A Gram-staining-positive, endospore-forming and rod-shaped bacterial strain, designated KUDC0114 T , was isolated from rhizospheric soil of Elymus tsukushiensis from Dongdo Island, one of the largest of the Dokdo Islands, South Korea. The strain displayed optimal growth at 37 6C, pH 8.5 in the absence of NaCl. Based on phylogenetic analysis of 16S rRNA gene sequences, strain KUDC0114T represented a member of the genus Paenibacillus and was most closely related to Paenibacillus taichungensis BCRC 17757 T (98.46 %). The cell-wall peptidoglycan was A1c type, and the predominant quinone was menaquinone-7 (MK-7). The major cellular fatty acids were anteiso-C 15 : 0 and C 16 : 0 . The DNA-DNA hybridization of strain KUDC0114 T with nine other strains indicated less than 23 % relatedness, and its DNA G+C content was 44.30 mol%. Based on genomic, phenotypic and phylogenetic analyses, KUDC0114 T should be classified as representing novel species within the genus Paenibacillus.

We aimed to evaluate the predictive performance of previously constructed free (C free ) and total (C total ) cefoxitin pharmacokinetic models and the possibility of administering cefoxitin via the target-controlled infusion (TCI) method in clinical practice.Two external validation studies (N = 31 for C free model, N = 30 for C total model) were conducted sequentially. Cefoxitin (2 g) was dissolved in 50 mL of normal saline to give a concentration of 40 mg mL À1 . Before skin incision, cefoxitin was infused with a TCI syringe pump. Target concentrations of free concentration and total concentration were set to 25 and 80 μg mL À1 , respectively, which were administered throughout the surgery. Three arterial blood samples were collected to measure the total and free plasma concentrations of cefoxitin at 30, 60 and 120 min, after the start of cefoxitin administration. The predictive performance was evaluated using four parameters: inaccuracy, divergence, bias and wobble. The pooled median (95% confidence interval) biases and inaccuracies were À 45.9 (À47.3 to À44.5) and 45.9 (44.5 to 47.3) for C free model (Choi_F model), and À 16.6 (À18.4 to À14.8) and 18.5 (16.7 to 20.2) for C total model (Choi_T old model), respectively. The predictive performance of the newly constructed model (Choi_T new model), developed by adding the total concentration data measured in the external validation, was better than that of the Choi_T old model. Models constructed with total concentration data were suitable for clinical use. Administering cefoxitin using the TCI method in patients maintained the free concentration above the minimal inhibitory concentration (MIC) breakpoints of the major pathogens causing surgical site infection throughout the operation period.

Aortic stenosis (AS) is the second most common valvular heart disease in the United States. Although the prevalence of AS does not significantly differ between the sexes, there is some controversy on whether sex differences affect the long-term mortality of patients with severe AS undergoing surgical aortic valve replacement (SAVR). Therefore, we retrospectively analyzed the medical records of 917 patients (female, n = 424 [46.2%]) with severe AS who had undergone isolated SAVR at a tertiary care center between January 2005 and December 2018. During a median follow-up of 5.2 years, 74 (15.0%) male patients and 41 (9.7%) female patients died. The Kaplan–Meier analysis revealed that the 10-year mortality rate was significantly higher in male than female patients (24.7% vs. 17.9%, log-rank p = 0.005). In the sequential Cox proportional hazard regression model for assessing long-term mortality up to 10 years post-surgery, the adjusted hazard ratio of male sex for mortality was 1.93 (95% confidence interval, 1.28–2.91; p = 0.002). The association between male sex and postoperative long-term mortality was not significantly diminished by any demographic or clinical factor in subgroup analyses. In conclusion, female sex was significantly associated with better long-term survival in patients with severe AS undergoing SAVR.