Participation in and perceptions of antibiotic stewardship behaviors among nurses at a children's hospital in South Korea: a descriptive study.

PURPOSE: This study investigated participation in and perceptions of antibiotic stewardship among nurses at a children's hospital. METHODS: This descriptive study included 125 nurses working in the inpatient ward, intensive care unit and emergency room of a single tertiary children's hospital. The study measured 14 factors influencing antibiotic stewardship behaviors using the theoretical domains framework. Each factor was analyzed by categorizing it into components (capability, opportunity, and motivation) that have been proposed as influencing factors in the COM-B model of behavior. One-way analysis of variance and Pearson correlation coefficients were used to explore differences in antibiotic stewardship behaviors and influencing factors according to general characteristics and the correlation between antibiotic stewardship behaviors and COM-B components. RESULTS: No statistically significant difference in antibiotic stewardship behaviors was found based on the experience of antibiotic stewardship education or the nursing department. However, significant differences were observed in the perception levels of factors related to antibiotic stewardship behaviors according to the experience of antibiotic stewardship education in skill (physical) (p=.042), knowledge (p=.027), intentions (p=.028), and social influences (p=.010). Additionally, significant differences were observed in perception levels according to the sub-components of the COM-B model, specifically physical capability (p=.042), psychological capability (p=.027), and social opportunity (p=.010). CONCLUSION: To expand nurses' involvement and roles in antibiotic stewardship, nurses should acknowledge the significance of appropriate antibiotic use, aiming to enhance the quality of medical care and ensure patient safety. In pursuit of this objective, tailored education aligning with the specific needs and practices of nurses is essential.

Impact of national policy on hand hygiene promotion activities in hospitals in Korea.

BACKGROUND: After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the Government established a strategy for infection prevention to encourage infection control activities in hospitals. The new policy was announced in December 2015 and implemented in September 2016. The aim of this study is to evaluate how infection control activities improved within Korean hospitals after the change in government policy. METHODS: Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using a multivariable linear regression model, we analyzed the change in total HHSAF score according to survey year. RESULTS: A total of 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In the multivariable linear regression model, total HHSAF score was significantly associated with hospital teaching status (ß coefficient of major teaching hospital, 52.6; 95% confidence interval [CI], 8.9 to 96.4; P = 0.018), beds size (ß coefficient of 100 beds increase, 5.1; 95% CI, 0.3 to 9.8; P = 0.038), and survey time (ß coefficient of 2017 survey, 45.1; 95% CI, 19.3 to 70.9; P = 0.001). CONCLUSIONS: After the new national policy was implemented, the number of infection control professionals increased, and hand hygiene promotion activities were strengthened across Korean hospitals.

Methotrexate-loaded multifunctional nanoparticles with near-infrared irradiation for the treatment of rheumatoid arthritis.

BACKGROUNDS: Despite the advances of rheumatoid arthritis (RA) therapeutics, several patients do not receive adequate treatment due to the toxicity and/or insufficient response of drugs. The aim of this study is to design photothermally controlled drug release from multifunctional nanoparticles (MNPs) at a near-infrared (NIR) irradiated site to improve therapeutic efficacy for RA and reduce side effects. METHODS: Au film was deposited onto methotrexate (MTX)-loaded poly(ethylene glycol)-poly(lactic-co-glycolic acid) (PLGA) nanoparticles, resulting in MTX-loaded MNPs. The synergistic effects of MTX-loaded MNPs with NIR irradiation were investigated using RA fibroblast-like synoviocytes (FLSs) and collagen-induced arthritis (CIA) mice. RESULTS: Upon NIR irradiation, NIR resonance of the Au half-shell generated heat locally, accelerating MTX release from PLGA nanoparticles. In vivo NIR images of MTX-loaded MNPs indicated effective delivery of the MNPs to the inflamed joints. Moreover, in collagen-induced arthritis mice, MTX-loaded MNPs containing 1/1400 of MTX solution (repeated-dose administration) had therapeutic effects comparable to conventional treatment with MTX solution. In vitro experiments showed higher therapeutic efficacy of MTX-loaded MNPs with NIR irradiation than that of chemotherapy alone. CONCLUSIONS: A combination therapy of MTX-loaded MNP and NIR irradiation showed durable and good treatment efficacy for the suppression of arthritis in a single administration of small dose of MTX. Our results demonstrate that the treatment modality using drug-loaded MNP with NIR irradiation may be a promising therapeutic strategy for the treatment of RA and allow in vivo NIR optical imaging.

[Stressors and Stress Responses of Unmarried Mothers Based on Betty Neuman's Systems Model: An Integrative Review]. / 국내 미혼모의 ìŠ¤íŠ¸ë ˆìŠ¤ì›ê³¼ ìŠ¤íŠ¸ë ˆìŠ¤ 반응에 대한 í†µí•©ì  ê³ ì°°: ë² í‹° 뉴만의 체계 모델을 기반으로.

PURPOSE: The purpose of this study was to explore the structure of variables in studies related to unmarried mothers (UMs) based on Neuman's systems model, and the stressors and stress responses of UMs. METHODS: Whittemore and Knafl's methodology for integrative reviews was applied. The literature was searched using five electronic databases (KISS, KMbase, KoreaMed, NDSL, and RISS) and a total of 99 variables were collected from 15 studies published between 2009 and 2019. RESULTS: The main stressors for UMs were a sense of loss and burden caused by childbirth and childrearing. The main stress responses were parenting stress and depression, respectively. Within the basic structure of variables related to UMs, self-esteem played a crucial role by helping UMs adapt to their situation. Meanwhile, social support of UMs was significantly correlated with parenting stress, depression, and self-esteem. CONCLUSION: In order to understand UMs' stress, is necessary to explore their sense of loss, burden, and self-esteem. Furthermore, it is important to assess the level of parenting stress and depression of UMs and to provide effective interventions to alleviate these stressors. The results of this study provide useful knowledge that can be applied to nursing assessment and interventions for stress management in UMs.

14-3-3ζ targeting induced senescence in Hep-2 laryngeal cancer cell through deneddylation of Cullin1 in the Skp1-Cullin-F-box protein complex.

OBJECTIVES: Despite of the aberrant expression of 14-3-3ζ in head and neck squamous cell carcinoma (HNSCC), little is known about the role of 14-3-3ζ in the regulation of senescence in HNSCC. This study was performed to investigate whether 14-3-3ζ is implicated in senescence evasion of Hep-2 laryngeal cancer cells. METHODS: The expression of 14-3-3ζ was suppressed using RNA interference strategy. Senescence induction was determined by senescence-associated ß-galactosidase staining and the numbers of promyelocytic leukaemia nuclear body. Real-time PCR, western blotting and immunohistochemistry were applied for the expression of corresponding proteins. Xenograft experiment was performed to show in vivo effect of 14-3-3ζ silencing on tumour growth. RESULTS: 14-3-3ζ silencing significantly induced senescence phenotypes via 27 accumulations. Subsequently, we demonstrated that p27 accumulation is linked to inactivation of SCFSkp2 complex activity, probably due to the deneddylation of cullin-1 (Cul-1) as follows. (a) Neddylated Cul-1 is decreased by 14-3-3ζ silencing. (b) Blocking neddylation using MLN4924 reproduces senescence phenotypes. (c) Knockdown of CSN5, which functions as a deneddylase, was shown to restore the senescence phenotypes induced by 14-3-3ζ depletion. Finally, we demonstrated that 14-3-3ζ depletion effectively hindered the proliferation of Hep-2 cells implanted into nude mice. CONCLUSION: 14-3-3ζ negatively regulates senescence in Hep-2 cells, suggesting that 14-3-3ζ targeting may serve to suppress the expansion of laryngeal cancer via induction of senescence through the Cul-1/SCFSkp2 /p27 axis.

Supplementation with Aspergillus oryzae-fermented kochujang lowers serum cholesterol in subjects with hyperlipidemia.

BACKGROUND & AIMS: Kochujang, a traditional fermented red pepper paste, is known for its hypocholesterolemic effect; however, these studies used non-commercial preparations of kochujang. In this study, we examined whether commercially-made kochujang in which Aspergillus oryzae (also known as koji) was used as a microorganism for fermentation has the same cholesterol-lowering effects. METHODS: Hyperlipidemic subjects (based upon criteria of 110 ∼ 190 mg/dL LDL cholesterol or 200 ∼ 260 mg/dL total cholesterol) who had not been diagnosed with any disease and met the inclusion criteria were recruited for this study. The 30 subjects were randomly divided into either the kochujang (n = 15) or placebo (n = 15) group. All subjects ingested either the kochujang pill (34.5 g/d) or a placebo three times daily during meals for 12 weeks. Outcomes included measurements of efficacy (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride) and safety (adverse events, laboratory tests, electrocardiogram, and vital signs). RESULTS: In the kochujang-supplemented group, subjects' total cholesterol level significantly decreased (from 215.5 ± 16.1 mg/dL to 194.5 ± 25.4 mg/dL, p = 0.001). LDL-C cholesterol levels were also decreased by kochujang supplementation (from 133.6 ± 14.8 mg/dL to 113.5 ± 23.1 mg/dL); however no significant difference was seen between groups (p = 0.074). There were no statistically significant differences in HDL-cholesterol and triglyceride levels between the supplemented and non-supplemented groups. None of the subjects complained of any adverse effects. CONCLUSIONS: These results indicate that A. oryzae-fermented kochujang elicits a significant hypocholesterolemic effect and might be useful for improving blood cholesterol levels in subjects at high risk for cardiovascular disease. CLINICAL TRIAL REGISTRATION: NCT01865370.

Investigation and control of an outbreak of imipenem-resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit.

BACKGROUND: This study investigated the clinical details and epidemiology of the imipenem-resistant Acinetobacter baumannii (IRAB) outbreak that occurred at a pediatric intensive care unit (PICU), and describes successful outcome of the implemented infection control measures. METHODS: With the recognition of 3 clustered cases with IRAB bacteremia at the PICU of Seoul National University Children's Hospital, Korea, from August to September 2010, the following outbreak control strategies were implemented: reinforcement of hand hygiene and contact precautions, investigation of environmental contamination, disinfection of the contaminated environment and medical equipment, active surveillance culture upon PICU admission and isolation of IRAB-positive patients. The clinical and microbiological data were reviewed for A. baumannii positive cases in the PICU from April 2001 to June 2011. Multilocus sequence typing was also performed. RESULTS: Twenty IRAB-positive cases (bacteremia in 10, pneumonia in 3 and colonizers in 7) were detected from January 2010 to February 2011. Thirteen IRAB-infected patients were all placed on a mechanical ventilator, had central venous catheters, received broad-spectrum antimicrobial treatment and had underlying diseases. Eleven (85%) IRAB-infected patients died probably due to IRAB infection. IRAB grew in 4 samples obtained from sinks and water taps from 38 environmental samples. Multilocus sequence typing analysis revealed 2 sequence types: ST138 (n=16) and its single-locus variant ST92 (n=4). Eleven weeks after the initiation of active surveillance, no further IRAB isolates were identified. CONCLUSIONS: This study identifies the environmental source of an IRAB outbreak in a PICU and describes successful control of the outbreak with a multicomponent intervention program.

Melanogenesis inhibitory effect of fatty acid alkyl esters isolated from Oxalis triangularis.

Ten fatty acid alkyl esters isolated from Oxalis triangularis, were evaluated for the effects on melanogenesis using mouse B16 melanoma cells. Treatment of methyl linoleate, methyl linolenate, ethyl linoleate and ethyl linolenate significantly blocked forskolin-induced melanogenesis and inhibited tyrosinase activity. In addition, we found that they inhibited cAMP production, suggesting that their anti-melanogenic effect is mediated by the inhibition of cAMP production. We concluded that methyl/ethyl linoleate and linolenate isolated from Oxalis triangularis have pigment inhibition activity. These compounds may be useful as the cosmetic agent to stimulate skin whitening.

Involvement of nuclear factor-kappaB in the inhibition of pro-inflammatory mediators by pinosylvin.

Nuclear factor-kappaB (NF-kappaB) is a critical transcription factor for maximal expression of many of the cytokines that are involved in the pathogenesis of inflammatory diseases. In this study, we found that pinosylvin, a natural stilbenoid that is a component of the pine leaf (Pinus densiflora), significantly inhibited LPS-induced NF-kappaB activation in a concentration-dependent manner. Additionally, pinosylvin was found to inhibit the LPS-induced phosphorylation and degradation of IkappaB alpha in THP-1 cells. Therefore, we have attempted to determine whether pinosylvin can inhibit the expression of cytokines possessing NF-kappaB binding sites in their promoter regions. In a consistent result, pinosylvin inhibited LPS-induced production of TNF alpha and interleukin-8 (IL-8). Taken together, these results show that pinosylvin suppresses the production of pro-inflammatory mediators through the inhibition of the NF-kappaB signaling pathway.