Nosocomial infections caused by antibiotic-resistant Klebsiella pneumoniae are emerging as a major health problem worldwide, while community-acquired K. pneumoniae infections present with a range of diverse clinical pictures in different geographic areas. In particular, an invasive form of K. pneumoniae that causes liver abscesses was first observed in Asia and then was found worldwide. We are interested in how differences in gene content of the same species result in different diseases. Thus, we sequenced the whole genome of K. pneumoniae NTUH-K2044, which was isolated from a patient with liver abscess and meningitis, and analyzed differences compared to strain MGH 78578, which was isolated from a patient with pneumonia. Six major types of differences were found in gene clusters that included an integrative and conjugative element, clusters involved in citrate fermentation, lipopolysaccharide synthesis, and capsular polysaccharide synthesis, phage-related insertions, and a cluster containing fimbria-related genes. We also conducted comparative genomic hybridization with 15 K. pneumoniae isolates obtained from community-acquired or nosocomial infections using tiling probes for the NTUH-K2044 genome. Hierarchical clustering revealed three major groups of genomic insertion-deletion patterns that correlate with the strains' clinical features, antimicrobial susceptibilities, and virulence phenotypes with mice. Here we report the whole-genome sequence of K. pneumoniae NTUH-K2044 and describe evidence showing significant genomic diversity and sequence acquisition among K. pneumoniae pathogenic strains. Our findings support the hypothesis that these factors are responsible for the changes that have occurred in the disease profile over time.
Paralleling with the contribution of Western systems thinking to the development of modern Chinese system theory, the authors notice that the concept of yin-yang is scattered in many social science researches in the West. However, those researches were still not rich enough to yield insights into the core value of yin-yang and, in turn, there is seemly no one unified guiding law or principle which governs both its theoretical and empirical applications. In this study, axiom system of the Yin-Yang-based system has been proposed and elaborated through the comparisons of systematic thinking between East and West. After incorporating the concept of causal chains, it can also be used to work as quantitative tool for business decision analysis in management practices. The aim of this study is to bridge the contemporary systematic thinking gap between East and West and to provide a complement to aid in further development of system theory.
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