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This is a copy of the slides presented at the meeting but not formally written up for the volume.
Stripe domains in ferroelectric thin films form in order to minimize the total energy of the film. It has been known for some time that a stable configuration is reached when the decrease in elastic energy from domain formation is balanced by the energetic costs of domain wall formation, local elastic strains in the substrate, and internal electric field formation from domain polarizations. The size and strain of each domain is determined by the lattice mismatch and the energetic costs of interface formation. Recent piezoelectric force microscopy measurements have shown that BiFeO3 (BFO) films on SrRuO3/SrTiO3 (001) substrates form striped polarization domains. Since the details of the local structure and polarization cannot be measured at the same time with conventional techniques, we have used synchrotron x-ray microdiffraction to study these effects. Probing only a few domains at a time with the submicron x-ray spot resulted in a diffraction pattern near the substrate (103) reflection consisting of several BFO peaks. We have unambiguously assigned these peaks to individual structural variants. Based on these results, we propose a physical model that includes the striped domains. The structural variants within the stripes are similar to those predicted by striped patterns in rhombohedral films which minimize elastic energy. The local piezoelectric properties were measured using time-resolved microdiffraction in order to examine the role of the striped domains in the linear responses of the film. The out of plane piezoelectric coefficient d33 was approximately 50 pm/V and the piezoelectric strain was proportional to electric field was up to 0.55%, the maximum strain we have measured. The projection of the in-plane piezoelectric coefficients onto the reciprocal space maps for different structural variants had vastly different values due to the differences in orientation of the domains.
A new design method of an ultra-wideband circularly-polarized planar multiple-input-multiple-output (MIMO) antenna is presented in this paper. The proposed MIMO antenna consists of four unit cell antennas, being comprised of a microstrip feed line and a square slotted ground plane. In the proposed unit cell design, a circular stub is protruded from the ground plane strip for achieving circular polarization. The unit cell of the MIMO antenna is optimized by adjusting design parameters. The compact four-port MIMO antenna prototype is designed on the FR4 substrate with the overall dimensions of 45 × 45 × 1.6 mm3. The proposed four-port MIMO antenna design provides an impedance bandwidth (S11 < −10 dB) of 112% (3.1–11 GHz) and a 3 dB axial ratio bandwidth of 36% (4.8–6.9 GHz). The performance of the fabricated MIMO antenna shows good agreement between the EM simulation and measurement results.
Cosmopolitan habitat-forming taxa of algae such as the genus Corallina provide an opportunity to compare patterns of biodiversity over wide geographic scales. Nematode assemblages inhabiting Corallina turves were compared between the south coasts of the British Isles and South Korea. A fully nested design was used with three regions in each country, two shores in each region and replicate samples taken from three patches on each shore to compare differences in the taxonomic and biological trait composition of nematode assemblages across scales. A biological traits approach, based on functional diversity of nematodes, was used to make comparisons between countries, among regions, between shores and among patches. The taxonomic and biological trait compositions of nematode assemblages were significantly different across all spatial scales (patches, shores, regions and countries). There is greater variation amongst nematode assemblages at the scale of shore than at other spatial scales. Nematode assemblage structure and functional traits are influenced by the local environmental factors on each shore including sea-surface temperature, the amount of sediment trapped in Corallina spp. and tidal range. The sea-surface temperature and the amount of sediment trapped in Corallina spp. were the predominant factors determining nematode abundance and composition of assemblages and their functional diversity.
The aims of this study were to identify the unmet care needs and to examine the mediating effect of unmet supportive care needs in the relationship between functional status and quality of life (QOL) in Korean patients with amyotrophic lateral sclerosis (ALS).
This was a cross-sectional study conducted among 186 patients with ALS recruited from a tertiary hospital in Seoul, South Korea. ALS patients' functional status, unmet supportive care needs, and QOL were assessed by Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, the Amyotrophic Lateral Sclerosis Supportive Care Needs Instrument, and the Amyotrophic Lateral Sclerosis Specific Quality of Life – Revised Instrument, respectively. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test.
The mean score for functional status was 33.35 ± 8.89; for unmet supportive care needs it was 2.40 ± 0.66; and for QOL it was 4.95 ± 1.29. Functional status was significantly correlated with unmet care needs and QOL. Unmet care needs satisfaction demonstrated a complete mediating effect on the relationship between functional status and QOL of the patients with ALS (β = –0.53, p < 0.001) and the effect was significant (Sobel test; Z = 5.48, p < 0.001).
Significance of results
Although QOL was negatively affected by the functional status in our sample, the relationship was fully mediated via unmet supportive care needs. Because there is no cure for ALS, and the condition is rapidly progressive with a lethal outcome, providing care by meeting patients’ needs is a critical aspect of caring for these patients. Early assessment of supportive care needs, providing services, and referring ALS patients to appropriate resources could enhance their QOL.
South Korea experienced Middle East Respiratory Syndrome (MERS) outbreak in 2015. To mitigate the threat posed by MERS, the Ministry of Health and Center for Disease Control designated hospitals to be responsible for managing any suspected or confirmed infectious patient. These hospitals receive mandatory training in managing infectious patients, but many of the trainings lack practical skills practice and pandemic preparedness exercise.
To develop and evaluate a training course designed to train healthcare providers from designated hospitals to enhance their competencies in managing emerging infectious diseases and potential outbreaks.
A two-day course was developed by the Center for Disaster Relief, Training, and Research in collaboration with the Korea Health Promotion Institute using Kern’s 6-step approach. The course consisted of didactic lectures, technical skills training, tabletop simulation, and scenario-based simulation. Table-top simulation exercises consisted of cases involving a single infectious patient detected in the outpatient clinic and outbreak in the emergency department. Scenario-based simulation exercises involved managing a critically ill infectious patient in an isolated ward. A post-survey questionnaire was used to evaluate the course and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.
A total of 121 healthcare providers participated in three separate courses. The competencies for pandemic preparedness knowledge, skills, and attitude improved from pre- to post-course. The differences were all statistically significant (p<0.05). Overall course satisfaction in average for expectation, time, delivery method, and contents were 9.5, 9.2, 9.4, and 9.2, respectively.
There needs to be tests and exercises to recognize gaps of systems in place for pandemic preparedness. Simulation exercises are ideal tools for this purpose. Although this was only a two-day intensive course, this increased familiarity with workflows, tested the coordination of workflows between different disciplines and allowed the identification of gaps.
Recent hospital fire incidents in South Korea have heightened the importance of patient evacuation. Moving patients from an intensive care unit (ICU) or emergency department (ED) setting is a challenge due to the complexity of moving acutely unwell patients who are reliant on invasive monitoring and organ support. Despite the importance of patient evacuation, the readiness of ICU and ED for urgent evacuation has not been assessed.
To enhance the readiness and competencies of workers from ICU and ED in the evacuation of patients during a simulated tabletop fire exercise.
A tabletop simulation exercise was developed by the Center for Disaster Relief, Training, and Research referencing the fire evacuation manual developed by the hospital’s ICU and ED. The scenario consisted of evacuating patients horizontally and vertically from each department. The participants’ actions were assessed using a checklist. A debriefing was completed after the exercise to discuss the gaps observed. A post-survey questionnaire was used to evaluate the exercise and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.
A total of 22 and 29 people participated in the exercise from ICU and ED, respectively. Knowledge and confidence improved post-exercise for both ICU and ED scenarios (p<0.05). Course satisfaction was 7.9 and 8.7, respectively for ICU and ED exercise. Correct performance rates for ICU and ED were 59% and 58%, respectively. Common gaps noted for both ICU and ED were wearing protective masks, patient hand-over communication, and preparation for resources.
There need to be exercises to recognize system gaps in place for hospital fire evacuation preparedness. Tabletop simulation exercises are ideal tools for this purpose. Although this was a short 90-minute exercise, this increased familiarity with the evacuation plan, tested the plan, and allowed for identification of gaps.
Tin zinc oxide (SnZnO) thin film transistors (TFTs) with different component fraction fabricated by solution process were reported. Sn chloride and Zn acetate were used as precursor and the maximum annealing temperature was 500°C. The electrical characteristics of TFTs were acutely affected by the molar ratio between Sn and Zn in the lattice, and showed the highest mobility and on-to-off ratio of about 17 cm2/Vs and 2×106, respectively. The origins of the high performance were traced through both structural and electrical aspects. Sn was generally considered to offer carrier path by superposition of s orbital, but it was found that the increase of Sn fraction only below specific value in lattice contributed to increase mobility, which could be explained by the structural distortion and the defect generation. Zn atoms introduced in the lattice were necessary to control both mobility and carrier concentration. From these results, the solution-processed SnZnO TFT with high performance was suggested.
Sport participation is well known to promote health outcomes for children and adolescents. Nevertheless, there is insufficient evidence about the psychological and social outcomes of sport participation for older adults. This article provides the results of a systematic review of the psychological and social outcomes of sport participation for older adults. A systematic review of seven electronic databases was conducted and a total of 21 studies published that attended to psychological and/or social health benefits from sport participation of older adults (50 years old and over) were included. The outcomes of older adults’ sport participation included life satisfaction, depression, anxiety, stress, mood state, hedonistic values, socialisation, competition, and personal psychological outcomes such as personal empowerment, self-confidence, self-esteem and resistance to the negative view of ageing. Future studies are needed to conceptualise and operationalise the different levels of involvement of sport participation.
The aim of the present study was to compare selected obesity indicators with comprehensive health status.
The study employed a pooled cross-sectional design.
BMI, waist circumference, waist-to-height ratio (WHtR) and body fat percentage were considered as indirect obesity indicators. The Edmonton Obesity Staging System (EOSS) was used as a composite indicator to comprehensively reflect obesity-related co-morbidities. Cohen’s κ coefficient was used to evaluate inter-measurement agreement for obesity. Conformity of indirect obesity indicators to the EOSS was assessed based on percentage agreement (proportion classified as obese and severely unhealthy as a result of obesity among the total sample), sensitivity (proportion classified as obese among individuals severely unhealthy as a result of obesity) and specificity (proportion classified as non-obese among fairly healthy individuals). Logistic regression analysis was used to identify the sociodemographic factors most strongly associated with conformity.
The study included 17338 adults from the Korea National Health and Nutrition Examination survey conducted between July 2008 and May 2011.
Level of conformity to the EOSS was highest for WHtR (60·77 %) and lowest for BMI (35·96 %). WHtR and BMI had the highest sensitivity (53·7 %) and specificity (98·4 %), respectively. Predictability of conformity was lower among men for all indirect obesity indicators.
WHtR has the greatest potential to identify individuals at risk of health problems due to obesity. Individual demographic factors must be considered in selecting the most appropriate obesity measurement.
Curiosity and situational interest are powerful driving forces in learning and motivation that lead students to learn more effectively. In this chapter, we elucidate curiosity and situational interest by focusing on (1) conceptual definitions and characteristics, (2) antecedents, (3) cognitive and behavioral outcomes, and (4) strategies to foster them in school. Curiosity is a short-lasting, aversive state that desires an acquisition of specific information. Its properties contrast with those of situational interest, which is an overall positive affect and a general preference for a topic. Whereas curiosity and situational interest are stimulated by similar contextual features (such as collative variables), triggering curiosity requires one to perceive an information gap between what one knows and what one wants to know. Despite these differences, ample evidence displays that both curiosity and situational interest positively impact students’ learning, motivation, creativity, and well-being once triggered. Thus, in closing, integrative and specific pedagogical guidelines to enhance students’ curiosity and situational interest in education practice are suggested.
Despite the possibility that cognitive deficits associated with depression may have different patterns depending on the level of neurocognitive impairment, there remains no clear evidence of this. This study aimed to investigate the differential association between depression and cognitive function in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD).
A cross-sectional analysis was performed of data from 1,724 patients with MCI and 1,247 patients with AD from the Clinical Research Center for Dementia in Korea. Depression was assessed using the Korean form of the Geriatric Depression Scale, and cognition was measured using the Seoul Neuropsychological Screening Battery, which includes five domains (attention, language and related function, visuospatial function, memory, and frontal/executive function).
Significant differences were found between the two groups (non-depressed vs. depressed) in visuospatial, memory, and executive function domains in the MCI group, as well as in the attention domain in the AD group. The association between depressive symptoms and cognitive function was significantly greater in patients with MCI than in those with AD. These associations were more pronounced in memory and executive function.
Our findings suggest that the association between depression and decreased cognitive function is more pronounced in MCI than AD.
We investigated potential nosocomial aerosol transmission of severe fever with thrombocytopenia syndrome virus (SFTSV) with droplet precautions. During aerosol generating procedures, SFTSV was be transmitted from person to person through aerosols. Thus, airborne precautions should be added to standard precautions to avoid direct contact and droplet transmission.
This study aimed to investigate associations among spirituality, coping strategies, quality of life (QOL), and the effects of depression and anxiety thereon in cancer patients.
In total, 237 cancer patients referred to a psycho-oncology clinic at a university hospital in Korea were enrolled. After identifying predictors of patient QOL in a stepwise regression model, we developed a hypothetical path model wherein interpersonal coping was considered as a mediating variable between spirituality (meaning/peace) and QOL and wherein depression and anxiety affected each of these three variables.
The direct effect of spirituality (meaning/peace) on QOL was 36.7%. In an indirect model, interpersonal coping significantly mediated the relationship between spirituality (meaning/peace) and QOL. Depression exerted the largest negative effect on spirituality (meaning/peace), interpersonal coping, and QOL. Anxiety had negative effects on spirituality (meaning/peace) and QOL, but a positive effect on interpersonal coping.
Significance of results
Interpersonal coping strategies work as a partial mediator of the relationship between meaning/peace subscales of spirituality and QOL. Effective management of depression may help in achieving better outcomes associated therewith. Greater attention and efforts to improve social connectedness and meaning of life in spiritual well-being may improve the QOL of cancer patients.
Hospital workers are critical for a successful response to an infectious disease outbreak and for preventing disease transmission to the community. Therefore, hospital crisis management should implement efforts to improve hospital workers’ preparedness in responding to public health emergencies caused by infectious diseases. Traditionally, preparedness and skill of hospital workers have been emphasized, but awareness of the importance of the emotional mindset of hospital workers in dealing with disease outbreaks has only recently increased; therefore, empirical approaches to examining emotional responses of hospital workers has been limited. This study analyzed qualitative data of the 2015 Middle East Respiratory Syndrome outbreak in South Korea. In particular, negative emotions and stress experienced by hospital workers who treated patients were characterized, as were the events that triggered such experiences. These events were categorized into four themes (eg, Mistake, Missing, Delay Due to Communication Failure). Identifying events that trigger negative emotions in hospital workers has important implications for hospitals’ management guidance in relation to an infectious disease outbreak. (Disaster Med Public Health Preparedness. 2019;13:504-510)
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.
This study investigates whether maintaining high levels of cognitive impairment and weak grip strength will predict a higher risk for mortality.
Data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2014 was assessed using longitudinal data analysis and included 5,812 research subjects. Our modeling approach jointly estimated multi-period trajectories of grip strength and cognitive impairment, and the primary analysis was based on Cox proportional hazards models.
A four-class linear solution fit the data best in both cognitive impairment and grip strength based on the model fitness, respectively. The hazard ratio (HR) of mortality in group 1 (consistently low) of cognitive impairment and of grip strength were 2.114 times higher (p-value 0.001) and 3.405 times higher (p-value <.0001) compared with group 3 (consistently high) and group 4 (consistently high), respectively.
This study provides insightful scientific evidence into the specificity of longitudinal changes in grip strength and cognitive impairment on mortality. Our findings suggest that declined cognitive ability and weak grip strength are predictors of mortality in older Korean people.
Clonorchis sinensis (C. sinensis), a trematode parasite that invades the hypoxic hepatobiliary tract of vertebrate hosts requires a considerable amount of oxygen for its sexual reproduction and energy metabolism. However, little is known regarding the molecular mechanism of C. sinensis involved in the adaptation to the hypoxic environments. In this study, we investigated the molecular structures and induction patterns of hypoxia-inducible factor-1α (HIF-1α) and other basic helix–loop–helix and Per–Arnt–Sim (bHLH–PAS) domain-containing proteins such as HIF-1β, single-minded protein and aryl hydrocarbon receptor, which might prompt adaptive response to hypoxia, in C. sinensis. These proteins possessed various bHLH–PAS family-specific domains. Expression of C. sinensis HIF-1α (CsHIF-1α) was highly induced in worms which were either exposed to a hypoxic condition or co-incubated with human cholangiocytes. In addition to oxygen, nitric oxide and nitrite affected the CsHIF-1α expression depending on the surrounding oxygen concentration. Treatment using a prolyl hydroxylase-domain protein inhibitor under 20%-oxygen condition resulted in an increase in the CsHIF-1α level. Conversely, the other bHLH–PAS genes were less responsive to these exogenous stimuli. We suggest that nitrite and nitric oxide, as well as oxygen, coordinately involve in the regulation of HIF-1α expression to adapt to the hypoxic host environments in C. sinensis.