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Network approach has been applied to a wide variety of psychiatric disorders. The aim of the present study was to identify network structures of remitters and non-remitters in patients with first-episode psychosis (FEP) at baseline and the 6-month follow-up.
Methods
Participants (n = 252) from the Korean Early Psychosis Study (KEPS) were enrolled. They were classified as remitters or non-remitters using Andreasen's criteria. We estimated network structure with 10 symptoms (three symptoms from the Positive and Negative Syndrome Scale, one depressive symptom, and six symptoms related to schema and rumination) as nodes using a Gaussian graphical model. Global and local network metrics were compared within and between the networks over time.
Results
Global network metrics did not differ between the remitters and non-remitters at baseline or 6 months. However, the network structure and nodal strengths associated with positive-self and positive-others scores changed significantly in the remitters over time. Unique central symptoms for remitters and non-remitters were cognitive brooding and negative-self, respectively. The correlation stability coefficients for nodal strength were within the acceptable range.
Conclusion
Our findings indicate that network structure and some nodal strengths were more flexible in remitters. Negative-self could be an important target for therapeutic intervention.
We calculated the human resources required for an antimicrobial stewardship program (ASP) in Korean hospitals.
Design:
Multicenter retrospective study.
Setting:
Eight Korean hospitals ranging in size from 295 to 1,337 beds.
Methods:
The time required for performing ASP activities for all hospitalized patients under antibiotic therapy was estimated and converted into hours per week. The actual time spent on patient reviews of each ASP activity was measured with a small number of cases, then the total time was estimated by applying the determined times to a larger number of cases. Full-time equivalents (FTEs) were measured according to labor laws in Korea (52 hours per week).
Results:
In total, 225 cases were reviewed to measure time spent on patient reviews. The median time spent per patient review for ASP activities ranged from 10 to 16 minutes. The total time spent on the review for all hospitalized patients was estimated using the observed number of ASP activities for 1,534 patients who underwent antibiotic therapy on surveillance days. The most commonly observed ASP activity was ‘review of surgical prophylactic antibiotics’ (32.7%), followed by ‘appropriate antibiotics recommendations for patients with suspected infection without a proven site of infection but without causative pathogens’ (28.6%). The personnel requirement was calculated as 1.20 FTEs (interquartile range [IQR], 1.02–1.38) per 100 beds and 2.28 FTEs (IQR, 1.93–2.62) per 100 patients who underwent antibiotic therapy, respectively.
Conclusion:
The estimated time required for human resources performing extensive ASP activities on all hospitalized patients undergoing antibiotic therapy in Korean hospitals was ~1.20 FTEs (IQR, 1.02–1.38) per 100 beds.
Several studies on the treatment of coronavirus disease 2019 (COVID-19) are being conducted, and various drugs are being tried; however, the results have not been uniform. Steroids have been widely used in the treatment of COVID-19, but their effects are controversial. As immunosuppressive and anti-inflammatory agents, steroids are considered to reduce lung damage by regulating various inflammatory responses. We report a case of severe acute respiratory syndrome coronavirus-2 pneumonia manifesting as a cryptogenic organizing pneumonia-like reaction and discuss its treatment, clinical course, and favorable outcomes after steroid administration.
A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital.
Methods:
The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient’s characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method.
Results:
DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector.
Conclusions:
For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients’ medical records, and to reorganize the DMAT dispatch system.
Hyperlipidaemia is a major cause of atherosclerosis and related CVD and can be prevented with natural substances. Previously, we reported that a novel Bacillus-fermented green tea (FGT) exerts anti-obesity and hypolipidaemic effects. This study further investigated the hypotriglyceridaemic and anti-obesogenic effects of FGT and its underlying mechanisms. FGT effectively inhibited pancreatic lipase activity in vitro (IC50, 0·48 mg/ml) and ameliorated postprandial lipaemia in rats (26 % reduction with 500 mg/kg FGT). In hypertriglyceridaemic hamsters, FGT administration significantly reduced plasma TAG levels. In mice, FGT administration (500 mg/kg) for 2 weeks augmented energy expenditure by 22 % through the induction of plasma serotonin, a neurotransmitter that modulates energy expenditure and mRNA expressions of lipid metabolism genes in peripheral tissues. Analysis of the gut microbiota showed that FGT reduced the proportion of the phylum Firmicutes in hamsters, which could further contribute to its anti-obesity effects. Collectively, these data demonstrate that FGT decreases plasma TAG levels via multiple mechanisms including inhibition of pancreatic lipase, augmentation of energy expenditure, induction of serotonin secretion and alteration of gut microbiota. These results suggest that FGT may be a useful natural agent for preventing hypertriglyceridaemia and obesity.
This study reports the earliest known reef-building anthaspidellid sponge, Rankenella zhangxianensis n. sp., from the Cambrian Series 3 (late Stage 5–early Guzhangian) deposit of the Zhangxia Formation, Shandong Province, China. Rankenella zhangxianensis mostly occurs within Epiphyton-Rankenella-Cambroctoconus reefs, with minor occurrence from inter-reef grainstone. The species has anthaspidellid-type regular ladderlike spicule networks consisting of dendroclones and trabs, and is characterized by trabs parallel/subparallel to the gastral surface that diverge and meet the dermal surface, which is typical of the genus. Compared to R. mors and R. hamdii, reported from the late Cambrian Series 2–late Cambrian Series 3 of Australia and the late Cambrian Series 3–early Furongian of Iran, respectively, R. zhangxianensis is characterized by a relatively thicker wall, high angle (~90°) between dermal surfaces and intersecting trabs, and minor occurrence of differentiated canals. On the other hand, R. zhangxianensis mainly shows obconical shape, which is far less diverse than the other two species showing conicocylindrical, digitate, explanate, or bowl shapes. These Cambrian Series 3 reefs from China are the ancestors of the Furongian anthaspidellid-microbial reefs and the Early Ordovician anthaspidellid-microbial reefs that flourished worldwide. They represent the resurgence of reef-building metazoans after the extinction of archaeocyaths at the end of Cambrian Series 2.
We report on the formation of highly flexible and transparent TiO2/Ag/ITO multilayer films deposited on polyethylene terephthalate substrates. The optical and electrical properties of the multilayer films were investigated as a function of oxide thickness. The transmission window gradually shifted toward lower energies with increasing oxide thickness. The TiO2 (40 nm)/Ag (18 nm)/ITO (40 nm) films gave the transmittance of 93.1% at 560 nm. The relationship between transmittance and oxide thickness was simulated using the scattering matrix method to understand high transmittance. As the oxide thickness increased from 20 to 50 nm, the carrier concentration gradually decreased from 1.08 × 1022 to 6.66 × 1021 cm−3, while the sheet resistance varied from 5.8 to 6.1 Ω/sq. Haacke's figure of merit reached a maximum at 40 nm and then decreased with increasing oxide thickness. The change in resistance for the 60 nm-thick ITO single film rapidly increased with increasing bending cycles, while that of the TiO2/Ag/ITO (40 nm/18 nm/40 nm) film remained virtually unchanged during the bending test.
To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents.
Methods
A prospective randomized, double-blind, placebo-controlled trial was conducted for patients with suspected appendicitis. The patients were randomized to receive placebo (normal saline intravenous [IV]) infusions over 5 minutes or the study drug (morphine 5 mg IV). All of the clinical evaluations by surgical residents were performed 30 minutes after administration of the study drug or placebo. After obtaining the clinical probability of appendicitis, as determined by the surgical residents, abdominal computed tomography was performed. The primary objective was to compare the influence of IV morphine on the ability of surgical residents to diagnose appendicitis.
Results
A total of 213 patients with suspected appendicitis were enrolled. Of these patients, 107 patients received morphine, and 106 patients received placebo saline. The negative appendectomy percentages in each group were similar (3.8% in the placebo group and 3.2% in the pain control group, p=0.62). The perforation rates in each group were also similar (18.9% in the placebo group and 14.3% in the pain control group, p=0.75). Receiver operating characteristic analysis revealed that the overall diagnostic accuracy in each group was similar (the area under the curve of the placebo group and the pain control group was 0.63 v. 0.61, respectively, p=0.81).
Conclusions
Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL).
Method:
We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire–End of Life (QCQ–EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation).
Results:
Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ–EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG–PS) scores were significantly associated with survival.
Significance of results:
Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG–PS are needed to help patients experience a dignified and comfortable death.
This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.
Methods:
In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.
Results:
Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.
Conclusions:
The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.
Energetic outflow from active galactic nuclei (AGNs) may play a critical role in galaxy evolution (e.g., Silk & Rees 1998). We present a velocity diagnostic for detecting gas outflow in the narrow-line region of Type-2 AGNs using line-of-sight velocity offsets of the [O iii] λ5007 and Hα emission lines with respect to the systemic velocity of stars in host galaxies (See Figure 1). We apply the diagnostics to nearby galaxies at 0.02 < z < 0.05, 3775 AGN-host and 907 star-forming galaxies as a comparison sample, which are selected from the Sloan Digital Sky Survey DR7. After obtaining a best-fit stellar population model for the continuum and a systemic velocity based on stellar lines, we subtract the stellar component to measure velocity offsets of each emission line. We find a sample of 169 AGN-host galaxies with outflow signatures, displaying a larger velocity shift of [O iii] than that of Hα, as expected in a decelerating outflow model (Komossa et al. 2008). We find that the offset velocity of [O iii] increases with Eddington ratio, suggesting that gas outflow depends on the energetics of AGN.
Despite numerous previous studies, relationships between watershed land use and adjacent streams and rivers at various scales in Korea remain unclear. This study investigated the relationships between land uses and the physical, chemical, and biological characteristics of 720 sites of streams and rivers across the country. The land uses at two spatial scales, including a 1-km buffer and the base watershed management region (BWMR), were computed in a geographical information system (GIS) with a digital land use/land cover map. Characteristics of land uses at two spatial scales were then correlated with the monitored multidimensional characteristics of the streams and rivers. The results of this study indicate that land use types have significant effects on stream and river characteristics. Specifically, most characteristics were negatively correlated with the proportions of urban, rice paddy, agricultural, and bare soil areas and positively correlated with the amount of forest. The site-scale and BWMR-scale analyses suggest that BWMR land use patterns were more strongly related to ecological integrity than they were to site land use patterns. Improving our understanding of land use effects will largely depend on relating the results of site-specific studies that use similar response techniques and measures to evaluate ecological integrity. In addition, our results clearly indicate that the characteristics of streams and rivers are closely linked and that land use types differentially affect those characteristics. Thus, effective restoration and management for ecological integrity of lotic system should consider the physical, chemical, and biological factors in combination.
We investigated the pressure dependence of the inductive coupled plasma (ICP) oxidation on the electrical characteristics of the thin oxide films. Activation energies and electron temperatures with different pressures were estimated. To demonstrate the pressure effect on the plasma oxide quality, simple N type metal-oxide-semiconductor (NMOS) transistors were fabricated and investigated in a few electrical properties. At higher pressure than 200mTorr, plasma oxide has a slightly higher on-current and a lower interfacial trap density. The on-current gain seems to be related to the field mobility increase and the lower defective interface to the electron temperature during oxidation.
Plasma doping (PLAD) process utilizing PH3 plasma to fabricate n-type junction with supplied bias of −1 kV and doping time of 60 sec under the room temperature is presented. The RTA process is performed at 900 °C for 10 sec. A defect-free surface is corroborated by TEM and DXRD analyses, and examined SIMS profiles reveal that shallow n+ junctions are formed with surface doping concentration of 1021atoms/cm3. The junction depth increases in proportion to the O2 gas flow when the N2 flow is fixed during the RTA process, resulting in a decreased sheet resistance. Measured doping profiles and the sheet resistance confirm that the n+ junction depth less than 52 nm and minimum sheet resistance of 313 Ω/□ are feasible.
To improve the IPD reliability of NAND flash memory, plasma oxidation was introduced as the post-treatment process of ONO (Oxide/Nitride/Oxide) IPD. The LP-CVD SiO2 modified by plasma oxidation showed the excellent electrical properties. e.g., low leakage current, high breakdown voltage etc. By the analysis of Tof-SIMS and XRR, we could observe the several changes of physical characteristics such as the reduction of impurities (H, N etc.), the increase of oxide density, and the improvement of oxide surface roughness. We found out the appropriate treatment condition to be able to densify oxide layer without the addition of ONO Equivalent Oxide Thickness (EOT). The LP-CVD SiO2 prepared by plasma oxidation was used for the ONO IPD of 50nm NAND flash device and also compared with the conventional LP-CVD SiO2 in the aspect of the IPD reliability.
The low frequency noise of individual ZnO nanowire (NW) field effect transistors (FETs) exposed to air is systematically characterized. The measured noise power spectrum shows a classical 1/f type. The noise amplitude is independent of source-drain current and inversely proportional to gate voltage. The extracted Hooge's constant of ZnO NW is found to be 6.52×10−3. In addition, the low frequency noise of ZnO NW according to NW resistance and contact property are investigated. The noise amplitude is proportional to the square of ZnO NW resistance. If a sample shows a nonlinear current-voltage (I-V) characteristic due to a poor electrical contact, the noise power spectrum is proportional to the third power of current instead of the square of current.
Field effect transistors(FETs) made of ZnO nanowires are very sensitive to the gas environment, so that the passivation can be a good way to get reliable nanowire FETs with longer lifetime and the better mobility. The studies on the passivation effects with the positive electron-beam resist was investigated by selectively covering the part of nanowire devices between the electrodes. Reproducible electrical characteristics were recorded, reflecting the stable electrical properties by the passivation which deters the degradation of a device. Considering the defect states of oxide nanowires dominate the charge states, the pre-state just before the passivation process will be crucial to understand the reproducible and controllable device characteristics of nanowire devices.
This paper reports the fabrication of and characterization on EWOD(electrowetting-on-dielectric) devices on flexible substrates of interest to the flexible displays and devices. The EWOD devices were fabricated on PET (poly ethylene terephthalate) and PMMA(polymethylmethacrylate) substrates. Au and ITO(indium tin oxide) were used as electrode materials. The wet etching process was developed not to attack plastic flexible substrates. The photo resist was used as an insulator materials in EWOD devices due to the deformation of substrate when oxide layer was deposited on plastic substrate. As a hydrophobic layer, cytop was spin-coated on the photo resist. Wetting tests were done with DI water in air environment. In sessile droplet test, the contact angle of droplet changed from 116◦ to 80◦ under DC power. Threshold voltage was 20 Vdc. The droplet was oscillated under AC power because of the frequency. But the contact angle of droplet was began to change at 30Vac and decrease with the increase of AC power. In droplet transporting test, a droplet(0.2§¡) was started transporting at 20Vac and the transporting speed increased with the increase of AC power. But the droplet transporting was not occurred under DC power because of slower contact angle recovery rate under DC power.