Epidemiologic characteristics of children who visited an emergency department: a single center study over three years

Purpose Increasing visit of children to emergency departments (EDs) necessitates the effort to expand pediatric emergency medicine resources. We conducted this study to understand the epidemiologic characteristics of children who visited a community hospital ED. Methods The medical records of 32,031 children aged younger than 18 years were reviewed retrospectively from January 2013 to December 2015. We analyzed the age distribution, season, day, and time of visit, cause of visit, test performed, initial diagnosis, injury mechanisms, and disposition. Results Mean age of the children was 6.2±5.1 years and boys accounted for 59.1%. Children who had disease (65.5%) and aged 1 to 4 years (41.9%) accounted for the largest population. There was no difference of age distribution through seasons (P = 0.07). The proportions of children with disease and injury were the highest during winter (72.5%) and autumn (38.2%), respectively (P < 0.001). Children tended to visit the ED more frequently during non-business hours. In particular, children who aged 1 to 4 years, had disease or were slight ill visited the ED more frequently during this period (P < 0.001). Plain abdomen radiographs and urinalyses were performed to 29.8% and 16.1% of the children, respectively. Functional gastrointestinal disorder (20.3%) and laceration (30.1%) were the most common initial diagnoses among the children with disease and injury, respectively. The most common injury mechanism was struck injury (29.7%). After the treatment, 94.4% of the children were sent home from the ED. Of the remaining children, 5.5% were admitted, 0.1% were transferred to other hospitals, and 0.04% expired. Conclusion Children who aged 1 to 4 years, had disease or were slight ill visited the ED more frequently during non-business hours than business hours. Pediatric emergency medicine resources should be expanded in consideration of this

A Case of Primary Infective Endocarditis Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in a Healthy Individual and Colonization in the Family

Primary community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) endocarditis has rarely been reported in healthy individuals without risk factors, such as skin and soft tissue infections, and intravenous drug abuse. We describe a case of infective endocarditis by CA-MRSA (ST72-PVL negative-SCCmec IVA) in previously healthy individuals with no underlying medical condition and CA-MRSA colonization in the family

Epiregulin and EGFR interactions are involved in pain processing

The EGFR belongs to the well-studied ErbB family of receptor tyrosine kinases. EGFR is activated by numerous endogenous ligands that promote cellular growth, proliferation, and tissue regeneration. In the present study, we have demonstrated a role for EGFR and its natural ligand, epiregulin (EREG), in pain processing. We show that inhibition of EGFR with clinically available compounds strongly reduced nocifensive behavior in mouse models of inflammatory and chronic pain. EREG-mediated activation of EGFR enhanced nociception through a mechanism involving the PI3K/AKT/mTOR pathway and matrix metalloproteinase-9. Moreover, EREG application potentiated capsaicin-induced calcium influx in a subset of sensory neurons. Both the EGFR and EREG genes displayed a genetic association with the development of chronic pain in several clinical cohorts of temporomandibular disorder. Thus, EGFR and EREG may be suitable therapeutic targets for persistent pain conditions

Development of multiplex real-time PCR for rapid identification and quantitative analysis of Aspergillus species.

The identification of Aspergillus species and azole resistance is highly important for the treatment of invasive aspergillosis (IA), which requires improvements in current fungal diagnostic methods. We aimed to develop multiplex real-time PCR to identify major Aspergillus section and azole resistance. BenA and cyp51A genes were used to design primers, probes, and control DNA for multiplex PCR. Qualitative and quantitative analysis was conducted for 71 Aspergillus and 47 non-Aspergillus isolates. Further, the limit of detection (LOD) and limit of quantitation (LOQ) from hyphae or conidia were determined according to the culture time. Newly developed real-time PCR showed 100% specificity to each Aspergillus section (Fumigati, Nigri, Flavi, and Terrei), without cross-reaction between different sections. In quantitative analysis of sensitivity measurements, LOD and LOQ were 40 fg and 400 fg, respectively. Melting temperature analysis of the cyp51A promoter to identify azole resistance showed temperatures of 83.0 ± 0.3°C and 85.6 ± 0.6°C for susceptible A. fumigatus and resistant isolates with TR34 mutation, respectively. The minimum culture time and fungal colony size required for successful detection were 24 h and 0.4 cm in diameter, respectively. The developed multiplex real-time PCR can identify common Aspergillus sections quantitatively and detect presence of the TR34 mutation. Further, this method shows high sensitivity and specificity, allowing successful detection of early-stage fungal colonies within a day of incubation. These results can provide a template for rapid and accurate diagnosis of IA

A Novel Egr-1-Agrin Pathway and Potential Implications for Regulation of Synaptic Physiology and Homeostasis at the Neuromuscular Junction

Synaptic transmission requires intricate coordination of the components involved in processing of incoming signals, formation and stabilization of synaptic machinery, neurotransmission and in all related signaling pathways. Changes to any of these components cause synaptic imbalance and disruption of neuronal circuitry. Extensive studies at the neuromuscular junction (NMJ) have greatly aided in the current understanding of synapses and served to elucidate the underlying physiology as well as associated adaptive and homeostatic processes. The heparan sulfate proteoglycan agrin is a vital component of the NMJ, mediating synaptic formation and maintenance in both brain and muscle, but very little is known about direct control of its expression. Here, we investigated the relationship between agrin and transcription factor early growth response-1 (Egr-1), as Egr-1 regulates the expression of many genes involved in synaptic homeostasis and plasticity. Using chromatin immunoprecipitation (ChIP), cell culture with cell lines derived from brain and muscle, and animal models, we show that Egr-1 binds to the AGRN gene locus and suppresses its expression. When compared with wild type (WT), mice deficient in Egr-1 (Egr-1−/−) display a marked increase in AGRN mRNA and agrin full-length and cleavage fragment protein levels, including the 22 kDa, C-terminal fragment in brain and muscle tissue homogenate. Because agrin is a crucial component of the NMJ, we explored possible physiological implications of the Egr-1-agrin relationship. In the diaphragm, Egr-1−/− mice display increased NMJ motor endplate density, individual area and area of innervation. In addition to increased density, soleus NMJs also display an increase in fragmented and faint endplates in Egr-1−/− vs. WT mice. Moreover, the soleus NMJ electrophysiology of Egr-1−/− mice revealed increased quantal content and motor testing showed decreased movement and limb muscle strength compared with WT. This study provides evidence for the potential involvement of a novel Egr-1-agrin pathway in synaptic homeostatic and compensatory mechanisms at the NMJ. Synaptic homeostasis is greatly affected by the process of aging. These and other data suggest that changes in Egr-1 expression may directly or indirectly promote age-related pathologies

Spatial and Temporal Exposure Assessment to PM2.5 in a Community Using Sensor-Based Air Monitoring Instruments and Dynamic Population Distributions

This research was to conduct a pilot study for two consecutive days in order to assess fine particulate matter (PM2.5) exposure of an entire population in a community. We aimed to construct a surveillance system by analyzing the observed spatio-temporal variation of exposure. Guro-gu in Seoul, South Korea, was divided into 2,204 scale grids of 100 m each. Hourly exposure concentrations of PM2.5 were modeled by the inverse distance weighted method, using 24 sensor-based air monitoring instruments and the indoor-to-outdoor concentration ratio. Population distribution was assessed using mobile phone network data and indoor residential rates, according to sex and age over time. Exposure concentration, population distribution, and population exposure were visualized to present spatio-temporal variation. The PM2.5 exposure of the entire population of Guro-gu was calculated by population-weighted average exposure concentration. The average concentration of outdoor PM2.5 was 42.1 &micro;g/m3, which was lower than the value of the beta attenuation monitor measured by fixed monitoring station. Indoor concentration was estimated using an indoor-to-outdoor PM2.5 concentration ratio of 0.747. The population-weighted average exposure concentration of PM2.5 was 32.4 &micro;g/m3. Thirty-one percent of the population exceeded the Korean Atmospheric Environmental Standard for PM2.5 over a 24 h average period. The results of this study can be used in a long-term aggregate and cumulative PM2.5 exposure assessment, and as a basis for policy decisions on public health management among policymakers and stakeholders

Nanowire-assisted freestanding liquid metal thin-film patterns for highly stretchable electrodes on 3D surfaces

Abstract Stretchable electronics is playing an integral role in fields such as wearable electronics and soft robots. Among soft conductive materials, liquid metal is drawing intense attention as an electrode material due to its liquid nature at room temperature. However, the merits of liquid metal conductor are limited by the presence of substrates or enclosed microchannels from physical disturbances by the underlying substrate when applying it to 3D surface and modifying complex circuit. To overcome this limitation, we develop freestanding patterned liquid metal thin-film conductor (FS-GaIn). FS-GaIn was achieved by introducing metal nanowires to liquid metal and subsequent sequential selective laser processing and etching of directly patterned traces. FS-GaIn can be applied directly to nonflat surface without substrates. When incorporated into electrical circuits, FS-GaIn shows high electrical conductivity, stretchability, and stability. The concept of freestanding liquid metal can open a functionality to the conventional liquid metal electronics

One-dimensional nanostructured vanadium oxides with single-crystalline structure synthesized by cellulose nanocrystal-template-assisted hydrothermal method for Li-ion battery cathodes

Cellulose nanocrystals (CNCs) have emerged as a promising templating material due to unique features, such as high surface area, surface hydroxyl groups and rod-like shape, which allow for sustainable nanoscale control of advanced functional materials. Especially, such high surface functionality and specific morphology can be imparted on the resultant nanomaterials with beneficial properties during templating. Here, we present synthesis of one-dimensional (1D) nanostructured vanadium oxides, such as VO2(B) and V2O5·nH2O nanobelts, with single- crystalline structure by hydrothermal treatment using CNCs as a sacrificial template. Importantly, the single-crystal vanadium oxide nanobelts exhibit the enhanced electrochemical performance of Li ion batteries with high specific capacity (> 300mAh/g) and long lifespan (> 244mAh/g at 50 cycles) compared to the polycrystalline nanoflakes counterpart. Furthermore, we suggest that during hydrothermal treatment the sacrificial CNC template-derived carbon is beneficial for electron transfer in cathode materials. Thus, we demonstrate that the utilization of CNC templating to develop novel single-crystalline oxide cathode nanomaterials can provide a fruitful pathway for extraordinary electrochemical performance of next-generation alkaline batteries. © 2023, The Author(s), under exclusive licence to Springer Nature B.V.FALS

A Simple Method for the Design and Development of Flavivirus NS1 Recombinant Proteins Using an In Silico Approach

Even in countries that are currently not facing a flavivirus epidemic, the spread of mosquito-borne flaviviruses presents an increasing public threat, owing to climate change, international travel, and other factors. Many of these countries lack the resources (viral strains, clinical specimens, etc.) needed for the research that could help cope with the threat imposed by flaviviruses, and therefore, an alternative approach is needed. Using an in silico approach to global databases, we aimed to design and develop flavivirus NS1 recombinant proteins with due consideration towards antigenic variation. NS1 genes analyzed in this study included a total of 6,823 sequences, from Dengue virus (DENV), Japanese encephalitis virus (JEV), West Nile virus (WNV), Zika virus (ZIKV), and Yellow fever virus (YKV). We extracted and analyzed 316 DENV NS1 sequence types (STs), 59 JEV STs, 75 WNV STs, 30 YFV STs, and 43 ZIKV STs using a simple algorithm based on phylogenetic analysis. STs were reclassified according to the variation of the major epitope by MHC II binding. 78 DENV epitope type (EpT), 29 JEV EpTs, 29 WNV EpTs, 12 YFV EpTs, and 5 ZIKV EpTs were extracted according to their major epitopes. Also, frequency results showed that there were dominant EpTs in all flavivirus. Fifteen STs were selected and purified for the expression of recombinant antigen in Escherichia coli by sodium dodecyl sulfate extraction. Our study details a novel in silico approach for the development of flavivirus diagnostics, including a simple way to screen the important peptide regions