Correlation of ciprofloxacin resistance with the AdeABC efflux system in Acinetobacter baumannii clinical isolates

Background: Acinetobacter baumannii is one of the most important pathogens capable of colonization in burn patients, leading to drug-resistant wound infections. This study evaluated the distribution of the AdeABC efflux system genes and their relationship to ciprofloxacin resistance in A. baumannii isolates collected from burn patients. Methods: A total of 68 A. baumannii clinical strains were isolated from patients hospitalized in Motahari Burns Center in Tehran, Iran. Ciprofloxacin susceptibility was tested by the disk diffusion and agar dilution methods. PCR amplification of the adeRS-adeB drug efflux genes was performed for all resistant and susceptible isolates. To assess the role of the drug efflux pump in ciprofloxacin susceptibility, carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as an efflux pump inhibitor (EPI). Results: Approximately 95.6% of the Acinetobacter isolates were resistant to ciprofloxacin, with minimum inhibitory concentration (MIC) values ranging from 4 to ≥128 μg/mL. The susceptibility of 86.1% of the resistant isolates increased by factors of 2 to 64 in the presence of CCCP. All resistant isolates were positive for the adeRS-adeB genes, and 73.2% of them had mutations in the AdeRS regulatory system. Conclusions: The results showed that AdeABC genes are common in A. baumannii, which might be associated with ciprofloxacin non-susceptibility, as indicated by the observed linkage to the presence of the genes essential for the activity of the AdeABC, several single mutations occurring in the adeRS regulatory system, and an increase of ciprofloxacin susceptibility in the presence of a CCCP EPI. © The Korean Society for Laboratory Medicin

Integrative analysis of the inter-tumoral heterogeneity of triple-negative breast cancer.

Triple-negative breast cancers (TNBC) lack estrogen and progesterone receptors and HER2 amplification, and are resistant to therapies that target these receptors. Tumors from TNBC patients are heterogeneous based on genetic variations, tumor histology, and clinical outcomes. We used high throughput genomic data for TNBC patients (n = 137) from TCGA to characterize inter-tumor heterogeneity. Similarity network fusion (SNF)-based integrative clustering combining gene expression, miRNA expression, and copy number variation, revealed three distinct patient clusters. Integrating multiple types of data resulted in more distinct clusters than analyses with a single datatype. Whereas most TNBCs are classified by PAM50 as basal subtype, one of the clusters was enriched in the non-basal PAM50 subtypes, exhibited more aggressive clinical features and had a distinctive signature of oncogenic mutations, miRNAs and expressed genes. Our analyses provide a new classification scheme for TNBC based on multiple omics datasets and provide insight into molecular features that underlie TNBC heterogeneity

Asymptotic solutions for turbulent mass transfer at high Schmidt number

International audienceThis paper introduces a new methodology for the complexity analysis of higher-order functional programs, which is based on three ingredients: a powerful type system for size analysis and a sound type inference procedure for it, a ticking monadic transformation, and constraint solving. Noticeably, the presented methodology can be fully automated, and is able to analyse a series of examples which cannot be handled by most competitor methodologies. This is possible due to the choice of adopting an abstract index language and index polymorphism at higher ranks. A prototype implementation is available

Unit testing methods for Internet of Things Mbed OS operating system

Abstract. Embedded operating systems for Internet of Things are responsible for managing hardware and software in these systems. From the vast number of IoT operating system projects available, some projects are backed by large companies or institutes and some are developed completely by the open source community. IoT operating system testing focuses on the key features of IoT such as networking and limited resources. In this thesis, problems in Mbed OS operating system testing methods are identified and a unit testing solution is implemented. The implemented unit testing framework allows developers to write and run unit tests. The framework is also integrated into Mbed OS continuous integration to increase test coverage. This thesis shows how functional testing and unit testing are the most common types of testing in open source embedded operating system projects. Mbed OS unit testing framework results shows how running tests on PC platforms is faster than running tests on IoT devices. This framework also enables developers to write unit tests more freely and improve Mbed OS development process. The implemented unit testing framework solved issues in Mbed OS testing but more in depth research is needed to improve testing methods further.Yksikkötestausmenetelmät esineiden internet Mbed OS käyttöjärjestelmälle. Tiivistelmä. Esineiden internettiin tarkoitetut sulautetut käyttöjärjestelmät ovat tarvittavia laitteiston ja sovellusten hallintaan IoT järjestelmissä. Saatavilla olevien IoT käyttöjärjestelmien joukosta osa on suurten yritysten tai instituutioiden tukemia, ja osa on täysin vapaan lähdekoodin yhteisön kehittämiä. IoT käyttöjärjestelmän testaus keskittyy esineiden internetin avainominaisuuksiin kuten verkkotietoliikenteeseen ja rajallisiin resursseihin. Työssä tunnistetaan Mbed OS käyttöjärjestelmän testausmenetelmien ongelmia ja kehitetään yksikkötestaustyökalu. Kehitetty yksikkötestausympäristö mahdollistaa kehittäjille yksikkötestien kirjoittamisen ja ajamisen. Testaustyökalu yhdistetään myös Mbed OS jatkuvan integraation prosessiin testauskattavuuden parantamiseksi. Työssä katsotaan kuinka funktionaaliset testit ja yksikkötestit ovat yleisimmät testityypit avoimen lähdekoodin sulautetuissa käyttöjärjestelmäprojekteissa. Mbed OS yksikkötestaustyökalu näyttää kuinka testien ajaminen PC ympäristössä on nopeampaa kuin IoT laitteissa. Tämä työkalu myös mahdollistaa kehittäjien kirjoittaa yksikkötestejä vapaammin ja siten parantaa kehitysprosessia. Kehitetty yksikkötestaustyökalu ratkaisi Mbed OS testauksen ongelmia, mutta syventävää tutkimusta tarvitaan enemmän testausmenetelmien parantamiseksi edelleen

On the nature of the ISO-selected sources in the ELAIS S2 region

We have studied the optical, near-IR and radio properties of a complete sample of 43 sources detected at 15-micron in one of the deeper ELAIS repeatedly observed region. The extragalactic objects in this sample have 15-micron flux densities in the range 0.4-10 mJy, where the source counts start diverging from no evolution models. About 90% of the sources (39 out of 43) have optical counterparts brighter than I=21 mag. Eight of these 39 sources have been identified with stars on the basis of imaging data, while for another 22 sources we have obtained optical spectroscopy, reaching a high identification percentage (30/43, ~70%). All but one of the 28 sources with flux density > 0.7 mJy are identified. Most of the extragalactic objects are normal spiral or starburst galaxies at moderate redshift (z_med~0.2); four objects are Active Galactic Nuclei. We have used the 15-micron, H_alpha and 1.4-GHz luminosities as indicators of star-formation rate and we have compared the results obtained in these three bands. While 1.4-GHz and 15-micron estimates are in good agreement, showing that our galaxies are forming stars at a median rate of ~40 Mo/yr, the raw H_alpha-based estimates are a factor ~5-10 lower and need a mean correction of ~2 mag to be brought on the same scale as the other two indicators. A correction of ~2 mag is consistent with what suggested by the Balmer decrements H_alpha/H_beta and by the optical colours. Moreover, it is intermediate between the correction found locally for normal spirals and the correction needed for high-luminosity 15-micron objects, suggesting that the average extinction suffered by galaxies increases with infrared luminosity.Comment: 19 pages, 11 figures (3 in JPEG format), MNRAS, accepte

Is quality of life measurement likely to be a proxy for health needs assessment in patients with coronary artery disease?

BACKGROUND: The identification of patients' health needs is pivotal in optimising the quality of health care, increasing patient satisfaction and directing resource allocation. Health needs are complex and not so easily evaluated as health-related quality of life (HRQL), which is becoming increasingly accepted as a means of providing a more global, patient-orientated assessment of the outcome of health care interventions than the simple medical model. The potential of HRQL as a surrogate measure of healthcare needs has not been evaluated. OBJECTIVES AND METHOD: A generic (Short Form-12; SF-12) and a disease-specific questionnaire (Seattle Angina Questionnaire; SAQ) were tested for their potential to predict health needs in patients with acute coronary disease. A wide range of healthcare needs were determined using a questionnaire specifically developed for this purpose. RESULTS: With the exception of information needs, healthcare needs were highly correlated with health-related quality of life. Patients with limited enjoyment of personal interests, weak financial situation, greater dependency on others to access health services, and dissatisfaction with accommodation reported poorer HRQL (SF-12: p < 0.001; SAQ: p < 0.01). Difficulties with mobility, aids to daily living and activities requiring assistance from someone else were strongly associated with both generic and disease-specific questionnaires (SF-12: r = 0.46-0.55, p < 0.01; SAQ: r = 0.53-0.65, p < 0.001). Variables relating to quality of care and health services were more highly correlated with SAQ components (r = 0.33-0.59) than with SF-12 (r = 0.07-0.33). Overall, the disease-specific Seattle Angina Questionnaire was superior to the generic Short Form-12 in detecting healthcare needs in patients with coronary disease. Receiver-operator curves supported the sensitivity of HRQL tools in detecting health needs. CONCLUSION: Healthcare needs are complex and developing suitable questionnaires to measure these is difficult and time-consuming. Without a satisfactory means of measuring these needs, the extent to which disease impacts on health will continue to be underestimated. Further investigation on larger populations is warranted but HRQL tools appear to be a reasonable proxy for healthcare needs, as they identify the majority of needs in patients with coronary disease, an observation not previously reported in this patient grou

Return to work after trauma: A survival analysis

Purpose To evaluate the return to work (RTW) rate, time and predictors among trauma patients using survival analysis. Methods This cohort study was conducted with a three-month follow-up on 300 trauma patients hospitalized in Shahid Beheshti Hospital, Kashan, Iran in 2014. The data were collected through conducting interviews and referring to patients' medical records during their hospital stay and follow-up information at one & three months after discharge from hospital. Final analysis was conducted on the data retrieved from 273 patients. Data were analyzed by chi-square test, Mann–Whitney U test and survival analysis method. Results The rate of RTW at the end of the first and the third follow-up months was respectively 21.6% and 61.2%. Survival analysis showed that the RTW time (Time between admission to first return to work) was significantly longer among patients with illiteracy, drug abuse, hospitalization history in the intensive care unit, low socioeconomic status, non-insurance coverage, longer hospital stay, multiple and severe injuries as well as severe disability. Conclusion Our findings indicated that trauma has profound effects on the rate and time of RTW. Besides disability, many personal and clinical factors can affect the outcome of RTW

Unmet health needs in patients with coronary heart disease: implications and potential for improvement in caring services

BACKGROUND: Improving the quality of health care services requires tailoring facilities to fulfil patients' needs. Satisfying patients' healthcare needs, listening to patients' opinions and building a closer provider-user partnership are central to the NHS. Few published studies have discussed cardiovascular patients' health needs, but they are not comprehensive and fail to explore the contribution of outcome to needs assessment. METHOD: A comprehensive self-administered health needs assessment (HNA) questionnaire was developed for concomitant use with generic (Short Form-12 and EuroQOL) and specific (Seattle Angina Questionnaire) health-related quality of life (HRQL) instruments on 242 patients admitted to the Acute Cardiac Unit, Nottingham. RESULTS: 38% reported difficulty accessing health facilities, 56% due to transport and 32% required a travelling companion. Mean HRQOL scores were lower in those living alone (P < 0.05) or who reported unsatisfactory accommodation. Dissatisfaction with transport affected patients' ease of access to healthcare facilities (P < 0.001). Younger patients (<65 y) were more likely to be socially isolated (P = 0.01). Women and patients with chronic disease were more likely to be concerned about housework (P < 0.05). Over 65 s (p < 0.05) of higher social classes (p < 0.01) and greater physical needs (p < 0.001) had more social needs, correlating moderately (0.32 < r < 0.63) with all HRQL domains except SAQ-AS. Several HRQL components were highly correlated with the HNA physical score (p < 0.001). CONCLUSIONS: Patients wanted more social (suitable accommodation, companionship, social visits) and physical (help aids, access to healthcare services, house work) support. The construct validity and intra-class reliability of the HNA tool were confirmed. Our results indicate a gap between patients' health needs and available services, highlighting potential areas for improvement in the quality of service