Background: The purpose of this study was to find out the relationship between appropriateness of antibiotic prescription and clinical outcomes in patients with community-acquired acute pyelonephritis (CA-APN). Methods: A multicenter prospective cohort study was performed in 8 Korean hospitals from September 2017 to August 2018. All hospitalized patients aged ≥19 years diagnosed with CA-APN at admission were recruited. Pregnant women and patients with insufficient data were excluded. In addition, patients with prolonged hospitalization due to medical problems that were not associated with APN treatment were excluded. The appropriateness of empirical and definitive antibiotics was divided into “optimal,” “suboptimal,” and “inappropriate,” and optimal and suboptimal were regarded as appropriate antibiotic use. The standard for the classification of empirical antibiotics was defined reflecting the Korean national guideline for the antibiotic use in urinary tract infection 2018. The standards for the classification of definitive antibiotics were defined according to the result of in vitro susceptibility tests of causative organisms. Clinical outcomes including clinical failure (mortality or recurrence) rate, hospitalization days, and medical costs were compared between patients who were prescribed antibiotics appropriately and those who were prescribed them inappropriately. Results: In total, 397 and 318 patients were eligible for the analysis of the appropriateness of empirical and definitive antibiotics, respectively. Of these, 10 (2.5%) and 18 (5.7%) were inappropriately prescribed empirical and definitive antibiotics, respectively, and 28 (8.8%) were prescribed either empirical or definitive antibiotics inappropriately. Patients who were prescribed empirical antibiotics appropriately showed a lower mortality rate (0 vs 10%; P = .025), shorter hospitalization days (9 vs 12.5 days; P = .014), and lower medical costs (US$2,333 vs US$4,531; P = .007) compared to those who were prescribed empirical antibiotics “inappropriately.” In comparison, we detected no significant differences in clinical outcomes between patients who were prescribed definitive antibiotics appropriately and those who were prescribed definitive antibiotics inappropriately. Patients who were prescribed both empirical and definitive antibiotics appropriately showed a lower clinical failure rate (0.3 vs 7.1%; P = .021) and shorter hospitalization days (9 vs 10.5 days; P = .041) compared to those who were prescribed either empirical or definitive antibiotics inappropriately. Conclusions: Appropriate use of antibiotics leads patients with CA-APN to better clinical outcomes including fewer hospitalization days and lower medical costs.

Funding: No

Disclosures: None

Table 1.

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In this paper, we have observed an atomic-scale structure and compositional variation at the interface of the InGaN/GaN multi-quantum wells (MQW) by both scanning transmission electron microscopy (STEM) using high-angle annular dark-field mode and atom probe tomography (APT). The iso-concentration analysis of APT results revealed that the roughness of InGaN/GaN interface increased as the MQW layers were filled up, and that the upper interface of MQW (GaN/InGaN to the p-GaN side) was much rougher than that of the lower interface (InGaN/GaN tot he n-GaN side). On the basis of experimental results, it is suggested that the formation of interface roughness can affect the quantum efficiency of InGaN-based light-emitting diodes.

Leaf stomatal characteristics of Siberian elm (Ulmus pumila) were investigated by electron microscopy and white light scanning interferometry. On the basis of average annual precipitations, two types of tree specimens were collected from Korea, China, and Mongolia: (1) trees under normal environmental conditions and (2) trees under arid conditions. Field emission scanning electron microscopy revealed oval-shaped stomata on the lower surface, and they were ca. 20 μm in width. In-lens secondary electron imaging showed differences in electron density and stomatal pore depth between the two types. According to the line profile analysis by white light scanning interferometry, stomata under arid conditions appeared to have higher levels of the stomatal pore depth than ones under normal conditions. Focused ion beam–field emission electron microscopy supported the increased stomatal pore depth with the increasing drought stress gradient. These results suggest that complementary microscopy can be employed to unravel the adaptive phenotypic plasticity of Siberian elm in response to drought stress.

Background: Mortality associated with depression may be influenced by severity of depression and gender. We investigated the differential impacts on all-cause mortality of late-life depression by the type of depression (major depressive disorder, MDD; minor depressive disorder, MnDD; subsyndromal depression, SSD) and gender after adjusting comorbid conditions in the randomly sampled elderly.

Methods: One thousand community-dwelling elderly individuals were enrolled. Standardized face-to-face clinical interviews, neurological examination, and physical examination were conducted to diagnose depressive disorders and comorbid cognitive disorders. Depressive disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria and SSD to study-specific operational criteria. Five-year survivals were compared between groups using Cox proportional hazards models.

Results: By the end of 2010, 174 subjects (17.4%) died. Depressive disorder (p = 0.001) and its interaction term with gender (p < 0.001) were significant in predicting five-year survival. MDD was an independent risk factor for mortality in men (hazard ratio = 3.65, 95% confidence interval = 1.67–7.96) whereas MnDD and SSD were not when other risk factors were adjusted.

Conclusions: MDD may directly confer the risk of mortality in elderly men whereas non-major depression may be just an indicator of increased mortality in both genders.

Human complement regulatory protein hCD46 may reduce the hyperacute rejection (HAR) in pig-to-human xenotransplantation. In this study, an hCD46 gene was introduced into porcine embryonic germ (EG) cells. Treatment of human serum did not affect the survival of hCD46-transgenic EG cells, whereas the treatment significantly reduced the survival of non-transgenic EG cells (p < 0.01). The transgenic EG cells presumably capable of alleviating HAR were transferred into enucleated oocytes. Among 235 reconstituted oocytes, 35 (14.9%) developed to the blastocyst stage. Analysis of individual embryos indicated that 80.0% (28/35) of embryos contained the transgene hCD46. The result of the present study demonstrates resistance of hCD46-transgenic EG cells against HAR, and the usefulness of the transgenic approach may be predicted by this cytolytic assessment prior to actual production of transgenic pigs. Subsequently performed EG cell nuclear transfer gave rise to hCD46-transgenic embryos. Further study on the transfer of these embryos to recipients may produce hCD46-transgenic pigs.

There has been a significant effort to create spiral sensors by changing either the periodic d-spacing of the structure or the dielectric constants of the materials by combining the multi-faceted environmental responsiveness of polymer hydrogels with dielectrical structures.1 Reversible spiral switches with dimensional functionalities that respond to chemical environment were constructed. When the spiral photonic actuator was swollen in hydrophilic acetic acid, right-handed spiral structures are formed, while the spiral photonic actuator was swollen in hydrophobic hexane, left-handed spiral structures are formed. All actuators returned back to the transparent planar state after deswelling processes. These reversible spiral photonic actuators can be applied in the application of mechanical actuators, electrical devices, and optical components.

We report on the basic characteristics and gas sensing operation of density controlled single-walled carbon nanotube (SWCNT) thin films on poly(dimethyl siloxane) (PDMS) substrates The vacuum filteration and PDMS mold transfer method allowed the density of SWCNT distributed to have non-local uniformity. The optical transparency of the SWCNT thin films was inversely proportional to SWCNT density and conductivity. The flexible SWCNT thin film showed high mechanical stability with negligible change in conductance after being bent by 180o. We evaluated its gas sensing operation depending on SWCNT density and bias voltage. It was shown that lower SWCNT density thin films had higher sensitivity to NH3 gas, which may be due to higher exposed surface area for lower density SWCNT thin films. Also, we found that lower bias voltage devices showed faster recovery times. The results show that vacuum filteration and mold transfer method produced flexible SWCNT thin films that have stable mechanical and electrical characteristics and also stable gas sensing capabilities making them applicable to future flexible integrated sensors.

CIGS nanoparticles for the CIGS absorber layer have been synthesized by low temperature colloidal routes. The CIGS absorber layers for solar cells have been prepared by spray deposition of CIGS nanoparticle precursors (∼20 nm) in glove box under inert atmosphere. An automatic air atomizing nozzle spray system with computer controlled X-Y step motor system was used to spray. The nanoparticle precursor CIGS film was deposited onto molybdenum-coated soda-lime glass substrates (2.5 cm × 5.0 cm) heated to 160°C. The film thickness in the range of 2 μm ± 0.3 μm was attained by spraying of 3 mM colloidal over an area of 12.5 cm2. The coalescence between particles was observed in the CIGS absorber layer under post-treatment of over 550 °C. This is related to the reactive sintering among the nanoparticles to reduce surface energy of the particles. The CuxSe thin film, formed on Mo film by evaporation, improved adhesion between CIGS and Mo layers and enhanced the coalescence of the particles in the CIGS layer. These are closely related to the fluxing of Cu2Se phase which has relatively low melting temperature. The CdS buffer layer was deposited on the CIGS/Mo/soda-lime glass substrate by chemical bath deposition. The CIGS nanoparticles-based absorber layers were characterized by using energy dispersive spectroscopy (EDS), x-ray diffraction (XRD) and high-resolution scanning electron microscopy (HRSEM).

The quarternary CIGS nanoparticles for absorber layer of solar cells have been synthesized with various mole ratios by colloidal route. The CIGS nanoparticles were prepared by reacting CuI, InI3, GaI3 in pyridine with Na2Se in methanol at 0°C under inert atmosphere. For Cu0.9In0.8Ga0.3Se2 and Cu0.9In0.7Ga0.4Se2 stoichiometric ratios, tube-type nanofibers were obtained with the widths in the range of 20–50 nm and lengths of 0.1–3 μm from reaction at 0°C for 20 min. For Cu1.1In0.68Ga0.23Se1.91, and Cu0.9In0.68Ga0.23Se1.91 ratios, spherical nanoparticles were obtained from the same reaction condition. As compared to particles from Cu0.9In0.68Ga0.23Se1.91 ratio, more uniform and smaller nanoparticles with diameter in the range of 5–20 nm were obtained from the Cu1.1In0.68Ga0.23Se1.91 stoichiometric ratio. The morphology change of the CIGS particles seems to be closely related to the ratio of Cu/(In, Ga).

Various low-k materials are being pursued as dielectric materials for future interconnects. However, poor thermo-mechanical properties of low-k materials cause tremendous reliability concerns, thus the proper materials for integration with Cu are not suggested yet. In this study, the line width and spacing dependence of damascene Cu lines embedded by TEOS and low-k materials (CORAL) was analyzed using x-ray diffraction. Generally, the hydrostatic stress of Cu/TEOS was greater than that of Cu/CORAL, while the opposite for von-Mises stress. Using a three-dimensional finite analysis (FEA), the effect of low-k materials on the stress and its distribution in via-line structures of dual damascene Cu interconnects was studied. In the case of Cu/TEOS, the hydrostatic stress was concentrated at the via and on the top of the lines, where it was suspected that the void would nucleate. On the other hand, in the via-line structures integrated with organic low-k materials, large von-Mises stress was maintained in the via. Therefore, the deformation of via, rather than voiding, may be the main failure mode in the interconnects with low-k materials.

AlxGa1-xN sample with x=0.36 was epitaxially grown on sapphire by MOCVD. SAW velocity of 5420 m/s and TCF (temperature coefficient of frequency) of -51.20 ppm/°C were measured from the SAW devices fabricated on the AlxGa1-xN sample, when kh value was 0.078, at temperatures between –30 °C and 60 °C Electromechanical coupling coefficient was ranged from 1.26 % to 2.22 %. The fabricated SAW filter have shown a good device performance with insertion loss of -33.853 dB and side lobe attenuation of 20 dB.

The relationship between the dielectric properties of the complex perovskite (Pb1−xCax)(Mg0.33Ta0.67)O3 ceramics, where 0.45 ≤ × ≤ 0.60, and the dielectric polarizability, related to bond valences of A-site ions, was investigated at microwave frequencies. As the Ca content (x) increased, the deviation of the observed dielectric polarizabilities, calculated by the Clausius–Mosotti equation from the theoretical values calculated by the additivity rule of dielectric polarizability, decreased from −3% to −0.69%. It was found that this deviation was related to the bond valence of the A-site. Smaller negative deviation corresponded to the cations with lower bond valence, and larger negative deviation corresponded to the cations with higher bond valence. Also, the temperature coefficient of resonant frequency (TCF) was affected by the bond valence of the A-site, and then TCF decreased with decreasing bond valence of the A-site in ABO3 perovskite compounds.

This paper compared two different film deposition processes for formation of TiN barrier layers, conventional TiCl4-based chemical vapor deposition and atomic layer deposition (ALD). The 30nm thick TiN film deposited by conventional TiCl4-based CVD at the process temperature of 600°C followed by NH3 post-deposition anneal showed about 180 μΩcm of resistivity, over 95 % of step coverage for the pattern aspect ratio of 6 on 0.35 μm contact diameters, and below 2 at.% of chlorine contents in the film. Meanwhile, the films deposited by ALD at 100°C lower process temperature than CVD showed much better film properties even without post-deposition anneal. It showed lower resistivity values and lower chlorine incorporation along with better step coverage characteristics. More detailed material analysis was done by AFM, SEM, and AES.

The cocktail source of BST was prepared by mixing of Ba, Sr, and Ti precursor solution with specific mole ratio. This cocktail source was vaporized and delivered into the warm wall reactor by liquid delivery system(LDS) and gaseous source was distributed by simple structure of gas injector instead of showerhead system. The thickness uniformity of BST on 8 inch wafers were less than 3%. The Ti composition uniformity of our films were less than the 1 at%(1σ ) at stoichiometric and near stoichiometric. Their dielectric constant was about 230 and leakage current density was lower than 10-8 A/cm2 under ±1V bias. Excellent step coverage and smooth (haze-free) surface morphology of BST films were obtained by a deposition using a noble dome type reactor. The merit of our warm wall type reactor also will be explained by excellent step coverage and the uniform composition with 3 dimensional structure. Our achievement should be applicable to the capacitor of next generation DRAM.

Tantalum nitride (TaN) films were deposited using pentakis-diethylamido-tantalum [PDEAT, Ta(N(C2H5)2)5] as a precursor. During film growth, N- and Ar-ion beams with an energy of 120 eV were supplied in order to improve the film quality. In case of thermallydecomposed films, the deposition rate is controlled by the surface reaction up to about 350 °C with an activation energy of about 1.07 eV. The activation energy of the surface reaction controlled regime is decreased to 0.26 eV when the Ar-beam is applied. However, in case of Nbeam bombarded films, the deposition is controlled by the precursor diffusion in gas phase at the whole temperature range. By using Ar-beam, the resistivity of the film is drastically reduced from approximately 10000 µω-cm to 600 µω-cm and the density of the film is increased from 5.85 g/cm3 to 8.26 g/cm3, as compared with thermally-decomposed film. The use of N-beam also considerably lowers the resistivity of films (∼ 800 µω-cm) and increases the density of the films (7.5 g/cm3). Finally, the diffusion barrier properties of 50-nm-thick TaN films for Cu were investigated aftre annealing by X-ray diffraction analysis. The films deposited using N- and Arbeam showed the Cu3Si formation after annealing at 650 °C for 1 hour, while thermallydecomposed films showed Cu3Si peaks firstly after annealing at 600 °C. It is considered that the improvements of the diffusion barrier performance of the films deposited using N- and Ar-ion beam are the consequence of the film densification resulting from the ion bombardment during film growth.

Ba(Ti1−xSnx)O3 (0 ≤ x ≤ 0.3) thin films were deposited on a platinized silicon substrate by a solution deposition process with methoxyethanol, water, and propylene glycol as solvents. Dielectric properties and current–voltage characteristics of the thin films were investigated in conjunction with phase evolution and microstructures by varying heating temperatures and Sn contents (x). Thin films annealed above 700 °C showed a pure perovskite phase with nanoscaled grains (20–30 nm). The dielectric constant of the thin films depended on the Sn content and showed a maximum value of 330 at x = 0.15. The leakage current behavior of an optimum composition corresponding to x = 0.15 was examined by correlating with charge transport mechanisms. Schottky emission was found to be predominant at voltages less than 6.8 V, and Fowler–Nordheim tunneling appeared to be responsible above 6.8 V. The Schottky barrier of the Ba(Ti0.85Sn0.15)O3–Pt interface was determined to be 1.49 eV.