This study aimed to develop a predictive tool for identifying individuals with high antibody titers crucial for recruiting COVID-19 convalescent plasma (CCP) donors and to assess the quality and storage changes of CCP. A convenience sample of 110 plasma donors was recruited, of which 75 met the study criteria. Using univariate logistic regression and random forest, 6 significant factors were identified, leading to the development of a nomogram. Receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) evaluated the nomogram’s discrimination, calibration, and clinical utility. The nomogram indicated that females aged 18 to 26, blood type O, receiving 1 to 2 COVID-19 vaccine doses, experiencing 2 symptoms during infection, and donating plasma 41 to 150 days after symptom onset had higher likelihoods of high antibody titres. Nomogram’s AUC was 0.853 with good calibration. DCA showed clinical benefit within 9% ~ 90% thresholds. CCP quality was qualified, with stable antibody titres over 6 months (P > 0.05). These findings highlight developing predictive tools to identify suitable CCP donors and emphasize the stability of CCP quality over time, suggesting its potential for long-term storage.

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.

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.

Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.

As part of a long-term experiment to determine the impacts of composted manure and straw amendments (replacing 50% of chemical fertilizer with composted pig manure, wheat straw return combined with chemical fertilizer, and setting no fertilizer and chemical fertilizer-only as controls) on rice-associated weeds in a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, species richness, abundance, density, and biomass of weeds were assessed during years 8 and 9. Fertilization decreased the species richness and total density of rice-associated weeds but increased their total biomass. The species richness and densities of broadleaf and sedge weeds decreased with fertilization, while species richness of grass weeds increased only with straw return and density was not significantly affected. The shoot biomass per square meter of grass and broadleaf weeds was significantly higher with fertilization treatments than with the no-fertilizer control, while that of sedge weeds declined with fertilizer application. With fertilization, the densities of monarch redstem (Ammannia baccifera L.) and smallflower umbrella sedge (Cyperus difformis L.) decreased, that of Chinese sprangletop [Leptochloa chinensis (L.) Nees] increased, and those of barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.] and monochoria [Monochoria vaginalis (Burm. f.) C. Presl ex Kunth] were not significantly affected. Ammannia baccifera was the most abundant weed species in all treatments. Whereas composted pig manure plus fertilizer resulted in higher density of A. baccifera and lower shoot biomass per plant than chemical fertilizer only, wheat straw return plus chemical fertilizer caused lower density and shoot biomass of A. baccifera. Therefore, it may be possible that fertilization strategies that suppress specific weeds could be used as improved weed management program components in rice production systems.

This paper presents a modularized autonomous pipeline inspection robot called MRINSPECT VII+, which we recently developed. MRINSPECT VII+ is aimed at inspect in-service urban gas pipelines with a diameter of 200 mm. The robot consists of five basic modules: driving, sensing, joint, and battery modules. For nondestructive testing (NDT), an NDT module can be added to the system. The driving module uses a multiaxial differential gear mechanism to provide traction forces to the robot. The sensor module recognizes the pipeline element using position-sensitive detector (PSD) sensors and a CCD camera. The control module contains a computing unit and manages the robot’s autonomous navigation. The battery module supplies power to the system. Each module is connected via backdrivable active joint modules, which provide flexibility while moving inside narrow pipelines. Additionally, the wireless communication module helps the system communicate with the ground station. We tested MRINSPECT VII+ in real pipeline environments and validated its feasibility successfully.

This study aimed to investigate the environmental contamination of nucleic acid at 2019 novel coronavirus (2019-nCOV) vaccination site and to evaluate the effect of improvement to the vaccination process. Nucleic acid samples were collected from the surface of the objects in 2019-nCOV vaccination point A (used between 15 November 2020 and 25 December 2020) and point B (used after 27 December 2020) in a comprehensive tertiary hospital. Samples were collected from point A before improvement to the vaccination process, and from point B (B1 and B2) after improvement to the vaccination process. The real-time fluorescence polymerase chain reaction method was used for detection. The positive rate of vaccination room was 47.06% (24/51) at point A. No positive result was found in point B1 both at working hours (0/27) and after terminal disinfection (0/27). In point B2, the positive results were found in vaccine's outer packaging and staff gloves at working hours, with a positive rate of 7.41% (2/27). The positive rate was 0 (0/27) after terminal disinfection in point B2. The nucleic acid contamination in the vaccination room of 2019-nCOV vaccine nucleic acid sampling point is serious, which can be avoided through the improvement and intervention (such as personal protection, vaccination operation and disinfection methods).

Background: We describe and evaluate our outbreak of carbapenem-resistant K. pneumoniae transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) were identified from bile specimens of 4 patients. The investigation included medical record review, practice audits, and surveillance cultures of duodenoscopes and environmental sites. If available, clinical specimens were obtained from patients who had undergone ERCP in the previous 3 months. Carbapenem-resistant Enterobacteriaceae (CRE) screening cultures were performed to identify additional patients until no CRE cases were detected during 2 consecutive weeks. Pulsed-field gel electrophoresis (PFGE) of KPC-KP isolates was implemented. Results: In total, 12 cases were identified with exposure to duodenoscope from February 2019 through April 2019, including 6 cases with infections and 6 asymptomatic carriers. Case-control analysis showed that 2 specific duodenoscopes would be associated with the KPC-KP outbreak. Duodenoscope reprocessing procedures did not deviate from manufacturer recommendations for reprocessing. After ethylene oxide (EO) gas sterilization, the outbreak was terminated. Conclusions: Meticulous cleaning protocol and enhanced surveillance are necessary to prevent outbreaks of CRE. Notably, enhanced cleaning measures, such as sterilization for duodenoscopes, would be required after procedures with KPC-KP carriers.

Funding: None

Disclosures: None

The effects of trace Ca and Sr addition on dynamic precipitates, dynamic recrystallization (DRX) behavior, and texture evolution of Mg–5Zn alloy sheets fabricated by high strain rate rolling (HSRR) were investigated by electron backscattered diffraction (EBSD), transmission electron microscopy (TEM), small-angle X-ray scattering (SAXS), and X-ray diffraction (XRD). The Zn-rich precipitates formed with plate shapes, short-rod shapes, and near-spherical shapes, indicating that the most important function of adding Ca and Sr is to promote the precipitation process. The precipitate density increases, but the precipitate size and DRX volume fraction decrease with the addition of the alloying elements. It is concluded that the effects of combined Ca/Sr addition on promoting precipitation and refining precipitate size are more effective than that of single Ca addition, and the reduction in DRX volume fraction can be attributed to the inhibition of fine precipitation on the nucleation and growth of DRX. Moreover, the macro-texture intensity is mainly related to DRX as the DRX grains are much more randomly oriented than deformed grains. In addition, the texture intensity in DRX regions is primarily associated with the precipitates, which can inhibit DRX grain rotation due to their pinning effect on the grain boundaries.

The CoCrNiMox (x = 0, 0.1, and 0.2 in molar ratio) medium entropy alloys (MEAs) were fabricated by vacuum arc melting, followed by cold rolling and annealing treatments. The X-ray diffraction (XRD), electron back-scattered diffraction (EBSD), and transmission electron microscopy (TEM) were employed to characterize the microstructures. It has been shown that the CoCrNi MEA has a single FCC phase and the Mo-containing MEAs contain (Cr, Mo)-rich σ precipitates. In addition, the Mo addition caused significant grain refinement, due to the fact that the presence of σ phase exerts a strong pinning effect on the grain boundary migration. The hardness testing results indicate an increment in Vickers hardness from 187.5 ± 4.5 Hv of CoCrNi alloy to 309.5 ± 10.3 Hv of CoCrNiMo0.2 alloy. The yield strength and ultimate tensile strength also increase from 339 ± 2 to 644 ± 5 MPa and from 810 ± 5 to 1071 ± 17 MPa, respectively, but the elongation drops from 88.4 ± 4.0% to 29.5 ± 7.6%. The grain refinement and the precipitation of σ phase make synergistic contribution to the reinforcement of Mo-containing CoCrNi-based MEAs. The details and explanations in this study may guide the future design and research of the CoCrNi-based quaternary alloys with enhanced properties.

The microstructure evolution, dynamic recrystallization (DRX) and precipitation of the ZM61 alloy sheets prepared with different rolling conditions were studied. The DRX grain sizes (dDRX) at four high strain rate rolling (HSRR) temperatures (275–350 °C) are 1.9, 2.3, 2.6 and 3.1 μm, respectively, while the DRX volume fractions (fVDRX) are 69, 73, 76 and 82%, respectively. 300 °C is selected as the optimal HSRR temperature. The dDRX and fVDRX of the alloys prepared by pre-rolling (PR) at 300 °C + HSRR are 1.0 μm and 91%, respectively. The PR treatment does not change the types of the precipitates but promotes the precipitation. The tensile strength (UTS) of 369 MPa and yield strength (YS) of 261 MPa can be achieved by HSRR at 300 °C, while a further increase in both UTS and YS can be obtained by PR treatment.

A number of microorganisms were hypothesised as an aetiology of the Kawasaki disease. Unfortunately, no specific agent that provides reproducible evidence has yet been reported. We report two cases of extremely rare Kawasaki disease with tsutsugamushi disease. These case reports suggest that Kawasaki disease can rarely occur concurrently or immediately after a rickettsial illness such as tsutsugamushi disease.

The mammary gland, a unique exocrine organ, is responsible for milk synthesis in mammals. Neonatal growth and health are predominantly determined by quality and quantity of milk production. Amino acids are crucial maternal nutrients that are the building blocks for milk protein and are potential energy sources for neonates. Recent advances made regarding the mammary gland further demonstrate that some functional amino acids also regulate milk protein and fat synthesis through distinct intracellular and extracellular pathways. In the present study, we discuss recent advances in the role of amino acids (especially branched-chain amino acids, methionine, arginine and lysine) in the regulation of milk synthesis. The present review also addresses the crucial questions of how amino acids are transported, sensed and transduced in the mammary gland.