Overlapping infections of Mycobacterium canariasense and Nocardia farcinica in an immunocompetent patient: A case report.

BACKGROUND: Infections by non-tuberculous mycobacteria (NTM) have become more common in recent years. Mycobacterium canariasense (M. canariasense) was first reported as an opportunistic pathogen in 2004, but there have been very few case reports since then. Nocardia is a genus of aerobic and Gram-positive bacilli, and these species are also opportunistic pathogens and in the Mycobacteriales order. Conventional methods for diagnosis of NTM are inefficient. Metagenomic next-generation sequencing (mNGS) can rapidly detect many pathogenic microorganisms, even rare species. Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms. There are no previous reports of infection by M. canariasense and Nocardia farcinica (N. farcinica), especially in immunocompetent patients. This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M. canariasense, N. farcinica, and Candida parapsilosis (C. parapsilosis) based on mNGS. CASE SUMMARY: A 52-year-old woman presented with a productive cough and chest pain for 2 wk, and recurrent episodes of moderate-grade fever for 1 wk. She received antibiotics for 1 wk at a local hospital, and experienced defervescence, but the productive cough and chest pain persisted. We collected samples of a lung lesion and alveolar lavage fluid for mNGS. The lung tissue was positive for M. canariasense, N. farcinica, and C. parapsilosis, and the alveolar lavage fluid was positive for M. canariasense. The diagnosis was pneumonia, and application of appropriate antibiotic therapy cured the patient. CONCLUSION: Etiological diagnosis is critical for patients with infectious diseases. mNGS can identify rare and novel pathogens, and does not require a priori knowledge.

Comparing the risk of deep vein thrombosis of two combined oral contraceptives: Norethindrone/ethinyl estradiol and drospirenone/ethinyl estradiol.

Background: Deep vein thrombosis (DVT) has been reported as an adverse event for patients receiving combined oral contraceptives. Norethindrone/ethinyl estradiol (NET/EE) and drospirenone/ethinyl estradiol (DRSP/EE) are two commonly prescribed combined hormonal oral contraceptive agents used in the United States, differing in their progestin component. Objective: The purpose of this study was to determine the association between the progestin component of a combined oral contraceptive and the risk of DVT in patients taking oral contraceptives for birth control using data derived from the FDA Adverse Event Reporting System (FAERS). Methods: The risk of DVT was compared between patients that had taken NET/EE with those that had taken the DRSP/EE COC formulation for birth control. In addition, age was assessed as a possible confounder and the outcome severity for those diagnosed with DVT were compared between the two groups. Finally, association rule mining was utilized to identify possible drug-drug interactions that result in elevated DVT risk. Results: DVT was the fourth most commonly adverse event reported for patients taking DRSP/EE accounting for 8558 cases and the seventeenth most commonly reported adverse event for NET/EE accounting for 298 cases. Age was found to be a significant confounder for users of DRSP/EE with regards to DVT risk across all age groups assessed: 2040 (ROR = 3.69, 95% CI 3.37-4.04) However, there was only a statistically significant elevated risk in patients over 40 years of age taking NET/EE (ROR = 1.98, 95% CI 1.36-2.88). Patients that had taken DRSP/EE and the corticosteroid prednisone simultaneously had an approximately 3-fold increase in DVT risk (ROR = 2.77, 95% CI 2.43-3.15) relative to individuals that had only taken DRSP/EE. Conclusion: Based on this analysis, there is a higher risk of developing DVT when taking DRSP/EE than when taking NET/EE as hormonal contraception. In addition, a possibly significant drug-drug interaction between different COC formulations and prednisone were identified. This interaction may result in elevated DVT risk due to a synergistic impairment of fibrinolysis and a decrease in plasmin production.

The association between warfarin usage and international normalized ratio increase: systematic analysis of FDA Adverse Event Reporting System (FAERS).

Introduction: Elevated international normalized ratio (INR) has been commonly reported as an adverse drug event (ADE) for patients taking warfarin for anticoagulant therapy. Aim: The purpose of this study was to determine the association between increased INR and the usage of warfarin by using the pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS). Methods: The ADEs in patients who took warfarin (N = 77,010) were analyzed using FAERS data. Association rule mining was applied to identify warfarin-related ADEs that were most associated with elevated INR (n = 15,091) as well as possible drug-drug interactions (DDIs) associated with increased INR. Lift values were used to identify ADEs that were most commonly reported alongside elevated INR based on the correlation between both item sets. In addition, this study sought to determine if the increased INR risk was influenced by sex, age, temporal distribution, and geographic distribution and were reported as reporting odds ratios (RORs). Results: The top 5 ADEs most associated with increased INR in patients taking warfarin were decreased hemoglobin (lift = 2.31), drug interactions (lift = 1.88), hematuria (lift = 1.58), asthenia (lift = 1.44), and fall (lift = 1.32). INR risk increased as age increased, with individuals older than 80 having a 63% greater likelihood of elevated INR compared to those younger than 50. Males were 9% more likely to report increased INR as an ADE compared to females. Individuals taking warfarin concomitantly with at least one other drug were 43% more likely to report increased INR. The top 5 most frequently identified DDIs in patients taking warfarin and presenting with elevated INR were acetaminophen (lift = 1.81), ramipril (lift = 1.71), furosemide (lift = 1.64), bisoprolol (lift = 1.58), and simvastatin (lift = 1.58). Conclusion: The risk of elevated INR increased as patient age increased, particularly among those older than 80. Elevated INR frequently co-presented with decreased hemoglobin, drug interactions, hematuria, asthenia, and fall in patients taking warfarin. This effect may be less pronounced in women due to the procoagulatory effects of estrogen signaling. Multiple possible DDIs were identified, including acetaminophen, ramipril, and furosemide.

Dysphagia Risk in Patients Prescribed Rivastigmine: A Systematic Analysis of FDA Adverse Event Reporting System.

BACKGROUND: Dysphagia has been reported as an adverse event for patients receiving rivastigmine for Alzheimer's disease (AD) treatment. OBJECTIVE: The purpose of this study was to determine the association between dysphagia and the usage of rivastigmine by using the pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS). METHODS: The risk of dysphagia in patients who took rivastigmine was compared with those of patients who took other medications. In addition, this study sought to determine if the dysphagia risk was influenced by sex, age, dosage, and medication routes of administration. RESULTS: When compared to patients prescribed donepezil, galantamine, or memantine, individuals prescribed rivastigmine were almost twice as likely to report dysphagia as an adverse event. The dysphagia risk in individuals prescribed rivastigmine is comparable to individuals prescribed penicillamine but significantly higher than clozapine, drugs of which have been previously shown to be associated with elevated dysphagia likelihood. Individuals older than 80 were 122% more likely to report having dysphagia after being prescribed rivastigmine than patients that were 50-70 years of age. Oral administration of rivastigmine was associated with approximately 2 times greater likelihood of reporting dysphagia relative to users of the transdermal patch. In addition, dysphagia showed higher association with pneumonia than other commonly reported adverse events. CONCLUSION: Patients prescribed rivastigmine were at greater risk of reporting dysphagia as an adverse event than patients prescribed many other medicines. This increase in dysphagia occurrence may be attributed to the dual inhibition of both acetylcholinesterase and butyrylcholinesterase.

Structural, magnetic, and electronic properties of EuSi2 thin films on the Si(111) surface.

Searching for magnetic silicide thin films has long been a hot topic in condensed matter physics and materials science based on their fundamental physics and promising device applications. Here we report a systematic study on the structural, magnetic, and electronic properties of EuSi2 thin films on the Si(111) surface by ab initio calculations. Total energy calculations show that the EuSi2 thin film in AA stacking is more favorable than that in AB or ABC stacking. The Eu2 + ions are coupled ferromagnetically within each layer and antiferromagnetically across the adjacent silicene layers with a large local spin moment of 6.96-7.00µB derived from the Eu-4f orbital electrons. Electronic band structure calculations indicate that the monolayer EuSi2 thin film is a semiconductor with an indirect surface band gap of 0.45 eV, while the multilayer EuSi2 thin films exhibit metallic behavior. These findings provide a systematic understanding of rare-earth metal silicides on the Si surface and will provide guidance for Si-based nanoelectronics and spintronics.

Thermal and moisture response to land surface changes across different ecosystems over Heilong-Amur River Basin.

The Heilong-Amur River Basin (HARB) in Northeast Asia has experienced distinct land surface changes during the past 40 years due to extensive ecological restoration programs, agricultural management, and grassland grazing in different ecosystems. However, the regional climate impact caused by the long-term spatially heterogeneous land surface changes in this mid-high latitude region is not well documented. Therefore, this study used multi-source satellite measurements records and a high-resolution land-atmosphere coupled regional climate model (WRF) to investigate the land surface changes and their associated thermal and moisture impacts across three main ecosystems over the Heilong-Amur River basin from 1982 to 2018. Firstly, satellite observations indicated an overall greening in HARB, with variations across ecosystems. The significant summer farmland greening is the most representative, with the farmland green vegetation fraction (GVF) remarkably increasing by 7.78% in summer. The forest greening magnitude is stronger in spring (3.42%) than in summer (2.85%), while the grassland vegetation showed some local browning signals in summer. Secondly, our simulated results showed the summer farmland greening accelerated evapotranspiration (ET) by 0.161 mm/d and significantly cools the surface temperature by 0.508 °C averaged at the ecosystem scale, which was highly correlated with the satellite observations but with lower cooling magnitude. The forest greening brought less surface cooling in spring than summer due to the stronger albedo feedback, despite with greater increase in GVF and ET. While with the opposite process, the local grassland browning leads to consistent warming effects, which can be detected from both satellite observations and our simulation results. Finally, our results also found that rainfall increasing averagely at the ecosystem scale can't fully compensate the water emission from enhanced ET due to the surface greening, contributing to soil moisture decline in both farmland and relative dry forests.

Six- or four-fold band degeneration in CoAs3, RhAs3 and RhSb3 topological semimetals.

Searching for new topological phases of matter has long been a hot topic in condensed matter physics and materials science based on its fundamental physics and promising device applications. Here we report a systematic ab initio study on the topological electronic properties of CoAs3, RhAs3, and RhSb3 binary compounds. Without spin-orbit coupling, there is a six-fold band crossing node at the high-symmetric Γ point with topological charge , which is denoted as "six-fold excitation". This nodal point is formed by the highest occupied band and two of the lowest unoccupied bands, and protected by time-reversal symmetry, and spatial-inversion symmetry and stabilized by the two-fold rotational symmetry. Detailed band structure and elementary band representation analysis shows that the six-fold band degeneracy at the Γ point near the Fermi level is formed by the bands of Ag@8c originating from the d-orbital of metal atoms. Meanwhile, with spin-orbit coupling, the six-fold nodal point becomes a four-fold degenerate quadratic Dirac point with the topological charge conserved as . These results provide a systematic understanding of the electronic properties of the skutterudite compounds and enrich the families of topological fermions in condensed matter systems.

The Association Between Use of Rivastigmine and Pneumonia: Systematic Analysis of FDA Adverse Event Reporting System.

BACKGROUND: Pneumonia is an inflammatory condition induced by infection of the lungs and is frequently a cause of morbidity and mortality among patients with Alzheimer's disease (AD). Some studies have shown an association between acetylcholinesterase inhibitor use and elevated pneumonia risk. OBJECTIVE: The purpose of this study was to perform a comparative analysis of the number of reported pneumonia cases in individuals prescribed rivastigmine relative to the number of reported cases by patients using other therapeutics including over-the-counter drugs and other AD therapeutics, as reported to the FDA Adverse Event Reporting System (FAERS) database. METHODS: A disproportionality analysis was conducted to investigate the association between using rivastigmine and risk of pneumonia. Age, gender, dosage, temporality, and geographic distribution of reported cases were also assessed. RESULTS: Patients prescribed rivastigmine were more likely to report pneumonia as an adverse event than many drugs except galantamine. Males were found to be 46% more likely than females to report pneumonia as an adverse event while likelihood of pneumonia diagnosis increases 3-5-fold in patients older than 65 years of age. CONCLUSION: The observed elevated frequency of aspiration pneumonia in patients prescribed rivastigmine may be due to an induced cholinergic crisis that is selective for the medulla oblongata, resulting in gastrointestinal distress, impaired swallowing, heightened salivation, and labored breathing. The observed elevated frequency of infectious pneumonia in patients prescribed rivastigmine may also be linked to overstimulation of neurons in the medulla oblongata and downstream suppression of localized inflammatory responses.

Bradycardia Due to Donepezil in Adults: Systematic Analysis of FDA Adverse Event Reporting System.

BACKGROUND: Bradycardia is a physiological condition characterized by a decrease in heart rate and is a side effect of many drug classes. Bradycardia has been reported as an adverse event for patients receiving donepezil for Alzheimer's disease (AD) treatment. OBJECTIVE: The purpose of the paper is to systematically investigate the association between the occurrence of bradycardia in adults and the usage of donepezil using clinical data derived from the FDA Adverse Event Reporting System (FAERS) database. METHODS: The risk of bradycardia in patients who only took donepezil was compared with those of patients who only took over-the-counter medications, multiple arrhythmia drugs, or other medications for AD treatment. In addition, this study sought to determine if this heightened bradycardia risk was influenced by sex, age, and dosage. RESULTS: The results indicated that there was a significant greater likelihood of reporting bradycardia in patients administered donepezil than most of the drugs investigated. There was no significant association between age or the dosage of donepezil and the likelihood of reporting bradycardia. However, males were found to be more likely than females to report bradycardia as an adverse event. Tumor necrosis factor inhibition and the stimulation of endothelial nitric oxide synthase were proposed to be the primary mechanism of actions which confer elevated bradycardia risk when using donepezil. CONCLUSION: These findings identified strong association between the usage of donepezil and bradycardia in adults as well as provided insight into the underlying molecular mechanisms that induce bradycardia by donepezil.

A clinical prediction nomogram to assess risk of colorectal cancer among patients with type 2 diabetes.

Colorectal cancer remains a major health burden worldwide and is closely related to type 2 diabetes. This study aimed to develop and validate a colorectal cancer risk prediction model to identify high-risk individuals with type 2 diabetes. Records of 930 patients with type 2 diabetes were reviewed and data were collected from 1 November 2013 to 31 December 2019. Clinical and demographic parameters were analyzed using univariable and multivariable logistic regression analysis. The nomogram to assess the risk of colorectal cancer was constructed and validated by bootstrap resampling. Predictors in the prediction nomogram included age, sex, other blood-glucose-lowering drugs and thiazolidinediones. The nomogram demonstrated moderate discrimination in estimating the risk of colorectal cancer, with Hosmer-Lemeshow test P = 0.837, an unadjusted C-index of 0.713 (95% CI 0.670-0.757) and a bootstrap-corrected C index of 0.708. In addition, the decision curve analysis demonstrated that the nomogram would be clinically useful. We have developed a nomogram that can predict the risk of colorectal cancer in patients with type 2 diabetes. The nomogram showed favorable calibration and discrimination values, which may help clinicians in making recommendations about colorectal cancer screening for patients with type 2 diabetes.

Novel electronic properties of monoclinic MP4 (M = Cr, Mo, W) compounds with or without topological nodal line.

Transition metal phosphides hold novel metallic, semimetallic, and semiconducting behaviors. Here we report by ab initio calculations a systematical study on the structural and electronic properties of [Formula: see text] (M = Cr, Mo, W) phosphides in monoclinic C2/c ([Formula: see text]) symmetry. Their dynamical stabilities have been confirmed by phonon modes calculations. Detailed analysis of the electronic band structures and density of states reveal that [Formula: see text] is a semiconductor with an indirect band gap of 0.47 eV in association with the p orbital of P atoms, while [Formula: see text] is a Dirac semimetal with an isolated nodal point at the [Formula: see text] point and [Formula: see text] is a topological nodal line semimetal with a closed nodal ring inside the first Brillouin zone relative to the d orbital of Mo and W atoms, respectively. Comparison of the phosphides with group VB, VIB and VIIB transition metals shows a trend of change from metallic to semiconducting behavior from [Formula: see text] to VIIB-[Formula: see text] compounds. These results provide a systematical understandings on the distinct electronic properties of these compounds.

Nomogram for Predicting Risk of Digestive Carcinoma Among Patients with Type 2 Diabetes.

PURPOSE: Digestive carcinomas remain a major health burden worldwide and are closely related to type 2 diabetes. The aim of this study was to develop and validate a digestive carcinoma risk prediction model to identify high-risk individuals among those with type 2 diabetes. PATIENTS AND METHODS: The prediction model was developed in a primary cohort that consisted of 655 patients with type 2 diabetes. Data were collected from November 2013 to December 2018. Clinical parameters and demographic characteristics were analyzed by logistic regression to develop a model to predict the risk of digestive carcinomas; then, a nomogram was constructed. The performance of the nomogram was assessed with respect to calibration, discrimination, and clinical usefulness. The results were internally validated by a bootstrapping procedure. The independent validation cohort consisted of 275 patients from January 2019 to December 2019. RESULTS: Predictors in the prediction nomogram included sex, age, insulin use, and body mass index. The model showed good discrimination (C-index 0.747 [95% CI, 0.718-0.791]) and calibration (Hosmer-Lemeshow test P=0.541). The nomogram showed similar discrimination in the validation cohort (C-index 0.706 [95% CI, 0.682-0.755]) and good calibration (Hosmer-Lemeshow test P=0.418). Decision curve analysis demonstrated that the nomogram would be clinically useful. CONCLUSION: We developed a low-cost and low-risk model based on clinical and demographic parameters to help identify patients with type 2 diabetes who might benefit from digestive cancer screening.

Monitoring the long term vegetation phenology change in Northeast China from 1982 to 2015.

Global warming has contributed to the extension of the growing season in North Hemisphere. In this paper, we investigated the spatial characteristics of the date of the start of the season (SOS), the date of the end of the season (EOS) and the length of the season (LOS) and their change trends from 1982 to 2015 in Northeast China. Our results showed that there was a significant advance of SOS and a significant delay of EOS, especially in the north part of Northeast China. For the average change slope of EOS in the study area, the delay trend was 0.25 d/y, which was more obvious than the advance trend of -0.13 d/y from the SOS. In particular, the LOS of deciduous needleleaf forest (DNF) and grassland increased with a trend of 0.63 d/y and 0.66 d/y from 1982 to 2015, indicating the growth season increased 21.42 and 22.44 days in a 34-year period, respectively. However, few negative signals were detected nearby Hulun Lake, suggesting that the continuous climate warming in the future may bring no longer growing periods for the grass in the semiarid areas as the drought caused by climate warming may limit the vegetation growth.

Computational prediction of a simple cubic carbon allotrope consisting of C12 clusters.

We identify by ab initio calculations a new simple cubic carbon phase in Pa3¯ symmetry, which has a 48-atom unit cell in all-sp3 bonding networks, thus termed SC48 carbon. It can be viewed as a crystalline form of C12 clusters or a combined structure of SC24 and BC12 carbon, but it is energetically more stable than the recently reported cubic carbon phases such as BC8, SC24, BC12, and fcc-C12. The structural stability is verified by phonon mode analysis. Electronic band and density of state calculations reveal that SC48 carbon is an insulator with a large direct band gap of 4.40 eV. Moreover, simulated x-ray diffraction patterns provide an excellent match to the distinct diffraction peaks found in milled fullerene soot. These results provide a solid foundation for further exploration of this new carbon allotrope.

[Monitoring on spatial and temporal changes of snow cover in the Heilongjiang Basin based on remote sensing].

This paper extracted and verified the snow cover extent in Heilongjiang Basin from 2003 to 2012 based on MODIS Aqua and Terra data, and the seasonal and interannual variations of snow cover extent were analyzed. The result showed that the double-star composite data reduced the effects of clouds and the overall accuracy was more than 91%, which could meet the research requirements. There existed significant seasonal variation of snow cover extent. The snow cover area was almost zero in July and August while in January it expanded to the maximum, which accounted for more than 80% of the basin. According to the analysis on the interannual variability of snow cover, the maximum winter snow cover areas in 2003-2004 and 2009-2010 (>180 x 10(4) km2) were higher than that of 2011 (150 x 10(4) km2). Meanwhile, there were certain correlations between the interannual fluctuations of snow cover and the changes of average annual temperature and precipitation. The year with the low snow cover was corresponding to less annual rainfall and higher average temperature, and vice versa. The spring snow cover showed a decreasing trend from 2003 to 2012, which was closely linked with decreasing precipitation and increasing temperature.