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To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS).
Methods
Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M).
Results
Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline.
Conclusions
Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes.
The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.
Method:
We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.
Results:
Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).
Discussion:
The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.
Feasibility of multiwavelength Raman spectroscopy was studied as a potentialin-line monitoring technique for grain size distribution in channel poly-Si usedin three dimensional stacked NAND (3D NAND) Flash memory devices. Variouschannel poly-Si materials in 3D-NAND Flash memory devices, converted fromchemical vapor deposition (CVD) grown a-Si, were characterized usingnon-contact, multiwavelength Raman spectroscopy and high resolutioncross-sectional transmission electron microscopy (HRXTEM). The Ramancharacterization results were compared with HRXTEM images. The correlationbetween the grain size distribution characterized by multiwavelength Ramanspectroscopy and “on current” (ION) of 3D NANDFlash memory devices was investigated. Good correlation between these techniqueswas seen. Multiwavelength Raman spectroscopy is very promising as anon-destructive in-line monitoring technique for grain size distribution inchannel poly-Si used in 3D NAND Flash memory devices.
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.
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.
The liquid lens based on MEMS technology can be an appropriate solution to improve the imaging capability of a capsule endoscope because it can be realized small enough and also consume negligible power. In this paper, a cylinder-type liquid lens was designed to minimize the dead area and then fabricated with MEMS technology combining the silicon thin-film process and the wafer bonding process where the multiple dielectric layer of Teflon, silicon nitride and thermal oxide was formed on the cylinder wall. The focal length of the lens module including the fabricated liquid lens was changed reproducibly as a function of the applied voltage. With the change of 30V in the applied bias, the focal length of the constructed lens module could be tuned in the range of about 42cm. The fabricated liquid lens was also proven to be small enough to be adopted in the capsule endoscope, which means the liquid lens can be utilized for the imaging capability improvement of the capsule endoscope.
To develop new evaluation indices of infection control and to use them to evaluate Korean infection surveillance and control programs (ISCPs).
Design.
We performed a questionnaire-based survey to 164 acute care general hospitals throughout the Republic of Korea that had more than 300 beds. Study methods were based completely on those of the Study on the Efficacy of Nosocomial Infection Control (SENIC). Four SENIC indices (hospital epidemiologist index, infection control nurse index, surveillance index, and control index) and 4 newly developed indices (healthcare worker index, quality improvement index, resource index, and hand hygiene facilities index) were used to evaluate Korean ISCPs. Data were collected by questionnaire from June 17 to October 11, 2003.
Setting.
One hundred sixty-four general hospitals with more than 300 beds in the Republic of Korea.
Results.
Personnel from 85 general hospitals responded to the study questionnaire. The reliability and validity of the evaluation indices were statistically significant (P<.05). The 8 evaluation indices were categorized into 2 factor groups: personnel factors (hospital epidemiologist index and infection control nurse index) and activity factors (the remaining 6 indices). Korean ISCPs showed a major weakness in surveillance. The scores for the newly developed evaluation indices were better than those for the SENIC evaluation indices. However, most Korean hospitals were estimated to have had only slight reductions in nosocomial infection rates. The evaluation indices were influenced significantly by the number of beds in the hospital, whether the hospital was located in the Seoul-Gyonggi region, the presence of full-time infection control nurses at the hospital, the education level of the infection control nurses, and the nurses' experience in infection control (P<.05).
Conclusions.
The reliability and validity of the SENIC evaluation indices and the newly developed evaluation indices were satisfactory in evaluating Korean ISCPs. However, surveillance should be improved to increase the efficacy of Korean ISCPs.
Bump process using gold bump led to many cleaning problems like polymer residues, metal and polyimide consumption after stripping process. First of all, stripping process of bump photoresist is one of the difficult technologies since thickness of PR pattern of bump is thicker than that of general metal line at least 100 times. We investigated the improvement of LDI BUMP stripping Process at 25 with new chemical. We found that the wettability may be improved when the additive was added to the chemical and it improves the stripping ability. It was found that new chemical was superior to commercial chemical in terms of chemical stability, removal efficiency of polymer residue and decrease in metal and polyimide consumption. Also, we could obtain removal mechanism of photoresist pattern by measured Raman equipment and enhancement of yield in mass production line of semiconductor.
The MEMS (micro-electro-mechanical systems) microphone enables the manufacturing of small mechanical components on the surface of a silicon wafer. The MEMS microphones are less susceptible to vibration because of the smaller diaphragm mass and an excellent candidate for chip-scale packaging. In this paper, we present a piezoelectric MEMS microphone based on (1-x)Pb(Mg1/3Nb2/3)O3-xPbTiO3 (PMN-PT) single crystal diaphragm. The PMN-PT materials exhibit extremely high piezoelectric coefficients and other desirable properties for an acoustic sensor. The piezoelectric-based microphone can offer the ability to passively sense without the power requirements. In particular, this paper introduces the design of a PMN-PT single crystal diaphragm with interdigitated electrode. We were able to fabricate miniaturized PMN-PT single crystal diaphragms. The fabricated sensor exhibits the sensitivity of 1.5mV/Pa. This implies that the PMN-PT thin film microphone has a potential of excellent acoustic characteristics.
A gold and aluminum layer was investigated as an anode for organic light-emitting devices (OLEDs). By pretreating the ultrathin aluminum layer in an oxygen (O2) plasma, the hole injection from the metal anode to the organic layer was greatly enhanced. The fabricated OLEDs demonstrated improved current density and luminance characteristics as compared with other devices using a gold anode and an aluminum layer not treated with an oxygen plasma.
The reaction sequence and microstructure evolution of a crystalline MgB2 layer were examined during ex situ annealing of evaporated amorphous boron (a-B) with Mg vapor. Mg was found to migrate rapidly into the a-B layer in the initial stage of reaction with a uniform concentration of about 12 at.%. A thin layer of crystalline MgO was observed at the interface between a-B and the Al2O3 substrate. It was identified that an MgB2 layer started to form at the surface by the nucleation and growth process in polycrystalline form. It appears that there exists two distinct growth fronts in the MgB2 layer: one lying at the surface and the other lying at the interface between the MgB2 layer and the a-B. The microstructural evolution of this layer showed significant differences depending on the location of these two growth fronts.
Metal-insulator-metal (MIM) capacitors were fabricated in a coplanar waveguide type using the Al2O3 thin film. The Al2O3 film was grown by atomic layer deposition(ALD) using Methyl-Pyrolidine-Tri-Methyl-Aluminum (MPTMA) and H2O on Ti. The capacitance per unit area of the fabricated MIM capacitor was 0.229 μF/cm2. And it had lower voltage coefficient of capacitance (VCC) and lower leakage current than that of Al2O3 MIM capacitor prepared by Al oxidation and Si3N4 MIM capacitor prepared by PECVD respectively. The fabricated Al2O3 MIM capacitors prepared by ALD exhibited low VCC, low leakage current, small frequency-dependent capacitance reduction, low temperature coefficient of capacitance (TCC) and good reliability. The characteristics of the device were suitable for RF ICs and DRAM.
Proper selection of an osteotome for nasal osteotomy is important for minimizing soft tissue trauma. Radiographic analysis of the facial bony lateral wall thickness was performed to suggest a guideline for an appropriate osteotome size for Asians. Facial bone computed tomography (CT) of 100 patients (50 male, 50 female) were studied. The thickness of the facial bony lateral wall at three points along the track of a lateral osteotomy, and two points along the track of a medial osteotomy and intermediate osteotomy were measured. The average bony thickness along the track of a lateral osteotomy was 2.61 ± 0.66 mm at the low level, 2.75 ± 0.76 mm at the middle level, and 2.72 ± 0.53 mm at the high level in subjects. The average bony thickness along the track of an intermediate osteotomy were 1.26 ± 0.34 mm at the low level, and 1.31 ± 0.32 mm at the high level in the subjects. The average bony thickness along the track of the medial osteotomy were 2.54 ± 0.31 mm at the lowlevel, and 2.77 ± 0.30 mm at the high level in subjects. These results may provide a guideline for choosing an osteotome of appropriate size for the Asian population.
Low-temperature deposition of high-quality (Ba, Sr)TiO3 (BST) thin films was achieved in air on Pt/Ti/SiO2/Si substrates using the charged liquid cluster beam (CLCB) method. The Ba, Sr, and Ti precursors were synthesized using alkoxy carboxylate ligands to tailor their physical properties to the CLCB process. The as-deposited BST films fabricated at substrate temperatures as low as 280 °C exhibited high purity. The leakage current density and dielectric constant of the film, deposited at 300 °C and subsequently annealed at 700 °C, were 2.5 × 10−9 A/cm2 at 1.5 V and 305, respectively.
The good field-emission properties of carbon nanotubes coupled with their high mechanical strength, chemical stability, and high aspect ratio, make them ideal candidates for the construction of efficient and inexpensive field-emission electronic devices. The fabrication process reported here has considerable potential for use in the development of integrated radio frequency amplifiers or field emission-controllable cold electron guns for field emission displays. This fabrication process is compatible with currently used semiconductor processing technologies. Micropatterned vertically aligned carbon nanotubes were grown on planar Si surface or inside the trenches, using chemical vapor deposition, photolithography, pulsed-laser deposition, reactive ion etching, and the lift-off method. To control the field-emission current by a 3rd electrode, the gate electrode, we grew carbon nanotubes inside the trenches. This triode-type structure is the best to realize the gray-scale carbon nanotube field emission. This carbon nanotube fabrication process can be widely applied for the development of electronic devices using carbon nanotube field emitters as cold cathodes and could revolutionize the area of field-emitting electronic devices such as RF amplifiers and field emission displays.
We have grown well-aligned carbon nanotube arrays by thermal chemical vapor deposition at 800°C on Fe nanoparticles deposited by a pulsed laser on a porous Si substrate. Porous Si substrates were prepared by the electrochemical etching of p-Si(100) wafers with resistivities of 3 to 6 ωcm. These well-aligned carbon nanotube field emitter arrays are suitable for electron emission applications such as cold-cathode flat panel displays and vacuum microelectronic devices like microwave power amplifier tubes. Field emission characterization has been performed on the CNT-cathode diode device at room temperature and in a vacuum chamber below 10−6 Torr. The anode is maintained at a distance of 60[.proportional]m away from the carbon nanotube cathode arrays through an insulating spacer of polyvinyl film. The measured field emitting area is 4.0×10−5cm2. Our carbon nanotube field emitter arrays emit 1mA/cm2at the electric field, 2V/[.proportional]m. And they emit a large current density as high as 80mA/cm2 at 3V/[.proportional]m. The open tip structure of our carbon nanotubes and their good adhesion through Fe nanoparticles to the Si substrate are part of the reason why we can attain a large field emission current density within a low field. The field emitter arrays in our diode device are vertically well-aligned carbon nanotubes on the Si-wafer substrate.
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