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Rapid diagnostic testing (RDT) can provide prompt, accurate identification of infectious organisms and be a key component of antimicrobial stewardship (AMS) programs. However, their use is less widespread in Asia Pacific than western countries. Cost can be prohibitive, particularly in less resource-replete settings. A selective approach is required, possibly focusing on the initiation of antimicrobials, for differentiating bacterial versus viral infections and identifying locally relevant tropical diseases. Across Asia Pacific, more data are needed on RDT use within AMS, focusing on the impact on antimicrobial usage, patient morbidity and mortality, and cost effectiveness. Moreover, in the absence of formal guidelines, regional consensus statements to guide clinical practice are warranted. These will provide a regionally relevant definition for RDT; greater consensus on its role in managing infections; advice on implementation and overcoming barriers; and guidance on optimizing human resource capacity. By addressing these issues, the outcomes of AMS programs should improve.
To examine the associations of home cooking with caregiver–child interaction and child mental health in Japan.
Cross-sectional data collected in 2018. Frequency of home cooking was assessed by a questionnaire among 4126 caregivers and classified as high (almost every day), medium (4–5 d/week) or low (≤3 d/week). Caregiver–child interaction was evaluated by assessing frequency of talking and playing together (per week). Behaviour problems and prosocial behaviour were assessed by the Strengths and Difficulties Questionnaire, and resilience was assessed using the Children’s Resilient Coping Scale.
Children aged 9–10 years and their caregivers in Adachi, Tokyo, Japan.
Low and middle frequency of home cooking were associated with lower frequencies of talking about school life, talking about news with the child, talking about television shows with the child and helping with the child’s homework. Children with low and/or middle frequency of home cooking had more behaviour problems (low frequency: β = 3·95, 95 % CI 1·30, 6·59 and medium frequency: β = 3·38, 95 % CI 2·07, 4·70), lower prosocial behaviour (low frequency: β = −5·85, 95 % CI −10·04, −1·66) and lower resilience (low frequency: β = −6·56, 95 % CI −9·77, −3·35 and medium frequency: β = −4·11, 95 % CI −5·71, −2·51), compared with children with high frequency of home cooking after adjusting covariates including socio-economic status. These associations were mediated by child’s eating behaviours and/or caregiver–child interaction.
Creating an environment that encourages caregivers to cook at home may be important for children’s mental health.
Differences in individual eating habits may be influenced by genetic factors, in addition to cultural, social or environmental factors. Previous studies suggested that genetic variants within sweet taste receptor genes family were associated with sweet taste perception and the intake of sweet foods. The aim of this study was to conduct a genome-wide association study (GWAS) to find genetic variations that affect confection consumption in a Japanese population. We analysed GWAS data on confection consumption using 14 073 participants from the Japan Multi-Institutional Collaborative Cohort study. We used a semi-quantitative FFQ to estimate food intake that was validated previously. Association of the imputed variants with confection consumption was performed by linear regression analysis with adjustments for age, sex, total energy intake and principal component analysis components 1–3. Furthermore, the analysis was repeated adjusting for alcohol intake (g/d) in addition to the above-described variables. We found 418 SNP located in 12q24 that were associated with confection consumption. SNP with the ten lowest P-values were located on nine genes including at the BRAP, ACAD10 and aldehyde dehydrogenase 2 regions on 12q24.12-13. After adjustment for alcohol intake, no variant was associated with confections intake with genome-wide significance. In conclusion, we found a significant number of SNP located on 12q24 genes that were associated with confections intake before adjustment for alcohol intake. However, all of them lost statistical significance after adjustment for alcohol intake.
Infants with complete atrioventricular septal defect occasionally accompany pulmonary hypertension; however, the pulmonary circulation can be altered by pulmonary vascular conditions as well as the left heart lesions. This study aimed to explore whether the left heart lesions were related to the pulmonary circulation among them.
We performed echocardiography and cardiac catheterisation in 42 infants with complete atrioventricular septal defect and studied relationships between the pulmonary haemodynamic parameters and the left heart morphology.
Age and weight at preoperative evaluation were 65 days (47-114) (the median following interquartile range) and 5.5 kg (4.0-7.1), respectively. There were 27 individuals with Down syndrome. Gestational age was 38 weeks (37-39). Catheterisation showed mean pulmonary arterial pressure: 36 (29-46) mmHg, the ratio of pulmonary to systemic blood flow: 3.45 (2.79-4.98), pulmonary vascular resistance: 2.20 Wood units·m2 (1.53-3.65), and pulmonary arterial compliance: 2.78 (1.86-4.10) ml/Hg/m2. Echocardiography showed the Rastelli classification type A in 28 and type C in 14, moderate or severe left atrioventricular valve regurgitation in 19 patients (45%), atrioventricular valve index of 0.67 (0.56-0.79), left ventricular end-diastolic volume z score of 4.46 (1.96-7.78), and aortic valve diameter z score of −0.70 (−1.91 to 0.20). Multivariable regression analysis revealed that preoperative pulmonary vascular resistance was significantly correlated to gestational age (p = 0.002), and that preoperative pulmonary arterial compliance was significantly correlated to gestational age (p = 0.009) and Down syndrome (p = 0.036).
The pulmonary circulation does not depend upon the presence of left heart lesions but gestational age and Down syndrome in infants with complete atrioventricular septal defect.
Not all patients who acquire carbapenemase-producing Enterobacteriaceae (CPE) develop infections by these organisms; many remain only colonized. Of 54 CPE-colonized patients, 16 (30%) developed CPE infections. We identified indwelling urinary catheter exposure, exposure to intravenous colistin, and overseas transfer as variables associated with CPE infection development among colonized patients.
We study the dynamics of viscous capillary rising in small corners between two curved walls described by a function
$n \ge 1$
. Using the Onsager principle, we derive a partial differential equation that describes the time evolution of the meniscus profile. By solving the equation both numerically and analytically, we show that the capillary rising dynamics is quite universal. Our theory explains the surprising finding by Ponomarenko et al. (J. Fluid Mech., vol. 666, 2011, pp. 146–154) that the time dependence of the height not only obeys the universal power-law of
, but also that the prefactor is almost independent of
We present the case of a 10-year-old boy with congenital complete atrioventricular block who had cardiac strangulation by an epicardial pacemaker lead placed during infancy. Coronary angiography and Tc99m tetrofosmin myocardial perfusion scintigraphy suggested sub-clinical myocardial ischaemia.
The aim of this study is to examine the association between maternal adverse childhood experiences (ACEs) and mental health problems in adolescent offspring. Data were obtained from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, and participants were 10,810 children in the fifth grade (3,144 pairs), eighth grade (3,497 pairs), and eleventh grade (4,169 pairs) living in Kochi Prefecture, Japan. Mothers of participating children were asked about their ACEs, childhood social economic status, current mental and physical health, current social economic status, positive parenting behaviors, child maltreatment, marital status, and child behavior problems using the Strength and Difficulty Questionnaire. Children reported their depressive symptoms using the Depression Self-Rating Scale. Children of mothers with a larger number of ACEs showed higher levels of behavior problems (p for trend <.001) and depressive symptoms (p for trend <.001), adjusting for potential confounders. In particular, maternal psychological distress mediated the association between maternal ACEs and child mental health. The adverse effects of maternal ACEs may have a direct intergenerational impact on behavior problems and depressive symptoms in adolescent offspring. Further studies to elucidate possible mediators are needed.
Recent studies suggest that depression is associated with somatic pain. Despite growing research interest in the topic, the effects of depression-related somatic pain remain unclear. The present study sought to investigate the relationships between depression-related somatic pain, treatment satisfaction, and functions of daily living, and to compare them with the relationships between these factors and mental health measures.
We administered an Internet-based survey to 663 patients with depression in Japan, including questions about pain symptoms, mental health, functions of daily living, and dissatisfaction with depression treatment. The SF-8 questionnaire was used to assess functions of daily living. We conducted a multiple linear regression analysis to examine the associations between depression-related somatic pain, functions of daily living and treatment satisfaction, and between mental health measures, somatic pain and functions of daily living.
An increase per unit in the number of pain symptoms was associated with a 1.04-unit decrease in physical functioning score (P < 0.001), a 0.67-unit decrease in the role functioning-physical score (P < 0.001), and a 0.53-unit decrease in role functioning-emotional score (P = 0.0010). Meanwhile, we found no significant association between the number of pain symptoms and patients’ satisfaction with treatment, and no significant association between the number of pain symptoms and social functioning.
These results suggest that even when patients report satisfaction with their treatment, they may be suffering from reduced physical functioning and role functioning. These impairments may escape clinical recognition when clinicians or patients fail to discuss pain symptoms.
Atrioventricular interval optimisation is important in patients with dual-chamber pacing, especially with heart failure. In patients with CHD, especially in those with Fontan circulation, the systemic atrial contraction is supposed to be more important than in patients without structural heart disease.
We retrospectively evaluated two patients after Fontan procedure with dual-chamber pacemaker with a unique setting of optimal sensed atrioventricular interval.
The optimal sensed atrioventricular interval determined by echocardiogram was extremely short sensed atrioventricular interval at 25 and 30 ms in both cases; however, the actual P wave and ventricular pacing interval showed 180 and 140 ms, respectively. In both cases, the atrial epicardial leads were implanted on the opposite site of the origin of their own atrial rhythm. The time differences between sensed atrioventricular interval and actual P wave and ventricular pacing interval occurred because of the site of the epicardial atrial pacing leads and the intra-atrial conduction delay.
We need to consider the origin of the atrial rhythm, the site of the epicardial atrial lead, and the atrial conduction delay by using electrocardiogram and X-ray when we set the optimal sensed atrioventricular interval in complicated CHD.
Describe the epidemiological and molecular characteristics of an outbreak of Klebsiella pneumoniae carbapenemase (KPC)–producing organisms and the novel use of a cohorting unit for its control.
A 566-room academic teaching facility in Milwaukee, Wisconsin.
Solid-organ transplant recipients.
Infection control bundles were used throughout the time of observation. All KPC cases were intermittently housed in a cohorting unit with dedicated nurses and nursing aids. The rooms used in the cohorting unit had anterooms where clean supplies and linens were placed. Spread of KPC-producing organisms was determined using rectal surveillance cultures on admission and weekly thereafter among all consecutive patients admitted to the involved units. KPC-positive strains underwent pulsed-field gel electrophoresis and whole-genome sequencing.
A total of 8 KPC cases (5 identified by surveillance) were identified from April 2016 to April 2017. After the index patient, 3 patients acquired KPC-producing organisms despite implementation of an infection control bundle. This prompted the use of a cohorting unit, which immediately halted transmission, and the single remaining KPC case was transferred out of the cohorting unit. However, additional KPC cases were identified within 2 months. Once the cohorting unit was reopened, no additional KPC cases occurred. The KPC-positive species identified during this outbreak included Klebsiella pneumoniae, Enterobacter cloacae complex, and Escherichia coli. blaKPC was identified on at least 2 plasmid backbones.
A complex KPC outbreak involving both clonal and plasmid-mediated dissemination was controlled using weekly surveillances and a cohorting unit.
The dynamics of spreading of a macroscopic liquid droplet over a wetting surface is often described by a power-law relaxation, namely, the droplet radius increases as
, which is known as Tanner’s law. Here we show, by both experiments and theory, that when the liquid spreading takes place between a thin soap film and a glass fibre penetrating the film, the spreading is significantly slowed down. When the film thickness
becomes smaller than the fibre diameter
, the strong hydrodynamic confinement effect of the soap film gives rise to a logarithmic relaxation with fibre creeping time
. Such a slow dynamics of spreading is observed for hours both in the measured time-dependent height of capillary rise
on the fibre surface and viscous friction coefficient
felt by the glass fibre in contact with the soap film. A new theoretical approach based on the Onsager variational principle is developed to describe the dynamics of thin film spreading along a fibre. The newly derived equations of motion provide the analytical solutions of
and contact angle
, which are found to be in good agreement with the experimental results. Our work thus provides a common framework for understanding the confinement effect of thin soap films on the dynamics of spreading along a fibre.
We report a 3-year-old boy with giant and atypical coronary artery aneurysms in the acute phase of Kawasaki disease, despite appropriate therapeutic intervention, in Noonan syndrome with a novel heterozygous PTPN11 mutation, c. 907 G>A (p.Asp303Asn). We hypothesised that this PTPN11 mutation might affect both hyperinflammation caused by Kawasaki disease and vascular fragility in the coronary artery, resulting in coronary artery aneurysms.
Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity.
SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope, cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions.
SPICA instruments offer spectral resolving power ranging from R ~50 through 11 000 in the 17–230 μm domain and R ~28.000 spectroscopy between 12 and 18 μm. SPICA will provide efficient 30–37 μm broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 μm. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of ~5 × 10−20 W m−2 (5σ/1 h)—over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
Studies have consistently shown that subthreshold depression is associated with an increased risk of developing major depression. However, no study has yet calculated a pooled estimate that quantifies the magnitude of this risk across multiple studies.
We conducted a systematic review to identify longitudinal cohort studies containing data on the association between subthreshold depression and future major depression. A baseline meta-analysis was conducted using the inverse variance heterogeneity method to calculate the incidence rate ratio (IRR) of major depression among people with subthreshold depression relative to non-depressed controls. Subgroup analyses were conducted to investigate whether IRR estimates differed between studies categorised by age group or sample type. Sensitivity analyses were also conducted to test the robustness of baseline results to several sources of study heterogeneity, such as the case definition for subthreshold depression.
Data from 16 studies (n = 67 318) revealed that people with subthreshold depression had an increased risk of developing major depression (IRR = 1.95, 95% confidence interval 1.28–2.97). Subgroup analyses estimated similar IRRs for different age groups (youth, adults and the elderly) and sample types (community-based and primary care). Sensitivity analyses demonstrated that baseline results were robust to different sources of study heterogeneity.
The results of this study support the scaling up of effective indicated prevention interventions for people with subthreshold depression, regardless of age group or setting.
This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.
The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.
Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.
The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.
IR spectroscopy in the range 12–230 μm with the SPace IR telescope for Cosmology and Astrophysics (SPICA) will reveal the physical processes governing the formation and evolution of galaxies and black holes through cosmic time, bridging the gap between the James Webb Space Telescope and the upcoming Extremely Large Telescopes at shorter wavelengths and the Atacama Large Millimeter Array at longer wavelengths. The SPICA, with its 2.5-m telescope actively cooled to below 8 K, will obtain the first spectroscopic determination, in the mid-IR rest-frame, of both the star-formation rate and black hole accretion rate histories of galaxies, reaching lookback times of 12 Gyr, for large statistically significant samples. Densities, temperatures, radiation fields, and gas-phase metallicities will be measured in dust-obscured galaxies and active galactic nuclei, sampling a large range in mass and luminosity, from faint local dwarf galaxies to luminous quasars in the distant Universe. Active galactic nuclei and starburst feedback and feeding mechanisms in distant galaxies will be uncovered through detailed measurements of molecular and atomic line profiles. The SPICA’s large-area deep spectrophotometric surveys will provide mid-IR spectra and continuum fluxes for unbiased samples of tens of thousands of galaxies, out to redshifts of z ~ 6.
The brown planthopper Nilaparvata lugens Stål (BPH) can be found year-round in tropical region and causes severe damage to rice. Although there has been documented BPH damage to rice crops in the past decade in Cambodia, the extent of this epidemic is poorly understood. Here, we examined the time variation of BPH population in the abundance of morphotypes in 13 main rice-producing provinces (86 sites) by aspirator method and in the Takeo Province (five sites) by yellow sticky trap method. At least three generations were observed during the 3-month collection period in the rainy growing season. Regarding the occurrence of BPH morphotypes, in July the macropterous adults were restricted to south Cambodia and in August all morphotypes, adults (macropterous and brachypterous) and nymphs, appeared in all sampling sites. To explain the difference of regional distribution, the genetic differentiation was analyzed in south and northwest Cambodia (three sites) by using single nucleotide polymorphisms (SNP) analysis via genotyping-by-sequencing (GBS) using next-generation sequencing. The 2455 SNPs obtained by GBS clarified the three sub-populations and they corresponded to the expected dissemination patterns. These results provide a clue to understand the differentiation and epidemic of BPH in Cambodia.