Risk factors and economic burden for community-acquired multidrug-resistant organism-associated urinary tract infections: A retrospective analysis.

The spread of multidrug-resistant organisms (MDROs) has resulted in a corresponding increase in the incidence of urinary tract infections (UTIs). The risk factors and hospitalization burden for community-acquired MDRO-associated UTIs are discussed herein. This retrospective study included 278 patients with community-based MDRO-associated UTIs from January 2020 to January 2022. The MDRO (n = 139) and non-MDRO groups (n = 139) were separated based on drug susceptibility results. Community-based MDRO-associated UTIs mainly occurred in the elderly and frail patients with a history of invasive urinary tract procedures. The MDRO group imposed a greater economic burden compared to the non-MDRO group. Independent risk factors for community-based MDRO-associated UTIs were as follows: white blood cell (WBC) count > 10.0 × 109/L (OR = 2.316, 95% CI = 1.316-3.252; P = .018); ≥3 kinds of urinary tract obstructive diseases (OR = 1.720, 95% CI = 1.004-2.947; P = .048); use of 3rd generation cephalosporins (OR = 2.316, 95% CI = 1.316-4.076; P = .004); and a history of invasive urologic procedures (OR = 2.652, 95% CI = 1.567-4.487; P < .001). Days of hospitalization, antibiotic use, and bladder catheter use were significantly greater in the MDRO group than the non-MDRO group (P < .05).

Investigating the Immunogenic Cell Death-Dependent Subtypes and Prognostic Signature of Triple-Negative Breast Cancer.

Recently, immunotherapy has emerged as a promising and effective method for treating triple-negative breast cancer (TNBC). However, challenges still persist. Immunogenic cell death (ICD) is considered a prospective treatment and potential combinational treatment strategy as it induces an anti-tumor immune response by presenting the antigenic epitopes of dead cells. Nevertheless, the ICD process in TNBC and its impact on disease progression and the response to immunotherapy are not well understood. In this study, we observed dysregulation of the ICD process and verified the altered expression of prognostic ICD genes in TNBC through quantitative real-time polymerase chain reaction (qRT-PCR) analysis. To investigate the potential role of the ICD process in TNBC progression, we determined the ICD-dependent subtypes, and two were identified. Analysis of their distinct tumor immune microenvironment (TIME) and cancer hallmark features revealed that Cluster 1 and 2 corresponded to the immune "cold" and "hot" phenotypes, respectively. In addition, we constructed the prognostic signature ICD score of TNBC patients and demonstrated its clinical independence and generalizability. The ICD score could also serve as a potential biomarker for immune checkpoint blockade and may aid in the identification of targeted effective agents for individualized clinical strategies. Supplementary Information: The online version contains supplementary material available at 10.1007/s43657-023-00133-x.

Monitoring Multidrug-Resistant Acinetobacter baumannii Infections in the Neurosurgery ICU Using a Real-Time Surveillance System.

Multidrug-resistant Acinetobacter baumannii (MDR-AB) infections are becoming increasingly common. The Real-Time Nosocomial Infection (NI) Surveillance System (RT-NISS) was used to monitor MDR-AB NI in intensive care units (ICUs) to prevent NI outbreaks. Therefore, the RT-NISS was used in the current study to monitor MDR-AB infections in a neurosurgery ICU. Clinical interventions, including recommended antibiotics, bacterial distribution in the patient analysis, and bed adjustments, were carried out based on the monitoring results. The RT-NISS was also used to monitor clinical data, implement, and provide training on NI control. The RT-NISS detected a potential cluster of XDR-AB when five patients admitted to the neurosurgery ICU were tested positive for AB between 11 and 17 June 2019. Only two infected cases originated in the hospital, and there was no NI outbreak. The hospital Infection Control Department took appropriate measures to prevent cross-infection; specifically, an epidemiologic investigation and environmental assessment were conducted, and NI prevention and outbreak management training was provided. In summary, the RT-NISS enhanced the timeliness and efficacy of NI control and surveillance in a neurosurgery ICU. In order to prevent NI outbreaks, the Real-Time Nosocomial Infection (NI) Surveillance System (RT-NISS) was employed to monitor MDR-AB NI in critical care units (ICU). Based on the monitoring data, clinical actions such as required antibiotics, bacterial distribution in the patient analysis, and bed changes were carried out. In a neurosurgery ICU, the RT-NISS improved the timeliness and efficacy of NI control and surveillance.

Energy-Efficient Time Synchronization Based on Nonlinear Clock Skew Tracking for Underwater Acoustic Networks.

Time synchronization plays an important role in the scheduling and position technologies of sensor nodes in underwater acoustic networks (UANs). The time synchronization (TS) algorithms face challenges such as high requirements of energy efficiency, the estimation accuracy of the time-varying clock skew and the suppression of the impulsive noise. To achieve accurate time synchronization for UANs, an energy-efficient TS method based on nonlinear clock skew tracking (NCST) is proposed. First, based on the sea trial temperature data and the crystal oscillators' temperature-frequency characteristics, a nonlinear model is established to characterize the dynamic of clock skews. Second, a single-way communication scheme based on a receiver-only (RO) paradigm is used in the NCST-TS to save limited energy. Meanwhile, impulsive noises are considered during the communication process and the Gaussian mixture model (GMM) is employed to fit receiving timestamp errors caused by non-Gaussian noise. To combat the nonlinear and non-Gaussian problem, the particle filter (PF)-based algorithm is used to track the time-varying clock state and an accurate posterior probability density function under the GMM error model is also given in PF. The simulation results show that under the GMM error model, the accumulative Root Mean Square Errors (RMSE) of NCST-TS can be reduced from 10-4 s to 10-5 s compared with existing protocols. It also outperforms the other TS algorithms in the aspect of energy efficiency.

[Effect of L-arginine liposome on nitric oxide content and nitric oxide synthase gene expression in rats chronically exposed to hypoxia and hypercapnia].

AIM: To investigate the effects of L-arginine liposome on nitric oxide(NO) and nitric oxide synthase gene (NOS mRNA) in rats chronically exposed to hypoxia-hypercapnia. METHODS: Fourty male SD rats were randomly divided into four groups (n=10): normal control group(NC), hypoxia-hypercapnia group (HH), hypoxia-hypercapnia + L-arginine group(HL) and hypoxia-hypercapnia + L-arginine liposome group (HP). Contents of NO in plasma were measured using colorimetric analysis. Expression of nitric oxide synthase gene were measured with situ hybridization. RESULTS: (1) The mean pulmonary artery pressure(mPAP) and weight ratio of right ventricle to left ventricle and septum(RV/LV + S) of HP group were obviously lower than those of HH group and HL group. (2) The NO contents in plasma of HP group were obviously higher than those of HH group and HL group (P < 0.01). (3) Situ hybridization showed the average value of integral light density(LD) of ecNOS mRNA in pulmonary arterioles was significantly higher in rats of HP group than that of HH group and HL group (P < 0.01). (4) Light microscopy showed WA/TA (vessel wall area/total area) and PAMT (media thickness ratio of pulmonary arterioles) were significantly lower in rats of HP group than those of HH group (P < 0.01). CONCLUSION: L-arginine liposome could lower the mPAP and lighten the remodeling of pulmonary arterioles of the rats chronically exposed to hypoxia-hypercapnia than L-arginine does. It suggests that L-arginine liposome significantly promotes the membrane transportin of L-arginine.