Perkinspotts7337

OBJECTIVES We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA). BACKGROUND It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions. METHODS Between January 2011 and February 2014, 264 patients after second-generation drug-eluting stent (DES) implantation following RA were retrospectively enrolled. CN was defined as a convex shape of the luminal side of calcium as assessed by intravascular ultrasound. The primary endpoint was the cumulative 5-year incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, clinically driven target lesion revascularization (CDTLR), and definite stent thrombosis (ST). RESULTS CN was observed in 128 patients (48.5%) with heavily calcified lesions. Cumulative 5-year incidence of MACE was significantly higher in the CN group than in the non-CN group, mainly driven by a higher rate of CDTLR and ST (35.4% vs. 18.8%, p less then  .001; 23.2% vs. 7.9%, p less then  .001; 7.0% vs. 0.93%, p = .009, respectively). Independent risk factors of 5-year MACE included hemodialysis (hazard ratio [HR] = 3.39, 95% confidence intervals [CI] 2.00-5.73, p less then  .001), CN (HR = 2.53, 95% CI 1.49-4.27, p less then  .001), ostial lesion (HR = 3.02, 95% CI 1.58-5.78, p = .001), left ventricular ejection fraction ≤40% (HR = 2.17, 95% CI 1.27-3.70, p = .005), and right coronary artery lesion (HR = 1.82, 95% CI 1.07-3.11, p = .03). CONCLUSIONS CN was observed in 48.5% of heavily calcified lesions, resulting in unfavorable long-term clinical outcomes after second-generation DES implantation following RA. © 2020 Wiley Periodicals, Inc.CO 2 methanation exhibits great potentials in environmental remediation and renewable energy storage. Therefore, it is of pivotal importance to develop efficient catalysts and investigate the intrinsic mechanism for CO 2 methanation. Herein, we reported that PdFe intermetallic nanocrystals afforded high activity and stability for CO 2 methanation. The mass activity of fct -PdFe nanocrystals reached 5.3 mmol g -1 h -1 , under 1 bar (CO 2 H 2 = 14) at 180 o C, being 6.6, 1.6, 3.3, and 5.3 times as high as that of fcc -PdFe nanocrystals, Ru/C, Ni/C, and Pd/C, respectively. After 20 rounds of successive reaction, 98% of the original activity was retained for PdFe intermetallic nanocrystals. Further mechanistic studies revealed that PdFe intermetallic nanocrystals enabled the maintenance of metallic Fe species via a reversible oxidation-reduction process in CO 2 methanation. The metallic Fe in PdFe intermetallic nanocrystals induced the direct conversion of CO 2 into CO* as the intermediate, contributing to the enhanced activity. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Q fever, caused by the zoonotic bacterium Coxiella burnetii, is a globally distributed emerging infectious disease. Livestock are the most important zoonotic transmission sources, yet infection in people without livestock exposure is common. Identifying potential exposure pathways is necessary to design effective interventions and aid outbreak prevention. We used natural language processing and graphical network methods to provide insights into how Q fever notifications are associated with variation in patient occupations or lifestyles. Using an 18-year time-series of Q fever notifications in Queensland, Australia, we used topic models to test whether compositions of patient answers to follow-up exposure questionnaires varied between demographic groups or across geographical areas. To determine heterogeneity in possible zoonotic exposures, we explored patterns of livestock and game animal co-exposures using Markov Random Fields models. Finally, to identify possible correlates of Q fever case severity, we modelled patient probabilities of being hospitalized as a function of particular exposures. Different demographic groups consistently reported distinct sets of exposure terms and were concentrated in different areas of the state, suggesting the presence of multiple transmission pathways. Macropod exposure was commonly reported among Q fever cases, even when exposure to cattle, sheep or goats was absent. Males, older patients and those that reported macropod exposure were more likely to be hospitalized due to Q fever infection. Our study indicates that follow-up surveillance combined with text modelling is useful for unravelling exposure pathways in the battle to reduce Q fever incidence and associated morbidity. © 2020 Blackwell Verlag GmbH.OBJECTIVES We sought to determine hemodynamic effects of aortic paravalvular leak (PVL) and predictors of clinical outcomes after aortic PVL closure. BACKGROUND The significance of hemodynamic alterations in PVL and relation to severity, procedural success of percutaneous closure and clinical outcomes have not been defined. METHODS Patients undergoing percutaneous PVL closure between July 21, 2004 and September 10, 2018 were included. PVL severity was assessed by echocardiography and aortic angiography. Hemodynamics were assessed by intra-arterial pressure tracings before and after PVL closure. The primary outcome was a composite of mortality, redo aortic valve replacement (AVR) and redo PVL closure. RESULTS One hundred and seventeen patients (mean age 70.3 ± 14.9 years, 79% surgical and 21% transcatheter prostheses) underwent PVL closure with 94% technical success. PVL was moderate or greater in 106 (91%) at baseline and 11 (11%) post-procedure. Diastolic BP for those with moderate or greater PVL was lower than for those with less PVL (50.3 ± 11.7 vs. 56.5 ± 12.4 mmHg, p  less then  .001). Pulse pressure was similar between these groups (69.9 ± 20.3 vs. 67.4 ± 21.2 mmHg, p = .39). 35 patients (34%) had 40 events during a mean follow-up of 1.6 ± 1.9 years (23 deaths, 12 redo AVR, and five redo PVL closures). In a multivariate model, final diastolic BP less then 47 mmHg (HR 3.27 [1.45-7.36], p = .007) was a significant predictor of the composite endpoint. CONCLUSIONS Diastolic BP was significantly associated with aortic PVL severity and clinical outcomes after PVL closure. In contrast, pulse pressure did not correlate with PVL severity or outcomes. These findings have implications for clinical management of patients with aortic PVL. © 2020 Wiley Periodicals, Inc.Bacterial flagella are nanomachines that drive bacteria motility and taxis in response to environmental changes. Whether flagella are permanent cell structures and, if not, the circumstances and timing of their production and loss during the bacterial life cycle remain poorly understood. Here we used the single polar flagellum of Vibrio alginolyticus as our model and, implementing in vivo fluorescence imaging, revealed that the percentage of flagellated bacteria (PFB) in a population varies substantially across different growth phases. In the early-exponential phase, the PFB increases rapidly through widespread production of flagella. In the mid-exponential phase, the PFB peaks at around 76% and the partitioning of flagella between the daughter cells is 11 and strictly at the old poles. After entering the stationary phase, the PFB starts to decline, mainly because daughter cells stop making new flagella after cell division. Interestingly, we observed that bacteria can actively abandon flagella after prolonged stationary culturing, though cell division has long been suspended. Further experimental investigations confirmed that flagella were ejected in V. alginolyticus, starting from breakage in the rod. Our results highlight the dynamic production and loss of flagella during the bacterial life cycle. This article is protected by copyright. All rights reserved.A new approach is introduced for the construction of a predictive QSAR model in which only ligand-receptor (LR) interaction features are used as relevant descriptors. This approach combines the benefit of the random forest (RF) as a new variable selection method with the intrinsic capability of the artificial neural network (ANN). The interaction information of the ligand-receptor (LR) complex was used as molecular docking descriptors (MDDs). The most relevant descriptors were selected using the RF technique and used as inputs of ANN. The proposed random forest artificial neural network (RF-LM-ANN) method was optimized and then evaluated by the prediction of pEC50 for some of the azine derivatives as non-nucleoside reverse transcriptase inhibitors (NNRTIs). RF-LM-ANN model under the optimal conditions was evaluated using internal (validation) and external test sets. The determination coefficients of the external test and validation sets were 0.88 and 0.89, respectively. The mean square deviation (MSE) values for the prediction of biological activities in the external test and validation sets were found 0.10 and 0.11, respectively. The results obtained demonstrated the good prediction ability and high generalizability of the proposed RF-LM-ANN model based on the MMDs alone. This article is protected by copyright. All rights reserved.Caerin 4 is a family of AMPs isolated from the frog called Litoria caerulea. In silico drug designing methods and using machine learning algorithms for AMPs design can reduce their usage restrictions such as production costs and the time required for investigation of their activity and toxicity. In this study, two short peptides were designed based on direct and reverse mirror repeats of GLWQKI conserved sequence from Caerin 4 family that called dCar12 and rCar12. Also, Caerin 4.1 was synthesized without primary GLWQKI sequence and named Car7-23 . Following the synthesis of peptides, their antimicrobial properties, cytotoxicity, secondary structure, and mode of action were further evaluated. Results indicated that rCar12 had a good antibacterial activity (at an MIC of 3.9-62.5 µg/ml), while Car7-23 did not have any antimicrobial properties. https://www.selleckchem.com/products/Trichostatin-A.html Cytotoxicity of rCar12 at MICs range was less then 5%, which is much less than Caerin 4.1. In conclusion, rCar12 with reverse mirror repeat has different functional properties compared with dCar12. These results corroborate the fact that in two peptides with identical residues and length, the position and arrangement of amino acids are very important concerning peptide function. Moreover, GLWQKI sequence is highly crucial for the antimicrobial activity of Caerin 4 antimicrobial peptide family. © 2020 John Wiley & Sons A/S.AIMS The food supply is a potential source of antimicrobial resistance. Current surveillance programs targeting food are limited to beef, pork and poultry and do not capture niche products. In this study, imported reptile and amphibian products were screened for antimicrobial resistant bacteria. METHODS AND RESULTS Fifty-three items including soft shell turtles, frog legs, geckos, snakes and a turtle carapace were purchased from specialty markets in Vancouver and Saskatoon, Canada. Samples were selectively cultured for Salmonella spp., Escherichia coli, extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae and meropenem resistant organisms. Salmonella, all pan-susceptible, were grown from six dried geckos. E. coli were isolated from 19 samples, including ESBL producers from six items. One multidrug resistant E. coli possessed both the blaCTX-M-55 and mcr-1 genes. An NDM-1 producing Acinetobacter spp. was also isolated from a dried turtle carapace. CONCLUSIONS Our results suggest that imported reptile and amphibian meats are an underappreciated source of resistant bacteria.