Background: Data on antimicrobial use at the national level is crucial to establish domestic antimicrobial stewardship policies and enable medical institutions to benchmark against each other. This study aimed to analyze antimicrobial use in Korean hospitals. Methods: We investigated the antimicrobials prescribed in Korean hospitals between 2018 and 2021, using data from the Health Insurance Review and Assessment. Primary care hospitals (PCHs), secondary care hospitals (SCHs), and tertiary care hospitals (TCHs) were included in this analysis. Antimicrobials were categorized according to the Korea National Antimicrobial Use Analysis System (KONAS) classification, which is suitable for measuring antimicrobial use in Korean hospitals. Results: Out of more than 1,900 hospitals, PCHs and TCHs represented the largest and lowest percentage of hospitals, respectively. The most frequently prescribed antimicrobial in 2021 was piperacillin/β-lactamase inhibitor (9.3%) in TCHs, ceftriaxone (11.0%) in SCHs, and cefazedone (18.9%) in PCHs. Between 2018 and 2021, the most used antimicrobial class according to the KONAS classification was ‘broad-spectrum antibacterial agents predominantly used for community-acquired infections’ in TCHs and SCHs, and 'narrow spectrum beta-lactam agents' in PCH. Total consumption of antimicrobials has decreased from 951.7 to 929.9 days of therapy (DOT)/1,000 patient-days in TCHs and from 817.8 to 752.2 DOT/1,000 patient-days in SCHs during study period, but not in PCHs (from 504.3 to 527.2 DOT/1,000 patient-days). Moreover, in 2021, while use of reserve antimicrobials has decreased from 13.6 to 10.7 DOT/1,000 patient-days in TCHs and from 4.6 to 3.3 DOT/1,000 patient-days in SCHs, it has increased from 0.7 to 0.8 DOT/1,000 patient-days in PCHs. Conclusion: This study confirms that antimicrobial use differs by hospital type in Korea. Recent increases of use of antimicrobials, including reserve antimicrobials, in PCHs reflect the challenges that must be addressed.

This study investigates the impact of molecular thermal fluctuations on compressible decaying isotropic turbulence using the unified stochastic particle (USP) method, encompassing both two-dimensional (2-D) and three-dimensional (3-D) scenarios. The findings reveal that the turbulent spectra of velocity and thermodynamic variables follow the wavenumber (k) scaling law of ${k}^{(d-1)}$ for different spatial dimensions $d$ within the high wavenumber range, indicating the impact of thermal fluctuations on small-scale turbulent statistics. With the application of Helmholtz decomposition, it is found that the thermal fluctuation spectra of solenoidal and compressible velocity components (${\boldsymbol {u}}_{s}$ and ${\boldsymbol {u}}_{c}$) follow an energy ratio of 1 : 1 for 2-D cases, while the ratio changes to 2 : 1 for 3-D cases. Comparisons between 3-D turbulent spectra obtained through USP simulations and direct numerical simulations of the Navier–Stokes equations demonstrate that thermal fluctuations dominate the spectra at length scales comparable to the Kolmogorov length scale. Additionally, the effect of thermal fluctuations on the spectrum of ${\boldsymbol {u}}_{c}$ is significantly influenced by variations in the turbulent Mach number. We further study the impact of thermal fluctuations on the predictability of turbulence. With initial differences caused by thermal fluctuations, different flow realizations display significant disparities in velocity and thermodynamic fields at larger scales after a certain period of time, which can be characterized by ‘inverse error cascades’. Moreover, the results suggest a strong correlation between the predictabilities of thermodynamic fields and the predictability of ${\boldsymbol {u}}_{c}$.

In this paper, a method of planning the expanded S-curve trajectory of robotic manipulators is proposed to minimize the execution time as well as to achieve the smoother trajectory generation in the deceleration stage for point-to-point motions. An asymmetric parameter is added to the piecewise sigmoid function for an improved jerk profile. This asymmetric profile is continuous and infinitely differentiable. Based on this profile, two analytical algorithms are presented. One is applied to determine the suitable time intervals of trajectory satisfying the time optimality under the kinematic constraints, and the other is to determine the asymmetric parameter generating the minimum execution time. Also, the calculation procedure for the time-scaled synchronization for all joints is given to decrease unnecessary loads onto the actuators. The velocity, acceleration, jerk and snap (the derivative of jerk) of the joints and the end-effector are equal to zero at two end points of motion. The simulation results through 3 DOF and 6 DOF robotic manipulators show that our approach reduces the jerk and snap of the deceleration stage effectively while decreasing the total execution time. Also, the analysis for a single DOF mass-spring-damper system indicates that the residual vibration could be reduced to 10% more than the benchmark techniques in case velocity, acceleration and jerk are limited to 1.24 m/s, 6 m/s2 and 80 m/s3, respectively and displacement is set to 0.8m. These results manifest that the performance of reducing residual vibrations is good and demonstrate an important characteristic of the proposed profile suitable for point-to-point motion.

Mosquito-borne diseases have emerged in North Borneo in Malaysia due to rapid changes in the forest landscape, and mosquito surveillance is key to understanding disease transmission. However, surveillance programmes involving sampling and taxonomic identification require well-trained personnel, are time-consuming and labour-intensive. In this study, we aim to use a deep leaning model (DL) to develop an application capable of automatically detecting mosquito vectors collected from urban and suburban areas in North Borneo, Malaysia. Specifically, a DL model called MobileNetV2 was developed using a total of 4880 images of Aedes aegypti, Aedes albopictus and Culex quinquefasciatus mosquitoes, which are widely distributed in Malaysia. More importantly, the model was deployed as an application that can be used in the field. The model was fine-tuned with hyperparameters of learning rate 0.0001, 0.0005, 0.001, 0.01 and the performance of the model was tested for accuracy, precision, recall and F1 score. Inference time was also considered during development to assess the feasibility of the model as an app in the real world. The model showed an accuracy of at least 97%, a precision of 96% and a recall of 97% on the test set. When used as an app in the field to detect mosquitoes with the elements of different background environments, the model was able to achieve an accuracy of 76% with an inference time of 47.33 ms. Our result demonstrates the practicality of computer vision and DL in the real world of vector and pest surveillance programmes. In the future, more image data and robust DL architecture can be explored to improve the prediction result.

The immobilization of antimicrobial drugs can be used to expand the application of antibacterial properties to consumer products. The purpose of this study was to stabilize an antimicrobial agent, levofloxacin (LVX), for sustained antibacterial activity by immobilizing the drug molecules in a layered double hydroxide (LDH) and embedded in a polyurethane substrate. As-prepared MgAl-LDH was calcined at 400°C and reconstructed with LVX for intercalation. The X-ray diffraction patterns and cross-sectional transmission electron microscopy images showed lattice expansion along the crystallographic c axis upon LVX intercalation, suggesting successful loading of the drug. Fourier-transform infrared spectra revealed that the structure of LVX was well preserved between LDH layers. Elemental analysis indicated that the loading capacity of LVX in the hybrid was 41.7%. Bacterial-colony forming inhibitory assay on Bacillus subtilis exhibited ~100% antibacterial activity of both LVX alone and LVX-LDH hybrid (LL). To determine sustainability of antibacterial activity by the hybrid, either LVX alone or LL hybrid was loaded in the polyurethane (PU) substrate for which antibacterial activity was evaluated before and after immersion in a phosphate-buffered saline for 3 days. The LVX-composited PU showed a dramatic decrease in antibacterial activity, down to 0% after buffer treatment; LL-composited PU still contained antibacterial activity (~34% of colony suppression) after phosphate-buffered saline immersion.

Schistosomiasis, a parasite infectious disease caused by Schistosoma japonicum, often leads to egg granuloma and fibrosis due to the inflammatory reaction triggered by egg antigens released in the host liver. This study focuses on the role of the egg antigens CP1412 protein of S. japonicum (SjCP1412) with RNase activity in promoting liver fibrosis. In this study, the recombinant egg ribonuclease SjCP1412, which had RNase activity, was successfully prepared. By analysing the serum of the population, it has been proven that the anti-SjCP1412 IgG in the serum of patients with advanced schistosomiasis was moderately correlated with liver fibrosis, and SjCP1412 may be an important antigen associated with liver fibrosis in schistosomiasis. In vitro, the rSjCP1412 protein induced the human liver cancer cell line Hep G2 and liver sinusoidal endothelial cells apoptosis and necrosis and the release of proinflammatory damage-associated molecular patterns (DAMPs). In mice infected with schistosomes, rSjCP1412 immunization or antibody neutralization of SjCP1412 activity significantly reduced cell apoptosis and necroptosis in liver tissue, thereby reducing inflammation and liver fibrosis. In summary, the SjCP1412 protein plays a crucial role in promoting liver fibrosis during schistosomiasis through mediating the liver cells apoptosis and necroptosis to release DAMPs inducing an inflammatory reaction. Blocking SjCP1412 activity could inhibit its proapoptotic and necrotic effects and alleviate hepatic fibrosis. These findings suggest that SjCP1412 may be served as a promising drug target for managing liver fibrosis in schistosomiasis japonica.

High-intensity vortex beams with tunable topological charges and low coherence are highly demanded in applications such as inertial confinement fusion (ICF) and optical communication. However, traditional optical vortices featuring nonuniform intensity distributions are dramatically restricted in application scenarios that require a high-intensity vortex beam owing to their ineffective amplification resulting from the intensity-dependent nonlinear effect. Here, a low-coherence perfect vortex beam (PVB) with a topological charge as high as 140 is realized based on the super-pixel wavefront-shaping technique. More importantly, a globally adaptive feedback algorithm (GAFA) is proposed to efficiently suppress the original intensity fluctuation and achieve a flat-top PVB with dramatically reduced beam speckle contrast. The GAFA-based flat-top PVB generation method can pave the way for high-intensity vortex beam generation, which is crucial for potential applications in ICF, laser processing, optical communication and optical trapping.

Linear stabilities of the liquid metal mixed convection in a horizontal pipe under bottom heating and transverse magnetic field are studied through linear global stability analyses. Three branches of the linear stability boundary curves are determined by the eigenvalue computation of the most unstable modes. One branch is located in the region of large Hartmann number and determined by the linear unstable mode which was first revealed by the numerical simulations of Zikanov, Listratov & Sviridov (J. Fluid Mech., vol. 720, 2013, pp. 486–516). This branch curve shows that the global unstable mode exists above a threshold of Hartmann number, which agrees with the experiment of Genin et al. (Temperature fluctuations in a heated horizontal tube affected by transverse magnetic field. In Proc. 8th PAMIR Conf. Fund. Appl. MHD, Borgo, Corsica, France, pp. 37–41, 2011). The other two branch curves determined by two different long-wave unstable modes intersect with each other in the region of small Hartmann number. The critical Grashof number on these two curves increases exponentially with the increase of the Hartmann number. Through energy budget analyses at the critical thresholds of these unstable modes, it is found that, for the unstable mode at large Hartmann numbers, buoyancy is the dominant destabilizing term which demonstrates the hypothetical explanation of Zikanov et al. (2013) who regard natural convection as a destabilization mechanism. It is further revealed that, with respect to the unstable modes on the critical stability curves of small Hartmann numbers, the dominant destabilization comes from the streamwise shear of the basic flow. Finally, within the linear unstable region, fully developed nonlinear flow states of the mixed convection are investigated by direct numerical simulations (DNS) with several sets of selected dimensionless parameters. The spatio-temporal structures of these nonlinear flow states are discussed in detail with comparison with the linear unstable global modes.

The present study examined the association between adolescents’ extracurricular activities and bullying perpetration and victimisation. The sample was drawn from the 2016 National Survey of Children’s Health dataset. Analyses included descriptive statistics and logistic regression for the early adolescent and middle adolescent groups. Among early adolescents, sports were negatively associated with victimisation. Participation in clubs/organisations, organised activities or lessons, and community services were negatively associated, while employment was positively related to bullying perpetration. Among middle adolescents, all extracurricular activities were negatively related to victimisation. As for bullying perpetration, organised activities or lessons and community services were negatively associated with bullying. The study highlights the potential for sport and extracurricular involvement as ways to possibly deter bullying perpetration and victimisation. Future research should consider these associations longitudinally.

It has been suggested that added sugar intake is associated with non-alcoholic fatty liver disease (NAFLD). However, previous studies only focused on sugar-sweetened beverages; the evidence for associations with total added sugars and their sources is scarce. This study aimed to examine the associations of total added sugars, their physical forms (liquid v. solid) and food sources with risk of NAFLD among adults in Tianjin, China. We used data from 15 538 participants, free of NAFLD, other liver diseases, CVD, cancer or diabetes at baseline (2013–2018 years). Added sugar intake was estimated from a validated 100-item FFQ. NAFLD was diagnosed by ultrasonography after exclusion of other causes of liver diseases. Multivariable Cox proportional hazards models were fitted to calculate hazard ratios (HR) and corresponding 95 % CI for NAFLD risk with added sugar intake. During a median follow-up of 4·2 years, 3476 incident NAFLD cases were documented. After adjusting for age, sex, BMI and its change from baseline to follow-up, lifestyle factors, personal and family medical history and overall diet quality, the multivariable HR of NAFLD risk were 1·18 (95 % CI 1·06, 1·32) for total added sugars, 1·20 (95 % CI 1·08, 1·33) for liquid added sugars and 0·96 (95 % CI 0·86, 1·07) for solid added sugars when comparing the highest quartiles of intake with the lowest quartiles of intake. In this prospective cohort of Chinese adults, higher intakes of total added sugars and liquid added sugars, but not solid added sugars, were associated with a higher risk of NAFLD.

This study utilized social exchange and social learning perspectives to develop a theoretical model about how leader humility predicts follower unethical pro-organizational behavior (UPB). Using two-wave data obtained from 203 full-time employees nested within 46 work teams in eastern China, regression analyses revealed a nonmonotonic association between leader humility and follower UPB, such that follower UPB was most at intermediate levels of leader humility. Moreover, the strength of this curvilinear relationship was found to be moderated by the followers' organizational identification, such that the inverted U-curve relationship between leader humility and follower UPB will be stronger for followers with high organizational identification than for those with low organizational identification. Implications in theory and practice, along with limitations of our findings, were discussed.

Prospective cohort studies linking organ meat consumption and non-alcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between organ meat consumption and risk of NAFLD in a general Chinese adult population. This prospective cohort study included a total of 15 568 adults who were free of liver disease, CVD and cancer at baseline. Dietary information was collected at baseline using a validated FFQ. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between organ meat consumption and risk of NAFLD. During a median of 4·2 years of follow-up, we identified 3604 incident NAFLD cases. After adjusting for demographic characteristics, lifestyle factors, vegetable, fruit, soft drink, seafood and red meat consumption, the multivariable hazard ratios (95 % CI) for incident NAFLD across consumption of organ meat were 1·00 (reference) for almost never, 1·04 (0·94, 1·15) for tertile 1, 1·08 (0·99, 1·19) for tertile 2 and 1·11 (1·01, 1·22) for tertile 3, respectively (P for trend < 0·05). Such association did not differ substantially in the sensitivity analysis. Our study indicates that organ meat consumption was related to a modestly higher risk of NAFLD among Chinese adults. Further investigations are needed to confirm this finding.

Although employee creativity has been identified to promote organizational competitiveness, its effect on leader empowering behaviors remains underexplored. This study investigated the underlying mechanism and boundary condition under which employee creativity influences leader empowering behaviors. Drawn on social exchange theory and similarity-attraction theory, this study developed a moderated-mediation model in which supervisor–subordinate guanxi serves as the intervening mechanism and supervisor–subordinate similarity serves as a boundary condition influencing this relationship. Using three-wave, time-lagged survey data collected from 309 supervisor–subordinate dyads, this study found that supervisor–subordinate guanxi mediates the relationship between employee creativity and leader empowering behaviors, and that this relationship is stronger when supervisor–subordinate similarity is high rather than low. Finally, theoretical and practical implications were discussed.

Robots of next-generation physically interact with the world rather than be caged in a controlled area, and they need to make contact with the open-ended environment to perform their task. Compliant robot links offer intrinsic mechanical compliance for addressing the safety issue for physical human–robot interactions (pHRI). However, many important research questions are yet to be answered. For instance, how do system parameters, for example, mechanical compliance, motor torque, impact velocities, and so on, affect the impact force? how to formulate system impact dynamics of compliant robots, and how to size their geometric dimensions to maximize impact force reduction. In this paper, we present a parametric study of compliant link (CL) design for safe pHRI. We first present a theoretical model of the pHRI system that is comprised of robot dynamics, an impact contact model, and dummy head dynamics. After experimentally validating the theoretical model, we then systematically study the effects of CL parameters on the impact force in more detail. Specifically, we explore how the design and actuation parameters affect the impact force of pHRI system. Based on the parametric studies of the CL design, we propose a step-by-step process and a list of concrete guidelines for designing CL with safety constraints in pHRI. We further conduct a simulation case study to validate this design process and design guidelines.