Recent evidence indicates that water is one of the most overlooked and underestimated sources of healthcare-associated infections (HAIs). Opportunistic premise plumbing pathogens (OPPPs) are a group of natural waterborne pathogens that can persist in premise plumbing for long periods because of their unique characteristics. These include disinfectant resistance, viability inside amoeba, biofilm formation, and growth in nutrient-depleted environments. The pathogens can affect patients through various mechanisms, including direct contact, ingestion, aspiration, and aerosol inhalation. Most importantly, the transfer of pathogens between human microbiota and premise plumbing can cause hospital water systems to be reservoirs of multidrug-resistant bacteria. Biofilms formed on the outlet devices, such as tap faucets, shower heads, and sink drains provides an ideal niche for transmission of antimicrobial resistance. Contaminated wastewater systems are often sources of HAIs. A combination of interventions must be employed to manage water-related HAIs, including the general reinforcement of infection control measures, thermal and chemical disinfection, and consistent water flow.

Recent evidence indicates that water is one of the most overlooked and underestimated sources of healthcare-associated infections (HAIs). Opportunistic premise plumbing pathogens (OPPPs) are a group of natural waterborne pathogens that can persist in premise plumbing for long periods because of their unique characteristics. These include disinfectant resistance, viability inside amoeba, biofilm formation, and growth in nutrient-depleted environments. The pathogens can affect patients through various mechanisms, including direct contact, ingestion, aspiration, and aerosol inhalation. Most importantly, the transfer of pathogens between human microbiota and premise plumbing can cause hospital water systems to be reservoirs of multidrug-resistant bacteria. Biofilms formed on the outlet devices, such as tap faucets, shower heads, and sink drains provides an ideal niche for transmission of antimicrobial resistance. Contaminated wastewater systems are often sources of HAIs. A combination of interventions must be employed to manage water-related HAIs, including the general reinforcement of infection control measures, thermal and chemical disinfection, and consistent water flow.

Recent evidence indicates that water is one of the most overlooked and underestimated sources of healthcare-associated infections (HAIs). Opportunistic premise plumbing pathogens (OPPPs) are a group of natural waterborne pathogens that can persist in premise plumbing for long periods because of their unique characteristics. These include disinfectant resistance, viability inside amoeba, biofilm formation, and growth in nutrient-depleted environments. The pathogens can affect patients through various mechanisms, including direct contact, ingestion, aspiration, and aerosol inhalation. Most importantly, the transfer of pathogens between human microbiota and premise plumbing can cause hospital water systems to be reservoirs of multidrug-resistant bacteria. Biofilms formed on the outlet devices, such as tap faucets, shower heads, and sink drains provides an ideal niche for transmission of antimicrobial resistance. Contaminated wastewater systems are often sources of HAIs. A combination of interventions must be employed to manage water-related HAIs, including the general reinforcement of infection control measures, thermal and chemical disinfection, and consistent water flow.

Recent evidence indicates that water is one of the most overlooked and underestimated sources of healthcare-associated infections (HAIs). Opportunistic premise plumbing pathogens (OPPPs) are a group of natural waterborne pathogens that can persist in premise plumbing for long periods because of their unique characteristics. These include disinfectant resistance, viability inside amoeba, biofilm formation, and growth in nutrient-depleted environments. The pathogens can affect patients through various mechanisms, including direct contact, ingestion, aspiration, and aerosol inhalation. Most importantly, the transfer of pathogens between human microbiota and premise plumbing can cause hospital water systems to be reservoirs of multidrug-resistant bacteria. Biofilms formed on the outlet devices, such as tap faucets, shower heads, and sink drains provides an ideal niche for transmission of antimicrobial resistance. Contaminated wastewater systems are often sources of HAIs. A combination of interventions must be employed to manage water-related HAIs, including the general reinforcement of infection control measures, thermal and chemical disinfection, and consistent water flow.

No abstract available.
Amputation* ; Forearm* ; Upper Extremity*

In this article, the statement of ethical statement about animal experiment was omitted.

No abstract available.
Hand*

Objectives: ：The aim of this study was to determine how the efficacy and compliance of positive airway pressure (PAP) varies depending on the depressive symptom with obstructive sleep apnea (OSA). Methods: ：We collected data about baseline Apnea-Hyponea Index (AHI), sleep and mood state and demographic information from 125 obstructive sleep apnea patients prior to the start of positive airway pressure treatment. The Apnea-Hyponea Index and daytime sleepiness were examined as indicators of efficacy of positive airway pressure and daily average usage time and the utilization rate (%) for more than 4 hours were calculated as indicators of compliance of positive airway pressure at the time of 1, 3 or 9 months after the start of positive airway pressure. Repeated-measures ANOVA and linear mixed model (LMM) with adjusting age, body mass index and baseline Insomnia severity index were used for revealing any significant differences between groups over time passed. Results: ：This difference was confirmed at 9 months after starting positive airway pressure, between the two groups and the usage rate for more than 4 hours in depressive group was lower than that in non-depression group (56.2% vs. 67.5%). Conclusions ：We demonstrated that there would be a difference in the compliance of positive airway pressure among patients with obstructive sleep apnea according to depressive state. Therefore, we suggest evaluating depressive symptoms in patients with obstructive sleep apnea before starting positive airway pressure, to increase the compliance of the positive airway pressure, which is essential to maintain the efficacy of the positive airway pressure.

Objectives: ：South Korea has one of the highest suicide rates in the world, with the highest rate reported in Busan metropolitan city in the past decade. Based on the data collected regarding the characteristics of suicide completers, we investigated gender- and age-related differences in the causes and methods of completed suicides. Methods: ：Information from 675 persons who committed suicide was included in the statistical analysis, and descriptive statistics were used to present the demographic variables. To ascertain the differences by gender and age, logistic regression analyses were also conducted. Age groups were stratified according to the stage in life: young, middle, and late adulthood. Additionally the odds ratios and 95% confidence intervals were estimated using gender and age as independent variables, and methods and causes as dependent variables. Results: ：The most frequent suicide method and cause were hanging and physical illness, respectively, with women were more likely to choose jumping as a suicide method than men. In terms of suicide causes, economic difficulties were more often related to men than women. While the young adulthood group was more likely to choose jumping and gassing than the late adulthood group, the latter was more likely to choose chemical poisoning as a suicide method.Furthermore, in terms of suicide causes, economic difficulty and psychiatric disorder were more often related to the young adulthood group than the late adulthood group. In addition, the middle adulthood group was more often associated with economic difficulty than the late adulthood group, while the latter was more often related with physical illness than the young adulthood group. Conclusions ：The causes and methods of suicide in suicide completers differ according to age and gender. The results of our study underline the need to reflect age- and gender-related characteristics in establishing suicide prevention policies.

OBJECTIVE: The aim was to establish an optimal cut-off score of the Children's Depression Inventory (CDI) for detecting depression and rating severity in Korean adolescents. METHODS: A total of 468 students aged 12-16 years from 8 middle schools in Busan, Korea participated in this study. The Korean version of the CDI and Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version were used to evaluate depressive symptoms. Receiver-operating characteristics (ROC) analyses were conducted to evaluate case-finding performance and set the cut-off scores. RESULTS: ROC analyses demonstrated that the overall discrimination power of the CDI is good enough to evaluate adolescent depression. The CDI sum score of 20 was identified as the optimal screening cut-off score, where sensitivity was 0.83 and specificity was 0.89. This cut-off score could apply regardless of subjects' gender. The cut-off scores were examined in order of the depression severity: 15 for mild, 20 for moderate, and 25 for severe depression with high sensitivity and specificity. CONCLUSION: The CDI cut-off scores of our study can be recommended for screening depressed youth and rating the severity of depressive symptoms. The high negative predictive value suggested that the cut-off score of 20 would result in a small number of missed cases. Further studies are needed to ascertain these CDI cut-off scores for different age groups.
Adolescent* ; Appointments and Schedules ; Busan ; Depression* ; Discrimination (Psychology) ; Humans ; Korea ; Mass Screening* ; Mood Disorders ; ROC Curve ; Schizophrenia ; Sensitivity and Specificity