960 research outputs found
Prolonged mechanical ventilation in a respiratory-care setting: a comparison of outcome between tracheostomized and translaryngeal intubated patients
The Arabidopsis Malectin-Like/LRR-RLK IOS1 is Critical for BAK1-Dependent and BAK1-Independent Pattern-Triggered Immunity
Plasma membrane-localized pattern recognition receptors (PRRs) such as FLAGELLIN SENSING2 (FLS2), EF-TU RECEPTOR (EFR) and CHITIN ELICITOR RECEPTOR KINASE 1 (CERK1) recognize microbe-associated molecular patterns (MAMPs) to activate pattern-triggered immunity (PTI). A reverse genetics approach on genes responsive to the priming agent beta-aminobutyric acid (BABA) revealed IMPAIRED OOMYCETE SUSCEPTIBILITY1 (IOS1) as a critical PTI player. Arabidopsis thaliana ios1 mutants were hyper-susceptible to Pseudomonas syringae bacteria. Accordingly, ios1 mutants showed defective PTI responses, notably delayed up-regulation of the PTI-marker gene FLG22-INDUCED RECEPTOR-LIKE KINASE1 (FRK1), reduced callose deposition and mitogen-activated protein kinase activation upon MAMP treatment. Moreover, Arabidopsis lines over-expressing IOS1 were more resistant to bacteria and showed a primed PTI response. In vitro pull-down, bimolecular fluorescence complementation, co-immunoprecipitation, and mass spectrometry analyses supported the existence of complexes between the membrane-localized IOS1 and BRASSINOSTEROID INSENSITIVE1-ASSOCIATED KINASE1 (BAK1)-dependent PRRs FLS2 and EFR, as well as with the BAK1-independent PRR CERK1. IOS1 also associated with BAK1 in a ligand-independent manner, and positively regulated FLS2-BAK1 complex formation upon MAMP treatment. In addition, IOS1 was critical for chitin-mediated PTI. Finally, ios1 mutants were defective in BABA-induced resistance and priming. This work reveals IOS1 as a novel regulatory protein of FLS2-, EFR- and CERK1-mediated signaling pathways that primes PTI activation
Open lung biopsy in early-stage acute respiratory distress syndrome
INTRODUCTION: Acute respiratory distress syndrome (ARDS) has heterogeneous etiologies, rapid progressive change and a high mortality rate. To improve the outcome of ARDS, accurate diagnosis is essential to the application of effective early treatment. The present study investigated the clinical effects and safety of open lung biopsy (OLB) in patients with early-stage ARDS of suspected non-infectious origin. METHODS: We undertook a retrospective study of 41 patients with early-stage ARDS (defined as one week or less after intubation) who underwent OLB in two medical intensive care units of a tertiary care hospital from 1999 to 2005. Data analyzed included baseline characteristics, complication rate, pathological diagnoses, treatment alterations, and hospital survival. RESULTS: The age of patients was 55 ± 17 years (mean ± SD). The average ratio of arterial partial pressure of oxygen (PaO(2)) to fraction of inspired oxygen (FiO(2)) was 116 ± 43 mmHg (mean ± SD) at biopsy. Seventeen patients (41%) were immunocompromised. Postoperative complications occurred in 20% of patients (8/41). All biopsies provided a pathological diagnosis with a diagnostic yield of 100%. Specific pathological diagnoses were made for 44% of patients (18/41). Biopsy findings led to an alteration of treatment modality in 73% of patients (30/41). The treatment alteration rate was higher in patients with nonspecific diagnoses than in patients with specific diagnoses (p = 0.0024). Overall mortality was 50% (21/41) and was not influenced by age, gender, pre-OLB oxygenation, complication rate, pathological results, and alteration of treatment. There was no surgery-related mortality. The survival rate for immunocompromised patients was better than that for immunocompetent patients (71% versus 33%; p = 0.0187) in this study. CONCLUSION: Our retrospective study suggests that OLB was a useful and acceptably safe diagnostic procedure in some selected patients with early-stage ARDS
High Altitude Pulmonary Edema in a Patient with Previous Pneumonectomy
High altitude pulmonary edema (HAPE) is a life-threatening illness that can occur in individuals ascending to altitudes exceeding 2400 m. The risk factors are rapid ascent, physical exertion and a previous history of HAPE. This work presents a case study of a 74-year-old man who underwent left side pneumonectomy 40 years ago and subsequently experienced several instances of HAPE. The well-known risk factors for HAPE were excluded in this patient. We suspect that the post-pneumonectomy condition may be a risk factor for HAPE based on this case. [J Formos Med Assoc 2007;106(4):320-322
A huge traumatic pulmonary pseudocyst
AbstractTraumatic pulmonary pseudocyst (TPP) is a rare complication following blunt trauma. We report a 26-year-old male patient who presented to the emergency room with internal bleeding and shock. Huge TPP (14 cm in diameter) was seen on whole-body computed tomography scan and complicated with bronchial bleeding. He deteriorated to respiratory failure soon after arriving at the emergency room. TPPs imply high-energy impact on the chest region and frequently complicated with pulmonary contusions, hemo- and pneumo-thorax, multiple rib fractures, flail chest, and concurrent with abdominal injuries. Emergency physicians should be aware of such rare entity and manage correctly
Self-supervised learning-based general laboratory progress pretrained model for cardiovascular event detection
The inherent nature of patient data poses several challenges. Prevalent cases
amass substantial longitudinal data owing to their patient volume and
consistent follow-ups, however, longitudinal laboratory data are renowned for
their irregularity, temporality, absenteeism, and sparsity; In contrast,
recruitment for rare or specific cases is often constrained due to their
limited patient size and episodic observations. This study employed
self-supervised learning (SSL) to pretrain a generalized laboratory progress
(GLP) model that captures the overall progression of six common laboratory
markers in prevalent cardiovascular cases, with the intention of transferring
this knowledge to aid in the detection of specific cardiovascular event. GLP
implemented a two-stage training approach, leveraging the information embedded
within interpolated data and amplify the performance of SSL. After GLP
pretraining, it is transferred for TVR detection. The proposed two-stage
training improved the performance of pure SSL, and the transferability of GLP
exhibited distinctiveness. After GLP processing, the classification exhibited a
notable enhancement, with averaged accuracy rising from 0.63 to 0.90. All
evaluated metrics demonstrated substantial superiority (p < 0.01) compared to
prior GLP processing. Our study effectively engages in translational
engineering by transferring patient progression of cardiovascular laboratory
parameters from one patient group to another, transcending the limitations of
data availability. The transferability of disease progression optimized the
strategies of examinations and treatments, and improves patient prognosis while
using commonly available laboratory parameters. The potential for expanding
this approach to encompass other diseases holds great promise.Comment: published in IEEE Journal of Translational Engineering in Health &
Medicin
Using Knowledge Building to Foster Conceptual Change
In recent years, there have been many exchanges of perspectives and debates in the field of conceptual change. Most of the classical views on conceptual change have been criticized, and there have been recent discussions around bridging the cognitive and socio-cultural approaches in the research on conceptual change. On the other hand, researchers and educators in the knowledge building communities have been working towards advancing the frontier of knowledge work and knowledge creation in education in order to cope with the challenges of an emerging knowledge society. In this paper, we examine some of the main principles of knowledge building in relation to fostering conceptual change with reference to specific examples. Specifically, we highlight the foundational goal of knowledge building with respect to conceptual change
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