Objectives: Central-line–associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that a care bundle is effective in reducing CLABSI rates; however, the data on long-term sustainability and cost savings of bundled care are limited. Methods: From January 2011 to December 2020, a prospective surveillance was performed to monitor CLABSI at a university hospital in northern Taiwan. To reduce the CLABSI rate, a hospital-wide bundled care program for CLABSI prevention was implemented in 2013. We evaluated the long-term effect of the care bundle on CLABSI incidence and length of stay in the ICU. Results: During the study period, the overall CLABSI incidence decreased from 8.22 per 1,000 catheter days before the care bundle was implemented to 6.33 per 1,000 catheter days in 2020 (P for trend <.01). The most common pathogens causing CLABSI were gut organisms (1,420 of 2,363, 60.1%), followed by environmental organisms (734 of 2,363, 31.1%) and skin organisms (177 of 2,363, 7.5%). The decreasing trend was statistically significant in the incidence of CLABSI caused by skin organisms (P for trend < .01), but not in the incidence of CLABSI caused by environmental organisms (P for trend = .86) or gut organisms (P for trend = .06). In the multivariable analysis, implementation of this care bundle was independently associated with a decrease in the CLABSI rate (RR, 0.77; 95% CI, 0.66–0.88). Compared with patients without CLABSI, patients with CLABSI had a longer average ICU length of stay (27 vs 17 days). Conclusions: A sustainable reduction in the incidence of CLABSI caused by common commensals could be achieved through a cost-saving bundled care program.

Ageing accompanied by a decline in cognitive performance may be a result of the long-term effects of oxidative stress on neurologic processes. It has been shown that high-cholesterol contents in the blood and brain may lead to the deposition of the β-amyloid (Aβ) protein in the brain, which damages brain cells. The present study was designed to observe the effect of polyphenol-rich Oriental plums on cognitive function and cerebral neurodegeneration-related protein expression in mice that were fed a high-cholesterol diet for 5 months. The study consisted of four groups: the control (Ctrl) group, which was fed the American Institute of Nutrition (AIN)-93M diet; the high cholesterol (HC) group, which was fed the AIN-93M diet with 5 % cholesterol; the high cholesterol+low Oriental plum (LOP) group, which was fed the AIN-93M diet with 5 % cholesterol and 2 % Oriental plum powder; and the high cholesterol+high Oriental plum (HOP) group, which was fed the AIN-93M diet with 5 % cholesterol and 5 % Oriental plum powder. Measurements of cognitive function were assessed using the Morris water maze, and the mRNA expression of cholesterol hydroxylase (Cyp46), Aβ and β-secretase 1 (BACE1) were analysed. The results showed that cholesterol concentrations in both the blood and the brain were significantly higher in the HC group than in the Ctrl and HOP groups at the end of the trial. The high-cholesterol diet per se produced significant cognitive deficits, which were accompanied by a significantly increased mRNA expression of Cyp46, BACE1, Aβ and 24-hydroxycholesterol in the brain cortex and hippocampus. However, all of these variables were non-significantly increased in the HOP group as compared to the Ctrl group. In conclusion, incorporating polyphenol-enriched Oriental plum into a high-cholesterol diet can ameliorate some of the symptoms of neurodegenerative conditions.

The surface morphologies of AlGaN/AlN/GaN HEMT structures were examined by using the atomic force microscopy (AFM).These HEMT structures have been grown by metalorganic chemical vapor deposition (MOCVD) onto the sapphire (0001) substrates where the thicknesses of AlN interlayers were varied from 0 to 5 nm. After the growth of GaN buffer layer, the AlN intermediate and AlGaN top layers were subsequently deposited at 1130°C in an trimethylaluminum (TMAl) and ammonia (NH3) atmosphere. The surface of AlGaN layers shows the thick- and fine-thread patterns.

It was found that the root-mean-square (RMS) roughness of the samples with 0, 0.5, 2.5 and 5nm AlN interlayer thickness are 0.503, 0.534, 0.534 and 0.601nm, respectively. Although the cracks and rougher surfaces show that the qualities of AlGaN barrier layers have slightly degraded in the samples with thicker AlN layer. These phenomena could be attributed to the lattice mismatch and the growth temperature. In addition, the room-temperature two-dimensional electron gas (2DEG) mobility and density analysis were performed on the AlGaN surfaces and the measured results were discussed in detail.

Modulation of the cellular response by the administration of probiotic bacteria may be an effective strategy for preventing or inhibiting tumour growth. We orally pre-inoculated mice with probiotics Lactobacillus acidophilus NCFM (La) for 14 d. Subcutaneous dorsal-flank tumours and segmental orthotopic colon cancers were implanted into mice using CT-26 murine colon adenocarcinoma cells. On day 28 after tumour initiation, the lamina propria of the colon, mesenteric lymph nodes (MLN) and spleen were harvested and purified for flow cytometry and mRNA analyses. We demonstrated that La pre-inoculation reduced tumour volume growth by 50·3 %, compared with untreated mice at 28 d after tumour implants (2465·5 (sem 1290·4) v. 4950·9 (sem 1689·3) mm3, P < 0·001). Inoculation with La reduced the severity of colonic carcinogenesis caused by CT-26 cells, such as level of colonic involvement and structural abnormality of epithelial/crypt damage. Moreover, La enhanced apoptosis of CT-26 cells both in dorsal-flank tumour and segmental orthotopic colon cancer, and the mean counts of apoptotic body were higher in mice pre-inoculated with La (P < 0·05) compared with untreated mice. La pre-inoculation down-regulated the CXCR4 mRNA expressions in the colon, MLN and extra-intestinal tissue, compared with untreated mice (P < 0·05). In addition, La pre-inoculation reduced the mean fluorescence index of MHC class I (H-2Dd, -Kd and -Ld) in flow cytometry analysis. Taken together, these findings suggest that probiotics La may play a role in attenuating tumour growth during CT-26 cell carcinogenesis. The down-regulated expression of CXCR4 mRNA and MHC class I, as well as increasing apoptosis in tumour tissue, indicated that La may be associated with modulating the cellular response triggered by colon carcinogenesis.

Prolonged fever, 5 days or more, is the cardinal feature of Kawasaki disease. We described a 5-year-old boy with initial presentations of fever, conjunctivitis, and strawberry tongue. The fever only lasted for 3 days. However, giant coronary aneurysms developed later. This patient reminds us that coronary complications could happen even the fever is less than 5 days. Criteria of fever duration might need reconsideration.

This paper analyzes the pressure distribution on the platform screen door (PSD) subjected to a moving train running through a station in the tunnel. The advantages of adopting PSD design are to reduce the cooling load and the construction cost in mass rapid transport underground station. However, as the moving train enters or leaves the station, the PSD will face a long-term wind oscillation pressure force. For the safety design, dynamic simulation is requisite for the analysis of pressure force exerted on the PSD. The present study uses the commercial code PHOENICS to simulate dynamically the pressure and velocity distribution on the platform screen door. The results show that the maximum pressure on the platform screen door occurs at 6 m behind the front platform end with the values of 1,457 and 942 Pa, as the train moving speeds are 80km/hr and 65km/hr respectively. It is also indicated that the ratio of the different maximum pressures exerted on the PSD has a linear relationship with the square of train speed ratio for two different train speeds.

Goldfish embryos of pre-morula, somite formation, optic vesicle, heart formation and pigment formation stages were tested for cryoprotectant toxicity, using DMSO and glycerol at 10, 12 and 15% concentration. Those that showed 50% or more survival were employed for cold shock test, from 24 to 4 °C at the rate of –1 °C/min. Only embryos at the heart formation stage protected with 12% DMSO showed 60% survival and 35% hatching. A group of embryos of that stage went through a freezing and thawing test to temperatures of –15, –25 and –35 °C. They showed 30, 5 and 2% survival and 12, 3 and 1% hatching respectively.