Objectives: Neonatal intensive care unit (NICU) admits premature babies and neonates with acute illness who are under high infection risk due to immature immune response system. Infections caused by carbapenem- resistant Enterobacterales (CRE) is a serious threat to such patient population. A single case of CRE infection occurred in 36-bed NICU on July 2023. Infection control measures were put in place to prevent further CRE infection within the NICU. Methods: A neonate delivered at gestational age of 23 weeks and 6 days with birth weight of 650g was under mechanical ventilator care. On 35th day of life, CRE (Escherichia coli, New Delhi metallo-beta- lactamase-1 positive) was isolated from this neonate’s endotracheal suction material. After discussion with infection control physician, the bacterial culture was determined to have been resulted from colonization or localized infection, rather than invasive infection. Five measures were taken to prevent additional infection within the NICU. One, contact precaution was issued for CRE-infected baby, and an isolation ward and a designated nurse was assigned for the baby to prevent cross infection. Two, adherence to hand hygiene and personal protective equipment (PPE) application was monitored for medical personnel and visitors entering the NICU. Three, a checklist was designed specifically for disinfection of NICU isolation ward, and the designated cleaner and assistants were educated on the checklist. Four, testing with fluorescent markers was performed to validate cleaning. Five, the infectious disease specialist and the pharmacy analyzed the prescription pattern of broad-spectrum antibiotic among patients in NICU for systematic antibiotic regulation. Results: The following results were obtained after 2 weeks of infection control measures. 57 subjects underwent hand hygiene monitoring, on which 15.8%(9 case) of the subjects unadequately passed. Immediate feedback was provided upon these detections. Cleaning validation detected a single cases of inadequate disinfection (door to isolation ward), for which re-cleaning and education was performed. An increasing trend in consumption of 3rd generation cephalosporin (8.96% in April 2023 to 21.21% in June 2023) was found, and the neonatology department was advised to be more selective in prescription of broad- spectrum antibiotics. Conclusions: There was no CRE infection for 6 months following infection control measures. This case was determined to be an isolated case of CRE infection, and no further surveillance culture was obtained. Proactive infection control measures, including contact isolation, hand hygiene, environment cleaning, and regulation of broad-spectrum antibiotics, are necessary to prevent secondary infections that may follow an index CRE infection in the NICU.

Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.

Outdoor air pollution continues to be a challenging health issue, even as countries experience economic growth. By exploiting a unique transboundary setting in East Asia, we study the impact of an increase in particulate matter (PM) concentrations on fetal deaths. Due to the westerlies in the mid-latitudes, residents in South Korea at times experience intermittent exposure to high levels of air pollution. Using such atmospheric setting, we estimate a reduced-form impact of high PM events on fetal deaths, which captures in utero exposure to pollution. Controlling for local weather and pollution trends, regression results indicate that high PM events in Beijing lead to a significant increase in daily fetal mortality rates in Korea, by approximately 7.4 per cent. This research finding provides lower-bound estimates of not only negative spillovers manifested in fetal health but also the impact of pollution on the health of the Chinese population and calls for a need to tackle transboundary air pollution via international cooperation.

A 44-year-old man developed sudden non-fluent aphasia and right hemiplegia due to left striatocapsular infarction (Figure). Neurologic examination revealed gaze deviation to the right with eyes closed, but not with eyes open (Video). There was no spontaneous or gaze-evoked nystagmus, even after elimination of visual fixation. Leftward pursuit was impaired in a craniotopic frame of reference, and horizontal saccades were hypometric in both directions. Head impulse test was normal in the horizontal plane and there were no visual field defects. The contralesional gaze deviation with eye closure persisted for ten days.

Background: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education.

Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (−1.5 to −1.0 standard deviation (SD)) and late-stage aMCI (below −1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated.

Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores.

Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.

Platelet-derived growth factor (PDGF)-BB can induce abnormal proliferation and migration of vascular smooth muscle cells (VSMC) that are involved in the development of CVD. In our preliminary study, phytoalexin glyceollins (glyceollins I, II and III) isolated from soyabean seeds cultured with Aspergillus sojae showed strong antioxidant and anti-inflammatory activity. Since antioxidants showed beneficial effects on chronic inflammatory diseases, the purpose of the present study was to examine the effects of glyceollins on PDGF-induced proliferation and migration in human aortic smooth muscle cells (HASMC). Incubation of resting HASMC with glyceollins for 24 h significantly diminished PDGF-increased cell number and DNA synthesis in a dose-dependent manner without any cytotoxicity. In addition to blocking of the PDGF-inducible progression through the G0/G1 to the S phase of the cell cycle, glyceollins down-regulated the expression of cyclin-dependent kinase (CDK)2 and cyclin D1, and up-regulated the expression of CDK inhibitors such as p27kip1 and p53.Glyceollins also effectively inhibited reactive oxygen species generation and phosphorylation of PDGF receptor-β, phospholipase Cγ1, Akt and extracellular signal-regulated kinase 1/2 by PDGF stimulation. Furthermore, glyceollins were found to inhibit PDGF-induced dissociation of actin filaments and cell migration. Thus, the results suggest that glyceollins could become a potent therapeutic agent for regulating VSMC-associated vascular disease such as atherosclerosis and restenosis after angioplasty.

In this paper, we present technique to fabricate nanopatterns on Cu thin films via an electrochemical nanomachining (ECN) using an atomic force microscope (AFM). A conductive AFM cantilever tip (Pt/Ir5 coated) was used to form an electric field between tip and Cu substrate with applying a voltage pulse, resulting in the generation of an etched nanopattern. In order to precisely construct the nanopatterns, an ultra-short pulse was applied onto the Cu film through the AFM cantilever tip. The line width of the nanopatterns (the lateral dimension) increased with increased pulse amplitude, on-time, and frequency. The tip velocity effect on the nanopattern line width was also investigated that the line width is decreased with increasing tip velocity. Experimental results were compared with an equivalent electrochemical circuit model representing an ECN technique. The study described here provides important insight for fabricating nanopatterns precisely using electrochemical methods with an AFM cantilever tip.

The relationship between dietary Zn intake and the risk of atherosclerosis remains unclear, and no epidemiological studies have been reported on the effects of dietary Zn intake on morphological changes in the vascular wall. We examined the relationship between dietary Zn intake and common carotid intima-media thickness (IMT) as a marker of subclinical atherosclerosis among the middle-aged and elderly populations. A cross-sectional analysis of a prospective cohort baseline study was performed with 4564 adults aged 40–89 years and free of clinical CVD. Dietary data were collected by trained interviewers using an FFQ. Common carotid IMT was measured using a B-mode ultrasound imaging technique. Subclinical atherosclerosis was determined using carotid IMT, and defined as >80th percentile of carotid IMT or ≥ 1 mm of carotid IMT. After adjustment for potential confounders, the mean carotid IMT in the low Zn intake group was higher than that in the high Zn intake group. When subclinical atherosclerosis was defined as >80th percentile value of IMT or ≥ 1 mm of carotid IMT, after adjustment for potential confounders, Zn intake was inversely related to subclinical atherosclerosis (5th v. 1st quintile, OR 0·64, 95 % CI 0·45, 0·90, P for trend = 0·069; 5th v. 1st quintile, OR 0·34, 95 % CI 0·16, 0·70, P for trend = 0·005, respectively). In persons free of clinical CVD, dietary Zn intake was inversely correlated with subclinical atherosclerosis. The present findings suggest a putative protective role of dietary Zn intake against the development of atherosclerosis.

Ferromagnetic Cu-doped GaN film was grown on a GaN-buffered sapphire (0001) substrate by a hybrid physical-chemical-vapor-deposition method (HPCVD). The GaCuN film (Cu: 3.6 at.%) has a highly c-axis-oriented hexagonal wurtzite crystal structure, which is similar to GaN buffer but without any secondary phases such as metallic Cu, CuxNy, and CuxGay compounds. Two weak near-band edge (NBE) emissions at 3.38 eV and donor-acceptor-pair (DAP) transition at 3.2 eV with a typical strong broad yellow emission were observed in photoluminescence spectra for GaN buffer. In contrast, the yellow emission was completely quenched in GaCuN film because Ga vacancies causing the observed yellow emission in undoped GaN were substituted by Cu atoms. In addition, GaCuN film exhibits a blue shift of NBE emission, which could be explained with the +2 oxidation state of Cu ions, replacing +3 Ga ions resulting in band gap increment. The valance sate of Cu in GaCuN film was also confirmed by x-ray photoelectron spectroscopy (XPS) analysis. The GaCuN film shows ferromagnetic ordering and possesses a residual magnetization of 0.12 emu/cm3 and a coercive field of 264 Oe at room temperature. The unpaired spins in Cu2+ ions (d9) are most likely to be responsible for the observed ferromagnetism in GaCuN.

Central venous catheter-related bloodstream infection is clinically important because of its high mortality rate. This prospective study shows by multivariate analysis that the use of maximal sterile barrier precautions (odds ratio, 5.205 [95% confidence interval, 0.015-1.136]; P= .023) and the use of antimicrobial-coated catheters (odds ratio, 5.269 [95% confidence interval, 0.073-0.814]; P = .022) are independent factors associated with a lowered risk of acquiring a central venous catheter-related bloodstream infection.

We studied 52 children in order to assess the prevalence, natural history, and electrophysiologic effects of cardiac rhabdomyoma in tuberous sclerosis. Their ages ranged from one day to 12 years (median age 1.33 year). The tumors in the heart were found in 22 patients through cross-sectional echocardiography. The overall prevalence of cardiac rhabdomyoma was 42%. The prevalence of cardiac tumors in patients first seen in infancy was 77%, and that in patients over one year of age was 31%. Those with cardiac tumors diagnosed in infancy had more tumors per person than did the patients diagnosed after infancy, and the tumors were smaller in the patients diagnosed over one year of age. Follow-up cross-sectional echocardiography showed that almost all tumors showed spontaneous regression. Complete regression occurred more commonly in younger patients, and in those with smaller tumors. About 70% of patients with cardiac tumors had either normal findings or infrequent premature contractions on 24hour Holter monitorings. The rest of the patients with cardiac tumors showed either frequent premature contractions, atrioventricular block, or atrial tachycardia, but antiarrhythmic medication was rarely required. Cross-sectional echocardiography, therefore, seems to be the best diagnostic tool for screening cardiac rhabdomyomas in patients with tuberous sclerosis. The tumors may be managed more conservatively in view of their high rate of spontaneous regression and rather rare association with symptomatic arrhythmias.

The good field-emission properties of carbon nanotubes coupled with their high mechanical strength, chemical stability, and high aspect ratio, make them ideal candidates for the construction of efficient and inexpensive field-emission electronic devices. The fabrication process reported here has considerable potential for use in the development of integrated radio frequency amplifiers or field emission-controllable cold electron guns for field emission displays. This fabrication process is compatible with currently used semiconductor processing technologies. Micropatterned vertically aligned carbon nanotubes were grown on planar Si surface or inside the trenches, using chemical vapor deposition, photolithography, pulsed-laser deposition, reactive ion etching, and the lift-off method. To control the field-emission current by a 3rd electrode, the gate electrode, we grew carbon nanotubes inside the trenches. This triode-type structure is the best to realize the gray-scale carbon nanotube field emission. This carbon nanotube fabrication process can be widely applied for the development of electronic devices using carbon nanotube field emitters as cold cathodes and could revolutionize the area of field-emitting electronic devices such as RF amplifiers and field emission displays.