Background： Klebsiellapneumoniae （KP） is a pathogen commonly causing nosocomial infection. Carbapenem-resistant KP （CRKP） is more resistant to multiple antimicrobial drugs than carbapenem-susceptible ...KP （CSKP） isolates. The aim of the present study was to identify the risk factors for CRKP infection and the predictors of mortality among KP-infected adult patients. Methods： Patients with CRKP and CSKP infection were categorized as the case group and control group, respectively, and we conducted a 1：1 ratio case-control study on these groups. The CRKP isolates collected were tested tbr antimicrobial susceptibility and presence of KP carbapenemase （KPC） gene. Clinical data were collected to identity risk factors for CRKP infection and mortality of KP infection. Risk factors were analyzed under univariable and multivariable logistic regression model. Results： The independent risk factors for CRKP infection were admission to Intensive Care Unit （odds ratio OR： 15.486, 95% confidence interval CI： 3.175-75.541, P 〈 0.001）; use of I3-1actams and 3-1actamase inhibitor combination （OR： 4.765, 95% CI： 1.508-15.055, P = 0.008）： use of cephalosporins （OR： 8.033, 95% CI： 1.623-39.763, P = P= 0.019）： and indwelling of urethral catheter （OR： 6.164, 95% CI： 1.847 0.011 ）; fluoroquinolones （OR： 6.090, 95% CI： 1.343-27.613, -20.578, P = 0.003）. However, older age （OR： 1.079, 95% CI： 1.005-1.158, P= 0.036）, Charlson comorbidity index （OR： 4.690, 95% CI：2.094-10.504, P= 0.000）, and aminoglycoside use （OR： 670.252, 95% CI： 6.577-68,307.730, P = 0.006） were identified as independent risk factors for patient deaths with KP infection. The mortality of CRKP group was higher than that of the CSKP group. KPC gene did not play a role in the CRKP group. CRKP mortality was high. Conclusion： Implementation of infection control measures and protection of the immunefunction are crucial.
As of June 8, 2020, the global reported number of COVID-19 cases had reached more than 7 million with over 400 000 deaths. The household transmissibility of the causative pathogen, severe acute ...respiratory syndrome coronavirus 2 (SARS-CoV-2), remains unclear. We aimed to estimate the secondary attack rate of SARS-CoV-2 among household and non-household close contacts in Guangzhou, China, using a statistical transmission model.
In this retrospective cohort study, we used a comprehensive contact tracing dataset from the Guangzhou Center for Disease Control and Prevention to estimate the secondary attack rate of COVID-19 (defined as the probability that an infected individual will transmit the disease to a susceptible individual) among household and non-household contacts, using a statistical transmission model. We considered two alternative definitions of household contacts in the analysis: individuals who were either family members or close relatives, such as parents and parents-in-law, regardless of residential address, and individuals living at the same address regardless of relationship. We assessed the demographic determinants of transmissibility and the infectivity of COVID-19 cases during their incubation period.
Between Jan 7, 2020, and Feb 18, 2020, we traced 195 unrelated close contact groups (215 primary cases, 134 secondary or tertiary cases, and 1964 uninfected close contacts). By identifying households from these groups, assuming a mean incubation period of 5 days, a maximum infectious period of 13 days, and no case isolation, the estimated secondary attack rate among household contacts was 12·4% (95% CI 9·8–15·4) when household contacts were defined on the basis of close relatives and 17·1% (13·3–21·8) when household contacts were defined on the basis of residential address. Compared with the oldest age group (≥60 years), the risk of household infection was lower in the youngest age group (<20 years; odds ratio OR 0·23 95% CI 0·11–0·46) and among adults aged 20–59 years (OR 0·64 95% CI 0·43–0·97). Our results suggest greater infectivity during the incubation period than during the symptomatic period, although differences were not statistically significant (OR 0·61 95% CI 0·27–1·38). The estimated local reproductive number (R) based on observed contact frequencies of primary cases was 0·5 (95% CI 0·41–0·62) in Guangzhou. The projected local R, had there been no isolation of cases or quarantine of their contacts, was 0·6 (95% CI 0·49–0·74) when household was defined on the basis of close relatives.
SARS-CoV-2 is more transmissible in households than SARS-CoV and Middle East respiratory syndrome coronavirus. Older individuals (aged ≥60 years) are the most susceptible to household transmission of SARS-CoV-2. In addition to case finding and isolation, timely tracing and quarantine of close contacts should be implemented to prevent onward transmission during the viral incubation period.
US National Institutes of Health, Science and Technology Plan Project of Guangzhou, Project for Key Medicine Discipline Construction of Guangzhou Municipality, Key Research and Development Program of China.
The American Joint Committee on Cancer (AJCC) staging system is inadequate for an accurate prognosis in nasopharyngeal carcinoma (NPC). Thus, new biomarkers are under intense investigation. Here, we ...investigated whether the density of TILs could predict prognosis in NPC. First, we used 1490 cases of nasopharyngeal carcinoma samples from two independent cohorts to evaluate the density and distribution of tumor‐infiltrating lymphocytes (TILs). Second, in one cohort, we assessed associations between TILs and clinical outcomes in 593 randomly selected samples (defined as the training set) and validated findings in the remaining 593 samples (defined as the validation set). Furthermore, we confirmed the prognostic value of TILs in a second independent cohort of 304 cases (defined as the independent set). Based on multivariable Cox regression analysis, we also established an effective prognostic nomogram including TILs to improve accuracy in predicting disease‐free survival (DFS) for patients with nondisseminated NPC. We found that high TILs in the training set were significantly associated with favorable DFS hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.28–0.58, p < 0.001, overall survival (OS, HR 0.42, 95% CI 0.27–0.64, p < 0.001), distant metastasis‐free survival (DMFS, HR 0.37, 95% CI 0.23–0.58, p < 0.001) and local‐regional recurrent free survival (LRRFS, HR 0.43, 95% CI 0.25–0.73, p = 0.002). Multivariate analysis showed that TILs are an independent prognostic indicator for DFS in all cohorts. In summary, this study indicated that TILs may reflect the immunological heterogeneity of NPC and could represent a new prognostic biomarker.
What's new?
Doctors typically use tumor stage to help determine cancer prognosis, but for nasopharyngeal cancer, it is not precise enough. These authors turned to the immune system for prognostic clues. They looked at the density and distribution of tumor‐infiltrating lymphocytes (TILs) in NPC patients from China. TILs turned out to be a strong independent predictor of disease‐free survival: greater numbers of TILs, they found, meant better outcomes. Once a standardized method for evaluating TILs can be developed, this metric could be extremely valuable for predicting disease progression in NPC patients.
Leveraging the outstanding nonlinear optical properties and the ultra‐high spatial confinement of light, microresonators based on lithium niobate (LN) thin films have emerged as intriguing elements ...in various frontiers such as integrated photonic circuits and quantum photonics. A number of applications have been realized based on LN thin‐film microresonators toward various on‐chip devices. In this paper, the recent advances of microresonators based on LN thin films are reviewed, including essential techniques used in fabrication/characterization and a detailed overview of applications, ranging from frequency conversion, electro‐optic modulation, frequency combs, microwave‐to‐optical transducers, quantum photonics, to lasing. A short summary and perspective is presented to indicate possible research topics related to LN thin‐film.
Leveraging the outstanding nonlinear optical properties and the ultra‐high spatial confinement of light, microresonators based on lithium niobate thin films have emerged as intriguing elements in various frontiers such as integrated photonic circuits and quantum photonics. In this paper, the fabrication technologies used to produce and probe lithium niobate thin‐film microresonators are summarized, together with their ingenious applications.
•The removal ratio of phosphate onto Zn–Al LDH was higher than Mg–Al LDH and reached 95% respectively.•Mg–Al and Zn–Al LDHs exhibited rapid adsorption rates of phosphate and could reach equilibrium ...at 40min.•Phosphate species are adsorbed by LDHs via electrostatic attraction, ligand exchange and ion exchange.
Phosphate removal is important for the natural water or wastewater treatment, and adsorption is an efficient treatment process. In this study, Mg–Al and Zn–Al layered double hydroxides (LDHs) were synthesized by co-precipitation method at a constant pH of 9–10. The prepared LDHs were characterized by X-ray diffraction (XRD) and BET surface area determination. The XRD patterns showed the characteristic basal reflections of hydrotalcite-like LDH materials. BET surface area of Zn–Al LDH was larger than that of Mg–Al LDH. Adsorption experiments were carried out as a function of LDHs dosage, contact time and initial pH of phosphate solution. The adsorption of phosphate reached equilibrium quickly at about 40min. The experimental data showed a good compliance with the pseudo-second-order kinetic model. The Freundlich and Langmuir models both described the adsorption isotherm data well (R2>0.98). Zeta potential and fourier transform infrared spectroscopy (FTIR) analyses were used to elucidate adsorption mechanisms. The results indicated that phosphate species were adsorbed via electrostatic attraction, ligand exchange and ion exchange. The removal ratio of phosphate onto Zn–Al LDH was higher than Mg–Al LDH and reached 95% respectively, suggesting that Mg–Al and Zn–Al LDHs were excellent adsorbents for phosphorus removal from aqueous solution.
Gene expression patterns can be used as prognostic biomarkers in various types of cancers. We aimed to identify a gene expression pattern for individual distant metastatic risk assessment in patients ...with locoregionally advanced nasopharyngeal carcinoma.
In this multicentre, retrospective, cohort analysis, we included 937 patients with locoregionally advanced nasopharyngeal carcinoma from three Chinese hospitals: the Sun Yat-sen University Cancer Center (Guangzhou, China), the Affiliated Hospital of Guilin Medical University (Guilin, China), and the First People's Hospital of Foshan (Foshan, China). Using microarray analysis, we profiled mRNA gene expression between 24 paired locoregionally advanced nasopharyngeal carcinoma tumours from patients at Sun Yat-sen University Cancer Center with or without distant metastasis after radical treatment. Differentially expressed genes were examined using digital expression profiling in a training cohort (Guangzhou training cohort; n=410) to build a gene classifier using a penalised regression model. We validated the prognostic accuracy of this gene classifier in an internal validation cohort (Guangzhou internal validation cohort, n=204) and two external independent cohorts (Guilin cohort, n=165; Foshan cohort, n=158). The primary endpoint was distant metastasis-free survival. Secondary endpoints were disease-free survival and overall survival.
We identified 137 differentially expressed genes between metastatic and non-metastatic locoregionally advanced nasopharyngeal carcinoma tissues. A distant metastasis gene signature for locoregionally advanced nasopharyngeal carcinoma (DMGN) that consisted of 13 genes was generated to classify patients into high-risk and low-risk groups in the training cohort. Patients with high-risk scores in the training cohort had shorter distant metastasis-free survival (hazard ratio HR 4·93, 95% CI 2·99–8·16; p<0·0001), disease-free survival (HR 3·51, 2·43–5·07; p<0·0001), and overall survival (HR 3·22, 2·18–4·76; p<0·0001) than patients with low-risk scores. The prognostic accuracy of DMGN was validated in the internal and external cohorts. Furthermore, among patients with low-risk scores in the combined training and internal cohorts, concurrent chemotherapy improved distant metastasis-free survival compared with those patients who did not receive concurrent chemotherapy (HR 0·40, 95% CI 0·19–0·83; p=0·011), whereas patients with high-risk scores did not benefit from concurrent chemotherapy (HR 1·03, 0·71–1·50; p=0·876). This was also validated in the two external cohorts combined. We developed a nomogram based on the DMGN and other variables that predicted an individual's risk of distant metastasis, which was strengthened by adding Epstein–Barr virus DNA status.
The DMGN is a reliable prognostic tool for distant metastasis in patients with locoregionally advanced nasopharyngeal carcinoma and might be able to predict which patients benefit from concurrent chemotherapy. It has the potential to guide treatment decisions for patients at different risk of distant metastasis.
The National Natural Science Foundation of China, the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period, the Natural Science Foundation of Guang Dong Province, the National Key Research and Development Program of China, the Innovation Team Development Plan of the Ministry of Education, the Health & Medical Collaborative Innovation Project of Guangzhou City, China, and the Program of Introducing Talents of Discipline to Universities.
Chiral perovskites have emerged as a significant class of materials showing promising optoelectronic and spintronic applications. Reports of chiral perovskite ferroelectrics, however, have been ...scarce. In this work, we have successfully synthesized homochiral lead–iodide perovskite ferroelectrics (R)‐N‐(1‐phenylethyl)ethane‐1,2‐diaminiumPbI4 and (S)‐N‐(1‐phenylethyl)ethane‐1,2‐diaminiumPbI4 by introducing a methyl group into the organic cation of the parent (N‐benzylethane‐1,2‐diaminium)PbI4. Vibrational circular dichroism spectra identify the chiral mirroring relationship. They both undergo 222F2‐type paraelectric–ferroelectric behavior at around 378 K coupled with clear ferroelastic domain “ON/OFF” switching. Besides, they exhibit an evident thermochromism with color change from orange–yellow to orange–red. To our knowledge, the discovery of integrated ferroelectricity, ferroelasticity, and reversible thermochromism in chiral perovskites is unprecedented.
2D homochiral lead‐iodide perovskites were constructed by the introduction of a chiral center. The perovskites exhibit coexisting ferroelectricity, ferroelasticity, and reversible thermochromism, offering great application prospects for next‐generation smart devices.
Although tumor mutation burden (TMB) has been well known to predict the response to immune checkpoint inhibitors (ICI), lack of randomized clinical trial data has restricted its clinical application. ...This study aimed to explore the significance and feasibility of biomarker combination based on TMB and copy-number alteration (CNA) for the prognosis of each tumor and prediction for ICI therapy in metastatic pan-cancer milieu.
Non-ICI-treated MSK pan-cancer cohort was used for prognosis analysis. Three independent immunotherapy cohorts, including non-small cell lung cancer (
= 240), skin cutaneous melanoma (
= 174), and mixed cancer (Dana-Farber,
= 98) patients from previous studies, were analyzed for efficacy of ICI therapy.
TMB and CNA showed optimized combination for the prognosis of most metastatic cancer types, and patients with TMB
CNA
showed better survival. In the predictive analysis, both TMB and CNA were independent predictive factors for ICI therapy. Remarkably, when TMB and CNA were jointly analyzed, those with TMB
CNA
showed favorable responses to ICI therapy. Meanwhile, TMB
CNA
as a new biomarker showed better prediction for ICI efficacy compared with either TMB-high or CNA-low alone. Furthermore, analysis of the non-ICI-treated MSK pan-cancer cohort supported that the joint stratification of TMB and CNA can be used to categorize tumors into distinct sensitivity to ICI therapy across pan-tumors.
The combination of TMB and CNA can jointly stratify multiple metastatic tumors into groups with different prognosis and heterogeneous clinical responses to ICI treatment. Patients with TMB
CNA
cancer can be an optimal subgroup for ICI therapy.
•Mg–Al-LDH was well crystallized and highly efficient in removing three red dyes.•The adsorption rate of the red dyes by Mg–Al-LDH was fast and reached equilibrium after 60min.•The three red dyes ...were adsorbed by Mg–Al-LDH via anion exchange, also by electrostatic forces of attraction for congo red.
The Mg–Al-CO3-LDH with Mg2+/Al3+ molar ratio of 2 was prepared via coprecipitation method at constant pH of 9–10 and used to remove three red dyes by batch adsorption method. The results showed the Mg–Al-LDH were well crystallized and can adsorb the red dyes effectively. The optimal adsorbent dosage and contact time were 1.0g and 60min, respectively. Adsorbed amount hardly changed when pH<10. The adsorption kinetics fit the pseudo-second order kinetic models well and isotherms correspond to Langmuir model strictly. All the relevant mechanisms were studied and manifested as anion exchange and also electrostatic attraction for CR.
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