We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Critical congenital heart disease (CCHD) refers to a group of heart defects that cause serious, life-threatening symptoms in the neonatal period and requires timely surgical or catheter interventions. We tried to explore current status of CCHD burden and the effect of early diagnosis of CCHD to mortality using the Korean national health insurance (NHI) data.
Methods
We analyzed the national health insurance (NHI) data from 2014 to 2018. We identified CCHD patients using the diagnosis codes and intervention codes from the claim data and the prevalence, mortality and medical expenditure of CCHD were analyzed. We linked neonatal data with their mother’s medical claim data and developed retrospective cohort data set for analyzing the effect of early diagnosis to mortality and related outcomes of CCHD treatment.
Results
The annual prevalence of neonatal CCHD in Korea was 0.144% percent. A total of 2,241 CCHD neonates, 1,546 (69.0%) underwent cardiac ultrasound within three days after birth, and mothers of 419 neonates had a record of prenatal fetal ultrasound (18.7%). In our comparison of neonates diagnosed with CCHD within three days of birth with those diagnosed with CCHD on or after day 4 of birth, the probability of early diagnosis increased for preterm infants and infants with low birth rate. Regarding mortality rate, most types of CCHD showed a significantly higher mortality rate in the early diagnosis group.
Conclusions
The reason for the high mortality rate despite a high early diagnosis rate pertains to the high percentage of patients with severe conditions that induce a serious heart rate within three days of birth. More than half of the neonates with CCHD were found to have not undergone a prenatal fetal ultrasound, rendering this an important policy target.
Critical congenital heart disease (CCHD) refers to a group of heart defects that cause serious, life-threatening symptoms in the neonatal period and requires timely surgical or catheter interventions. We reviewed evidence for incorporating a mandatory neonatal CCHD screening test as a national public health project for all neonates born in Korea by analyzing the validity and cost-effectiveness of neonatal CCHD screening using pulse oximetry in Korea.
Methods
We performed a rapid literature review to establish models for the diagnostic accuracy and economic evaluation of pulse oximetry. Also, we analyzed the prevalence, mortality, and medical expenditure for different types of CCHD using the national health insurance (NHI) data. We analyzed the cost-effectiveness of pulse oximetry by comparing the group of neonates who received a combination of a physical examination and pulse oximetry, and group of neonates who only received a physical examination. For the cost-effectiveness analysis for the CCHD screening test in this study, we used a duration of one year, diagnostic accuracy as the clinical endpoint, and Life Year Gain (LYG) as the effectiveness indicator.
Results
We used recent systematic review he pooled sensitivity can be enhanced from 76.5 percent (pulse oximetry alone) to 92 percent (combined with physical examination). We used a total of 2,334 neonates with CCHD data for the economic model. Our analysis revealed that adding pulse oximetry to the routine neonatal physical examination leads to 2.34 of LYG and a cost difference of USD1,080,602, showing a ICER of KRW610,063,240 (USD461,857)/LYG.
Conclusions
Considering the benefit of LYG and cost of reducing the complications and after effects of newborns with CCHD who survived early diagnosis, it is considered to be worthwhile in Korea for a mandatory screening test.
Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.
Given the dynamic characteristic of an individual’s drinking behaviours, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥ 40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5·3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the third visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2·9 mmHg, P = 0·032) and -adjusted models (3·6 mmHg, P = 0·001), and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3·9 mmHg, P = 0·003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption rather than the trajectory may be significantly related to raised SBP, and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP is adjusted in men.
Here, we present an overview of how a tertiary hospital responded to maintain necessary activities and protect patients and staff from the coronavirus disease (COVID-19) outbreak.
Methods:
Gil Medical Center, a tertiary hospital in Incheon, has operated a special response team since January 21, 2020. All visitors were assessed for body temperature and respiratory symptoms, and screened for recent overseas travel. Suspected COVID-19 patients were taken to a screening clinic. All febrile patients with or without respiratory symptoms were taken to a respiratory safety clinic. An isolation ward, which consisted of 10 negative-pressure rooms, was used to treat confirmed cases. More than 120 beds were prepared for the outbreak, and patients with pneumonia were preemptively isolated.
Results:
By May 5, 480 960 visitors were assessed at the control station, 3350 patients visited the triage center, and 1794 were treated in the respiratory safety clinic. Seventeen confirmed cases were admitted to the negative isolation ward, and 350 patients with pneumonia were preemptively isolated. A total of 2977 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction tests were performed.
Conclusions:
While tertiary hospitals play an important role in treating both COVID-19 patients and non-COVID-19 patients, hospital staff have to protect themselves from unexpected in-hospital transmission. A multifaceted response must be undertaken to protect tertiary hospitals and their staff during the COVID-19 epidemic.
During the past decade, carbapenemase-producing Enterobacteriaceae (CPE) has emerged and spread across the world.1 The major carbapenemase enzymes currently being reported are KPC, NDM-1, VIM, IMP, and OXA.2 Because carbapenemase can be effectively transmitted via mobile genetic elements, and current therapeutic options for CPE infections are extremely limited, CPE may be one of the most serious contemporary threats to public health. However, very little is known about the characteristics of CPE carriage during hospitalization. The aims of this study were to investigate the clearance rate of CPE carriage and determine the number of consecutive negative cultures required to confirm CPE clearance. We also examined CPE transmission among hospitalized patients.
Infect. Control Hosp. Epidemiol. 2015;36(11):1361–1362
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.
The effects of tannic acid (TA) supplementation (0·02 %, wt/wt) were compared with the effects of clofibrate (CF) supplementation (0·02 %, wt/wt) in apo E-deficient (apo E− / −) mice fed a AIN-76 semi-synthetic diet (normal diet) over 20 weeks. The mice were monitored for the modulation of hepatic mRNA expression and the activities of lipid-regulating enzymes. Both TA and CF supplementation lowered hepatic 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMGR) activity and prevented atherosclerotic lesion formation in comparison with the control group. Hepatic carnitine palmitoyl transferase and β-oxidation activities were significantly higher in the TA and CF groups than in the control group. Both CF and TA supplementation resulted in significant decreases in hepatic HMGR mRNA levels in association with its enzyme activity. However, in contrast to CF supplementation, TA supplementation seemed to decrease the accumulation of hepatic lipids in the apo E− / − mice without increasing liver weight. These results suggest that the overall effect of TA is more desirable than CF for the alleviation of hepatic lipogenesis and atherogenesis in apo E− / − mice.
The objectives of this study were to evaluate fish guild compositions and national river health using a multi-metric model of the Korean index of biological integrity using fishes (K-IBIF) in four major Korean watersheds along with water chemistry and habitat quality. Tolerant and omnivore fish species dominated all the watersheds, and the proportions of tolerance guilds and trophic guilds reflected water chemistry and habitat quality. The number of sensitive species and insectivore species had negative correlations (r < −0.42, P < 0.01) with chemical water quality (biological oxygen demand (BOD)), while tolerant species and omnivore species had positive correlation (r > 0.27, P < 0.05) with BOD values. Physical habit conditions, based on qualitative habitat evaluation index (QHEI) model, indicated a “good” condition (mean = 68.9; range = 45–105) in three watersheds, except for the Yeongsan River watershed. Values of QHEI were significantly correlated (R2 > 0.4, P < 0.01) with nitrogen and phosphorus levels in all watersheds, suggesting that habitat degradation is associated with eutrophication. Model values of K-IBIF in the watersheds averaged 18.2, indicating a “fair” condition, and about 37% of all observations in K-IBIF model values were judged as a “poor” health condition, indicating severe health impairment. Overall, our data suggest that degradation of the river health was due to a combined effect of chemical pollution and physical habitat modifications. This research provides valuable information on Korean river conservation and restoration in the future.
Planarization characteristics of ultra low diluted Ceria (CeO2) based slurry, especially a multi-layered Chemical Mechanical Polishing (CMP) process, have been studied. The multi-layer represents the polished film consists of more than two different materials, so that, more than two different materials are exposed to the polished surface. In this work, ultra low diluted ceria based slurry was introduced to minimize micro-dishing effect of the process such as a storage node contact and a bit line contact in 80nm feature sized DRAM device, which has multi-layer film surfaces. As a result, we can minimize micro dishing of silicon dioxide and polycrystalline silicon at memory cell area, and silicon dioxide dishing at peripheral area.
We report on the insulator-charging-effects of poly-4-vinylphenol (PVP) gate dielectric on the reliabilities of pentacene thin-film transistors (TFTs). Our PVP films were prepared by spin coating and curing at various temperatures (155, 175, and 200 °C). Evaluated using Au/PVP/p+−Si structures, the dielectric strength of PVP films cured at 175 °C was superior to those of the other PVP films cured at different temperatures. Although saturation current and field mobility (∼0.13 cm2/Vs) obtained from a TFT with PVP film cured at 200 °C appeared higher than those (∼0.07 cm2/Vs) from the device with 175 °C-cured polymer film, the TFT prepared at 200 °C revealed a low on/off current ratio of less than 104 due to its high off-state current and also unreliable saturation behavior under repetitive gate voltage sweep. The unreliable behavior is due to the dielectric-charging caused by gate-electron-injection. We thus conclude that there are some optimal PVP-curing conditions to improve the reliability of pentacene TFT.
A stress-driven formation of self-assembled InGaAs islands has been studied by the growth on GaAs (100) substrates with sub-micron platinum stripe pattern. Islands or quantum dots preferentially nucleate at the boundary of metal patterns. In addition, a quantum dot-free region near the boundary of the metal pattern is found. Those results are attributed to the stress between metal stripe and GaAs surface, which produces a laterally stressed region around the metal stripe. Adatoms on this region preferentially migrate toward the edge of metal stripes with maximum stress. This result may show a possible way for the interconnection between randomly distributed self-assembled quantum dots and metal stripes.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.