In search of high-performance field-effect transistors (FETs) made of atomic thin semiconductors, indium selenide (InSe) has held great promise because of its high intrinsic mobility and moderate electronic band gap (1.26 eV). Yet the performance of InSe FETs is decisively determined by the surface oxidation of InSe taking place spontaneously in ambient conditions, setting up a mobility ceiling and causing an uncontrollable current hysteresis. Encapsulation by hexagonal boron nitride (h-BN) has been currently used to cope with this deterioration. Here, we provide insights into the role of surface oxides played in device performance and introduce a dry-oxidation process that forms a dense capping layer on top, where InSe FETs exhibit a record-high two-probe mobility of 423 cm/V·s at room temperature and 1006 cm/V·s at liquid nitrogen temperature without the use of h-BN encapsulation or high-κ dielectric screening. Ultrahigh on/off current ratio of >10 and current density of 365 μA/μm can be readily achieved without elaborate engineering of drain/source contacts or gating technique. Thickness-dependent device properties are also studied, with optimized performance shown in FETs comprising of 13 nm thick InSe. The high performance of InSe FETs with ultrathin dry oxide is attributed to the effective unpinning of the Fermi level at the metal contacts, resulting in a low Schottky barrier height of 40 meV in an optimized channel thickness.
In this study, 283 multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream isolates were collected between 1996 and 2004, from three teaching hospitals located in different regions of Taiwan. Susceptibility data showed that strains carrying class 1 integrons were significantly more resistant (p <0.01) to all tested antibiotics (except aztreonam and chloramphenicol) than strains lacking integrons, Seven types of gene cassette were identified among these strains, including two that have not been previously reported. The vast majority of the cassettes encoded aminoglycoside resistance genes, including aacA4, aacC1, aac(6')-II, aadA1, aadA2, aadA4 and aadDA1. Sixteen distinct ribotypes were identified in MDR-AB isolates carrying class 1 integrons. Only one strain was found to produce an extended-spectrum beta-lactamase, i.e. VEB-3. In the 18 imipenem-resistant strains, two carbapenenmase genes, bla(VIM-11) and bla(OXA-58), were found concomitantly in one isolate. An island-wide epidemic clone and an endemic clone from a hospital located in the northern region were identified by ribotyping. On the basis of the susceptibility data among the different ribogroups, the epidemic clone was associated more significantly with resistance to cefepime and ampicillin-sulbactam than was the endemic clone. In conclusion, the presence of class 1 integrons was significantly associated with resistance in MDR-AB, and the epidemic, class 1 integron-carrying MDR-AB clone was found to be widespread in Taiwan.
BackgroundIliopsoas abscess (IPA) is a rare clinical entity and is difficult to diagnose due to its insidious onset and nonspecific symptoms. The association between IPA and cardiovascular disorders (CVD) has been rarely reported. Computed tomographic (CT) scan can provide a definitive diagnosis of IPA and associated foci of adjacent structures. IPA is a life-threatening condition, especially when associated with CVD.Materials and methodsWe conducted a hospital-based observational study of IPA associated with CVD. Data were collected from the electronic clinical database of Taichung Veterans General Hospital (1520-bed tertiary referral hospital in central Taiwan) between July 2007 and December 2017. The diagnosis of IPA associated with CVD was confirmed by classical findings on CT and transesophageal echocardiography with compatible clinical presentation and cultures from pus/tissue and blood.ResultsFifteen patients of IPA associated with CVD were studied. They included 12 males (80%) and 3 females (20%), with a mean age 63.2 ± 16.9 years (31–85 years). CVD included stent-graft/endograft infection of abdominal aortic aneurysm (AAA) (40%), primary mycotic AAA (33.3%), and infective endocarditis (26.7%). Staphylococcus aureus is the most common microorganism in pus/tissue cultures (n = 3, 37.5%) and in blood cultures (n = 6, 40%). The average length of hospital stay was 33.1 ± 20.5 days (range, 3–81 days; median, 33 days). Hospital stay lasted 42.6 ± 19.2 days in the survival group and 19.0 ± 14.1 days (P = 0.018) in the non-survival group. Incidence of patients staying in the intensive care unit (ICU) with intubation > 3 days was 33% in the survival group and 100% (P = 0.028) in the non-survival group. Intra-hospital mortality rate was 40%. Poor prognostic factors in the non-survival group were hypoalbuminemia, hyponatremia, involved disc/vertebral body and/or epidural abscess, and ICU stay with intubation > 3 days. Cumulative survival rate was 25% under conservative treatments and 66.3% under aggressive treatments (P = 0.038).ConclusionDue to high mortality rates, clinicians should keep a high suspicion index for IPA associated with CVD through clinical presentation, physical examination, and imaging study. Timely empiric antibiotics for common bacteria, drainage for IPA, endovascular repair, or vascular reconstruction by graft replacement or bypass with intensive care should be mandatory to shorten the hospital stay, reduce medical costs, and lower mortality rate.
Intra-abdominal infection due to Chryseobacterium meningosepticum is rare, and bacteremia complicated with pleural effusion and retroperitoneal hematoma caused by C. meningosepticum has not been reported previously. A 57-year-old diabetic man presented with bacteremia with retroperitoneal abscess and pleural effusion caused by C. meningosepticum on the 12th day of hospitalization. His clinical condition improved after antimicrobial therapy with levofloxacin and rifampin, debridement of the retroperitoneal hematoma and left-side chest tube insertion. Antibiotics were administered for 1 month, and he was later transferred to a local respiratory care ward under afebrile condition. C. meningosepticum should be included in the list of suspected nosocomial infections, especially in patients with immunocompromised status. Administration of appropriate antibiotics, such as quinolone, minocycline, trimethoprim-sulfamethoxazole or rifampin, and treatment of local infection improve the clinical outcome of patients with C. meningosepticum infection.
Primary splenic lymphoma (PSL) is a rare disease with ambiguous definition, comprising less than 1% of non-Hodgkin's lymphoma. Even rarer is PSL combined with hemophagocytic lymphohistiocytosis (HLH), which has presentations of fever, cytopenia, hepatosplenomegaly, hyperferritinemia, and phagocytosis of hematopoietic cells in the reticuloendothelial system. We report the case of a 77-year-old man who presented with HLH initially. Refusing diagnostic splenectomy, he received chemotherapy. Spontaneous splenic rupture occurred after chemotherapy. In the following emergency operation, PSL was diagnosed. He received another 5 courses of chemotherapy with the R-CNOP regimen (rituximab, cyclophosphamide, mitoxantrone, vincristine, prednisolone). Now he has no residual or relapsed disease. Diagnostic splenectomy for adult HLH patients without definite etiologies may play an important role.
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