposed. And a method to estimate the evaluation stress of the root from the measurable stresses at four points was proposed. It was confirmed that the error of the proposed estimation method was generally within 10%. As a validation of the estimation method, it was confirmed that the fatigue test results could be properly evaluated.
In this study, the effect of the stress state of a welded joint during application of high-frequency mechanical impact (HFMI) treatment on the resulting fatigue strength was investigated through ...fatigue tests and finite element analysis. A high-frequency impact treatment tool was used as the HFMI device. Longitudinal attachment welded joints were treated under a state in which a static load was applied and subsequently tested under a constant stress amplitude with stress ratios of 0 or 0.5. In addition, residual stress measurements and finite element analysis simulating welding and treatment processes were performed. The results indicate that the HFMI treatment is beneficial even when applied under a static tensile load, as the resulting compressive residual stresses are similar regardless of the stress state in the joint during treatment, meaning that the HFMI is applicable to existing structures.
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