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We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area.
We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs. We compared prehospital response times using multiple linear regression.
A total of 33,276 EMS-treated patients were matched. The prehospital response time for the category of 3 hours before the MCIs was 8.8 minutes (SD: 8.2), treated as the reference, whereas that for the category of 0-1 hour after the MCI was 11.3 minutes (P<0.01). The multiple linear regression analysis revealed that prehospital response time increased by 2.5 minutes (95% CI: 2.3-2.8) during the first hour and by 0.3 minutes (95% CI: 0.1-0.6) during the second hour after MCIs.
There were significant delays in the prehospital response time for emergency patients after MCIs, and it lasted for 2 hours as the spillover effect. (Disaster Med Public Health Preparedness. 2018;12:94–100)
This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL).
We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire–End of Life (QCQ–EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation).
Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ–EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG–PS) scores were significantly associated with survival.
Significance of results:
Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG–PS are needed to help patients experience a dignified and comfortable death.
We investigated the electrical conduction and resistance switching mechanisms of TiOx thin films grown on three kinds of bottom electrode at room temperature (an inert Pt, an active Ti and fluorine tin oxide FTO electrodes). The bottom electrode materials strongly affect the I-V characteristics and switching parameters. The I-V characteristic is explained through the presence of interface states in the metal electrode devices (Pt and Ti) and the work function in the metal oxide device (FTO). The Pt device has the smallest VSET and largest switching ratio, while the Ti device shows the largest VSET and smallest switching ratio. XPS data shows non-lattice oxygen in TiOx films. Therefore, the proposed bipolar resistance switching arises from formation and rupture of filament paths, generated by the movement of oxygen vacancies. All devices depict the same electrical conductions, trap-controlled space-charge-limited, FN tunneling and Ohmic conductions for a high resistance state and a low resistance state, respectively. In this study, the rarely reported FN tunneling conduction in published TiOx-based ReRAM device was found, which can be attributed to an influence of the bottom electrode on the electronic distribution in devices.
The liquid phase plasma reduction method has been applied to prepare silver nanoparticles from a solution of silver nitrate (AgNO3) using a bipolar pulsed electrical discharge system. The excited states of atomic silver, hydrogen and oxygen as well as the molecular bands of hydroxyl radicals were detected in the emission spectra. As the discharge duration increased up to 10 min, silver particle peaks produced by surface plasmon absorption were observed around 430 nm. Both the particle size and the particle numbers were observed to increase with the length of the plasma treatment time and with the initial AgNO3 concentration. Spherical nanoparticles of about 5–20 nm in size were obtained with the discharging time of 5 min, whereas aggregates of nanoparticles of about 10–50 nm in size were mainly produced with the discharging time of 20 min. The cationic surfactant of cetyltrimethylammonium bromide (CTAB) added with the CTAB/AgNO3 molar ratio of 30% was shown to inhibit nanoparticle aggregation.
The oxidation behavior of Cu50Zr50 and Cu46Zr46Al8 glasses during continuous heating up to 1073 K has been investigated, with special emphasis on the oxidation resistance in the supercooled liquid (SCL) state. For Cu50Zr50, the oxide layer mostly consists of monoclinic ZrO2 (m-ZrO2), while for Cu46Zr46Al8, the oxide layer consists of two different layers: an outer layer consisting of tetragonal ZrO2 (t-ZrO2) + Al2O3 + metallic Cu (oxidation product from the SCL state of the glass matrix) and inner layer comprised of m-ZrO2 + metallic Cu islands (oxidation product from the crystallized matrix). Cu-enriched regions consisting of Cu51Zr14 (in Cu50Zr50) or AlCu2Zr + Cu70Zr15Al15 + Cu51Zr14 (in Cu46Zr46Al8) are present below the oxide layer. The present study shows that the addition of Al (8 at.%) in Cu50Zr50 results in a significant deterioration of the oxidation resistance in the SCL state since the solutionizing of Al in t-ZrO2 leads to a higher oxygen ion vacancy concentration, thus providing a higher activity of oxygen ions.
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 low frequency noise of individual ZnO nanowire (NW) field effect transistors (FETs) exposed to air is systematically characterized. The measured noise power spectrum shows a classical 1/f type. The noise amplitude is independent of source-drain current and inversely proportional to gate voltage. The extracted Hooge's constant of ZnO NW is found to be 6.52×10−3. In addition, the low frequency noise of ZnO NW according to NW resistance and contact property are investigated. The noise amplitude is proportional to the square of ZnO NW resistance. If a sample shows a nonlinear current-voltage (I-V) characteristic due to a poor electrical contact, the noise power spectrum is proportional to the third power of current instead of the square of current.
To investigate the annual rate of tuberculosis (TB) infection among newly employed nurses using both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G; Cellestis Limited) assay.
A prospective cohort study involving newly employed nurses.
A tertiary care university hospital in South Korea.
All participants (n = 196) were tested with the TST and QFT-G assay at baseline. After 1 year, the TST and QFT-G assay were reperformed for subjects who had negative TST results at baseline and for all subjects, respectively.
The baseline TST and QFT-G assays were positive for 101 subjects (51.5%) and 28 subjects (14.3%), respectively; 22 subjects (11.2%) had positive results of both tests. Although the overall between-test agreement was 54.9% (κ = 0.151 [95% confidence interval, 0.047–0.245]), agreement improved to 78.5% (κ = 0.462 [95% confidence interval, 0.007–0.917]) for subjects who had not received bacille Calmette-Guérin vaccination. After 1 year, the TST yielded positive results for 16 (21.3%) of 75 nurses with negative baseline results, and the QFT-G assay yielded positive results for 21 (14.4%) of 146 subjects with negative baseline Results. Collectively, 5 subjects (3.0%) experienced conversion to positive results with both tests, and 32 subjects (18.9%) experienced conversion to positive results with one of the tests. Neither the employing hospital department nor exposure to patients with TB affected test conversion status.
The poor overall agreement between TST and QFT-G results may have been caused by the confounding effect of bacille Calmette-Guérin vaccination. The annual risk of TB infection among newly employed nurses was at least 3% on the basis of results of both the TST and QFT-G test. Stricter preventive strategies against TB spread should be implemented in our hospital.
The Yonsei-Yale Isochrones have been widely used since its birth in 2001. We announce a major upgrade mainly making varieties of helium values available. The recent works on the globular clusters with extreme helium abundances have called for such a need. The new version of the Y2 Isochrones are available for [α/Fe] = 0 through 0.6, ΔY/ΔZ = 1.5 through 3.0, and extreme helium abundances (Y = normal 0.05, 0.1, 0.15, 0.2), and for 11 metallicity grids, with full capability of interpolation. The database will be powerful for making population models. Besides, the accuracy of the models on the lower main sequence has been substantially improved. We illustrate the major upgrades and demonstrate the power of the new grids.
This paper gives a necessary and sufficient condition for a Kuhn-Tucker point of a non-smooth vector optimisation problem subject to inequality and equality constraints to be an efficient solution. The main tool we use is an alternative theorem which is quite different to a corresponding result by Xu.
Incomplete reprogramming of the donor cell nucleus after nuclear transfer (NT) probably leads to the abnormal expression of developmentally important genes. This may be responsible for the low efficiency of cloned animal production. Insulin-like growth factor 2 (IGF2) and IGF2 receptor (IGF2R) are imprinted genes that play important roles in preimplantation development. To obtain an insight into abnormal gene expression after nuclear transfer, we assessed the transcription patterns of IGF2-IGF2R in single in vitro fertilised and cloned embryos by reverse-transcription polymerase chain reaction (RT-PCR). IGF2R expression did not differ significantly but IGF2 was more highly expressed in cloned embryos than in IVF embryos (p < 0.05). This was confirmed by a quantitative RT-PCR method. Thus, incomplete reprogramming may induce abnormal transcription of IGF2 in cloned embryos.
The sliding friction and wear performance of Al–Ni–Co–Si quasicrystalline coatings deposited by the high-velocity oxy-fuel technique were investigated under dry sliding conditions. This study indicated that changes in the imposed sliding test conditions modified the friction and wear behavior of quasicrystalline coatings. Qualitative analysis of the contact interface and wear debris were performed with the aim of understanding the role of the third body on the friction and wear processes. The dependence of the coefficient of friction on the sliding velocity and counterpart material was explained by the stick-slip behavior. It was also shown that test conditions favorable for the formation of thick intermediate layers and the densification of the coating subsurface led to low wear rates. Large cylindrical particles, formed by agglomeration of small wear debris, were suggested as a beneficial factor for the reduction of the coefficient of friction.
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