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Nurses are at an increased risk for work-related stress resulting in post-traumatic stress disorder (PTSD). They are susceptible due to frequent exposure to traumatic situations providing care for patients.
Objectives
The purpose of this systematic review is to comprehensively review the content and characteristics of intervention programs for reducing the post-traumatic stress of nurses or nursing students, providing a basis for developing a standardized protocol for programs to promote the integrated health of nurses and protect them from stress events in clinical environments.
Methods
This is a systematic review. Participants (P) targeted nurses or nursing students; Intervention (I) included intervention programs for reducing post-traumatic stress; Comparison (C) was control groups provided with usual or no interventions ; and Outcomes (O) referred to changes in physical or emotional reactions toward post-traumatic stress. Two researchers searched four databases including PubMed, CINAHL, PsycINFO, and EMBASE with keywords such as “nurse,” “post-trumatic stress disorder,” “program,” and “intervention”. A total of 7,523 studies were searched and 10 studies were included for final analysis (Image 1). The Risk of Bias2 (Image 2) and the Risk of Bias for Non-randomized Study I (Image 3) were used to evaluate the quality the included studies.
Results
The number of studies is increasing, with four studies published before 2020, and six studies published since, of which three in 2022. Definitions of trauma situations to which nurses are exposed included diverse elements such as patient death, workplace violence, the COVID-19 pandemic, and complex trauma experiences due to working environments. Most studies have provided multiple intervention sessions, which is appropriate considering the characteristics of PTSD. Most studies examined the secondary effects on mental health such as anxiety, depression, and burnout caused by stress rather than evaluating stress itself. The quality of the study was generally highly biased. The risk of bias increased for the two randomized controlled trials in terms of measurement outcomes and outcome description. The other eight non-randomized studies all included a self-reporting questionnaire of participants, leading to a risk of bias in terms of measurement outcomes.
Image:
Image 2:
Image 3:
Conclusions
Studies have been conducted to confirm the effectiveness of interventions given heightened concerns about PTSD in nurses. However, the concept of the trauma experienced by nurses was not integrally defined, and information on interventions was often limited. Efforts are required to improve the quality of research in terms of experimental study design.
Depression and anxiety are common and highly comorbid, and their comorbidity is associated with poorer outcomes posing clinical and public health concerns. We evaluated the polygenic contribution to comorbid depression and anxiety, and to each in isolation.
Methods
Diagnostic codes were extracted from electronic health records for four biobanks [N = 177 865 including 138 632 European (77.9%), 25 612 African (14.4%), and 13 621 Hispanic (7.7%) ancestry participants]. The outcome was a four-level variable representing the depression/anxiety diagnosis group: neither, depression-only, anxiety-only, and comorbid. Multinomial regression was used to test for association of depression and anxiety polygenic risk scores (PRSs) with the outcome while adjusting for principal components of ancestry.
Results
In total, 132 960 patients had neither diagnosis (74.8%), 16 092 depression-only (9.0%), 13 098 anxiety-only (7.4%), and 16 584 comorbid (9.3%). In the European meta-analysis across biobanks, both PRSs were higher in each diagnosis group compared to controls. Notably, depression-PRS (OR 1.20 per s.d. increase in PRS; 95% CI 1.18–1.23) and anxiety-PRS (OR 1.07; 95% CI 1.05–1.09) had the largest effect when the comorbid group was compared with controls. Furthermore, the depression-PRS was significantly higher in the comorbid group than the depression-only group (OR 1.09; 95% CI 1.06–1.12) and the anxiety-only group (OR 1.15; 95% CI 1.11–1.19) and was significantly higher in the depression-only group than the anxiety-only group (OR 1.06; 95% CI 1.02–1.09), showing a genetic risk gradient across the conditions and the comorbidity.
Conclusions
This study suggests that depression and anxiety have partially independent genetic liabilities and the genetic vulnerabilities to depression and anxiety make distinct contributions to comorbid depression and anxiety.
Hearing impairment in older adults may affect cognitive function and increase the risk of dementia. Most cognitive tests are delivered auditorily, and individuals with hearing loss may fail to hear verbal instructions. Greater listening difficulty and fatigue in acoustic conditions may impact test performance. This study aimed to examine the effect of decreased audibility on cognitive screening test performance in older adults.
Method
Older adults (n = 63) with different levels of hearing loss completed a standard auditory Mini-Mental State Examination test and a written version of the test.
Results
Individuals with moderate to moderately severe hearing loss (41–70 dB) performed significantly better on the written (24.34 ± 4.90) than on the standard test (22.55 ± 6.25), whereas scores were not impacted for mild hearing loss (less than 40 dB).
Conclusion
Hearing evaluations should be included in cognitive assessment, and test performance should be carefully interpreted in individuals with hearing loss to avoid overestimating cognitive decline.
Hwa-Byung is a cultural-related mental syndrome that reflects the cultural characteristics of Korean in DSM-IV. This syndrome is caused by anger or resentment towards unreasonable social violence and trauma.
Objectives
The purpose of this study is to revise and validate the ’Hwa-Byung scale’, which can be used to diagnose Hwa-Byung and evaluate the severity of its symptoms.
Methods
To begin with, the factors of the Hwa-Byung scale were set based on the previous studies. Additionally, the respective subfactors were generated by the semi-structured interviews with these patients. Based on these factors and previous studies, a 142-item pool was developed and verified by six Oriental Neuropsychiatrists. A pilot study was conducted on 50 patients with Hwa-Byung and the main study for the validation was conducted on 200 Hwa-Byung patients. Item analysis, internal consistency, and exploratory/confirmatory factor analysis were performed. Lastly, this study analyzed the ROC curve to present the diagnostic cut-off score of the scale.
Results
As a result of analyzing the content validity of the item pool, we constructed a preliminary scale. We excluded the inadequate questions from the pilot study results. In the main study, The Hwa-Byung scale showed high internal consistency and its items were suitable for the factor structure. Finally, we suggest an optimal cut-off score of the symptoms sub-scale for screening Hwa-Byung.
Conclusions
Overall, the results of this study indicated the reliability and validity of the Hwa-Byung Scale. Based on these results, we discussed several values and limitations of this study and provided suggestions for further research.
Bipolar Disorder (BD) is a disorder in which cognitive function is relatively preserved but social functioning is markedly impaired. Interestingly, studies on BD show that the patients have a strong desire for social rewards. Hypersensitivity to social rewards in BD has not yet been sufficiently examined through experimental methods, although recent studies have pointed out that their reward hypersensitivity is the cause of symptoms and dysfunction.
Objectives
The purpose of this study was to investigate whether patients with BD are hypersensitive to social rewards using the social value capture task.
Methods
Groups of 25 BD and healthy control (HC) each completed the social value attention capture task. This task consists of a practice phase in which associative learning of social rewards with specific stimuli occurs, and a test phase in which the stimuli associated with rewards appear as distractors during the participants performing a selective attention task. We also recorded event-related potential (ERP) in the practice phase in order to investigate BDs’ cortical activity for social reward.
Results
showed significantly decreased accuracy rate and increased reaction time in the high social reward-associated distractor trials of the test phase in the BD compared to the HC. As a result of analysis in ERP components, P3 amplitude for social reward was significantly greater in the BD than the HC.
Conclusions
BD patients exhibit behavioral and physiological hypersensitivity to social rewards that might contribute to social dysfunction.
Hwa-Byung is a mental syndrome classified as a “cultural-related syndrome” which reflects the cultural characteristics of Korea in DSM-IV. Hwa-Byung is caused by anger, which is characterized by feelings of anger or resent about unreasonable social violence and trauma. Kwon et al (2008) had developed self-report measure to assess severity of Hwa-Byung but it has several limitations to use in current clinical settings. Therefore, we investigated opinions of experts who have professionality in giving treatment of Hwa-Byung patients in the clinical settings.
Objectives
The present study aimed to reach consent of oriental neuropsychiatrists’ opinions about the direction of revision of the Hwa-Byung scale.
Methods
The Delphi method is a survey method that induces people to freely present their opinions without face-to-face processes and reaches consent through continuous feedback of survey results while ensuring anonymity. The Consensus Panel consists of 16 experts who are Oriental neuropsychiatrists and have experience in diagnosing patients with Hwa-Byung. A total of four surveys were conducted as consensus was reached on the fourth round. Each questionnaire was distributed by mail to a panel of experts and was asked to submit a response after receiving the questionnaire.
Results
The results of the study are as follows. First, common factors for Hwa-Byung include anger, resent/blame, modify memory bias and attention bias for anger events. Second, characteristics of young Hwa-Byung patients include stress caused by social factors and excessive immersion in certain things such as drinking or smoking.
Conclusions
Therefore, when revising the Hwa-Byung scale, it would be necessary to include these factors.
The building of online atomic and molecular databases for astrophysics and for other research fields started with the beginning of the internet. These databases have encompassed different forms: databases of individual research groups exposing their own data, databases providing collected data from the refereed literature, databases providing evaluated compilations, databases providing repositories for individuals to deposit their data, and so on. They were, and are, the replacement for literature compilations with the goal of providing more complete and in particular easily accessible data services to the users communities. Such initiatives involve not only scientific work on the data, but also the characterization of data, which comes with the “standardization” of metadata and of the relations between metadata, as recently developed in different communities. This contribution aims at providing a representative overview of the atomic and molecular databases ecosystem, which is available to the astrophysical community and addresses different issues linked to the use and management of data and databases. The information provided in this paper is related to the keynote lecture “Atomic and Molecular Databases: Open Science for better science and a sustainable world” whose slides can be found at DOI : doi.org/10.5281/zenodo.6979352 on the Zenodo repository connected to the “cb5-labastro” Zenodo Community (https://zenodo.org/communities/cb5-labastro).
In real gas turbines, multiple nozzles are used instead of a single-nozzle; therefore, interactions between flames are inevitable. In this study, the effects of flame-flame interaction on the emission characteristics and lean blowout limit were analysed in a CH4-fueled single- and dual-nozzle combustor. OH* chemiluminescence imaging showed that a flame-interacting region, where the two flames from the nozzles were merged, was present in the dual-nozzle combustor, unlike the single-nozzle combustor. Flow-field measurements using particle image velocimetry confirmed that a faster velocity region was formed at the flame merging region, thereby hindering flame stabilisation. In addition, we compared the emission indices of NOx and CO between the two combustors. The emission indices of CO were not significantly different; however, a distinct effect of flame-flame interaction was indicated in NOx. To understand the effect of flame-flame interaction on NOx emissions, we measured temperature distribution using a multi-point thermocouple. Results showed that a wider high-temperature region was formed in the dual-nozzle combustor compared to the single-nozzle combustor; this was attributable to the high OH* chemiluminescence intensity in the flame-interacting region. Furthermore, it was confirmed that the size of this interacting region caused the deformation of the temperature distribution in the combustor, which can induce a difference in the increase ratio of NOx emission between high and low equivalence ratio ranges. In conclusion, we confirmed that flame-flame interaction significantly affected temperature distribution in the downstream of the flame, and the change in temperature distribution contributed primarily to the varying concentration of the emission gas.
Background: Phase 3 COMET trial (NCT02782741) compares avalglucosidase alfa (n=51) with alglucosidase alfa (n=49) in treatment-naïve LOPD. Methods: Primary objective: determine avalglucosidase alfa effect on respiratory muscle function. Secondary/other objectives include: avalglucosidase alfa effect on functional endurance, inspiratory/expiratory muscle strength, lower/upper extremity muscle strength, motor function, health-related quality of life, safety. Results: At Week 49, change (LSmean±SE) from baseline in upright forced vital capacity %predicted was greater with avalglucosidase alfa (2.89%±0.88%) versus alglucosidase alfa (0.46%±0.93%)(absolute difference+2.43%). The primary objective, achieving statistical non-inferiority (p=0.0074), was met. Superiority testing was borderline significant (p=0.0626). Week 49 change from baseline in 6-minute walk test was 30.01-meters greater for avalglucosidase alfa (32.21±9.93m) versus alglucosidase alfa (2.19±10.40m). Positive results for avalglucosidase alfa were seen for all secondary/other efficacy endpoints. Treatment-emergent adverse events (AEs) occurred in 86.3% of avalglucosidase alfa-treated and 91.8% of alglucosidase alfa-treated participants. Five participants withdrew, 4 for AEs, all on alglucosidase alfa. Serious AEs occurred in 8 avalglucosidase alfa-treated and 12 alglucosidase alfa-treated participants. IgG antidrug antibody responses were similar in both. High titers and neutralizing antibodies were more common for alglucosidase alfa. Conclusions: Results demonstrate improvements in clinically meaningful outcome measures and a more favorable safety profile with avalglucosidase alfa versus alglucosidase alfa. Funding: Sanofi Genzyme
Major depressive disorder (MDD) is a common, debilitating, phenotypically heterogeneous disorder with heritability ranges from 30% to 50%. Compared to other psychiatric disorders, its high prevalence, moderate heritability, and strong polygenicity have posed major challenges for gene-mapping in MDD. Studies of common genetic variation in MDD, driven by large international collaborations such as the Psychiatric Genomics Consortium, have confirmed the highly polygenic nature of the disorder and implicated over 100 genetic risk loci to date. Rare copy number variants associated with MDD risk were also recently identified. The goal of this review is to present a broad picture of our current understanding of the epidemiology, genetic epidemiology, molecular genetics, and gene–environment interplay in MDD. Insights into the impact of genetic factors on the aetiology of this complex disorder hold great promise for improving clinical care.
To assess the Framingham risk score as a prognostic tool for idiopathic sudden sensorineural hearing loss patients.
Methods
Medical records were reviewed for unilateral idiopathic sudden sensorineural hearing loss patients between January 2010 and October 2017. The 10-year risk of developing cardiovascular disease was calculated. Patients were subdivided into groups: group 1 – Framingham risk score of less than 10 per cent (n = 28); group 2 – score of 10 to less than 20 per cent (n = 6); and group 3 – score of 20 per cent or higher (n = 5).
Results
Initial pure tone average and Framingham risk score were not significantly associated (p = 0.32). Thirteen patients in group 1 recovered completely (46.4 per cent), but none in groups 2 and 3 showed complete recovery. Initial pure tone average and Framingham risk score were significantly associated in multivariable linear regression analysis (R2 = 0.36). The regression coefficient was 0.33 (p = 0.003) for initial pure tone average and −0.67 (p = 0.005) for Framingham risk score.
Conclusion
Framingham risk score may be useful in predicting outcomes for idiopathic sudden sensorineural hearing loss patients, as those with a higher score showed poorer hearing recovery.
The prevalence of internet game use among children and adolescents has been increased in the recent years.
Objectives:
Internet addiction has been found to cause various psychiatric symptoms and psychological problems. Internet addiction has been found to cause various psychiatric symptoms and psychological problems.
Aims:
The aim of this study was to examine the association between problematic internet game use and psychiatric symptoms in a sample of the Child and Adolescent Psychiatric Clinic, Ulsan University Hospital.
Methods:
We analyzed data from 447 subjects who first visit the Child and Adolescent Psychiatric Clinic of the Ulsan University Hospital. The level of Internet addiction was categorized as either high-risk (≥108; group 3), potential risk (95 to 107; group 2), or no risk (≤94, group 1) based on the total score. Data were analyzed using SPSS version 17.0 and one-way ANOVA and multiple logistic regression method were used.
Results:
Thirteen adolescents met the criteria for high risk group of internet game addiction. in the high risk group, 10 were male and 3 were female adolescents. There was an mean difference among group 3 (high risk)< 1 (no risk),2 (potential risk) in AHI ; whereas group 3 (high risk)>1 (no risk), 2 (potential risk) in BDI, BAI, inattention, hyperactivity/impulsivity and K-ARS score. with multiple logistic regression analysis, K-scale was significantly related with male sex, BDI, ARShyperactivity/ impulsivity score.
Conclusion:
We conclude that having male sex, happiness and depressive symptoms is associated with the risk of developing internet use disorders.
To analyse how the auditory brainstem response changes in patients with sudden sensorineural hearing loss.
Method
Data were collected via retrospective medical chart review.
Results
Forty-three patients were included in this study. The mean latency of auditory brainstem response wave 1 was significantly longer for the affected side than for the unaffected side (p = 0.003). The mean latency of auditory brainstem response wave 1 was significantly shorter, and the mean amplitude of auditory brainstem response wave 1 was significantly larger, in the good response group compared to the poor response group. In forward conditional logistic regression analysis, auditory brainstem response wave 1 latency was an independent predictor of a good response (odds ratio = 34.37, 95 per cent confidence interval = 1.56–757.15, p = 0.025).
Conclusion
In patients with sudden sensorineural hearing loss, the latency of wave 1 of the auditory brainstem response was significantly increased and was related to prognosis.
There are no definite guidelines regarding the most adequate steroid regimens for acute acoustic trauma.
Objective
To elucidate the dose-dependent differing benefits of oral steroids on hearing improvement following acute acoustic trauma.
Methods
Twenty-nine patients treated with oral steroids following a diagnosis of unilateral acute acoustic trauma were retrospectively reviewed. Patients were sorted into two groups with an oral steroid regimen. Group 1 received a 14-day course of treatment: 60 mg prednisolone daily for 10 days, tapering off over days 11–14. Group 2 received prednisolone for a total of 10 days: 60 mg for 5 days, tapering down each day for the remainder. Multivariable linear regression analysis was performed to evaluate the factors associated with the hearing gain.
Results
In the multivariable regression (R2 = 0.51, p < 0.001), patients in group 1 showed more significant improvement in the degree of hearing gain compared to group 2 (p = 0.03).
Conclusion
After comparing the differing benefits of oral steroids on hearing improvement by dosage, we recommend a high dose of prednisolone (60 mg per day) for 10 days, tapering over the remaining 4 days, for better hearing recovery following acute acoustic trauma.
We report on the astrometric registration of VLBI images of the SiO and H2O masers in OH 231.8+4.2, the iconic Proto-Planetary Nebula also known as the Calabash nebula, using the KVN and Source/Frequency Phase Referencing. This, for the first time, robustly confirms the alignment of the SiO masers, close to the AGB star, which drives the bi-lobe structure with the water masers in the out-flow.
Thermal plasma wind tunnels with power of 0.4 MW and 2.4 MW have been constructed at Chonbuk National University (CBNU) in Korea. This facility is capable of producing a heat flux greater than 10 MW/m2, a level that is relevant for testing thermal protection materials that are used for re-entry vehicles in space transportation. A segmented arc plasma torch was adopted as a plasma source; this was designed to have high thermal efficiency and long life, and to produce a supersonic plasma flow with enthalpy greater than 10 MJ/kg. We investigated the characteristics of the supersonic plasma flow using intrusive and non-intrusive diagnostic systems. Ablation characteristics of potential thermal protection materials such as carbon/carbon composites and graphite were investigated with the plasma wind tunnel. Cracks and pores in the materials accelerated the erosion. For carbon/carbon composites, the pores grew and the cracks which occurred at the interfaces between the carbon fibres and the matrix propagated, while for the graphite, the erosion started at the pores and peeled off the surface.
A two-phase flow parametric study on an air induction nozzle with water and air as the working fluids is presented. Liquid was supplied at the pre-orifice with various inlet pressures ranging from 3 to 6 bar. The interaction between air and water at the molecular level at the orifice exit leads to formation of a strong shear layer that is intensified with the increase in inlet pressure. Thus, it is vital to regulate the ratio of the intake air to the supplied liquid so that the generated micro bubbles fit the design criteria. CFD analysis was conducted using the commercial software STAR CCM+ from Siemens and validated against experimental data to investigate the design parameters and their effect on the ALR. A volume of fluid (VOF) method of the RANS models was used to undertake the air-water interaction. Parameters such as the throat, air orifice, and air inlet diameter, along with the diffuser angle, were investigated. It was found that certain parameters such as the throat diameter have a more significant effect on the air/liquid entrainment ratio than other parameters.
A new approach is proposed to analyze Bremsstrahlung X-rays that are emitted from laser-produced plasmas (LPP) and are measured by a stack type spectrometer. This new method is based on a spectral tomographic reconstruction concept with the variational principle for optimization, without referring to the electron energy distribution of a plasma. This approach is applied to the analysis of some experimental data obtained at a few major laser facilities to demonstrate the applicability of the method. Slope temperatures of X-rays from LPP are determined with a two-temperature model, showing different spectral characteristics of X-rays depending on laser properties used in the experiments.
Two experiments were conducted to investigate the effects of dietary supplementation of bacteriophage cocktail, probiotics and a combination of these two supplements on performance and gut health of weanling pigs. In Experiment 1, 150 weaned piglets were randomly allotted to three treatments on the basis of BW. The dietary treatments included a basal diet supplemented with 0 (control), 1.0 and 1.5 g/kg bacteriophage cocktail. Pigs fed 1.0 and 1.5 g/kg bacteriophage product had greater (P<0.05) average daily gain (ADG), apparent total tract digestibility of dry matter from day 22 to 35, ileal Lactobacillus spp., villus height (duodenum and jejunum), and fewer coliforms (ileum) and Clostridium spp. (ileum). In Experiment 2, 200 weaned piglets were randomly allotted to four treatments. Dietary treatments included basal diet, basal diet supplemented with 3.0 g/kg fermented probiotic product (P), 1.0 g/kg bacteriophage cocktail (B) and combination of 1.0 g/kg bacteriophage cocktail and 3.0 g/kg fermented probiotic product. Pigs fed bacteriophage cocktail diets had greater (P<0.05) overall ADG, gain to feed ratio (G : F), fecal score from day 8 to day 21, and pigs fed bacteriophage cocktail diets had fewer coliforms (ileum) Clostridium spp. (ileum and cecum). Probiotics significantly increased G : F, colonization of Lactobacillus spp. in ileum. At day 35, bacteriophage treatment group showed greater (P<0.05) villus height of the duodenum, but a deeper crypt in duodenum. The present results indicate that the bacteriophage cocktail had a potential to enhance the performance and gut health of weanling pigs, however their combination with probiotics did not show an interaction.
Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.
OBJECTIVE
To evaluate risk factors for treatment of ASB.
DESIGN
Retrospective observational study.
SETTING
A tertiary academic hospital, county hospital, and community hospital.
PATIENTS
Hospitalized adults with bacteriuria.
METHODS
Patients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.
RESULTS
Among 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14–0.80], P =.01), presence of leukocyte esterase (5.48 [2.35–12.79], P<.01), presence of nitrites (2.45 [1.11–5.41], P=.03), and Escherichia coli on culture (2.4 [1.2–4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.
CONCLUSIONS
ASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.
Infect. Control Hosp. Epidemiol. 2016;37(3):319–326