Uncommon pathogen misidentification of Herbaspirillum huttiense as Burkholderia cepacia in bacteremia: a case report.

Herbaspirillum huttiense is an opportunistic pathogen associated with rare cases of bacteremia. In this case report, H huttiense was isolated from blood samples collected from an intravenous catheter (incubated for 20.8 hours) and a peripheral vein (incubated for 14.16 hours) of a lung adenocarcinoma patient. Positive blood culture bottles were subjected to smear preparation, and Gram staining and microscopic examination revealed the presence of gram-negative rods in both aerobic bottles. We used the VITEK MS automatic microbial mass spectrometry system, VITEK 2 Compact automatic microbial analysis system, and high-throughput nucleic acid sequencing for accurate identification of the isolate. It is noteworthy that although the VITEK 2 Compact identified the isolate as Burkholderia cepacia, confirmation through VITEK MS mass spectrometry and 16S ribosomal DNA (rDNA) sequencing identified it as H huttiense. Subsequently, antimicrobial susceptibility testing was performed using the broth microdilution method, following the guidelines for nonfermenting gram-negative bacilli provided by the Clinical and Laboratory Standards Institute. This case highlights the possibility of misidentification of H huttiense as B cepacia by VITEK 2 Compact in certain situations, emphasizing the importance of considering uncommon pathogens, such as H huttiense, in the context of bacteremia in cancer patients.

Unexplained Serum Iron Elevation After Neoadjuvant Chemotherapy in Pancreatic Cancer.

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a malignant tumor originating from the epithelium of the pancreatic duct. Neoadjuvant chemotherapy FOLFIRINOX (a combination of oxaliplatin, irinotecan, and 5-fluorouracil/leucovorin) is considered to be the most effective regimen for patients with resected pancreatic cancer. METHODS: This article reports a case of a pancreatic ductal adenocarcinoma patient who exhibited regular periodic fluctuations in the serum iron level during FOLFIRINOX. RESULTS: It indicates that an unexplained increase in serum iron levels after each cycle of FOLFIRINOX is non-cell destructive and due to a reduction in iron consumption, after ruling out other potential causes. CONCLUSIONS: FOLFIRINOX in pancreatic cancer patients may cause an elevation of serum iron levels.

Research and design of simulation and verification system of intelligent expressway based on ETC big data.

Electronic toll collection (ETC) system records a large number of travel trajectories of vehicles on expressways, and it has a great potential application value. However, the current simulation system mainly focuses on simulating the characteristics of traffic flow while ignoring the real-time flow conditions of the road is difficult to calculate and display quantitatively, and the overall optimization cost is also notably substantial. Currently, there is a lack of a simulation system tailored for the ETC environment, which addresses the challenge of real-time traffic flow computation and holistic optimization, fulfilling the requisites of pertinent research. According to the topological structure inherent to an actual provincial road network on expressways, this paper devises a framework for a simulation system that conforms to the current ETC environment. We solved the critical problem of generating simulation data in the simulation system by establishing a Feature Extraction Algorithm for spatio-temporal features derived from ETC transaction data (Edata). Then we put forward Traffic Control Strategy Algorithm in ETC simulation system, which can provide decision indicators for simulating the control of traffic flow of the expressway. At the same time, we optimized the improved Multi-Task Scheduling Algorithm (ETC_MTS) based on the application scenario of real-time parallelism of multi-task on expressways, which provides better execution performance compared with the current mainstream algorithms such as Shortest Job First Scheduling Algorithm (SJFS), Priority Scheduling Algorithm (Priority), First Come First Serve Scheduling Algorithm (FCFS) and Round Robin Scheduling Algorithm (RR).

Contrast Media Ioversol Interferes with Urinalysis.

BACKGROUND: Ioversol is a commonly used non-ionic radiological contrast media in medical imaging to enhance the visualization of blood vessels, tissues, or organs. However, if it is not completely excreted, ioversol can interfere with urinalysis and lead to abnormal test results. METHODS: This study reported a case where the contrast media ioversol interfered with Sysmex UN automated urine analyzer. RESULTS: UC-3500 displayed no test results except the error code "0401". UF-4000 indicated "abnormally high RBCs" and no parameter results. CONCLUSIONS: Urine specimens containing contrast media are considered unqualified samples. Urinalysis should be performed only after the patient has completely excreted the contrast media.

An over-the-horizon potential safety threat vehicle identification method based on ETC big data.

Smart cars rely on sensors like LIDAR and high-precision map-based perception for driving environment sensing. However, they can't detect low-speed vehicles beyond visual range, affecting safety and comfort. Manual vehicles face similar challenges. Low-speed driving contributes to expressway accidents due to limited visibility, road design, and equipment performance. To enhance safety, an over-the-horizon potential safety threat vehicle identification method using ETC big data is proposed. It consists of three layers. The first layer is the vehicle section travel speed sensing layer based on the wlp-XGBoost algorithm. The second layer is the in-transit vehicle position estimation layer based on the DR-HMM algorithm. The third layer is the Multi-information fusion of potential safety threat vehicle identification layer. Dynamic real-time detection and identification of potential safety threats in expressway sections were achieved, and simulations were conducted using real-time ETC data from Quanxia section on an ETC platform. Results show accurate prediction of vehicle speed and position in different road sections and traffic situations, with over 95% accuracy and recall in identifying potential safety threat vehicles. It perceives changes in the traffic conditions of road sections in real-time based on the changing trend of potential safety threat vehicle numbers, providing a vital reference for speed planning and risk avoidance.

Preliminary Study on Apoptotic Proteins in Platelet from Adult Patients with Chronic Immune Thrombocytopenic Purpura.

BACKGROUND: Adult chronic idiopathic thrombocytopenic purpura (ITP) is a chronic and usually lifelong hemorrhagic disorder in which enhanced platelet destruction and -weakened platelet production lead to thrombocytopenia. In this study, the p38 mitogen-activated protein kinase (p38-MAPK), early growth response 1 (EGR-1), p53, Bcl-xL, Bak, Bax, and reactive oxygen species (ROS) in platelets from adult patients with chronic ITP were investigated. METHODS: Platelets were isolated from blood samples collected from 20 adult patients with chronic ITP and 20 healthy volunteers. p38-MAPK, EGR-1, p53, Bcl-xL, Bak, Bax, and ROS were determined by flow cytometry, and the results were analyzed by EXPO32 ADC. RESULTS: Flow cytometry showed the expression levels of p38-MAPK (61.66 ± 19.38% vs. 27.52 ± 14.34%), EGR-1 (62.22 ± 20.48% vs. 9.05 ± 5.79%), p53 (56.82 ± 20.07% vs. 4.35 ± 2.04%), Bak (39.86 ± 11.45% vs. 20.82 ± 11.85%), Bax (36.85 ± 15.99% vs. 6.69 ± 5.01%), and ROS (19.98 ± 1.47% vs. 1.29 ± 0.10%) were all elevated (p < 0.05 compared with healthy volunteers). In addition, pro-survival Bcl-xL (5.38 ± 1.52% vs. 21.20 ± 6.04%) was decreased markedly in platelets from adult patients with chronic ITP (p < 0.05 compared with healthy volunteers). CONCLUSIONS: Our findings reveal that platelets in adults with chronic ITP display a proapoptotic gene expression phenotype, based on the enhanced expression of p38-MAPK, EGR-1, p53, Bak, Bax, and ROS, and attenuated expression of Bcl-xL, suggesting increased sensitivity toward apoptosis.

Investigation of Lymphocyte Subsets in Peripheral Blood of Patients with Dyslipidemia.

OBJECTIVE: In order to evaluate the effect of dyslipidemia on cellular or humoral immunity in patients, changes in the absolute number of lymphocyte subsets were detected. METHODS: Flow cytometry was applied to determine the absolute value of lymphocyte subsets: B cell, NK cell, CD4+ T cell including the functional subset (CD4+CD28+), native subset (CD4+CD45RA+CD62L+), memory T cell subset (CD4+CD45RA-), CD8+ T cell including the functional subset (CD8+CD28+) and activated subsets (CD8+CD38+ and CD8+DR+). The relationship between lymphocyte subsets and hypercholesterolemia and hypertriglyceridemia was analyzed. RESULTS: The absolute values of CD19+ B cell, CD3+ T cell, CD4+ Th cell, CD4+CD28+ cell, naive CD4+ T cell and memory CD4+ T cell in patients with dyslipidemia were markedly higher than those in healthy controls (P<0.05). There was no significant difference between healthy controls and dyslipidemia patients in other lymphocyte subsets (P>0.05). The absolute values of CD3+ T cell and naive CD4+ T cell were significantly positively correlated with hypercholesterolemia in peripheral blood (r=0.291 and 0.306, respectively, all P<0.05). There was no significant correlation between hypertriglyceridemia and lymphocyte subsets (P>0.05). CONCLUSION: Dyslipidemia has potential effects on immune profiles in lymphocytes subsets, and changes in lymphocyte subsets in dyslipidemia patients may lead to immune dysfunction.

Apoptosis in platelets from adult patients with chronic idiopathic thrombocytopenic purpura.

Adult chronic idiopathic thrombocytopenic purpura (cITP) is a chronic and usually life-long haemorrhagic disorder in which enhanced platelet destruction and weakened platelet production lead to thrombocytopenia. Platelets were isolated from blood samples collected from 40 adult patients with cITP and 40 healthy volunteers. Mitochondrial membrane potential (ΔΨm) and plasma membrane phosphatidylserine externalization were determined by flow cytometry, and activation of caspase-3 and expressions of Bax, Bak and Bcl-xL were analysed by western blotting. Flow cytometry showed increased mitochondrial depolarization and lower ΔΨm in platelets from adult patients with cITP. In addition, plasma membrane phosphatidylserine externalization was observed on platelets from adult patients with cITP, but rarely from healthy volunteers. Western blot analysis of platelet proteins revealed that, in adult cITP patients, caspase-3 was activated, which cleaved gelsolin and to release a 47-kDa fragment. Moreover, the expressions of Bax and Bak were elevated, and Bcl-xL was decreased markedly in platelets from adult patients with cITP. Our findings reveal, based on loss of mitochondrial membrane potential (Δψm), phosphatidylserine exposure, caspase-3 activation, enhanced expression of Bax and Bak, and attenuated expression of Bcl-xL, that platelet death in the pathogenesis of thrombocytopenia in chronic ITP in adults is apoptotic.