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The aim of this study was to evaluate the impact of coronavirus disease 2019 (COVID-19) on treatment outcomes in critically ill patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI). This single-centre, retrospective cohort study was conducted in a 1,048-bed university-affiliated tertiary hospital in the Republic of Korea from January 2021 to March 2022. The study participants included consecutive hospitalised adult patients (aged ≥18 years) in the intensive care unit with CRAB monomicrobial BSI. During the study period, a total of 70 patients were included in our study, and 24 (34.3%) were diagnosed with COVID-19. The 28-day mortality rate was 64.3%. In the multivariate Cox proportional hazard regression analysis, diagnosis of COVID-19 (hazard ratio (HR), 2.91; 95% confidence interval (CI): 1.45–5.87), neutropenia (HR, 2.76; 95% CI: 1.04–7.29), Pitt bacteraemia score (per point; HR, 1.30; 95% CI: 1.19–1.41), and appropriate definite antibiotic therapy (HR, 0.31; 95% CI: 0.15–0.62) were independent predictors of 28-day mortality in patients with CRAB BSI. In conclusion, our findings suggested that COVID-19 has a negative prognostic impact on patients with CRAB BSI. Further study is needed to investigate the specific mechanisms of how COVID-19 worsens the prognosis of CRAB infection.
Prognostic heterogeneity in early psychosis patients yields significant difficulties in determining the degree and duration of early intervention; this heterogeneity highlights the need for prognostic biomarkers. Although mismatch negativity (MMN) has been widely studied across early phases of psychotic disorders, its potential as a common prognostic biomarker in early periods, such as clinical high risk (CHR) for psychosis and first-episode psychosis (FEP), has not been fully studied.
A total of 104 FEP patients, 102 CHR individuals, and 107 healthy controls (HCs) participated in baseline MMN recording. Clinical outcomes were assessed; 17 FEP patients were treatment resistant, 73 FEP patients were nonresistant, 56 CHR individuals were nonremitters (15 transitioned to a psychotic disorder), and 22 CHR subjects were remitters. Baseline MMN amplitudes were compared across clinical outcome groups and tested for utility prognostic biomarkers using binary logistic regression.
MMN amplitudes were greatest in HCs, intermediate in CHR subjects, and smallest in FEP patients. In the clinical outcome groups, MMN amplitudes were reduced from the baseline in both FEP and CHR patients with poor prognostic trajectories. Reduced baseline MMN amplitudes were a significant predictor of later treatment resistance in FEP patients [Exp(β) = 2.100, 95% confidence interval (CI) 1.104–3.993, p = 0.024] and nonremission in CHR individuals [Exp(β) = 1.898, 95% CI 1.065–3.374, p = 0.030].
These findings suggest that MMN could be used as a common prognostic biomarker across early psychosis periods, which will aid clinical decisions for early intervention.
The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.
Over the past two decades, early detection and early intervention in psychosis have become essential goals of psychiatry. However, clinical impressions are insufficient for predicting psychosis outcomes in clinical high-risk (CHR) individuals; a more rigorous and objective model is needed. This study aims to develop and internally validate a model for predicting the transition to psychosis within 10 years.
Two hundred and eight help-seeking individuals who fulfilled the CHR criteria were enrolled from the prospective, naturalistic cohort program for CHR at the Seoul Youth Clinic (SYC). The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression was used to develop a predictive model for a psychotic transition. We performed k-means clustering and survival analysis to stratify the risk of psychosis.
The predictive model, which includes clinical and cognitive variables, identified the following six baseline variables as important predictors: 1-year percentage decrease in the Global Assessment of Functioning score, IQ, California Verbal Learning Test score, Strange Stories test score, and scores in two domains of the Social Functioning Scale. The predictive model showed a cross-validated Harrell's C-index of 0.78 and identified three subclusters with significantly different risk levels.
Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals.
Firefighters are routinely exposed to various traumatic events and often experience a range of trauma-related symptoms. Although these repeated traumatic exposures rarely progress to the development of post-traumatic stress disorder, firefighters are still considered to be a vulnerable population with regard to trauma.
To investigate how the human brain responds to or compensates for the repeated experience of traumatic stress.
We included 98 healthy firefighters with repeated traumatic experiences but without any diagnosis of mental illness and 98 non-firefighter healthy individuals without any history of trauma. Functional connectivity within the fear circuitry, which consists of the dorsal anterior cingulate cortex, insula, amygdala, hippocampus and ventromedial prefrontal cortex (vmPFC), was examined using resting-state functional magnetic resonance imaging. Trauma-related symptoms were evaluated using the Impact of Event Scale – Revised.
The firefighter group had greater functional connectivity between the insula and several regions of the fear circuitry including the bilateral amygdalae, bilateral hippocampi and vmPFC as compared with healthy individuals. In the firefighter group, stronger insula–amygdala connectivity was associated with greater severity of trauma-related symptoms (β = 0.36, P = 0.005), whereas higher insula–vmPFC connectivity was related to milder symptoms in response to repeated trauma (β = −0.28, P = 0.01).
The current findings suggest an active involvement of insular functional connectivity in response to repeated traumatic stress. Functional connectivity of the insula in relation to the amygdala and vmPFC may be potential pathways that underlie the risk for and resilience to repeated traumatic stress, respectively.
There is growing evidence that, among the various subclasses of carbon-enhanced metal-poor (CEMP) stars, the outer halo of the Milky Way exhibits a higher frequency of CEMP-no stars (those having no over-abundances of heavy neutron-capture elements) compared with the CEMP-s stars (those with over-enhancements of the s-process elements), while the inner halo shows a higher frequency of CEMP-s stars. We map out fractions of CEMP-no and CEMP-s stars in the inner- and outer-halo populations, separated by their spatial distribution of carbonicity ([C/Fe]), a so-called “carbonicity map”, based on a sample of over 100,000 main-sequence turnoff stars with available spectroscopy from the Sloan Digital Sky Survey. The CEMP-no and CEMP-s objects are classified by different levels of absolute carbon abundances for our sample, A(C). We also present kinematic and orbital characteristics of these subclasses for each population. The contrast appearing in these characteristics provides critical constraints on the assembly history of the two primary stellar components of the Galactic halo.
Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression.
Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers’ personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined.
Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL.
Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.
During the past decade, carbapenemase-producing Enterobacteriaceae (CPE) has emerged and spread across the world.1 The major carbapenemase enzymes currently being reported are KPC, NDM-1, VIM, IMP, and OXA.2 Because carbapenemase can be effectively transmitted via mobile genetic elements, and current therapeutic options for CPE infections are extremely limited, CPE may be one of the most serious contemporary threats to public health. However, very little is known about the characteristics of CPE carriage during hospitalization. The aims of this study were to investigate the clearance rate of CPE carriage and determine the number of consecutive negative cultures required to confirm CPE clearance. We also examined CPE transmission among hospitalized patients.
Infect. Control Hosp. Epidemiol. 2015;36(11):1361–1362
We report on the formation of highly flexible and transparent TiO2/Ag/ITO multilayer films deposited on polyethylene terephthalate substrates. The optical and electrical properties of the multilayer films were investigated as a function of oxide thickness. The transmission window gradually shifted toward lower energies with increasing oxide thickness. The TiO2 (40 nm)/Ag (18 nm)/ITO (40 nm) films gave the transmittance of 93.1% at 560 nm. The relationship between transmittance and oxide thickness was simulated using the scattering matrix method to understand high transmittance. As the oxide thickness increased from 20 to 50 nm, the carrier concentration gradually decreased from 1.08 × 1022 to 6.66 × 1021 cm−3, while the sheet resistance varied from 5.8 to 6.1 Ω/sq. Haacke's figure of merit reached a maximum at 40 nm and then decreased with increasing oxide thickness. The change in resistance for the 60 nm-thick ITO single film rapidly increased with increasing bending cycles, while that of the TiO2/Ag/ITO (40 nm/18 nm/40 nm) film remained virtually unchanged during the bending test.
Lutein has significant nutritional benefits for human health. Therefore, enhancing soybean lutein concentrations is an important breeding objective. However, selection for soybeans with high and environmentally stable lutein concentrations has been limited. The objectives of this study were to select soybeans with high seed lutein concentrations and to determine the stability of lutein concentrations across environments. A total of 314 genotypes were screened and 18 genotypes with high lutein concentrations and five genotypes with low lutein concentrations were selected for further examination. These 23 genotypes and two check varieties were evaluated under six environments (two planting dates for 2 years at one location and two planting dates for 1 year at another location). Lutein concentrations were influenced by genotype, environment and genotype × environment interactions. Genotypes with late maturity and low lutein concentrations were more stable than those with early maturity and high concentrations. Early (May) planting resulted in greater lutein concentrations than late (June) planting. Among the genotypes evaluated, PI603423B (7.7 μg/g) and PI89772 (5.8 μg/g) had the greatest mean lutein concentrations and exhibited medium and high stability across the six environments, respectively. Thus, these genotypes may be useful for breeding soybeans with high and stable seed lutein concentrations.
Based on the sequences of Brassica rapa ssp. pekinensis, we carried out a single-nucleotide polymorphism (SNP) study for genes controlling disease resistance (clubroot, turnip mosaic virus and soft rot) and leaf traits in B. rapa leafy genotypes ‘VC40’ and ‘SR5’. In total, 7645 SNP markers were obtained based on the annotation of a B. rapa database for disease resistance. Among these 7645 SNP markers, 141 were related to 125 genes linked to leaf traits. From these 141 SNP markers, 63 were screened and High Resolution Melt (HRM) primers were designed for genomic studies. A total of 20 polymorphic SNP primers were finally obtained. Eventually, these markers will be further used for the detection of quantitative trait loci and mapping studies.
Next-generation sequencing technique has been known as a useful tool for de novo transcriptome assembly, functional annotation of genes and identification of molecular markers. This study was carried out to mine molecular markers from de novo assembled transcriptomes of four chilli pepper varieties, the highly pungent ‘Saengryeg 211’ and non-pungent ‘Saengryeg 213’ and variably pigmented ‘Mandarin’ and ‘Blackcluster’. Pyrosequencing of the complementary DNA library resulted in 361,671, 274,269, 279,221, and 316,357 raw reads, which were assembled in 23,607, 19,894, 18,340 and 20,357 contigs, for the four varieties, respectively. Detailed sequence variant analysis identified numerous potential single-nucleotide polymorphisms (SNPs) and simple sequence repeats (SSRs) for all the varieties for which the primers were designed. The transcriptome information and SNP/SSR markers generated in this study provide valuable resources for high-density molecular genetic mapping in chilli pepper and Quantitative trait loci analysis related to fruit qualities. These markers for pepper will be highly valuable for marker-assisted breeding and other genetic studies.
Resistance degradation of zirconium (Zr)-doped barium titanate (BaTiO3) was investigated. A series of Ba(Ti1−yZry)O3 powders and coarse-grained ceramics ranging y from 0 to 0.1 were prepared. The increase of Zr concentration systematically increased the time to as well as electric field to degradation. Such behaviors directly corresponded to those of ionic conduction contribution as evaluated by the Warburg impedance. The magnitude of Warburg impedance decreased with the increase of Zr concentration, which demonstrates that the Zr incorporation inhibits the ionic conduction caused by oxygen vacancies. The prototype multilayer ceramic capacitor (MLCC) samples were also prepared by applying these Ba(Ti1−yZry)O3 base powders and formulated X5R additives of commercial application. In this case, however, such distinct difference in degradation behavior with the variation of Zr concentration did not appear. It is supposed that the influence of additives far outweighs the effect of relative difference in the ionic conduction of Ba(Ti1−yZry)O3 under the MLCC test condition where the applied electric field strength is much higher than those for the coarse-grained bulk ceramics. Resistance degradation of MLCC under such high field might not be explained by only oxygen vacancy-related behavior alone.
To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.
Retrospective cohort study.
Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).
From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.
SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.
Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.
To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
A nationwide prospective multicenter study.
Twenty university-affiliated hospitals in Korea.
The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.
Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
Both luminous efficiency and lifetime in blue fluorescence organic light
emitting devices (OLEDs) have been improved by modified HTMs with higher
LUMO energy levels. The LUMO energy levels of HTM were increased by
modifying substituent in HTM molecules. Two HTMs containing ortho and meta
biphenyl substituent and one HTM containing thiophene substituent were
synthesized via palladium catalyzed amine coupling reactions to compare with
a para biphenyl substituent HTM-1 as a standard molecule. According to TDDFT
calculations, these three modified HTMs showed 0.05-0.15 eV higher LUMO
energy levels compared to the para biphenyl substituent HTM-1. The luminous
efficiency and the lifetime (LT90) of OLEDs using HTM-2 at 500
cd/m2 have been enhanced up to 20 % and 52 %, respectively,
compared to the standard device using HTM-1.
Decision making in an emotionally conflicting situation is important in social life. We aimed to address the similarity and disparity of neural correlates involved in processing ambivalent stimuli in patients with schizophrenia and patients with depression. Behavioral task-related hemodynamic responses were measured using [15O]H2O positron emission tomography (PET) in 12 patients with schizophrenia and 12 patients with depression. The task was a modified word-stem completion task, which was designed to evoke ambivalence in forced and non-forced choice conditions. The prefrontal cortex and the cerebellum were found to show increased activity in the healthy control group. In the schizophrenia group, activity in these two regions was negligible. In the depression group, the pattern of activity was altered and a functional compensatory recruitment of the inferior parietal regions was suggested. The prefrontal cortex seems to be associated with the cognitive control to resolve the conflict toward the ambivalent stimuli, whereas the cerebellum reflects the sustained working memory to search for compromise alternatives. The deficit of cerebellar activation in the schizophrenia group might underlie the inability to search and consider compromising responses for conflict resolution. (JINS, 2009, 15, 990–1001.)