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배경 Hand hygiene (HH) is a cornerstone of infection control. A review of HH studies by the World Health Organization (WHO) found that the baseline compliance of HH among healthcare personnel was only an average of 40%. The HH promotion activities are known to be effective, but there is limited data on the long-term effect. This study aimed to investigate the long-term effect of HH promotion activities. 방법 The study institution is a 734-bed acute-care referral hospital in South Korea. The study institution launched the HH promotion team in 2010 and has been conducting interventions, including goal setting, observation and feedback, education, reward incentive, and accountability. We retrospectively collected HH and optimal HH compliance rates for 12 years (from 2010 to 2021). The HH compliance rate was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on the 6-step technique from the WHO recommendations. We followed the HH monitoring methods using direct observation methods as per the WHO. Poisson regression analysis was used to determine the trend of HH compliance according to years. 결과 In 2010, the HH and optimal HH compliance rates were 59.7% and 15.6%, respectively. The HH com- pliance rate increased to 83.9% in 2013 and was maintained at 80% except in 2016 (75.5%) and 2017 (77.4%). The HH compliance rate increased significantly with a relative ratio (RR) of 1.014 (1.002-1.025, P = 0.018). The optimal HH compliance rate increased to 67.8% in 2013 and was maintained at 60% except in 2016 (58.8%) and 2019 (59.8%). The optimal HH compliance has a trend of increasing with RR 1.033 (0.991-1.076, P = 0.123) (Figure 1). The HH and optimal HH compliance per job categories (nurses, doctors, and other healthcare workers) increased significantly for 12 years (Figure 2). 결론 Overall compliance in the study hospital increased over time. The HH promotion team activities can improve and maintain optimal HH compliance among healthcare personnel. To maintain compliance, the HH promotion team activities should be effective and encouraged. [ABSTRACT FROM AUTHOR]

During our on-going screening program designed to isolate natural compounds from marine environments, we isolated isoketochabrolic acid (IKCA) from Sargassum micracanthum, an important brown algae distributed in Jeju Island, Korea. Furthermore, we evaluated the inhibitory effects of IKCA on nitric oxide (NO) production in lipopolysaccharide (LPS)-triggered macrophages. IKCA strongly inhibited NO production, with an IC50 value of 58.31 µM. Subsequent studies demonstrated that IKCA potently and concentration-dependently reduced prostaglandin E2 (PGE2), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1ß, and IL-6 cytokine production. In conclusion, to the best of our knowledge, this is the first study to show that IKCA isolated from S. micracanthum has a potent anti-inflammatory activity. Therefore, IKCA might be useful as an anti-inflammatory health supplement or functional cosmetics. [ABSTRACT FROM AUTHOR]

Purpose: The administration of recombinant human growth hormone in adults with growth hormone deficiency has been known to improve metabolic impairment and quality of life. Patients, however, have to tolerate daily injections of growth hormone. The efficacy, safety, and compliance of weekly administered sustained-release recombinant human growth hormone (SR-rhGH, Declage™) supplement in patients with growth hormone deficiency were evaluated. Materials and Methods: This trial is 12-week prospective, single-arm, open-label trial. Men and women aged ≥20 years with diagnosed growth hormone deficiency (caused by pituitary tumor, trauma and other pituitary diseases) were eligible for this study. Each subject was given 2 mg (6 IU) of SR-rhGH once a week, subcutaneously for 12 weeks. Efficacy and safety at baseline and within 30 days after the 12th injection were assessed and compared. Score of Assessment of Growth Hormone Deficiency in Adults (AGHDA score) for quality of life and serum IGF-1 level. Results: The IGF-1 level of 108.67±74.03 ng/mL was increased to 129.01±68.37 ng/mL (p=0.0111) and the AGHDA QoL score was decreased from 9.80±6.51 to 7.55±5.76 (p<0.0001) at week 12 compared with those at baseline. Adverse events included pain, swelling, erythema, and warmth sensation at the administration site, but many adverse events gradually disappeared during the investigation. Conclusion: Weekly administered SR-rhGH for 12 weeks effectively increased IGF-1 level and improved the quality of life in patients with GH deficiency without serious adverse events. [ABSTRACT FROM AUTHOR]

Plasma actuators are used to control far-field noise in Mach 1.65 jets from contoured and conical supersonic axisymmetric nozzles (henceforth, contoured and conical jets, respectively). The contoured nozzle is designed using the method of characteristics for a shock-free jet. The conical nozzle has converging and diverging conical sections with a sharp throat. Eight plasma actuators, distributed uniformly around the nozzle exit, are used and the jet is forced with azimuthal modes (m) 0-3 and ±4 and forcing Strouhal numbers ranging from 0.09 to 4.0. The far-field acoustic noise is measured by a linear microphone array covering polar angles from 25 deg to 80 deg relative to the jet axis. In both jets, the lower forcing azimuthal modes (m = 0 and 1) are less effective than the higher modes (m = 2, 3, and ±4), which have similar levels of overall sound pressure level (OASPL) reduction. At shallow angles relative to the jet axis, the reduction in OASPL is about 1.6-1.8 dB at low forcing Strouhal numbers in both jets at the most effective forcing mode of m = 3. However, the OASPL in the sideline direction is only slightly increased (about 1 dB)for both the contoured and conical jets at m = 3. The reduction at shallow polar angles is related to the decrease in the peak mixing noise level in both jets. The range of forcing Strouhal numbers providing significant noise reduction and the range of polar angles over which the noise is reduced are both much larger in the conical jet compared with the contoured jet. The screech tones are also reduced or suppressed -- most likely due to weakening of naturally occurring structures by forcing. [ABSTRACT FROM AUTHOR]

The main goal of the present work is to excite various instabilities of an axisymmetric Mach 0.9 jet with a ReD of 0.76 x 106, track the ensuing large-scale structures/instability waves, and investigate relations between the dynamics of these structures and the far-field sound. The jet was excited over a large range of Strouhal numbers and several azimuthal modes by eight localized arc filament plasma actuators, equally spaced around the circumference of the nozzle, near the nozzle exit. The flow field and far-field noise were investigated using particle image velocimetry and a three-dimensional array of 12 microphones at 30° polar angle to the downstream jet axis. The microphone array results show that the high amplitude noise radiated to 30° polar angle is originated just downstream of the end of the potential core, in agreement with our previous results and the results in the literature. The streamwise noise source distribution was only sensitive to azimuthal modes around the jet preferred mode. Otherwise, the general trend was that forcing the jet at low Strouhal numbers moves the distribution upstream compared to the baseline jet, and at high Strouhal numbers results in a source distribution similar to the baseline jet. Conditionally-averaged PIV data were used to relate the flow dynamics and noise sources. The growth, saturation, and decay of the conditionally-averaged velocity fluctuations along the jet centerline correlate well with the far-field noise and the noise source distribution estimated using the microphone array. For m = 0 mode excitation around the jet column Strouhal number, the conditionally-averaged streamwise velocity fluctuations correlate well with the noise source distribution. While for m = 1, the correlation is best with the conditionally-averaged cross-stream fluctuations. [ABSTRACT FROM AUTHOR]

To develop a new potent anti-melanogenic agent, we have conjugated lipoic acid (LA) to poly (ethylene) glycol (PEG) of molecular weight 2000 and examined the effects on inhibition of tyrosinase activity and melanin synthesis in B16F10 melanoma cells. The water-soluble LA–PEG 2000 was synthesized from LA and methylated PEG by an esterification reaction in the presence of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide. Synthetic LA–PEG 2000 was confirmed by IR and 1H-NMR spectroscopy. The new conjugate is a highly water-soluble molecule, which has lower cell cytotoxicity than LA. Treatment with LA–PEG 2000 significantly suppressed the biosynthesis of melanin by up to 63% at 0.25 mM and reduced tyrosinase activity by up to 80% at 0.50 mM in B16F10 melanoma cells. Furthermore, Western blot and RT-PCR studies indicated that treatment with LA–PEG 2000 decreased the level of tyrosinase, which is a melanogenic enzyme. Taken together, these results suggest that LA–PEG 2000 may inhibit melanin biosynthesis by down-regulating levels and expression of tyrosinase activity. Therefore, LA–PEG 2000 can be used effectively as a new agent to inhibit melanogenesis, with lower cytotoxicity than LA (parent molecule) in B16F10 melanoma cells. [ABSTRACT FROM AUTHOR]

Experiments were conducted to measure convective velocity of large-scale structures in the shear layer of a Mach 2.0 free jet with a convective Mach number of 0.87 and Reynolds number based on a nozzle diameter of 2.6×106. Real-time flow visualization and planar Doppler velocimetry (PDV) measurements along with space-time correlation were used. The results reveal that regardless of the measurement technique employed, whether qualitative flow visualization or quantitative PDV, the method of seeding can have a significant effect on the ability to accurately identify, track, and measure convective velocity of large-scale structures. This is apparent by the relatively large spread in convective velocity results obtained in the same jet by using various methods of seeding and qualitative and quantitative visualization. Convective velocity measurements made under the best seeding conditions available with PDV indicate a convective velocity of structures that is close to the value predicted by theory up to the convective Mach number of 0.87 used in the current work. This is in contrast to previously reported convective velocity measurements (including those of the present authors) that indicated a deviation from the theoretically predicted value but were based on measurements made under less than ideal seeding conditions. [ABSTRACT FROM AUTHOR]

Flavonoids and related compounds exhibit a wide range of useful pharmacological properties but present challenges related to their stability and solubility in commonly available solvents. In this study, polymethyl methacrylate (PMMA) microcapsules were prepared using a novel polyol-in-oil-in-polyol (P/O/P) emulsion solvent evaporation method as a means of stabilizing the flavonoids, using quercetin as a model flavonoid drug. The morphology of the microcapsules was evaluated using a scanning electron microscope, revealing a spherical shape with a smooth surface. The cross-section image of the PMMA microcapsules prepared with an amphiphilic polymer in the inner polyol phase showed that the microcapsule was filled with several submicron microspheres. The mean diameter varied from 1.03±0.12 μm to 2.39±0.42 μm, and the encapsulation efficiency ranged from 12.7% to 26.9%. When free quercetin was stored at 42°C, the residual quercetin content gradually decreased to 18% over 28 days as a result of oxidation. However, when encapsulated in PMMA microcapsules with an amphiphilic polymer in the inner polyol phase, the residual quercetin content decreased to just 82%. In-vitro release studies indicated a sustained release pattern throughout the 36-h study. The release kinetics of the microcapsules with an amphiphilic polymer followed a diffusion-controlled mechanism and the microcapsule without amphiphilic polymer followed an anomalous diffusion behaviour. This study suggests that the novel P/O/P emulsion solvent evaporation method can be applied to the encapsulation of flavonoids. [ABSTRACT FROM AUTHOR]

Although many hypo-pigmenting agents are currently available, the demand for novel whitening agents is increasing, in part due to the weak effectiveness and unwanted side effects of currently available compounds. To screen for novel hypo-pigmenting agents, many methodologies such as cell culture and enzymatic assays are routinely used. However, these models have disadvantages in terms of physiological and economic relevance. In this study, we validated zebrafish as a whole-animal model for phenotype-based screening of melanogenic inhibitors or stimulators. We used both the well-known melanogenic inhibitors (1-phenyl-2-thiourea, arbutin, kojic acid, 2-mercaptobenzothiazole) and newly developed small molecule compounds (haginin, YT16i). All the tested compounds produced inhibitory effects on the pigmentation of zebrafish, most likely due to their inhibitory potential on tyrosinase activity. In simultaneous in vivo toxicity tests, a newly developed melanogenic inhibitor YT16i showed massive abnormalities in terms of deformed morphologies and cardiac function. Together, these results provide a rationale in screening and evaluating the putative melanogenic regulatory compounds. We suggest that the zebrafish system is a novel alternative to mammalian models, with several advantages including the rapidity, cost-effectiveness, and physiological relevance. [ABSTRACT FROM AUTHOR]

A theoretical analysis is carried out to predict the amplification of turbulence in flows experiencing one-dimensional and axisymmetric dilatations. When three representative vortices are tracked, the variations of Vortex radius and vorticity are calculated, and then the amplification of turbulence is obtained from them. When a vortex is tracked, conservation laws of mass and angular momentum of the vortex are used. For a one dimensionally compressed flow, the present analysis slightly underestimates the amplification of velocity fluctuations and turbulent kinetic energy, relative to that of rapid distortion theory in the solenoidal limit. For an axisymmetrically distorted flow, the amplification of velocity fluctuations and turbulent kinetic energy and the anisotropy depend not only on the density ratio, but also on the ratio of streamwise mean velocities, which represents streamwise vortex contraction/stretching. The amplification predicted by the present analysis is in excellent agreement with that by the rapid distortion theory. In both flows, the amplification of turbulence is dictated by the mean density ratio, whereas the anisotropy is primarily dictated by the flow boundary. However, streamwise vortex stretching/contraction alters the amplification slightly and the anisotropy significantly in the axisymmetric flow. [ABSTRACT FROM AUTHOR]

Predicts the effects of bulk expansion and compression on turbulence levels in supersonic boundary layers. Variation of vorticity through perturbation; Schematic of a quasi-two-dimensional boundary layer with the coordinate system used; Turbulence intensity variation; Comparison of the predicted amplification factor with experimental results for compression flows.

A number of fish species have been used for studies on endocrine disrupting chemicals (EDCs). However, despite the widespread use of oviparous fish, relatively little attention has been given to viviparous species. This study investigated the effects of EDCs in a viviparous fish and examined the possible usefulness of the fish as an alternative model for the studies on EDCs. Swordtails (Xiphophorus helleri) were exposed to nonylphenol (NP), bisphenol A (BPA), and their mixture. Both short-term (3- d) and relatively long-term (60-d) exposures were carried out using adult male and 30-d-old juvenile fish, respectively. Following the short-term exposure, both NP and BPA caused vitellogenin mRNA expression. Flow cytometric analysis and terminal deoxynucleotidyl transferase assay on the testes of treated fish indicated reproductive damage. Histopathological analysis found degenerative and necrotic cells in seminiferous tubules following the exposure to 100 ppb NP. The testes with lesions were also associated with highly suppressed spermatogenesis. Following the long-term exposure, both NP and BPA exposures significantly affected the growth of swordtails. In all cases, the results showed that the mixture was always more potent than a single chemical and that swordtail fish can be a useful model for the study of endocrine disruptors. [ABSTRACT FROM AUTHOR]

Background:Fine-needle aspiration diagnosis of follicular carcinoma presents a dilemma because malignancy is confirmed when vascular or capsular invasion is present. Completion thyroidectomy may be necessary when the diagnosis of follicular carcinoma is made following hemithyroidectomy. Ablation of the remaining lobe with radioactive iodine has been used as an alternative to completion thyroidectomy. Here we report an unusual apparent complication of this treatment.Patient Findings:A 51-year-old woman presented in September 24, 2009 with a stony, hard calcification of left thyroid gland. She complained of recent progressive hoarsening of her voice. Her medical history was positive for a subtotal thyroidectomy on September 6, 1993. Histologic analysis identified follicular carcinoma. Two months postoperatively, the remaining tissue was ablated with 131I (150 mCi) as an alternative to completion thyroidectomy. We performed computed tomography of the neck, which demonstrated 1.6 × 1.9 × 2.2 cm dense speculated calcification of the entire left residual thyroid gland. The calcification infiltrated the trachea wall. Completion thyroidectomy, including resection of the calcification, was performed. Histologic examination revealed dystrophic calcification.Conclusion:We report an unusual replacement of the thyroid remnant with calcification that developed over a period of 16 years following radioactive iodine lobe ablation as an alternative to completion thyroidectomy for thyroid follicular carcinoma. To our knowledge, this is the first such case in the English language literature. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Effects of Rebamipide on Gastrointestinal Symptoms in Patients With Type 2 Diabetes Mellitus," that was published in the previous issue.

The article focuses on the correlation of thyroid hormone condition with insulin resistance, and reflects on correlation between ghrelin, leptin, andinsulin hormone.

A response from the author of the article "Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus" in the 2013 issue is presented.

Abstract Background Hand hygiene (HH) is a fundamental component of infection prevention and control in healthcare settings. This study aimed to identify knowledge, attitude, and barriers to HH according to occupational groups and strategies to increase the rate of HH compliance among healthcare workers (HCWs). Methods This cross-sectional survey was conducted in July 2018 at four university-affiliated hospitals. The survey comprised seven parts with 49 items, including self-reported HH compliance, knowledge, attitudes, behaviours, barriers to HH, and improvement strategies. Results A total of 1046 HCWs participated in the survey. The nursing group’s self-reported HH compliance rate was the highest, followed by other HCWs and physicians. The scores regarding knowledge, attitudes, and behaviours regarding HH were the highest in the nursing group. The nursing group also had higher internal and emotional motivation scores. Physicians and nurses found HH the most challenging in emergencies, while other HCWs considered skin problems caused by HH products the most significant barrier. Among 12 improvement measures, approximately 20% of the respondents ranked “diversify types of hand sanitisers,“ “install soap and paper towels in each hospital room,“ and “change perception through various HH campaigns” as the top three priorities. The physician group deemed the timely reminder of HH compliance as the second most critical improvement measure. Conclusion Differences in knowledge, attitude and barriers hindering HH compliance and improvement plans were identified for each group. The findings suggest that targeted interventions tailored to the specific needs of different occupational groups may effectively improve HH compliance in healthcare settings.

Abstract Background Although sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus, real-world evidence regarding their benefits to diabetic patients with acute myocardial infarction (AMI) is insufficient. This study evaluated cardiovascular outcomes by comparing SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4i) in combination with metformin in diabetic patients with AMI. Methods This study involved 779 diabetic participants with AMI from a Korean nationwide multicenter observational cohort, who were divided into two groups: (1) metformin plus SGLT2i group (SGLT2i group, n = 186) and (2) metformin plus DPP-4i (DPP-4i group, n = 593). The primary endpoint was one year of major adverse composite events (MACEs), a composite outcome of all-cause mortality, non-fatal myocardial infarction, any revascularization, cerebrovascular accident, and stent thrombosis. To balance the baseline differences, inverse probability of treatment weighting (IPTW) was performed. Results After IPTW, the rate of MACEs in the SGLT2i group was not significantly lower than that in the DPP-4i group (hazard ratio [HR], 0.99; 95% confidence interval [Cl], 0.46 to 2.14, p = 0.983). In the unadjusted and adjusted analyses, all items for clinical outcomes were comparable between the two groups. In our exploratory analysis, the left ventricular ejection fraction showed a significant improvement in the SGLT2i group than in the DPP-4i group before achieving statistical balancing (6.10 ± 8.30 versus 2.95 ± 10.34, p = 0.007) and after IPTW adjustment (6.91 ± 8.91 versus 3.13 ± 10.41, p = 0.027). Conclusions Our findings demonstrated that SGLT2i did not influence the rate of MACEs compared with DPP-4i in combination with metformin in diabetic patients with AMI but did improve left ventricular ejection fraction. Trial registration Not applicable (retrospectively registered).