Background Monitoring of hand hygiene is an important part of the improvement of hospital quality indicators. Methods This study was prospectively performed over a 14-week (electronic observer) ...period from December 3, 2013-March 9, 2014, to evaluate hand hygiene compliance in an adult step-down unit. We compared electronic handwash counters with the application of radiofrequency identification (RFID - ZigBee; i-Healthsys, São Carlos, Brazil) (electronic observer), which counts each activation of the alcohol gel dispenser to direct observation (human observer) using the iScrub application. Results For the overall time period of simultaneous electronic and human observation, we found that the electronic observer identified 414 hand hygiene episodes, whereas the human observers identified 448 episodes. Therefore, we found 92% (95% confidence interval CI, 90%-95%) overall concordance (414/448), with an intraclass correlation coefficient of .87 (95% CI, 0.77-0.92). Conclusion Our RFID (ZigBee) system showed good accuracy (92%) and is a useful method to monitor hand hygiene compliance.
Porous hydroxyapatite(HA) prepared on the surface of mortar by a wet process at 40-100°C and pH 10 was characterized with a scanning electron microscope(SEM) and by energy dispersed analysis of ...X-ray(EDX) and X-ray diffractometry. The appropriate conditions of HA preparation and the formation mechanisms of the HA were briefly discussed.
This paper describes the emission reduction technologies applied to 4- and 6-cylinder engines used on Japanese market models certified as ultra-low emission vehicles (U-LEVs) in Japan. To qualify for ...this rigorous U-LEV certification, a vehicle must reduce hydrocarbon (HC) and nitrogen oxide (NOx) emissions by an additional 75% from the levels mandated by Japan's 2000 exhaust emission regulations. Nearly all Nissan Japanese models fitted with a gasoline engine, ranging from in-line 4-cylinder engines to V6 engines, have now been certified as U-LEVs. This has been accomplished by further improving the emission reduction technologies that were developed for the Sentra CA, which was launched in the U.S. market in 2000 as the world's first gasoline-fueled vehicle to qualify for Partial Zero Emission Vehicle (P-ZEV) credits from the California Air Resources Board. The specific new technologies involved are as follows. The adoption of a newly developed tandem catalyst system has made it possible to obtain high conversion efficiencies for both HC and NOx emissions with a smaller catalyst capacity. A new catalyst coating has also been developed that is specifically designed to shorten catalyst light-off time. In addition, a new HC trap catalyst has been developed that attains a high HC conversion rate at low temperatures. The use of a fast-acting oxygen sensor has made it possible to reduce the engine-out HC level. On the basis of simulations and experimental results, a new exhaust manifold has been developed, along with optimizing the valve timing. As a result, by suppressing the decline in exhaust gas temperature right after engine start, it is possible to obtain high power output combined with low emission levels. Moreover, a system has also been adopted for reducing engine-out HC emissions. The application of these newly developed technologies has now made it possible to obtain U-LEV certification in Japan for nearly all Nissan passenger car models.
We analyze the regional tsunami hazard along the Sea of Japan coast associated with 60 active faults beneath the eastern margin of the Sea of Japan. We generate stochastic slip distribution using a ...Monte Carlo approach at each fault, and the total number of required earthquake samples is determined based on convergence analysis of maximum coastal tsunami heights. The earthquake recurrence interval on each fault is estimated from observed seismicity. The variance parameter representing aleatory uncertainty for probabilistic tsunami hazard analysis is determined from comparison with the four historical tsunamis, and a logic-tree is used for the choice of the values. Using nearshore tsunami heights at the 50 m isobath and an amplification factor by the Green’s law, hazard curves are constructed at 154 locations for coastal municipalities along the Sea of Japan coast. The highest maximum coastal tsunamis are expected to be approximately 3.7, 7.7, and 11.5 m for the return periods of 100-, 400-, and 1000-year, respectively. The results indicate that the hazard level generally increases from southwest to northeast, which is consistent with the number and type of the identified fault systems. Furthermore, the deaggregation of hazard suggests that tsunamis in the northeast are predominated by local sources, while the southwest parts are likely affected by several regional sources.
We investigated the effects of fault parameter uncertainty on the deterministic assessment of tsunami hazards for the submarine and coastal active faults in the Sea of Japan that were recently ...modeled by the Integrated Research Project on Seismic and Tsunami Hazards around the Sea of Japan. A key parameter in scenario-based tsunami assessment is the fault slip amount, which is usually calculated from empirical scaling relations that relate the fault size to the slip. We examined four methods to estimate the fault slip amounts and compared the coastal tsunami heights from the slip amounts obtained by two different empirical relations. The resultant coastal tsunami heights were strongly affected by the choice of scaling relation, particularly the fault aspect ratio (fault length/fault width). The geometric means of the coastal tsunami heights calculated from the two methods ranged from 0.69 to 4.30 with an average of 2.01. We also evaluated the effects of fault slip angles, which are also important parameters for controlling coastal tsunami heights, by changing the slip angles for faults in the southwestern and central parts of the Sea of Japan, where the strike-slip faults are concentrated. The effects of uncertainty of the fault slip angles (± 30° from the standard) on the coastal tsunami heights were revealed to be equal to or greater than those resulting from the choice of scaling relations; the geometric means of the coastal tsunami heights from the modified fault slip angles relative to the standard fault slip angles ranged from 0.23 to 5.88. Another important characteristic is that the locations of the maximum coastal tsunami height and the spatial pattern of the coastal tsunami heights can change with varying fault slip angles.
Graphical Abstract
The loss of integrity of the glomerular filtration barrier results in proteinuria that is often attributed to podocyte loss. Yet how damaged podocytes are lost remains unknown. Germline loss of ...murine podocyte-associated Hdac1 and Hdac2 ( Hdac1/2 ) results in proteinuria and collapsing glomerulopathy due to sustained double-stranded DNA damage. Hdac1/2 deletion induces loss of podocyte quiescence, cell cycle entry, arrest in G1, and podocyte senescence, observed both in vivo and in vitro . Through the senescence secretory associated phenotype, podocytes secrete proteins that contribute to their detachment. These results solidify the role of HDACs in cell cycle regulation and senescence, providing important clues in our understanding of how podocytes are lost following injury.
Intact expression of podocyte histone deacetylases (HDAC) during development is essential for maintaining a normal glomerular filtration barrier because of its role in modulating DNA damage and preventing premature senescence.
Germline podocyte-specific Hdac1 and 2 ( Hdac1 / 2 ) double-knockout mice were generated to examine the importance of these enzymes during development.
Podocyte-specific loss of Hdac1 / 2 in mice resulted in severe proteinuria, kidney failure, and collapsing glomerulopathy. Hdac1 / 2 -deprived podocytes exhibited classic characteristics of senescence, such as senescence-associated β-galactosidase activity and lipofuscin aggregates. In addition, DNA damage, likely caused by epigenetic alterations such as open chromatin conformation, not only resulted in podocyte cell-cycle entry as shown in vivo by Ki67 expression and by FUCCI-2aR mice, but also in p21-mediated cell-cycle arrest. Through the senescence secretory associated phenotype, the damaged podocytes secreted proinflammatory cytokines, growth factors, and matrix metalloproteinases, resulting in subsequent podocyte detachment and loss, evidenced by senescent podocytes in urine.
Hdac1 / 2 plays an essential role during development. Loss of these genes in double knockout mice leads to sustained DNA damage and podocyte senescence and loss.
We identified 2 genes, histone deacetylase 1 (HDAC1) and HDAC2, contributing to the pathogenesis of proteinuric kidney diseases, the leading cause of end-stage kidney disease. mRNA expression ...profiling from proteinuric mouse glomeruli was linked to Connectivity Map databases, identifying HDAC1 and HDAC2 with the differentially expressed gene set reversible by HDAC inhibitors. In numerous progressive glomerular disease models, treatment with valproic acid (a class I HDAC inhibitor) or SAHA (a pan-HDAC inhibitor) mitigated the degree of proteinuria and glomerulosclerosis, leading to a striking increase in survival. Podocyte HDAC1 and HDAC2 activities were increased in mice podocytopathy models, and podocyte-associated Hdac1 and Hdac2 genetic ablation improved proteinuria and glomerulosclerosis. Podocyte early growth response 1 (EGR1) was increased in proteinuric patients and mice in an HDAC1- and HDAC2-dependent manner. Loss of EGR1 in mice reduced proteinuria and glomerulosclerosis. Longitudinal analysis of the multicenter Veterans Aging Cohort Study demonstrated a 30% reduction in mean annual loss of estimated glomerular filtration rate, and this effect was more pronounced in proteinuric patients receiving valproic acid. These results strongly suggest that inhibition of HDAC1 and HDAC2 activities may suppress the progression of human proteinuric kidney diseases through the regulation of EGR1.
The study of gene-environment (GxE) interactions is a research priority for the NCI. Previously, our group analyzed NCI's extramural grant portfolio from fiscal years (FY) 2007 to 2009 to determine ...the state of the science in GxE research. This study builds upon our previous effort and examines changes in the landscape of GxE cancer research funded by NCI.
The NCI grant portfolio was examined from FY 2010 to 2018 using the iSearch application. A time-trend analysis was conducted to explore changes over the study interval.
A total of 107 grants met the search criteria and were abstracted. The most common cancer types studied were breast (19.6%) and colorectal (18.7%). Most grants focused on GxE using specific candidate genes (69.2%) compared with agnostic approaches using genome-wide (26.2%) or whole-exome/whole-genome next-generation sequencing (NGS) approaches (19.6%); some grants used more than one approach to assess genetic variation. More funded grants incorporated NGS technologies in FY 2016-2018 compared with prior FYs. Environmental exposures most commonly examined were energy balance (46.7%) and drugs/treatment (40.2%). Over the time interval, we observed a decrease in energy balance applications with a concurrent increase in drug/treatment applications.
Research in GxE interactions has continued to concentrate on common cancers, while there have been some shifts in focus of genetic and environmental exposures. Opportunities exist to study less common cancers, apply new technologies, and increase racial/ethnic diversity.
This analysis of NCI's extramural grant portfolio updates previous efforts and provides a review of NCI grant support for GxE research.
The progression of proteinuric kidney diseases is associated with podocyte loss, but the mechanisms underlying this process remain unclear. Podocytes reenter the cell cycle to repair double-stranded ...DNA breaks. However, unsuccessful repair can result in podocytes crossing the G1/S checkpoint and undergoing abortive cytokinesis. In this study, we identified Pfn1 as indispensable in maintaining glomerular integrity - its tissue-specific loss in mouse podocytes resulted in severe proteinuria and kidney failure. Our results suggest that this phenotype is due to podocyte mitotic catastrophe (MC), characterized histologically and ultrastructurally by abundant multinucleated cells, irregular nuclei, and mitotic spindles. Podocyte cell cycle reentry was identified using FUCCI2aR mice, and we observed altered expression of cell-cycle associated proteins, such as p21, p53, cyclin B1, and cyclin D1. Podocyte-specific translating ribosome affinity purification and RNA-Seq revealed the downregulation of ribosomal RNA-processing 8 (Rrp8). Overexpression of Rrp8 in Pfn1-KO podocytes partially rescued the phenotype in vitro. Clinical and ultrastructural tomographic analysis of patients with diverse proteinuric kidney diseases further validated the presence of MC podocytes and reduction in podocyte PFN1 expression within kidney tissues. These results suggest that profilin1 is essential in regulating the podocyte cell cycle and its disruption leads to MC and subsequent podocyte loss.
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