We evaluated the secondary COVID-19 incidence among uninfected hospitalized patients after nosocomial COVID-19 exposure. An exposure source of SARS-CoV-2 was hospitalized patients or healthcare personnel (HCP) newly diagnosed as having COVID-19. Patients exposed to a COVID-19-infected patient in a shared room more frequently developed COVID-19 than those exposed to an infected HCP.

Inspired by a result in T. H. Colding. (16). Acta. Math. 209(2) (2012), 229-263 [16] of Colding, the present paper studies the Green function $G$ on a non-parabolic $\operatorname {RCD}(0,\,N)$ space $(X,\, \mathsf {d},\, \mathfrak {m})$ for some finite $N>2$. Defining $\mathsf {b}_x=G(x,\, \cdot )^{\frac {1}{2-N}}$ for a point $x \in X$, which plays a role of a smoothed distance function from $x$, we prove that the gradient $|\nabla \mathsf {b}_x|$ has the canonical pointwise representative with the sharp upper bound in terms of the $N$-volume density $\nu _x=\lim _{r\to 0^+}\frac {\mathfrak {m} (B_r(x))}{r^N}$ of $\mathfrak {m}$ at $x$;

\[ |\nabla \mathsf{b}_x|(y) \le \left(N(N-2)\nu_x\right)^{\frac{1}{N-2}}, \quad \text{for any }y \in X \setminus \{x\}. \]

$y \in X \setminus \{x\}$

$N$

$\operatorname {RCD}(N-2,\, N-1)$

$x$

$N$

$N$

$\mathbb {R}^N$

$\operatorname {RCD}(0,\,N)$

The reactivity and stability of the edge faces of swelling clay minerals can be altered by layer charge and the stacking structure; however, these effects are poorly understood due to experimental limitations. The structure and stability of the montmorillonite {110}, {010}, {100}, and {130} edge faces with a layer charge of either y = 0.50 or y = 0.33 (e−/Si4O10) were investigated using first-principles calculations based on density functional theory. Stacked- and single-layer models were tested and compared to understand the effect of stacking on the stability of montmorillonite edge faces. Most stacked layers stabilize the edge faces by creating hydrogen bonds between the layers; therefore, the surface energy of the layers in the stacked-layer model is lower than in the single-layer model. This indicates that the estimates of edge face surface energy should consider the swelling conditions. Negative surface energies were calculated for these edge faces in the presence of chemisorbed water molecules. A high layer charge of 0.50 reduced the surface energy relative to that of the low layer charge of 0.33. The isomorphic substitution of Mg for Al increased the stability of interlayer Na ion positions, which were stable in the trigonal ring next to the Mg ions. The lowest surface energies of the {010} and {130} edge faces were characterized by the presence of Mg ions on edge faces, which had a strong cation adsorption site due to the local negative charge of the edges. The coordination numbers of O atoms around cations adsorbed to these edge faces were small in comparison to interlayers without water.

We evaluated the impact of carbapenem shortage on antimicrobial practice and patient outcome at a tertiary care center. During the shortage, hospital antimicrobial practice could be safely managed through additional antimicrobial stewardship measures including treatment guidance and mandatory preauthorization. Antimicrobial shortage may present a unique opportunity for promoting antimicrobial stewardship.

Phenotypic variation is the result of gene expression based on complex interaction between genetic and environmental factors. It is well known that genetic and environmental factors influence gene expression, but our understanding of their relative importance remains limited. To obtain a hint for the understanding of their contributions, we took advantage of monozygotic twins, as they share genetic and shared environmental factors but differ in nonshared factors, such as environmental differences and stochastic factors. In this study, we performed cap analysis of gene expression on three pairs of twins and clustered each individual based on their expression profiles of annotated genes. The dendrogram of annotated gene transcripts showed a monophyletic clade for each twin pair. We also analyzed the expression of retrotransposons, such as human endogenous retroviruses (HERVs) and long interspersed nuclear elements (LINEs), given their abundance in the genome. Clustering analyses demonstrated that HERV and LINE expression diverged even within monozygotic twin pairs. Thus, HERVs and LINEs are more susceptible to nonshared factors than annotated genes. Motif analysis of differentially expressed annotated genes suggests that specificity protein/Krüppel-like factor family transcription factors are involved in the expression divergence of annotated gene influenced by nonshared factors. Collectively, our findings suggest that expressions of annotated genes and retrotransposons are differently regulated, and that the expression of retrotransposons is more susceptible to nonshared factors than annotated genes.

The persistence of seed-dispersing animals in degraded habitats could be critical for ensuring the long-term conservation value and restoration of forests. This is particularly important in Southeast Asia, where > 70% of the remaining forest areas are within 1 km of a forest edge, and many are degraded (e.g. logged). We synthesized information on the habitat associations of the binturong Arctictis binturong, a large, semi-arboreal, frugivorous civet and one of the most important seed dispersers in the region, especially for figs (Ficus spp). We adopted a multiscale approach by employing ensemble species distribution modelling from presence-only records, assessing landscape-scale variation in detection rates in published camera-trap studies and using hierarchical occupancy modelling to assess local (i.e. within-landscape) patterns observed from 20 new camera-trap surveys. Contrary to prior reports that binturongs are strongly associated with intact forests, the species was equally present in degraded forests and near forest edges where sufficient forest cover was maintained (> 40% forest cover within a 20-km radius). The species also tolerates moderate incursions of oil palm plantations (< 20% of the area within a 20-km radius covered by oil palm plantations). The relative resilience of binturongs to habitat degradation could be in part because of behavioural adaptations towards increased nocturnal activity. These results support the notion that key seed dispersers can persist and maintain their ecological function in degraded forests.

Design aesthetics are one of the most important factors affecting the attractiveness of industrial products. Psychological theory suggests that a moderate level of novelty and complexity yields pleasant feelings in users. A design that is initially surprising to consumers and acceptable over time requires aesthetic interest associated with its novelty and complexity. In this study, we formulated the perceived novelty and complexity of a closed contour shape. Based on this formulation, we developed “Hybrid-GAN,” which is a shape-generation system capable of generating a variety of shapes of arbitrary novelty and complexity. In a series of experiment, we obtained subjective evaluations of novelty and complexity, as well as beauty and interest, for the generated shape samples. The results indicated that our novelty and complexity formulations had significant positive correlations with subjective evaluations. The sum of the formulated novelty and complexity also had a significant positive correlation with interest. The results of this study are expected to be used to support the design of attractive shapes by providing feedback to designers regarding the degrees of novelty and complexity that users find most pleasant.

The incidence of seasonal infections due to respiratory viruses other than severe acute respiratory coronavirus virus 2 (SARS-CoV-2) has declined due to heightened public infection prevention measures against coronavirus disease 2019 (COVID-19). We describe an outbreak of human coronavirus OC43 infection that occurred at a long-term care facility and whose clinical features were indistinguishable from COVID-19.

We evaluated the impact of discontinuing universal preadmission screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) on the occurrence of nosocomial clusters of coronavirus disease 2019 (COVID-19) during the SARS-CoV-2 o (omicron) variant period. No increasing trend in nosocomial clusters was observed during community-based surges before and after discontinuation. This finding supports the safety of the practice change.

Numerous state, national, and global resources exist for planning and executing mass vaccination campaigns. However, they are disparate and can be complex. The COVID-19 pandemic highlighted the need for clear, easy to use mass vaccination resources. Meanwhile, annual influenza vaccination, as well as outbreaks such as mpox, demonstrates the need for continued emphasis on timely and effective vaccinations to mitigate outbreaks. This pocket guide seeks to combine relevant resources and basic steps for setting up a mass vaccination clinic, utilizing experience from COVID-19 mass vaccination sites.

In the intellectual history of modern Japan, the late 1880s epitomized the Meiji government’s effort to ‘civilize’ through Westernization, driven by the social Darwinian vision of the survival of the fittest. During this period in the United States, the ideas of civilization theory, informed by the very antithesis of the Meiji state’s understanding, surfaced in the life and work of the aspiring young naturalist-botanist Minakata Kumagusu. He imagined a ‘different kind of civilization’ as he re-examined the nature of social evolution in microbes by turning to Indian-and-Chinese-derived knowledge of his home region of Kii, Japan. Buddhism, persecuted by the Meiji regime, most notably enabled his scientific enquiry, while the encyclopedic work of Wakan Sansai Zue (The Illustrated Three Knowledge of Sino-Japan) became another key inspiration. Chinese historiography and Confucian thoughts additionally facilitated his reasoning.

What interconnected all of these strands was what the author refers to as ‘queer nature’: the basis for truths whose ontological and experiential qualities resembled the microbe slime mould. Similar to this microbe that captured Kumagusu’s imagination, with queer nature the process of knowing defied the epistemological dichotomies and hierarchies that were fundamental to the social Darwinian theory of evolution. Experientially, it attracted the knower’s attention, induced their desire for intimacy with strange and curious others, and propelled greater intellectual enquiries. The article thus demonstrates a queer theory of intellectual history rooted in modern Japan, whose intellectual lineage derived from India and China instead of the West.

Background: Drawing blood cultures in the emergency room (ER) is essential for detecting bloodstream infections (BSIs). Although a practice of drawing blood culture usually indicates a presence of severe infection requiring hospitalization, some patients may nonetheless be safely discharged from the ER. Previous studies demonstrated that patients with a positive blood culture after ER discharge had favorable clinical outcomes. Moreover, given the increasing incidence of febrile illnesses, especially in the era of COVID-19, the shortage of inpatient hospital beds may lend further justification to this practice. We investigated the prevalence, outcomes, and factors associated with patient discharge from the ER after blood collection. Method: The present, nested, case–control study comparing patients initially discharged from the ER with those directly admitted to the study institution was conducted at a 790-bed tertiary-care medical center in Tokyo, Japan. The ratio of the respective patients was 1:3. Factors associated with ER discharge after a blood-culture collection were identified using multivariate logistic regression analysis. Results: From January 2014 through December 2020, 153,432 patients visited the ER. Blood cultures were obtained for 19,010 patients; 2,575 (13.5%) of these had a true BSI, and of the latter, 142 (5.5%) were initially discharged from the ER. During 2020, the proportion of patients with ER discharge increased 1.7 times over previous years. There was no significant difference in 28-day mortality between the groups (2.1% vs 4.5%; P = .31). On multivariate logistic regression analysis, factors significantly associated with the decision to discharge after blood culture collection were the absence of hypotension (aOR], 14,92; 95% CI, 3.38–65.93), lack of altered mental status (aOR, 8.44; 95% CI, 3.28–21.71) at ER presentation, unknown diagnosis at ER discharge (aOR, 3.75; 95% CI, 1.97–7.16), high level C-reactive protein (aOR, 0.91; 95% CI, 0.87–0.94), and a diagnosis of intra-abdominal or hepatobiliary infection (aOR, 0.11; 95% CI, 0.04–0.29). Conclusions: ER discharge after drawing blood for a culture was more frequently seen in the current COVID-19 era and was deemed acceptable under certain circumstances, such as patients with no systemic illnesses or specific diagnosis who may be managed safely without compromising clinical outcomes.

Funding: None

Disclosures: None

Antimicrobial use during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary-care center was analyzed using interrupted time-series analysis. Among intravenous antimicrobials, the use of azithromycin and third-generation cephalosporins significantly decreased during the current pandemic. Similarly, the use of oral antimicrobials, including azithromycin and fluoroquinolones, also decreased.