Suchergebnisse

China has the world's second largest tuberculosis (TB) burden after India [1]. Healthcare workers (HCWs) in China's National TB Control Programme have a significantly increased level of exposure to TB disease and patients. After the severe acute respiratory syndrome pandemic in 2003, the Chinese government made increased efforts to protect HCWs from nosocomial TB infections and other respiratory infectious diseases, especially for those HCWs working in chest hospitals and infectious disease hospitals. These efforts (although not universal throughout China) included the increased use of biosafety level 3 (BSL3) laboratories and respiratory isolation through negative pressure wards and rooms, and the practice of standardised biosafety protocols and procedures through continued training and education.

Abstract
Understanding how animals swim efficiently and generate high thrust in complex fluid environments is of considerable interest to researchers in various fields, including biology, physics, and engineering. However, the influence of often-overlooked perturbations on swimming fish remains largely unexplored. Here, we investigate the propulsion generated by oscillating tailbeats with superimposed rhythmic perturbations of high frequency and low amplitude. We reveal, using a combination of experiments in a biomimetic fish-like robotic platform, computational fluid dynamics simulations, and theoretical analysis, that rhythmic perturbations can significantly increase both swimming efficiency and thrust production. The introduction of perturbations increases pressure-induced thrust, while reduced phase lag between body motion and the subsequent fluid dynamics response improves swimming efficiency. Moreover, our findings suggest that beneficial perturbations are sensitive to kinematic parameters, resolving previous conflicts regarding the effects of such perturbations. Our results highlight the potential benefits of introducing perturbations in propulsion generators, providing potential hypotheses for living systems and inspiring the design of artificial flapping-based propulsion systems.

Bacterial pathogens possess complex type III effector (T3E) repertoires that are translocated inside the host cells to cause disease. However, only a minor proportion of these effectors have been assigned a function. Here, we show that the T3E AWR5 from the phytopathogen Ralstonia solanacearum is an inhibitor of TOR, a central regulator in eukaryotes that controls the switch between cell growth and stress responses in response to nutrient availability. Heterologous expression of AWR5 in yeast caused growth inhibition and autophagy induction coupled to massive transcriptomic changes, unmistakably reminiscent of TOR inhibition by rapamycin or nitrogen starvation. Detailed genetic analysis of these phenotypes in yeast, including suppression of AWR5-induced toxicity by mutation of CDC55 and TPD3, encoding regulatory subunits of the PP2A phosphatase, indicated that AWR5 might exert its function by directly or indirectly inhibiting the TOR pathway upstream PP2A. We present evidence in planta that this T3E caused a decrease in TOR-regulated plant nitrate reductase activity and also that normal levels of TOR and the Cdc55 homologues in plants are required for R. solanacearum virulence. Our results suggest that the TOR pathway is a bona fide T3E target and further prove that yeast is a useful platform for T3E function characterisation. ; This work was funded by projects AGL2013-46898-R (MINECO, Spain) to N.S.C. and M.V., AGL2010-21870 (MICINN, Spain) to M.V., EU-Marie Curie Actions (PCDMC-321738 and PIIF-331392) and BP_B 00030 from the Catalan Government to N.S.C.; grants BFU2011-30197-C3-01 and BFU2014-54591-C2-1-P (MINECO, Spain) and 2014SGR4 from the Catalan Government to J.A. ; Peer reviewed

IMPORTANCE: Over the past decade, reducing 30-day readmission rates has been emphasized in the United States (including via the implementation of the Hospital Readmissions Reduction Program) but not Canada. OBJECTIVE: To examine changes that occurred from April 1, 2005, to December 31, 2015, in the United States and Canada for hospitalization length of stay and 30-day readmission rates of patients with heart failure. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included patients admitted with a primary diagnosis of heart failure to Canadian and US hospitals between April 1, 2005, and December 31, 2015, using International Classification of Diseases, Ninth Revision code 428.xx and Tenth Revision code I50. The study examined secular trends in length of stay and readmissions in both countries and tested for changes after implementation of the Hospital Readmissions Reduction Program using segmented regression models and the association between length of stay and readmissions using patient-level and hospital-level multivariable logistic regression models. Data analysis was completed from February 2018 to August 2018. MAIN OUTCOMES AND MEASURES: Thirty-day readmissions. RESULTS: Between 2005 and 2015, mean length of stay declined marginally in Canadian hospitals (from a mean [SD] of 7.5 [5.7] to 7.3 [5.6] days; P < .001) but remained stable in US hospitals (mean [SD], 4.9 [3.7] days to 4.9 [3.5] days). Thirty-day readmission rates declined similarly in Canada (from 4088 of 20 758 patients [19.7%] to 3823 of 21 733 patients [17.6%] for all-cause readmissions; P < .001; and from 1743 of 20 758 patients [8.4%] to 1490 of 21 733 patients [6.9%] for heart failure–specific readmissions; P < .001) and the United States (from 21.2% to 18.5% for all-cause readmissions; from 7.6% to 5.7% for heart failure–specific readmissions; both P < .001). There were small but statistically significant positive correlations between length of stay and 30-day readmissions in both Canada (odds ratio, 1.01 [95% CI, ...

BACKGROUND: The aim of this study was to determine the demographic profile of driver gene alterations, especially low‐frequency gene alterations in Chinese patients with non‐small cell lung cancer (NSCLC). METHODS: A total of 7395 Chinese patients with NSCLC were enrolled in the study. Next‐generation sequencing (NGS) was performed on formalin‐fixed paraffin‐embedded specimens collected via either surgical resection or biopsy. RESULTS: The frequent genomic alterations found in the study were EGFR mutations (51.7%), KRAS mutations (13.1%), MET alterations (5.6%; 3.2% copy number gains and 0.5% exon 14 skipping mutation), HER2 alterations (7.0%; 2.0% copy number gains and 5.4% mutations), ALK alterations (7.2%; 3.9% rearrangements), RET rearrangements (1.4%), ROS1 rearrangements (0.9%), and NTRK rearrangements (0.6%). The EGFR mutation rate was found to be significantly higher in women than in men (69.1% vs. 38.5%, P 40 years, while the KRAS mutation rate tended to increase with age. The HER2 mutation (13.9% vs. 6.7%, P < 0.001) and ALK alteration rates (14.3% vs. 6.9%, P < 0.001) were significantly higher in the group aged <40 years than in groups aged 40 years or older. CONCLUSIONS: The frequency of different driver genes was diverse in different age‐gender groups, and the results of this study may assist clinicians in clinical decision‐making and the development of public healthcare strategies in the future. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This study demonstrated that the frequency of different driver genes was diverse in different age‐gender groups. What this study adds: It may enable clinicians to make clinical decisions, and assist government, pharmaceutical researchers and insurance companies develop public healthcare strategies.