Elizabethkingia infections are difficult to treat because of intrinsic antimicrobial resistance, and their incidence has recently increased. We conducted a propensity score-matched case-control study ...during January 2016-June 2017 in South Korea and retrospectively studied data from patients who were culture positive for Elizabethkingia species during January 2009-June 2017. Furthermore, we conducted epidemiologic studies of the hospital environment and mosquitoes. The incidence of Elizabethkingia increased significantly, by 432.1%, for 2016-2017 over incidence for 2009-2015. Mechanical ventilation was associated with the acquisition of Elizabethkingia species. Because Elizabethkingia infection has a high case-fatality rate and is difficult to eliminate, intensive prevention of contamination is needed.
Background Attention deficit hyperactivity disorder (ADHD) patients often use complementary and alternative medicine to treat symptoms, and acupuncture is one option. This systematic review aims to ...assess whether acupuncture is an effective treatment for attention deficit hyperactivity disorder (ADHD). Methods We will search nine databases from their inception: PubMed, AMED, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials, RISS, KoreaMed, KISS, and the China National Knowledge Infrastructure database. Two investigators will independently review the selected studies, extract the data, and analyze them. The Cochrane Risk of Bias Assessment Tool will be used to assess the risk of bias. Discussion Because this is a systematic review, no ethical approval is needed. The systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to support health policy and practice. Trial registration number Reviewregistry1345.
Since the ethanol extract of Alisma orientale Juzepzuk (EEAO) suppresses lung inflammation by suppressing Nuclear Factor-kappa B (NF-κB) and activating Nuclear Factor Erythroid 2-related Factor 2 ...(Nrf2), we set out to identify chemicals constituting EEAO that suppress lung inflammation. Here, we provide evidence that among the five most abundant chemical constituents identified by Ultra Performance Liquid Chromatography (UPLC) and Nuclear Magnetic Resonance (NMR), alismol is one of the candidate constituents that suppresses lung inflammation in a lipopolysaccharide (LPS)-induced acute lung injury (ALI) mouse model and protects mice from ALI-like symptoms. Alismol did not induce cytotoxicity or reactive oxygen species (ROS). When administered to the lung of LPS-induced ALI mice (n = 5/group), alismol decreased the level of neutrophils and of the pro-inflammatory molecules, including Tumor Necrosis Factor-alpha (TNF-α), Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), Monocyte Chemoattractant Protein-1 (MCP-1), Interferon-gamma (IFN-γ), and Cyclooxygenase-2 (COX-2), suggesting an anti-inflammatory activity of alismol. Consistent with these findings, alismol ameliorated the key features of the inflamed lung of ALI, such as high cellularity due to infiltrated inflammatory cells, the development of hyaline membrane structure, and capillary destruction. Unlike EEAO, alismol did not suppress NF-κB activity but rather activated Nrf2. Consequently, alismol induced the expression of prototypic genes regulated by Nrf2, including Heme Oxygenase-1 (HO-1), NAD(P)H: quinine oxidoreductase-1 (NQO-1), and glutamyl cysteine ligase catalytic units (GCLC). Alismol activating Nrf2 appears to be associated with a decrease in the ubiquitination of Nrf2, a key suppressive mechanism for Nrf2 activity. Together, our results suggest that alismol is a chemical constituent of EEAO that contributes at least in part to suppressing some of the key features of ALI by activating Nrf2.
We aimed to assess the effectiveness of the first 6 months of a 24 month multidisciplinary intervention program including circuit training and a balanced diet in children and adolescents with ...obesity.
A quasi-experimental intervention trial included 242 participants (age mean±standard deviation: 11.3±2.06 years, 97 girls) of at least 85th percentile of age- and sex-specific body mass index (BMI). Participants were grouped into three to receive usual care (usual care group), exercise intervention with circuit training (exercise group), or intensive nutritional and feedback intervention with a balanced diet (nutritional group). Primary outcome was BMI z-score, while secondary outcomes included body composition, cardiometabolic risk markers, nutrition, and physical fitness.
Among the participants, 80.6% had a BMI ≥ the 97th percentile for age and sex. The BMI z-score of the overall completers decreased by about 0.080 after 6 months of intervention (p < 0.001). After the intervention, both exercise and nutritional groups had significantly lower BMI z-scores than the baseline data by about 0.14 and 0.075, respectively (p < 0.05). Significant group by time interaction effects were observed between exercise versus usual care group in BMI z-score (β, -0.11; 95% confidence interval (CI), -0.20 to -0.023) and adiponectin (β, 1.31; 95% CI, 1.08 to 1.58); and between nutritional versus usual care group in waist circumference (β, -3.47; 95% CI, -6.06 to -0.89). No statistically significant differences were observed in any of the other secondary outcomes assessed.
Multidisciplinary intervention including circuit training and a balanced diet for children and adolescents with obesity reduced the BMI z-score and improved cardiometabolic risk markers such as adiponectin and waist circumference.
The COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV ...service access and delivery in the Asia region.
A descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam.
Across the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services.
The COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighted differences in HIV prevention to care continuum via telehealth services utilisation by PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems for continued HIV care with minimal disruptions during health emergency crises.
Thermoelectric generators (TEGs) represent a promising technology for self-powered wearable systems. Since the conventional TEGs have limitation to be used on the human body due to its structural ...rigidity, flexible TEGs have been studied and developed so that TEGs can be attached to an arbitrarily shaped surface on the human body. However, flexible TEGs require a good heatsink with good flexibility to allow them to produce enough power for wearable devices. In this study, a high-performance flexible heatsink based on a phase-change material (PCM) was proposed. PCM blocks were arranged in an array and good flexibility was realized with an elastomer that filled the space between the PCM blocks. Given that PCM can absorb a large amount of heat at the phase-change temperature, the heatsink can hold the temperature difference across the TEG constant for a relatively long period of time. Thus, the generated power from the flexible TEG was maintained at around 20 μW/cm2 for 33 min. The flexible heatsink can be reused because the PCM solidifies at room temperature. Furthermore, the PCM-based flexible heatsink is smaller and lighter than the conventional metal heatsink. The proposed heatsink is expected to contribute to the commercialization of self-powered wearable devices.
•A phase-change material based flexible heatsink (f-HS) is developed.•Design guideline of the f-HS for wearable applications is proposed.•Performance of the f-HS is better than that of the metal heatsink of the same size.•A thermoelectric generator with the f-HS generates high power for 33 min.
is an emerging worldwide fungal pathogen. Over the past 20 years, 61 patient isolates of
(4 blood and 57 ear) have been obtained from 13 hospitals in Korea. Here, we reanalyzed those molecularly ...identified isolates using two matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems, including Biotyper and Vitek MS, followed by antifungal susceptibility testing, sequencing of the
gene, and genotyping. With a research-use-only (RUO) library, 83.6% and 93.4% of the isolates were correctly identified by Biotyper and Vitek MS, respectively. Using an
diagnostic (IVD) library of Vitek MS, 96.7% of the isolates were correctly identified. Fluconazole-resistant isolates made up 62.3% of the isolates, while echinocandin- or multidrug-resistant isolates were not found. Excellent essential (within two dilutions, 96.7%) and categorical agreements (93.4%) between the Clinical and Laboratory Standards Institute (CLSI) and Vitek 2 (AST-YS07 card) methods were observed for fluconazole. Sequencing
for all 61 isolates revealed that only 3 fluconazole-resistant isolates showed the Erg11p amino acid substitution K143R. All 61 isolates showed identical multilocus sequence typing (MLST). Pulsed-field gel electrophoresis (PFGE) analyses revealed that both blood and ear isolates had the same or similar patterns. These results show that MALDI-TOF MS and Vitek 2 antifungal susceptibility systems can be reliable diagnostic tools for testing
isolates from Korean hospitals. The Erg11p mutation was seldom found among Korean isolates of
, and multidrug resistance was not found. Both MLST and PFGE analyses suggest that these isolates are genetically similar.
Cholesteric liquid crystals (CLCs) can be applied to various physical and chemical sensors because their alignment structures are changed by external stimuli. Here, we propose a CLC device fabricated ...by vertically forming the helical axis of the CLC between the cross-sections of two optical fiber ferrules. An optical fiber temperature sensor was successfully implemented using the proposed optical fiber ferrule-based CLC device. A wideband wavelength-swept laser with a center wavelength of 1073 nm and scanning range of 220 nm was used as a light source to measure the variations in the reflection spectrum band according to the temperature change in the CLC cell. The wavelength variation of the reflection spectrum band according to the temperature applied to the CLC cell was reversible and changed linearly with a change in the temperature, and the long-wavelength edge variation rate according to the temperature change was −5.0 nm/°C. Additionally, as the temperature applied to the CLC cell increased, the reflection spectrum bandwidth gradually decreased; the reflection spectrum bandwidth varied at a rate of −1.89 nm/°C. The variations in the refractive indices with temperature were calculated from the band wavelengths of the reflection spectrum. The pitch at each temperature was calculated based on the refractive indices and it gradually decreased as the temperature increased.
This study investigates the secondary bonding of aircraft skin/stiffener assemblies using press conduction welding with carbon fiber/polyetherketoneketone thermoplastic composites and polyetherimide ...adhesive. Recognizing the challenges posed by conventional welding methods in maintaining material integrity and uniformity, this research explores an alternative methodology that mitigates these issues while ensuring high-strength bonds. The press conduction welding parameters were selected based on single-lap shear tests and applied in the bonding of skin and omega stiffener components. The temperature range was determined using differential scanning calorimetry. The pressure was held at 1 MPa for 180 s. The welding temperature that produced a high-bonding strength was identified experimentally; these key variables were then used in the welding process of the skin and omega stiffener. By analyzing how the fibers tear and the effectiveness of interdiffusion between the plies, we were able to gain insights into the bonding strength and fractured surface. The findings suggest that press conduction welding provides a viable route for secondary bonding in thermoplastic composite structures, highlighting its advantages in terms of processing efficiency and integrity. This study contributes to the understanding of the mechanical behaviors of bonded joints and underscores the significance of temperature control in the welding process.
In order to increase the exhaust-gas temperature of austenitic stainless cast steels used for turbo-charger-housings up to 1050 °C, the more excellent high-temperature strength should be obtained ...because it works for keeping a sustainability of the housing shape. Three austenitic stainless cast steels were fabricated in this study by adding Nb into the Ni/Mn-replaced conventional ASTM HK40 steel, and their high-temperature strength was investigated in relation with the carbide formation and matrix strengthening. The 1-wt%-Nb-added steel showed the enhancement in high-temperature strength over the non-Nb-added steel. This indicated that the Nb addition was effective on the strength improvement because it raised both the fraction of thermally-stable hard MC-type carbides and the austenite-matrix hardness. However, the 1.5-wt%-Nb-added steel showed the lower high-temperature strength than the 1-wt%-Nb-added steel, although it contained the more MC carbides. The more MC carbides reduced the matrix hardness, enlarged the hardness difference between carbides and matrix, and deteriorated the high-temperature strength. Our results demonstrate that the strengthened matrix as well as populated carbides due to the Nb addition are desirable for further improving the high-temperature strength.
Graphic Abstract