Necrotizing fasciitis in liver cirrhosis

SummaryBackgroundNecrotizing fasciitis (NF) is associated with a high mortality rate. Hepatitis is endemic in Taiwan, and liver cirrhosis is associated with the development of NF. The characteristics of these patients, however, have not been well documented or the predictors of mortality clearly identified. The purpose of this study is to identify predictors of mortality in patients with liver cirrhosis and necrotizing fasciitis.MethodsThis study was conducted at the Chi-Mei Medical Center in southern Taiwan. Demographic data, clinical characteristics, and the microorganisms responsible for NF in patients with liver cirrhosis were recorded. To identify independent predictors associated with mortality, univariate analysis followed by multivariate logistic regression modeling was performed.ResultsDuring the period 2003–2011, a total of 55 patients with liver cirrhosis and NF were treated at the Chi-Mei Medical Center. Most patients had infections by monomicrobial Gram-negative bacilli. Univariate analysis revealed that severity of liver cirrhosis, shock, band polymorphonuclear neutrophil (>10%), international normalized ratio (>1.5), serum creatinine (>2.0 mg/dL), serum albumin (<2.5 g/dL), and activated partial thromboplastin time (>60 seconds) were significantly associated with mortality. However, multivariate logistic regression analysis revealed that serum albumin of <2.5 g/dL was the only independent predictor of mortality in patients with liver cirrhosis and NF.ConclusionNF in the vast majority of cirrhotic patients was caused by Gram-negative bacilli. Hypoalbuminemia (serum albumin <2.5 g/dL) was associated with mortality in patients with liver cirrhosis and NF. Further studies are needed to assess whether resuscitation with albumin-containing solutions lowers the mortality rate in such patients

An earthquake slip zone is a magnetic recorder

International audienceDuring an earthquake, the physical and the chemical transformations along a slip zone lead to an intense deformation within the gouge layer of a mature fault zone. Because the gouge contains ferromagnetic minerals, it has the capacity to behave as a magnetic recorder during an earthquake. This constitutes a conceivable way to identify earthquakes slip zones. In this paper, we investigate the magnetic record of the Chelungpu fault gouge that hosts the principal slip zone of the Chi-Chi earthquake (Mw 7.6, 1999, Taiwan) using Taiwan Chelungpu-fault Drilling Project core samples. Rock magnetic investigation pinpoints the location of the Chi-Chi mm-thick principal slip zone within the 16-cm thick gouge at ~1 km depth. A modern magnetic dipole of Earth magnetic field is recovered throughout this gouge but not in the wall rocks nor in the two other adjacent fault zones. This magnetic record resides essentially in two magnetic minerals; magnetite in the principal slip zone, and neoformed goethite elsewhere in the gouge. We propose a model where magnetic record: 1) is preserved during inter-seismic time, 2) is erased during co-seismic time and 3) is imprinted during post-seismic time when fluids cooled down. We suggest that the identification of a stable magnetic record carried by neoformed goethite may be a signature of friction-heating process in seismic slip zone

A strong-motion hot spot of the 2016 Meinong, Taiwan, earthquake (M_w = 6.4)

Despite a moderate magnitude, M_w = 6.4, the 5 February 2016 Meinong, Taiwan, earthquake caused significant damage in Tainan City and the surrounding areas. Several seismograms display an impulsive S-wave velocity pulse with an amplitude of about 1 m s-1, which is similar to large S-wave pulses recorded for the past several larger damaging earthquakes, such as the 1995 Kobe, Japan, earthquake (M_w = 6.9) and the 1994 Northridge, California, earthquake (M_w = 6.7). The observed PGV in the Tainan area is about 10 times larger than the median PGV of M_w = 6.4 crustal earthquakes in Taiwan. We investigate the cause of the localized strong ground motions. The peak-to-peak ground-motion displacement at the basin sites near Tainan is about 35 times larger than that at a mountain site with a similar epicentral distance. At some frequency bands (0.9 - 1.1 Hz), the amplitude ratio is as large as 200. Using the focal mechanism of this earthquake, typical “soft” and “hard” crustal structures, and directivity inferred from the observed waveforms and the slip distribution, we show that the combined effect yields an amplitude ratio of 17 to 34. The larger amplitude ratios at higher frequency bands can be probably due to the effects of complex 3-D basin structures. The result indicates that even from a moderate event, if these effects simultaneously work together toward amplifying ground motions, the extremely large ground motions as observed in Tainan can occur. Such occurrences should be taken into consideration in hazard mitigation measures in the place with frequent moderate earthquakes

Transmission of acute infectious illness among cases of Kawasaki disease and their household members

Background/purposeKawasaki disease (KD) is a disease of unknown cause and the causative agent is most likely to be infectious in nature. To investigate the household transmission pattern of infectious illness and etiology, we thus initiated a prospective case and household study.MethodsWe enrolled KD cases and their household members from February 2004 to September 2008. The KD cases and their household members accepted questionnaire-based interviews of the contact history, signs of infection, and symptoms to check whether clusters of infectious illness occurred.ResultsA total of 142 KD cases and 561 household members were enrolled. Among the 142 KD cases, 136 cases (96%) were typical KD, and six (4%) were atypical KD. Of the 561 household members, 17% were siblings, 46% were parents, 18% were grandparents, and the others were cousins or babysitters. Prior to the onset of their KD illness, 66% (94/142) KD cases had contact with ill household members. On the same day of the onset of KD cases' illness, 4% (6/142) KD cases had household members with illness. After KD cases' disease onset, 70% (100/142) KD cases had at least one other family member with illness. Overall, 61% (343/561) of all the household members had acute infectious illness during KD cases' acute stage, and 92% (130/142) of the families had clusters of infectious illness.ConclusionA total of 66% KD cases had positive contact with ill household members prior to their disease onset and 92% of families had clusters of infectious illness, so KD is strongly associated with infections

Joint Effect of Heavy Vehicles and Diminished Light Conditions on Paediatric Pedestrian Injuries in Backover Crashes: A UK Population-Based Study

Backover crashes cause considerable injuries especially among young children. Prior research on backover crashes has not assessed the joint effect of heavy vehicles and diminished light conditions on injuries. By analysing the United Kingdom STATS19 crash dataset from 1991 to 2020, this study focused on backover crashes involving paediatric cyclists or pedestrians aged ≤17 years and other motorised vehicles. By estimating the adjusted odds ratio (AOR) of multiple logistic regression models, pedestrians appeared to have 82.3% (95% CI: 1.78–1.85) higher risks of sustaining killed or serious injuries (KSIs) than cyclists. In addition, casualties involved in backover crashes with heavy vehicles were 39.3% (95% CI: 1.35–1.42) more likely to sustain KSIs than those involved in crashes with personal cars. The joint effect of heavy vehicles and diminished light conditions was associated with a 71% increased probability of sustaining KSIs (AOR = 1.71; 95% CI: 1.60–1.83). Other significant joint effects included young children (aged 0 to 5 years) as pedestrian (AOR = 1.92; 95% CI: 1.87–1.97), in diminished light conditions (AOR = 1.23; 95% CI: 1.15–1.31), and with heavy vehicle (AOR = 1.37; 95% CI: 1.28–1.47)

A strong-motion hot spot of the 2016 Meinong, Taiwan, earthquake (M_w = 6.4)

Despite a moderate magnitude, M_w = 6.4, the 5 February 2016 Meinong, Taiwan, earthquake caused significant damage in Tainan City and the surrounding areas. Several seismograms display an impulsive S-wave velocity pulse with an amplitude of about 1 m s-1, which is similar to large S-wave pulses recorded for the past several larger damaging earthquakes, such as the 1995 Kobe, Japan, earthquake (M_w = 6.9) and the 1994 Northridge, California, earthquake (M_w = 6.7). The observed PGV in the Tainan area is about 10 times larger than the median PGV of M_w = 6.4 crustal earthquakes in Taiwan. We investigate the cause of the localized strong ground motions. The peak-to-peak ground-motion displacement at the basin sites near Tainan is about 35 times larger than that at a mountain site with a similar epicentral distance. At some frequency bands (0.9 - 1.1 Hz), the amplitude ratio is as large as 200. Using the focal mechanism of this earthquake, typical “soft” and “hard” crustal structures, and directivity inferred from the observed waveforms and the slip distribution, we show that the combined effect yields an amplitude ratio of 17 to 34. The larger amplitude ratios at higher frequency bands can be probably due to the effects of complex 3-D basin structures. The result indicates that even from a moderate event, if these effects simultaneously work together toward amplifying ground motions, the extremely large ground motions as observed in Tainan can occur. Such occurrences should be taken into consideration in hazard mitigation measures in the place with frequent moderate earthquakes

A strong-motion hot spot of the 2016 Meinong, Taiwan, earthquake (Mw = 6.4)

Despite a moderate magnitude, Mw = 6.4, the 5 February 2016 Meinong, Taiwan, earthquake caused significant damage in Tainan City and the surrounding areas. Several seismograms display an impulsive S-wave velocity pulse with an amplitude of about 1 m s-1, which is similar to large S-wave pulses recorded for the past several larger damaging earthquakes, such as the 1995 Kobe, Japan, earthquake (Mw = 6.9) and the 1994 Northridge, California, earthquake (Mw = 6.7). The observed PGV in the Tainan area is about 10 times larger than the median PGV of Mw = 6.4 crustal earthquakes in Taiwan. We investigate the cause of the localized strong ground motions. The peak-to-peak ground-motion displacement at the basin sites near Tainan is about 35 times larger than that at a mountain site with a similar epicentral distance. At some frequency bands (0.9 - 1.1 Hz), the amplitude ratio is as large as 200. Using the focal mechanism of this earthquake, typical “soft” and “hard” crustal structures, and directivity inferred from the observed waveforms and the slip distribution, we show that the combined effect yields an amplitude ratio of 17 to 34. The larger amplitude ratios at higher frequency bands can be probably due to the effects of complex 3-D basin structures. The result indicates that even from a moderate event, if these effects simultaneously work together toward amplifying ground motions, the extremely large ground motions as observed in Tainan can occur. Such occurrences should be taken into consideration in hazard mitigation measures in the place with frequent moderate earthquakes

Microwave amplification via interfering multi-photon processes in a half-waveguide quantum electrodynamics system

We investigate the amplification of a microwave probe signal by a superconducting artificial atom, a transmon, strongly coupled to the end of a one-dimensional semi-infinite transmission line. The end of the transmission line acts as a mirror for microwave fields. Due to the weak anharmonicity of the artificial atom, a strong pump field creates multi-photon excitations among the dressed states. Transitions between these dressed states, Rabi sidebands, give rise to either amplification or attenuation of the weak probe. We obtain a maximum amplitude amplification of about 18 %, higher than in any previous experiment with a single artificial atom, due to constructive interference between Rabi sidebands. We also characterize the noise properties of the system by measuring the spectrum of spontaneous emission

Diversity of the association of serum levels and genetic variants of MHC class I polypeptide-related chain A with liver fibrosis in chronic hepatitis C

Background/Aims Genetic variants of MHC class I polypeptide-related chain A (MICA) at rs2596542 have been associated with hepatocellular carcinoma. The linkage between serum MICA (sMICA) and liver fibrosis in chronic hepatitis C is elusive. Results: Linear regression analysis revealed that sMICA were independently correlated to α-fetoprotein (β: 0.149; 95% confidence interval [CI]: 0.001, 0.003; P = 0.007)and MICA rs2596542 GG genotype (β: 0.209; 95% CI: 0.153, 0.483; P 50 pg/mL provided a positive predictive value of 72 % in predicting advanced liver fibrosis (F3-4) and of 90% in significant fibrosis (> F2) in MICA rs2596542 A allele carriers. Materials and Methods Serum level and single nucleotide polymorphism at rs2596542 of MICA were tested for the association with liver fibrosis in 319 biopsy proven chronic hepatitis C patients. Conclusions: Levels of sMICA were highly correlated to liver disease severity in chronic hepatitis C patients who carried the MICA rs738409 A allele. Patients possessing the genetic predisposition had a higher likelihood of progressed liver fibrosis if they expressed higher sMICA levels