The efficacy of treatment of Helicobacter pylori infection has decreased steadily because of increasing resistance to clarithromycin, metronidazole, and levofloxacin. Resistance to amoxicillin is ...generally low, and high intragastric pH increases the efficacy of amoxicillin, so we investigated whether a combination of a high-dose proton pump inhibitor and amoxicillin (dual therapy) was more effective than standard first-line or rescue therapies in eradicating H pylori.
We performed a large-scale multihospital trial to compare the efficacy of a high-dose dual therapy (HDDT) with that of standard therapies in treatment-naive (n = 450) or treatment-experienced (n = 168) patients with H pylori infection. Treatment-naive patients were randomly assigned to groups given HDDT (rabeprazole 20 mg and amoxicillin 750 mg, 4 times/day for 14 days, group A1), sequential therapy for 10 days (group B1), or clarithromycin-containing triple therapy for 7 days (group C1). Treatment-experienced patients were randomly assigned to groups given HDDT for 14 days (group A2), sequential therapy for 10 days (B2), or levofloxacin-containing triple therapy for 7 days (C2). H pylori infection was detected by using the (13)C-urea breath test. We evaluated factors associated with treatment outcomes.
In the intention-to-treat analysis, H pylori was eradicated in 95.3% of patients in group A1 (95% confidence interval CI, 91.9%-98.8%), 85.3% in B1 (95% CI, 79.6%-91.1%), and 80.7% in group C1 (95% CI, 74.3%-87.1%). Infection was eradicated in 89.3% of patients in group A2 (95% CI, 80.9%-97.6%), 51.8% in group B2 (95% CI, 38.3%-65.3%), and 78.6% (95% CI, 67.5%-89.7%) in group C2. The efficacy of HDDT was significantly higher than that of currently recommended regimens, irrespective of CYP2C19 genotype. Bacterial resistance to drugs was associated with treatment failure. There were no significant differences between groups in adverse events or patient adherence.
HDDT is superior to standard regimens as empirical first-line or rescue therapy for H pylori infection, with similar safety profiles and tolerability. ClinicalTrials.gov number: NCT01163435.
It is discovered that the memory‐type behaviors of novel carbohydrate‐block‐polyisoprene (MH‐b‐PI) block copolymers‐based devices, including write‐once‐read‐many‐times, Flash, and ...dynamic‐random‐access‐memory, can be easily controlled by the self‐assembly nanostructures (vertical cylinder, horizontal cylinder, and order‐packed sphere), in which the MH and PI blocks, respectively, provide the charge‐trapping and stretchable function. With increasing the flexible PI block length, the stretchability of the designed copolymers can be significantly improved up to 100% without forming cracks. Thus, intrinsically stretchable resistive memory devices (polydimethylsiloxane(PDMS)/carbon nanotubes(CNTs)/MH‐b‐PI thin film/Al) using the MH‐b‐PI thin film as an active layer is successfully fabricated and that using the MH‐b‐PI12.6k under 100% strain exhibits an excellent ON/OFF current ratio of over 106 (reading at −1 V) with stable V
set around −2 V. Furthermore, the endurance characteristics can be maintained over 500 cycles upon 40% strain. This work establishes and represents a novel avenue for the design of green carbohydrate‐derived and stretchable memory materials.
Novel stretchable block copolymers, carbohydrate‐block‐polyisoprene (MH‐b‐PI), designed for developing fully stretchable resistive memory, are demonstrated. Diverse self‐assembly nanostructures with respect to the ratio of charge‐trapping MH to stretchable PI can exhibit different memory behaviors. The polymer with longer PI, MH‐b‐PI12.6k, shows an excellent ON/OFF ratio of over 106 upon 100% stretching and the endurance characteristics can be maintained over 500 cycles.
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has been used as a damage control procedure in trauma patients. We hypothesized that REBOA increases risk of venous thromboembolic ...(VTE) complications.
This was an American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database study. Excluded were transfers, deaths within 24 h, and severe head injuries. Included were trauma patients receiving REBOA within 4 h from arrival. Outcomes in the two groups were compared after using propensity score matching (PSM) for demographic and clinical characteristics, body area abbreviated injury scale, injury severity score, pelvis and lower extremity fractures, angiographic intervention, preperitoneal pelvic packing, pharmacological VTE prophylaxis, laparotomy, laparotomy and specific orthopedic procedures.
After PSM, 339 REBOA patients were matched with 663 patients with No REBOA. REBOA patients were significantly more likely to develop pulmonary embolism (PE) (5.3% vs. 2.7%, p = .037) and VTE (14.7% vs. 10.0%, p = .025).
REBOA is associated with an increased risk of PE and VTE complications. Patients managed with REBOA should receive adequate thromboprophylaxis and be monitored closely for VTE complications.
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•REBOA in trauma patients:•Higher incidence of venous thromboembolic complications.•Higher incidence of pulmonary embolism.•Higher incidence acute kidney injuries.
Few investigations have been made to determine what factors influence people in withholding knowledge from their colleagues. We created a construct,
knowledge withholding (KW), defined as the ...likelihood that individuals contribute less knowledge to others in the organization than they could. We have formulated a model, based on social exchange theory and social cognition theory, to analyze the antecedents of KW from both personal and contextual perspectives. The contextual influencers were subdivided into dimensions of rational choice, normative conformity, and affective bonding to help in understanding KW. Results of a survey of 162 MIS alumni of a university, who had experienced software development, trust, distributive justice, and team-related work showed that personal outcome expectations had a substantial influence on KW.
Bone loss induced by hypoxia is associated with various pathophysiological conditions, however, little is known about the effects of hypoxia and related signaling pathways on osteoblast ...differentiation and bone formation. Because bone marrow-derived mesenchymal stem cells (MSCs) survive under hypoxic conditions and readily differentiate into osteoblasts by standard induction protocols, they are a good in vitro model to study the effects of hypoxia on osteoblast differentiation.
Using human MSCs, we discovered TWIST, a downstream target of HIF-1α, was induced under hypoxia and acted as a transcription repressor of RUNX2 through binding to the E-box located on the promoter of type 1 RUNX2. Suppression of type 1 RUNX2 by TWIST under hypoxia further inhibited the expression of BMP2, type 2 RUNX2 and downstream targets of RUNX2 in MSCs.
Our findings point to the important role of hypoxia-mediated signalling in osteogenic differentiation in MSCs through direct regulation of RUNX2 by TWIST, and provide a method for modifying MSC osteogenesis upon application of these cells in fracture healing and bone reconstruction.
2D transition metal dichalcogenide (TMD) layered materials are promising for future electronic and optoelectronic applications. The realization of large‐area electronics and circuits strongly relies ...on wafer‐scale, selective growth of quality 2D TMDs. Here, a scalable method, namely, metal‐guided selective growth (MGSG), is reported. The success of control over the transition‐metal‐precursor vapor pressure, the first concurrent growth of two dissimilar monolayer TMDs, is demonstrated in conjunction with lateral or vertical TMD heterojunctions at precisely desired locations over the entire wafer in a single chemical vapor deposition (VCD) process. Owing to the location selectivity, MGSG allows the growth of p‐ and n‐type TMDs with spatial homogeneity and uniform electrical performance for circuit applications. As a demonstration, the first bottom‐up complementary metal‐oxide‐semiconductor inverter based on p‐type WSe2 and n‐type MoSe2 is achieved, which exhibits a high and reproducible voltage gain of 23 with little dependence on position.
Dissimilar transition metal dichalcogenides (TMDs) are grown concurrently and location‐selectively by a new method. Precise control over the transition‐metal‐precursor vapor pressure allows successful lateral and vertical heterojunction growth, as well as growth of p‐ and n‐type TMDs at desired locations. A new synthetic strategy for future (opto)electronic applications is thus provided.
The factors influencing KMS usage are of major concern to the MIS community. Among the diverse theories employed to help understand this is task technology fit (TTF), which considers the needed ...technological characteristics of the task as a major factor determining usage. This theory, however, ignores the personal cognition dimension, which has been found to affect the use of an IS. By integrating TTF and social cognitive theory (SCT), we attempted to determine the key factors affecting KMS usage in IT, the organizational task, and personal cognition. Through a survey of 192 KMS users, task interdependence, perceived task technology fit, KMS self-efficacy, and personal outcome expectations were found to have substantial influences on KMS usage. Among the key factors, KMS self-efficacy was found to be especially important as it was substantially and positively correlated to perceived task technology fit, personal and performance-related outcome expectations, and KMS usage.
Research on electronic channel materials has traditionally focused on bulk and nanocrystals, nanowires, and nanotubes. However, the recent surge of interest in two-dimensional (2D) transition-metal ...dichalcogenides (TMDs) has emerged as a game-changer in this field. The atomically thin structure of 2D TMDs offers unique electronic and optical properties, which have been shown to have significant potential in various applications, such as optoelectronics, energy harvesting, and spintronics. Epitaxy growth of single-crystal 2D TMDs on oxide or metallic substrates has opened up new opportunities for direct integration into existing manufacturing pathways. In this article, we discuss recent advances in achieving continuous single-crystallinity of 2D TMDs on oxide and metallic substrates by controlling the nucleation and growth rate of crystalline domains. We also review strategies for the controlled introduction of defects through postgrowth processing and substrate engineering. Finally, we highlight emerging strategies, new opportunities, and remaining challenges for bridging the gap between lab innovations and commercialization. The ability to grow high-quality 2D TMDs on scalable and industry-compatible substrates represents a significant breakthrough in the field of electronic materials and has the potential to revolutionize the semiconductor industry. Despite the remaining challenges, the future of 2D TMDs looks promising. Their integration into existing manufacturing pathways could open up new avenues for advanced electronic devices with improved performance and reduced power consumption.
Graphical abstract
The decision of members in a knowledge-intensive team to withhold their knowledge may threaten the performance of the team. To address the problem of knowledge resource risk in project teams, we ...maintain that it is important to understand why team members choose to withhold their knowledge, conceptualized as knowledge-withholding intentions. In line with the literature on effort withholding, the research on multifoci relations between justice perceptions and social exchanges, and social cognitive theory, we proposed that the social exchange relationships that individuals form in the workplace, their perceptions of justice, and their knowledge withholding self-efficacy would influence their knowledge-withholding intentions. Through a survey of 227 information system development team workers, we found that all social exchange relationship variables had a significant impact on knowledge-withholding intentions. However, the justice perception variables only indirectly influenced knowledge-withholding intentions through the mediation of social exchange relationships. In addition, one of the task variables, task interdependence, influenced knowledge withholding intentions through the mediation of knowledge withholding self-efficacy. Our results contribute to the knowledge management literature by providing a better understanding of the antecedents of knowledge withholding. We also offer suggestions for future research utilizing the framework of Kidwell and Bennett (1993) to study effort and knowledge withholding.
•We investigate factors that influence team members’ knowledge withholding intentions (KWI).•Perceived organizational support, leader-member and team-member exchange directly reduce KWI.•Justice perceptions indirectly influence KWI through meditation of social exchange variables.•KWSE mediates the relationship between task interdependence and KWI.
What is known and objective
The role of continuous/extended beta‐lactam infusions (CEIs) in improving clinical outcomes among critically ill patients remains controversial. Therefore, we aimed to ...compare the clinical efficacy of CEI versus intermittent administration (IA) of beta‐lactams by performing a systematic review and meta‐analysis.
Methods
PubMed, the Cochrane Library and Embase were searched from inception until December 2018 for studies comparing clinical outcomes of CEI versus IA in critically ill patients. The meta‐analysis included 18 randomized controlled trials (RCTs) and 13 non‐RCTs.
Results and discussion
For CEI versus IA, the summary relative risk (RR) for overall mortality and clinical cure was 0.82 (95% confidence interval CI: 0.72–0.94) and 1.31 (95% CI: 1.15–1.49), respectively. Subgroup and meta‐regression analyses of the loading dose revealed a significantly increased clinical cure rate in the loading‐dose group (RR: 1.44, 95% CI: 1.22–1.69), which remained significant after adjustments for beta‐lactam type, and association between clinical cure and loading dose for clinical cure (RR: 1.47, 95% CI: 1.20–1.80; p = .001). Subgroup analysis of administration type indicated that both groups had low mortality and high clinical cure rates; however, the heterogeneity analysis did not support an association across continuous infusion and extended infusion groups. Subgroup analysis of the Acute Physiology and Chronic Health Evaluation (APACHE) score was conducted; according to APACHE scores ≥ 16, overall mortality and clinical cure significantly differed between CEI and IA.
What is new and conclusion
CEIs with loading‐dose treatment may significantly improve the clinical outcomes in critically ill sepsis or septic shock patients.
Our subgroup and meta‐regression analyses of the loading dose revealed a significantly increased clinical cure rate in the loading‐dose group (RR: 1.44, 95% CI: 1.22–1.69), which remained significant after adjustments for beta‐lactam type, and association between clinical cure and loading dose for clinical cure (RR: 1.47, 95% CI: 1.20–1.80; p = .001). According to APACHE scores ≥ 16, overall mortality and clinical cure significantly differed between CEI and IA.
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