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We calculated the human resources required for an antimicrobial stewardship program (ASP) in Korean hospitals.
Multicenter retrospective study.
Eight Korean hospitals ranging in size from 295 to 1,337 beds.
The time required for performing ASP activities for all hospitalized patients under antibiotic therapy was estimated and converted into hours per week. The actual time spent on patient reviews of each ASP activity was measured with a small number of cases, then the total time was estimated by applying the determined times to a larger number of cases. Full-time equivalents (FTEs) were measured according to labor laws in Korea (52 hours per week).
In total, 225 cases were reviewed to measure time spent on patient reviews. The median time spent per patient review for ASP activities ranged from 10 to 16 minutes. The total time spent on the review for all hospitalized patients was estimated using the observed number of ASP activities for 1,534 patients who underwent antibiotic therapy on surveillance days. The most commonly observed ASP activity was ‘review of surgical prophylactic antibiotics’ (32.7%), followed by ‘appropriate antibiotics recommendations for patients with suspected infection without a proven site of infection but without causative pathogens’ (28.6%). The personnel requirement was calculated as 1.20 FTEs (interquartile range [IQR], 1.02–1.38) per 100 beds and 2.28 FTEs (IQR, 1.93–2.62) per 100 patients who underwent antibiotic therapy, respectively.
The estimated time required for human resources performing extensive ASP activities on all hospitalized patients undergoing antibiotic therapy in Korean hospitals was ~1.20 FTEs (IQR, 1.02–1.38) per 100 beds.
Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders.
We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling.
We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders.
We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.
To evaluate the appropriateness of the screening strategy for healthcare personnel (HCP) during a hospital-associated Middle East Respiratory Syndrome (MERS) outbreak, we performed a serologic investigation in 189 rRT-PCR–negative HCP exposed and assigned to MERS patients. Although 20%–25% of HCP experienced MERS-like symptoms, none of them showed seroconversion by plaque reduction neutralization test (PRNT).
To determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.
We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.
We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.
Significance of Results:
Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
Genetic variation in wild soybean (Glycine soja Sieb. and Zucc.) is a valuable resource for crop improvement efforts. Soybean is believed to have originated from China, Korea, and Japan, but little is known about the diversity or evolution of Korean wild soybean. Therefore, in this study, we evaluated the genetic diversity and population structure of 733 G. soja accessions collected in Korea using 21 simple sequence repeat (SSR) markers. The SSR loci produced 539 alleles (25.7 per locus) with a mean genetic diversity of 0.882 in these accessions. Rare alleles, those with a frequency of less than 5%, represented 75% of the total number. This collection was divided into two populations based on the principal coordinate analysis. Accessions from population 1 were distributed throughout the country, whereas most of the accessions from population 2 were distributed on the western side of the Taebaek and Sobaek mountains. The Korean G. soja collection evaluated in this study should provide useful background information for allele mining approach and breeding programmes to introgress alleles into the cultivated soybean (G. max (L). Merr.) from wild soybean.
Suicide among older people is one of the most rapidly emerging healthcare issues. The objective of this study was to identify the factors associated with suicide ideation in the aged population in South Korea.
The study recruited 684 subjects older than 65 years old (males = 147, females = 537, mean age = 78.20±7.02 years), and trained interviewers performed the interviews. The study was performed as part of a community mental health suicide prevention program. The subjects’ socio-demographic data, physical health, alcohol problems, social relationships, psychological well-being, and depression severity were all considered. The Korean version of the Beck Scale for Suicide Ideation (K-BSI) was used to evaluate the intensity of suicide ideation. Correlation and hierarchical multiple regression analyses were performed to identify the factors associated with the K-BSI. The study results were tested using a path analysis.
Depression severity was positively correlated with suicide ideation, and economic status, psychological well-being, and social relationships were negatively correlated with suicide ideation. Depression severity had the largest direct impact, and economic status and social relationships had indirect impacts on suicide ideation. Psychological well-being exerted both direct and indirect influences.
Depression severity was the most important predictor of suicide ideation among older people. Other direct and indirect factors played secondary roles. Effective suicide prevention strategies should focus on early detection and active intervention for depression. Socio-economic programs may also indirectly reduce suicide ideation among the aged population.
Plant genetic resources (PGR) include cultivars, landraces, wild species closely related to cultivated varieties, breeder's elite lines and mutants. The loss of genetic diversity caused by the practice of agriculture and the availability of genetic information has resulted in a great effort dedicated to the collection of PGR. Prior to the advent of molecular profiling, accessions in germplasm collections were examined based on morphology. The development of molecular techniques now allows a more accurate analysis of large collections. Next-generation sequencing (NGS) with de novo assembly and resequencing has already provided a substantial amount of information, which warrants the coordination of existing databases and their integration into genebanks. Thus, the integration and coordination of genomic data into genebanks is very important and requires an international effort. From the determination of phenotypic traits to the application of NGS to whole genomes, every aspect of genomics will have a great impact not only on PGR conservation, but also on plant breeding programmes.
The sap of Acer mono has been called ‘bone-benefit-water’ in Korea because of its mineral and sugar content. In particular, the calcium concentration of the sap of A. mono is 37·5 times higher than commercial spring water. In the current study, we examined whether A. mono sap could improve or prevent osteoporosis-like symptoms in a mouse model. Male mice (3 weeks old) were fed a low-calcium diet supplemented with 25, 50 or 100 % A. mono sap, commercial spring water or a high calcium-containing solution as a beverage for 7 weeks. There were no differences in weekly weight gain and food intake among all the groups. Mice that were given a low-calcium diet supplemented with commercial spring water developed osteoporosis-like symptoms. To assess the effect of sap on osteoporosis-like symptoms, we examined serum calcium concentration, and femur density and length, and carried out a histological examination. Serum calcium levels were significantly lower in mice that received a low-calcium diet supplemented with commercial spring water (the negative control group), and in the 25 % sap group compared to mice fed a normal diet, but were normal in the 50 and 100 % sap and high-calcium solution groups. Femur density and length were significantly reduced in the negative control and 25 % sap groups. These results indicate that a 50 % sap solution can mitigate osteoporosis-like symptoms induced by a low-calcium diet. We also examined the regulation of expression of calcium-processing genes in the duodenum and kidney. Duodenal TRPV6 and renal calbindin-D9k were up-regulated dose-dependently by sap, and the levels of these factors were higher than those attained in the spring water-treated control. The results demonstrate that the sap of A. mono ameliorates the low bone density induced by a low-calcium diet, most likely by increasing calcium ion absorption.
Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life.
Prospective cohort study.
Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea.
Subjects and methods
Two groups were constructed for this study – the Ewha pregnancy cohort (n = 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n = 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth.
Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth.
Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.
The aim of the present study was to investigate whether ethanol extracts of Psoralea corylifolia L. (PCE) and its active component protect against bone loss in ovariectomised rats. We screened oestrogenic activities of the main extract fractions using in vitro assays and identified bakuchiol as the most active oestrogenic component by HPLC and LC/MS, and then demonstrated that bakuchiol had strong binding affinity for oestrogen receptor (ER) α. Seventy female Sprague–Dawley rats were assigned to either a sham-operated group (n 10) or an ovariectomised group (n 60). The ovariectomised group was subdivided into six groups, each containing ten rats: vehicle group, two bakuchiol-treated groups (dose of 15 mg/kg per d or 30 mg/kg per d; ten rats for each group), two PCE-supplemented groups (0·25 % or 0·5 % extracts of diets; ten rats for each group) and a 17β-oestradiol (E2)-treated group (20 μg/kg per d). We recorded weight and feed intake every week, and killed all animals after 6 weeks. Blood was collected, and the uterus, kidneys and livers were removed. Bakuchiol has a three-fold higher binding affinity for ERα than for ERβ. Bakuchiol and PCE treatments had no uterotrophic activity even though they demonstrated oestrogenic activity in the in vitro assays. Bakuchiol and PCE treatments reduced postmenopausal bone loss by increasing alkaline phosphatase, Ca concentrations, serum E2 concentration and bone mineral density, and by decreasing the inorganic P level. The present study indicated that bakuchiol and PCE treatments could protect against bone loss.
Carbosilane dendrimers adorned with either triarylamine or carbazole units in their periphery exhibit novel electrochemical behavior in which the electrochemical deposition is controlled by dendrite generation. In addition, the deposited layers remained intact in the depositing solvent, methylene chloride, allowing a second layer to be deposited on top of the first layer. We have sought to establish the suitability of this electrochemical deposition technique for use in the construction of multi-layer OLEDs, which cannot be fabricated via conventional spin-coating with a polymeric precursor. Thus, the electrochemical deposition-based process could potentially offer an ideal combination of deposition control on the one hand and multi-layer fabrication on the other. We report herein the novel electrochemical deposition behavior of arylamine or carbazole end-capped carbosilane dendrimers of the type GnNPB or GnCBP (n = 1-4) and their use for the formation of multi-layer devices for OLEDs.
The interests of low-k dielectric materials to reduce capacitance in multilevel metal interconnects of integrated circuits are well known in the semiconductor industry. Mechanical properties of low-k film are currently the main issues. Improved hardness and modulus are desirable because, when building a multilayered stack and doing sequential processing, films go through chemical mechanical planarization. In this proceeding, we reports the Young's moduli of the typical low k materials, and the effects of various factors for Young's moduli of materials, such as, structures of precursors, density, and porosity. Using atomistic molecular dynamics simulation with experimental measurements, the Young's moduli of films of amorphous silicon oxide in which 25% of Si-O-Si chains were replaced by Si-(CH3 H3C)-Si, Si-CH2-Si, Si-(CH2)2-Si, Si-(CH2)3-Si, Si-(CH2)4-Si, Si-(CH2)6-Si, were measured and analyzed. The predicted trends of Young's moduli of films formed by above precursors are in good consistent with those observed from experiments. The Young's moduli of materials are largely dependent on the densities of materials. Young's modulus of material increases as the density of the material increases. The chemical properties, chain length, and connectivity of material take effects on the Young's modulus of material. Given the same densities of material the smaller number of cavities per unit volume the material has, the lower Young's modulus it shows. Based on the results, the method of predict mechanical properties of materials by the conjunction of basic experimental measurements and atomistic simulation will be discussed.
The effects of IrO2/Pt layered hybrid bottom and/or top electrode structures on the leakage current density versus voltage (J–V), polarization versus voltage (P–V), ferroelectric imprint, and fatigue properties of chemical-solution-derived Pb(ZrxTi1−x)O3 (PZT, Zr/Ti = 35/65) thin films were investigated. The best P–V and J–V performances were obtained from a capacitor with nonhybrid electrodes (Pt/PZT/Pt capacitor). However, the poor fatigue performance of the capacitor required the adoption of hybrid electrode structures. A thin IrO2 layer, as thin as 6 nm, which was inserted between top Pt electrode and PZT layer was sufficient for improving the fatigue performance without any degradation of the other ferroelectric properties. However, the same layer adopted on the bottom Pt electrode was not effective in improving the fatigue performance with degradation in P–V and J–V properties. This was ascribed to IrO2 layer dissolution into the PZT layer during the crystallization annealing of the PZT thin film. A thicker IrO2 layer resulted in more serious degradation.
The BZN pyrochlore thin films were prepared on platinized Si substrates using a reactive RF magnetron sputtering. The structures, surface morphologies, dielectric properties and voltage tunable properties of films with deposition parameters were investigated. The BZN thin films have a cubic pyrochlore phase and secondary phases of zinc niobate, bismuth niobate when crystallized at 600° 800°. The dielectric constant and tunability of thin films are O2/Ar ratio and post-annealing temperature dependent. The BZN thin films sputtered in 15% O2 and annealed at 700° had a dielectric constant of 153, tan δof~0.003 and maximum tunability of 14% at 1,000kV/cm.
(200)-oriented Pt thin films were deposited on SiO2/Si substrates by dc magnetron sputtering using Ar/O2 gas mixtures. Oxygen incorporation into Pt films changed deposition rate, resistivity, stress, and preferred orientation of the films. Increase in film resistivity and decrease in tensile stress were presumed to be the results of the incorporated oxygen into grain boundaries, while the change of preferred orientation resulted from the oxygen incorporation into the Pt lattice. The preferential growth of (200) planes with less total strain energy from the incorporated oxygen resulted in strong (200) preferred orientation in Pt films.
Highly (200)-oriented Pt films on SiO2/Si substrates were successfully prepared by a combination of a dc magnetron sputtering using Ar/O2 gas mixtures and subsequent controlled annealing. The intensity ratio of (200) to (111) planes (I200/I111) was over 200. The (200)-oriented Pt microcrystallites were less susceptible to amorphization due to their lower strain energy with oxygen incorporation than (111)-oriented ones. The controlled grain growth from the selected (200)-oriented seed microcrystallites during subsequent annealing provided a kinetic pathway where grain growth of the seed microcrystallites was predominant, while suppressing the nucleation of surface energy-driven, (111)-oriented seed microcrystallites and subsequent (111) preferred orientation.
The cross-sectional transmission electron microscopy (TEM) specimens of Pt/Ti/SiO2/Si, RuO2/SiO2/Si, W/TiN/SiO2/Si, (Pb,La)TiO3/Pt/MgO, Bi4Ti3O12/Lal-xCaxMnO3/MgO, and GaN/Al2O3 were successfully made by the rocking-angle ion-milling technique. The differential thinning problems could be effectively mitigated when the rocking-angle and the ion-beam incidence angle were optimized for each heterostructure. It was found that the sputtering yield ratio between the layer milled most quickly and the layer milled most slowly is one of the important factors which determine the optimum rocking-angle ion-milling condition. The atomic force microscopy study on the surface topography of the cross-sectional Pt/Ti/SiO2/Si TEM sample after ion-milling provided quantitative information about the effects of the rocking-angle variation. A parameter which is the ratio between the layer with a minimum electron transparency and the layer with a maximum electron transparency was suggested.