Septic Shock after Conservative Management for Placenta Accreta

SummaryObjectiveThe rate of placenta accreta has risen in the last three decades due to the increasing rate of cesarean section. Placenta accreta usually results in severe postpartum hemorrhage requiring massive blood transfusion and postpartum hysterectomy. Conservative treatment is an alternative in selected patients to preserve fertility and decrease postpartum hemorrhage, but the risks of conservative treatment have seldom been described.Case ReportA 39-year-old woman with placenta accreta diagnosed during cesarean section was treated conservatively. Persistent puerperal fever with leukocytosis developed during the postpartum period in spite of long-term antibiotic treatment. Evacuation of the retained placenta resulted in septic shock, which occurred immediately after dilatation and curettage. An uneventful recovery was achieved after use of strong antibiotics and fluid challenge.ConclusionAt present, there is no consensus about the optimal treatment for placenta accreta. Conservative treatment appears to be an alternative in selected patients, but the complications such as sepsis should be carefully identified and appropriately managed

THE VARIATION OF DOMINANT ELBOW RANGE OF MOTION AMONG DIFFERENT MATURE STAGE FOR BASEBALL PITCHERS

The purpose of this study was to examine the variation of elbow range of motion (ROM) in the dominant arm between different maturity levels in baseball pitchers. Sixty-two pitchers, including 17 early-puberty players, 22 later-puberty players, and 23 adult players, participated in this study. A goniometer was used to assess elbow ROM in the dominant arms, including elbow flexion, hyper-extension, supination, pronation and valgus angles. The results showed that smaller ROM was found in elbow flexion, supination, and pronation, and larger ROM in elbow valgue, in pithers of later puberty level (

Learning to predict expression efficacy of vectors in recombinant protein production

<p>Abstract</p> <p>Background</p> <p>Recombinant protein production is a useful biotechnology to produce a large quantity of highly soluble proteins. Currently, the most widely used production system is to fuse a target protein into different vectors in <it>Escherichia coli </it>(<it>E. coli</it>). However, the production efficacy of different vectors varies for different target proteins. Trial-and-error is still the common practice to find out the efficacy of a vector for a given target protein. Previous studies are limited in that they assumed that proteins would be over-expressed and focused only on the solubility of expressed proteins. In fact, many pairings of vectors and proteins result in no expression.</p> <p>Results</p> <p>In this study, we applied machine learning to train prediction models to predict whether a pairing of vector-protein will express or not express in <it>E. coli</it>. For expressed cases, the models further predict whether the expressed proteins would be soluble. We collected a set of real cases from the clients of our recombinant protein production core facility, where six different vectors were designed and studied. This set of cases is used in both training and evaluation of our models. We evaluate three different models based on the support vector machines (SVM) and their ensembles. Unlike many previous works, these models consider the sequence of the target protein as well as the sequence of the whole fusion vector as the features. We show that a model that classifies a case into one of the three classes (no expression, inclusion body and soluble) outperforms a model that considers the nested structure of the three classes, while a model that can take advantage of the hierarchical structure of the three classes performs slight worse but comparably to the best model. Meanwhile, compared to previous works, we show that the prediction accuracy of our best method still performs the best. Lastly, we briefly present two methods to use the trained model in the design of the recombinant protein production systems to improve the chance of high soluble protein production.</p> <p>Conclusion</p> <p>In this paper, we show that a machine learning approach to the prediction of the efficacy of a vector for a target protein in a recombinant protein production system is promising and may compliment traditional knowledge-driven study of the efficacy. We will release our program to share with other labs in the public domain when this paper is published.</p

The potential application of ultra-nanocrystalline diamond films for heavy ion irradiation detection

[[abstract]]The potential of utilizing the ultra-nanocrystalline (UNCD) films for detecting the Au-ion irradiation was investigated. When the fluence for Au-ion irradiation is lower than the critical value (fc = 5.0 × 1012 ions/cm2) the turn-on field for electron field emission (EFE) process of the UNCD films decreased systematically with the increase in fluence that is correlated with the increase in sp2-bonded phase (π*-band in EELS) due to the Au-ion irradiation. The EFE properties changed irregularly, when the fluence for Au-ion irradiation exceeds this critical value. The transmission electron microscopic microstructural examinations, in conjunction with EELS spectroscopic studies, reveal that the structural change preferentially occurred in the diamond-to-Si interface for the samples experienced over critical fluence of Au-ion irradiation, viz. the crystalline SiC phase was induced in the interfacial region and the thickness of the interface decreased. These observations implied that the UNCD films could be used as irradiation detectors when the fluence for Au-ion irradiation does not exceed such a critical value.[[incitationindex]]SCI[[booktype]]電子

Applicability of perturbative QCD to Λb→Λc\Lambda_b \to \Lambda_c decays

We develop perturbative QCD factorization theorem for the semileptonic heavy baryon decay $\Lambda_b \to \Lambda_c l\bar{\nu}$, whose form factors are expressed as the convolutions of hard $b$ quark decay amplitudes with universal $\Lambda_b$ and $\Lambda_c$ baryon wave functions. Large logarithmic corrections are organized to all orders by the Sudakov resummation, which renders perturbative expansions more reliable. It is observed that perturbative QCD is applicable to $\Lambda_b \to \Lambda_c$ decays for velocity transfer greater than 1.2. Under requirement of heavy quark symmetry, we predict the branching ratio $B(\Lambda_b \to \Lambda_c l{\bar\nu})\sim 2$, and determine the $\Lambda_b$ and $\Lambda_c$ baryon wave functions.Comment: 12 pages in Latex file, 3 figures in postscript files, some results are changed, but the conclusion is the sam

Genotypic analyses and virulence characterization of Glaesserella parasuis isolates from Taiwan

Background Glaesserella (Haemophilus) parasuis (G. parasuis) causes severe economic losses in the swine industry. Multiple G. parasuis strains can exist in single animals. Typing techniques are required for identifying G. parasuis isolates. Different strains within a serovar display varying virulence. Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) can assess the heterogeneity. The group 1 virulence-associated trimeric autotransporters (vtaA) gene is an indicator of virulence. The aim of this study was to characterize Taiwanese G. parasuis isolates via molecular serotyping, vtaA PCR and ERIC-PCR. Methods One hundred and forty-five strains were collected between November 2013 and March 2017 in Taiwan and further examined by molecular serotyping, vtaA PCR and ERIC-PCR. Results The dendrogram revealed heterogeneous genetic diversity within many clusters. Partial correlation between the ERIC-PCR clusters of different strains, serovars and lesion patterns was observed. Twelve herds (8.3%) infected with more than one strain. Group 1 vtaA positive rate reached 98.6%. Discussion This study showed the high genetic diversity of G. parasuis in Taiwan by a high discriminatory capability of ERIC-PCR. Group 1 vtaA commonly exists in G. parasuis isolates and may play important roles in the pathogenesis of Taiwanese G. parasuis isolates

Molecular serotyping of Haemophilus parasuis isolated from diseased pigs and the relationship between serovars and pathological patterns in Taiwan

Background Haemophilus parasuis is the etiological agent of Glässer’s disease, and causes severe economic losses in the swine industry. Serovar classification is intended as an indicator of virulence and pathotype and is also crucial for vaccination programs and vaccine development. According to a polysaccharide biosynthesis locus analysis, H. parasuis isolates could be classified by a molecular serotyping assay except serovars 5 and 12 detected by the same primer pair. The aim of this study was to identify H. parasuis isolates from diseased pigs in Taiwan by using a molecular serotyping assay and to analyze the relationship between serovars and pathological patterns. Methods From August 2013 to February 2017, a total of 133 isolates from 277 lesions on 155 diseased animals from 124 infected herds serotyped by multiplex PCR and analyzed with pathological data. Results The dominant serovars of H. parasuis in Taiwan were serovars 5/12 (37.6%), 4 (27.8%) and 13 (15%) followed by molecular serotyping non-typable (MSNT) isolates (13.5%). Nevertheless, the serovar-specific amplicons were not precisely the same sizes as previously indicated in the original publication, and MSNT isolates appeared with unexpected amplicons or lacked serovar-specific amplicons. Most H. parasuis isolates were isolated from nursery pigs infected with porcine reproductive and respiratory syndrome virus. The percentage of lung lesions (30.4%) showing H. parasuis infection was significantly higher than that of serosal lesions. Discussion Collectively, the distribution of serovars in Taiwan is similar to that found in other countries, but MSNT isolates remain due to genetic variations. Furthermore, pulmonary lesions may be optimum sites for H. parasuis isolation, the diagnosis of Glässer’s disease, and may also serve as points of origin for systemic H. parasuis infections in hosts