S. Spoto, J. Daniel Markley, Emanuele Valeriani
et al.
Objective The prevalence of colonization with multidrug-resistant organisms (MDRO) has increased over the last decade, reaching levels as high as 23% in certain patient populations. Active surveillance cultures (ASC) represent a valuable tool to identify patients colonized with MDRO to apply preventive measures, reduce transmission, and guide empiric antimicrobial therapy. There is a paucity of data evaluating the impact of admission ASCs to predict future infection. The aim of this study was to evaluate the concordance between ASCs results and the development of clinical infection by the same microorganism identified in the surveillance swab (“swab-related infection”), in hospitalized septic patients, and to evaluate the presence of specific risk factors associated with the development of a swab-related infection. Methods All adults admitted to the Diagnostic and Therapeutic Medicine Department of the University Hospital Campus Bio-Medico of Rome with a diagnosis of infection or any other medical reason with admission surveillance swabs (rectal or nasal) between January 2018 and February 2021 were included in the study. A retrospective chart review was conducted to identify patients that developed infections with concordant MDROs identified on ASC, and the risk factors for swab-related infection. Secondary outcomes were need of intensive care unit transfer, length of stay, sepsis or septic shock development, and all-cause mortality. Results A total of 528 patients were included in the study, of which 97 (18.3%) had a positive surveillance swab. Among patients with positive surveillance swabs, 18 (18.5%) developed an infection with the same microorganism recovered from the swab, 57 (58.8%) developed an infection with a different microorganism than that recovered from the surveillance swab, and 22 (22.7%) did not develop an infection during hospitalization. The number of colonized sites, an interventional procedure within the previous 3 months, a Systemic Inflammatory Response Syndrome (SIRS) score ≥ 2, and a quick Sequential Organ Failure Assessment (q-SOFA) score ≥ 2 were associated with a significantly higher risk of developing a swab-related infection. SIRS and q-SOFA scores ≥ 2 and procalcitonin ≥ 0.43 ng/ml help for identifying patients with a swab-related infection. Conclusion Patients with positive surveillance swabs were at increased risk for development of infections by the same MDRO identified in surveillance swabs (swab-related infection). This study is the first to show that the positivity of surveillance swabs, in combination with anamnestic data, PCT values, and SIRS or q-SOFA scores, serves as a valuable tool to help clinicians predict patients at higher risk for swab-related infection development and guide the administration of appropriate empiric antimicrobial therapy in septic patients.
Abstract Useful fuels and chemicals can be produced from lignin by microwave-assisted pyrolysis, but a dearth of understanding of this process impedes its successful implementation. Continuous mass loss kinetics of the pyrolysis of Kraft lignin pellets were carried out in an innovative reactor system comprised of a high-Q cylindrical microwave resonant cavity and a specially designed quartz reactor, in the temperature range of 300–700 °C. Multiphysics numerical simulations indicated that both absorbed power and resulting temperatures profiles are heavily dependent on position of the sample relative to the electric field. Kraft lignin degradation (5 g samples) was complete in about 40 s, which was much faster than conventionally heated reactors. Activation energies (5–22 kJ/mol) and pre-exponential factors (0.06–0.64 s−1) were indicative that the process is low in energy consumption. At higher temperatures, phenols and phenolics were the major constituents of the bio-oil. A reliable method of obtaining microwave-assisted mass loss kinetics continuously is established.
ETHNOPHARMACOLOGICAL RELEVANCE Walnut kernel, a well-known TCM, is often used after being defatted in tradition. And defatted walnut powder extract (DWPE) has the actions of tonifying the liver and kidney, dissipating stagnation and removing blood stasis, which has the effect on non-alcoholic fatty liver disease (NAFLD). However, the effective components of DWPE in vivo were unclear and the multiple mechanisms of DWPE against NAFLD have not been explored. AIM OF THE STUDY The studies were performed to screen the effective substances in vivo by identification of the metabolites of DWPE in rats and to seek the potential mechanisms of DWPE on NAFLD by construction of the network pharmacology based on metabolites and verification of the highly correlated pathway. MATERIALS AND METHODS To explore the effective substances in vivo, the metabolites of DWPE were identified in SD rats' bio-samples through UPLC-Q-Exactive Orbitrap MS. To analyze the mechanisms of DWPE on NAFLD, a Metabolite-Target-Disease network was established and the potential mechanisms were predicted. Then, highly correlated pathway was verified in animal and cells studies. RESULTS A total of 52 metabolites of DWPE were identified in vivo, which were derived from gallic acid, ellagic acid (EA) and glansreginin A (Gla A). The possible metabolic pathways were phase Ⅰ (hydroxylation, hydrolyzation, etc) and phase Ⅱ metabolic reactions (methylation, sulfation and glucuronidation). Furthermore, in the network pharmacology, 54 core targets were enriched into pathways in cancer, nitrogen metabolism and other 9 pathways, which were essential pathways of DWPE against NAFLD. And the mechanism of nitrogen metabolism was verified in both of animal and cells studies. The results showed that DWPE could decline the concentration of ammonia and increase the expressions of carbonic anhydrase 2 (CA2) and carbamoylphosphate synthetase (CPS1) in nitrogen metabolism. CONCLUSION Taken together, the study revealed the absorption components and their metabolic pathways and demonstrated the mechanism of nitrogen metabolism of DWPE on anti-NAFLD.
BACKGROUND AND OBJECTIVE Hemodynamic blood flow analysis in the cerebrovascular is has become one of the important research topics in the bio-mechanic in recent decades. The primary duty of the cerebral blood vessel is supplying Glucose and oxygen for the brain. METHODS In this investigation, the non-Newtonian blood flow in the cerebral blood vessels studied. For modeling the geometry of this problem, we used Magnetic Resonance Image (MRI) approach to take Digital Imaging and Communications in Medicine (DICOM) images and using an open-source software package to construct the geometry, which is a complicated one. The power-law indexes, heat flux, and Reynolds number range in the investigation are 0.6 ≤ n ≤ 0.8, 5 ≤ q ≤ 15Wm-2 and 160≤Re≤310. Effects of Reynolds number, power-law indexes and heat fluxes are investigated. RESULTS We found that the pressure drop increase with increasing the Reynolds number and power-law index. The maximum Nusselt number in the cerebral blood vessels accrued in the running position of the body in n = 0.8. Also, the highest average wall shear stress occurs in maximum power-law indexes and Reynolds number. CONCLUSION By increasing the power-law index and Reynolds number, the wall shear stress increases.
Designing scaffolds with persistent elasticity and conductivity to mimic microenvironment becomes a feasible way to repair cardiac tissue. Injectable biomaterials for cardiac tissue engineering have demonstrated able to restore cardiac function by preventing ventricular dilation, enhancing angiogenesis, and improving conduction velocity. However, limitations are still among them, such as poor mechanical stability, low conductivity, and complicated procedure. Here, we developed thermal plastic poly(glycolic acid) surgical suture and mussel-inspired conductive particle's adhesion into a highly elastic, conductive spring-like coils. The polypyrrole (PPy) coated bio-spring acted as an electrode and then was assembled into a solid-state supercapacitor. After being injected through a syringe needle (0.33 mm inner diameter), the tangled coils formed an elastically conductive three-dimensional (3-D) network to modulate cardiac function. We found that cardiomyocytes (CMs) grew along the spring coils' track with elongated morphologies and formed highly oriented sarcomeres. The bio-spring enhanced the CMs' maturation in synchronous contraction accompanied with high expressions of cardiac-specific proteins in α-actinin and connexin 43 (cx43). After the elastic, conductive bio-springs were injected into the myocardial infarction (MI) area, the left ventricular fractional shortening was improved about 12.6% and the infarct size was decreased by about 34%. Interestingly, the spring can be utilized as a sensor to measure the CMs' contractile force, which was 1.57 х 10-3 0.26 х 10-3 mN (~ 4.1х106 cells). Accordingly, this study highlights an injectable bio-spring to form a tangled conductive 3-D network in vivo for MI repair.
Human beings process stereoscopic correspondence across multiple scales. However, this bio-inspiration is ignored by state-of-the-art cost aggregation methods for dense stereo correspondence. In this paper, a generic cross-scale cost aggregation framework is proposed to allow multi-scale interaction in cost aggregation. We firstly reformulate cost aggregation from a unified optimization perspective and show that different cost aggregation methods essentially differ in the choices of similarity kernels. Then, an inter-scale regularizer is introduced into optimization and solving this new optimization problem leads to the proposed framework. Since the regularization term is independent of the similarity kernel, various cost aggregation methods can be integrated into the proposed general framework. We show that the cross-scale framework is important as it effectively and efficiently expands state-of-the-art cost aggregation methods and leads to significant improvements, when evaluated on Middlebury, KITTI and New Tsukuba datasets.