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Coping styles can be improved by dyadic palliative care interventions and may alleviate patients’ and family caregivers’ distress. Moreover, family caregivers’ preloss resilience protects against depression after bereavement. This study aimed to determine the types of coping styles can be encouraged to increase resilience.
Methods
A self-reported questionnaire survey was administered to family caregivers at the 4 palliative care units, and their resilience was assessed using the Connor–Davidson Resilience Scale (CD-RISC) and their coping styles were assessed using the Brief Coping Orientation to Problem Experienced, as well as their background characteristics.
Results
Among 291 caregivers with a mean CD-RISC score of 56.2 (standard deviation: 16.13), internal locus of control, educational level, and history of psychotropic drug use were associated with resilience. After adjusting for the aforementioned factors, more frequent use of positive coping styles such as active coping (Spearman’s ρ = 0.29), acceptance (ρ = 0.29), positive reframing (ρ = 0.29), planning (ρ = 0.24), and humor (ρ = 0.18), was found to be associated with higher resilience. On the contrary, more frequent use of negative coping styles such as behavioral disengagement (ρ = −0.38), self-blame (ρ = −0.27), and denial (ρ = −0.14) was found to be associated with less resilience.
Significance of results
By assessing internal locus of control, educational level, and history of psychotropic medication use of family caregivers, as factors associated with their respective resilience, may help identify less resilient family caregivers who are at risk for developing major depression after bereavement. In addition, coping skill-based educational interventions targeting patients and their family caregivers that focus on specific coping styles associated with resilience may increase family caregivers’ resilience, resulting in less emotional distress and a lower risk of major depression after bereavement.
Lottocracy and epistocracy have received deeply insightful attention as political regimes. Herein, by conducting an experiment using an online survey, we explored the extent to which public opinion is receptive to political decisions under various regimes regarding two environmental policies: education policy and environmental tax policy. By doing so, we examined whether the presence of tax burdens affected the acceptability of political regimes, i.e., electoral democracy, lottocracy, and epistocracy. Our results revealed that decisions based on lottocracy and epistocracy were significantly less acceptable than those based on electoral democracy. Nevertheless, lottocratic and epistocratic decisions were more acceptable regarding the issue of environmental tax policy. The difference was mainly attributed to people's rejection of environmental tax policy offsetting their rejection of lottocracy and epistocracy. This suggests, first, that decisions based on electoral democracy increase policies' acceptability if they do not involve taxation, and second, that the status of whether or not a decision is electoral does not significantly affect policy acceptability if taxation is involved, whereas on the other hand, people are sensitive to differences between the regimes if the policy does not involve taxation.
It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
Methods
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
Results
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.
Method
This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.
Results
A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.
Significance of results
Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.
In recent years, the use of both molecular targeting agents (MTAs) and immune-checkpoint inhibitors (ICIs) tend to occupy important positions in systemic anticancer therapy (SACT). The objective of this study is to describe the predictors of SACT include both MTAs and ICIs near the end of life (EOL) and the effect on EOL care in patients with advanced cancer.
Methods
We analyzed all patients who died of advanced cancer from August 2016 to August 2019, and we analyzed the survival time of patients who underwent anticancer agents excluded due to the loss of information about the last administration of SACT. The primary endpoint of this study was to identify predictors during the last administration of SACT near EOL.
Results
In a multivariate analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS) (ORs 33.781) was significantly related factors within 14 days of death from the last administration of SACT. Age (ORs 0.412), ECOG-PS (ORs 11.533), primary cancer site of upper GI cancers (ORs 2.205), the number of comorbidities (ORs 0.207), MTAs (ORs 3.139), and ICIs (ORs 3.592) were significantly related factors within 30 days of death. The median survival time (MST) of patients with PS 3–4 was 29 days, while that of patients with both PS 0–2 was 76 days. The prevalence rate of delirium with MTAs was 17.5%, which was significantly lower than that of patients without it (31.8%). The prevalence rate of the mean dose of opioids in patients with ICIs was 97.9 mg/day, which was significantly higher than that of patients without it (44.9 mg/day).
Conclusions
Age, ECOG-PS, primary cancer site, the number of comorbidities, MTAs, and ICIs use were significant associated with SACT near EOL. Information on these factors may aid clinical decision making in referral to palliative care institutes.
We report fourteen and twenty-eight protocluster candidates at z = 5.7 and 6.6 over 14 and 19 deg2 areas, respectively, selected from 2,230 Lyα emitters (LAEs) photometrically identified with Subaru/Hyper Suprime-Cam (HSC) deep images. Six out of the 42 protocluster candidates include at least 1 spectroscopically confirmed LAEs at redshifts up to z = 6.574. By the comparisons with the cosmological Lyα radiative transfer (RT) model reproducing LAEs with the reionization effects, we find that more than a half of these protocluster candidates might be progenitors of the present-day clusters with a mass of ≳ 1014M⊙. We also investigate the correlation between LAE overdensity and Lya rest-frame equivalent width (EW), because the cosmological Lyα RT model suggests that a slope of EW-overdensity relation is steepened towards the epoch of cosmic reionization (EoR), due to the existence of the ionized bubbles around galaxy overdensities easing the escape of Lyα emission from the partly neutral intergalactic medium. The available HSC data suggest that the slope of the EW-overdensity correlation does not evolve from the post-reionization epoch z = 5.7 to the EoR z = 6.6 beyond the moderately large statistical errors.
The Bereavement Risk Assessment Tool (BRAT) seems to be useful in identifying those who are likely to suffer from the more severe consequences of bereavement. To date, however, only a few studies have examined bereavement risk using the BRAT. This study investigated bereavement risk in family caregivers of patients with cancer using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). We also investigated the relationship of bereavement risk with psychological distress and resilience among caregivers to determine the validity of the BRAT-J.
Methods
We conducted family psychoeducation in the palliative care unit of Tohoku University Hospital with participants who were recruited in this study. Among the participants, 50 family caregivers provided their written informed consent and were included in this study. Participants were assessed using the BRAT-J and completed the Japanese version of the Kessler Psychological Distress Scale (K6) and the Tachikawa Resilience Scale (TRS).
Results
According to the BRAT-J, five individuals (10%) were in the high category of bereavement risk (level 4 or 5). We also found that family caregivers of patients experienced many different pressures, such as facing the unknown; their own work; and insufficient financial, practical, or physical resources. These issues are associated with various mental problems. Additionally, the level of bereavement risk was significantly correlated with K6 scores (ρ = 0.30, p = 0.032), and the TRS score (ρ = –0.44, p = 0.001). These correlations confirmed previous findings and that the BRAT-J can be an efficient screening tool for the bereavement risk of family caregivers of patients with cancer.
Significance of results
It appears that the BRAT-J is useful in predicting the likelihood of difficulties or complications in bereavement for family caregivers and could help to provide support with these issues when needed.
A nonlinear circuit model (NCM) with physical parameters is proposed for direct simulation of the RF characteristics of GaN high-electron-mobility transistors (GaN HEMTs) on the basis of device structure. The physical equations are used for the construction of the model in order to connect strongly the model parameters with the device/physical parameters. Hyperbolic tangent functions are used as the model equations to ensure good model convergence and rapid simulation (short simulation time). The usefulness of these equations is confirmed by technology computer aided design (TCAD) simulation. The number of model parameters for the nonlinear components (Ids, Cgs, Cgd) is reduced to 17 by using common physical parameters for modeling the drain current and capacitance. The accuracy of this model is verified by applying to GaN HEMTs. The modeled I–V and capacitance characteristics agree well with the measurement data over a wide voltage range. Furthermore, this model can be used for the accurate evaluation of S-parameters and large-signal RF characteristics.
High-energy protons are generated by focusing an ultrashort pulsed
high intensity laser at the Advanced Photon Research Center, JAERI-Kansai
onto thin (thickness <10 μm) Tantalum targets. The laser
intensities are about 4 × 1018 W/cm2. The
prepulse level of the laser pulse is measured with combination of a PIN
photo diode and a cross correlator and is less than 10−6.
A quarter-wave plate is installed into the laser beam line to create
circularly polarized pulses. Collimated high energy protons are observed
with CH coated Tantalum targets irradiated with the circularly polarized
laser pulses. The beam divergence of the generated proton beam is measured
with a CR-39 track detector and is about 6 mrad.
Room-temperature Er-related electroluminescence (EL) properties have been investigated in Er,O-codoped GaAs (GaAs:Er,O) light emitting diodes (LEDs) grown by organometallic vapor phase epitaxy (OMVPE). Under forward bias, characteristic emission due to a luminescence center consisting of Er coordinated by O and As was clearly observed at room temperature, while the Er-related EL was undetectable under reverse bias. At lower current densities, the EL intensity increased linearly with the current density. Subsequently, the intensity exhibited a tendency to saturate at higher current densities. By analyzing the behavior with a fitting according to rate equations, the excitation cross section of Er ions due to current injection was determined to be approximately 10-15 cm2, which is by five orders in magnitude larger than that for optical excitation in Er-doped fiber amplifiers (10-20∼10-21 cm2).
Asynthesized calculation model for developing metallic glasses has been created by taking into account criteria for the achievement of high glass-forming ability (GFA) and viscosity. The model deals with amorphous-forming composition region (AFCR), crystallization temperature (Tx) and three GFA factors: critical cooling rate (Rc), reduced glass-transition temperature (Tg/Tm) and supercooled liquid region (ΔTx=Tx-Tg) where Tg and Tm are glass transition and melting temperature, respectively. The principle of the model is based on thermodynamic functions for multicomponent systems, i.e., mismatch entropy and mixing enthalpy which express the criteria in terms of the number of elements, atomic size differences and the heat of mixing. By combining these thermodynamic quantities with the Miedema's semi-empirical model, AFCR was calculated, and was compared with the experimental results. The GFA factors were also analyzed from viscosity. The Rc was derived from transformation diagram of metallic glasses for crystallization while ΔTx was calculated by solving a differential equation expressing the change in free volume with temperature. As a result of these analyses, Rc-Tg/Tm and R-ΔTx diagrams were found to fit with the experimental results qualitatively. Furthermore, crystallization temperature (Tx) was also calculated for multicomponent metallic glasses by the modification of the Miedema's binary model for the calculation of Tx. The reduced crystallization temperature (Tx/Tl), where Tl is liquidus temperature, was calculated for evaluating GFA of metallic glasses instead of Tg/Tm. Some of the calculation methods used in the present study have theadvantage giving results as a function of composition; thus, there exists possibility to lead to the prediction of glassy alloys compositions. In this sense, the present calculation methods are completely different to the current method for the development of new metallic glasses relying on the empirical criteria which suggest only appropriate systems and/or elements of the alloysfor the achievement of high GFA. In near future, this kind of calculation technique can be used for the prediction of optimal compositions of the metallic glasses with high GFA.
We examined numerous ovarian follicles from 32–35 d virgin mice by transmission electron microscopy and
light microscopic immunohistochemistry. No macrophages were seen, but various stages of apoptotic
granulosa cells were encountered. Presumably a granulosa cell or its debris in an advanced stage of
apoptosis was destined to be phagocytosed by adjacent normal-looking granulosa cells. Other granulosa cells
of normal appearance were seen in the region of the zona pellucida in contact with and apparently
phagocytosing atrophic oocytes. Such granulosa cells were characterised by the presence of gap junctions
with other cells and frequently contained annular gap junctions in the cytoplasm. To confirm the lack of
involvement of macrophages in the process of follicular atresia and elimination, specially prepared ovarian
sections were incubated with antimouse macrophage monoclonal antibodies (F4/80, Mac-1, Mac-2). None
of the follicles examined showed positive immunoreactivity with these antibodies. Atretic follicles may shrink
and eventually disappear from the ovary as a result of repeated apoptosis and phagocytosis by granulosa
cells. There is no evidence for the presence or involvement of macrophages in the atretic follicles, at least in
prereproductive mice as examined.
A high-concentration ozone generator operating at atmospheric pressure has been developed for fabrication of ultra thin silicon oxide films. The generator can supply atmospheric pressure of ozone jet with ozone concentration up to 80 vol%. The ozone jet is generated by desorbing ozone at nearbyn room temperature, which has been condensed on silica-gel by passing ozone/oxygen mixture gas from a commercial ozonizer at a low temperature (<-50°C); at the temperature ozone is more selectively adsorbed on silica-gel than oxygen. The high purity ozone jet with a concentration of 25 vol% at a pressure of 1 × 105 Pa had so large oxidation power that SiO2 film as thick as 3.3 nm grew on a Si surface after 60 min exposure at 375°C. The density of the film was equivalent to that of the film formed by a conventional thermal oxidation process, judging from etching rate with dilute HF solution.
Rayleigh surface wave velocities in Ag/Cr and Au/Cr metallic superlattices have been measured by Brillouin scattering spectroscopy. These metallic superlattices were prepared by the metal-MBE method. X-ray diffraction measurements indicated that the structures of Ag/Cr and Au/Cr superlattices were almost the same. In the Au/Cr superlattices a maximum in a plot of surface wave velocities as a function of the bilayer thickness was observed. On the contrary, a distinct dip was shown in Ag/Cr systems. This anomalous behavior of the sound velocity could not be attributed to the expansion and the contraction of the lattices. Differences in atomic scale structure in the interface seem to play a major role in these systems.
The annihilation of thermal donors in silicon by rapid thermal annealing (RTA) has been studied with deep-level transient spectroscopy. The electron trap AO (Ec – 0.13 eV) observed after heat treatment at 450 °C for 10 h, which is identified with the thermal donor, disappears by RTA at 800 °C for 10 s. However, four electron traps, A1 (Ec 0.18 eV), A2 (Ec – 0.25 eV), A3 (Ec – 0.36 eV), and A4 (Ec – 0.52 eV), with the concentration of ∼1012 cm−3 are produced after annihilation of thermal donors by RTA. These traps are also observed in silicon which receives only RTA at 800 °C. This indicates that traps A1–A4 are thermal stress induced or quenched-in defects by RTA, not secondary defects resulting from annealing of thermal donors.
Effects of rapid thermal processing (RTP) on SiO2/GaAs interfaces have been studied with X-ray photoelectron spectroscopy, capacitance-voltage measurements and deep-level transient spectroscopy. SiO2 films of 50, 200 and 1250 nim thickness have been deposited on GaAs. RTP has been performed at 760 and 910°C for 9 s. The rapid diffusion of Ga through the SiO2 film occurs, and the As loss and the formation of the As layer near the interface are observed. The decrease of the carrier concentration occurs in all RTP samples. Five electron traps EAI (Ec – 0.27 eV), EA2 (Ec – 0.32 eV), EA3 (Ec – 0.47 eV), EA4 (Ec – 0.58 eV) and EL2 (Ec – 0.78 eV) are produced by RTP. It is considered that the production of the trap EL2 is closely related to the Ga outdiffusion into the SiO2 film and the As indiffusion from the pile-up of elemental As near the interface. Effects of SiO2 film thickness on RTP-SiO2/GaAs are also reported.
Effects of rapid thermal processing (RTP) on SiO2/GaAs interfaces have been investigated with Auger electron spectroscopy and X-ray photoelectron spectroscopy. SiO2 films of 100, 175, 200 and 1250 nm thickness have been deposited on liquid encapsulated Czochralski-grown (100) n-type GaAs wafers by the RF sputtering method. RTP has been performed at 800°C for 6 s. For comparison, conventional furnace processing (CFP) has also been performed at 800°C for 20 min for 200-nm-thick SiO2/GaAs. The Ga is observed on the outer SiO2 surface for RTP samples as well as CFP samples. This indicates that the outdiffusion of Ga occurs after only 6 s at 800°C even through 1250-nm-thick SiO2 films. The depth profile of Ga reveals the pile-up of Ga on the outer SiO2 surface for both RTP and CFP samples. The amount of Ga on the outer surface gradually increases in the thickness range 1250 to 175 nm. The As is also observed on the outer surface. The amount of Ga and As on the outer surface rapidly increases at 100 nm thickness. Electron traps in RTP samples have been studied with deep-level transient spectroscopy. Different electron traps are produced in GaAs by RTP between 100-nm- and 200-nm-thick SiO2/GaAs. It is thought that the production of different traps by RTP is related to the amount of Ga and As loss through SiO2 films from GaAs.
The prophylactic effects of carbamazepine (CBZP) were studied in 32 patients with affective disorder who were receiving long-term therapy with CBZP. Complete inhibition of both manic and depressive episodes was observed in four cases, reduced incidence of episodes or decreased intensity of symptoms in twenty, and no change in eight. CBZP was significantly more effective in cases with an onset before the age of 20, and subjects showing a continuous pattern of alternating episodes responded better than those with a more intermittent history of mania and depression. Where CBZP had an effect it was generally apparent soon after therapy started. These results suggest that in some cases CBZP is an agent suitable for long-term continuous prophylactic therapy in manic-depressive disorder.
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