This study aims to identify suitable lactobacilli that have anti-carbapenem-resistant
(CRE) activity with
tolerance to pepsin and bile salts.
Fifty-seven
spp. strains encompassing nine species were ...collected for investigation. Their viabilities in the presence of pepsin and bile salts were tested using tolerance tests. Their anti-CRE effects were assessed by agar well diffusion and broth microdilution assay, as well as time-kill test.
Of the 57
isolates collected, 31 had a less than 2-log reduction in their viability in both pepsin and bile salt tolerance tests. Of these 31 isolates, 5 (LUC0180, LUC0219, LYC0289, LYC0413, and LYC1031) displayed the greatest anti-CRE activity with a CRE zone of inhibition greater than 15 mm in agar well diffusion assays. The minimal inhibitory percentages of supernatants from these five strains against CREs ranged from 10 to 30%. With the exception of LUC0180, which had a minimal bactericidal percentage ≥ 40%, the bactericidal percentage of all the strains ranged from 20 to 40%. The inhibitory effect of the cell-free culture supernatants from these
strains did not change after heating but was abolished as the pH changed to 7.0. After a 24-h incubation, five of the
strains at a concentration of 10
CFU/ml totally inhibited the growth of carbapenem-resistant
(CRE316) and
(CRE632). After a 48-h incubation, the growth of CRE316 was completely inhibited under each concentration of lactobacilli based on time-kill test. Furthermore, when the concentration of lactobacilli was at 10
CFU/ml, the decline in pH was faster than at other concentrations.
Some
strains exhibit anti-CRE activity, which suggests potential applications for controlling or preventing CRE colonization or infection.
Recently, several Delta-Sigma modulators (DSMs) with ultra-high quadrature-amplitude-modulation (QAM) order larger than one million, e.g., 1048576 and 4194304 QAM are reported. As different DSM works ...were implemented with different oversampling rates (OSRs), and pursuing a higher DSM QAM order seems to deviate from its original idea to achieve high spectral efficiency. Up to the authors' knowledges, there is still no comprehensive comparison of the intrinsic efficiencies of different DSM works. In this work, we first summarize the recent DSM works and compare their efficiencies. We also propose and demonstrate a 1-bit DSM and a 2-bit multi-stage noise shaping (MASH) DSM for the baseband-over-fiber system. The modified 1-bit DSM can achieve record efficiencies of 0.589 and 0.665 under the hard-decision (HD) and the 25% soft-decision (SD) forward error correction (FEC) requirements, respectively. The 2-bit MASH DSM can also achieve record efficiencies of 1.025 (HD) and 1.150 (SD) respectively.
To determine the influence of femur and tibia rotations in the transverse and frontal planes on patella cartilage stress.
Patella cartilage stress profiles of six healthy females were obtained during ...a squatting task using subject-specific finite element models of the patellofemoral joint (45° of knee flexion). Input parameters for the finite element model included joint geometry, quadriceps muscle forces, and weight-bearing patellofemoral joint kinematics. The femur and tibia of each model were then rotated to 2°, 4°, 6°, 8°, and 10° along their respective axes beyond that of the natural degree of rotation in weight-bearing. The process was repeated for internal rotation, external rotation, adduction, and abduction. Quasi-static loading simulations were performed to quantify average patella cartilage stress.
Incremental femur internal rotation beyond that of the natural rotation resulted in progressively greater patella cartilage stress (41–77%), whereas incremental tibia internal rotation resulted in a decrease in patella cartilage stress (7–10%). Femur and tibia external rotation resulted in a mild increase in patella cartilage stress, but only at 10° (9%). Incremental femur adduction resulted in an increase in patella cartilage stress, but only at 10° (43%). Femur abduction and frontal plane tibia rotation in either direction had no influence on patella cartilage stress.
Femur internal rotation and adduction resulted in the greatest increases in patella cartilage stress. In contrast, tibia rotations in the transverse and frontal planes had minimal to no influence on patella cartilage stress. These results emphasize the need for clinicians to identify and correct faulty hip kinematics in persons with PFP.
•To determine the influence of femur and tibia rotations on patella cartilage stress.•Patella cartilage stress was examined using subject-specific finite element models.•Stress was obtained in healthy females during a squatting task.•Femur internal rotation resulted in greatest increases in patella cartilage stress.
We put forward and demonstrate a steerable optical beam visible light communication (VLC) system combining orthogonal frequency division multiplexing (OFDM) and non-orthogonal multiple access (NOMA) ...schemes, and utilizing a spatial light modulator (SLM)-based reconfigurable intelligent surface (RIS) for beam steering. When utilizing the SLM as RIS for optical beam steering, its operation principle, maximum achievable steering angle (i.e., field-of-view, FOV), as well as the corresponding loss should be analyzed. We theoretically and experimentally analyzed in detail the characters of SLM when acting as the RIS. Experimental results demonstrate the flexibility of both active beam control and data rate allocation for multiple users. The SLM-based RIS can independently and simultaneously control multiple beams, and significantly reduce the deploying cost of the increase in the devices for the multi-beam handling scenario. All of the specified channels under evaluation satisfy the pre-forward error correction bit-error rate limit (pre-FEC BER = 3.8 × 10 −3 ).
Locally advanced colon cancer (LACC) is associated with surgical challenges during R0 resection, increased postoperative complications, and unfavorable treatment outcomes. Neoadjuvant concurrent ...chemoradiotherapy followed by surgical resection is an effective treatment strategy that can increase the complete surgical resection rate and improve the patient survival rate. This study investigated the efficacy and toxicity of concurrent chemoradiotherapy in patients with LACC as well as the prognosis and long-term clinical outcomes of these patients.
From January 2012 to July 2020, we retrospectively reviewed the real-world data of 75 patients with LACC who received neoadjuvant concurrent chemoradiotherapy. The chemotherapy regimen consisted of folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX). The following data were obtained from medical records: patients' characteristics, pathologic results, toxicity, and long-term oncologic outcome.
Of the 75 patients, 13 (17.3%) had pathologic complete responses. Hematologic adverse effects were the most common (grade 1 anemia: 80.0% and leukopenia: 82.7%). Conversely, grade 2 or 3 adverse effects were relatively uncommon (<10%). Pathologic N downstaging, ypT0, and pathologic complete responses were significant prognostic factors for patient survival. Multivariate analysis revealed that pathologic N downstaging was an independent predictor of patients' overall survival (P = 0.019). The estimated 5-year overall and disease-free survival rates were 68.6% and 50.6%, and the medians of overall and disease-free survival periods were 72.3 and 58.7 months, respectively. Moreover, patients with pathologic complete responses had improved overall survival (P = 0.039) and an improved local recurrence control rate (P = 0.042) but an unfavorable distant metastasis control rate (P = 0.666) in the long-term follow-up.
The long-term oncologic outcome of patients with LACC following concurrent chemoradiotherapy is acceptable, and the adverse effects seem to be tolerable. Pathologic N downstaging was an independent prognostic factor for patients' overall survival. However, a large prospective, randomized control study is required to confirm the current results.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Pneumonia is a leading cause of death worldwide, ranking third both globally and in Taiwan. This guideline was prepared by the 2017 Guidelines Recommendations for Evidence-based Antimicrobial agents ...use in Taiwan (GREAT) working group, formed under the auspices of the Infectious Diseases Society of Taiwan (IDST). A consensus meeting was held jointly by the IDST, Taiwan Society of Pulmonary and Critical Care Medicine (TSPCCM), the Medical Foundation in Memory of Dr. Deh-Lin Cheng, the Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines. The final guideline was endorsed by the IDST and TSPCCM. The major differences between this guideline and the 2007 version include the following: the use of GRADE methodology for the evaluation of available evidence whenever applicable, the specific inclusion of healthcare-associated pneumonia as a category due to the unique medical system in Taiwan and inclusion of recommendations for treatment of pediatric pneumonia. This guideline includes the epidemiology and recommendations of antimicrobial treatment of community-acquired pneumonia, hospital-acquired pneumonia, ventilator-associated pneumonia, healthcare-associated pneumonia in adults and pediatric pneumonia.
This aim of this study was to evaluate the effects of time interval between the completion of radiotherapy and robotic-assisted surgery on the outcomes among patients with rectal cancer undergoing ...preoperative concurrent chemoradiotherapy (CCRT).
In total, 116 patients with stage I-III rectal cancer who underwent preoperative CCRT and robotic-assisted surgery between September 2013 and February 2019 were enrolled. Patients were categorized into two groups based on the time interval: group A (10-12 weeks) and group B (≥ 12 weeks).
Among the 116 enrolled patients, 98 (84.5%) had middle and lower rectal cancers. Two (1.7%) patients underwent abdominoperineal resection with a sphincter preservation rate of 98.3%. Thirty-seven (31.9%) patients had a pathologic complete response (pCR). The circumferential resection margin and distal resection margin were positive in 2 (1.7%) and 1 (0.9%) patients, respectively. Therefore, the R0 resection rate was 97.4%. A total of 24 (22.4%) patients experienced postoperative relapse and 12 (10.3%) patients died; these were slightly more common in group B than in group A (28.8% vs 15.8% and 15.3% vs 5.3%, respectively; both P > 0.05); however, this difference was nonsignificant. Three-year disease-free survival (DFS) and overall survival (OS) were 75% and 89%, respectively, among all patients. Non-significant trend of favorable 3-year DFS, 3-year OS, 3-year locoregional control rate and 3-year distant metastasis control rate were observed in group A compared with group B (all P > 0.05).
Robotic-assisted surgery after a longer interval is safe and feasible for patients with rectal cancer undergoing preoperative CCRT. The present study's results suggested that the time interval of 10-12 weeks can be considered because comparable clinical and perioperative outcomes and preferable oncological outcomes were observed for interval of this length. However, future prospective randomized clinical trials are required to verify the present finding.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Whether high or low ligation of the inferior mesenteric artery (IMA) is superior in surgery for rectal and sigmoid colon cancers remains controversial. Although several meta-analyses have been ...conducted, the level of lymph node clearance was poorly defined. We performed a meta-analysis comparing high and low ligation of the IMA for sigmoid colon and rectal cancers, with emphasis on high dissection of the lymph node at the IMA root in all the included studies.
PubMed, MEDLINE, and EMBASE databases were searched to identify relevant articles published until 2020. The patient's perioperative and oncologic outcomes were analyzed. Statistical analysis was performed using the statistical software RevMan version 5.4.
A total of 17 studies, including four randomized controlled trials, published between 2011 and 2020 were selected. In total, 1,846 patients received low ligation of the IMA plus high dissection of lymph nodes (LL+HD), and 2,648 patients received high ligation of the IMA (HL). LL+HD was associated with low incidence of anastomotic leakage (
< 0.001), borderline long operative time (
= 0.06), and less yields of total lymph nodes (
= 0.03) but equivalent IMA root lymph nodes (
= 0.07); moreover, LL+HD exhibited non-inferior long-term oncological outcomes.
In comparison with HL, LL+HD was an effective and safe oncological procedure for sigmoid colon and rectal cancers. Therefore, to ligate the IMA below the level of the left colic artery with D3 high dissection for sigmoid colon and rectal cancers might be suggested once the surgeons are familiar with this technique.
INPLASY.com, identifier 202190029.
P2Y12 inhibitor monotherapy is a feasible alternative treatment for patients after percutaneous coronary intervention (PCI) in the modern era. Clinical trials have shown that it could lower the risk ...of bleeding complications without increased ischemic events as compared to standard dual antiplatelet therapy (DAPT). However, the efficacy and safety of this novel approach among patients with acute coronary syndrome (ACS) are controversial because they have a much higher risk for recurrent ischemic events. The purpose of this study is to evaluate the efficacy and safety of this novel approach among patients with ACS. We conducted a meta-analysis of randomized controlled trials that compared P2Y12 inhibitor monotherapy with 12-month DAPT in ACS patients who underwent PCI with stent implantation. PubMed, Embase, the Cochrane library database, ClinicalTrials.gov, and other three websites were searched for data from the earliest report to July 2022. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction, stent thrombosis, or stroke. The primary safety outcome was major or minor bleeding events. The secondary endpoint was net adverse clinical events (NACE), defined as a composite of major bleeding and adverse cardiac and cerebrovascular events. Five randomized controlled trials with a total of 21,034 patients were included in our meta-analysis. The quantitative analysis showed a significant reduction in major or minor bleeding events in patients treated with P2Y12 inhibitor monotherapy as compared with standard DAPT(OR: 0.59, 95% CI: 0.46-0.75,
< 0.0001) without increasing the risk of MACCE (OR: 0.98, 95% CI: 0.86-1.13,
= 0.82). The NACE was favorable in the patients treated with P2Y12 inhibitor monotherapy (OR: 0.82, 95% CI: 0.73-0.93,
= 0.002). Of note, the overall clinical benefit of P2Y12 inhibitor monotherapy was quite different between ticagrelor and clopidogrel. The incidence of NACE was significantly lower in ticagrelor monotherapy as compared with DAPT (OR: 0.79, 95% CI: 0.68-0.91), but not in clopidogrel monotherapy (OR: 1.14, 95% CI: 0.79-1.63). Both clopidogrel and ticagrelor monotherapy showed a similar reduction in bleeding complications (OR: 0.46, 95% CI: 0.22-0.94; OR: 0.60, 95% CI: 0.44-0.83, respectively). Although statistically insignificant, the incidence of MACCE was numerically higher in clopidogrel monotherapy as compared with standard DAPT (OR: 1.50, 95% CI: 0.99-2.28,
= 0.06). Based on these findings, P2Y12 inhibitor monotherapy with ticagrelor would be a better choice of medical treatment for ACS patients after PCI with stent implantation in the current era.
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