Background: Surveillance of healthcare-associated infection (HAI) is the basis of infection prevention programs. However, manual review of medical records is a labor-intensive and time-consuming process. We evaluated the diagnostic performance of automated surveillance of HAI using electronic screening algorithms. Methods: Between April and June 2022, we conducted surveillance of HAI manually and automatically using electronic screening algorithm on 75 units (general medical and surgical wards and ICUs) in a 2,700-bed, tertiary-care hospital in South Korea. Algorithms for surveillance of HAI were developed accordance with NHSN surveillance definitions (Fig. 1). Catheter-associated urinary tract infections (CAUTIs) were automatically detected when eligible pathogen and fever (>38°C) were matched within infection window period. Other specific types of infection were automatically classified based on laboratory results that met NHSN criteria. After the algorithm showed possible cases that met laboratory-confirmed bloodstream infection (LCBI) criteria, we excluded secondary BSIs using the automatic surveillance algorithm. We analyzed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the automated surveillance system compared to manual surveillance. Results: An algorithm for detecting CAUTI showed 98.7% sensitivity (78 of 79), 100.0% specificity (2,443 of 2,443), 100.0% PPV (78 of 78), and 100.0% NPV (2,443 of 2,444). For CLABSI, the algorithm had 97.3% sensitivity (214 of 220), 98.3% specificity (5,759 of 5,861), 67.7% PPV (214 of 316), and 99.9% NPV (5,759 of 5,765). In total, 102 cases of possible CLABSI were identified by the algorithm, and 76 (74.5%) were eventually diagnosed as secondary BSIs. Also, by chart review, 20 BSIs (19.6%) were present on arrival in ER (ER-POA). In 4 cases (3.9%), an original pathogen reoccurred in a repeated infection timeframe (RIT), and 2 cases (2%) were mucosal barrier injury-LCBI (MBI-LCBI). When we additionally performed manual surveillance for intra-abdominal infection secondary BSI, ER-POA, and assigning pathogen to original BSI in RIT, PPV increased to 87.7% (214 of 244). Conclusions: Algorithm for automated surveillance of CAUTI had good performance; however, automated surveillance of CLABSI was suboptimal. More elaborate screening algorithm for diagnosis CLABSI is needed, and further studies are needed to determine whether an automated surveillance system can reduce workload for surveillance of HAI.

Disclosures: None

In this review, we introduce our recent applications of deep learning to solar and space weather data. We have successfully applied novel deep learning methods to the following applications: (1) generation of solar farside/backside magnetograms and global field extrapolation based on them, (2) generation of solar UV/EUV images from other UV/EUV images and magnetograms, (3) denoising solar magnetograms using supervised learning, (4) generation of UV/EUV images and magnetograms from Galileo sunspot drawings, (5) improvement of global IRI TEC maps using IGS TEC ones, (6) one-day forecasting of global TEC maps through image translation, (7) generation of high-resolution magnetograms from Ca II K images, (8) super-resolution of solar magnetograms, (9) flare classification by CNN and visual explanation by attribution methods, and (10) forecasting GOES solar X-ray profiles. We present major results and discuss them. We also present future plans for integrated space weather models based on deep learning.

Background: After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the government newly established the additional reimbursement for infection prevention to encourage infection control activities in the hospitals. The new policy was announced in December 2015 and was implemented in September 2016. We evaluated how infection control activities improved in hospitals after the change of government policy in Korea. Methods: Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using multivariable linear regression model including hospital characteristics, we analyzed the changes in total HHSAF scores according to the survey time. Results: In total, 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In a multivariable linear regression model, the total HHSAF scores were significantly associated with hospital teaching status (β coefficient of major teaching hospital, 52.6; 95% CI, 8.9–96.4; P = .018), bed size (β coefficient of 100-bed increase, 5.1; 95% CI, 0.3–9.8; P = .038), and survey time (β coefficient of 2017 survey, 45.1; 95% CI, 19.3–70.9; P = .001). Conclusions: After the national policy implementation, the number of infection control professionals increased, and the promotion of hand hygiene activities was strengthened in Korean hospitals.

Funding: None

Disclosures: None

Background: Recently, healthcare-associated infections (HAIs) in long-term care hospitals (LTCHs) have markedly increased, but no infection control policy has been established in South Korea. We investigated the current HAI surveillance system and executed a point-prevalence pilot study in LTCHs. Methods: HAIs were defined by newly established surveillance manual based on McGeer criteria revised in 2012. Three LTCHs in Seoul and Gyeonggi province were voluntarily recruited, and data were collected from up to 50 patients who were hospitalized on August 1. The medical records from September to November 2018 were retrospectively reviewed by a charge nurse for infection control per each hospitals after 1 day of training specific for LTCH surveillance. All data were reviewed by a senior researcher visiting onsite. Results: The participating hospitals had 272.33 ± 111.01 beds. Only 1 hospital had an onsite microbiological laboratory. In total, 156 patients were enrolled and 5 HAIs were detected, for a prevalence rate of 3.2%. The average patient age was 79.04 ± 9.92 years. The HAIs included 2 urinary tract infections, skin and soft-tissue infection, low respiratory infection, and conjunctivitis. Conclusions: This is the first survey of HAI in LTCHs in South Korea. The 3.2% prevalence rate is lower than those from previous reports from the European Union or the United States. This study supports the development of a national HAI surveillance and infection control system in LTCHs, although implementation may be limited due to the lack of laboratory support and infection control infrastructure in Korea.

Funding: None

Disclosures: None

The experiments reported in this research paper aimed to determine the effect of supplementing different forms of L-methionine (L-Met) and acetate on protein synthesis in immortalized bovine mammary epithelial cell line (MAC-T cells). Treatments were Control, L-Met, conjugated L-Met and acetate (CMA), and non-conjugated L-Met and Acetate (NMA). Protein synthesis mechanism was determined by omics method. NMA group had the highest protein content in the media and CSN2 mRNA expression levels (P < 0.05). The number of upregulated and downregulated proteins observed were 39 and 77 in L-Met group, 62 and 80 in CMA group and 50 and 81 in NMA group from 448 proteins, respectively (P < 0.05). L-Met, NMA and CMA treatments stimulated pathways related to protein and energy metabolism (P < 0.05). Metabolomic analysis also revealed that L-Met, CMA and NMA treatments resulted in increases of several metabolites (P < 0.05). In conclusion, NMA treatment increased protein concentration and expression level of CSN2 mRNA in MAC-T cells compared to control as well as L-Met and CMA treatments through increased expression of milk protein synthesis-related genes and production of the proteins and metabolites involved in energy and protein synthesis pathways.

We investigated potential nosocomial aerosol transmission of severe fever with thrombocytopenia syndrome virus (SFTSV) with droplet precautions. During aerosol generating procedures, SFTSV was be transmitted from person to person through aerosols. Thus, airborne precautions should be added to standard precautions to avoid direct contact and droplet transmission.

A few epidemiological data are available assessing the associations of intakes of sodium (Na) and potassium (K) with non-alcoholic fatty liver disease (NAFLD). We aimed to examine the associations of dietary intake of Na and K with the prevalence of ultrasound-diagnosed NAFLD. We performed a cross-sectional study of 100 177 participants (46 596 men and 53 581 women) who underwent a health screening examination and completed a FFQ at the Kangbuk Samsung Hospital Total Healthcare Centers, South Korea, between 2011 and 2013. NAFLD was defined by ultrasonographic detection of fatty liver in the absence of excessive alcohol intake or other known causes of liver disease. The proportion of NAFLD was 35·6 % for men and 9·8 % for women. Increasing prevalence of NAFLD was observed with increasing Na intake. The multivariable-adjusted prevalence ratios (PR) of NAFLD comparing the highest with the lowest quintile of energy-adjusted Na intake were 1·25 (95 % CI 1·18, 1·32; Ptrend<0·001) in men and 1·32 (95 % CI 1·18, 1·47; Ptrend <0·001) in women. However, when we additionally adjusted for body fat percentage, the association became attenuated; the corresponding PR of NAFLD were 1·15 (95 % CI 1·09, 1·21) in men and 1·06 (95 % CI 0·95, 1·17) in women. No inverse association was observed for energy-adjusted K intake. Our findings suggest that higher Na intake is associated with a greater prevalence of NAFLD in young and middle-aged asymptomatic adults, which might be partly mediated by adiposity.

Hallux valgus (HV) is a common foot deformity of multifactorial etiology, but knowledge about the relative importance of genetics and environments on HV has been limited. In order to estimate genetic influences on HV, 1,265 adults, including 175 monozygotic twin (MZ) pairs, 31 dizygotic twin (DZ) pairs, and 853 first-degree singleton family members of the twins were included from the Healthy Twin study, a population-based twin-family cohort in Korea. All participants underwent foot examination and weight-bearing radiographic assessment (anterior-posterior and lateral) in addition to a general health survey. Of the subjects, 208 (16.4%) were classified as HV (as HV angle >20°). The genetic influence on HV was estimated to be substantial; the heritability of HV was 0.51 (95% CI 0.42–0.59) and the heritability of HV angle was 0.47 (0.38–0.56), while contributions from shared environmental effects were negligible. These findings suggest that genetic factors play an important role in determining HV deformity.

The growth of high-quality indium (In)-rich InXGa1−XN alloys is technologically important for applications to attain highly efficient green light-emitting diodes and solar cells. However, phase separation and composition modulation in In-rich InXGa1−XN alloys are inevitable phenomena that degrade the crystal quality of In-rich InXGa1−XN layers. Composition modulations were observed in the In-rich InXGa1−XN layers with various In compositions. The In composition modulation in the InXGa1−XN alloys formed in samples with In compositions exceeding 47%. The misfit strain between the InGaN layer and the GaN buffer retarded the composition modulation, which resulted in the formation of modulated regions 100 nm above the In0.67Ga0.33N/GaN interface. The composition modulations were formed on the specific crystallographic planes of both the {0001} and {0114} planes of InGaN.

At the apical tip of Drosophila testis, there is a stem cell niche known as the proliferation center, where the stem cells are maintained by hub cell cluster for the regulation of differentiation and proliferation. Germline stem cells go through mitosis four times from one primary spermatogonial cell to the 16-cell stage before the maturation. The cells derived from the same germline stem cell are located within one cyst, an enclosed system by two cyst cells, and they are connected by the intercellular bridges called ring canals. In this study, the three-dimensional (3D) structure of Drosophila testis tip was reconstructed from serial sections. The size of cells at each stage was compared in volume from the 3D structure. The stages of cells in a cyst could be distinguishable exactly by counting the cells linked with intercellular bridges in 3D-reconstructed structure. The cysts containing the same stage cells appeared in the horizontal plane. Both the germline stem cell directly attached to the hub cell and the spermatogonial cells detached from the hub cell were divided at the almost perpendicular direction to the spermatogonial cell layers. The dividing phase in one cyst was delayed gradually through the cytoplasmic region of intercellular bridge.

We previously demonstrated that the chronic consumption of a high-fat diet (HFD) promotes lung and liver metastases of 4T1 mammary carcinoma cells in obesity-resistant BALB/c mice. To examine early transcriptional responses to tumour progression in the liver and lungs of HFD-fed mice, 4-week-old female BALB/c mice were divided into four groups: sham-injected, control diet (CD)-fed; sham-injected, HFD-fed (SH); 4T1 cell-injected, CD-fed (TC); 4T1 cell-injected, HFD-fed (TH). Following 16 weeks of either a CD or HFD, 4T1 cells were injected into the mammary fat pads of mice in the TC and TH groups and all mice were continuously fed identical diets. At 14 d post-injection, RNA was isolated from hepatic and pulmonary tissues for microarray analysis of mRNA expression. Functional annotation and core network analyses were conducted for the TH/SH Unique gene set. Inflammation in hepatic tissues and cell mitosis in pulmonary tissues were the most significant biological functions in the TH/SH Unique gene set. The biological core networks of the hepatic TH/SH Unique gene set were characterised as those genes involved in the activation of acute inflammatory responses (Orm1, Lbp, Hp and Cfb), disordered lipid metabolism and deregulated cell cycle progression. Networks of the pulmonary Unique gene set displayed the deregulation of cell cycle progression (Cdc20, Cdk1 and Bub1b). These HFD-influenced alterations may have led to favourable conditions for the formation of both pro-inflammatory and pro-mitotic microenvironments in the target organs that promote immune cell infiltration and differentiation, as well as the infiltration and proliferation of metastatic tumour cells.

Aim: To determine whether or not the change in cervical length (CL) over time is valuable in predicting spontaneous preterm delivery (SPTD) in asymptomatic twin pregnancies with a normal mid-trimester CL (>25 mm). Methods: This was a prospective study including 190 consecutive asymptomatic twin gestations with a CL > 25 mm at 20–24 weeks. The women underwent an initial CL measurement at the time of routine ultrasound examination between 20 and 24 weeks’ gestation, followed 4–5 weeks later by a repeat CL measurement. The primary outcome measure was SPTD at <32 completed weeks’ gestation. Multicollinearity was a concern in the multivariable model since change in CL and follow-up CL were highly correlated. Results: The rate of SPTD at <32 weeks was 4.2%. Multiple logistic regression analyses demonstrated that the change in CL and the follow-up CL were significantly associated with SPTD before 32 weeks after adjusting for baseline covariate such as in vitro fertilization. The best cut-off values for the prediction of SPTD at <32 weeks’ gestation were 13% for the change in CL with a sensitivity of 87.5% and a specificity of 63.2%. There was no significant difference in the area under the receiver operating characteristic curves between the change in CL and the follow-up CL. Conclusions: A greater change in CL is a good predictor of SPTD in asymptomatic twin pregnancies with a normal mid-trimester CL. However, the change in CL cannot provide data beyond the follow-up CL. In the setting of a normal mid-trimester CL, a follow-up CL measurement should be considered in asymptomatic twin pregnancies.