Intrahospital spread of Candida auris, which survives tenaciously in many environments, can cause sustained colonization and infection. A large outbreak of C. auris was experienced in the intensive ...care units (ICUs) at the study hospital during the coronavirus disease 2019 (COVID-19) pandemic.
The index patient with severe COVID-19, who was transferred from Vietnam in January 2022, developed C. auris candidaemia 10 days after hospitalization. From mid-June 2022 to January 2023, strengthened infection prevention and control (IPC) measures were implemented in three ICUs: (1) contact precautions and isolation (CPI) for C. auris-positive cases; (2) surveillance cultures including point-prevalence (N=718) for patients or close contacts or ICU-resident healthcare workers (HCWs); (3) intensive environmental disinfection with 10-fold diluted bleach; and (4) 2% chlorhexidine bathing for all ICU patients. Environmental cultures (ECx) on surfaces and shared objects (N=276) were conducted until early September 2022, when all ECx were negative.
Among 53 C. auris-positive patients between February 2022 and January 2023, invasive infections resulted in seven cases of candidaemia and one case of pneumonia. C. auris was isolated from reusable tympanic thermometers (TTMs) contaminated with earwax. The isolation rate of C. auris in ECx decreased from 6.8% in June 2022 to 2.0% in August 2022, and was no longer detected in TTMs. Colonization in HCWs was remarkably rare (0.5%). The number of C. auris-positive patients peaked in July (N=10) then decreased gradually. By January 2023, no C. auris were isolated in the ICU.
Aggressive IPC measures with CPI, ECx and surveillance, decontamination of TTMs, and bathing were effective in successfully controlling this C. auris outbreak.
Urban wastewater treatment plants (WWTPs) as an important engineering facility for urban water pollution prevention and control, the appropriate location selection for the WWTPs is the most important ...stage in the process of wastewater treatment. Improper site selection can lead to degradation of the water environment. Phnom Penh is located in the delta between the Mekong River and Tonle Sap River, with dense population, and most residents are religious. There are no sufficient and proper WWTPs available in many areas resulting in the environmental degradation and human health issues, so it is used as the study area. In the article, we proposed a new indicator system to select the location for WWTPs. The indicator system is established from RS/GIS data, which integrates social-cultural and multiple others factors, and more comprehensively analyzes the spatial distribution of suitable and demand areas for WWTPs. Finally, the minimize facilities and maximize coverage model are further used for spatial location selection of WWTPs, which can supply scientific plan and technological support for location selection of the WWTPs.
Abstract
This study examines whether the number of hidden layers in a deep neural network significantly influences the model accuracy and efficiency for appraising housing prices. We provide ...empirical evidence that the deep neural network can achieve high accuracy with a small number of hidden layers on our dataset, which contains various hedonic variables. Furthermore, we show that adding layers does not necessarily guarantee the model’s accuracy and effectiveness of the computing time.
We evaluated the effect of ketamine as an adjunct to a fentanyl-based i.v. patient-controlled analgesia (IV-PCA) on postoperative nausea and vomiting (PONV) in patients at high risk of PONV ...undergoing lumbar spinal surgery.
Fifty non-smoking female patients were evenly randomized to either the control or ketamine group. According to randomization, patients received either ketamine 0.3 mg kg−1 i.v. or normal saline after anaesthetic induction with fentanyl-based IV-PCA either with or without ketamine mixture (3 mg kg−1 in 180 ml). The incidence and severity of PONV, volume of IV-PCA consumed, and pain intensity were assessed in the postanaesthesia care unit, and at postoperative 6, 12, 24, 36, and 48 h.
The overall incidence of PONV during the first 48 h after surgery was similar between the two groups (68 vs 56%, ketamine and control group, P=0.382). The total dose of fentanyl used during the first 48 h after operation was lower in the ketamine group than in the control group mean (sd), 773 (202) μg vs 957 (308) μg, P=0.035. The intensity of nausea (11-point verbal numerical rating scale) was higher in the ketamine group during the first 6 h after operation median (interquartile range), 6 (3–7) vs 2 (1.5–3.5), P=0.039, postoperative 12–24 h 5 (4–7) vs 2 (1–3), P=0.014, and postoperative 36–48 h 5 (4–7) vs 2 (1–3), P=0.036. Pain intensities were similar between the groups.
Ketamine did not reduce the incidence of PONV and exerted a negative influence on the severity of nausea. It was, however, able to reduce postoperative fentanyl consumption in patients at high-risk of PONV.
Abstract Our previous studies showed that the assembly of the GluR6–PSD95–mixed lineage kinase 3 (MLK3) signaling module played an important role in rat ischemic brain injury. In this study, we aimed ...to elucidate whether ischemic preconditioning could downregulate the assembly of the GluR6–PSD95–MLK3 signaling module and suppress the activation of MLK3, MKK4/7, and c-Jun N- terminal kinase (JNK). As a result, ischemic preconditioning could not only inhibit the assembly of the GluR6–PSD95–MLK3 signaling module, diminish the phosphorylation of the transcription factor c-Jun, downregulate Fas ligand expression, attenuate the phosphorylation of 14-3-3 and Bcl-2 and the translocation of Bax to mitochondria, but also increase the release of cytochrome c and the activation of caspase-3. In contrast, both GluR6 antisense ODNs (oligodeoxynucleotides) and 6,7,8,9-tetrahydro-5-nitro-1 H-benzgindole-2,3-dione-3-oxime (NS102), an antagonist of GluR6 receptor, prevented the above effects of preconditioning, which shows that suppressing the expression of GluR6 or inhibiting GluR6 activity contributes negatively to preconditioning-induced ischemia tolerance. Taken together, our results indicate that preconditioning can inhibit the over-assembly of the GluR6–PSD95–MLK3 signaling module and the JNK3 activation. GluR6 subunit-containing kainite receptors play an important role in the preconditioning-induced neuronal survival and provide new insight into stroke therapy.
The IL-3 alpha chain receptor (CD123) is a cell surface protein that is widely expressed by various subtypes of acute leukemia, including acute myeloid leukemia (AML), acute lymphoblastic leukemia ...and blastic plasmacytoid dendritic cell neoplasm. Notably, CD123 is preferentially overexpressed in leukemia stem cells (LSC) in contrast to normal hematopoietic stem cells, and this differential expression allows for the selective eradication of LSC and leukemic blasts through therapeutic targeting of CD123, with less impact on hematopoietic cells. The level of CD123 expression in AML correlates with both treatment response and outcomes. Therefore, targeting CD123 represents a promising universal therapeutic target in advanced acute leukemias irrespective of the individual leukemia phenotype. There are currently 31 ongoing clinical trials examining the utility of CD123-based targeted therapies. Here we focus our review on current efforts to target CD123 in acute leukemia through various therapeutic constructs.
Abstract The dynamics of nickel (Ni) uptake, transfer, retention and clearance in fetuses and late gestational rats were investigated by assessing its distributions in placenta, maternal and fetal ...organs and tissues during the 24 h period after a single dose of63 Ni intraperitoneal injection on gestational day 20. Peak63 Ni radioactivity was detected at 0.5 h in maternal blood, at 3 h in placenta, fetal membranes, fetal blood, fetal heart, maternal kidney, lung, stomach, liver and brain, at 9 h in fetal kidney, stomach, liver and brain, and lastly at 24 h in fetal lung and amniotic fluid. The maximal63 Ni radioactivity among all samples was detected consistently in the fetal membranes and placenta. The63 Ni radioactivity in fetal blood was higher than that in maternal blood from 3 to 24 h. The fetal liver, heart, stomach and brain exhibited higher63 Ni radioactivity than the corresponding maternal organs from 6 to 24 h. However, maternal kidney consistently exhibited significantly higher63 Ni radioactivity than the fetal kidney. The63 Ni in fetal lung and amniotic fluid increased throughout the period of experimental observation. These observations corroborated previous finding that nickel is actively transferred across the blood-placenta-barrier into fetus, but hardly from fetus to mother. Moreover, these results suggest that the placenta has a high affinity for nickel and its barrier does not protect the fetus from nickel exposure. The fact that nickel concentrations are higher in most fetal organs and tissues than in corresponding maternal organs and tissues in late gestation indicates that, unlike the dam, fetuses lack effective means for getting rid of excessive nickel due to its confined environment and relatively weak kidney functions. The situation is exacerbated by mother-to-fetus unidirectional transfer. Consequently, the fetuses are particularly vulnerable to the damaging effects of nickel.
•Postpartum uterine contraction pain is common and severe in some women.•Multiparous women experience more intense postpartum uterine contraction pain.•Women with dysmenorrhea have a higher risk of ...postpartum uterine contraction pain.•Breastfeeding exacerbates uterine contraction pain in the early postpartum period.
Postpartum uterine contraction pain has not been studied sufficiently. We aimed to assess the incidence, intensity, and risk factors for postpartum uterine contraction pain.
Women with singleton pregnancies who delivered vaginally were enrolled in this prospective, observational, single-institution study. We determined the numerical rating scale (NRS) score (0 to 10-point) for uterine contraction pain at 6, 12, 24, and 48 h after delivery. Generalized mixed modeling was used to identify the risk factors for significant postpartum uterine contraction pain (NRS score ≥3). We compared the incidence and severity of postpartum uterine contraction pain between nulliparous and multiparous women.
Two hundred and sixty-five nulliparous and 139 multiparous women were included. Forty-seven percent (188/404; 95% confidence interval CI 41.7% to 51.4%) of women presented with significant uterine contraction pain within 48 h of delivery. The generalized mixed model showed that nulliparous women had a lower risk of significant postpartum uterine contraction pain compared with multiparous women (odds ratio OR 0.33, 95% CI 0.17 to 0.61; P<0.001). Women with a history of dysmenorrhea had higher risk of significant postpartum uterine contraction pain (OR 1.77, 95% CI 1.12 to 2.79; P=0.014). Both nulliparous and multiparous women reported more intense uterine contraction pain while breastfeeding (P<0.001).
Postpartum uterine contraction pain is common and severe in some women. Parity and history of dysmenorrhea are significant risk factors for significant postpartum uterine contraction pain.
Micro ribonucleic acid (miRNA) is a type of noncoding RNA, and it has been revealed to play important roles in the activity of the mammary gland (MG) in some species. However, the function of miRNAs ...in MG of sheep is poorly understood. In the study, Gansu Alpine Merino (GAM; n = 9) and Small-tailed Han sheep (STH; n = 9) with different milk production traits were investigated. Microstructures and the expression profile of miRNAs of MG tissues at peak lactation were studied. Mature alveolar lumens of MG in appearance were larger in STH than GAM. The expression levels of CSN2 and the content of rough endoplasmic reticulum were also higher in STH ewes than GAM ewes. A total of 124 mature miRNAs were expressed, and 18 of these were differentially expressed between the 2 breeds. The KEGG analysis results showed that the targeted genes of differentially expressed miRNAs were mainly involved in some metabolic pathways and signaling pathways related to MG development, milk protein, and fat synthesis. The findings in the study can improve our understanding of the roles of miRNAs in the development and lactation of MG in sheep.
•The number of mature alveolar determines the milk yield of ewes.•The miRNAs may cause the difference in milk traits between 2 breeds.•Targeted genes of miRNAs were involved in mammary gland development and lactation.
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